Critical Program Movement Integration of STD Prevention with

Critical Program Movement: Integration of STD Prevention with Other Programs Kevin Fenton, MD, Ph. D, FFPH Director National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 2008 National STD Prevention Conference March 13, 2008

Objectives • Provide an update on progress toward Program Collaboration and Service Integration (PCSI) • Describe ways we are changing NCHHSTP culture to promote program integration • Reflect on steps we can take to accelerate our progress and achieve greater health impact

Framework for Successful Change Management • • • Identify articulate and disseminate a clear vision Develop a clear pathway, key steps and milestones Enlist the support of willing partners and coalitions. Identify barriers and opportunities for execution. Codify, disseminate and encourage the uptake of best and promising practices Evaluate, evaluate.

Identify, articulate and disseminate a clear vision

Program Collaboration and Service Integration (PCSI) • Operating Definition: v. A mechanism of organizing and blending inter-related health issues, separate activities, and services in order to maximize public health impact through new and established linkages between programs to facilitate the delivery of services

Program Collaboration and Service Integration (PCSI) • Goal: v. Provide prevention services that are holistic, science based, comprehensive, and high quality to appropriate populations at every interaction with the health care system. • Vision: v. Remove barriers to and facilitate adoption of service delivery integration at the client level by aligning NCHHSTP activities, systems, and policies with this goal.

Program Collaboration and Service Integration (PCSI) • Integration should be focused at the field or client level where the interface between the system and the consumer takes place. • • Integration should result in more holistic services for clients, regardless of the agency structure. Key Principles of PCSI: v v v Appropriateness Effectiveness Flexibility Accountability Acceptability

Develop a clear pathway, key steps and milestones for achieving the vision

Program Collaboration and Service Integration: • NCHHSTP green paper, July 2007 v. Green paper: a discussion document intended to stimulate debate and launch a process of consultation • Paper describes how NCHHSTP will • work with partners to advance PCSI strategic priority url: http: //www. cdc. gov/nchhstp/programintegration

Consultation on PCSI • • • Held August 21 -22, 2007 in Atlanta Attended by more than 70 partners and 50 NCHHSTP staff members Purpose: v. To advise NCHHSTP on the development PCSI activities over the next 5 years

PCSI Priorities arising from the August 2007 CDC Consultation • 1. Focus efforts and opportunities for promoting integrated surveillance • 2. Focus efforts on training on PCSI and integrated training opportunities • 3. Accelerate the use of program announcements to support and enhance funding for PCSI.

1. Integrated Surveillance Key Priorities and Needs for PCSI • Integrated surveillance reports • Standards for sharing of data • Guidelines for integrated data with common • • demographics, variables, and definitions Address confidentiality issues – create a gold standard Surveillance systems that work with and across programs

2. Integrated Training efforts Key Priorities and Needs for PCSI • Flexible funding for training • Integrated and comprehensive guidelines • Program announcements that include • common language and objectives to address Center’s diseases Training centers required to have integrated training curricula

3. Integrated funding Key Priorities and Needs for PCSI • • Integrative program announcements (PA’s) (leverage integration through PA’s) Collaboration on program announcements and post award management Incentives for state and federal funding to support integration Incentives for “in-kind funds” and/or require matching funds Reprioritization of funds at CDC level Reporting and evaluation components Fund pilots or demonstrations

Enlist the Support of Partners and Coalitions in the Journey

Identify Barriers and Opportunities for Implementation

Barriers and Opportunities Barriers • • • Lack of national guidelines Administrative requirements Data collection and surveillance systems not integrated Lack of integrated prevention guidelines Insufficient translation and integration of science and program Insufficient support for cross training, evaluation and dissemination of best practices • • • Opportunities Increased efficiency and reduced redundancy Increased flexibility by enabling partners to adapt, implement, and modify integrated services to increase responsiveness to evolving epidemics or changing contexts Increased control over operations, using local information from surveillance and key performance indicators

Identify, Disseminate and Encourage Best and Promising Practices

2008 National STD Prevention Conference Collaboration and Integration Sessions • PCSI Specific Sessions • A 5 Workshop – The Power of Many Voices • B 5 Symposium – Collaboration for STD, HIV and Teen Pregnancy Prevention • B 6 Oral Presentations – Issues in Integration of STD Prevention • B 8 Oral Presentations – Alternative Venues; STD Prevention Outside the STD Clinic

2008 National STD Prevention Conference Collaboration and Integration Sessions • Population Focus • A 4 Symposium – Implementing and • • Sustaining a School based STD Screening Program B 5 Symposium – Collaboration for STD, HIV and Teen Pregnancy Prevention B 1 Symposium – Chlamydia screening in Indian Country

2008 National STD Prevention Conference Collaboration and Integration Sessions • Partner Notification • D 8 Symposium – Promising Practices: Integrating STD and HIV Partner Services Guidelines • Surveillance • D 6 Workshop – Contemporary Issues for Data Integration and Dissemination

Evaluation

What You Can Do? • Be committed to: v. Service v. Action v. Evidence-based public health practice v. Partnerships v. Timely implementation

PCSI Program Collaboration and Service Integration