The formation of a complex community program for diabetes control: lessons learned from a case study of Project DIRECT.

A case study was conducted of the formation of a diabetes initiative in a largely African American urban community. The study focused on how confluent the original project model was with actual formation, what benefits were produced, what areas of needed improvement surfaced, and how different stakeholder groups characterized one another's involvement. The project produced several benefits but also experienced needed improvements in its formation, which suffered from a lack of communication, cooperation, and coordination; unclear goals and personnel roles; and early delays. Lessons include treating project formation as an important developmental stage and reducing bureaucratic management approaches not suited for community partnerships.