North Carolina Project DIRECT - Diabetes Assistance Programs in North Carolina

North Carolina Project DIRECT

Project DIRECT is the largest community-based intervention for diabetes ever funded to date. The project is conducted through a cooperative agreement between the Centers for Disease Control and Prevention, the North Carolina Department of Health and Human Services, Wake County Human Services and the local community of Southeast (SE) Raleigh.

Community members are actively involved in the project, including membership on the Executive Committee, participation in the Community Coalition and Resource Pool, as well as participation in faith based activities, health promotion, health outreach, and diabetes education activities. In 1999, DIRECT and the NC Diabetes Prevention and Control Unit merged to form a comprehensive state diabetes program.

The specific goals for DIRECT are to:

1. Improve the quality of care provided to people with diabetes and to improve self-care practices related to diabetes management;
2. Detect previously undiagnosed diabetes, especially among African Americans and to see that those previously diagnosed with diabetes are in the health care system;
3. Reduce risk factors related to diabetes especially through increasing physical activity and decreasing fat intake.

The mission of DIRECT is to reduce the burden of diabetes and its complications. The target population is the African American community in Southeast Raleigh, NC and the places where the residents obtain medical services. For DIRECT, the community has been defined geographically as seven census tracts and the units of patterned social interaction that occur within these geographic boundaries and outside of this area. There are approximately 25,000 persons living within these geographic boundaries.

An important distinction between Project DIRECT and previous cardiovascular disease studies is that DIRECT includes all three levels of prevention: primary, secondary, and tertiary. Previous community-based approaches have frequently omitted or minimized interventions aimed at tertiary prevention.