Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108512

Kelly J. Acton, MD, MPH¹, Susan Gilliland, PhD, RN¹, Yvette Roubideaux, MD MPH², and Kelly Moore, MD¹. (1) National Headquarters Diabetes Program, Indian Health Service, 5300 Homestead Rd NE, Albuquerque, NM 87110, 505-248-4182, kelly.acton@mail.ihs.gov, (2) Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, 500 N. Tucson Blvd, #110, Tucson, AZ 85716

Background: Managing chronic conditions requires evolution of health care system model that effectively addresses prevention and long-term care of chronic conditions. Methods: Used components of Chronic Care Model (CCM) and International Care for Chronic Conditions (ICCC) framework to examine DDTP's experience of diabetes prevention and treatment from 1997 to 2002. Results: Delivery system design - Use of key quality care elements increased 34% flow sheet use, 54% use of registries, 65% team approach, and 32% specialty clinics. Self Management Support – Availability of self management services increased in education programs (63%), support groups (43%) and behavioral health services (48%). Health system organization – Community (12%-42%) and tribal leaders (51%) partnerships with local health care system increased. Health-promoting policy and organizational changes increased within tribal worksites (30%), school food services (26%) and tribal administrations (29%). Decision support – IHS Standards of Care and IHS Standards for Diabetes Education were updated and distributed in 2002. 14 Best Practices models developed for and implemented by grantees. Clinical information systems – 239 programs participated in 2002 Diabetes Care and Outcomes Audit representing over 100,000 patients. Intermediate outcomes of care improved – A1C, blood pressure, lipid levels, CVD risk factors, and care to prevent kidney disease. Community Resources and Policies – Availability of community-based programs increased 62% for healthy eating programs for families, 42% for management of overweight children programs, and 51% for youth physical activity programs. Conclusion: DDTP experience provides examples of how chronic condition is addressed by strengthening traditional health care to include prevention while broadening partnerships and resources.

Learning Objectives:

• To identify lessons learned from the IHS Division of Diabetes Treatment and Prevention(DDTP) experience in relation to chronic care models.

Keywords: Diabetes, Chronic Diseases

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation