title: Perceived benefits and challenges of coordinated approaches to chronic disease prevention in state health departments.
abstract: BACKGROUND
  Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding.
  
  
  METHODS
  A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ(2) tests, and analysis of variance were conducted.
  
  
  RESULTS
  The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges "lack of communication across programs" (P = .02) and "funding might be reduced" differed by program area (P < .001).
  
  
  CONCLUSIONS
  Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners.
authors.affiliation: Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, 621 Skinker Blvd, St. Louis, MO, 63130-4838. Telephone: 314-935-0116. E-mail: pallen@brownschool.wustl.edu.
authors.forename: Peg
authors.initials: P
authors.lastname: Allen
authors.affiliation: Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Sonia
authors.initials: S
authors.lastname: Sequeira
authors.affiliation: Pennsylvania Department of Health, Harrisburg, Pennsylvania.
authors.forename: Leslie
authors.initials: L
authors.lastname: Best
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Ellen
authors.initials: E
authors.lastname: Jones
authors.affiliation: Saint Louis University, St. Louis, Missouri.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Baker
authors.affiliation: Washington University in St. Louis and Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
mesh_terms: D000288:Administrative Personnel / Q000523:psychology*; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000517:prevention & control*; D055317:Evidence-Based Practice / Q000379:methods / Q000458:organization & administration; D005260:Female; D005380:Financing, Government; D006077:Government Agencies; D006292:Health Priorities; D006801:Humans; D008297:Male; D009937:Organizational Objectives; D010465:Perception; D011314:Preventive Health Services / Q000458:organization & administration* / Q000592:standards; D011361:Professional Competence; D011634:Public Health; D011635:Public Health Administration; D013219:State Government; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce