semi-annual progress report june 30, 2007 special diabetes program for indians healthy heart...

Semi-Annual Progress Report

June 30, 2007

SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

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Overview• Semi-Annual Progress Report

– Data submitted through June 30, 2007– 2 reports:

• Overall – grant program results by site # only, not site names

• Grantee-specific data – separate report sent only to you

– Purpose – to measure our progress over time– Important notes:

• Not all annual data have been submitted – data are very preliminary

• Represents data analyzed so far - many steps to get to this point

• Overall – good progress!

SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

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267AACE (A1)

Annual Assessment

1486 BACE (B1) = Participants

Baseline Assessment

2051 Individuals reported to have signed consent forms

4309 Individuals in Excel Registry

HH: Recruitment, Participant Accrual, and Baseline/Annual Assessment Progress

(November 1, 2005 – June 30, 2007)

** Data from 30 HH Grant Programs in which the majority of programs have completed 1 year of Intensive Activities as of June 30, 2007

4Figure 1.01: HH Monthly Actual Participant Accrual vs. Expected

Accrual

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Figure 1.02. HH Monthly Actual Participant Accrual vs. Expected Accrual

Adjusted by Date of First Intensive Activity

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Figure 1.03: HH Percent of BACE/B1 Submissions Goal (75) Achieved

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Figure 1.04: HH Percent of BACE/B1 Submissions Goal Achieved by Grantee’s User

Population Size User Population categories: small < 5,000; medium = 5,000-9,999; large > 10,000.

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HH: Data Submission and Quality

• Data Submission – only 1 program missed more than 20 percent of

scheduled data submissions• Data Quality

– the range of missing or invalid data on B1 forms for each grant program is 38.6% to 94.9%

• Timeline Compliance – 51.0% of B1 forms did not meet timeline

requirements• Other (based on baseline participant

numbers)– Percent of “expected” A1 forms received: 63.9%– Number of participants reported to be inactive:

9.1%

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Table 4B.01: HH Baseline Clinical Characteristics

NBaseline

Mean

Weight (lbs) 1414 220.4

BMI 1414 36.6

Waist (inches) 1395 45.3

Hip (inches) 1391 47.3

Waist to Hip Ratio 1391 1.0

Data from January 1, 2006 to June 30, 2007 – most programs have completed at least one full year of intensive activities.

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Table 4B.01: HH Baseline Clinical Characteristics

NBaseline

Mean

Systolic Blood Pressure (mm Hg)

1414 128.6

Diastolic Blood Pressure (mm Hg)

1414 75.5

LDL (mg/dl) 1382 99.9

HDL (mg/dl) 1411 44.2

Triglycerides (mg/dl) 1414 188.2

Total Cholesterol (mg/dl) 1414 177.8

HbA1C (%) 1413 7.6

Data from January 1, 2006 to June 30, 2007 – most programs have completed at least one full year of intensive activities.

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HH: Comorbidities at Baseline

• Diabetes + Percent

High Blood Pressure 66.4

Back Pain 44.4

Depression 26.3

Osteoarthritis 24.8

Heart Disease 18.4

Rheumatoid Arthritis 11.7

Ulcer/stomach disease 10.5

Lung Disease 7.1

Anemia or other blood disease

6.8

Kidney Disease 4.2

Liver Disease 2.4

Cancer 1.8

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HH: Lifestyle MeasurementsBaseline (%)

Physical activity at least 150 minutes per week 25%

Stages of change for physical activity – preparation stage

36%

Reported never drinking alcohol 69%

Reported drinking 4 or more times per week 1 %

Stages of change for alcohol use – contemplation stage

50 %

Never smoked 50%

Current smokers 17%

Participants spent 3-5 hours per day watching TV, sitting at a computer, or doing other

sedentary activities

48%

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HH: Physical Activity

Figure 4C.01: HH Baseline Minutes of Physical Activity per Week

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HH: Baseline Psychosocial Measurements

Age 18-39

Age > 60

Scale – low to high

Diabetes General Knowledge 71 64 0-100%

Insulin Use Knowledge 71 56 0-100%

Health Literacy Scale 3.51 3.2 1-5

Percent correctly answered Health Literacy Questions

71 66 0-100%

Distress Scale 2.1 1.67 1-5

Post Traumatic Stress 41 21 0-100%

Anger Scale 0.4 0.26 0.1-1.0

Hostility Scale 0.37 0.25 0.1-1.0

Bold means higher in that age group

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HH: Baseline General Diabetes Knowledge

Figure 4B.01: HH Baseline Rate of Correctly Answered General Diabetes Knowledge Questions

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HH: Baseline Psychosocial Measurements

Age 18-39

Age > 60

Scale – low to high

Perceived Health Competence Scale

3.07 3.41 1-5

Coping Ability Scale 3.13 3.32 1-5

Everyday Discrimination Scale 2.1 1.84 1 (never) – 4 (often)

Positive Family Support Scale 2.04 1.79 1-5

Cultural Spirituality Scale 3.6 3.96 1-5

Bold means higher in that age group

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HH: Baseline Ethnic Identity

Figure 4D.09: HH Baseline Ethnic Identity Scale

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HH: Ability to Speak Tribal Language

Figure 4D.10: HH Baseline Reported Ability to Speak Tribal

Language

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HH: Baseline Importance of Spirituality

Figure 4D.11: HH Baseline Importance of Spirituality

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HH: Baseline Cultural Spirituality Scale

Figure 4D.12: HH Baseline Cultural Spirituality Scale

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HH: Annual December Data

• Provider Annual Questionnaire– Most hours spent on intensive activities, planning, and

recruitment/screening, with variations by job/role

• Organizational Questionnaire– Organizational culture – dominant overall is “clan culture” –

focus on keeping things running smoothly internally, with flexibility, concern for people and sensitivity to customers

– Executive support scale – 2.26 score (1= no support, 5=strong support from executive management for SDPI program)

– Competing values framework – HH scored high in 7 of 8 areas of organizational effectiveness, except growth & resource acquisition (diagram)

• Community Annual Questionnaire– 58% strongly agree that this program was good for the

community

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HH: Summary• Report shows good progress overall!• Useful baseline characteristics of participants• Annual data available in next HH report• Grantee-specific reports

– Data specific to your program to compare to overall report– Make sure you explain the data and its context to anyone

who reads it – careful to interpret if small numbers of participants in some cells

– Confidentiality – consider who views the report• Next Semi-Annual Progress Report

– Data submitted as of 12/31/07– Report in Spring 2008, likely at next grantee

meeting

SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

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Questions?

SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

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HH Diet Survey Summary

SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

• To Decrease:– Bacon/sausage– Processed meats– Bread processed from flour– Frybread– Baked goods– Regular soft drinks– Add sugar/creamer to

coffee/tea– Regular fat salad dressing– Fast food

• To Increase:– Whole grain bread– Fruit– Lettuce/green leafy

salad– Cooked dried beans– Fish/chicken/game– Vegetables

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Why No Annual Data in This Progress Report?

SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 1

• We had not yet collected a full year’s worth of annual data.

• By 06/30/07, the CC only received 267 A1 forms, which is less than 30% of the B1 forms we received last year (961).

• Only 10 grantees submitted ≥ 10 A1 forms, and only 5 grantees submitted ≥ 15 A1 forms – if we had reported aggregate annual data in this progress report, it would have only represented the data from a few grantees, not a real overall picture.