Research Translation and Dissemination: CDC Initiatives and Activities

1. Research Translation and Dissemination: CDC Initiatives and Activities Director, Healthy Aging Program Division of Adult and Community Health National Center for Chronic Disease Prevention and Health Promotion, CDC Lynda A. Anderson, PhD Hartford Geriatric Social Work Scholars Leadership Conference April 6, 2008

2. Topics for Discussion Centers for Disease Control and Prevention (CDC) Examples of CDC activities that can help with moving science to practice CDC’s Healthy Aging Program Examples of activities that can help with moving science to practice

3. Public Health and Medicine H Fineberg, Harvard School of Public Health, 1990

4. Centers for Disease Control and Prevention

5. CDC′s Mission “To promote health and quality of life by preventing and controlling disease, injury, and disability"   CDC′s History Founded as the Communicable Disease Center 60th anniversary in 2006

11. CDC ActivitiesSelect Examples • National and state-based surveillance systems • Reviews of community-based interventions • Research Translation • Grants (R 18) • Prevention Research Centers

12. National and State-based Surveillance

13. Actual Causes of Death† United States, 2000 Leading Causes of Death* United States, 2000 Heart Disease Tobacco Cancer Poor diet/Physical inactivity Alcohol consumption Stroke Chronic lower respiratory disease Microbial agents Toxic agents Unintentional Injuries Motor vehicles Diabetes Firearms Pneumonia/influenza Alzheimer’s disease Sexual behavior Kidney disease Illicit drug use 0 5 10 15 20 0 5 10 15 20 25 30 35 Percentage (of all deaths) Percentage (of all deaths) ~ * Minino AM, et al. Deaths: final data for 2000. National Vital Statistics Reports 2002; 50(15):1-120. † Mokdad AH, et al. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238-1246.

14. Behavioral Risk Factor Surveillance System • Established in 1984 • Largest continuously conducted telephone health survey in the world • 356,112 interviews in 2005 • Conducted by health departments in all states, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam

15. Behavioral Risk Factor Surveillance System • Collects information from adults aged 18 years and older • Enables the CDC, state health departments, and other health and education agencies to monitor risk behaviors related to chronic diseases, injuries, and death • Effective tool in preventing disease and promoting health

16. Identify health problems Establish and track health objectives Support health policies and legislation Develop and evaluate public health programs Applications of BRFSS

19. No Data <10% 10%-14% 15%-19% 20%-24%  25% Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Source: Mokdad A H, et al. J Am Med Assoc 2001;286:10

20. No Data <10% 10%-14% 15%-19% 20%-24%  25% Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Source: Mokdad A H, et al. J Am Med Assoc 2001;286:10

21. No Data <10% 10%-14% 15%-19% 20%-24%  25% Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI 30, or ~ 30 lbs overweight for 5’4” woman) Source: Centers for Disease Control and Prevention, BRFSS, 2004

22. Establish and Track Health Objectives • Healthy People 2010 Objectives • Chronic Disease Indicators • State Goals & Objectives

24. Reviews of Community-based Interventions

25. Evidence-based Reviews www.thecommunityguide.org

26. Guide to Community Preventive Services • U.S. Community Preventive Services Task Force Appointed by CDC Director in 1996 • Non-Federal independent task force of experts in multiple relevant disciplines • Epidemiology • Public health practice • Behavioral sciences • Evidence-based public health

27. Community Guide • Provides information about high-priority interventions in high-priority areas • More than 175 evidence-based findings • Provides information on key health, proxy, or behavioral outcomes • Includes economic analysis when available • Implementation information is recognized but not yet addressed by the Community Guide

28. Community Guide Topics

29. How Do I Locate Findings From the Guide? • Publications • MMWR Reports & Recommendations (R&R) series • American Journal of Preventive Medicine – special supplements • Website • www.thecommunityguide.org

30. Translational Grantsand Programs

31. Translation Research Grant • "Elimination of Health Disparities through Translation Research (R18)" • Published in www.grants.com • The direct link to the FOA is: www.cdc.gov/od/gov/funding/CD08-001.htm Applications are due May 2, 2008 • Purpose: • Accelerate the translation of research findings into public health practice through implementation, dissemination, and diffusion research • Agency-wide announcement that addresses CDC's strategic imperatives and Health Protection Goals

32. 1984: Congress authorizes PRC Program • Centers to conduct research and dissemination related to health promotion and disease prevention • Located in an academic health centers -- school of public health or schools of medicine or osteopathy with a preventive residency program • Wide range of population groups with incidences of diseases most amenable to preventive intervention

33. PRC Research Settings • Schools • Communities • Homes • Workplaces • Healthcare settings • Places of worship

34. PRC Health Issues • Aging • Risks for obesity, heart disease, and cancer • Health conditions such as asthma and arthritis • Prevention of HIV/AIDS • Oral Health • Vision and hearing impairment

35. PRC Strengths • Build relationships with underserved communities • Utilize a community-based participatory research approach (CBPR) • Produce quality research and move effective intervention into practice • Offer training to colleagues • Special Interest Projects

36. Prevention Research Centers2004 - 2009 University of Kentucky University of Rochester University of Washington at Seattle University of State University of New York at Albany Minnesota University of Illinois at Chicago Oregon Health and Sciences University Universityof Michigan West Virginia Harvard University University Boston University Yale University University of Iowa Columbia University University of Pittsburgh University of The Johns Hopkins California University University of at Berkeley Colorado St. Louis University Universityof University of University California North Carolina at of San Diego State University University of at Los Angeles Chapel Hill Oklahoma New Mexico University of South Carolina University of Texas A&M University Morehouse Arizona School of Medicine University Of Texas HSC, Houston University of Tulane Alabama at Emory University University Birmingham University of South Florida

37. Healthy Aging Program www.cdc.gov/prc

38. Healthy Aging Program Division of Adult and Community Health, National Center for Chronic Disease and Health Promotion

39. Healthy Aging Program • Healthy Aging Program • Data into action • Link public health and aging networks • Promote research translation • Healthy Brain Initiative (Alzheimer’s segment)

40. Healthy Aging Program ActivitiesSelect Examples • Turning data into action • Promote research translation

41. Data into Action

42. The State of Aging and Health in America Reports

43. Report Data National level • 15 key indicators • BRFSS • National Hospital Discharge Survey • Measures progress made toward Healthy People targets State level • 14 key indicators (no hip fracture hospitalizations) • BRFSS • State-by-state comparison for each indicator

44. Health Status Physically unhealthy days Frequent mental distress Complete tooth loss Disability Health Risk Behaviors No leisure-time physical activity Eating ≥5 fruits & vegetables daily Obesity Current smoking Key Indicators • Preventive Care & Screening • Flu vaccine in the past year • Ever had pneumonia vaccine • Mammogram in past two years • Colorectal cancer screening • Cholesterol screening • Up-to-date on select preventive services (men & women) • Injury • Hip fracture hospitalization

46. Research Translation

47. Healthy Aging Research Network • Formed in 2001 • CDC’s Prevention Research Centers Program • Mission: • To better understand the determinants of healthy aging • To identify interventions that promote healthy aging • To assist in the translation of research into sustainable community-based programs http://depts.washington.edu/harn/

48. Promoting Translation of Prevention Research

49. Special Interest ProjectsExamples in Aging • PRC Healthy Aging Research Network (PRC HAN) • Lead Center plus 9 PRC programs ($550,000/year) • Evidence-based review of depression interventions for older adults ($250,000) • Evidence-based review of emotional health interventions for older adults ($150,000) • Identification and Development of Prevention Opportunities to Promote or Maintain Brain Health in Older Adults ($250,000/year) • Data on the Health of Older Adults at State and Local Levels ($100,000)

50. “ “The RE-AIM model has been successfully used as a planning and evaluation framework in many different health and lifestyle programs. It is most timely to have RE-AIM applied to caregiving issues with examples that will resonate with both researchers and practitioners . . . .” Marcia G. Ory, Ph.D., M.P.H. Texas Healthy Aging Network School of Rural Public Health The Texas A&M Health Science Center