National Diabetes Education Program

Healthy People 2010

Glaucoma Education Continues

Low Vision Education Program

Studies on Hispanic Health

Hispanic Community Initiative

National Diabetes Month

NEHEP on Web

The National Eye Health Education Program is coordinated by the National Eye Institute, National Institutes of Health, Public Health Service, U.S. Department of Health and Human Services. This administrative document may be reprinted without permission.

Hispanic Outreach

How NEHEP Partners Communicate with the Hispanic Community

With the special needs of the Hispanic community, providing information about the dangers of diabetic eye disease can be challenging. But three partners in the National Eye Health Education Program (NEHEP) are meeting the task.

Outlook spoke with representatives of these organizations about steps they take to reach out to the Hispanic community about diabetic eye disease. We talked with Rosie Perez, president of the Hispanic Nurses Association (Houston Chapter); Gwen Gallegos of the National Association of Hispanic Nurses; and Sonia Ruiz, Program Coordinator for the Latino Children's Health Insurance Initiative of the National Council of La Raza.

Speak the Language

According to Rosie Perez, the most effective strategy for reaching the Hispanic population is communicating in Spanish. "When you speak their language, it makes it easier to get your message across," she said. "People in the community like to see their own faces look back at them. It is important to talk with people on a personal level. Most of the Hispanic nurses in our Association are bilingual. They have contact with several different community-based organizations, so every time we hold a vision screening we drop off flyers to these neighborhood agencies. They in turn let people know where the screenings will be."

Perez said one of the special needs of the Hispanic community "is the need for information. Sometimes the community feels left out of the loop or that certain screenings that are held in certain areas are for populations that exclude them. That's why it is important to have people who speak Spanish at the screenings." Perez said that at the vision screenings, "we explain the difference between a vision screening and a dilated eye exam and the importance of detecting diabetic retinopathy. We strongly encourage everyone at the vision screening to get a dilated eye exam every year, particularly if they have diabetes. If a vision screening finds a problem, we make a referral for that person to get a dilated eye exam."

Perez said her group coordinated a vision screening for a Vietnamese community, "and even though Hispanic nurses conducted the vision screening, we had Vietnamese volunteers translating for us. Communication is the real key, and having people there on-site who speak the language and pass on information is crucial."

Gwen Gallegos emphasized the importance of bilingual education. "A lot of our patients and clients may speak English, but their first language is Spanish, so we always need bilingual information," she said.

Ties to the Community

Sonia Ruiz said a key to working successfully in the Hispanic community is trust. "Latinos want to see people who have earned their respect and trust and will keep information private," she said. "A key component is being an established community organization where people can go and know they are safe."

Ruiz offered a twist about speaking Spanish in the Latino community. "Being fluent in Spanish is not enough," she said. "It's important that you know the lingo. Even though people may speak Spanish, different communities have different lingoes. It is important that community workers come from the community and know and understand the lingo in the community."

Gallegos said her organization works with "promotoras," or "promoters of health." Promotoras are lay health workers--women who live in the rural areas and know the area and the people. Working with health care professionals throughout the Southwest, promotoras canvas the community and give out health information at health fairs and at senior citizen centers. "We also give information on diabetes to school children so they can take it home to their parents," Gallegos said. "Hopefully we can fuel some interest, and parents can then follow up by seeking out more information.

"Hispanic people tend to stay within their community if they are not English-speaking or if English is not their primary language," Gallegos said. "They don't go to the big health centers or the hospitals. We get information into the community through lay health workers, who distribute the information and educate people in their homes, community centers, food banks--wherever people go."

Form Collaborations

Ruiz said the National Council of La Raza is forming coalitions throughout the United States with the approximately 227 community-based organizations through which the Council is affiliated. The Council is also encouraging several community-based organizations to form coalitions so together they can address the issue of diabetes in their communities. "When these groups work together, they've established a coalition that helps each other out," Ruiz said. "When they do outreach on the streets or a presentation or workshop, more than one organization is behind the effort." Ruiz said some community groups the National Council of La Raza has helped bring together include three Los Angeles-area organizations: Altamed Health Services Corporation, the East Los Angeles Mental Health Services, and the Multi-Cultural Area Health Education Center.

Yanira Cruz Gonzalez of the National Association of Hispanic Nurses leads a Diabetes Coalition workshop in El Paso, Texas.

Ruiz said the Council offers training to community-based organizations about diabetes. "We train the trainers, so they in turn talk to the community about diabetes," she said. "That's one of our links to the community."

Gallegos said a goal of the National Association of Hispanic Nurses is to increase awareness within the Hispanic community and among other professionals about diabetes and related complications, including diabetic eye disease. "It's important for us to form collaborative associations with other professionals to provide the services needed by our clients to maintain their health," she said. As an example, Gallegos said her employer, Carondelet Holy Cross Hospital, has collaborated with the Arizona Ophthalmological Society, the University of Arizona, and the local Lions Club to provide free dilated eye exams for persons with diabetes. "We've held these exams during November--National Diabetes Month--since 1996," she said.

Gallegos is excited about the Santa Cruz Collaborative Diabetes Project, a collaborative, bilingual, and bicultural education program available to all persons in Arizona's Santa Cruz County. "The goals of the project are to provide early detection, prevention, treatment, follow up, and referral for acute complications of diabetes for all persons in the community," she said. "The project offers and promotes cost-effective, quality diabetes services in a variety of community settings. We want to promote better health among the community and delay, if not prevent, the serious complications of diabetes through education and healthy lifestyle changes."

Other partners in the Santa Cruz Collaborative Diabetes Project are community health and education centers and the University of Arizona. The project is funded by the Health Resources and Services Administration's Office of Rural Health Policy, which earmarks Federal funds for diabetes education in rural areas. "This is our second year," Gallegos said, "and through this project, we provide diabetes education and information to the community free of charge."

Gallegos said the Santa Cruz Collaborative Diabetes Project receives referrals from physicians for people who have diabetes, "and we present diabetes education sessions consisting of five classes. One of our sessions deals with avoiding complications, including diabetic retinopathy. We stress that everyone with diabetes should have a dilated eye exam every year. Many people then go back to their primary care providers and request a referral if they have insurance. If they don't have insurance, we try to assist them with funding so they can receive a dilated eye exam."

Community Outreach

Ruiz said that when speaking to the community, it is important to hear people's questions and concerns. "Material should be presented on a step-by-step basis," she said. "Give people a simple explanation of diabetic eye disease. Make sure the information is presented on a personal level and relates to them."

A diabetes education workshop, part of the Santa Cruz Collaborative Diabetes Project--San Diego, California.

Ruiz said another strategy for reaching Hispanics is tying vision screening into community events, such as a health fair or movie nights for the youth. "It's better to have a teen educator speak to the youth," she said. "It empowers teens so they can be the role models and leaders and explain to other teens about diabetes."

Many times the Hispanics depend on annual community health fairs for their sole yearly checkup, according to Ruiz. "Organizations will bring their cholesterol and diabetes screening and that's it," she said. "There has to be some consistency, a way to follow up. Fortunately, this is where case managers and social workers can perform community outreach."

Perez said the Hispanic Nurses Association (Houston Chapter) visits nonprofit agencies, churches, and schools to inform the community about where people can get different health screenings at no cost. The organization also participates in the Houston/Hispanic Forum Career Day and the American Diabetes Association Walktoberfest. "During National Diabetes Month, we tie in vision screenings with some of the other programs we have, such as glucose testing," Perez said. "We go to strip malls or multi-purpose/community centers or apartment complexes--all in areas we identify that are predominantly Hispanic.

"The big event this year was the Hispanic Health Coalition Health Expo for the National Council of La Raza held in late July," Perez said. "The National Council of La Raza brought its 1999 annual conference to Houston, and there were over 15,000 participants. "We opened the health fair up to the Houston community and invited everyone, not just Hispanics. We offered glucose testing and vision screening, and educated thousands of people."

Gallegos said Hispanics who live in rural areas have limited access to health care. "The University of Arizona has a mobile clinic that goes to Nogales, about 60 miles from Tucson, and performs diabetic retinopathy exams for persons with diabetes free of charge," she said. "This is a way to increase community access to health care."

Educational Materials

Perez said organizations, such as the National Eye Institute, have been helpful in providing materials in an easy-to-read bilingual format and at low or no cost. "While people wait to receive a vision screening, they watch a video we obtained at no cost that explains the importance of vision screening and serious eye conditions," Perez said.

Gallegos said she gives the NEHEP's Ojo Con Su Visión brochure to her patients. "The information in it is excellent," she said. Gallegos also uses the Educating People With Diabetes kit, "where I get much of my educational material. This year I'm sending a kit to every U.S. chapter president of the National Association of Hispanic Nurses so they can provide this information to their members."

For more information, contact Rosie Perez of the Hispanic Nurses Association (Houston Chapter) at 713-794-0068; Gwen Gallegos of the National Association of Hispanic Nurses at 520-291-0253; or Sonia Ruiz of the National Council of La Raza at 202-776-1721.

The National Diabetes Education Program

The National Diabetes Education Program (NDEP), a federally sponsored initiative, is aimed at improving the treatment and outcomes for people with diabetes and promoting early diagnosis. Launched in June 1997, the NDEP is jointly sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention.

"Our goal is to reduce the morbidity and mortality associated with diabetes and its complications," said Joanne Gallivan, director of the National Diabetes Education Program for NIH. "Scientific evidence demonstrates that much of diabetes' morbidity and mortality can be prevented or delayed by normalizing blood glucose levels through aggressive treatment. This treatment can include diet, exercise, routine blood glucose monitoring, and new pharmacology approaches."

Gallivan said that "public awareness about diabetes is very low, despite the fact that the disease is one of the leading causes of death and disability in the United States. Diabetes affects an estimated 16 million Americans, including 5.4 million who are undiagnosed." Gallivan said the NDEP's audiences include people with diabetes and their families, with particular emphasis on minority populations; health care providers; the public; and health care payers and policymakers.

According to Gallivan, the objectives of the National Diabetes Education Program are to

• Increase public awareness of the seriousness of diabetes, its risk factors, and potential strategies for preventing diabetes and its complications.
• Improve understanding about diabetes and its control and promote better self-management behaviors among people with diabetes.
• Improve health care providers' understanding of diabetes and its control and promote an integrated approach to care.
• Promote health care policies that improve the quality of and access to diabetes care.

Gallivan said the NDEP has developed and implemented ongoing diabetes awareness and education activities. In June 1998, the NDEP launched its first public awareness campaign, Control Your Diabetes. For Life. "Identifying and disseminating educational tools and resources, including those that address the needs of special populations, is a crucial part of the program and one that is receiving special attention. Public service announcements and materials have been developed to tailor the campaign's message for African Americans, Hispanic Americans, American Indians, Asian Americans, Pacific Islanders, seniors, and general audiences.

"The NDEP is forming partnerships with organizations concerned about diabetes and the health status of their constituents," Gallivan said. "Organizations can work with the National Diabetes Education Program in a variety of ways. The NDEP's messages can be adopted and tailored to a specific group. Organizations can team up to help promote integrated approaches to diabetes care. Information can be disseminated, activities can be coordinated, and resources can be shared. The NDEP's "how-to" guide, Diabetes: A Guide for Communities, includes ideas, tools, and interventions for implementing community partnerships and diabetes activities."

To learn more about the National Diabetes Education Program, contact Gallivan at the National Institute of Diabetes and Digestive and Kidney Diseases at 301-496-3583 or visit the website at http://www.ndep.nih.gov. To order NDEP materials, call 800-438-5383.

Healthy People 2010

Our Nation's Health Initiative Recognizes
the Importance of Vision Health

In an effort to put vision on the public health agenda, a chapter recognizing the importance of vision to the health of Americans has been added to Healthy People 2010, a national health promotion initiative that identifies opportunities to improve the health of all Americans.

According to the Healthy People 2010 document, the new chapter on vision and hearing "is devoted to recognizing the needs and addressing the multiple challenges posed by the loss or impairment of the critical senses of vision and hearing." The chapter on vision also speaks to the importance of hearing loss to the health of Americans.

Since 1979, when the first set of national health targets was published, the U.S. Department of Health and Human Services has used health promotion and disease prevention objectives to improve the health of the American people. The second set of health initiatives, called Healthy People 2000, did not emphasize visual impairment issues within a separate chapter.

"The inclusion of the vision objectives in Healthy People 2010 represents the public health establishment's recognition that vision is a critical health priority," said Suzanne Gedance, Senior Vice President of Prevent Blindness America. "Public health agencies throughout the country use the Healthy People program to establish annual programs and resource allotments. The new vision and hearing chapter in Healthy People 2010 elevates eye health as a critical part of caring for our communities."

The new vision objectives in Healthy People 2010 address visual impairment due to diabetic retinopathy, refractive errors, cataract, and glaucoma. The chapter also discusses visual impairment in children, vision screening for children, and vision rehabilitation services and devices. Other topics include dilated eye exams, occupational eye injuries, and protective eyewear.

According to Healthy People 2010, the national objective on vision and hearing is to "improve the visual and hearing health of the Nation through early detection, treatment, and rehabilitation, and through the timely dissemination of information that will promote health and prevent disease and injury." The document states that "in children, visual impairment is associated with developmental delays and the need for special educational, vocational, and social services. In adults, visual impairment is associated with loss of personal independence, decreased quality of life, and difficulty maintaining employment. For older adults, visual problems have a negative impact on quality of life, equivalent to that of life-threatening conditions such as heart disease and cancer."

Glaucoma Education Continues After Awareness Month

From The Bronx, New York, to Safford, Arizona, the hundreds of national and community organizations that participated in the second annual Glaucoma Awareness Month in January 1999 continue to spread the word about this debilitating eye disease.

"It doesn't stop in January," said Alice Kelsey of Prevent Blindness America, one of the 30 National Eye Health Education Program (NEHEP) Partnership organizations that sponsored Glaucoma Awareness Month. According to Kelsey, Prevent Blindness America affiliates in 43 local offices last year screened 1.2 million people for eye disorders, including glaucoma. "Our members are always looking to educate the public about glaucoma and help reach people at elevated risk," she said.

As part of its ongoing awareness campaign, Prevent Blindness America will release a new patient support video about glaucoma later this year. In July, the organization conducted education and screening at "Taste of Chicago," a city festival that attracted thousands. "We enjoyed great visibility there and spread the word," Kelsey said.

Glaucoma occurs when the normal fluid pressure inside the eye increases progressively, leading to optic nerve damage and reduced peripheral (side) vision. Although it is a leading cause of irreversible vision loss in the United States, early detection and treatment can control it before it causes severe vision loss or blindness.

Because many of the more than 60 million people at risk for the disease are unaware of the importance of early detection, glaucoma education outreach is a key prevention strategy for the National Eye Institute (NEI) and the NEHEP Partnership. People at high risk for glaucoma are African Americans aged 40 and older, everyone 60 and older, and people with a family history of the disease.

According to the NEI, in 1999 more than 9,000 Glaucoma Awareness Month kits were distributed through NEHEP Partnership organizations and community-based organizations, a 55-percent increase over the number of kits distributed the year before. In addition, more than one million glaucoma brochures and bookmarks were distributed. A description of some of the community-based efforts follows.

• Lighthouse International's Staten Island, New York, chapter worked with Staten Island University Hospital to provide a glaucoma presentation, a video, and referrals for glaucoma screenings.
• The Chi Eta Phi Sorority, Delta Chi Chapter, Bronx, New York, worked with the Glaucoma Foundation, local eye professionals, and a senior center to hold a screening and education day at the center.
• Crown Jewels, a Charlotte, North Carolina, chapter of The Links, Inc. (a national service organization), distributed more than 7,000 glaucoma brochures at 25 historically Black churches.
• The Hispanic Nurses Association and St. Joseph Hospital in Houston, Texas, provided a Healthy Living Mobile Unit for glaucoma screenings, as well as referrals and transportation to eye care professionals.
• The Oregon Academy of Ophthalmology held a screening day at the State House in Salem.
• The Lions Club in Safford, Arizona, provided transportation to glaucoma screenings and sponsored an awareness lecture and film.
• Grant Vision Care, an optometrist center in Cuyahoga Falls, Ohio, offered free screenings and seminars to local community groups.

Businesses spread the message on glaucoma awareness, too. Patricia Kidd of CIBA Vision Corporation, a contact lens company in Duluth, Georgia, said several ophthalmologists and optometrists on staff conducted free glaucoma screening exams for employees and their families.

"We were pleased with the response," Kidd said. "Almost all of the people who signed up participated in the awareness activities, and that usually doesn't happen." Kidd said employees and their families may get another chance to learn about glaucoma when the company holds a health fair this fall.

John Whitener of the American Optometric Association (AOA) said his organization continues to encourage its 30,000 members to reinforce the message that people at risk for glaucoma should have their eyes examined. At the annual congress held this June, AOA members saw well-placed exhibits on glaucoma and diabetes. Next March, during "Save Your Vision" week, Whitener said members will take part in a national campaign to educate Americans about eye diseases, including glaucoma.

"We had about 86 percent of our members who signed up for the program say that the awareness month helped them open up discussions with their patients about glaucoma, its risks, and prevention," Whitener said. He added that 81 percent of those who answered the AOA activities survey said that they would participate again next year.

Marilyn Merz of the Lions Eye Health Program, part of the Lions Clubs International Foundation, said that local clubs "continually promote glaucoma awareness" and the message for people to "save their sight." Information about Glaucoma Awareness Month appeared in the LION Magazine, LEHP into Action newsletter, and on the organization's website. "From the response we are getting, it appears the clubs took the information supplied by NEHEP, went into the communities, and adapted the information to get the word out at a local level," Merz said. "It has given local Lions across the country a chance to link with the national organization and play an active role in getting the message out to people at risk."

One Lion who got the word out was Byron Guenthner of Laurel, Montana. "The key thing out here in Montana is to make sure that members have the tools to work with," he said. Glaucoma outreach activities in Laurel and eastern and central Montana included articles in the local newspaper, flyers in drug stores, and pamphlets in health clinics, libraries, and senior citizen centers. "I don't leave any stone unturned," Guenthner said. To promote glaucoma awareness throughout the year, Guenthner said that about a dozen regional Lions Clubs would continue distributing materials and take the campaign into several American Indian reservations in the state.

Guenthner noted one obstacle: some local ophthalmologists were reluctant to perform screenings because of liability issues. He said that the solution might be for ophthalmologists to offer discount coupons in the newspaper for eye exams. "It's a relatively new health area for us out here," he said. "We are making progress and looking forward to more outreach next year."

October Launch Set for Low Vision Public Education Program

Recognizing that low vision interferes with an individual's ability to perform daily routine activities and is a growing health concern, the National Eye Health Education Program (NEHEP) is launching a low vision public education program to inform people about the services and devices available to assist people with low vision. The kick-off for the Low Vision Public Education Program is set for October 19, 1999, at the National Press Club in Washington, DC.

"Many people feel there is nothing they can do about their low vision and their inability to perform routine tasks, such as read or cook," said Rosemary Janiszewski, director of the NEHEP. "The Low Vision Public Education Program hopes to reach the 13 million Americans with low vision with a simple message: Help is available."

Low vision is broadly defined as a visual impairment that is not correctable by standard eye glasses or contact lenses and interferes with an individual's ability to perform daily activities, such as reading the newspaper, preparing meals, or recognizing faces. The inability to see well affects functional capabilities and social interactions and can lead to a loss of independence. The impact of low vision on quality of life can be devastating.

"We hope the campaign will replace the notion that low vision is a normal part of the natural aging process with a message of hope," Janiszewski said. "We want to stress that there is help for people with low vision. There are many services and devices, such as magnifiers and hand-held scanners, that allow people with low vision to maintain their independence. Minor home modifications can make a big difference in daily living. Visual rehabilitation may help improve quality of life."

Alberta Orr, chairperson of the National Aging Program at the American Foundation for the Blind, voiced strong support for the public education program on low vision. "Older people and their family members need to know that a low vision evaluation, instruction in the use of low vision optical and nonoptical devices, and follow-up care can make a significant difference in the daily functioning of older Americans experiencing vision loss," she said.

"The NEHEP Low Vision Education Program is an important vehicle to help people with eye wellness," said Carmel Kang, disability specialist with the American Association of Retired Persons. "Early detection and getting the help we need is an important part of enhancing the quality of our lives and our independence."

Janiszewski said the primary audience for the program is people over the age of 65 who have decreased visual function. "We also intend to reach individuals who may experience vision loss at an earlier age, especially African Americans and Hispanics," she said. "Secondary audiences include family and friends, members of the aging network, professionals who work with older adults, and social workers."

An educational, large-print brochure describing low vision and its causes will be available. The brochure provides guidance for people with low vision on how to maximize their remaining sight. The brochure will also be available in audio and video.

The Low Vision Public Education Program will be launched with a nationwide consumer media campaign. "Americans use a variety of media to get news and other information," Janiszewski said. "We are developing public service announcements (PSAs) for print, radio, and television focusing on the message that help is available for people coping with low vision." The media campaign will also

• Encourage the publication of human interest stories about people coping with low vision in small community newspapers.
• Support momentum by publicizing developments in low vision research and treatment.

The program will educate health professionals about rehabilitation resources, information services, and assistive devices that are available for their patients with low vision. "Our plans for reaching health professionals include making presentations at professional meetings and/or exhibiting at professional conferences, writing articles and editorials for professional journals, and producing a variety of resources that can be used in clinics and community settings," Janiszewski said.

A major feature of the Low Vision Public Education Program is a traveling exhibit. This exhibit will travel to various shopping malls around the country starting in 2000. "The traveling exhibit will help educate people with low vision on the services and visual aids that can help in maintaining independence and quality of life," Janiszewski said. "Visitors can use the multimedia touchscreen program and view a display of vision aids that can help a person with low vision perform routine tasks, such as reading or cooking. The exhibit will provide a resource list of local low vision agencies and organizations, and allow on-site volunteers from local organizations to answer questions."

The Low Vision Traveling Exhibit is an important informational tool, according to Bryan Gerritsen, Low Vision Section Chairman of the Association for the Education and Rehabilitation of the Blind and Visually Impaired. "A comparison between the number of people with low vision being served by the busiest vision rehabilitation centers and the actual number of people with low vision being seen by their eye doctor makes it clear that we are only scratching the surface in identifying and serving these people," he said. "Much of this disparity is simply because most persons with low vision are not aware of what help and resources are available. The Low Vision Traveling Exhibit will help to close this gap. It will inform persons with low vision and their families about the availability of local and national services and where to get help."

Janiszewski said a special low vision section on the National Eye Institute website is planned "to promote awareness of the help available for people with low vision. A version of the Low Vision Traveling Exhibit's interactive program will be available online, extending the reach of the exhibit beyond the shopping malls and into the home. The program materials and an online order form will be placed on the website for easy download by users.

"Loss of vision can be frightening," Janiszewski said. "While there may not be anything medically that can be done for people with low vision, their quality of life can be greatly improved. The Low Vision Public Education Program seeks to emphasize that just because people don't see as well as they did before, they don't have to lose their independence."

For more information about the Low Vision Public Education Program, contact Rosemary Janiszewski at 301-496-5248.

NEI Funding Two Studies on Hispanic Health

The National Eye Institute (NEI) is supporting two large studies--The Los Angeles Latino Eye Study and the Visual Impairment Among Hispanics in Arizona Study--designed to improve understanding of eye disease and visual impairment in our country's Hispanic population. The Los Angeles Latino Eye Study is partially funded by the National Institutes of Health's Office of Research on Minority Health.

Hispanics as a racial/ethnic group stand apart from other racial/ethnic groups in terms of their population growth, socioeconomic characteristics, and health-related issues. Previous research has provided estimates of the prevalence of eye disease among Whites and African Americans in the United States, but no published comparable data exist on the U.S. Hispanic population. "The absence of data on visual impairment for the United States Hispanic population hampers the creation of appropriate eye health services," said Dr. Carl Kupfer, director of the NEI. "The findings of these two research projects will help direct appropriate manpower and resources toward the major eye health needs of a population that is traditionally underserved. With information from these studies, it may be possible to tailor eye care education and programs to the Hispanic population, one that is at increased risk for eye disease."

NIH Creates Hispanic Communications Initiative

In its efforts to improve health communication outreach to the Hispanic community in the United States, the National Institutes of Health (NIH) has developed the Hispanic Communications Initiative (HCI). The HCI will help to create a sustained, broad-ranging, and culturally appropriate NIH health communication program aimed at Hispanics living in the United States.

"The HCI is part of a Federal government effort to improve outreach and services to the rapidly growing Hispanic community," said Carlos Ugarte, the coordinator of the HCI. "There is a disparity in the health of Hispanics compared to nonminority populations in this country. The government's disease prevention and health-oriented messages are reaching some, but not all, of its citizens.

"At the NIH, there hasn't been a coordinated effort across Institutes to extend our health messages to the Hispanic community," Ugarte said. "Up to now, Hispanic outreach has been on an institute-by-institute basis. Some institutes have set up well-structured Hispanic programs, while others have an interest in creating Hispanic-related activities but are unsure of how to proceed."

Ugarte said the HCI will

• Emphasize a coordinated NIH approach for providing health information to Hispanic communities.
• Strengthen skills and capabilities across NIH for communicating with Hispanics.
• Offer coordination and advice on Hispanic communications and outreach activities planned and developed by the 25 Institutes, Centers, and Offices that make up the NIH.
• Sponsor various special projects, such as the development and implementation of a Hispanic Communications Research Agenda.
• Develop collaborative efforts with government and nongovernment entities with a goal toward improving the health of Hispanics across the United States.

Since it was created in the fall of 1998, the HCI has overseen the development of an NIH Spanish-language web page at http://www.nih.gov/welcome/hispanic and a series of Spanish-language articles developed by NIH and distributed as inserts to the national Spanish-language magazine ProSalud. For more information, contact Carlos Ugarte at 301-496-8856.

National Diabetes Month

Materials for National Diabetes Month (NDM) in November are now available from the National Eye Health Education Program. This year's materials feature a new, all-in-one resource guide containing

• Suggested activities for increasing awareness in the community and through the local media.
• Information about each of the sponsoring organizations, including program activities, publications, and state-level contacts.
• Reproducible fact sheets and materials to distribute during community activities.
• Press releases, radio scripts, and print advertisements to send to local media outlets.
• An annotated materials list and order form describing the many materials available during the campaign, including open- and closed-captioned videos and Spanish-language materials.
• Samples of the campaign brochure, bookmark, and poster, which can be ordered in bulk quantities.
• A reporting form for explaining and detailing NDM activities and providing suggestions for future campaigns.

Materials can be ordered by calling 800-869-2020; through the National Eye Institute website at http://www.nei.nih.gov; or by writing to the National Eye Health Education Program at 2020 Vision Place, Bethesda, MD 20892-3655.

NEHEP on the Web In Fall 1999, the National Eye Institute (NEI) is launching a new section on its website featuring the National Eye Health Education Program (NEHEP). This link will connect users to the NEHEP program and key public education areas, such as diabetic eye disease, glaucoma, and low vision. The NEHEP section contains information for health professionals, educators, and the public. Materials available include brochures on diabetic eye disease (in English and Spanish) and glaucoma, as well as resources for the National Diabetes Month and Glaucoma Awareness Month campaigns. "The new NEHEP section on the NEI website will make it easier for educators and health professionals to access NEHEP materials, such as the Eye-Q Tests, public service ads, and other educational resources," said Rosemary Janiszewski, director of the NEHEP. The link to the new NEHEP section can be found on the NEI website front page at http://www.nei.nih.gov.

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