# Presentation: 435909

## DHDSP Leadership Presentation  

**      ****Darwin R. Labarthe, MD, MPH, PhD – Division Director**
**       ****Judy Hannan, RN, MPH – Deputy Director **
**      **_**Branch Chiefs: **_
**       ****Robert Merritt, MA (Acting) – Epidemiology & Surveillance**
**       ****Michael Schooley, MPH – Applied Research & Evaluation **
**       ****Nancy Watkins, MPH – Program Development and Services**
-  September 18, 2007 ~ Atlanta, GA

_**DHDSP Leadership Presentation**_** **

##                  Global Activities

**Notes:**
Collaboration is one of the themes that we are focusing on during this national meeting.  You will also be hearing a lot on the topic of HBP.  
Today in my talk, combine collaboration and high blood pressure.  
The Division has been involved in partnerships, collaborations and trainings around the globe.  Let me share a few highlights with you:
The World Action on Salt and Health hosted __________________________________________________________.  This relates particurlarly to the states in that 
1)2)3)
This summer the Division partnered with the IHUPE  International Union for Health Promotion and Education to host our 4th training seminar in Africa.  This year 40 public health practitioners---nurses, health educators, physicians, media and elected officials attended the sessions held in Nairobi, Kenya.  This series of seminars is designed to help build capacity for heart disease and stroke prevention in sub-Saharan Africa.  
And earlier this year, we had the pleasure to work with IUHPE as they celebrated the 10th anniversary of the organization with a series of programs in Vancouver, British Columbia
The Council on Epidemiology and Prevention of the World Heart Federation held  its 40th Ten-Day International Teaching Seminar on Cardiovascular Disease Epidemiology and Prevention to be held in August in  Norway.   36 Fellows interested and working in CVD participated.  
And in collaboration with the WHO we 
1)2)3) 

##       “Team Up for Healthy Hearts!”

**      “****Team Up for Healthy Hearts!**”

**Notes:**
I also wanted to recognize that September 30 is World Heart Day, where over 100 countries in the world are drawing attention to the toll heart disease and stroke is taking  across the globe.  Again, another opportunity to highlight the need for prevention to others AND TO YOURSELF.   

As you know, WHD is an annual campaign sponsored by the World Heart Federation and is an opportunity to increase public awareness of the risk factors for heart disease and stroke and what people can do to prevent them.  

This is a great opportunity to call media attention to the issues through events planned in your communities, such as free health screenings, fitness events, and public talks to hosting scientific forums. 

By now you should have received  a tool-kit that our Division Communications Office sent you.  This year we are supporting the WHF efforts by promoting the use of the toolkit with its rich ideas, resources, and materials for working with the media, employers, and faith based and community organizations.  We hope that  the toolkit will be useful to you this year or as a model for other opportunities that come along.  

We would love to hear about any activities that you organize for this event.  Please be sure to highlight these with your project officers.  

## National Activities

**Notes:**
The Division hosts and participants in heart disease and stroke prevention initiatives across the country.   Among the highlights of our activities:

 40 public health professionals participated in the WW annual training in North Carolina--  
The Nutrition and Public Health Course for Community Practitioners – which enhances the capacity among public health professionals for implementing community-based interventions to increase healthy eating among adults with little or no access to health care. 
The program uses  socio-ecologic and MATCH models as frameworks for designing and implementing nutrition interventions at multiple levels of impact.
Participants include WISEWOMAN state & local program directors & program coordinators, community health advisors, nurse consultants, nurses, interventionists, and public health researchers.

In the spring of this year, the Division partnered with the American Heart Association, the Association of State and Territorial Health Officers and the National Association of Chronic Disease Directors to host The National Forum held its 5th meeting “Making Connections– in Science, policy and Action last spring.  For that meeting, the Division produced the National Forum Reader on Economics and Prevention.....the first such document for the Forum.  The reader included selected materials on the economics of heart disease and stroke prevention.  Dr. David Eddy—who conceived the Archemedies Model that  employs a a innovative mathematical approach to integrate data from many sources to develop theories on heart disease and stroke was among the featured speakers for the Forum.  More than 100 representatives of public and private healthcare, advocacy, policy and faith and community organizations and international programs participated in the 3 day meeting.  We invite you to mark your calendars to attend the 6th National Forum next March in Washington, DC.  Please expect to receive information from us within the next few weeks with details of the 6th National Forum.

3) CDC/Y-USA Partnership
Since the fall of 2004, the Division has been involved in CDC’s collaboration with the YMCA serving as expert advisors and as members of the steering committee.   This national partnership is an innovative public health collaboration linking the resources and technical expertise of the federal government with YMCAs across the U.S. in an effort to widely disseminate evidence-based, promising community interventions that reduce the burden of chronic diseases and improve the health of local communities. 

This joint effort expands the goal of creating communities supportive of healthy living to a much further reach than what one organization can do alone.  The partnership has the potential to reach over twenty-five hundred diverse communities.

4)  We are especially proud to have had the opportunity to collaborate with The National Association of Chronic Disease Directors’ CVH Council  to develop a heart disease and stroke prevention (HDSP) themed issue of the CDC e-journal Preventing Chronic Diseases: Public Health Research, Practice and Policy (PCD)...to be released next Spring. The journal is published by the National Center for Chronic Disease Prevention and Health Promotion

I want to personally thank all of you who have worked on the 16 articles and manuscripts  for this special issue.  Topics will include policy, environmental and systems-level interventions and tools in healthcare and worksite settings, heart disease and stroke prevention policy database tool, results of heart attack and stroke awareness campaigns, emergency care for stroke patients, and public health approaches for hypertension control.   

 This issue of CDC’s peer-reviewed electronic journal will provide an excellent forum for public health researchers and practitioners to learn more about the heart disease and stroke prevention programs,  study results and practical experiences resulting from your work in the field.

## National Goals for HDSP

**Prevention of risk factors**
**Detection and treatment of risk factors **
**Early identification and treatment of heart disease and stroke**
**Prevention of recurrent cardiovascular events**

## Slide 6

**Notes:**
Division staff is proud to have partnered with the National Institutes of Health in the completion of  The Healthy People 2010 Midcourse Review.  The document  presents an assessment of the Nation's progress toward increasing the quality and years of healthy life and eliminating health disparities for all Americans, halfway through the first decade of the 21st century. This report provides a midcourse assessment through January 2005. 

At the heart of Healthy People 2010 are its science-based, data-driven objectives that enable progress and trends to be tracked. 

By defining national health objectives with measurable targets, we can assess the inroads we have made at the midpoint of the decade and against the 10-year end goals. As we measure our Nation's health by the length and quality of life and work aggressively to eliminate health disparities, 

The current data reflect promise and caution: our Nation's health is improving overall, but health disparities remain virtually unchanged. Nearly 60 percent of the objectives that can be tracked either met or moved toward their targets, and 20 percent moved away from their targets. The remaining objectives were unchanged or showed mixed progress. Importantly, the challenges that have impeded progress are addressed in the Midcourse Review. 

## Objective 12-9 

**Objective 12-9 **
**Prevalence of high blood pressure -**
**    ****	****MOVED AWAY FROM THE TARGET, ****	****by 33% **
** ****for adults age 20+, from 1988-94 to                                1999-2002.**

**Notes:**
Division staff is proud to have partnered with the National Institutes of Health in the completion of  The Healthy People 2010 Midcourse Review.  The document  presents an assessment of the Nation's progress toward increasing the quality and years of healthy life and eliminating health disparities for all Americans, halfway through the first decade of the 21st century. This report provides a midcourse assessment through January 2005. 

At the heart of Healthy People 2010 are its science-based, data-driven objectives that enable progress and trends to be tracked. 

By defining national health objectives with measurable targets, we can assess the inroads we have made at the midpoint of the decade and against the 10-year end goals. As we measure our Nation's health by the length and quality of life and work aggressively to eliminate health disparities, 

The current data reflect promise and caution: our Nation's health is improving overall, but health disparities remain virtually unchanged. Nearly 60 percent of the objectives that can be tracked either met or moved toward their targets, and 20 percent moved away from their targets. The remaining objectives were unchanged or showed mixed progress. Importantly, the challenges that have impeded progress are addressed in the Midcourse Review. 

## NHANES data for children and adolescents aged 8-12  and 13-17 years in 1999-2000 showed 

**NHANES data for children and adolescents aged 8-12  and 13-17 years in 1999-2000 showed **
**      ****	*****SIGNIFICANT INCREASES  IN ******	******BLOOD PRESSURE*****  **
**from 1988-1994. **

## The greatest increases were for the younger age group,  and  increasing BMI explained little of the major increase  in diastolic pressure.

**The greatest increases were for the younger age group,  and  increasing BMI explained little of the major increase  in diastolic pressure.**

## Persistent, longstanding racial and ethnic disparities  result  in especially high blood pressure among  African Americans and especially poor control among Mexican Americans.

**Persistent, longstanding racial and ethnic disparities  result  in especially high blood pressure among  African Americans and especially poor control among Mexican Americans.**

## An immediate and urgent priority among 

***An immediate and urgent priority among ***
***public health approaches to address prevention and control of high blood pressure is to achieve marked reduction in population-wide salt consumption, consistent with USDA's 2005 Dietary Guidelines for Americans:***** **

**2300 mg sodium /day EXCEPT: African Americans, hypertensives, middle age and older adults – 1500 mg sodium/day**

**Notes:**
(DHDSP is exploring or already engaged in multiple levels of  collaboration in pursuit of this goal.)

 1) The HP2010 Mid-Course Review showed one major objective for heart disease and stroke prevention - #12-9, prevalence of high blood pressure - to have MOVED AWAY FROM THE TARGET, by 33%, from the baseline years 1988-1994 to 1999-2002, for adults age 20+.

2) Analysis of NHANES data for children and adolescents aged 8-12 and 13-17 years in 1999-2000 showed SIGNIFICANT INCREASES IN BLOOD PRESSURE from the same baseline years, 1988-1994. The greatest increases were for the younger age group, and increasing BMI explained little of the major increase in diastolic pressure.

3)  Persistent, longstanding racial and ethnic disparities result in especially high blood pressure among African Americans and especially poor control among Mexican Americans.

4) An immediate and urgent priority among public health approaches to address prevention and control of high blood pressure is to achieve marked reduction in population-wide salt consumption, consistent with USDA's 2005 Dietary Guidelines for Americans. DHDSP is exploring or already engaged in multiple levels of  collaboration in pursuit of this goal.

Please visit the Healthy People website to download a complete copy of the Midcourse review. 

## COLLABORATING  ON THE SOLUTIONS 

**COLLABORATING  ON THE SOLUTIONS **

**Notes:**
This strategic plan outlines our focus areas and the directions we will take to lead the nation’s public health efforts to achieve the Healthy People 2010 goals for heart disease and  stroke prevention as discussed earlier.  

The Division will continue to use A Public Health Action Plan to Prevent Heart Disease and Stroke as its primary guidance to structure its activities in  in reaserch, surveillance, public health leadership, communications and regional and global partnerships.  

## Thank You.  

**Darwin R. Labarthe**
**dlabarthe@cdc.gov **

## 	   DHDSP Overview

**	****   **_**DHDSP Overview**_
**    **** **
**     ****Judy Hannan, RN, MPH**
**     ****Deputy Division Director**
**     ****Division for Heart Disease and Stroke Prevention **
**September 18, 2007**
**Atlanta, GA  **

## Slide 15

**Notes:**
Step back a minute to look at our Division and where we are positioned in the National Center for Chronic Disease and Health Promotion.  Won’t go any higher up in the bureacracy than that ... too confusing! 

The CDC is organized into three coordinating centers.  
Within that structure is the National Center for Chronic Disease Prevention and Health Promotion....this is where the Division is located. 
As you can see the division is  one of the 10 divisions within the National Center for Chronic Disease and Health Promotion (NCCDPHP), many of which address risk factors related to HDSP.  

## Division for Heart Disease and Stroke Prevention

- Policy

- Communications

**Notes:**
Here you can see the organizational structure of the Division.  NEED NEW SLIDE HERE!!! 

## DHDSP Funding

**HDSP****	****	****	****$37.9 million**
**WISEWOMAN****	****	****$12.5 million**
**Coverdell****	****	**_**$  4.4 million **_
**	****	****	****	****	****$54.8 million **

## DHDSP Strategic Plan

**   **
_**Vision**_
**A heart-healthy **
**and stroke free world.**
_**Mission**_
**To serve as the Nation’s public health leader for achieving cardiovascular health for all and for reducing the disparity among populations in the burden of heart disease **
**and stroke.**

**Notes:**
As part of our continued growth as a new Division over the past year, we have invested many hours and resources into developing an internal strategic plan for the Division.  This plan, developed through a participatory staff process at all levels, will guide our work internally and inform our state programs, partners and other interested partners on the Division’s focus for the next several years.  

As you can see, this plan reflects, as illustrated on the screen  our vision (read) and our mission  (read).  

This planning process has just recently been completed within the Division.  Within the next few months the document it will be ready to share with all of you.  We are crossing our fingers and hoping for November.  (Be on the lookout for the cover ... we have already moved into layout and design).  

Today I will take just a few minutes to share with you some of the highlights of this plan.   

**    **_**Our Values**_
**    ***Accountability*
*Collaboration*
*Communication*
*Integrity*
*Leadership*
*Respect*
*Service*

**    ****DHDSP Strategic Plan  **

**Notes:**
After much discussion among all of our staff, this is what we have all agreed upon as our core values, or our guiding principles.  

Accountability
Collaboration
Communication
Integrity
Leadership
Respect
Service

##       DHDSP Core Functions

**      ****DHDSP Core Functions**

**Notes:**
Our Core Functions – These are the major functions we primarily do as a division.   

Within each of our core function areas, we are committed to being good stewards of public funds.  We use the best science and resources available to develop interventions and programs that promote health equity throughout the lifespan, regardless of gender, disability, race, ethnicity, age, or socioeconomic status.  

Partnerships 
As the effects of heart disease and stroke reach beyond victims and their families into the community, we view partnership building with national, state and local stakeholders, academic researchers, government agencies, and private organizations essential to our work.  Partnerships allow us to leverage our collective resources and bring about broad, social environment and policy change in health care, worksite, school, and community settings. 

Programs
We provide funding, technical support, and expertise to state health departments, tribes, and other partners to promote science-based interventions and programs to the public.  We assist health departments increase their program capacity by developing or promoting evidence-based strategies and interventions that reduce health disparities and prevent heart disease and stroke throughout the lifespan.  

Research
We engage in applied research to support sound, evidence-based practice.  Through our research we assist state, national, and international health agencies develop public health strategies to address the burden of heart disease and stroke.  Our technical support and extramural research funding extends CDC’s capacity to improve cardiovascular health for all, eliminate disparities, and reduce the burden of cardiovascular disease and its risk factors.  

Resource Management 
We work to ensure that our recruitment, 
retention, and training policies sustain a highly-skilled and diverse workforce.  We maintain an organizational structure that keeps abreast of current policies and procedures and helps us to use our resources most efficiently. We promote integrity and accountability in all of our transactions.

Surveillance
Tracking trends in cardiovascular disease and risk factors enables the Division to assess and respond quickly to emerging issues as they occur.  Surveillance provides us with data to share with our colleagues, partners, and key stakeholders so that public health strategies can be consistently implemented to improve cardiovascular health. 
Evaluation
We evaluate programs, policies, and interventions regularly to ensure they are working as planned and producing the intended results.  We support state program evaluation activities through evaluation research, technical assistance, resource development and guidance, and capacity building in the area of evaluation. 

##                Our Strategic Imperative

**               **_**Our Strategic Imperative**_
*         *
* ****Lead the nation’s public health ***
***   ******efforts in achieving Healthy People 2010 ***
***         ******heart disease and stroke goals:***
- Prevent risk factors for heart disease and stroke.
- Increase detection and treatment of risk factors            for heart disease and stroke.
- Increase  early identification and treatment of heart disease and stroke.
- Prevent recurrences of heart attacks
-      and strokes.

**Notes:**
 Our strategic imperative came from ??? ..... Together NIH and CDC are charged with addressing the goals in HP 2010 related to heart disease and stroke prevention.  NIH focuses their work primarily on research and CDC focuses on public health and policy.  

Given that this is our charge, we decided to structure our strategic plan around these goals.  The goals from HP 2010 have become our goals within the Division’s strategic plan.  

In our strategic plan, we developed specific strategies related to each of these goal areas.  Those will be shared in the coming months in the public document.  

We have just recently – over the past couple of weeks - put the final touches on the content within the strategic plan and hope to have it ready to share with you in the next couple of months.... We are crossing our fingers that we can get through necessary clearances and printing by early November, but we’ll keep you posted on that.  

## Strategic Goal #5 

**   **
**Foster a skilled and engaged workforce to address heart disease and stroke. **
**DHDSP Workforce **
**Public health workforce **

**Notes:**
In addition to the HP 2010 goals that we are charged with addressing, the Division felt very strongly that we needed to add another goal.  One that focused on the workforce of those working in heart disease and stroke prevention.  

As a new Division, we felt that by having a goal focused on the workforce, this would help us maintain an emphasis on our efforts to support an internal workforce that is equipped with the knowledge, skills, and positive work environment it needs to be the best that it can be.   

We also want to contribute to building capacity of the workforce of those individuals working outside of our organization.  We want to find creative ways to share what we are learning as well as learn from you.    

## DHDSP Strategic Priorities 

**    ****Workforce Development **
**    ****Disparities **
**     **
**    ****Collaboration**** **

**Notes:**
Workforce

As I just mentioned, strengthening internal and external capacity in the public health workforce is a very important goal to us.  As we are a very young Division, we are focusing our efforts in this goal area on our internal workforce.  Even before the ink was dry on our new plan, we have formed an internal workgroup that is looking at ....  

We also are committed to developing the workforce of the future ... fellows/interns.  
Disparities 

Addressing disparities is not new to the Division.  For years, this has been area that has been weaved in throughout our work.  

For example .... 
Staff in our Epi branch is looking at disparities in dysphagia screening among acute stoke patients, capacity building for disparities in CVD and geographic disparities  in hospitalizations for chronic heart failure.   We are also investigating race and ethnic differences in disability among heart attack survivors.  Within the WISEWOMAN program, there are activities that address disparities and we are in the midst of developing an overall disparities plan for the Division.

As with the Workforce Development goal, we have also formed an internal (cross-divisional) workgroup asking staff to put some concrete plans on paper that will help operationalize the strategies suggested within the new division plan.  Currently the workgroup is doing an inventory  of current activities already  that address disparities and assessing the gaps for future planning future projects. 

Collaboration 

As Darwin mentioned collaboration and integration are definitely words that we embrace at the division, Center and all levels of CDC.  

As heart disease and stroke is very cross-cutting, especially as it relates to the risk factors, collaboration is something that we have recognized as crucial to our efforts for a long time.  

I wanted to share with you just a few of the areas where we are currently making great strides in our collaboration efforts. 

Internal workgroup to continue to  strengthen the infrastructure of the new division

Disparities

The Disparities Workgroup has finalized a definition of disparities as it pertains to heart disease and stroke. 

The Division is currently developing an  inventory of  disparities research and state  program activities. 

The workgroup will convene this month (September) with Macro to provide guidance and insight for the health disparities 

Identifying the scope of the problem among the disparate populations

Collaboration
We continue to expand and respond to request for partnership activities both within CDC and  with organizations across the globe addressing heart disease and stroke prevention in different venues.

## Collaboration – Risk Factors

**CVH Collaboration **
**NCCDPHP Divisions**

_**CVH Collaboration**_
**Division of Adolescent &  School Health **
**Division of Diabetes Translation**
**Office on Smoking &Health **
**Division of Adult & Community Health **
**Division of Nutrition, Physical Activity & Obesity **
**National Office of Public Health Genomics**
**NCCDPHP, Office of Director**
**Environmental Health Laboratory**
**Birth Defects and Developmental Disabilities**

**Notes:**
One of our most strategic ways that we collaborate with our “sister” divisions in the Chronic Disease Center at a high level is through the CVH Council.  This is a forum initiated and led by Dr. Labarthe and is time where the Directors from the most relevant divisions get together once a month and discuss high level issues related to HDSP.  

It is a time to consider cross-cutting issues, to develop consistent messages and to look for continued opportunities for programmatic collaboration across the Center.  Those divisions with asterisks by them are the members of this group.  

FUNDING MECHANISM 

As many of you are aware, there is a move under way within CDC to explore ways to enhance our work in the field through consolidated funding mechanisms.  ....  Judy – you’ll need to fill in the rest of your points on this

Not only are we working collaboratively with the leadership of the Divisions but we also work continuously with individual Divisions across the Center to find ways to carry each others messages, share strategies, and build programmatic opportunities.  

For example: 

OSH – make sure we include information on state quit lines in our materials 
DNPH0 – consult on appropriate dietary guidelines to include in our messaging
Genomics – as this is a relatively new and growing science in its relationship to HDSP, we are learning from our colleagues in this area in order to make sure we carry the appropriate messages in our work in the field  

## Collaboration - Funding

**Collaborative Funding  **
**Negotiated Agreements **
**Simplified Funding **

**Notes:**
Transition to Branches – collaborate across Divisions in Center but do a lot of collaborating across our branches as well.  

## Thank You.  

**Judy Hannan**
**JHannan@cdc.gov**

## 	  Applied Research & Evaluation Branch Overview

**	****  **_**Applied Research & Evaluation Branch Overview**_
**    **** **
**      ****Michael Schooley, MPH  **
**      ****Branch Chief – AR&E**
**      ****Division for Heart Disease and Stroke Prevention **
**September 18, 2007**
**Atlanta, GA**

##   DHDSP Applied Research & Evaluation Branch 

## DHDSP Applied Research & Evaluation Branch Key Topics

**	****Collaboration, Coordination & Partnership**

## DHDSP Applied Research & Evaluation Branch Key Topics

**	****Evaluation Capacity Building**

## DHDSP Applied Research & Evaluation Branch Key Projects

**Policy Tools**
**	****(Workshop 2)**
**Worksite Tools**
**	****(Workshop 14)**
**CHW Sourcebook**
**	****(Round Table 10)**
**PRC CVH Network**
**	****(Round Table 2)**

## DHDSP Applied Research & Evaluation Branch Key Projects

**Evaluation Plan**
**	*****(Round Table 9)***
**Evaluation Guides**
**	*****(Round Table 12)***
**Indicators Project**
**	*****(Plenary 6)***

## DHDSP Applied Research & Evaluation Branch Key Sessions

**Partnership Evaluation**
**	****  *****(Workshop 5)***
**Logic Models**
**	****   *****(Workshop 6)***
**Training Needs Assessment **
**	****   *****(Workshop 21)***
**Evaluation Plans, Logic Models, Intervention Evaluation **
**      *****(Special Sessions)***

## “Experience is what you get 

***when you don’t get what you want.”***
***— ******Unknown***

##           Thank You.

**          ****Thank You.**
**MSchooley.@cdc.gov**

## 	  Epidemiology & Surveillance Branch Overview

**	****  **_**Epidemiology & Surveillance Branch Overview**_
**    **** **
**      ****Robert Merritt, MA **
**      ****Acting Branch Chief – E&S Branch**
**      ****Division for Heart Disease and Stroke Prevention **
**September 18, 2007**
**Atlanta, GA  **

## DHDSP Epidemiology & Surveillance Branch 

##    DHDSP  Epidemiology and Surveillance Branch                Key Priority Areas

**Improve control of hypertension and**
**   ****high cholesterol**
**Improve emergency response**
**Improve quality of care**
**Eliminate disparities**

##   Improve Control of Hypertension and Cholesterol

|  Team | State Activities |
| --- | --- |
| Epidemiology and Surveillance | State Cardiovascular Health Examination Survey (AR, KS, OK, WA)

Core BRFSS (2007, 2009, 2011):

High blood pressure awareness and medication use

High cholesterol screening and awareness

BRFSS module (2007, 2009, 2011):

Actions to Control High Blood Pressure |

## Improve Emergency Response

|  Team | State Activities |
| --- | --- |
| Epidemiology and Surveillance | Annual state-level estimates of pre-transport death rates (all states) |
| Small Area Analysis | National survey of local and state 911 emergency medical services (AR, FL, KS, MA, MT, NM, OR, PA, SC) (NC)
Stroke Toolkit for Emergency Response (NC) |
| Health Services Research and Registries | Cardiac Arrest Registry to Enhance Survival (CARES) – prototype registry in Metro Atlanta to track and improve cardiac arrest survival. |

## Improve Quality of Care

|  Team | State Activities |
| --- | --- |
| Epidemiology and Surveillance | State-level estimates of procedure use during Medicare hospitalizations for heart disease and stroke 
(all states) |
| Small Area Analysis | Atlas of Stroke Hospitalizations in the Medicare Population (all states) |
| Health Services Research  and Registries | Paul Coverdell National Acute Stroke Registry (GA, IL, NC, MA, MN, OH, MI) to improve the quality of stroke care in hospitals |

## Eliminate Disparities

|  Team | State Activities |
| --- | --- |
| Epidemiology and Surveillance | State-specific estimates for disparities in risk factors, mortality, and Medicare hospitalizations (all states) |
| Small Area Analysis | Atlases (all states) 
Social determinants of disparities (SE region) |
| Health Services Research and Registries | Paul Coverdell National Acute Stroke Registry—improved evaluation, detection, and treatment for all |

## DHDSP  Epidemiology and Surveillance Branch

**DHDSP  Epidemiology and Surveillance**** Branch**
**                         ****New Resources**

## DHDSP  Epidemiology and Surveillance Branch Future Activities and Opportunities

**Provide guidance on disease definition and analysis.**
**Foster use of GIS technology with training and guidelines.**
**Develop questions and modules on surveys (e.g., BRFSS).**
**Develop demonstration models or prototypes to improve  surveillance and evaluation capacity of state programs.**
** **
**Develop a health services research agenda to address gaps in clinical preventive services.**
**Encourage enhancement of scientific capacity that will **
**    ****guide program development.**

## Thank You.

**Rob Merritt**
**RMerritt@cdc.gov**

##        Nancy Watkins, MPH

**	**** **_**Program Development & Services Branch Overview **_
**    **
-        Nancy Watkins, MPH
-      Branch Chief – PDSB
-      Division for Heart Disease and Stroke Prevention
-      September 18, 2007
-       Atlanta, GA

**Notes:**
Thank you ______

For about the next half hour, Dr. Bob Robinson and I will give you a quick overview of both quantitative AND qualitative information about tobacco use among the racial and ethnic groups you will hear about today.
The reason why we will focus on both is that our work in OSH has taught us that quantitative data alone, cannot provide all we need to know and understand about tobacco-related disparities in these population groups.
Because of their individual, social, cultural and economic environments within our nation, each of these groups will reflect the burden of tobacco use in wholly unique ways. Therefore, we are compelled to understand as much as we can about them.
Today, I will focus my presentation on just a few areas of disparities. Let me say that we do not presume that today’s presentation is complete and comprehensive. 

## State Heart Disease and Stroke Prevention and WISEWOMAN Programs, 2007

**State Heart Disease and Stroke Prevention ****and WISEWOMAN Programs, 2007**

**WA**

**OR**

**CA**

**NV**

**ID**

**MT**

**ND**

**SD**

**NE**

**KS**

**OK**

**TX**

**NM**

**AZ**

**CO**

**UT**

**MI**

**IL**

**MO**

**AR**

**LA**

**MS**

**AL**

**GA**

**FL**

**SC**

**NC**

**TN**

**KY**

**VA**

**WV**

**PA**

**NY**

**ME**

**OH**

**IN**

**VT**

**NH**

**MA**

**NJ**

**WY**

**MN**

**WI**

**IA**

**AK**

**HI**

**PR**

**DE**

**MD**

**DC**

**CDC WISEWOMAN Projects, Fiscal Year 2005**

**RI**

**CT**

-         No Funding             Capacity Building            Basic Implementation

**DE**

## State Heart Disease and Stroke Prevention Programs and Stroke Networks, 2007

**State Heart Disease and Stroke Prevention Programs and Stroke Networks, 2007**

**WA**

**OR**

**CA**

**NV**

**ND**

**SD**

**NE**

**KS**

**OK**

**TX**

**NM**

**AZ**

**CO**

**UT**

**MI**

**IL**

**MO**

**AR**

**LA**

**MS**

**AL**

**GA**

**FL**

**SC**

**NC**

**TN**

**KY**

**VA**

**WV**

**PA**

**NY**

**ME**

**OH**

**IN**

**VT**

**NH**

**MA**

**CT**

**NJ**

**WY**

**MN**

**WI**

**IA**

**AK**

**HI**

**RI**

**MI**

**IL**

**OH**

**IN**

**MN**

**WI**

**GA**

**SC**

**NC**

**AR**

**LA**

**MS**

**AL**

**TN**

**Tri-State Network**

**Delta States Network**

**Great Lakes Network**

**DC**

**Northwest**
**Regional Network**

**ID**

**MT**

-             **No funding**	      **Capacity Building**	               **Basic Implementation**

##    Program Development & Services Branch

## 
Training 
Technical Assistance
Internal Partnerships
External Partnerships
Management of grants

**Training **
**Technical Assistance**
**Internal Partnerships**
**External Partnerships**
**Management of grants**

**                     ****Role of Program Staff**

**Notes:**
Include test from Branch functions slides with circles:
Training, program guidance, evaluations, partnerships, resources, tools TA, promising practices
Build capacity;  Implement interventions;  Make system, policy and environmental changes
Support states, link strategies
Program priorities: Control HTN; improve quality care.
Division tools and guidance 

##  		State and Tribal Programs  

**Public Health Practice**
**	*****Socio-ecological model***
***	******Population-based approaches***
**  ****Science ****	**
** ****Clinical Guidelines**
** ****Evaluation****	**

** ****	****	****State and Tribal** **Programs** ** **

## 
WISEWOMAN FOA

Action Framework

Policy and systems change priorities 

**WISEWOMAN FOA**
**Action Framework**
**Policy and systems change priorities **

**	****State Program** **Priorities for 2008**

**Notes:**
Include test from Branch functions slides with circles:
Training, program guidance, evaluations, partnerships, resources, tools TA, promising practices
Build capacity;  Implement interventions;  Make system, policy and environmental changes
Support states, link strategies
Program priorities: Control HTN; improve quality care.
Division tools and guidance 

##      9 States are also HDSP Program States           

-  Serve low-income, under- or uninsured 40- to
-    64-year-old  women
-   Provide risk factor screening and medical and lifestyle
-     referrals to   prevent and reduce risk factors.
-    15 projects are funded in 14 States
-      *9 States are also HDSP Program States***           **

## Action Framework For A Comprehensive Public Health StrategyTo Prevent Heart Disease and Stroke

**Action Framework For A Comprehensive Public Health Strategy****To Prevent Heart Disease and Stroke**

** ****Goal 1 **

** ****Goal 3 **

** ****Goal 4 **

** ****Goal 2 **

**National Action Plan overarching goal: To increase quality and years of healthy life and to eliminate disparities**

- Prevent recurrence and complications of heart disease and stroke.

- Detect and treat risk factors for heart disease and stroke

- Prevent the development of risk factors for heart disease and stroke.

- Early identification and treatment of heart disease and stroke

**Roles of States**

- Control high blood pressure
- Control high cholesterol
- Increase awareness of Signs and    Symptoms

- Improve emergency response
- Improve quality of care
- Eliminate disparities

_**Supportive Role**_

_**Direct Program Role**_

## NACDD CVH Council

Expert Panels
 High Blood Pressure
 Emergency Medical Services

Promising Practices

Learn from States

Division Work Group

**Expert Panels**
*** ******High Blood Pressure***
*** ******Emergency Medical Services***
** **
**Promising Practices**
**Learn from States**
** **
**Division Work Group**

**Identifying Priority Policies and Systems Changes**

**Notes:**
Include test from Branch functions slides with circles:
Training, program guidance, evaluations, partnerships, resources, tools TA, promising practices
Build capacity;  Implement interventions;  Make system, policy and environmental changes
Support states, link strategies
Program priorities: Control HTN; improve quality care.
Division tools and guidance 

## DHDSP Program Development & Services Branch                         Future Priorities

**Basic Implementation funding for *****All *****States **
**   ****and Territories  **
**                         **
**Best practices for program interventions**
**Enhance web-based training and conferences **
**    ****for States**
**And enhanced collaboration within and **
**   ****between Divisions**

**Notes:**
Read Bullets but add...

Although we have a plan for the future we encourage you to communicate your needs and ideas to use, because, we are partners in our efforts to create a health healthy and stroke free society.

## Thank You.

**Nancy Watkins**
**NWatkins@cdc.gov**

##  Take a Minute for your Heart Health