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Special Diabetes Program for Indians Competitive Grant Program

SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Orientation for New Staff Day 2 Data Requirements - Continued. Special Diabetes Program for Indians Competitive Grant Program. Karen Wilde Rogers. Jeanne M. Amos.

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Special Diabetes Program for Indians Competitive Grant Program

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  1. SPECIAL DIABETES PROGRAM FOR INDIANS Competitive Grant Program Orientation for New Staff Day 2 Data Requirements - Continued Special Diabetes Program for Indians Competitive Grant Program

  2. Karen Wilde Rogers Jeanne M. Amos DP Data CoordinatorCGP Coordinating Centerkaren.rogers@uchsc.edu 303.724.1422 HH Data CoordinatorCGP Coordinating Centerjeanne.amos@uchsc.edu 303.724.0423

  3. Steps in Forms Collection Overview (Operations Manual pg. 32)

  4. Review of Day 1 • Data Requirements • Recruitment/Screening (Step 1) • Intensive Activity – Baseline (Step 2) • Timelines • Intensive Activity - DPP Curriculum/HH Case Management (Step 3)

  5. Day 2 Data Requirements • Safety and Confidentiality Forms • Participant Level Follow-up Forms (Step 4, DP only) • Participant Level Annual Forms (Step 5) • Grantee Level Annual Forms (on-going, various steps) • Grantee Level Annual Questionnaires (Step 6)

  6. Safety & Confidentiality Forms • Serious Adverse Event (SAE) • Incident Report Form (IRF) • Accounting of Disclosures Form

  7. Forms List • Forms Identification Scheme (Appendix J) • Forms List

  8. Participant Level Follow-up Forms(Step 4, DP only) • Participant Follow-up Assessment of Core Elements (FACE – F1) • Participant Follow-up Questionnaire (PFQ – F2) • Family Follow-up Questionnaire (FFQ – F3)

  9. Participant Level Annual Forms(Step 5) • Participant Annual Assessment of Core Elements DP / HH (AACE – A1) • Participant Annual Questionnaire DP / HH (PAQ – A2) • Will be mailed to grantees • This is a scannable form • Family Annual Questionnaire DP / HH (FAQ – A3) • Will be mailed to grantees • This is a scannable form

  10. DP Only – Midyear FBG • An FGB is required between Annual Assessments. • A 1-page form will be provided for the 18-month and 30-month FBG.

  11. Grantee Level Annual Forms(On-going) • Recruitment Team Meetings Form (R3) (Step 1) • DP Team Meetings Form (I1 - DP) (Step 3) OR Case Mgmt Team Meetings Form (I1 - HH) (Step 3) • Recruitment Activities Annual Report (AD1) (Step 1) • Retention Activities Annual Report (AD2) • After-Core Activities Annual Report (AD6 – DP only)

  12. Grantee Level Annual Questionnaires(Step 6) (For reference only) • Provider Annual Questionnaire (AD3) • Organization Annual Questionnaire (AD4) • Community Annual Questionnaire (AD5) • Scannable forms • Mailed out in November

  13. Karen Wilde Rogers Jeanne M. Amos DP Data CoordinatorCGP Coordinating Centerkaren.rogers@uchsc.edu 303.724.1422 HH Data CoordinatorCGP Coordinating Centerjeanne.amos@uchsc.edu 303.724.0423

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