Piloting a collaborative approach to chronic disease program integration with a focus on addressing health disparities

North Carolina is one of four pilot states attempting to formally integrate chronic disease programs by fostering collaboration and sharing resources. To spearhead this effort, the state created four cross-program collaborative teams in the areas of evaluation and epidemiology (Health Data), community initiatives (Healthy Communities), policy development and implementation (Policy and Environmental Change) and quality improvement among health providers (Healthcare Systems). These collaborative teams, or Communities of Practice (CoPs), bring together members of disease-specific and risk-factor-specific program staff as well as social marketing and health communication experts.

Reducing health disparities represents a key point of focus for all four CoPs and each team is tasked with responsibilities relevant to its area of expertise. Thus, Health Data is developing a social determinants of health data set to be incorporated into all program burden books. Healthy Communities works to increase the reach of programs into underserved populations by coordinating resources and reducing program redundancy. Healthcare Systems is working to increase access to care in areas with large minority populations, and Policy and Environmental Change encourages programs to develop evidenced-based policies that benefit all persons with or at risk for chronic diseases.

Working collaboratively to improve services for the State's most vulnerable citizens is a significant organizational change that is both helpful and ambitious. A recent assessment of CoP effectiveness revealed that while staff feel that they benefit from participation and that the teams are making progress towards their goals, challenges remain in the areas of “turf protection”, varying program standards and workload levels.