268417 Embedding interventions in delivery systems as an effective strategy for expanding reach of community-based interventions: Results of a cross-site evaluation

Tuesday, October 30, 2012

Jennifer Berktold, MA , Health Studies, Westat, Rockville, MD
Teresa Brady, PhD , Division of Adult and Community Health, Arthritis Team, Centers for Disease Control and Prevention, Atlanta, GA
Mari Brick, MA , Arthritis Council, National Association of Chronic Disease Directors, Voorheesville, NY
Joseph Sonnefeld, MA , Health Studies, Westat, Rockville, MD
One in five American adults has self-reported doctor-diagnosed arthritis (NHIS 2009). Participation in community-based self-management education and physical activity interventions has been demonstrated to improve quality of life for those who have arthritis. In order to increase the reach of these interventions, the CDC Arthritis Program funded 21 State health departments to engage delivery system partners and embed interventions in their routine operations. The purpose of the Arthritis Centralized Evaluation was to identify effective strategies States used to expand the reach of evidence-based interventions, comparing and contrasting processes used to achieve this expanded reach. The evaluation conducted site visits and interviews in 21 States and abstracted information from semi-annual progress reports. Data were compiled in an analytic rubric and analyzed using SAS.

The Centralized Evaluation found engaging delivery systems and embedding interventions was correlated with expanded intervention reach (p=0.027). Delivery systems would assume responsibility for day-to-day operations, such as recruiting leaders, scheduling classes, and working with sites. States, in turn, could focus their intervention-related efforts on partnership development, technical assistance, and quality control. The evaluation also found States encountered challenges that limited their ability to successfully engage delivery systems as partners. These barriers included difficulty identifying delivery system partners and the lengthy time periods partners needed to adopt and embed the interventions.

Engaging delivery system partners to adopt and embed interventions into routine operations is a successful way to expand the reach of interventions, although there are numerous challenges to be overcome in using this strategy.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
By the end of this presentation, participants will be able to: Describe how chronic disease programs can work with delivery system partners to increase the reach of community-based interventions. Discuss factors associated with increased reach of the community-based interventions and the barriers some States encountered that limited their ability to increase reach.

Keywords: Community Health Programs, Self-Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the director of the Arthritis Centralized Evaluation, the project described in this abstract. As part of this evaluation, I tracked State health department efforts to expand the reach of community-based interventions over a three-year period, led seven site visits to State health departments and conducted more than 20 telephone interviews with State health departments and their partners.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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