Diabetes Projects
Project Direct
Project DIRECT is a multiyear community diabetes demonstration project,
funded primarily by the Centers for Disease Control and Prevention (CDC).
DIRECT is an acronym for "Diabetes Intervention Reaching and Educating
Communities Together."
It is intended to develop, implement, and evaluate strategies that can
be incorporated into state-based diabetes prevention and control programs nationwide.
DIRECT involves a partnership among the following: the community of southeast
Raleigh, NC; the Division of Public Health in the North Carolina Department
of Health and Human Services; Wake County Human Services; and the CDC.
Mission
To reduce the burden of diabetes and its complications in an African-American
community through a community diabetes demonstration project
Target Population
The African-American community in southeast Raleigh, NC
Significance
- DIRECT is the largest community diabetes project in the United States.
- DIRECT focuses on an African-American community; African-Americans
are at increased risk for diabetes and diabetes-related complications.
- It is the first community project with a comprehensive approach to
reduce the burden of diabetes. DIRECT includes programs to address all
three levels of prevention, as follows:
- programs to reduce risk factors for diabetes (primary prevention);
- programs to improve identification of individuals with a disease
(secondary prevention);
- programs to improve the quality of care (tertiary prevention);
community-based approaches rarely include tertiary prevention.
- Major aspects were developed from the experience of other community-based
trials, especially cardiovascular disease studies.
Strategy
The three main intervention components are health promotion, outreach,
and diabetes care. The planning and implementation of activities for each
area are carried out by a coordinator in consultation with a workgroup.
Workgroups include individuals from the community, health professionals,
and representatives of local organizations.
Evaluation
The evaluation team has members of each workgroup area, community and
agency representatives, and scientific and technical consultants. The
workgroups and evaluation team assess the process and short-term impact
of project activities, and perform the following tasks:
- develop and review plans to evaluate activities; specific measures
are noted under each intervention area
- develop and review data collection forms that document planning and
implementation of program activities
- coordinate with the external evaluator, Research Triangle Institute
- maintain communications with the data management contractor
The external evaluator, Research Triangle Institute (RTI), is contracted
to examine the impact of interventions at the population level. RTI representatives
will survey a sample of the general population within the target area
and a sample of people with diabetes to learn about social networks, diabetes-related
knowledge, and beliefs about exercise and diet.
Public Health Agency Sponsors
The CDCs National Center for Chronic Disease Prevention and Health
Promotion, Division of Diabetes Translation, provides major funding and
technical assistance.
The Division of Public Health in the N.C. Department of Health and Human
Services has a cooperative agreement with the CDC, and is responsible
for overall project administration, scientific and technical aspects,
and for internal evaluation.
Wake County Human Services has a contract with the N.C. Division of Public
Health to plan and implement interventions, and to organize and support
coalitions.
Community Involvement
A coalition supports the project in its mission. It involves key individuals
and organizations in southeast Raleigh and the surrounding area. There
is representation from community leaders, business and industry, community
organizations and centers, media, public health agencies, professional
organizations, health care providers, religious leaders, fraternities
and sororities, and university faculty members including people from historically
black colleges and universities.
DIRECTS Executive Committee is responsible for policy management,
which includes the following:
- Develop policies and guidelines
- Review and endorse action plans
- Review the objectives and accomplishments throughout the year
- Help the project members to identify opportunities for visibility
The 13 members include the following: two from N.C. Department of Health
and Human Services Division of Public Health; two from Wake County Human
Services; two (chair and vice chair) are from the community plus seven
at-large community members.
Related Links
Gregg EW, Geiss LS, Saaddine J, et al. Use
of diabetes preventive care and complications risk in two African-American
communities. Am J Prev Med 2001;21(3):197-202.
For More Information
For more information, contact
Joyce Page, MPH, MSPH
Project Director
Diabetes Prevention and Control Unit
Division of Public Health
Department of Health and Human Services
Mail Service Center 1915
Raleigh, NC 27699-1915
E-mail: Joyce.Page@ncmail.net
Page last reviewed: July 12, 2007
Page last modified: December 20, 2005
Content Source: National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation
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