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LEADERSHIP: The state chronic disease prevention and control unit is the unifying voice for the prevention and control of chronic diseases. LS1 LS2 LS3 LS4 LS5 The unit is a key contact for others both inside and outside the state health department who are interested in chronic disease prevention and control. The unit effectively informs decision-makers and partners (including media, governor, legislature, other state agencies, community coalitions and consumer and advocacy groups) about the unit s value, assets, and accomplishments. The unit has demonstrated the capacity to be a catalyst for change at multiple levels (region, community, workplace, etc) and in multiple sectors of the community (public, private, non-profit). The unit has demonstrated the capacity to access, analyze, and present data to articulate the chronic disease health needs of state residents. The unit has demonstrated the ability to argue convincingly that a comprehensive approach to chronic health problems will help meet those needs. EPIDEMIOLOGY AND SURVEILLANCE: The state chronic disease prevention and control unit establishes the burden associated with chronic diseases and frames the problem to be addressed. ES1 The unit regularly monitors and reports factors related to health equity including social determinants of health and disparities in chronic disease prevalence, risk, and outcomes. PW=Present/weak www.chronicdisease.org/nacdd-initiatives/program-integration Page 1 of 6

ES2 ES3 ES4 The unit regularly develops and disseminates a chronic disease surveillance summary data report. The unit has assessed the completeness and validity of all core datasets, linking data sets when appropriate and useful to do so. The unit uses data (including prevalence, cost, return on investment, intervention effectiveness, etc) consistently and appropriately in all decision making. PARTNERSHIPS: The state chronic disease prevention and control unit establishes strong working relationships with other government agencies and with nongovernmental, lay and professional groups. PS1 The chronic disease prevention and control unit collaborates with other units within the state health department such as: MCH, EMS, environmental health, school health, substance abuse, injury, and occupational health. PS2 The unit collaborates with other state agencies such as: Medicare, Medicaid, Office on Aging, Department of Education, and Department of Mental Health. PS3 The unit collaborates with non-governmental organizations such as: American Cancer Society, American Diabetes Association, American Heart Association, American Lung Association, Arthritis Foundation, health care associations, and universities. PS4 The unit collaborates with health care partners including provider groups, insurers, health systems, hospitals, and Federally Qualified Health Centers. www.chronicdisease.org/nacdd-initiatives/program-integration Page 2 of 6

PS5 The unit collaborates with local health departments and communities including such groups as business and industry, consumer groups, youth-serving organizations, religious organizations, and PTA s. STATE PLANS: The state chronic disease prevention and control unit uses data and works with partners to develop comprehensive state plans to guide program efforts. SP1 SP2 The unit develops and implements a state health department plan to prevent and control chronic disease in the state that includes specific goals, objectives and activities, and timelines. The unit ensures that chronic disease prevention and control is included in all relevant state health plans. INTERVENTIONS: The state chronic disease prevention and control unit identifies specific targets for change (population segments, organizations, or environments), chooses the best channels through which to effect such changes, and selects appropriate strategies for doing so. IN1 The unit prioritizes interventions for populations with relatively high prevalence of disease or secondary risk factors, limited access to information or services, or a higher risk of developing disease. IN2 The unit implements interventions that use multiple channels for reaching targeted individuals and populations. IN3 The unit implements evidence-based interventions in organizations or systems capable of affecting the health of the priority population segments. www.chronicdisease.org/nacdd-initiatives/program-integration Page 3 of 6

IN4 IN5 IN6 IN7 IN8 The unit implements evidence-based interventions designed to change the physical or policy environment in which people live, work, learn and play. The unit implements evidence-based interventions designed to improve access to and quality of care both within health care systems and through community-clinical linkages. The unit implements interventions that simultaneously address multiple levels for change individual, organization or system, and policy or environment. The unit implements policy interventions that address multiple levels (state, regional, local) and multiple types of policy (voluntary, regulation, legislation, standards). The unit implements interventions that are sensitive to health inequities including but not limited to conditions in which people are born, grow, live, work and age influenced by varying distribution of money, power, resources and access to medical care. EVALUATION: The state chronic disease prevention and control unit establishes systematic approaches for determining whether its comprehensive chronic disease control program is being implemented successfully and whether its objectives are being achieved. EV1 The unit monitors progress in achieving the objectives of the chronic disease prevention and control plan or agenda. EV3 The unit uses evaluation findings to make programmatic adjustments and modifications. EV4 The unit disseminates evaluation findings to stakeholders. www.chronicdisease.org/nacdd-initiatives/program-integration Page 4 of 6

PROGRAM MANAGEMENT AND ADMINISTRATION: The state chronic disease prevention and control unit provides the consistent administrative, financial, and staff support necessary to maintain successful programs. PM1 The unit has uses a variety of modern, distance-learning technologies to support life-long learning appropriate to programmatic needs and improve staff s professional effectiveness. PM2 The unit has appropriate technology tools to describe the magnitude of chronic disease problems; analyze risk factors; identify community strengths from which strategies may be defined and tools created to intervene, prevent problems, and promote health and well-being; and continuously evaluate, refine, and implement what works. PM3 The unit s structure allows related programs to interface and interact easily. PM4 The unit s staff members have received basic training in chronic disease prevention and control. PM5 Key staff members have advanced training or experience in evaluation, strategic planning, the use of surveillance data, and grant writing. PROGRAM COORDINATION: The state chronic disease unit has strategically aligned chronic disease categorical program resources to increase the effectiveness and efficiency of each program in a partnership without compromising the integrity of categorical program objectives. PC1 The unit supports and strengthens cross-programming www.chronicdisease.org/nacdd-initiatives/program-integration Page 5 of 6

relationships that focus on mutual benefits and coordinated approaches to planning, implementation, and PC2 PC4 PC5 evaluation of integration efforts. The unit ensures communication networks and tools are in place for sharing of information among staff, partners, and community collaborators. The unit has established communication mechanisms to identify and share common linkages, gaps, workload and resources. The unit regularly reviews integrated and collaborative activities for efficiency and effectiveness. www.chronicdisease.org/nacdd-initiatives/program-integration Page 6 of 6