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

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

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

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

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

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?

THANK YOU!

Jason VahlingBranch Director303-692-2578

Jason.vahling@state.co.us

Ccpd presentation 11 4 2011

Health & Medicine