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Abstract #160290

Deborah S. Porterfield, MD, MPH, Social Medicine, University of North Carolina at Chapel Hill, CB #7240, UNC Chapel Hill, Chapel Hill, NC 27514, 919-843-6596, porterfi@email.unc.edu, Janet Reaves, RN, MPH, Chronic Disease and Injury Section, NC Division of Public Health, Mail Center 1915, Raleigh, NC 27699, Thomas R. Konrad, PhD, Program on Mental Health Services Research, Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Martin Luther King Jr. Blvd., CB#7590, Chapel Hill, NC 27599-7590, Curtis Dickson, ME, Hertford County Public Health Authority, PO Box 246, 801 N. King St., Winton, NC 27986, Bryan Weiner, PhD, Department of Health Policy and Administration, University of North Carolina at Chapel Hill, Campus Box 7411, 1102-C McGavran-Greenberg Hall, Chapel Hill, NC 27599, Mary Davis, Dr PH, MSPH, North Carolina Institute for Public Health, The University of North Carolina at Chapel Hill, Campus Box 8165, Chapel Hill, NC 27599-8165, Marcus Plescia, MD MPH, NC Division of Public Health, NC DHHS, 1915 Mail Service Center, Raleigh, NC 27699, and Edward L. Baker, MD, MPH, MSc, NC Institute for Public Health, UNC School of Public Health, Campus Box 8165, Chapel Hill, NC 27599.

Objective: To describe evidence-based practices in diabetes prevention and control in North Carolina local health departments (LHDs). Methods: We conducted a cross-sectional mailed survey of all 85 LHDs in North Carolina in 2005. The survey was designed to measure capacity and performance and was based on federal performance standards instruments. Specific questions assessed whether LHDs programs or services were consistent with recommendations of the American Diabetes Association (ADA) or the Community Guide (CG). We also asked about awareness and implementation of the recommendations of the CG. Results: The response rate was 100%. Overall personnel capacity in diabetes was low (median of 0.9 FTEs). The proportions of LHDs providing recommended services were: screening for diabetes (74%); screening for pre-diabetes (48%); case management (35%); disease management (31%); and health education for persons with diabetes (58%). Thirty-four percent screen for diabetes in community settings, which is discouraged by the ADA. Among LHDs conducting diabetes screening, 36% use ADA criteria, 59% screen whomever requests, and 74% screen at the provider's discretion. Only 24% were aware of CG recommendations, and only 11% were implementing or disseminating CG recommendations. Conclusions: As more evidence-based recommendations for public health practice emerge, it is useful to begin to examine adherence. We found varying levels of evidence-based diabetes prevention and control practices in NC LHDs. Where capacity exists to provide any programs or services in diabetes, work is needed to understand how to better align practice with evidence-based recommendations.

Learning Objectives:

• List the programs or services that can be provided in a local health department that are supported by evidence-based recommendations.
• Understand issues in measuring adherence to evidence-based recommendations.
• Understand the current status of diabetes prevention and control practices in North Carolina local health departments.

Keywords: Evidence Based Practice, Diabetes

Presenting author's disclosure statement:

Any relevant financial relationships? Yes

Name of Organization	Clinical/Research Area	Type of relationship
Pfizer	Pharmaceutical	grant: Pfizer Scholars Program in Public Health

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.