The role of state public health agencies in addressing less prevalent chronic conditions.
BACKGROUND
State-based chronic disease programs typically focus on the most prevalent chronic conditions, such as cancer, diabetes, and cardiovascular disease, but interest in less prevalent chronic conditions (LPCCs), such as epilepsy, is growing. In our study, we examined the perceived roles of state health departments in addressing LPCCs and used this information to develop recommendations for state health departments that are considering developing LPCCs programs. We also compared the identified state health department roles for LPCCs with roles related to healthy aging, as well as to the essential elements of existing state-based chronic disease programs, to determine whether future LPCCs programs would have any unique requirements.


METHODS
Participants used concept-mapping techniques to generate a set of 100 statements on steps that state health departments could take to address LPCCs. The participants sorted and rated each statement according to importance and feasibility. We used a sequence of multivariate statistical analyses to generate a series of maps, or clusters, and rating graphics. We reviewed the findings and produced recommendations for state health departments. We used a similar process to examine roles of state health departments in addressing healthy aging.


RESULTS
The participants grouped the LPCCs statements into nine clusters, which they rated as moderately feasible and important. The healthy aging statements were grouped into eight clusters. Clusters for LPCCs and healthy aging were similar. We also compared LPCCs clusters and the essential elements of existing state-based chronic disease programs and found that they were similar.


CONCLUSIONS
The similarities between LPCCs clusters and essential elements of existing state-based chronic disease programs highlight an important point. State health departments that are considering establishing LPCCs programs should use strategies that have already been used by other public health agencies to develop chronic disease prevention and control programs.
Wheeler
Fran C
FC
Association of State and Territorial Chronic Disease Program Directors, 1107 Rutland Dr, West Columbia, SC 29169, USA. wheeler@chronicdisease.org
Anderson
Lynda A
LA
Boddie-Willis
Cynthia
C
Price
Patricia H
PH
Kane
Mary
M
D002908:Chronic Disease / Q000453:epidemiology; D016000:Cluster Analysis; D006077:Government Agencies; D040361:Healthy People Programs; D006801:Humans; D015999:Multivariate Analysis; D015995:Prevalence; D011314:Preventive Health Services / Q000458:organization & administration; D011635:Public Health Administration; D013219:State Government; D014481:United States