Public health agencies at all levels have struggled to identify the optimum structure to support administrative and programmatic efficiencies that will maximize public health impact with the available resources.

In order to support state-level chronic disease prevention and health promotion practice, a national public sector public health practice organization developed an evidence and improvement science-based approach to organizational capacity building and improved effectiveness.

The resulting model is drawn from the current literature that includes aspects of organizational structure, function, and operations. Specifically, it examines the extent to which a State Health Department Chronic Disease Unit:

• establishes strong working relationships with diverse partners;
• is the unifying voice for the prevention and control of chronic disease;
• employs a strategic and systematic approach to learning and professional development;
• provides consistent administration and staff support necessary to maintain successful programs;  
• provides a culture that supports life-long learning, balance, and a diverse workforce;
• and promotes the use of evidence-based public health practice and decision-making.

Implementation of the model includes assessment of organizational capacity using measures of evidence-based attributes within the framework and provides a systematic approach to identify opportunities for increasing organizational capacity, facilitating development and implementation of a six-month plan for achieving improved organizational capacity, and supporting states during quality improvement cycle through peer learning opportunities and mentoring.

Seventeen states have applied the model in their chronic disease prevention practice units. Twelve-month follow-up evaluation results show organizational capacity improvement in conceptual model measures.

“In all my years of public health work, I have never been part of a process that has given my staff so much energy to continue to improve. STAR was a great return on investment for our team,” said Bruce Adkins, Director of the Office of Community Health Systems and Health Promotion at the West Virginia Bureau for Public Health.