Transcript A National, Multilevel Approach

REACH U.S.: Past, Present, & Future
Shannon White, MPH
Health Education Specialist
REACH U.S.
UAB Mid-South Regional Meeting
August 23, 2011
National Center for Chronic Disease Prevention and Health Promotion
Division of Community Health (proposed)
Program Focus on Health Equity

Health equity is at the core of all our programs and
activities.

Health equity is achieving the highest level of health for
all people.

It entails focused societal efforts to address avoidable
inequalities.
The goal is to equalize conditions for health for all
groups, especially for those experiencing socioeconomic
disadvantage or historical injustices.

Healthy People 2020
Programs and Activities
A NATIONAL, MULTILEVEL APPROACH
Racial and Ethnic Approaches to
Community Health (REACH)

Cornerstone of CDC efforts to eliminate racial and
ethnic health disparities

Program began in 1999
 Was aligned with Healthy People 2010 goals

Became REACH Across the U.S. (REACH U.S.)
in 2007

REACH U.S. program is funded through 2012
Socio-Ecological Model
REACH

Through the REACH program:
CDC supports grantee partners to establish and/or
support community-based programs and culturallytailored interventions to eliminate health disparities
among racial and ethnic minority groups.
Priority Health Areas
Racial/Ethnic Groups
Adult immunizations
African Americans
Asthma
Breast and cervical cancer
Cardiovascular disease
Diabetes mellitus
Infant mortality
American Indians and
Alaska Natives
Asian Americans
Hispanics/Latinos
Hepatitis B
Tuberculosis
Pacific Islanders
Example: REACH U.S. CEED Program
Institute for Urban Family Health
(New York, New York)
Mooove to 1% or Less – Yes!
Changing the Milk Policy in New York City Schools
Public health issue:
An estimated 120 million
containers of whole milk,
sweetened vanilla, chocolate,
and strawberry milk are served
each year in the public health
system.
Outcome:
A citywide low-fat/skim milk
only policy was put in place in
NYC public schools.
Example: REACH U.S. CEED Program
Mt. Sinai School of Medicine
Save Half For Later Campaign
Public health issue:
Increase consumer and
business awareness about
portion control and its relation
to obesity and diabetes.
Outcome:
Trained restaurant managers
and staff to promote and
implement portion control
strategy.
Example: REACH U.S. Legacy Program
Mt. Sinai School of Medicine
Concrete Safaris
Public health issue:
To increase youth
engagement in physical
activities and nutrition
principles as a means of early
age diabetes prevention.
Outcome:
Enrolled more than 35
children into the program
where they learned gardening
as a form of exercise and
about healthy eating.
Example: Action Community
Chicago Department of Public Health
Lawndale Christian Health Center
Public health issue:
Increase the proportion of the
population who report meeting
the daily physical activity
requirement.
Outcome:
Lawndale Christian Health Center
expanded to address access to
healthcare and physical
activity/nutrition resources and
offers medical care on a sliding
scale fee.
REACH U.S. Program Accomplishments
 Implementing strategies that fit unique social,
political, economic, and cultural circumstances
 Moving beyond individuals to community and
systems change
REACH U.S. Program Accomplishments

Empowering community members to seek better
health
 Bridging gaps between health care system and
community
 Changing social and physical environments to
overcome barriers to good health
Programs and Activities
Expanding REACH
REACH National Organizations that Serve
Minority Communities
 Launched in 2009, this REACH program
funds six national minority-serving organizations.
– Through their local affiliates and chapters, they
provide training and technical assistance in two
areas:
1) dissemination of evidence-based
strategies and tools
2) capacity building
REACH National Organizations that Serve
Minority Communities
Asian Pacific Partners for Empowerment, Advocacy and
Leadership (APPEAL)
National Black Women’s Health Imperative
National Council of La Raza
Inter-Tribal Council of Michigan
Society for Public Health Education (SOPHE)
Joint Center for Political and Economic Studies
Example: REACH U.S. National Organizations that Serve Minority
Communities
Asian Pacific Partners for Empowerment,
Advocacy, and Leadership (APPEAL), Oakland, CA
National Asian American and Pacific Islander Network To Eliminate Health Disparities
(NAPNEHD)
Affiliates: Coalition for Asian American Children and Families (New York, NY), Coalition for a Tobacco
Free Palau (Palau), and Washington Asian Pacific Islander (WAPI) Community Service (Seattle, WA)
Public health issue:
Reduce cardiovascular disease through
environmental and policy changes promoting
healthy eating and active living.
Outcome:
Increased capacity in AA and NHPI communities
for policy change by implementing APPEAL’s
Community Readiness, Leadership, Technical
Assistance and Training (TAT) and Four-Prong
Policy Change Models.
REACH Community Organized to Respond and
Evaluate (CORE)
 The two-year REACH CORE program supports
communities transitioning from the analysis of
intervention results to the use of these results in
facilitating health equity and policy change.
REACH Community Organized to Respond and
Evaluate (CORE)
 Health Departments and Universities:
–
–
–
–
–
–
–
–
–
–
Regents of the University of California, Los Angeles
University of Kansas Center for Research, Inc.
Arizona Department of Health Services
North Carolina Department of Health & Human Services
Department of Environment, City, and County of San Francisco
Schenectady County Public Health Service
Louisiana Public Health Institute
Michigan Public Health Institute
Asian Media Access
Maternal, Child and family Health Coalition of Metropolitan St. Louis
Example: REACH CORE Program
University of California Los Angeles Center for
Health Policy Research
(Los Angeles, CA)
Turning Data Into Action: Fighting Air Pollution in Two Immigrant
Communities
Public health issue:
Air pollution in two Latino
communities: Boyles Heights and
Long Beach, CA.
Goal:
Change public policies,
regulations, and transportation
practices to address
disproportional burden of air
pollution.
Racial and Ethnic Health Disparities
Action Institute (REHDAI)
 Begun in 2008, this three-year program:
– Equips nine community teams with the
knowledge and tools necessary to launch and
sustain an effective local community action plan.
– REACH U.S. CEEDs facilitate networking
opportunities to help build capacity.
Racial and Ethnic Health Disparities
Action Institute (REHDAI)
 Nine REHDAI Teams and CEEDs:
– Florida (Genesee County Health Department)
–
–
–
–
–
–
Kentucky (University of Illinois-Chicago)
Maryland (Mt. Sinai School of Medicine)
Minnesota (Regents of University of California, Los Angeles)
Mississippi (Medical University of South Carolina)
Missouri (Hidalgo Medical Services)
Oregon
(Regional Asthma Management and Prevention
Initiative)
– Tennessee (University of Alabama – Birmingham)
– Texas
(Boston Public Health Commission)
Example: Oregon REHDAI
Oregon Coalition to Improve Birth Outcomes
(OCIBO)
Public health issue:
Improve birth outcomes for
women of color.
Outcome:
State legislation directs Oregon
Health Authority to present plan
to improve birth outcomes for
underserved women through
use of doulas (birth companion)
and community health workers
by February 2012.
Programs and Activities
EVALUATING PROGRAM RESULTS
National REACH Program Evaluation
 Analysis:
– Use all available evaluation data to analyze
REACH program contributions and outcomes
in the four areas of study.
– Conduct other health economic, policy and
network analyses.
Literature/Document Reviews and Interviews

CDC: Retrospective (Completed)
–
–
Purpose and fit with overarching program model
Early decisions / challenges

Map literature review findings to evaluation
questions (Assessing the gap)

Interviews
– CEED POCs (June-July)
– REHDAI POCs (July-August)
Programs and Activities
PROGRAM IMPACT
REACH U.S. Risk Factor Survey
• The REACH U.S. Risk Factor Survey
began in 2009.
• It gathers data annually from 28
communities located in 17 states
with REACH U.S. community health
interventions.
• The survey includes questions about
health, chronic diseases, diet,
exercise, preventive services, and
adult immunizations.
• These community-level survey data
are being used by CDC and
community coalitions to monitor and
evaluate interventions in each
community.
American Indian
Asian
Black
Hispanic
REACH U.S. communities focusing on cardiovascular disease/diabetes mellitus
(2002 – 2006)
Racial and Ethnic Approaches to Community Health REACH Data, 2006, comparative data 2002-2006.
Programs and Activities
EXPANDING PROGRAM OUTREACH
International Outreach
 Expanding the influence of our programs
through international health promotion efforts
in:
 United Kingdom
 Zambia
 Sub-Sahara Africa
Translation and Training
Social Determinants of Health and Health Equity
• Communication Resources
• DANYA International Project
• Health Equity Workbook Update
• CHEB Training Cadre’
Cultural Competency
• Community Coalition Tools
Dissemination
Promoting Health Equity: A Resource to Help
Communities Address Social Determinants of Health:
http://www.cdc.gov/nccdphp/dach/chhep/pdf/SDOHworkbook.pdf
Morbidity and Mortality Weekly Report
Surveillance Summaries / Vol. 60 / No. 6 May 20, 2011
Surveillance of Health Status in Minority Communities —
Racial and Ethnic Approaches to Community Health
Across the U.S. (REACH U.S.)
Risk Factor Survey, United States, 2009
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6006a1.htm?s_cid=ss6006a1_w
Supplement to Family & Community Health, The Journal of Health
Promotion & Maintenance – Racial and Ethnic Approaches to
Community Health (REACH): Translating Processes of Change and
Attributing Improved Health Outcomes to Social Determinants of Health
Programs. Published January 2011.
http://journals.lww.com/familyandcommunityhealth/toc/2011/01001
Community Health and Equity
Program Partners
Directors of Health Promotion and Education
Institutes of Medicine of the National Academies
National Association of Chronic Disease
Directors
National Association of County and City Health
Officials
Society for Public Health Education
Next Steps
Community Transformation Grants
“… in order to reduce
chronic disease rates,
address health
disparities, and develop
a stronger evidence base
of effective prevention
programming”
$145 million announced by HHS for FY 2011
President’s Budget proposal for FY 2012 includes
$221 million
Community Transformation Grants
Program
focus
• Implementation, evaluation, and
dissemination of community-based
community prevention activities
Eligibility
• State/local governmental agencies,
state/local non-profit organizations,
tribes, national network CBOs
Current
status
• Applications were due July 15;
objective review the week of August
15; funding begins September 2011
Building on
success
• Work from programs such as REACH
and CPPW will help inform CTGs
Award Categories for Community
CTGs
 Capacity Building
– Awards range from $50,000-$500,000
 Implementation
– States, local governments, nonprofit
organizations: $500,000-$10,000,000
– Territories: $100,000-$150,000
– Tribal and AI/AN Consortia: $100,000$500,000
 Up to 75 awards will be made
For more information please contact Centers for Disease Control and
Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
National Center for Chronic Disease Prevention and Health Promotion
Division of Community Health (proposed)