Reaching outcomes through state infrastructure development: Evaluation of CDC's national cooperative agreement program

State oral health programs are vital in preventing oral diseases, reducing oral health disparities, and improving oral health and overall health. However, many state oral health programs lack sufficient infrastructure to develop effective and sustainable programs to effectively address the burden of oral disease. The Centers for Disease Control and Prevention (CDC) developed a program that incorporated core public health activities designed to build the infrastructure and capacity of state oral health programs. CDC evaluated this program to assess the outcomes of infrastructure development using a non-experimental, mixed methods design. Data from 12 funded states included a qualitative synthesis of state self-reports on program processes and outcomes analyzed using Atlas ti. In addition, a quantitative assessment of state progress in implementing core activities was completed using SPSS. Findings indicated that core activities could be grouped into 4 phases that were implemented over time: Phase 1 (leadership, partnerships, coalitions); Phase 2 (surveillance planning and capacity); Phase 3 (state plans, coalition efforts, policy efforts); and Phase 4 (prevention programs – community water fluoridation and dental sealant programs). Through implementation of the core activities, programs reported increased ability to leverage additional funding and support, as well as increased visibility and program reach. This session will discuss the key results of the evaluation including the benefits and challenges of infrastructure development, necessary resources, influence on prevention programs and policy, and the lessons learned for future infrastructure development programs.