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Tutorial Overview

  • TAKE HOME MESSAGES
  • DIABETES DATA
    • Epidemiology and Surveillance
    • Use of Surveillance  
    • What Kinds of Data Do You Need in Planning?
  • NATIONAL AND LOCAL DATA SOURCES
    • National Data Sources  
    • Local Data Sources
    • Other Local Sources
  • DATA QUEST
  • COMMUNITY RESOURCES
    • Assessing Community Resources
    • Barriers to Using Resources
  • COLLECTING YOUR OWN DATA
    • Identifying and Filling Data Gaps
    • Qualitative vs. Quantitative
  • SUMMARY
  • QUICK CHECK
  • REFERENCES

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TAKE HOME MESSAGES

After completing this tutorial, you will be familiar with:

  • Key terms related to diabetes data
  • Data needed for planning
  • National and local data sources
  • Community assets and resources
  • Qualitative and quantitative data

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DIABETES DATA

The first steps in the public health approach are to identify the problem through surveillance data and to identify risk factors associated with the problem.
The toll diabetes is taking on the health of our communities is opening eyes.  More data than ever before are available on diabetes incidence, prevalence, risk factors, and more.

Data answer fundamental public health questions that are critical to effective health planning. 

Data help to:

  • Create a shared understanding of the problem
  • Identify who is affected and by how much
  • Understand what causes or contributes to the problem and why
  • Identify effective solutions to bring about the desired change
  • Establish a baseline for measuring progress toward your goals (evaluation)

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DIABETES DATA cont'd

Epidemiology and Surveillance

Epidemiology is the study of the distributions and determinants of disease and injuries in human populations.  Epidemiology is…

  • Used to study frequency of cases of diabetes, its risk factors and complications
  • Concerned with groups rather than individuals
  • Used to study trends and draw conclusions based on those trends

Surveillance is the monitoring of trends over time of diabetes and its complications.  Surveillance is…

  • Used to detect changes in trends or distribution of diabetes-related factors
  • Data collected on hospitalizations, treatment use, preventive care practices, and many other indicators

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DIABETES DATA cont'd

Use of Surveillance

Normal
Prediabetes
Diabetes
Complications/Disability

 
Risk Factors for Diabetes Prevention Measures Preventive Care Practices Risk Factors for Complications  
  • Physical Inactivity
  • Obesity
  • Physical activity
  • Diet/nutrition
  • Foot exam
  • Self-monitoring blood sugar
  • Dilated eye examination
  • Smoking
  • Uncontrolled blood pressure
  • Inadequate glycemic control
  • Hyperlipidemia
  

This above diagram shows what kinds of data are valuable at points along the continuum from not having diabetes (“normal”) to death.  The bulleted items show where to intervene in order to stop or slow the progression of diabetes.  Hold your mouse over the words in the arrow for more information.

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DIABETES DATA cont'd

What Kinds of Data Do You Need in Planning?

Four types of data are used in health planning:

  1. 1. Surveillance– Surveillance data are able to tell us the burden and costs related to diabetes.

    Examples of standard surveillance data include:

Hold your mouse over the words in brown for more information

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DIABETES DATA cont'd

What Kinds of Data Do You Need in Planning? (cont'd)

  1. 2. Assessment– Assessment is the systematic analysis of the unique needs and assets within your diabetes prevention and control intervention. 

    Community/asset mapping – The process of cataloguing a community’s assets and resources.

    • A community asset is anything – person, place, organization/business, programs/services – that can be used to improve the health and well-being of a community.
    • Visual representation of the asset information, called mapping, can help you understand where resources are located or absent in your community.

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DIABETES DATA cont'd.

What Kinds of Data Do You Need in Planning? (cont'd)

  1. 2. Assessment examples, cont'd:
    • Environmental scan – The purpose of an environmental scan is to learn about the critical issues that should be considered when creating your goals and objectives.  This includes the social determinants of health.
    • SWOT analysis – SWOT stands for Strengths, Weaknesses, Opportunities, and Threats and is used to identify the positive and negative factors internal (strengths and weaknesses) and external (opportunities and threats) to your program or organization.
    • Document review – Examination of records or historical documents.

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DIABETES DATA cont'd.

What Kinds of Data Do You Need in Planning? (cont'd)

  1. 3. Evaluation– Good evaluation helps you understand if the intervention goals were met, and whether the individual strategies were successful.
  2. Evaluation data demonstrate the impact of your work and are excellent source of information for partners and stakeholders.

 

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DIABETES DATA cont'd.

What Kinds of Data Do You Need in Planning? (cont'd)

  1. 4. Evidence– Comprises effective solutions, such as evidence-based interventions and best or promising practices that will bring about change are derived from the published literature and other research and practice findings.

Two great resources for evidence-based interventions:

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NATIONAL AND LOCAL DATA SOURCES

Before going out and collecting your own data on diabetes in your community, it is helpful to check existing data from a few national and local data sources.

This data can give you an idea of the scope of diabetes in the populations in your community.

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NATIONAL AND LOCAL DATA SOURCES cont'd

National Data Sources 

These national surveys use very large sample sizes to collect data, which provide accurate estimates for diabetes prevalence in the U.S. population as a whole, as well as major subpopulations.

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NATIONAL AND LOCAL DATA SOURCES cont'd

Local Data Sources

Local data sources give you an idea of the prevalence of diabetes – as well as risk factors and complications – at the state, county, or community level.

Use these data to understand the need for diabetes programs in your community and compare your community to others in the state or nation (these comparisons can be compelling for policy makers).

  • CDC Diabetes Data and Trends
    http://www.cdc.gov/diabetes/statistics/index.htm
  • County Health Rankings
    http://www.countyhealthrankings.org/
  • State health departments
  • State diabetes prevention and control programs
  • Local colleges and universities
  • Local clinics and hospitals
  • Local chapters of professional organizations such as the American Diabetes Association

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NATIONAL AND LOCAL DATA SOURCES cont'd

Other Local Sources

The following surveys are relatively large local surveys designed to capture comprehensive health information from ethnically diverse populations concentrated in relatively small areas.  Check out these websites for best practices in conducting health surveys.

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DATA QUEST

Click here to do a DATA QUEST.  You will be asked to find relevant data using the resources you just covered that will be useful to you in developing your community action plan with your coalition.  The information you collect during this activity will be used in the Diabetes Today 2 day workshop.  Please bring these questions, along with your answers to the questions, to the Diabetes Today training.

If you would rather wait until you complete this tutorial to do the DATA QUEST, a link will be available at the end of this tutorial.

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COMMUNITY RESOURCES

Assessing Community Resources

After you understand the epidemiology of diabetes in your community and before you design your program, it is important to assess the resources already available in your community.

Anything that could positively impact the health of the community should be considered a resource.

In order to conduct a community resource assessment:

  • Collect information on organizations, professionals, people, and programs
  • Create a database or list of resources, especially diabetes-related health care services
  • Try to assess barriers to service use
  • Try to assess the quality of services

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COMMUNITY RESOURCES cont'd

Barriers to Using Resources

Your assessment may reveal many healthcare and wellness resources in your community that are not being fully utilized. 

Consider what this means in terms of the diabetes interventions and activities your coalition chooses.

Common barriers to accessing community services are:

  • Distance – Transportation may be a barrier
  • Time – Hours/days services are provided may be a barrier
  • Cost & coverage – Community members may not have insurance to cover costs
  • Community norms – The service, location, or specific organization may not be seen as appropriate by the community
  • Language – Language barriers may prevent participation.  Are directions, pamphlets, notices, etc. written in a language readable to the community?  Are staff bilingual?

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COLLECTING YOUR OWN DATA

Identifying and Filling Data Gaps

Sometimes the data you need are not readily available.  If this is the case, developing tools to collect your own data can help you to assess the problem of diabetes and its complications, implement a comprehensive diabetes program, and capitalize on the health care resources in your community.

When collecting your own data, determine whether to collect qualitative data, quantitative data, or both. It is important to choose the data collection method(s) that best suit your objectives and your audience.  Different methods serve different purposes.

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COLLECTING YOUR OWN DATA cont'd

Qualitative vs. Quantitative

 

Qualitative Data

Quantitative Data

Definition:

Provides insight into people’s attitudes, beliefs, values, motivations, and lifestyle.

Describes a situation or event in terms of numbers.

Data Collection Methods:

Observation

In depth interviews

Focus groups

Standardized Survey –

Face-to-face, telephone, mail, web, or email.

Characteristics

Subjective, open-ended questions

Probes for feelings, beliefs, impressions

Gathers detailed information from small number of people.

Open-ended responses make data analysis complex.

Objective, close-ended questions

Specific responses to specific questions

Gathers information from large number of people.

Fixed response choices make data analysis easy.

Example

How  people with diabetes feel about regulating their blood glucose

Percent of  people with diabetes who improved their blood-glucose regulation (e.g., the percentage of change in a particular behavior by the target population). 

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COLLECTING YOUR OWN DATA cont'd

Identifying and Filling Data Gaps cont'd

Whenever possible, use data that are available and recently collected. 

Check it out:
Rather than starting from scratch, identify questions from other national health surveys that meet your needs.  Take a few minutes to follow one or more of the links below and find the questions used in these national surveys.  These questions have been previously validated and will add credibility to your diabetes survey.  Think about which questions you might be able to repurpose for your own diabetes survey.

National Health Interview Survey (NHIS) http://www.cdc.gov/nchs/nhis.htm

National Health and Nutrition Examination Survey (NHANES) http://www.cdc.gov/nchs/nhanes.htm

Behavioral Risk Factor Surveillance Survey (BRFSS) www.cdc.gov\brfss

Note:  Collecting data in your community requires careful planning and specific knowledge of data collection methods.  Before collecting your own data, make sure someone on your coalition has those skills or you should consult an expert.

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SUMMARY

Understanding the burden of diabetes in your community requires collecting data on the prevalence of diabetes, its risk factors, and complications.  Data is available from several national and local sources.  Conducting a Community Resource Assessment is a valuable way of identifying what resources already exist in your community.  When collecting your own data, determine if it’s best to collect qualitative data, quantitative data, or both.

The next tutorial, Facilitating for Success, you will learn how to guide your coalition in making decisions through group facilitation techniques.

But first, a Quick Check…

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QUICK CHECK

Now, let’s check your understanding of the material we just covered. Read each question and select the best answer choice.

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QUICK CHECK cont'd

  1. Incidence is the number of existing cases of diabetes.
True Incorrect. Try again!
False Correct!

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QUICK CHECK cont'd

  1. ______ is used to monitor trends over time.
Surveillance Correct!
Epidemiology Incorrect. Try again!
Prevalence Incorrect. Try again!
Public health Incorrect. Try again!

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QUICK CHECK cont'd

  1. Which of the following should you do as part of a community resource assessment?
Collect information on organizations, professionals, people, and programs Incorrect. Try again!
Create a database or list of resources, especially diabetes-related health care services Incorrect. Try again!
Assess barriers to service use Incorrect. Try again!
Assess the quality of services Incorrect. Try again!
All of the above Correct!

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QUICK CHECK cont'd

  1. Which of the following is in the proper order?
Design intervention - Understand epidemiology of diabetes in your community - Assess community resources Incorrect. Try again!
Assess community resources - Design intervention - Understand epidemiology of diabetes in your community Incorrect. Try again!
Understand epidemiology of diabetes in your community - Assess community resources - Design intervention Correct!

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QUICK CHECK cont'd

  1. Which data gathering method is not characteristic of qualitative data?
Focus groups Incorrect. Try again!
Standardized survey Correct!
In depth interview Incorrect. Try again!
>All of the above Incorrect. Try again!

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REFERENCES

Adapted from:

 

  • Blais, LM (2006). Community Volunteer Leaders: Who are they? What do they look like? How do you engage them?. American Cancer Society Training, Pennsylvania.
  • Caldwell, GG (2006).  Introduction to the Public Health Approach.  Accessed on August 8, 2011 at chfs.ky.gov/NR/rdonlyres/C506EA79.../GCCThePHApproach121306.ppt
  • Frieden, TR (2010).  A framework for public health action:  The health impact pyramid.  American Journal of Public Health, 100: 590-595.
  • Institute of Medicine (2001).  Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences.  Accessed on August 8, 2011 at http://www.nap.edu/catalog/9838.html
  • Wallack, L., Dorfman,L., Jernigan, D. and Themba, M. (1993) Media advocacy and public health: Power for prevention. Newbury Park, CA: Sage.

 

Well done!

You have completed Tutorial 2: Using Data in Planning.  Click on Tutorial 3: Facilitating For Success on the left menu to go on to the next tutorial.

If you have not done so already, please take a few minutes to complete the DATA QUEST. You will use the information you collect during the Diabetes Today training.  Please bring the questions along with your answers to the training. You can print the document or save is as a Word file.

Want to learn more about using data in public health planning? Contact the Diabetes Training and Technical Assistance Center (DTTAC) at dttac.emory.edu for more information on designer workshops, trainings and services offered.