(taken from application): Professional Education & Outreach Core Accomplishments over the past 5 years include (i) 122 publications, books, chapters, and presentations in national meetings; (ii) 4 completed doctoral dissertations a total of 21 over the 20 years of the DRTC, (iii) completed development and institutional adoption of a masters in health care services centered around diabetes as a model for other chronic diseases; (iv) development of smoking cessation procedures tailored to those with diabetes; (v) extension of previous findings concerning family factors in diabetes management to African American children and families; (vi) development of NIDDK and NCI funded projects for peer- and community-based nutrition education to prevent diabetes; (vii) continued development of graduate training and research in health psychology and social work, focused on diabetes as a model disease; and (viii) collaboration with the Vanderbilt DRTC and the Am. Dietetic Assoc. in national curricula for dietetic training programs. In national efforts to translate the DCCT?s message of the value of metabolic control, we (ix) have contributed chapters on the Structure of the Health Care System and on Strategies and Models for Translation in Metabolic Control Matters, a key NIDDK planning document for DCCT translation; the latter chapter put forth the model for a National Diabetes Education Program, now underway as a collaboration of NIDDK, the CDC?s Division of Diabetes Translation, and numerous cooperating groups; and (x) identified key aspects of staff support for patients receiving intensive therapy. Proposed projects extend previous emphases on individual factors and the social/context by focusing on the interaction between the individual and the context. Project 1 will use the context of a capitated health plan to deliver interventions matched to individual physicians? readiness to follow guidelines aimed at improving metabolic control. Project 2 will evaluate how a critical component of the health care system, staff support, influences quality of life and other outcomes in the Diabetes Prevention Program. Project 3 will use community focused strategies to work with the Tohono O?odham Indian nation to extend to its members a nutrition activation program that we developed with low-income, African Americans in St. Louis. Project 4 works through OASIS, a national activity/education organization for older adults, to develop peer based promotion of exercise tailored to the individual?s readiness to change.
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