Realizing a vision: A look at chronic disease frameworks in multiple state health departments

Background: To increase efficiency and leverage limited resources, the Centers for Disease Control and Prevention (CDC) promotes integration and collaboration among state health department chronic disease programs. Recently, CDC has promoted this collaboration by releasing several integrated funding announcements. This presentation outlines the benefits of and barriers to collaboration across state health department chronic disease programs, with a focus on Comprehensive Cancer Control Programs (CCCs) and Tobacco Control Programs (TCPs). Description: Cross-collaboration, challenges encountered, and factors facilitating collaboration within a chronic disease framework were explored in 6 states. Individual and group interviews were conducted with 84 key stakeholders from state health department leadership, CCCs, TCPs, and tobacco and cancer control coalitions. Data were analyzed using NVivo 10.0. Lessons Learned: Integrated efforts are implemented formally (e.g., changes in organizational structure) and informally (e.g., cross-program communications). Barriers to implementing a chronic disease framework included funding restrictions on program-specific activities and fear of diluting an individual program's influence or importance. The benefits of a chronic disease framework (e.g., minimizing duplication of efforts) were extolled by most respondents. Leadership support was instrumental in implementing all collaborative activities. Recommendations: Efforts to promote integration of chronic disease programs are underway at federal, state, and local levels. As cross-collaboration becomes more common, many chronic disease program staff - including those in CCCs and TCPs - may find these results relevant to their work. Our recommendations include encouraging funding agencies to make meaningful collaboration a requirement of funding opportunities, and having states share successful cross-collaboration strategies with each other.