Kentucky Homeplace Defeat Diabetes Screening Test: an analysis of rural Kentucky's challenge to overcome the growing diabetes epidemic.

The University of Kentucky Center for Rural Health original research note, "Kentucky Homeplace Defeat Diabetes Screening Test: An Analysis of Rural Kentucky's Challenge to Overcome the Growing Diabetes Epidemic," provides the results of a yearlong diabetes risk survey that included more than 3,000 participants in rural Kentucky. It is well known that diabetes poses serious health threats across our country. For various reasons, that is especially true in Kentucky, with rural Kentucky having the highest prevalence for the disease. From September 2002 through August 2003, lay health workers with the nationally recognized Kentucky Homeplace program distributed and processed 3,092 diabetes self-test surveys to their clients across five regions of the state to get a better picture of the diabetes epidemic. The screening test was developed as an educational and public awareness tool by the Defeat Diabetes Foundation Inc, a nonprofit organization based in Madeira Beach, FL. It was distributed to various health agencies across the country. Each survey contained 16 questions, ranging from determining participants' urinary frequency and family medical history to their age and weight. Zero, five, or 10 points were allotted depending on respondents' degree of incidence for each question. A score of 0-15 points suggested a low risk for having diabetes, 20-25 points suggested that a respondent was at medium risk and should be tested for the disease, and a score of 30 points or higher suggested that he/she was at very high risk and "should seek (a) medical evaluation right away." Several months of analysis of the data collected indicated that 74.6% of the Kentucky Homeplace clients who participated in the survey were at moderate to significant risk of having or developing diabetes, a much higher rate than the approximately 50% of Kentucky adults in the general population that previous studies indicated were at risk. While findings from the survey of more than 3,000 Kentucky Homeplace clients cannot be generalized to Kentucky's population as a whole, they further confirm other evidence indicating that diabetes will continue to be one of the most serious health threats facing the state's rural populations. The research note further offered some recommendations for curbing rural Kentucky's diabetes epidemic, including increasing the number of certified diabetes educators serving rural Kentucky, expanding lay health worker programs within the rural portions of the Commonwealth, and studying the method and effectiveness of diabetes education between physicians and patients.