CCE Cardiometabolic disorders: University of Pittsburgh

Among the center's achievements is the Group Lifestyle Balance program, which has trained more than 400 healthcare professionals, many of whom report implementing the program in their own primary care practices, hospitals, and community centers, says Executive Director Linda Siminerio, RN, PhD.

"Our philosophy is that we should be able to train a variety of healthcare professionals to implement the program in a variety of settings, including but not limited to primary care practice, with the healthcare system and the primary care doctor providing the backbone," says DPSC director M. Kaye Kramer, DrPH, CCRC.

The Diabetes Prevention Support Center also evaluates the efficacy of teleconferencing as a means of expanding team care into the primary care arena, and in July launched a telemedicine project in a rural district in western Pennsylvania. The program connects patients from local clinics with university endocrinologists via live videoconferencing.

A key goal, Siminerio says, is to enable primary care physicians to provide specialty care-even in remote communities with limited resources. "You can have physicians make all the referrals they want, but some of these people are older or disabled or poor, and they can't afford to drive to Pittsburgh," she says.

The center recently completed a pilot study using the internet-based Virtual Lifestyle Management program to encourage diabetes prevention and weight loss. Fifty patients referred by primary care physicians were provided with online coaching and progress reporting of weight loss, nutrition, and exercise.

Additionally, the institute is testing a chronic-care management team approach to patient education and treatment at Lackland Air Force Base in San Antonio, Texas. The study comes in response to a 2003 report revealing that 144,000 Air Force personnel and family members had diabetes.

Both the Group Lifestyle Balance and Virtual Lifestyle Management programs were developed with a $10 million grant from the U.S. Department of Defense.

Siminerio says the strategies developed at Lackland will provide a treatment model for military bases nationwide as well as for Pennsylvania residents.