Generate, Educate, Activate, Respond (GEAR) Groups: Addressing Structural Inequities

Improving Chronic Disease Units Capacity to Address Structural Inequities

Generate, Educate, Activate, Respond (GEAR) Groups are peer-to-peer, case-based, action learning opportunities for state chronic disease practitioners. They are designed to catalyze planning for longer-term state level-action. Participants expand their knowledge of pressing topics, develop leadership skills, and network with other public health professionals at State Health Departments.
GEAR Groups use a virtual “All Teach / All Learn” approach to professional development. GEAR Groups virtually engage up to 10 states with a facilitator and strategist to explore emerging or long-standing chronic disease prevention and control topics. GEAR Groups meet four times: once a week for 90 minutes each. Meetings are facilitated conversations among participants requiring preparation and active participation. 
Between Aug 2021 – July 2022, NACDD’s Center for Public Health Leadership held three GEAR groups with a total of 26 participants from 17 states:
  • GEAR Group 1, Examining the Disparate Impact of and Solutions to Health Debt after the COVID-19 Pandemic, explored effective and promising practices that enable state health departments to address and mitigate health debt. Health debt is the accumulated impact of changes in health behaviors during the pandemic that will have long-term negative effects on health.
  • GEAR Groups 2 and 3 sessions, Using Data to Promote Equity in Policy and Programming, examined how to identify unintentional bias in the collection and utilization of data and explored strategies to address, avoid, and prevent it.
Participants developed and presented cases to a broader group seeking feedback to improve initiatives underway in their Chronic Disease Units. Some of the cases included:
  • Expanding access to Diabetes Self-Management Education and Support programs in remote areas
  • Addressing disparities in breastfeeding
  • Expanding migrant communities’ access to health resources and education
Overall, participants said they appreciated an opportunity to connect with peers from other states, learn what other states have done to address the issues, and to develop action plans.  As a result of participating in the GEAR groups:
• 73% say that they learned about evidence-based approaches that they can apply to their work
• 93% state that they identified actions they will take to apply in their work
• 89% report an improved understanding of the subject matter 
• 80% say that they were satisfied with their overall experience

“I really enjoyed the opportunity to connect with other states and learn about the health debt from NACDD. I walked away with some new information and contacts in three states that I wouldn’t have had before.”

“It helped me to understand how to start applying anti-racism approaches to my work and to learn about what other states have done or are doing in this area.”

“It helped me frame the issue, create an action plan and increased my motivation to continue focus on this work.”

(Anonymous comments from GEAR Group participants; Source: Evaluation Report)

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