Cathy Taylor, DrPH, MSN, RN

Laying the Groundwork
CINDY SANDERS
You must walk before you can run.

The Tennessee Center for Diabetes Prevention, which celebrates its first anniversary this month, has taken the old adage to heart in awarding $335,000 in Project Diabetes planning grants to seven programs across the state.

Assistant Commissioner of the Tennessee Department of Health Cathy Taylor, DrPH, MSN, RN, said the planning grants are designed to help people take innovative ideas and turn them into sustainable, measurable programs to reduce the burden of diabetes in Tennessee.

“It takes planning to do that … you can’t just implement a program without going through some very specific steps,” Dr. Taylor pointed out.

“The typical planning grant award was up to about $50,000 for a year,” she continued, saying the center looked for novel ideas that met specific needs within a community.

“It’s really seed money,” added Susan Cooper, MSN, RN, commissioner for the Department of Health. “A lot of communities have ideas but don’t really have the resources to get started.”

Those submitting a grant proposal were asked to meet stringent criteria.

“We were very specific in asking them to address measurable outcomes, realistic work steps and methodology,” said Taylor. “We asked them to track biologic measures common to type 2 diabetes.”

Both public health officials stressed that this money was meant to be used for one year to lay the necessary groundwork such as linking together community partners, identifying measurable goals and working through logistical steps in preparation for launching a program. The expectation is that those receiving planning grants in 2007 will be prepared to request implementation grants next year.

While the seven planning grants were publicly awarded in September, Cooper said she would soon be ready to announce the recipients of 17 implementation grants.

“For the implementation grants, they already have a well-designed program that they are ready to take to scale,” she explained of the difference in the two funding options.

Taylor said the typical implementation grant would be in the neighborhood of $250,000. Those receiving funding in this first year have already been notified, and state officials are working with them to finalize contracts and solidify plans to get the programs off to a running start.

A total of $21 million over three years was approved by the state legislature to create the Tennessee Center for Diabetes Prevention in an effort to stem the rising tide of type 2 diabetes.

Cooper noted that the center’s board made a strategic decision to only fund programs that had a reasonable chance of success based upon the available science.

“You could spend $7 million really easily and get nothing for it,” she pointed out. Instead, the Project Diabetes board opted to take an evidence-based approach to the problem. As a result, she continued, “We believe the investment of these dollars will produce a dramatic shift in the health outcomes of the people affected by these grants.”

Cooper and Taylor said the carefully laid groundwork was necessary because the stakes are so high.

“Of the children born in the year 2000, this is the first generation in history not expected to live as long as their parents,” said Cooper. “Of that same generation, one in three are anticipated to develop type 2 diabetes … and if you are African American or Hispanic, the numbers are one in two.”

She added, however, that much of the risk is related to behavior … and the good news is behaviors can change.

A shift in perspective is already being seen and felt around the state. Cooper said a look at the GetFitTN Web site (www.getfittn.com) shows that innovative programs and ideas are already taking root and growing.

“There are some really extraordinary things happening across the state, and that’s exciting,” she said.

Commissioner Cooper and Assistant Commissioner Taylor have seen the groundswell of support for living healthier lives in Tennessee as they have traveled the state to meet with individuals trying to make a difference within their own communities.

“I think it’s our job to go out and celebrate the enormous enthusiasm that exists for changing behaviors throughout this state,” Cooper stated.

“People are starting to feel connected,” Taylor continued, “and they have a common goal. If you make a commitment to your health and your child’s health, you start with healthy people becoming healthy communities … which leads to healthy counties becoming a healthier state.”

For Tennessee’s public health leadership, changing the health status is a multi-step process … but after all, you have to walk before you can run.

Seven Receive Initial Grants

Tennessee currently ranks 47th out of 50 states in terms of health status for its citizens — a fact Commissioner of the Tennessee Department of Health Susan Cooper called “completely unacceptable.”

In an effort to turn the tide, Project Diabetes recently announced seven planning grants for programs designed to prevent or treat diabetes and its most common risk factors:

• LeBonheur Community Outreach, Memphis, $49,951: Pilot project to assess healthcare needs of approximately 100 obese children, adolescents and adults who have been diagnosed with either diabetes or pre-diabetes in Hardin County.

• Lewis County Government, Hohenwald, $29,500: “Youth in Action” targets 700 Lewis County students between 12 and 18 in an effort to improve lifestyle choices and diabetes prevention behaviors.

• Meharry Medical College, Nashville, $50,000: A pilot project using community-based participatory research strategies to uncover barriers to type 2 diabetes management in a target population of African-American adults at high risk for developing diabetes-related complications.

• Meharry Medical College, Nashville, $57,119: A survey of 200 Latino participants with diabetes to determine health literacy, self-management and outcomes. Based on the findings, the Diabetes Literacy and Numeracy Education Toolkit will be adapted to become more culturally sensitive and relevant.

• University of Tennessee Health Science Center College of Nursing, Memphis, $48,964: The plan is to design and test a simulation-based educational program enhancing the cultural competency of nursing students caring for Hispanic patients at risk for or diagnosed with diabetes.

• Urban League of Greater Chattanooga, Chattanooga, $50,000: “Sisters Together: Move More, Eat Better” is an evidence-based lifestyle intervention to combat obesity. The Urban League plans to target 2,400 participants in the major metropolitan areas of Chattanooga, Knoxville, Memphis and Nashville.

• Vanderbilt University Medical Center, Nashville, $50,000: ADA practice guidelines will be used to expand and test improvements in the Diabetes Training Curriculum for Dietetic Interns at East Tennessee State University. Ultimately, the goal is to use the improved curriculum in all seven dietetic internship programs offered in Tennessee.

New Diabetes Tool Available on ADA Web Site

The American Diabetes Association recently unveiled a new web-based diabetes tool that makes it easier for people with diabetes — and their care providers — to share and organize important health information to improve their diabetes care. The tool, My Diabetes Connector, is a diabetes management software application developed by a software and services company, MyCareTeam, Inc. My Diabetes Connector is available by subscription at http://www.diabetes.org/mydiabetesconnector




November 2007

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