Grant

Austin Community Foundation
Name of Organization: Watauga County Healthy Carolinians
Street Address/P. O Box: 336 Deerfield Rd,
City: Boone, NC 28607 State:NC Zip: 28607
County: Watauga
Name of contact person: Alicia Dunn
Title of contact person: Health Promotion Director
Phone number: 910-555-0123
Name of project: Diabetes Self-Management Education Program
Geographic area and/or target population served: Adults in Watauga county who
have Diabetes
Project Dates: July 31, 2017- October 16, 2017
Amount requested: $1067.82
Signature of Authorized Agency Representative: Alicia Dunn
Date: March 1, 2017
1. Organizational capacity to conduct the project (Describe Appalachian

Carolinians mission, goals, programs/services, etc.)
Appalachian Carolinians is one of the five pilots across NC that is part of the Healthy
North Carolina, which is based off the national Health People Objectives for the
Nation. The Appalachian Carolinians work with area agencies such as the District
Health Department, Social services, Project on Aging, and Health and Hunger
Coalition. Appalachian Carolinians was formed in 1992. The mission of Appalachian
Carolinians is to work to improve communication, identify, obtain, and more efficiently
distribute resources, and more effectively utilize partnerships to improve health and
quality in Watauga county. Our current priority areas are senior health, community
worksite health screenings, Womens Health Expo, school health fairs, sun safety
programs for middle school students, CPR and First Aid classes, and diabetes
management.
Appalachian Carolinians has effectively implemented SAFE Kids that is currently
being sustained, Body Recall senior exercise program at the Council of Aging, and
numerous other grants. We have also been collaborative partner with the Appalachian
District Health Department (ADHD) and assisted with the community assessment that
is conducted every four years.
2. Provide a description of the project including key strategies, timeline for
project.
Through the Diabetes Self-Management Education Program, up to 25 members of the
Watauga Community will learn how to manage their diabetes through healthier food
choices, counting carbohydrates, incorporating physical fitness into their daily lives,
and education of the disease. The program will be based on the on the Diabetes
Self-Managment Program from the CDC. This program is a multi-phased program
intervention dealing with the individuals behaviors and practices relating to the
individuals diabetic knowledge and progression of disease. This twelve week program
will be led by a health promotion professional, a current certified personal
trainer/exercise physiologist, and a registered dietitian who is certified in diabetes
education. The twelve week program is to be held on Monday and Thursday evenings
from 6:00pm-7:30pm at Watauga Medical Center Conference Room B in Boone,
North Carolina.
Pre- and Post- education test and surveys will be developed to assess health
behaviors, beliefs, knowledge, and interests of participants before and after the
program. Sessions will concentrate on healthier food choices, counting
carbohydrates, incorporating physical fitness into family life, and education of the
disease. The program is to start on July 31, 2017. The Diabetes Self-Management
Program is expected to be able to start a new cohort of classes after every twelve
weeks.
3. Describe the need that the program will address Needs Statement
Watauga County is located in The High Country of Western NC. Diabetes in the
Western Mountain Region of NC has increased by 80% since 1999. The Western
region of NC has a prevelance rate of 10.7% of the population(The Burden of
Diabetes in NC, 2010) The need for a program to help native residents of Watauga
county to learn and manage their diabetes in a correct manner is very important.
Majority of the counties native residents are suffering from impoverished conditions.
Chronic disease, such as diabetes, can come about in the rural community due to
inadequate education, lack of nutritional understanding, and lack of physical activity in
everyday life.
Due to Watauga Countys impoverished conditions many individuals are unable to
receive the proper education and resources for preventing, handling, or managing
diabetes. With this grant, Appalachian Carolinians will be able to start a program to
help assess and implement the resources and education to help decrease the risk
and increase the ability of individuals to understand and properly manage diabetes.
The program will help provide individuals who financially might not be able to receive
resources to help manage their disease. This program can help in decreasing the
health disparities among individuals with diabetes.
4. List the overall goal (s) of the program.

1. To improve the knowledge of individuals who are diabetic by proper education on
the disease itself, benefits of physical activity/exercise, and proper dietary guidelines
and nutrition and education.
2. To reduce the progression of diabetes and help decrease the risk of being
susceptibility to other chronic diseases.
5. List the objectives. These should be measurable.
1. By October 16, 2017 at least 20 participants will have completed the Diabetes
self-Management Education program.
2. By October 16, 2017 at least 85% of the participants will be able to read nutrition
labels, count carbohydrates, and how to properly check blood sugars.by using a skills
check
3. By October 16, 2017 at least 80% of the participants will increase their physical
activity to 30-60 minutes 3x a week of moderate-vigorous intensity
4. By October16, 2017 at least 95% of participants will be able to understand the
progression of diabetes by using a post- education test.
6. List the strategies you will utilize to reach the program objectives- Methods
1. Talk to Hospital administrators about the benefits of Diabetes Self-Management
Education Program
2. Identify staff members and provide the correct guidelines provided by the CDC for
the program.
3. Train the staff members
4. Create a Budget
5. Print advertisements and pre- and post-surveys and education test, develop
summative evaluation
6. Post advertisements around the hospital, community, and website
7. Plan lessons for each week between nutrition, counting carbohydrates, education,
and physical activity
8. Print educational materials and summative evaluation
9. Administer pre-survey and education test and compile data
10. Have monthly meetings with hospital administration about the progress of the
program
11. Administer post-surveys, education tests, and evaluations -collect and compile
data
12. Report success of program to Watauga Medical Center, Healthy Carolinians, and
The Austin foundation
7. State how, when, and by whom an evaluation will be conducted including any
reports that will be compiled and how the evaluation will be used for
program improvements.
Watauga Healthy carolinians and Watauga Medical Center will evaluate Diabetes
Self-Managment Education Program to determine whether it met the desired
objectives. Evaluations will include:
1. Pre- and Post- surveys to assess health behaviors, belief, and interest of the
program members before and after the program
2. Pre- and Post- education test to assess the knowledge gained during the program
3. Documentation of number of participants
4. Participant satisfaction survey
Upon the completion of the Diabetes Self-Management Education Program, a
summarative evaluation will be compiled to evaluate the overall effectiveness of the
program. The results will be reported to Watauga Medical Center by October 25, 2017
and posted on the Hospitals website.
8. Describe how your program will be continued after the funding period.
Specify source of funding and commitment of your agency Sustainability
Strategies
Each Diabetes Self-Managment Education Program participant is committed to
sustaining the program by mobilizing the community by implementing two 5Ks per
year, along with researching and writing additional grants to the National Institute of
Health, and the Centers for Disease Control and Prevention. Watauga Medical Center
will help be responsible for providing the room to hold the program in and certain
items that will be needed (some educational handouts,salaries for staff, office
supplies, brochure, and advertisements. Five thousands dollars has already been
committed by Watauga Medical Center. Appalachian State University has agreed to
help provide volunteers and interns from the Health Sciences department.
Budget Sheet
Project/program budget year (s): July 31, 2017- October 16, 2017
Total amount of request: $1067.82
Item Item cost/amount needed Total amount
In-kind salaries
Registered dietitian $20/hr 3hr/wk for 12 weeks & 6 $840
hr training/meetings (Hospital
will pay Salary)
Certified Personal $18/hr 3hr/wk for 12 weeks & $768
Trainer/Exercise Physiologist 6hr training/meetings(Hospital
will pay Salary)
Health Promotion professional $20/hr 3hr/wk for 12 weeks & $840
6hr training/meetings(Hospital
will pay Salary)
In-Kind Materials
TV/DVD player Provided by Hospital $150
Conference Room B Provided By Hospital (3hr/wk for $230
12 weeks)
Watauga Medical Center Provided by hospital
Educational Handouts
Total In-Kind Contribution $2,948
Funding Request
Pre- and Post- surveys $0.05/page; 2 pages x 25 $2.50
copies
Pre- and Post- Education Test $0.05/page; 2 pages x 25 $2.50
copies
Food Diary Record Sheets $0.05/page; 1 pages x 300 $15
copies
Blood Glucose Record Sheets $0.05/page; 1 pages x 300 $15
copies
Notebooks $1.00 each x 25 $25
Pens $5.00/per 20-pack x 2packs $10
Precise Portions Go-Healthy 1/pack $39.99(4 comes in a $319.92
Store 'N Go Travel Combo pack) x 8
Pack
The Family Classics Diabetes $19.75; 1 x 19.75 $19.75

Cookbook
ADA Himalayan Stainless $19.99 x 25 $499.75
Steel Tumbler
Choose Your Foods: Food $79.20 x 2 $158.40
Lists for Diabetes (25/Pkg)
Total requested $1067.82

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Austin Community Foundation

Name of Organization: Watauga County Healthy Carolinians

Street Address/P. O Box: 336 Deerfield Rd,

City: Boone, NC 28607 State:NC Zip: 28607

Name of contact person: Alicia Dunn

Title of contact person: Health Promotion Director

Phone number: 910-555-0123

Name of project: Diabetes Self-Management Education Program

Project Dates: July 31, 2017- October 16, 2017

Amount requested: $1067.82

Signature of Authorized Agency Representative: Alicia Dunn

Date: March 1, 2017

1. Organizational capacity to conduct the project (Describe Appalachian

4. List the overall goal (s) of the program.

The Family Classics Diabetes $19.75; 1 x 19.75 $19.75

Total requested $1067.82

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