Challenges of EHR "Meaningful Use" in Rural Health Centers.

The Centers for Disease Control and Prevention (CDC) continues to promote the utilization of electronic health records (EHRs) to support population health management and reduce disparities. However, access to EHRs with capabilities to disaggregate data or generate digital dashboards is not always readily available in rural areas. With funding from CDC's DP-18-1815, the Division of Diabetes and Heart Disease Management (Division) at the South Carolina Department of Health and Environmental Control designed a quality improvement initiative to reduce health disparities for people with hypertension and high blood cholesterol in rural areas. With support from a nonprofit partner, the Division used qualitative evaluation methods to evaluate the extent to which practices were able to disaggregate data and report quality measures.

Associations Between Social Vulnerability and Providing Evidence-Based Diabetes Prevention and Management Activities in South Carolina, 2019.

We assessed associations between social vulnerability (ie, external stressors negatively affecting communities) and the provision of evidence-based diabetes prevention and management activities (eg, National Diabetes Prevention Program) in South Carolina counties with high burdens of diabetes and heart disease. These associations were examined by using relative risk estimation by Poisson regression with robust error variance. Results suggest that social vulnerability may have differential effects on the provision of evidence-based diabetes prevention and management activities in South Carolina. Findings support calls to identify upstream social factors contributing to adverse health outcomes and provide several potential points for intervention.

Expanding Applicability of Presentations at Public Health Conferences.

As public health practitioners and program evaluators for a state health department, we look forward to public health conferences for the opportunity to hear from leaders in the field and inform our own practice. While we feel that most presentations describe the work and why it matters, many of us leave sessions thinking, "Now what?" In other words, how do we apply what we learned to public health practice? As American Public Health Association (APHA) looks to celebrate its 150th year in 2022, now is an ideal time to focus on expanding the impact of our work. We offer several suggestions for how conference presenters can make their work more applicable to public health practitioners. We ground our recommendations in John Driscoll's reflective model for health care practitioners. This framework guides the audience through three questions designed to move from a description of what happened ("what?") to the potential significance of their findings ("so what?") and finally to the actions we can take as a result ("now what?"). These strategies are meant to help presenters describe processes and implications in addition to outcomes and theory. We hope that public health professionals can continue to look to the APHA Annual Meeting and other public health conferences as not only sources of innovative research but also as forums for practitioners to share the practical applications of their work.

Expanding Opportunities for Data Dissemination Through Collaborative Writing Teams in Public Health Practice Settings.

Government health departments at all levels make meaningful contributions to advancing the public health of communities, yet state health departments lack the time and infrastructure to share their findings with the broader scientific community. To address this gap in data dissemination, the South Carolina Department of Health and Environmental Control developed a "collaborative writing team" (CWT) pilot. As part of this pilot program, teams of staff members leveraged existing data to advance the public health knowledge base, with an emphasis on public health practice. The six steps of the CWT included (1) identify team members' skills/strengths, (2) discuss available data, (3) determine opportunities to share data, (4) divide responsibilities based on team members' strengths, (5) write and submit product, and (6) debrief. Between December 2019 and November 2020, the team had six abstracts accepted to two national conferences, one abstract accepted to a state public health conference, and one editorial published in a peer-reviewed journal. Feedback from participants indicated that self-efficacy in areas including writing, project facilitation, and analysis had increased among team. CWTs are a framework for people working within public health practice settings to disseminate findings.

Assessment of Chronic Disease Management Strategies Among Health Care Practices in Medically Underserved South Carolina Counties.

Diabetes and heart disease are among the leading causes of death and disability in the United States, and these conditions are especially prevalent in the South. South Carolina's persistent racial and socioeconomic disparities in chronic disease outcomes are well-documented, yet little is known about how health care practices in medically underserved areas are addressing these challenges. Data were collected through a cross-sectional survey as part of two complementary 5-year cooperative agreements between the Centers for Disease Control and Prevention and the Division of Diabetes and Heart Disease Management (the Division) at the South Carolina Department of Health and Environmental Control. The Division fielded a survey to (a) assist in determining which Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) were best poised to implement specific strategies as part of these cooperative agreements and (b) provide data to establish the baseline for performance measures. FQHCs and RHCs in the top 25% of counties with the highest diabetes and heart disease burden were surveyed about eight domains: staffing/services, electronic health records, team-based care policies, lifestyle change programs, medication therapy management, telehealth, quality improvement collaboratives, and patient demographics. Data representing 71 practices revealed contrasts between RHCs and FQHCs and opportunities for improvement. For example, while most practices reported they were not implementing evidence-based lifestyle change programs (e.g., the National Diabetes Prevention Program), most RHCs and FQHCs expressed interest in starting such programs. Findings are being used to guide efforts to improve diabetes and heart disease prevention and management in South Carolina.