Screening for diabetes in an African-American community: the Project DIRECT experience.
OBJECTIVE
To report the results of a community-based screening program associated with Project DIRECT, a multiyear diabetes mellitus prevention and control project targeting African-American residents of southeast Raleigh, NC.


METHODS
Between December 1996 and June 1999, 183 screening events took place in community settings. Screening was by capillary glucose concentration. Participants with a positive screen were referred for confirmatory testing and physician follow-up.


RESULTS
Risk factors for diabetes were prevalent, including ethnic minority race (88.2%), obesity (45.6%), and family history of diabetes (41.7%). In all, 197 personshad an elevated screening result; the prevalence of diabetes in the screened population that underwent follow-up testiing was 1.7%. Despite persistent tracking efforts, 28% of the persons with a high screening test received no final diagnosis


CONCLUSIONS
In this community-based screening program targeted to high-risk African Americans, risk factors for diabetes were common, but new cases of undiagnosed diabetes among participants were uncommon. Intensive follow-up for persons with high screening values is necessary but difficult to achieve. Our results support national recommendations against community-based screening; opportunistic screening for diabetes in clinical settings is likely a more effective use of resources.
Porterfield
Deborah S
DS
NC Department of Health and Human Services, Project DIRECT, Raleigh, NC 27599, USA. deborah.porterfield@ncmail.net
Din
Rebecca
R
Burroughs
Angela
A
Burrus
Barri
B
Petteway
Regina
R
Treiber
Linda
L
Lamb
Betty
B
Engelgau
Michael
M
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D015397:Program Evaluation; D012307:Risk Factors