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Coordinated Chronic Disease Prevention Program Needs Assessment Summary

The National Association of Chronic Disease Directors released a survey to all state Chronic Disease Directors and Coordinated CD Program Leads in mid-June 2012, in order to assess their needs for technical assistance and training. When the survey closed July 6, 25 states and one territory had replied.

Demographics

Several states had multiple responses, from categorical program managers, epidemiologists and evaluators, although the majority of the responses (51.1%) were from Chronic Disease Directors. A total of 48 responses were received. Most respondents (52.1%) reported working for the state health department for over ten years, yet only four respondents had been in their current position for that long.

Priorities

Respondents were asked to select their first, second and third priorities for the next year from a list of choices. Developing or updating a state plan was the first priority for 18 respondents, while 11 selected “Determining appropriate interventions/activities for each domain.” Top two choices for second priority were “Determining operational management of a coordinated program” and “Developing/updating a communications plan.” Third priority for a majority of respondents was “Developing a coordinated surveillance system.”

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Partnerships Respondents were asked about the current status of their external partnerships, and 62.6% (27) responded that they are in the process or are planning to integrate their categorical partner coalitions. One respondent reported that their state already had a fully integrated partnership group, while 12 (27.9%) reported that they did not plan to integrate coalitions but would bring partners together for specific projects. Many states reported that two or more of their categorical programs are working together on specific projects with the same external partners.

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Types of Technical Assistance

The bulk of the survey questions concerned the type of technical assistance states need and their preferred method of obtaining it. Respondents were asked to choose one of two topics for technical assistance, from three large categories: organizational issues, partner issues and activities/intervention issues. The activities/intervention issues category was further broken down by domain.

Organizational Needs

The first choice in the organizational issue category, selected by 58.1% (25) respondents was “Cross-program training and staff development.” The second choice was “Program staff issues in collaborating across chronic disease program areas.”

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Partnership Needs

With only four choices to select from in the Partner Issues category, 75.6% (34) of respondents selected “Coordinating or combining categorical coalitions.”

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Activities by Domain – Domain #1

The choices in the Activities category were broken down by domain. In the first domain, Epidemiology and Surveillance, the top choice for technical assistance, selected by 59.6% (28) or respondents was “Developing coordinated economic evaluation/return on investment reports.” Second choice was “Data collection from new sources such as electronic health records. “

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Activities by Domain – Domain #2

In the second domain, Environmental Approaches That Promote Health, the top choice was clearly “Addressing health equity/social determinants of health” with 71.7% (33) of respondents reporting a need for technical assistance on this activity.

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Activities by Domain – Domain #3

In the third domain, Health System Interventions, states were again clear about their needs with 71.7% (33) selecting “Improving staff skills to implement health care system change” as their top technical assistance need.

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Activities by Domain – Domain #4

The choices for activities in the fourth domain were also limited, and the top two choices were “Promoting chronic disease self management, including coverage and reimbursement” which was selected by 77.8% (35) of respondents, and “Promoting use of community health workers” which was selected by 68.9% (31) or respondents.

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Methods of Receiving Technical Assistance and Training

States were asked several questions about how they would like to receive technical assistance. Using communities of practice to learn from each other was selected by 89.4% (42) of respondents, although 59.6% (28) did not feel they could make use of a community of practice for at least 6 months. The most popular other methods included structured webinars, selected by 68.9% (31) and a dedicated area on the NACDD website, selected by 64.4% (29) of respondents.

Several states reported that they would be interested in sponsoring a Chronic Disease Academy in their state (41.9%). A clear majority, 91.5% (43) are somewhat comfortable using video conferencing or other methods of distance learning to receive training and technical assistance.

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment

The National Association of Chronic Disease Directors (NACDD) wants to provide you with the resources, tools, technical assistance, mentoring, and connections that will best meet your needs to build capacity in your Coordinated Chronic Disease Prevention program. Please help us by completing this brief survey so we can prioritize our activities over the next six months. We anticipate the survey taking about 15 minutes, and welcome Chronic Disease Directors (CDD) and Coordinated Chronic Disease Program Leads to take the survey, as well as categorical Program Managers and Staff as directed by their CDD.

1. What state are you from?

2. What is your current position? Please pick the position that matches yours most closely, even if it is not your exact title. "Specific" means you work in only one categorical program. "Cross­cutting" means you work in more than one or multiple programs, or you are part of the Coordinated Chronic Disease Prevention Program in your state. Please choose all that apply, e.g. Epidemiologist and Evaluator.

3. How long have you been in your current position?

State: 6

Chronic Disease Director

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Coordinated Chronic Disease Prevention Lead

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Program Manager/Coordinator (specific)

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Program Staff (specific)

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Program Staff( cross­cutting)

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Evaluator (specific)

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Evaluator (cross­cutting)

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Epidemiologist (specific)

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Epidemiologist (cross­cutting)

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Communications Specialist/Coordinator

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Policy Lead/Coordinator

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Other (please specify)

0 to 2 years

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3 to 5 years

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6 to 10 years

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10+ years

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment4. How long have you been working in the state health department?

5. Which of the following issues are your top priorities for the next year? Please select a first, second and third priority, even if you hope to accomplish more than three this year.

First Priority Second Priority Third Priority

Determining appropriate interventions/activities for each domain

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Determining fiscal management of a coordinated program

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Determining operational management of a coordinated program

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Determining which categorical programs to include in a coordinated program

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Developing a coordinated surveillance system

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Developing/updating a state plan

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Developing/updating a communications plan

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Coordinating evaluation processes

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Developing a staffing plan nmlkj nmlkj nmlkj

Hiring new staff nmlkj nmlkj nmlkj

Redesigning the chronic disease coalition/partnership to incorporate all included programs

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0 to 2 years

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3 to 5 years

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6 to 10 years

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10+ years

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment6. How would you describe your current situation regarding external partnerships or coalitions?

7. Which of the following settings are you currently working in with external partners, using a coordinated approach? (For example, two or more chronic disease programs are working with the same partner(s) on the same project.)

Currently Working In Planning to Work in Next 1­2 Years

Worksites nmlkj nmlkj

Schools nmlkj nmlkj

Communities nmlkj nmlkj

Senior Centers/Offices on Aging

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Health care systems nmlkj nmlkj

Emergency Medical System

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Rehabilitation/Tertiary Care

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None of the above nmlkj nmlkj

We have a fully integrated Chronic Disease Coalition (external partner group)

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We are moving to a fully integrated Chronic Disease Coalition and plan to have no categorical groups

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We have begun to integrate our external partner coalitions but still have several categorical groups

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We plan to maintain separate, categorical coalitions and provide opportunities to link them for specific projects or other purposes

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We are in the planning stages of partner integration

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We don't know where to start

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Other partnership format or brief description of above:

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Other (please specify)

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment8. Please select all the health topics on which you are currently working with external partners through a coordinated approach. (For example, two or more chronic disease programs are working with the same partner(s) on the same project.)

Currently Working On Planning to Work On in Next 1­2 Years

Chronic disease­related grants to local communities

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Development and/or dissemination of burden or other data­based reports

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Tobacco prevention and control

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Promoting healthy eating nmlkj nmlkj

Promoting physical activity nmlkj nmlkj

Promoting chronic disease self management

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Public awareness or health promotion messages

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Efforts to eliminate health disparities

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Efforts to reach specific population subgroups

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Efforts to address social determinants of health

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None of the above nmlkj nmlkj

Other (please specify)

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment9. Below are several possible topic areas that NACDD can provide technical assistance on, organized by type: * Organizational issues ­ how to structure a coordinated chronic disease program. * Partner issues ­ how to work with external partners. * Activities issues by Domain ­ how to conduct and evaluate cross­cutting activities to improve health outcomes. Please select one or two topics from each category that you would you like to learn more about over the next 12 months. Organizational components

Programs, unit structure and teams (Settings such as worksites/schools vs. risk factors vs. domains)

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Program staff issues in collaborating across chronic disease program areas

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Management and supervision issues as a result of increased expectations for coordination and collaboration

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Evaluation, epidemiology and surveillance staff issues including collaborating across categorical programs, management and supervision

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Working with contractors and local health departments

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Fiscal management

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Cross­program training and staff development

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Developing a state plan

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Developing a communications plan

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Other (please specify)

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment10. Please select one or two topics that you would you like to learn more about over the next 12 months. Partner components

11. Please select one or two topics that you would you like to learn more about over the next 12 months. Activities for Domain #1 (Epidemiology and Surveillance)

Coordinating or combining categorical coalitions

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Working with single issue partners

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Recruiting new partners based on new structure or focus

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Managing/staffing external partner coalitions

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Other (please specify)

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Coordinating chronic disease surveillance

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Data collection from new sources such as electronic health records

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Developing coordinated surveillance reports (burden of disease, burden of risk factors, etc.)

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Developing coordinated economic evaluation/return on investment reports

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Coordinating data communications to stakeholders

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Creating trend reports across BRFSS methodological changes

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Developing coordinated evaluation processes

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Other (please specify)

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment12. Please select one or two topics that you would you like to learn more about over the next 12 months. Activities for Domain #2 (Environmental approaches that promote health)

13. Please select one or two topics that you would you like to learn more about over the next 12 months. Activities for Domain #3 (Health system interventions)

Addressing health equity/social determinants of health

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Comprehensive approaches to improving community nutrition, including sodium and trans­fat reduction

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Comprehensive approaches to improving the school environment

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Comprehensive approaches to increasing physical activity

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Injury prevention

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Reducing tobacco use/increasing use of Quit­line

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Preventing youth tobacco initiation

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Increasing water fluoridation

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Other (please specify)

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Delivery of high­quality screening for breast, cervical, and colorectal cancers

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Improving staff skills to implement health care system change

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Improving quality through team­based care/patient centered medical homes

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Improving quality through the meaningful use of electronic health records, including clinical decision supports

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Improving quality through learning collaboratives for primary care providers

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Increasing Baby Friendly Hospital initiatives

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Increasing access to oral health services

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Other (please specify)

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment14. Please select one or two topics that you would you like to learn more about over the next 12 months. Interventions/activities for Domain #4 (Strategies to improve community­clinical linkages)

15. There are several ways that NACDD can provide technical assistance to your state. One way is through communities of practice. Communities of practice (CoP) are groups of people who share a concern or a passion for something they do, and learn how to do it better as they interact regularly. NACDD is considering forming several communities of practice to help states learn from each other. Each CoP will meet regularly via teleconference, using an NACDD facilitator. The group will explore and discuss all aspects of a specific topic, sharing state examples and looking at any external resources. The groups will be limited in size (ideally 10 individuals or fewer). Ideas and resources will be shared on the NACDD website so that non­CoP members can also benefit from the group discussion. Are you interested in joining a community of practice covering any of the topics mentioned in the previous questions?

Promoting chronic disease self management, including coverage and reimbursement

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Working with pharmacists

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Working with dentists

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Promoting use of community health workers

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Other (please specify)

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Yes, right away

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Yes, but not for at least 6 months

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No, this is not the right choice for me

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment16. What other ways would you like to receive technical assistance?

17. Are you interested in sponsoring a Chronic Disease Academy in your state, for state and/or local public health chronic disease staff?

Networking Now! monthly informational calls

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Dedicated area on the NACDD website to access resources and tools

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Forum/discussion group on the NACDD website

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Structured webinars held periodically to provide information from experts or other states

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Virtual Roundtables ­ one­time only, small group conference calls to discuss content from monthly calls or webinars with other states

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Peer to peer mentoring

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Access to experts for question and answer sessions

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Monthly e­bulletin

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None of the above

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Other (please specify)

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Yes, we would like to do this in the next year

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Yes, but unsure of the timing

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No, this would not suit our needs

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Unsure, I would like to learn more about an Academy

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Other (please specify)

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Coordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs AssessmentCoordinated Chronic Disease Prevention Program Needs Assessment18. Because of strict travel restrictions in most states and at CDC, technical assistance will often need to be provided via technological means rather than face­to­face. This might include "virtual" site visits from CDC Project Officers or "virtual" regional meetings. How comfortable are you with video conferencing technology?

19. NACDD would like to learn more about the technological capabilities of each state. We are preparing another survey to find out about states' access to distance learning or meeting, such as video conferencing (Skype, satellite connections, etc.,) webinar connections (Live Meeting, GoToMeeting, etc.,) and social media (FaceBook, Linked In, etc.) Please provide the contact information for the person at your state health department most knowledgeable about these technological capabilities, e.g. IT Coordinator. We will direct our brief survey to that person.Name

Email address

Phone number

Extremely uncomfortable; it is very difficult for me to interact this way

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Somewhat uncomfortable; it may be better than no meeting but not much better

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Somewhat comfortable; I can interact and learn in a "virtual" meeting

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Extremely comfortable; I am the person in my unit who knows how to set up the meeting

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Please feel free to comment:

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