Seven States and District of Columbia Stay Committed and Energized to Collective Action During the Public Health Emergency

NACDD and CDC have been supporting states and partners to implement the State Engagement Model since 2012. The primary purpose of the model is to enhance stakeholder engagement and cultivate diverse, lasting partnerships that include commitment and action to achieve shared goals. After more than a decade of states from across the country successfully convening State Engagement Meetings, one of the key pieces of applying the model, seven states and the District of Columbia were challenged with achieving quality partner engagement outcomes without meeting in person.

In  2020 and 2021, diabetes, oral health, and physical activity and nutrition partners in Delaware, District of Columbia, Hawai’i, Illinois, Iowa, North Dakota, Vermont, and Wisconsin persevered. While the public health landscape rapidly changed right before their eyes, partners in these states stayed committed, flexible, and energized. While utilizing approaches that address equity and disparities, they successfully identified diverse stakeholders, creatively engaged partners, collaboratively developed action plans, and collectively committed to action in preventing chronic disease in their states or District – all done without ever meeting in person. Each of the following Virtual State Engagement Model (vStEM) summaries highlight select successes from each state and district’s vStEM experience.

“Super impressed with the collaborative effort with national support and local [Hawai‘i Department of Health] coordinators of this meeting. Collective impact was evident and executed.” 

State Engagement Meeting Participant, Hawai‘i

blood testDelaware – Delaware convened 50 key partners for a three-part vStEM meeting series in March 2021. Following the development of their state action plan, Delaware and their partners had an early win in August 2021, onboarding seven healthcare delivery sites to pilot a protocol to increase screening, testing, and referrals for adults at high risk for type 2 diabetes, exceeding the originally planned six sites. Additionally, Delaware has made strides with coverage of the National Diabetes Prevention Program (National DPP) lifestyle change program, assisting the City of Wilmington with adding the benefit for approximately 3,000 employees, retirees, and their families. Delaware is continuing employer engagement in partnership with the Greater Philadelphia Business Coalition on Health.    

blood testDistrict of Columbia – The District of Columbia engaged a core group of partners in a strategic three-part vStEM series from October to November 2021. DC Health has drafted the District of Columbia’s Diabetes Action Plan and is convening meetings with their diabetes stakeholders to finalize the plan. The final diabetes action plan will focus on implementing a standard protocol to facilitate screening, testing, and referrals of adults at high risk for type 2 diabetes from community and clinical settings into the National DPP lifestyle change program. Furthermore, they plan to identify and implement at least five new or enhanced outreach and engagement activities designed to increase enrollment and retention in the lifestyle change program. Each of these initiatives prioritize residents in areas disproportionately affected by diabetes (Wards 5, 7, and 8) to align community needs with access to evidence-based diabetes prevention services.

weightliftingHawaii – Hawai‘i’s vStEM was integral to convening early childhood care and education (ECE) providers and stakeholders around increasing opportunities for healthy eating and physical activity for the youngest keiki. With facilitation support from NACDD, Hawai‘i was able to convene ECE stakeholders to draft a Healthy Keiki in ECE Settings (HKES) Action Plan. Participating in the vStEM process allowed Hawai‘i to apply to and be selected for the Healthy Kids, Healthy Future Technical Assistance Program from Nemours Children’s Health. Hawai‘i now has funding and technical assistance to implement the HKES Action Plan and move this important work forward.

blood testIllinois – Illinois convened over 50 partners for its vStEM meeting series throughout 2021. In a notable activity among many, Illinois partners are working to develop umbrella hub arrangements across the state. To do this, they surveyed existing and potential delivery organizations about their current work and needs, and the Illinois Public Health Institute drafted a landscape assessment that outlines potential umbrella hub organizations in Illinois. The vStEM generated learning opportunities, increased access to resources and funding, and encouraged collaboration and communication among diabetes prevention stakeholders. Illinois plans to keep the momentum going by reconvening partners in spring 2022.

weightliftingIowa – Iowa’s physical activity and nutrition vStEM meeting focused on strengthening nutrition and physical activity policy, systems, and environmental change (PSE) work through Iowa’s SNAP-Ed school grant program. Highlights from the first year include surveying principals on PSE priorities in their schools, providing training to contractors on PSE, and conducting a quality improvement adventure to dive deeper into the structure of the program and ways it could be modified to support PSE work.

toothNorth Dakota – In May 2021, North Dakota convened a vStEM meeting that was attended by more than 60 participants. The purpose of the meeting was to bring together key partners from across the state to create momentum, identify strategies for implementation, and foster partnerships that will lead to increased availability, accessibility, and utilization of oral health services for Medicaid eligible children and adults. Six months following the vStEM meeting, a new Oral Health Coalition was formed to implement the action plan was developed at the meeting.

“As a ‘newer’ State Oral Health Program Director, I learned so much more about oral health and my strengths as a leader throughout this [vStEM] process. The vStEM meeting was an opportunity for our state to reinvigorate the North Dakota Oral Health Coalition. [It was also an opportunity] to convene stakeholders across North Dakota to collectively bring forward new energy, innovative ideas, and strategies that would become our action plan, despite the challenges we all faced with the COVID-19 pandemic and strengthen oral health for all community members in North Dakota.”

Cheri Kiefer, Oral Health Program Director, North Dakota

weightliftingVermont – The Vermont vStEM meeting, hosted by the Vermont Department of Health and the Vermont Association of Planning and Development Agencies, was a momentum-building event for advancing capacity for the design of inclusive communities that support health, wellness, social connectedness, and economic vibrancy for all. A preliminary action plan was developed through the vStEM. Now in the implementation phase, participants are working to engage more partners and will center the priorities of those experiencing health inequities by honoring lived experience, shifting power in community planning, and coordinating the delivery of health and racial equity trainings.

weightliftingWisconsin – The Wisconsin physical activity and nutrition vStEM meeting brought together a diverse group of partners from across the state to develop a road map for advancing physical activity and nutrition policy, system, and environmental changes. The resulting road map seeks to be community-centered and community-driven with a focus on addressing systemic and institutional racism leading to health inequities. Following the vStEM meeting, partners received funding from CDC to develop a Social Determinants of Health Accelerator Plan and tribal partnerships have grown into a collective effort supporting an intertribal food system for greater access to traditional foods.

Starting in April 2022, NACDD is pleased to be working with members and partners from the District of Columbia, Indiana, and North Dakota on a new Physical Activity and Nutrition Partner Engagement Learning Lab. During the Learning Lab, states will learn about and apply some of the vStEM processes and tools to design and implement a tailored state partner engagement approach to advance their physical activity and nutrition equity goals. The State Engagement Model, originally designed for scaling and sustaining the National DPP, has been adapted for a variety of public health programs and continues to be a valuable model to engage partners working collaboratively to achieve common goals. 

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