Assessment of the Sustainability Capacity of a Coordinated Approach to Chronic Disease Prevention.

OBJECTIVE: This article outlines some factors that influenced the sustainability capacity of a coordinated approach to chronic disease prevention in state and territory health departments. DESIGN: This study involved a cross-sectional design and mixed-methods approach. Quantitative data were collected using the Program Sustainability Assessment Tool (PSAT), a 40-item multiple-choice instrument that assesses 8 domains of sustainability capacity (environmental support, funding stability, partnerships, organizational capacity, program evaluation, program adaptation, communications, and strategic planning). Qualitative data were collected via phone interviews. PARTICIPANTS: The PSAT was administered to staff and stakeholders from public health departments in 50 US states, District of Columbia, and Puerto Rico, who were involved in the implementation of coordinated chronic disease programs. Phone interviews were conducted with program coordinators in each state. MAIN OUTCOME MEASURE(S): Sustainability score patterns and state-level categorical results, as well as strengths and opportunities for improvement across the 8 program sustainability domains, were explored. RESULTS: On average, programs reported the strongest sustainability capacity in the domains of program adaptation, environmental support, and organizational capacity, while funding stability, strategic planning, and communications yielded lowest scores, indicating weakest capacity. Scores varied the most by state in environmental support and strategic planning. CONCLUSION: The PSAT results highlight the process through which states approached the sustainability of coordinated chronic disease initiatives. This process included an initial focus on program evaluation and partnerships with transfer of priority to long-term strategic planning, communications, and funding stability to further establish coordinated chronic disease efforts. Qualitative interviews provided further context to PSAT results, indicating that leadership, communications, partnerships, funding stability, and policy change were perceived as keys to success of the transition. Integrating these findings into future efforts may help those in transition establish greater sustainability capacity. The PSAT results and interviews provide insight into the capacity for sustainability for programs transitioning from traditional siloed programs to coordinated chronic disease programs.

Lessons learned while preparing a tailored, self-help, technology-driven intervention for national dissemination.

Tailored health interventions have been found to be effective in various areas of health promotion because of their delivery of customized content, which focuses the prevention messages more closely on the individual's risk behavior. However, the use of tailored interventions in the prevention of STD/HIV has been limited, and there is a void in the literature on translating tailored interventions into practice. This paper discusses the process of translating a tailored, self-help, technology-driven STD/HIV prevention intervention from research-to-practice. Three agencies were selected during the translation process to test the intervention materials and provided valuable lessons learned for translating a tailored intervention into practice. A racially diverse group of more than 250 women in six states participated in the intervention during this pilot test. Lessons learned for research-to-practice efforts for tailored interventions are presented, including expanding the reach of such interventions by making them more compatible for mobile technology.