Building sustainable systems for the distribution and delivery of the chronic disease self-management program

Sustainable systems are essential to ensure ongoing distribution and delivery of community-based programs, but how to effectively ensure continuation of grant funded community-based programs after funding ends remains a common challenge for program developers and funders. This session presents successful sustainability strategies used by grantees of the Communities Putting Prevention to Work: Chronic Disease Self-Management Program (CDSMP) initiative, that awarded two-year grants totaling $27 million to 45 states, the District of Columbia, and Puerto Rico to provide CDSMP to older adults in 2010. These strategies are based on findings of a multi-method national process evaluation of CDSMP implementation funded by the Administration for Community Living, based on site visits, surveys, key informant interviews, and grantee reports. Sustainable systems shared common features: (1) champions who integrated CDSMP into statewide strategic planning, actively support implementation through technical assistance, and advocate for statewide fidelity monitoring; (2) building a strong delivery system and broad support for the program is important, even when champions are present; (3) outsourcing program oversight and technical assistance as long as there is funding to do so; (4) “showing the numbers” to provide state officials with evidence of program benefits and cost-effectiveness; (5) developing effective recruiting strategies; (6) “smart” investment of program funds to develop infrastructure (e.g., developing marketing materials and Web sites, training program coordinators and leaders, establishing processes for fidelity monitoring); (7) integration of CDSMP into new delivery system and financing models. These strategies can help to support and sustain distribution and delivery of CDSMP and related programs.