Transforming Chronic Disease Program Silos: California's Integrated Approach

Objective: To encourage and support California’s chronic disease programs to integrate activities across disease-specific program lines to address the State’s leading causes of death, disability, injury, and major risk factors.

Methods: Programs within the Center for Chronic Disease Prevention and Health Promotion formed a Chronic Disease Integration Workgroup (CDIWG) with a mission to create a new organizational culture where collaboration and integration are defined as a normative priority process with the expectation to ultimately improve health outcomes and health equity. As a framework for action, CDIWG members use recommendations and tools from Partnership for Prevention’s Action Planning Handbook for States and Communities to identify common chronic disease risk factors and populations. Nineteen programs are actively participating in CDIWG activities

Results: The California Heart Disease and Stroke Prevention Program, the California Diabetes Program, the California Arthritis Partnership Program, and the California Smokers’ Helpline are collaborating on a pilot project to reduce the burden of cardiovascular disease morbidity and mortality. Disease-specific program objectives have been integrated into a comprehensive work plan that systematically builds on existing capacity within local health departments and communities to address cardiovascular disease risk factors of high blood pressure, diabetes, tobacco use, and arthritis.

Conclusion: Grassroots leadership within a state health department can result in organizational change to promote program integration and collaborative action-planning. Critical elements to integration that advances public health chronic disease action include:  program staff committed to the integration concept, a department Champion, and a workgroup structure to formalize the process.