In 2001 the Appalachian Regional Commission and the Centers for Disease Control and Prevention (CDC) began a joint effort to reduce the impact of diabetes on people in Appalachia. The project, overseen by The Robert C. Byrd Center for Rural Health at Marshall University in Huntington, West Virginia, focuses on improving the quality of life for people with diabetes in the Region's most economically depressed counties. 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:
- Mobilizing a community response
- Assessing the burden of diabetes in a community
- Planning and implementing a community-based diabetes control program
- 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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