ccpd presentation 11 4 2011
TRANSCRIPT
Integrating to Improve Chronic Disease Outcomes
Prevention Services Division
CCPD Review Committee November 4, 2011
Jason Vahling, Director of the Healthy Living and Chronic Disease Prevention Branch
Today’s Purpose
To describe:• How integration supports achieving positive
health outcomes in Colorado• Discuss the Chronic Disease Prevention
Planning Process
PSD shares responsibility with state and local partners for improving health-related quality of life for all Coloradans by preventing and postponing chronic disease and its complications.
Purpose
• Comprehensive Cancer• Diabetes• Heart Disease and Stroke• Oral Health• Tobacco• Obesity, physical activity and nutrition• *Breast and cervical cancer screening• *Colorectal cancer screening• *Chronic disease self-management
Department’s CDC Chronic Disease Initiatives
Continuum of ‘Working Together’
Cooperation Coordination,Collaboration
Integration
Increasing trust, time, dependence, relinquishing turf
47
39
33
2429
15
28
45
56 54
19
51
40
24
0
10
20
30
40
50
60
70M
onit
or
Ed
uca
te
Par
tner
ship
s
Po
licy
Lin
k
Wo
rkfo
rce
Eva
luat
e
pe
rce
nt
PSD State
National Public Health Performance Standards Assessment - 2005
Integration
• Formal reorganization - Prevention Services Division
• Consolidated all evaluation and epidemiology functions into a new branch
• Due to funding from A35 (~$50M/yr), began consolidating grants process
• Created informal teams on crosscutting issues, including health disparities and training
Underlying principles
• Use a comprehensive, strategic, holistic approach to achieve specific health outcomes
• Be data driven - what/where/who to focus on• Move toward increased use of evidence-based
practices and programs
Underlying Principles (cont’d.)
• Focus on heath disparities and social determinants
• Be more accountable to demonstrating health outcomes
• Maintain program-specific content experts
Why Integrate?
• Efficiency: To promote streamlined business processes
• Effectiveness: Preventing and reducing chronic disease is a complex problem requiring the efforts of many different programs working together
• Elegance: Chronic disease programs are designed to work at the intersection of many different systems
A Chronic Disease System Dynamics Map
Smoking
Obesity
Secondhandsmoke
Healthinessof diet
Extent ofphysical activity
Psychosocialstress
Diagnosisand control
CV events & lung cancers
Deaths
Access to and marketingof smoking quit products
and services
Access to andmarketing of mentalhealth services
Sources ofstress
Access to healthyfood options
Marketing & educ’naround healthy food options
Access to physicalactivity options
Marketing of physicalactivity options
Access to andmarketing of weightloss services
Access to andMarketing ofprimary care
Particulate airpollution
Utilization ofquality primary
care
Tobaccotaxes
Sales/marketing regulation
Smoking bans at workand public places
Junk food taxes
Sales/marketingregulations
Downwardtrend in CV
event fatality
Quality of primarycare provision
Anti-smokingsocial marketing
High BP
Highcholesterol
Diabetes
Morbidity
Screening forchronic disease
Chronic disease management
Oral diseases
Colorectal cancers
Breast cancers
COPD
What’s Common?
• Targeting same populations – low income, racial/ethnic and medically underserved
• Working through the same “channels” – communities, schools, health care providers, worksites
• Working with many of the same partners• Working with many people have multiple risk
factors
CDC Integration Demonstration Project
• Offered potential to remove external barriers• Provided visibility within Department• Created external products and deadlines
Cover this blue placeholder with your program logo
How We Got Here
• Developed mission, vision and health outcomes
• Conducted, coordinated strategic planning
• Submitted single work plans and reports
• Aligned and assigned resources for each goal
Cover this blue placeholder with your program logo
Health Outcomes
• Maintain prevalence of obesity among adults• Increase prevalence of healthy weight - youth and
children• Reduce prevalence of smoking - adults and youth• Reduce secondhand smoke exposure• Increase smoking cessation attempts
Cover this blue placeholder with your program logo
Health Outcomes (cont’d.)
• Increase prevalence of recommended physical activity - adults, youth, children
• Increase fruit and vegetable consumption • Increase screening and early detection – pap test,
colonoscopy, mammography, lipid testing, smoking cessation, weight management
• Increase participation in chronic disease self-management
Policy and Environmental Change Strategies
• Primarily tobacco use, physical activity and nutrition initiatives
• Healthy communities• Oral health• Policy and legal analysis
Links with Healthcare Systems and Practices Strategies
• Primarily cancer, diabetes, heart disease, stroke, oral health and smoking cessation initiatives
• Focus on screening, disease self-management and health systems change
Health Communications, Health Equity and Evaluation
Strategies
• Centralizing cross-cutting functions to better serve all initiatives – Media relations, marketing, written communications
and communications technology– Language services– Social determinants of health– Resource development– Coordinated surveillance and evaluation
Fiscal and Operations
• Incoming grants management, contract services and procurement, monitoring and fiscal support
• Coordinates outgoing grant programs, including Amendment 35 (State tobacco tax)
Benefits of Integration
• Brings categorical programs together to improve health outcomes
• Facilitates the strategic alignment of resources to maximize mutual benefits and opportunities
• Increases the effectiveness and efficiency of individual programs
• Protects the integrity of categorical program objectives
Lessons Learned from Integration
• Is a process, not a point in time event• Focuses limited resources on most pressing
public health issues• Provides more flexibility to respond to emerging
issues• Elevates focus on key winnable battles• Makes sense when approached by sector
Integration
Next Steps in PSD
• Integration in the Division and Department• Winnable Battles • Division Priorities
CDC Coordinated Chronic Disease Program
• Senate 2011 budget:
– Proposed collapsing 5 chronic disease lines into one grant program
• President’s Proposed FY 2012 budget:
– Puts 8 chronic disease lines into a grant program
CDC Coordinated Chronic Disease Program (cont’d.)
• Develop a state chronic disease plan & establish a statewide coalition of partners
CDC’S EXPECTATIONS OF STATESCDC’S EXPECTATIONS OF STATES
QUESTIONS?
