Competitive Grant Program Data Collection Process/Forms Screening, Registry, Recruitment Healthy Heart Project

SCREENING, REGISTRY, RECRUITMENT Ongoing until recruitment goals met BASELINE ASSESSMENTS DP: Within month before beginning curriculum HH: Within month before beginning case management INTENSIVE ACTIVITIES HH: Case management and HGHH Curriculum DP: DPP Curriculum and Lifestyle Coaching FOLLOW-UP ASSESSMENTS (DP ONLY) Within a month of completion of DPP Curriculum ANNUAL AFTER INTENSIVE ACTIVITY HH: Anniversary of Baseline Assessment DP: Anniversary of Follow-up Assessment ANNUAL (DECEMBER) Annual reports and Questionnaires ONE TIME TELEPHONE INTERVIEW Selected providers interviewed by CC 1 STEP ACTIVITY FIGURE 2: OVERVIEW OF DATA COLLECTION

Step 1 Flow Diagram

Registry Input Form Purpose: –gather information about individuals during recruitment and screening, working file Development: –During collaborative process, reviewed first draft at last meeting, input reviewed, revision, input this month Content: –Form # (Appendix D), Participant ID # (Appendix E), Person’s IdentificationForm # Participant ID # –Inclusion/Exclusion Criteria, Person’s Eligibility –Recruitment Record –Screening – Risk Factors, Screening – Test Results Timing: –Start one for everyone you contact during recruitment/screening Format: –Paper form, fill out with pencil Filled out by: –Project Coordinator or staff as assigned – usually recruitment team members

Registry Input Form Review of Form (Appendix G)Review of Form Instructions Excel Registry Instructions (Appendix H)Instructions Participant Record Form (Appendix I)Participant Record Form Evaluation Glossary (Appendix F)Evaluation Glossary