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Project Direct

Project DIRECT is a multiyear community diabetes demonstration project, funded primarily by the Centers for Disease Control and Prevention (CDC). DIRECT is an acronym for "Diabetes Intervention Reaching and Educating Communities Together."

It is intended to develop, implement, and evaluate strategies that can be incorporated into state-based diabetes prevention and control programs nationwide. DIRECT involves a partnership among the following: the community of southeast Raleigh, NC; the Division of Public Health in the North Carolina Department of Health and Human Services; Wake County Human Services; and the CDC.

Link to top of page Mission

To reduce the burden of diabetes and its complications in an African-American community through a community diabetes demonstration project

Link to top of page Target Population

The African-American community in southeast Raleigh, NC

Link to top of page Significance

  • DIRECT is the largest community diabetes project in the United States.
  • DIRECT focuses on an African-American community; African-Americans are at increased risk for diabetes and diabetes-related complications.
  • It is the first community project with a comprehensive approach to reduce the burden of diabetes. DIRECT includes programs to address all three levels of prevention, as follows:
    • programs to reduce risk factors for diabetes (primary prevention);
    • programs to improve identification of individuals with a disease (secondary prevention);
    • programs to improve the quality of care (tertiary prevention); community-based approaches rarely include tertiary prevention.
  • Major aspects were developed from the experience of other community-based trials, especially cardiovascular disease studies.

Link to top of page Strategy

The three main intervention components are health promotion, outreach, and diabetes care. The planning and implementation of activities for each area are carried out by a coordinator in consultation with a workgroup. Workgroups include individuals from the community, health professionals, and representatives of local organizations.

Link to top of page Evaluation

The evaluation team has members of each workgroup area, community and agency representatives, and scientific and technical consultants. The workgroups and evaluation team assess the process and short-term impact of project activities, and perform the following tasks:

  • develop and review plans to evaluate activities; specific measures are noted under each intervention area
  • develop and review data collection forms that document planning and implementation of program activities
  • coordinate with the external evaluator, Research Triangle Institute
  • maintain communications with the data management contractor

The external evaluator, Research Triangle Institute (RTI), is contracted to examine the impact of interventions at the population level. RTI representatives will survey a sample of the general population within the target area and a sample of people with diabetes to learn about social networks, diabetes-related knowledge, and beliefs about exercise and diet.

Link to top of page Public Health Agency Sponsors

The CDC’s National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, provides major funding and technical assistance.

The Division of Public Health in the N.C. Department of Health and Human Services has a cooperative agreement with the CDC, and is responsible for overall project administration, scientific and technical aspects, and for internal evaluation.

Wake County Human Services has a contract with the N.C. Division of Public Health to plan and implement interventions, and to organize and support coalitions.

Link to top of page Community Involvement

A coalition supports the project in its mission. It involves key individuals and organizations in southeast Raleigh and the surrounding area. There is representation from community leaders, business and industry, community organizations and centers, media, public health agencies, professional organizations, health care providers, religious leaders, fraternities and sororities, and university faculty members including people from historically black colleges and universities.

DIRECT’S Executive Committee is responsible for policy management, which includes the following:

  • Develop policies and guidelines
  • Review and endorse action plans
  • Review the objectives and accomplishments throughout the year
  • Help the project members to identify opportunities for visibility

The 13 members include the following: two from N.C. Department of Health and Human Services Division of Public Health; two from Wake County Human Services; two (chair and vice chair) are from the community plus seven at-large community members.

Link to top of page Related Links

Gregg EW, Geiss LS, Saaddine J, et al. Use of diabetes preventive care and complications risk in two African-American communities. Am J Prev Med 2001;21(3):197-202.

Link to top of page For More Information

For more information, contact
Joyce Page, MPH, MSPH
Project Director
Diabetes Prevention and Control Unit
Division of Public Health
Department of Health and Human Services
Mail Service Center 1915
Raleigh, NC 27699-1915
E-mail: Joyce.Page@ncmail.net


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This page last reviewed July 12, 2004.

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation