Evaluation of an Initiative to Develop Community-based Capacity in Appalachia for implementing Evidenced-based proctice for Diabetes Prevention and Control

Since 2000, the Centers for Disease Control and Prevention have supported capacity building coalitions (locally controlled plans for diabetes prevention and control) in Appalachia. These efforts, using a coalition building strategy based on the Diabetes Today framework, have been conducted through an interagency agreement with the Appalachian Regional Commission (Commission), a federal-state partnership to promote economic and social development of the Appalachian Region. As of 2012, the Appalachian region consisted of 420 counties along the Appalachian mountain chain containing all of West Virginia, and parts of Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, and Virginia. In FY 2011, the Commission designated 82 of these counties as distressed, meaning that they are among the poorest 10% nationwide, based on rates of poverty, unemployment and per capita market income. Problem: Are coalitions an effective means for promoting healthy behavior change and social and organizational support for diabetes prevention and control in Appalachia? Method: Multi-methods evaluation including quantitative and qualitative assessment of coalition membership, activities, perception of success, analysis of patterns and commonalities among coalitions and in-depth case studies of five coalitions. Results: Coalitions serve public health by promoting community connectedness. They provide valuable and culturally appropriate services for diabetes prevention and control in resource-poor areas in Appalachia. Conclusion: Building community capacity by developing local leadership and strategic partnerships is an important strategy for sustaining long term outcomes for diabetes prevention and control in Appalachia.