Performance Improvement 1999. Chronic Disease


TITLE: Development of an Evaluation Strategy for State-Based Diabetes Control Cooperative Agreement Programs

ABSTRACT: Diabetes and diabetes-related complications are a major cause of morbidity and premature mortality in the United States. Since 1977, Diabetes Control Programs (DCPs) have been supported by the Centers for Disease Control and Prevention (CDC), on the premise that the health consequences of diabetes can be substantially reduced by effective widespread clinical and health applications of preventive programs. This project develops a comprehensive evaluation strategy that provides the Division of Diabetes Translation the capacity to assess uniformly the progress that State-based DCPs are making in reducing the burden of diabetes in an evolving health system. This project: (1) identifies priority program performance standards; (2) delineates priority evaluation questions, health program outcomes, measurement methods, data sources, analyses and reporting strategies; (3) establishes process and outcome evaluation plans to assess components of State-based diabetes control programs; and (4) proposes strategies for implementing and managing proposed evaluation plans. The report concludes that: (1) DCPs should be encouraged to grow in ways that are appropriate to individual States; and (2) the multiplicity of program approaches does not hinder program evaluation and planning as long as certain base criteria are met. Recommendations for the program include: (1) provide technically and culturally competent health education; (2) provide access to and use of basic preventive services; (3) assist patients in compliance with diabetes control measures, including early detection and follow-up, to prevent or delay onset of symptoms; and (4) provide access to and use of cost-effective clinical services for complications and follow-up to prevent delay, or to delay progress from mild to severe symptoms. (Final report 121 pages plus appendices.)

AGENCY SPONSOR: National Center for Chronic Disease Prevention and Health Promotion


PHONE NUMBER: 770-488-5011

PIC ID: 6584

PERFORMER ORGANIZATION: Battelle Corporation Arlington, VA

TITLE: Evaluation of Dental Treatment and Health Status Differences Attributable to Water Fluoridation

ABSTRACT: For over 50 years, public health officials have known that water containing fluoride at a level of 0.7-1.2 mg/L reduces the occurrence of dental caries. However, as the use of other fluoridated products has increased, the observed differences in caries prevalence between children residing in fluoridated (F) and nonfluoridated (NF) communities have declined. Given the decline in caries prevalence, several review groups have noted the need for current data on the effectiveness of water fluoridation. This report assesses whether dental treatment experiences of children and adult members of a group-model HMO differ among those who consume fluoridated water and those who do not. The research setting for this project was Kaiser Permanente, Northwest Division, and the study period was 1990-1995. The two principle data sources for the project were the Membership Information Process System and the TEAM dental treatment database. Fluoridation status was determined through a random sample of subscribers. Outcomes of interest included: (1) dental care utilization, (2) mean number of filled surfaces, (3) dental care costs, (4) supplemental fluoride dispensings, and (5) endentulism rates. Descriptive statistics and regression analysis were used to compare results in the fluoridated and non-fluroridated samples. The report finds that, despite the sociodemographic characteristics of this insured population, community water fluoridation appeared to reduce total costs and total restorative costs. (Final report 41 pages plus appendices.)

AGENCY SPONSOR: National Center for Chronic Disease Prevention and Health Promotion

FEDERAL CONTACT: Dolores Malvitz, Dr.PH.

PHONE NUMBER: 404-639-8376

PIC ID: 6334