Integrating to Improve
Chronic Disease Outcomes
Prevention Services Division
CCPD Review Committee November 4, 2011
Jason ...
Today’s Purpose
To describe:
• How integration supports achieving positive
health outcomes in Colorado
• Discuss the Chron...
PSD shares responsibility with state and local
partners for improving health-related quality of life
for all Coloradans by...
• Comprehensive Cancer
• Diabetes
• Heart Disease and Stroke
• Oral Health
• Tobacco
• Obesity, physical activity and nutr...
Continuum of ‘Working Together’
Cooperation Coordination,
Collaboration
Integration
Increasing trust, time, dependence, re...
47
39
33
24
29
15
28
45
56
54
19
51
40
24
0
10
20
30
40
50
60
70
Monitor
Educate
Partnerships
Policy
Link
Workforce
Evalua...
Integration
• Formal reorganization - Prevention Services
Division
• Consolidated all evaluation and epidemiology
function...
Underlying principles
• Use a comprehensive, strategic, holistic approach
to achieve specific health outcomes
• Be data dr...
Underlying Principles
(cont’d.)
• Focus on heath disparities and social
determinants
• Be more accountable to demonstratin...
Why Integrate?
• Efficiency: To promote streamlined business
processes
• Effectiveness: Preventing and reducing chronic
di...
A Chronic Disease System Dynamics Map
Smoking
Obesity
Secondhand
smoke
Healthiness
of diet
Extent of
physical activity
Psy...
What’s Common?
• Targeting same populations – low income,
racial/ethnic and medically underserved
• Working through the sa...
CDC Integration
Demonstration Project
• Offered potential to remove external barriers
• Provided visibility within Departm...
How We Got Here
• Developed mission, vision and health
outcomes
• Conducted, coordinated strategic planning
• Submitted si...
Health Outcomes
• Maintain prevalence of obesity among adults
• Increase prevalence of healthy weight - youth and
children...
Health Outcomes (cont’d.)
• Increase prevalence of recommended physical activity
- adults, youth, children
• Increase frui...
Policy and Environmental
Change Strategies
• Primarily tobacco use, physical activity
and nutrition initiatives
• Healthy ...
Links with Healthcare Systems
and Practices Strategies
• Primarily cancer, diabetes, heart disease, stroke,
oral health an...
Health Communications,
Health Equity and Evaluation
Strategies
• Centralizing cross-cutting functions to better serve all
...
Fiscal and Operations
• Incoming grants management, contract services
and procurement, monitoring and fiscal support
• Coo...
Benefits of Integration
• Brings categorical programs together to improve
health outcomes
• Facilitates the strategic alig...
Lessons Learned from
Integration
• Is a process, not a point in time event
• Focuses limited resources on most pressing
pu...
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...
CDC Coordinated Chronic
Disease Program (cont’d.)
• Develop a state chronic disease plan &
establish a statewide coalition...
CDC’S EXPECTATIONS OF STATESCDC’S EXPECTATIONS OF STATES
QUESTIONS?
THANK YOU!
Jason Vahling
Branch Director
303-692-2578
Jason.vahling@state.co.us
Ccpd presentation 11 4 2011
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  • This chart from Dr. Friedan at the CDC shows the rationale behind focusing on policy and environmental change initiatives. We know that the most significant impacts on health are socioeconomic factors – the Social Determinants of Health. The next level of the pyramid encompasses the kinds of change we have been focused on. Data shows that changing the context to make the healthy choice the easy choice has a larger impact on population-level health outcomes than more targeted, individual interventions. In an era of limited funding, it is a more cost-effective strategy for improving population outcomes.
  • [
  • That ends our formal presentation. We’re happy to answer questions about the integration effort. You can ask a question by…
  • Ccpd presentation 11 4 2011

    1. 1. 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
    2. 2. Today’s Purpose To describe: • How integration supports achieving positive health outcomes in Colorado • Discuss the Chronic Disease Prevention Planning Process
    3. 3. 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
    4. 4. • 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
    5. 5. Continuum of ‘Working Together’ Cooperation Coordination, Collaboration Integration Increasing trust, time, dependence, relinquishing turf
    6. 6. 47 39 33 24 29 15 28 45 56 54 19 51 40 24 0 10 20 30 40 50 60 70 Monitor Educate Partnerships Policy Link Workforce Evaluate percent PSD State National Public Health Performance Standards Assessment - 2005
    7. 7. 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
    8. 8. 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
    9. 9. Underlying Principles (cont’d.) • Focus on heath disparities and social determinants • Be more accountable to demonstrating health outcomes • Maintain program-specific content experts
    10. 10. 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
    11. 11. A Chronic Disease System Dynamics Map Smoking Obesity Secondhand smoke Healthiness of diet Extent of physical activity Psychosocial stress Diagnosis and control CV events & lung cancers Deaths Access to and marketing of smoking quit products and services Access to and marketing of mental health services Sources of stress Access to healthy food options Marketing & educ’n around healthy food options Access to physical activity options Marketing of physical activity options Access to and marketing of weight loss services Access to and Marketing of primary care Particulate air pollution Utilization of quality primary care Tobacco taxes Sales/marketing regulation Smoking bans at work and public places Junk food taxes Sales/marketing regulations Downward trend in CV event fatality Quality of primary care provision Anti-smoking social marketing High BP High cholesterol Diabetes Morbidity Screening for chronic disease Chronic disease management Oral diseases Colorectal cancers Breast cancers COPD
    12. 12. 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
    13. 13. 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
    14. 14. 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
    15. 15. 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
    16. 16. 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
    17. 17. Policy and Environmental Change Strategies • Primarily tobacco use, physical activity and nutrition initiatives • Healthy communities • Oral health • Policy and legal analysis
    18. 18. 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
    19. 19. 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
    20. 20. Fiscal and Operations • Incoming grants management, contract services and procurement, monitoring and fiscal support • Coordinates outgoing grant programs, including Amendment 35 (State tobacco tax)
    21. 21. 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
    22. 22. 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
    23. 23. Integration
    24. 24. Next Steps in PSD • Integration in the Division and Department • Winnable Battles • Division Priorities
    25. 25. 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
    26. 26. CDC Coordinated Chronic Disease Program (cont’d.) • Develop a state chronic disease plan & establish a statewide coalition of partners
    27. 27. CDC’S EXPECTATIONS OF STATESCDC’S EXPECTATIONS OF STATES
    28. 28. QUESTIONS?
    29. 29. THANK YOU! Jason Vahling Branch Director 303-692-2578 Jason.vahling@state.co.us

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