Prevention Forward

Program Background

In 2018, the California Department of Public Health's (CDPH) Chronic Disease Control Branch (CDCB) was awarded a five-year grant (October 2018 through June 2023) by the Centers for Disease Control and Prevention (CDC) "Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke" (CDC‑RFA-DP18-1815PPHF18), known in California as Prevention Forward.

The purpose of the grant is to work with CDPH chronic disease prevention programs and stakeholders to implement diabetes management and Type 2 diabetes prevention, heart disease, high cholesterol, and stroke prevention and management strategies. The selected strategies are implemented in high burden areas and communities to ensure work on these strategies are mutually reinforcing across all community settings, and health system organizations.  CDPH is using a multi-level coordinated approach with a health equity focus interwoven throughout all strategies and interventions. This approach allows Prevention Forward activities to be supported by public private partnerships between state and local government, health systems, and community stakeholders.

Prevention Forward program's strategies include:

Category A - Diabetes management and type 2 diabetes prevention

• Improve access to and participation in American Diabetes Association (ADA)-Recognized/American Association of Diabetes Educators-Accredited Diabetes Self-Management Education/Support (DSMES) programs in underserved areas.
• Increase engagement of pharmacists in the provision of medication management or DSMES for people with diabetes.
• Assist healthcare organizations in implementing systems to identify people with prediabetes and refer them to CDC-recognized lifestyle change programs for type 2 diabetes prevention.
• Implement strategies to increase enrollment in CDC-recognized lifestyle change programs.
• Develop a statewide infrastructure to promote long-term sustainability/reimbursement for Community Health Workers (CHWs) to establish or expand their use in CDC-recognized lifestyle change programs.

Category B - Cardiovascular Disease prevention and management

• Promote the adoption and use of Electronic Health Record and Health information Technology to improve provider outcomes and patient health outcomes related to identification of individuals with undiagnosed hypertension (HTN) and management of adults with hypertension.
• Support engagement of non-physician team members (e.g. nurses, pharmacists, nutritionist, social workers, CHWs) in HTN and cholesterol management in clinical settings.
• Promote the adoption of Medication Therapy Management between pharmacists and physicians for the purpose of managing high blood pressure, high blood cholesterol and lifestyle modification.
• Develop a statewide infrastructure to promote sustainability for CHWs to promote management of HTN and high blood cholesterol.
• Implement strategies to increase enrollment in CDC-recognized lifestyle change programs.

Initiatives

Diabetes

CDPH's diabetes prevention and management goals and areas of focus are included in the Diabetes Prevention Through Lifestyle Change Programs: 2018 Action Plan  (PDF) (action plan). The action plan was developed to bring partners together to address the rising prevalence of diabetes in California through increased awareness, availability, and utilization of evidence-based National Diabetes Prevention Programs (National DPPs) by Californians with prediabetes or at high risk of type 2 diabetes. The action plan aligns with the objectives and guiding principles of the California Wellness Plan, the overarching goal of which is "Equity in Health and Wellness." The action plan includes a focus on low-income and communities of color where the burden of diabetes is the greatest. It is organized into four focused areas of action, or "pillars." The four pillars are: Availability; Community Engagement: Awareness; Coverage; and Provider Engagement: Screen, Test and Refer.

Cardiovascular Disease

CDPH prevention and management goals for heart disease, high blood cholesterol, and stroke will assess the utilization of chronic disease reporting systems in 15 health center locations statewide.  This work will determine current health information technology efforts in patient care for reporting clinical quality measures and referrals to nationally CDC-recognized lifestyle change programs.  Grant efforts will increase clinical quality care and support advancement in procedures and policy to improve chronic disease services in California.

Partnerships

• CDC's 6|18 Initiative is a unique opportunity to help Medicaid and public health officials collaborate on cost-effective prevention interventions that have improved health and controlled costs.  California's implementation goal of this intervention is to increase access and utilization of the Medi-Cal Diabetes Prevention Program (Medi-Cal DPP) benefit that went into effect January 1, 2019. The California Department of Health Care Service (DHCS) and CDPH's CDCB collaborate by performing outreach and education to members (patients), providers (health care professionals), Medi-Cal managed care plans, and National DPP organizations (National DPP suppliers). 

For more information on the Prevention Forward program contact the Chronic Disease Control Branch at CDCBadministration@cdph.ca.gov.