Strategies for Reducing Health Disparities — Selected CDC ...

1 Supplement / Vol. 65 / No. 1 February 12, 2016 Department of Health and Human ServicesCenters for disease control and PreventionMorbidity and Mortality Weekly ReportStrategies for Reducing Health Disparities Selected CDC- sponsored Interventions, United States, 2016 SupplementThe MMWR series of publications is published by the center for Surveillance, Epidemiology, and Laboratory Services, centers for disease control and prevention (CDC), Department of Health and Human Services, Atlanta, GA citation: [Author names; first three, then et al.]

2 , if more than six.] [Title]. MMWR Suppl 2016;65(Suppl-#):[inclusive page numbers].Centers for disease control and PreventionThomas R. Frieden, MD, MPH, Director Harold W. Jaffe, MD, MA, Associate Director for Science Joanne Cono, MD, ScM, Director, Office of Science Quality Chesley L. Richards, MD, MPH, Deputy Director for Public Health Scientific ServicesMichael F. Iademarco, MD, MPH, Director, center for Surveillance, Epidemiology, and Laboratory Services MMWR Editorial and Production Staff (Serials)Sonja A. Rasmussen, MD, MS, Editor-in-ChiefCharlotte K.

3 Kent, PhD, MPH, Executive Editor Christine G. Casey, MD, EditorTeresa F. Rutledge, Managing EditorDavid C. Johnson, Lead Technical Writer-EditorKristina B. Clark, Catherine B. Lansdowne, MS, Jeffrey D. Sokolow, MA, Project EditorsMartha F. Boyd, Lead Visual Information SpecialistMaureen A. Leahy, Julia C. Martinroe, Stephen R. Spriggs, Moua YangVisual Information SpecialistsQuang M. Doan, MBA, Phyllis H. King,Teresa C. Moreland, Terraye M. Starr,Information Technology SpecialistsMMWR Editorial BoardTimothy F. Jones, MD, ChairmanMatthew L.

4 Boulton, MD, MPHV irginia A. Caine, MD Katherine Lyon Daniel, PhDJonathan E. Fielding, MD, MPH, MBAD avid W. Fleming, MD William E. Halperin, MD, DrPH, MPHKing K. Holmes, MD, PhD Robin Ikeda, MD, MPH Rima F. Khabbaz, MDPhyllis Meadows, PhD, MSN, RNJewel Mullen, MD, MPH, MPAJeff Niederdeppe, PhDPatricia Quinlisk, MD, MPH Patrick L. Remington, MD, MPH Carlos Roig, MS, MAWilliam L. Roper, MD, MPH William Schaffner, MDCONTENTSF oreword ..1 Background and Promotion and Diabetes prevention in American Indian and Alaska Native Communities Traditional Foods Project, 2008 2014.

5 4 Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma ..11 Use of Evidence-Based Interventions to Address Disparities in Colorectal Cancer Screening ..21 Progress Toward Eliminating Hepatitis A disease in the United States ..29 Adaptation and National Dissemination of a Brief, Evidence-Based, HIV prevention Intervention for High-Risk Men Who Have Sex with Men ..42 The HoMBReS and HoMBReS Por un Cambio Interventions to Reduce HIV Disparities Among Immigrant Hispanic/Latino Men.

6 51 Preventing Violence Among High-Risk Youth and Communities with Economic, Policy, and Structural Strategies ..57 Living Well with a Disability, a Self-Management Program ..61 Epilogue ..68 SupplementMMWR / February 12, 2016 / Vol. 65 / No. 1 1US Department of Health and Human Services/Centers for disease control and PreventionReducing Health Disparities is a major goal of public Health . Despite the persistence of Disparities , progress is being made. Since 2011, CDC Health Disparities and Inequalities Reports (1,2) and the inaugural Strategies for Reducing Health Disparities report (3) have highlighted effective public Health programs that have demonstrably reduced Disparities .

7 The reports in this supplement add to this record of are six key components to effective public Health program implementation: innovation, a technical package of evidence-based interventions, performance management, partnerships, effective communication, and political commitment (4). Among these, performance management, the real-time monitoring and evaluation of programs to ensure continuous program improvement, is particularly important to reduce Health programs can be particularly difficult to manage because of the inability to track program performance in real time.

8 Moreover, results might not be apparent for months or even years. As a result, all programs must include sustainable monitoring systems that provide simple, accurate information on progress in program implementation and long-term impact. Even the best-designed programs might fail without timely, honest reports in this Supplement detail various CDC or CDC-funded programs that incorporate effective performance management. For example: Over a decade, the Advisory Committee on Immunization Practices made incremental changes to hepatitis A (HepA) vaccination recommendations intended to increase coverage for children and persons at high risk for HepA infection.

9 CDC analysis of data sets established that the recommended vaccinations eliminated most Disparities in HepA disease by age, racial and ethnic group, and geographic area. The analysis also documented an increased proportion of HepA among an emerging population of susceptible adults, underscoring the importance of improving programs and avoiding complacency (5). After conducting a needs assessment over two years, Boston Children s Hospital and CDC researchers developed a program at Harvard Medical School to address Disparities in pediatric asthma mortality.

10 Targeting primarily black and Hispanic low-income neighborhoods served by Boston Children s Hospital, the program offered families advanced asthma care, including care coordination, case management, and home visits. Evaluation compared program enrollees with children with asthma living in demographically similar areas. The program significantly improved asthma outcomes over a three-year period and has been adapted and replicated in other cities and states (6). Racial and ethnic minority groups, persons without Health insurance, and households with low educational attainment and income have lower rates of colorectal cancer (CRC) screening.