Chronic Disease Integration Yields Sustainable Intervention Dissemination Through Novel Partnerships

1. Significance of the problem. 50 million adults in the U.S. have doctor-diagnosed arthritis. It is the most common cause of disability among adults and adults with arthritis often report one or more other chronic diseases. In 2003, the total cost attributed to arthritis and other rheumatic conditions in the United States was 128 billion dollars. However, there are only 12 states funded to support significant arthritis prevention and control programs

2. Innovativeness of approach. A pilot project integrating arthritis-related public health interventions into non-arthritis specific program areas was funded in nine states.

3. Methodological rigor of approach. Programs emphasizing chronic disease self-management, risk reduction, self-efficacy, and physical activity have been particularly effective in reducing the burden of chronic diseases including arthritis. Such evidence-based programs include the Chronic Disease Self-Management Program, the Enhance Fitness program, the Arthritis Foundation Exercise program. Funded states disseminated these interventions through existing, though non-arthritis specific, delivery systems.

4. Findings. In four case examples highlighting key findings, arthritis interventions were embedded in a healthy aging and disability unit, an injury and disability prevention program, and two diabetes prevention and control programs. Novel partnerships included Area Agency on Aging networks and a statewide Parish Nurse program. Leveraging ARRA-related capacity and partners from the aging services networks were instrumental in expanding reach of these interventions.

5. Implications identified for future practice. Common program goals and components among categorical prevention programs make integration an appropriate and effective strategy for increasing and sustaining the reach of evidence-based interventions.