Diabetes Research and Training Center's Demonstration and Education Divisions


	The Diabetes Research and Training Center (DRTC) program was established in 1977 by the Diabetes Research and Education Act (Public Law 91-354) in response to a recommendation by the National Commission on Diabetes. Currently, six DRTCs are supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The DRTCs, which carry out basic and clinical research, are located at major academic institutions. Each DRTC includes a Demonstration and Education Division that focuses on issues related to diabetes translation, including diabetes education, professional training, and community outreach. The researchers at the Demonstration and Education Divisions develop and demonstrate innovative approaches to providing quality diabetes care. Several of the centers carry out their programs onsite in model demonstration units, while other centers conduct their programs in community settings. The Demonstration and Education Divisions have developed links with major diabetes professional and voluntary organizations as well as with groups in the communities served by the centers. The Demonstration and Education Divisions offer continuing education seminars, workshops in state-of-the-art diabetes management for professionals, an array of tested evaluation and assessment instruments, and professional expertise in developing and implementing diabetes programs in a variety of settings. Each center offers a range of educational materials, including videotapes, curricula, and program guides for health professionals. The following briefly describes the current activities at each DRTC Demonstration and Education Division.
Albert Einstein College of Medicine's DRTC Demonstration and Education Division	Dr. Judith Wylie-Rosett directs the Demonstration and Education Division of the Albert Einstein College of Medicine in the Bronx. The multidisciplinary clinical and education team develops and assesses models for preventive diabetes care services, focusing on the needs of underserved and high-risk populations. The division also offers continuing education on diabetes management for health care professionals. Current research and development projects include Development and evaluation of a telephone counseling intervention to increase the rate of retinopathy screening in African Americans and other high-risk populations. Development and evaluation of interactive weight-control interventions including a multimedia computer system, workbook, and a staff curriculum. The American Diabetes Association has published the workbook under the title, The Complete Weight Loss Workbook. Assessment of risk perceptions and barriers to medication adherence in individuals who have or are at high risk for developing diabetes. Health professional education programs include A diabetes management preceptorship for physicians, advanced-practice nurses, dietitians, and clinical health psychology trainees. The preceptorships are offered in conjunction with graduate or postgraduate training programs. A weekly clinical conference focusing on the multidisciplinary management of diabetes and new findings on diabetes clinical research. A description of the educational and research activities of the Albert Einstein DRTC can be found on the internet at http://medicine.aecom.yu.edu/diabetes/DEC.htm. Specific programs available for downloading include Prescribing the Diabetic Diet, an interactive program covering basic skills aimed at medical residents, medical students, and nurses. Twenty Questions on the Diabetic Diet, an interactive program featuring 20 questions on prescribing the diabetic diet, with immediate feedback and discussion of answers. Case studies keyed to the Centers for Disease Control and Prevention publication, The Prevention and Treatment of the Complications of Diabetes Mellitus: A Guide for Primary Care Practitioners. The student version contains a series of questions and clinical decisions with references to the Guide. The instructor's version also contains key teaching points.
University of Chicago's DRTC Demonstration and Education Division	Dr. Wylie L. McNabb directs the Demonstration and Education Division of the Chicago DRTC, based at the University of Chicago. Many of the programs focus on minority health issues. Special programs include Pathways, a weight-loss program for African-American women at risk for diabetes. This weight-loss program is conducted by lay volunteers in inner city black churches. Por Su Salud (For Your Health) also makes use of lay volunteers to deliver a lifestyle intervention (nutrition and exercise) to Hispanic women. The sessions are conducted in Spanish in a home setting in Chicago's Hispanic neighborhoods. A new project currently under way is a collaborative effort between the DRTC and the Chicago Department of Public Health (CDPH) to improve the quality of diabetes care provided to patients in all CDPH neighborhood clinics. DRTC faculty and staff are providing in-service programs to all clinic personnel--physicians, nurses, dietitians, certified medical assistants, and clerical personnel--to assist them in implementing the American Diabetes Association's clinical practice recommendations for diabetes management. A chart audit system is being implemented to provide feedback to clinics on diabetes outcome variables and to determine the effectiveness of the in-service program. Other programs developed by the DRTC include From Basics Forward, a comprehensive continuing education program for diabetes educators conducted nationally by the American Association of Diabetes Educators. In Control, a clinical patient education program for 9- to 12- year-old children with diabetes and their parents. Get Going, an exercise program for inner-city minority women with diabetes. Choices, a problem-solving curriculum to meet the special needs of adolescents with diabetes management problems.
Indiana University's DRTC Demonstration and Education Division	Dr. David G. Marrero directs the Demonstration and Education Division of the Indiana University DRTC in Indianapolis. This DRTC division develops model clinical and educational programs relating to low income and minority programs. Many of the programs incorporate computer and telecommunications technology to assist in patient care and professional education. The Indiana University DRTC has conducted several surveys of primary-care physicians within the State to assess their standards of diabetes care. The results have guided the development of several postgraduate education courses on implementing more intensive diabetes management, detecting and treating secondary complications associated with type 1 and type 2 diabetes, and applying nutrition and exercise in type 2 diabetes. Materials produced in support of these activities include Survey and assessment instruments for both patients and health care professionals. Content-specific study guides and video programs demonstrating care. Treatment algorithms. Physician chart "help aids" to facilitate monitoring diabetes care and education programs that use multimedia. The center is developing a program designed to improve the standard of diabetes care in rural, low-income communities.
University of Michigan's DRTC Demonstration and Education Division	Dr. Roland G. Hiss directs the Demonstration and Education Division of the DRTC at the University of Michigan in Ann Arbor. This division has developed model clinical and educational programs, as well as educational programs and materials for health-care professionals and people with diabetes. Many of the center's programs for diabetes education and empowerment focus on communities and community organizations. Along with clinical and educational programs, the University of Michigan DRTC also facilitates disease, cost-of-disease, and quality-of-life modeling to assess the relative effectiveness, cost-effectiveness, and cost utility of alternative strategies for the prevention, detection, and management of type 2 diabetes. In addition, this DRTC supports and coordinates studies that evaluate interventions directed at improving health outcomes of people with diabetes and studies that evaluate barriers that prevent adoption and dissemination of state-of-the-art diabetes care. Specific projects have been developed to evaluate culture-specific diabetes education programs, diabetes care for the underinsured, and people with diabetes in managed care systems. The University of Michigan DRTC Demonstration and Education Division also develops instructional materials and standardized instruments to measure knowledge (Diabetes Knowledge Test), patient self-care skills and practices (Diabetes Care Profile), attitudes of patients and health professionals (Diabetes Attitude Scale), and patient empowerment (Diabetes Empowerment Scale). The center offers an undergraduate course for students at the University of Michigan, other training opportunities for health professionals, and patient education materials. These materials and instruments are available from the center.
Vanderbilt University's DRTC Demonstration and Education Division	Dr. Rodney Lorenz directs the Demonstration and Education component of the Vanderbilt University DRTC in Nashvillle. This division has assumed a leading role in improving the teaching skills of health professionals involved in diabetes education and management. The center's widely attended Effective Patient Teaching (EPT) course emphasizes teaching, promoting adherence, and imparting problem-solving skills. By special arrangement with the Vanderbilt University DRTC, professionals can be trained to present the EPT program to colleagues in their own institutions. The center also offers the program Sugar is Not a Poison: The Dietitian's New Role in Diabetes Management to prepare dietitians for their expanded role in diabetes management. The program has been presented throughout the United States. Although the curriculum emphasizes skills needed for intensive diabetes management, the course is useful for all dietitians who work with people with diabetes. Other training materials available from the Vanderbilt University DRTC include manuals on interviewing, teaching, and problem-solving and brief videotapes for problem-based patient learning. DRTC staff have also developed Questionnaires for evaluating the reactions of adults and adolescents with diabetes in situations that challenge adherence to their meal plans and coping strategies. The Self-Monitoring Analysis System (SMAS), a DOS-based software package for microanalysis of eating behavior. Psychological Assessment Applications Generator (PAAG), a DOS-based package for developing, administering, scoring, and interpreting psychological tests. Assessment tools and teaching aids for promoting diabetes detection, treatment, and prevention in African-American communities. Primary Care Management of Diabetes Mellitus, a set of 178 PowerPoint slides for use in teaching health professionals about diabetes. A comprehensive content outline on diabetes, the slide series may be downloaded from the DRTC's Internet site.
Washington University's DRTC Demonstration and Education Division	Dr. Edwin B. Fisher, Jr. directs the Demonstration and Education Division of the Washington University DRTC in St. Louis. The Washington University DRTC division is currently involved in many projects designed to improve care for people with diabetes. Current projects at the Washington University DRTC include Evaluation and enhancement of care for type 2 diabetes among primary-care physicians in a large managed-care organization. Translation to a Native American community of peer-and community-based approaches to promoting a reduced-fat diet. Promotion of exercise among participants in an activity and health program for older adults. Study of social support provided by staff in diabetes care and especially in the Diabetes Prevention Program. A masters program in health care services is affiliated with this DRTC. This program for nurses, dietitians, physical and occupational therapists, and other professionals offers interdisciplinary training in health promotion, disease prevention, chronic disease care, patient education and counseling, and program development and evaluation. The curriculum covers programs serving diverse audiences in a variety of settings.
Diabetes Research and Training Centers Demonstration and Education Divisions	Albert Einstein College of Medicine DRTC Judith Wylie-Rosett, Ed.D., R.D. Albert Einstein College of Medicine Belfer Bldg. 1308 1300 Morris Park Avenue Bronx, NY 10461 Tel: (718) 430-3345 Fax: (718) 430-8634 E-mail: jwrosett@aecom.yu.edu Internet: http://medicine.aecom.yu.edu/diabetes/DEC.htm. University of Chicago DRTC Wylie L. McNabb, Ed.D. Center for Research in Medical Education and Health Care University of Chicago Department of Medicine 5841 South Maryland Avenue, MC 6091 Chicago, IL 60637 Tel: (773) 753-1310 Fax: (773) 753-1316 Indiana University DRTC David G. Marrero, Ph.D. Indiana University School of Medicine The National Institute for Fitness and Sport Room 122 250 North University Boulevard Indianapolis, IN 46202 Tel: (317) 278-0905 Fax: (317) 278-0911 E-mail: DMARREO@mdep.iupui.edu University of Michigan DRTC Roland G. Hiss, M.D. Michigan Diabetes Research and Training Center G1103 Towsley Center, Box 0201 University of Michigan Medical School Ann Arbor, MI 48109-0201 Tel: (313) 763-1426 Fax: (313) 936-1641 E-mail: mfunnell@medmail.med.umich.edu Home page: http://www.med.umich.edu/mdrtc/ Vanderbilt University DRTC Rodney Lorenz, M.D. Diabetes Research and Training Center Vanderbilt University School of Medicine 315 Medical Arts Building 1211 21st Avenue South Nashville, TN 37212 Tel: (615) 936-1149 Fax: (615) 936-1152 Home page: http://www.mc.vanderbilt.edu/vumc/centers/drtc/pc_dm.html Washington University DRTC Edwin B. Fisher Jr., Ph.D. Washington University School of Medicine Division of Health Behavior Research 4444 Forest Park Avenue St. Louis, MO 63108 Tel: (314) 286-1900 Fax: (314) 286-1919
	National Diabetes Information Clearinghouse 1 Information Way Bethesda, MD 20892-3560 E-mail: ndic@info.niddk.nih.gov The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Public Health Service. Established in 1978, the clearinghouse provides information about diabetes to people with diabetes and their families, health care professionals, and the public. NDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and government agencies to coordinate resources about diabetes. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability. This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.
	NIH Publication No. 95-3267 July 1998 e-text posted: 1 August 1998