High Rates of Diabetes in Appalachia Leads to a Partnership

The ARC/CDC partnership started because data from the Behavioral Risk Factor Surveillance Survey indicated higher rates of diabetes in Appalachian counties than in non-Appalachian counties. In addition, CDC determined that grassroots efforts help residents become more aware of preventive care, where to seek early detection for diabetes, how to proceed when diabetes is diagnosed, how to navigate through a complex and technical health care system, and where to turn for community resources and support.

Strategies for Reducing Diabetes

The project helps enable communities to conduct activities that will reduce the occurrence of diabetes. Four overlapping strategies are being used:

1. Mobilizing a community response
2. Assessing the burden of diabetes in a community
3. Planning and implementing a community-based diabetes control program
4. Evaluating the project, both in terms of process and impact

Communities Benefit from the ARC/CDC Partnership

Counties receiving grants to initiate diabetes projects benefit in many ways.

• The project promotes local leadership and partnerships, increase awareness of the disease, and enhance resources for the diagnosis and treatment of diabetes.
• The project promotes the provision and use of quality care for all people with diabetes in the targeted counties.
• The project promotes an aggressive community-based diabetes prevention and control program for the targeted counties
.

Community Partnerships are the Focus of Grants

Establishing community partnerships that can determine the magnitude of the problem, and then plan and implement an intervention can help reduce diabetes. These partnerships receive small grants of approximately $10,000 each, as well as training and technical assistance to get them started.

Active Projects

Seven of the Region's thirteen states—Alabama, Kentucky, Mississippi, North Carolina, Tennessee, Virginia and West Virginia—and eighteen distressed counties are participating in this jointly funded ARC/CDC project.

Macon County, Alabama
In Macon County, a coalition coordinated by Tuskegee University Cooperative Extension has formed to help residents with diabetes cope with their disease. The project will help 100 adults diagnosed with diabetes to better manage their disease. It will also teach the participants about diabetes risk factors and preventative behaviors for adults in the county.

Harlan County, Kentucky
The coalition is trying to get local restaurants to add items to their menus that are appropriate for a diabetic's diet. One family owned restaurant in the county has already made changes to their menu, and the coalition is hopeful that others will do the same. The county is also planning to start an adolescent diabetes support group this summer.

Graham County, North Carolina
The health department in Graham County, North Carolina, coordinates the county's project, as well as a health fair held in May 2003, which launched cooking and exercise classes for diabetics. The goal of Graham County's project is to lower the hemoglobin A1C of diagnosed diabetics and those at risk for diabetes.

Advisory Work Group Anticipates Additional Funding for New Projects

Central to the success of the joint ARC/CDC project is an Advisory Work Group, composed of representatives from State Diabetes Control Programs, academia, statewide or regional service organizations, persons with diabetes, residents of distressed counties, and a representative from ARC and CDC. Thus, the group represents diverse interests and issues. Once or twice a year the group meets to set policy and review and rank the proposals received from communities.

The Advisory Work Group met at the end of May 2003 to begin discussions for a new round of funding. The group anticipates that an additional 10-12 distressed counties will receive funding this fiscal year, bringing to 30 the number of distressed counties with a project specifically targeted to the community's diabetes problem.

Who May Apply

Only partnerships are eligible for funding. A partnership consists of two or more organizations from one of the Region's distressed counties (see ARC's list of distressed counties).

One of the organizations must be a Not-for-Profit 501-C3. Examples of non-profit organizations include primary care centers, county extension offices, community colleges, ARC local development districts, town councils, and the like.

The other partner should be a community group, which can include churches, volunteer clubs, county diabetes coalitions, retired health professionals, or informal groups of citizens.

The partnerships must be willing to participate in a planning and training program. And the organizations must make a commitment to implement and report on the project.

Each partnership must submit a proposal that includes:

• A brief history of how the grant-planning group came together.
• A discussion of the burden of diabetes in the county. What is the population of the county? How many people are estimated to have diabetes? Are certain groups affected more than others?
• A discussion of why the partnership is interested in addressing diabetes in their community and what the problems are in that community.
• A brief discussion of some activities the group is considering.
• A description of other community organizations in the county that are involved with diabetes care.
• A letter of acknowledgement from the state Diabetes Control Program Director. Letters of support from community organizations and individuals will strengthen the application.

For specific information on any of the current projects, contact Kendra Hannahs at Marshall University: hannahs@marshall.edu.

For additional information, contact Dr. Henry King, ARC's health program manager, at hking@arc.gov.

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