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DocuSign Envelope ID:505DF67F-22A8-4429-B254-C31 FF4638A8F <br /> Page 7 of 9 <br /> 2. Submit performance reports that include the information listed in the Tables 1 to 5 below: <br /> Table 1: Screenings and Referral Measures Minimum Reporting <br /> Standard Frequency <br /> 1. Total number of people screened for prediabetes via community 225 Monthly, Interim <br /> and clinical methods in FY 16 and Final <br /> 2. Percent of eligible people referred to Lifestyle class series 100% Monthly <br /> 3. Percent of eligible people referred to DSME program 100% Monthly <br /> 4. Percent minority MDPP participants in community and clinical >_75% Monthly <br /> screening events <br /> Table 2: MDPP Program Measures Minimum Reporting <br /> Standard Frequency <br /> 1. Number of class series offered across region >5 Monthly <br /> 2. Number of people enrolled in MDPP class series 75 Monthly <br /> 3. Number and percentage of MDPP participants who attend>4 >50 Monthly <br /> classes in the first 6 months <br /> 4. Number and percentage of MDPP participants who attend>8 >33% Monthly <br /> classes in the first 6 months <br /> 5. Number and percentage of MDPP participants who attend>9 >25% <br /> classes in the first 6 months <br /> 6. Number and percentage of MDPP participants who attend 16 Monthly <br /> classes in the first 6 months <br /> 7. Number and percentage of minority participants in MDPP >75% Monthly <br /> Lifestyle classes <br /> 8. Number and types of incentives distributed Monthly, Interim <br /> and Final <br /> 9. Number and percentage of MDPP participants who attend a Interim and Final <br /> minimum of 4 classes and lose>5%of their baseline body weight <br /> 10. Percentage of MDPP participants who report a change in Interim and Final <br /> knowledge <br /> 11. Percentage of MDPP participants who report a change in behavior Interim and Final <br /> Table 3: Outreach Measures Minimum Reporting <br /> Standard Frequency <br /> 1. Number of people who participate in community screening events Monthly <br /> 2. Number of people who submitted clinical screenings results Monthly <br /> 3. Number of follow-up phone calls to non-compliant MDPP >2 Monthly <br /> enrollees <br /> 4. Number of follow-up emails to non-compliant MDPP enrollees >_1 Monthly <br /> 5. Number of home visits to non-compliant MDPP enrollees Monthly <br /> (optional) <br /> Table 4: Meeting and Training Measures Minimum Reporting <br /> Standard Frequency <br /> 1. Attendance and participation in mandatory monthly meetings 100% Monthly <br /> 2. Attendance in NC OMHHD trainings 100% Interim and Final <br /> Revised July 2015 <br />