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King County Steps to Health: Building Sustainable Systems to Prevent and Control Chronic Illness

Mark P. Doescher, MD, MSPH, Family Medicine, University of Washington, Box 354696, Seattle, WA 98195-4696, (206) 616-9207, mdoesche@u.washington.edu, James Krieger, MD, MPH, Epidemiology, Planning and Evaluation Unit, Public Health - Seattle & King County, 999 Third Ave, Suite 1200-EPE, Seattle, WA 98104, and Virginia Lee, MPH, CHES, Prevention Division, Public Health - Seattle & King County, 400 Yesler Way, 5th Floor, Seattle, WA 98104.

Background: King County Steps aims to reduce chronic illness by engaging, schools, childcare sites, worksites, and healthcare providers to integrate existing and new activities across conditions (e.g., obesity and diabetes), sectors (e.g., clinics, schools and community groups), and institutions within sectors (e.g., emergency departments and outpatient clinics).

Methods: Our organizational framework includes a Consortium, a Leadership Team, and Sector and Evaluation Committees. The Consortium, includes over 100 representatives The decision-making Leadership Team, convenes monthly to provide strategic oversight and monitor budgets and performance. Sector Committees (Schools, Worksite, Healthcare Systems, Media/Policy, and Community) make recommendations about funding interventions by using explicit criteria, including effectiveness, feasibility, sustainability, and potential to reduce health disparities. The Evaluation Committee is using a logic-model design to conduct a participatory evaluation with key stakeholders.

Results: The committees and Leadership have developed a community action plan featuring coordinated and integrated strategies to control and prevent chronic disease. Community health workers will address multiple conditions and coordinate services between healthcare, school and community resources. Chronic disease support groups will assist persons with diverse chronic conditions. Clinical quality improvement activities will integrate clinical activities with community and managed care resources. We will describe these and other examples in detail.

Conclusions: King County Steps emphasizes the coordination and integration of chronic illness prevention and control activities rather than simply the delivery of services. While our approach has required considerable commitments of time and resources, this "up-front" work should yield long-term benefit by building sustainable systems to prevent and control chronic illness.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to

Keywords: Chronic Illness, Community-Based Partnership

Related Web page: www.metrokc.gov/health/steps

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

STEPS to a Healthier US Initiative: National and Community-Level Strategies to Address Chronic Disease

The 132nd Annual Meeting (November 6-10, 2004) of APHA