Attachment C NPHIDWH

October, 2007

The National Public Health

The overarching goal for
the initiative’s cosponsors
and partners is to
identify and implement
strategies that will make
a difference in the lives of
women and their families
who face the daily
challenges of diabetes.

Initiative on Diabetes and Women’s Health

Objectives
The Cosponsors of the National Public Health Initiative on Diabetes and
Women’s Health, the American Diabetes Association (ADA), the American
Public Health Association (APHA), the American Association of Diabetes
Educators (AADE), the Association of State and Territorial Health Officials
(ASTHO), and the Centers for Disease Control and Prevention (CDC) have
mobilized the collective energies and resources of multiple entities that serve as
partners in this initiative. The overarching goal for the Initiative is to identify
and implement strategies that will make a difference in the lives of women and
their families who face the daily challenges of diabetes. These women include
those with undiagnosed and diagnosed diabetes, and those at risk for developing
diabetes.
The National Public Health Initiative on Diabetes and Women’s Health
is structured to examine the impact of diabetes through the life stages of a
woman. The life stages identified by the Initiative—adolescent years (10–17),
reproductive years (18–44), middle years (45–64), and the older years (65 and
older)—were constrained by age groups previously identified by populationbased studies and national surveys.
Several objectives have been developed based on input from previous working
meetings with the cosponsors and partners of the Initiative. The intent of these
objectives is to develop measurable indicators that can be used to evaluate the
impact of the National Public Health Initiative on Diabetes and Women’s
Health. While all of the objectives listed are of importance, our initial focus
will be on implementing 12 priority objectives. The Steering Committee of
the National Public Health Initiative on Diabetes and Women’s Health has
highlighted these priority objectives in the text boxes found throughout this
document.
We encourage your active involvement in completing these objectives. The
National Public Health Initiative on Diabetes and Women’s Health plans to
collect information from partners and cosponsors to identify implementation
efforts related to these objectives. We hope you will join us in these efforts!

Community Health is a
perspective on public health
that assumes community to
be an essential determinant of
health and the indispensable
ingredient for effective public
health practice.

Community Health
Section A—Community Health: A perspective on public health that assumes
community to be an essential determinant of health and the indispensable
ingredient for effective public health practice. It takes into account the
tangible and intangible characteristics of the community—its formal and
informal networks and support systems, its norms and cultural nuances, and its
institutions, politics, and belief systems.
National Association of City and County Health Officials1
A1. By 2010, Cosponsors and Partner Organizations will develop talking
points for at least one article in magazines about diabetes prevention and
control.
A2. By 2010, Cosponsors and Partner Organizations will use the NDEP
gestational diabetes (GDM) Tip sheet in community-based/state-based
activities to educate women about diabetes prevention and control.
A3. By September 2006, cosponsors will develop an Internet spotlight
paragraph to place on CDC’s Division of Diabetes Translation’s Web site
and annually link to the “Take a Loved One for a Check-up Day” campaign
highlighting the importance of obtaining regular health care. [ACHIEVED]
A4. By 2010, Cosponsors and Partner Organizations will conduct at least one
training program on the use of NDEP products and tools which emphasize
how to prevent and control diabetes for women.
A5. By 2010, Cosponsors and Partner Organizations will collaborate with
at least two faith-based initiatives for the prevention of diabetes in at risk
women who live in rural areas.
A6. By 2012 date, NDEP will develop and disseminate at least two women’s
health products for community members.
Mobilizing Action through Planning and Partnerships. Available at:
http://mapp.naccho.org/MAPP_glossary.asp. Last accessed July 10 , 2006.

1

Diabetes State Programs
Section B—State Programs: The CDC funds 59 Diabetes Prevention and
Control Programs (DPCPs) to conduct a wide range of activities, including
defining the burden of diabetes and monitoring health outcomes, providing
technical assistance, planning and implementing community-based programs,
and increasing public awareness about diabetes and its complications.2
B1. By 2010 Date, CDC will revise the Funding Opportunity
Announcement (FOA) to encourage DPCP’s to collaborate with at least
one new partner to address an issue related to women and diabetes.
B2. By 2010, at least two DPCPs will educate women’s health advocates
and partners about diabetes and the National Public Health Initiative on
Diabetes and Women’s Health.
B3. By 2006, the Cosponsors will identify and provide at least three venues
for DPCPs to access information on women’s health and diabetes (or about
the National Public Health Initiative on Diabetes and Women’s Health).
[ACHIEVED]
B4. By 2006, the Cosponsors will identify or develop at least two resources
(e.g., monograph, fact sheets) to help DPCPs develop programs that address the
health issue concerns of women with diabetes. [ACHIEVED]
State-based Diabetes Prevention and Control Programs. Available at: http://www.cdc.gov/diabetes/states/assist.htm. Last accessed July 20, 2006.

2

The CDC funds 59 Diabetes
Prevention and Control
Programs.

Education and Community Outreach
Section C—Education: The lifelong acquisition of knowledge, skills, and
abilities that promote personal growth and fulfillment, economic viability
(at both the individual and community level), and community enrichment.
University of Illinois at Urbana-Campaign3
Community Outreach: The practice of conducting local public awareness
activities through targeted community interaction. Community outreach
activities are defined here as those efforts that can directly affect the behavior of
the driving public through local interaction. They are designed to educate the
public about a particular issue using respected and locally relevant channels of
communication. US Department of Transportation4

Education
C1. Cosponsors of the Initiative will develop at least one success story
annually on diabetes and women’s health across the life stages to educate the
public about diabetes and women’s health.
C2. At least twice a year, Cosponsors (ADA, APHA) will provide partners
with a Federal Legislative Update on Congressional activities related to
women and diabetes.

Outreach
C3. By 2010, Partner Organizations will actively participate in at least one
community-based activity related to diabetes and women’s health.
Dual Use Technology: A Total Community Resource. Available at: http://ceep.crc.uiuc.edu/
eecearchive/books/fte/equity/degnan.html. Last accessed July 17, 2007.

3

Community Outreach. Available at: http://knowledge.fhwa.dot.gov/cops/italladdsup.nsf/
All+Documents/81D9DF1A9F0C0EA285256BDF00126E6D/$FILE/J.Community%20Outreach.doc.
Last accessed July 17, 2007.

4

Quality Care
Section D—Quality Care: The degree to which health services for individuals
and populations increase the likelihood of desired health outcomes and are
consistent with current professional knowledge. Institute of Medicine, Crossing
the Quality Chasm: The IOM Health Care Quality Initiative5
D1. By 2010, Cosponsors will update their respective Web sites quarterly
to highlight upcoming conferences on women’s health and diabetes.
D2. By 2010 Date, Cosponsors will identify and provide partners with
two multidisciplinary evidence-based resources (i.e., guidelines) to educate
health care professionals about risk assessment and quality care for women
with diabetes.
D3. By 2010, Cosponsors will report key factors and recommendations
associated with quality of care for women with diabetes who live in rural areas
to be used by health care professionals.
Crossing the Quality Chasm. (2001). National Academy Press: National Academy Press,
Institute of Medicine.
5

Research development,
testing, and evaluation all
contribute to generalizable
knowledge.

Research
Section E—Research: A systematic investigation, including research
development, testing, and evaluation, designed to develop or contribute to
general knowledge.
CDC Guidelines, Department of Health and Human Services Policy for the
Protection of Human Research Subjects6
E1. By 2012, CDC will conduct a study to determine the economic impact
of diabetes on U.S. women, and disseminate research findings in at least one
peer-reviewed journal and one conference.
E2. By 2010, Cosponsors and Partner Organizations will disseminate
research findings on diabetes and women’s health in at least one Webbased report, one peer-reviewed publication, or one conference.
E3. By 2010, CDC will identify at least one contact person in its various
centers and divisions, fellow government agencies, or partner organizations to
conduct research on the health and well-being of women with and at risk for
diabetes, using a life-stage approach.
E4. By 2010, Cosponsors and Partner Organizations will collaborate with
at least two population-based programs to establish ongoing research to
identify the unique needs of women with and at risk for diabetes in different
life stages.
E5. By 2012, Cosponsors and Partner Federal Agencies will develop and
advertise at least one FOA to encourage research to develop models of
preventive health care to women with and at risk for diabetes in different life
stages.7
Department of Health and Human Services. Code of Federal Regulations: Title 45 Public Welfare,
Part 46 Protection of Human Subjects. Available at: http://www.hhs.gov/ohrp/humansubjects/
guidance/45cfr46.htm#46.102. Last accessed July 20, 2006.
6

Model is defined as: “A conceptual basis for how a program or evaluation is supposed to work,
explaining key factors and variables.” Modeste NN. Dictionary of Public Health Promotion and
Education: Terms and Concepts. Thousand Oaks: Sage Publications.
7

Surveillance
Section F—Surveillance: The ongoing, systematic collection, analysis, and
interpretation of outcome-specific data, closely integrated with the timely
dissemination of these data to those responsible for preventing and controlling
disease or injury.
CDC Guidelines, Department of Health and Human Services Policy for the
Protection of Human Research Subjects8
F1. By 2010, Cosponsors will establish interagency agreements with
partners to identify population-based surveillance programs to conduct
surveillance of women with and at risk for diabetes.
F2. By 2010, Partnering Federal Agencies and CDC will develop
a system to assess and monitor the usage of evidence-based
recommendations at the patient, provider, and health systems levels in
DHHS programs for women with and at risk for diabetes.
F3. By fiscal year 2007–2008, CDC will recommend that language be included
in the National Diabetes Prevention and Control Program FOA that provides
guidance for Diabetes Prevention and Control Programs to collect, analyze, and
disseminate life-stage surveillance data on the health and health care of women
with and at risk for diabetes.
F4. At the 2008 Annual Diabetes Translation Conference, CDC will sponsor a
panel discussion to share surveillance findings on the quality of care for women
with and at risk for diabetes.
F5. By fiscal year 2008–2009, CDC will identify a funding opportunity for
enabling at least four DPCPs to serve as pilot programs that will collect, analyze,
and disseminate surveillance data on the health and health care of women with
or at risk for diabetes.
F6. By 2010, using current surveillance data, Cosponsors and Partner
Organizations will highlight 2 specific needs of women with and at risk for
diabetes, including recent progress and challenges and report findings on
their respective Web sites.
Department of Health and Human Services. Code of Federal Regulations: Title 45 Public Welfare,
Part 46 Protection of Human Subjects. Available at: http://www.hhs.gov/ohrp/humansubjects/
guidance/45cfr46.htm#46.102. Last accessed July 20, 2006.
8

The collection, analysis, and
interpretation of data along
with timely dissemination
of the data are crucial
components for preventing
and controlling disease or
injury.

Examples of Activities

for Implementation of Objectives
Community Health—
A1. Magazine Articles: Cosponsors and Partners of the Initiative

Example: Cosponsors and Partner Organizations will identify and collaborate
with publishing companies which have a focus on women’s health and/or
diabetes to develop articles for publications in magazines.
A2. Use of the NDEP Gestational Diabetes Tip Sheet: Cosponsors and
Partners of the Initiative

Example: Cosponsors and Partner Organizations can organize communitybased/state-based events for women and community leaders to exhibit the
GDM Tip sheet and educate the community about GDM and the prevention of
diabetes.
A3. Take a Loved One for a Check-up Day: Cosponsors of the Initiative

Example: Cosponsors of the Initiative can maintain a link to the “Take a Loved
One for a Check-up Day” on their Web sites to encourage the public to obtain
regular health care.
A4. Training Program on NDEP Products: Cosponsors and Partners of the
Initiative

Example: Cosponsors and Partner Organizations can conduct training on
diabetes and women’s health issues using NDEP’s Road to Health toolkit for
community health workers/promotores or the NDEP GDM tip sheet.
A5. Faith-based Initiatives: Cosponsors and Partners of the Initiative

Example: Cosponsors and Partner Organizations can conduct a needs
assessment with faith-based organizations and develop collaborative plans to
implement activities associated with modifiable risk factors aimed at preventing
or delaying diabetes.
A6. NDEP Products on Women’s Health: Partners of the Initiative

Example: NDEP will develop and disseminate products for women across the
life stages that have or are at risk for diabetes.

Diabetes State Programs—
B1. Funding Opportunity Announcement (FOA): Cosponsors of the Initiative
(CDC)
Example: CDC will develop language to be included in the next FOA to
encourage DPCPs to address diabetes and women’s health issues with new
partners.
B2. DPCPs Educate Women’s Health Advocates: Partners of the Initiative
Example: DPCPs will use materials developed by the Cosponsors of the
Initiative (e.g., monograph on diabetes and women’s health, journal articles,
fact sheets) to tailor messages that advocates can use to raise awareness about
diabetes and women’s health.
B3. DPCP Access to Women’s Health and Diabetes Information: Cosponsors
of the Initiative
This objective was achieved through the dissemination of women’s health
materials at national conferences: The Division of Diabetes Translation’s
national conference, 2004 Partners’ Update Conference sponsored by the
National Public Health Initiative, the CDC/DDT Web page on diabetes and
women’s health.
B4. Resources for DPCPs: Cosponsors of the Initiative
This objective was achieved through the development of materials (2001
monograph on diabetes and women’s health, 30 minute video on diabetes
and women’s health) that were disseminated to help DPCPs with program
development and activities.

Education and Community Outreach—
C1. Success Stories: Cosponsors of the Initiative
Example: Cosponsors can develop success stories, such as state, national, and
local success stories, to be used to increase awareness about diabetes and women’s
health issues.
C2. Legislative Update: Cosponsors of the Initiative
Example: Through blast emails, the Initiative’s listserv and newsletter, ADA and
APHA can provide action alerts on legislation related to diabetes and women’s
health.
C3. Community-based Activities: Partners of the Initiative
Example: Partner Organizations can organize local activities to raise awareness
about diabetes and women’s health issues using materials developed by the
National Public Health Initiative on Diabetes and Women’s Health.

Quality Care—
D1. Update Web sites: Cosponsors of the Initiative
Example: Cosponsors can identify upcoming conferences which focus on
women’s health and/or diabetes and place such information on their Web pages.
D2. Evidence-based Resources: Cosponsors of the Initiative
Example: Cosponsors can identify multidisciplinary resources (i.e., guidelines
for gestational diabetes) to educate health care professionals about quality of care
issues for women with diabetes.
D3. Quality of Care for Rural Women: Cosponsors of the Initiative
Example: Cosponsors can develop a literature review which identifies the key
factors that are associated with quality of care for women who live in rural
communities. Recommendations, based on this literature review, should identify
ways to address barriers to care and quality of health care.

Research—
E1. Study on Economic Impact: Cosponsors of the Initiative (CDC)
Example: CDC can conduct a study by analyzing data on economic impact of
diabetes on women’s health. Such a study should be disseminated in a scholarly
journal and presented at national conferences.
E2. Web-based report: Cosponsors and Partners of the Initiative
Example: Cosponsors and Partner Organizations can develop manuscripts and
publish research findings on women’s health and diabetes in a peer-reviewed
journal; disseminate the information on Partner Organizations’ and Cosponsors’
Web sites, and present at a national women’s health or diabetes conference.
E3. Research on Well-being of Women: Cosponsors of the Initiative (CDC)
Example: CDC will conduct research on the quality of care of women with and
at risk for diabetes.
E4. Research on Unique Needs of Women: Cosponsors and Partners of the
Initiative
Example: Cosponsors and Partner Organizations can develop research that
specifically addresses unique needs of women in rural areas.
E5. Funding Opportunity Announcement: Cosponsors and Partner Federal
Organizations
Example: Cosponsors and Partnering Federal Agencies could develop and
support a Funding Opportunity Announcement (FOA) that solicits research
proposals regarding effective methods for delivering preventive care to women
with differing health care insurance coverage in different life stages.

Surveillance—
F1. Surveillance of Women with or at risk for Diabetes: Cosponsors of the
Initiative
Example: Cosponsors can collaborate with other organizations to analyze
data on variables associated with quality of care for women with and at risk for
diabetes using national datasets.
F2. Monitoring Use of Evidence-based Recommendations: Partnering Federal
Agencies and CDC
Example: Federal agencies can monitor and assess trends in the health status
and quality of care of women with gestational diabetes after delivery to provide
information on the unique needs of this group of women. This information could
be useful for public health programs aimed at primary prevention of diabetes.
F3. DPCP Surveillance Data on Women: Cosponsors of the Initiative (CDC)
Example: Cosponsors will develop language and recommend its inclusion in the
upcoming FOA to encourage DPCPs to collect and analyze data on the health
and health care of women with and at risk for diabetes.
F4. Presentation on Surveillance Findings on Women’s Health: Cosponsors of
the Initiative (CDC)
Example: CDC will analyze data on quality of care for women with or at
risk for diabetes and present such surveillance findings during a plenary or
concurrent session at the Division of Diabetes Translation’s national conference
(2008).
F5. Pilot Programs and Surveillance Data on Health: Cosponsors of the
Initiative (CDC)
Example: CDC, in collaboration with the Chronic Disease Directors, will
develop pilot programs with state DPCPs to collect and analyze data on the
health and health care of women with or at risk for diabetes.

F6. Surveillance of Specific Needs of Women with Diabetes: Cosponsors and
Partner Organizations
Example: Cosponsors and Partners (e.g., American Heart Association) with
direct or indirect access to data sets from long-term epidemiological studies of
cardiovascular disease (CVD), clinical trials to prevent CVD (e.g., the Women’s
Health Initiative), or other health care populations could undertake or sponsor
analyses of such data sets to provide information on prevalence and incidence of,
and trends in, myocardial infarction among women with and at risk for diabetes.
A report could be produced that describes the unique needs of these women and
makes specific recommendations for action.
For more information about the National Public Health Initiative on Diabetes
and Women’s Health, please visit our Web page at: www.cdc.gov/diabetes/
projects/women.htm.

Women &
Diabetes
TAKE CHARGE. FOR LIFE.

For more information, contact
CDC’s Diabetes Program
Phone toll-free: 800-CDC-INFO
(800-232-4636)
Email: [email protected]
www.cdc.gov/diabetes/projects/women.htm
CS115489