Data Collection Update SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 2 Jeanne M. Boswell

Overview Assessment Forms and Questionnaires - Keep up the good work! Serious Adverse Event Form (SAE) Participant Attendance Form (I2) Individual Retention Form (I3) SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 2

Are you submitting Serious Adverse Event (SAE) Forms? –83% (25/30) of grantees have submitted an SAE on one or more participants SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 2 –Guidelines for SAE forms can be found in the Operations Manual (pp ) 03%20Operations%20Manual%20Version%203.dochttp://aianp.uchsc.edu/sdpi/common/manual_v3/OM. 03%20Operations%20Manual%20Version%203.doc

Number of B1 Forms Number of Participants with SAE % Number of B1 Forms Number of Participants with SAE % Number of B1 Forms Number of Participants with SAE % HH SAE Report

Participant Attendance Form (I2) –Date of 1 st Case Management visit (CMV) Should match date of Scheduled Visit Number 1 Suggestion: Identify as “1 st CMV” in Provider Comments SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 2 –Indicate Monthly (M) or Quarterly (Q) CM visits –List ONLY Case Management Visits; use complete date –Indicate if CMV Appointment was Kept (yes/no) –If CMV missed but made up in same month, list make-up date in Provider Comments

Individual Retention Form (I3) Page 2: If participant missed CMV appointment listed on I2, and CMV was not made up within the calendar month, then write record in Retention Efforts table Use complete date (i.e., ) – Date should match missed CMV appointment on I2 Page 3: Always answer DROP-OUT question. If Yes, Proceed to REASONS. (Should be ‘Yes’ until next Annual December submission) SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 2

Questions? SPECIAL DIABETES PROGRAM FOR INDIANS Healthy Heart Project: Year 4 Meeting 2