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A
Public Health Action Plan to Prevent Heart Disease and Stroke
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Section 4. Implementation: Mobilizing for Action
Action
Steps for the Five Essential Components
The 22 recommendations presented in
Section 3 require specific action steps to guide implementation of the
plan. This section outlines action steps proposed by the Expert Panels and
synthesized by the Working Group. They are presented in the same order as
the plan's five essential components, which are taking action, strengthening
capacity, evaluating impact, advancing policy, and engaging in regional and
global partnerships. Each group of action steps is followed by expected
outcomes that indicate their potential impact.
Taking Action: Putting Present Knowledge to Work
- Initiate policy
development.
- Establish active
collaboration among public health agencies, clinical preventive service
providers, and other partners at all levels (e.g., purchasers of health
care insurance, insurers, providers of care, health counselors, patient
groups) to implement effective policies and programs that address CVH
promotion and primary and secondary prevention of cardiovascular disease
(CVD).
- Develop and
regularly update simulation models to address the expected health and
economic benefits to society from investing in heart disease and stroke
prevention.
- Conduct health
impact assessments of national policies and provide a framework to
states to conduct these assessments at the state level.
Expected
Outcomes
- Through technical
assistance, consultation, and cooperative arrangements, partners who
deliver CVH promotion and CVD prevention programs and services at all
levels are receiving active support and incentives. These partners are
developing and implementing more effective policies that address the
full spectrum of intervention approaches represented in the action
framework in Section 2 and reflect current knowledge of the efficacy
and safety of therapeutic interventions.
- Comprehensive
economic modeling of the CVD burden and the potential impact of
preventive policies and programs is ongoing and supports policy
development and implementation.
- National, state,
and local policies are regularly identified and subject to health
impact assessments with specific attention to their potential effects
on CVH and other chronic diseases of public health concern.
- Implement best
practices.
- Review, revise if
appropriate, and rigorously apply criteria for identifying model
programs. In the meantime, implement current programs and evaluate them
against these criteria.
- Identify and
disseminate information about model programs that include all elements
of best practices for a population–based approach to CVH. Test the
synergistic effects of composite programs.
- Generate and test
new intervention models by funding new demonstration projects. Share
materials and experiences in order to continually develop, implement,
and evaluate best practices.
Expected
Outcomes
- Criteria
appropriate for identifying best practices in CVH promotion and CVD
prevention are established and are being used. Programs considered the
most promising are implemented as expeditiously as possible, with
adequate provision for rigorously evaluating these programs in
accordance with accepted criteria.
- These criteria are
applied continually to identify model CVH/CVD programs, especially
those in which multiple components are coordinated and integrated for
maximum impact. These model programs are being disseminated.
- Innovative
demonstration programs are being funded and rigorously evaluated. The
resulting experiences are communicated rapidly and effectively to
facilitate program replication and dissemination.
- Address prevention
in all settings, life stages, and priority populations.
- Develop, implement,
and evaluate programs to address opportunities for CVH promotion and CVD
prevention in the full array of multiple settings (e.g., schools, work
sites, health care settings, other community sites), during all life
stages (gestation; infancy and childhood; adolescence; and early,
middle, and late adulthood), and among all priority populations (as
defined by excessive health burdens or needs).
Expected
Outcomes
- A matrix of
settings, life stages, and at–risk populations is developed and
disseminated as a tool for identifying policy and program needs and
opportunities. Model policies and programs to address the demonstrated
needs and opportunities are identified (or developed) and evaluated.
These model policies and programs are disseminated for implementation
at national, state, and local levels.
- Accept the full
scope of public health responsibility.
- Accept
accountability of public health agencies, their partners, and society as
a whole for addressing the full spectrum of opportunities to prevent
heart disease and stroke as part of a comprehensive public health
strategy.
- Collaborate with
partners in related fields (e.g., nutrition, physical activity, tobacco
control, substance abuse), including those working to detect and treat
risk factors (e.g., hyperlipidemia, high blood pressure, smoking,
diabetes, obesity). Support programmatic activities in schools, work
sites, health care settings, and community sites and for priority
populations.
- Establish or
strengthen collaborations with the Centers for Medicare & Medicaid
Services, the National Committee for Quality Assurance, and other
partners positioned to improve access to and use of high–quality care
for patients with or at risk for CVD.
Expected
Outcomes
- CVH programs are
recognized as having responsibility and accountability for a
comprehensive public health strategy that addresses the full array of
approaches to CVH promotion and CVD prevention, to help achieve the
four Healthy People 2010 Heart and Stroke Partnership goals for
preventing heart disease and stroke.
- The needed
partnerships and collaborations are in place at national, state, and
local levels to support these activities.
- Partnerships are
strengthened or established with the full array of organizations and
agencies committed to effectively delivering high–quality health
services (including preventive services) as part of a comprehensive
public health strategy.
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Strengthening Capacity: Transforming the
Organization and Structure of Public Health Agencies and Partnerships
- Establish CVH
entities within public health agencies.
- Transform public
health agencies at all levels so they can effectively prevent heart
disease and stroke.
- Establish or
strengthen identifiable CVH units in public health agencies at all
levels. These units should be able to effectively reach all communities
and have all necessary capacities for preventing heart disease and
stroke, including new competencies in policy and environmental change,
population–wide health promotion and behavioral change for risk factor
prevention, and early detection and control of risk factors.
Expected
Outcomes
- Public health
agencies throughout the nation are undergoing the changes needed to
expand their roles and meet the new challenges of preventing heart
disease and stroke and other chronic conditions of public health
concern.
- Every state and
territorial health agency has an identifiable unit or locus of
responsibility for CVH policy and programs. These agencies are able to
provide support and assistance in CVH activities to all local health
agencies within their jurisdictions. Through increased and creative
collaborations, public health agencies and their partners are
strengthening their efforts to promote CVH and prevent risk factors
and first CVD events.
- Reinvent innovative
training resources and opportunities.
- Develop training
resources, including technical assistance and materials, to enable
states to train staff in state and local health departments and in
partner organizations and agencies, assuring that they have core
competencies and meet performance standards in CVH. These include
changes in organizational structure, skills in incorporating best
practices, and assurance of partnership effectiveness.
- Establish training
in the following set of skills, which are essential to an effective
public health workforce:
- Developing and
maintaining partnerships and coalitions.
- Promoting
community mobilization for effective action.
- Using health
communications effectively.
- Defining and
identifying the burden and status of chronic diseases.
- Preventing and
managing risk factors.
- Formulating and
executing policy and environmental approaches to intervention.
- Organizing
effective prevention programs.
- Leading diverse
community organizations.
- Conducting
culturally appropriate interventions targeted to priority populations.
- Using sound
business practices and strategic planning to improve public health.
- Consider a variety
of options for training personnel. Possibilities include the following:
- Schools of public
health and other professional schools in health fields.
- Train–the–trainer
programs (e.g., in the use of data for health planning, health
promotion, primary and secondary prevention, program planning, and
evaluation, including population–based interventions).
- A certificate
program in CVH.
- CVH training at
Prevention Research Centers. CVH training programs with standard
curricula.
- An expanded
year–round program implemented with state and local health agencies.
- Joint school
health/public health courses.
- Regional networks
for education and training.
- Internet training
programs.
- Continuing
education, including training in information technology.
- Involve numerous
partners, such as directors of state chronic disease programs, voluntary
associations, and academic institutions, in the development of training
programs. Sample activities include the following:
- Allow all state
and local health agencies access to training and development
opportunities, information, and materials regardless of their funding
status.
- Provide state and
local health personnel and partners access to professional development
opportunities.
- Tailor training
programs to the concerns, interests, and needs of local, state, and
national constituents.
- Provide training
in chronic disease prevention to personnel from diverse organizations,
including governmental agencies, public health and education, schools
of public health, and nongovernmental health organizations.
Expected
Outcomes
- A comprehensive
CVH training function is developed and coordinated among all
interested parties, providing a resource for state and local health
agencies.
- Model curricula
and educational programs (e.g., Web–based, video training packages)
are available, including those needed for developing nontraditional
skills. Trainees in target areas are meeting established goals.
- Training programs
for CVH public health personnel are identified. State and regional
networks for CVH training and education are established to coordinate
training needs with available resources.
- Model education
and training programs are being developed and disseminated to state
and local health agencies and partners.
- Develop and
disseminate standards.
- Develop performance
standards and cultural competency guidelines for public health agencies
and partners. Include maintenance of laboratory capacity and
standardizations. Share these with schools of public health and other
educational sources for health professionals and encourage their
adoption in curricula.
- Identify mechanisms
(e.g., technical assistance, dedicated funding and staff) that enable
local and state health departments to meet standards.
Expected
Outcomes
- Performance
standards and cultural competency guidelines for CVH programs are
established to help public health agencies transcend “business as
usual” and undertake new directions in public health practice.
Existing mandates are maintained, and efforts are expanded in early
intervention (i.e., policy and environmental change; behavioral
change; and prevention, detection, and control of risk factors).
Laboratory capacity to address emerging issues is enhanced. Public
health agencies are communicating with schools of public health and
other training programs regarding training and curriculum requirements
for public health personnel working in CVH and related program areas.
- Public health
agencies are receiving technical assistance in monitoring and
improving cultural competency in CVH and related program areas.
- Provide technical
support.
- Develop and maintain
a cadre of educated practitioners and technical experts who can support
intervention needs in CVH promotion and CVD prevention (i.e.,
surveillance, trend analysis, behavior change, community development).
Draw these practitioners and experts from local, state, and national
public health agencies, as well as from voluntary health associations,
academia, foundations, and a variety of industries. Assure the means for
keeping their skills up–to–date (e.g., through meetings and Web–based
curricula).
- Develop materials
and tools to promote CVH at local and state levels.
- Strengthen the
internal communications infrastructure of public health agencies for
chronic disease programs as they make other general infrastructure
improvements.
Expected
Outcomes
- A register of
recognized experts willing to provide technical and policy assistance
to local, state, and federal health agencies and other CVH partners is
established and maintained. Use of the registry is supported and
monitored. Training and educational opportunities are provided, and
the registered experts use them.
- State and local
health agency needs for CVH promotional materials and an educational "toolbox" are being met.
- A public health
communications infrastructure supportive of CVH (and other chronic
disease) activities is in place and is continually adopting newer,
more effective communications technology.
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Evaluating Impact: Monitoring the Burden, Measuring
Progress, and Communicating Urgency
- Expand and
standardize population–wide data sources and activities.
- Define the
characteristics of surveillance and evaluation systems at minimal,
desirable, and optimal levels. Establish an inclusive framework and set
of indicators on the basis of 1) a review of existing surveillance and
evaluation frameworks (e.g., the World Health Organization's STEPwise
approach, Canada’s recent development of surveillance priorities); 2)
the new requirements for monitoring policy and environmental change;
behavioral change; biomarkers of CVD risk; and risk factor prevention,
detection, and control; and 3) input from national, state, and local
stakeholders and partner organizations. Include social and environmental
science and policy experts and those who collect, analyze, or use
relevant data.
- Assess the adequacy
of current systems on the basis of these characteristics and the need
for dynamic, interactive data access and use. Include the experts and
stakeholders described in the previous action step.
- Convene public
health agencies and partners to determine the mechanisms and costs
needed to fill identified information gaps. Improve existing data sets
and develop new ones as needed, with attention to timeliness,
sustainability, and standardization. Address standardization of data
systems across states, approaches to active or passive data collection,
ongoing versus episodic data collection requirements, availability of
data from health care insurers, and the paramount importance of
incidence data for monitoring progress in preventing heart disease and
stroke. Devise common data formats, data management policies and
practices, and methods for controlling interconnected data systems.
- Use data to plan
health programs and to communicate consistent messages about the urgency
of preventing heart disease and stroke. Enhance the incorporation of
current CVH data into broader social indicator reports, using model
programs and tested tools, formats, and templates for communicating and
disseminating this information.
Expected
Outcomes
- A framework is
reviewed and established for assessing data requirements for
monitoring and evaluating the comprehensive public health strategy. It
includes a mechanism for periodic updates and reassessments.
- An initial
inventory of health indicators (including applicable leading health
indicators from Healthy People 2010) and relevant surveillance
and evaluation data sources is completed and disseminated to
appropriate agencies and organizations for review and comment.
- A group has
convened and formulated a detailed implementation plan for developing
the monitoring and evaluation data systems needed to support the
Action Plan.
- As the available
data are used to communicate CVH messages, their strengths and
limitations and the current systems for managing and coordinating
these data are continuously monitored. System development is advanced
and adapted to changing needs.
- Establish data
systems for evaluation of policy and program interventions.
- Assure that
resources are allocated when projects or model programs are first funded
by public health agencies and partners (e.g., personnel or financial
set–asides) to permit adequate evaluation of outcomes and costs.
- Develop guidelines
for public health agencies and partners for content and format of such
evaluations, especially in the new areas of policy and environmental
change; behavioral change; and risk factor prevention, detection, and
control.
Expected
Outcomes
- Evaluation is an
expected component of every public health program aimed at preventing
heart disease and stroke. No program proceeds without commitment to
support this component.
- Tools are widely
available to support evaluations and the timely communication of their
findings. This allows the most effective interventions to be
replicated quickly. Mechanisms for disseminating and reviewing
evaluation results are strengthened to assure that the knowledge and
experience gained are applied in future policies and programs.
- Develop
professional staff capacity for monitoring and evaluation.
- Strengthen the
surveillance and program evaluation functions of public health agencies
through enhanced staffing and resources, especially for monitoring
policy and environmental change; behavioral change; and risk factor
prevention, detection, and control.
- Provide guidance to
state and local health agencies and partners regarding capacity
requirements for surveillance and evaluation activities.
- Establish resources
to support program evaluation through training, consultation, technical
assistance, and partnerships to develop logic models, methodology, data
collection, and reporting.
Expected
Outcomes
- Professional staff
development for monitoring and evaluation, especially in the new areas
required by the plan, is a priority for all public health agencies,
which have expanded their capacity for advancing methods and practices
in CVH program evaluation.
- State and local
public health agencies are receiving help in determining what
capacities they need to evaluate their programs.
- A plan for meeting
these requirements is developed and implemented.
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Advancing Policy: Defining the Issues and Finding
the Needed Solutions
- Conduct and
facilitate policy and environmental research.
- Focus on preventing
atherosclerosis and high blood pressure. Develop and support a
collaborative, detailed, and interdisciplinary research agenda and a new
framework for policy, environmental, and behavioral research to
determine which interventions (separately or in combination) will best
affect atherosclerosis and high blood pressure and their contribution to
the burden of heart disease and stroke. Support both targeted and
investigator–initiated research.
- Support research to
determine the best ways to implement and disseminate the most effective
policy, environmental, or behavioral change interventions to prevent
heart disease and stroke. Identify social and cultural factors that
promote or inhibit the sustainability of interventions, especially among
populations affected by disparities in CVD risk (based on
race/ethnicity, income, or place of residence).
- Conduct research to
answer questions such as the following: What are the social and
structural factors in various settings and sectors that affect CVH
status more than individual characteristics? What are specific
antecedent factors associated with specific components of risk (e.g.,
food intake, physical activity, adherence to preventive medical care)?
What are the social and cultural determinants of food consumption and
physical activity among children and families? How do these factors
differ by characteristics such as age, income, or race? What is the
public health importance of currently available genetic and other
biomarkers of risk or disease?
- Develop and support
a collaborative research agenda that focuses on health outcomes.
Establish effective interventions to overcome barriers and improve
access to and use of high–quality medical services for patients with or
at risk for heart disease and stroke.
- Support prevention
effectiveness research to determine what combinations of effective
interventions (e.g., policy, environment, individual) at what doses, in
what settings (e.g., family, school, work site, health care, community),
at what life stages, and among which priority populations are most
effective in preventing, detecting, and controlling CVD risk factors.
- Express strong
support for this new research agenda with the help of partners
positioned to educate key stakeholders, to help policy makers recognize
its value, and to assure its implementation and the continual
advancement of resulting policies and programs.
Expected
Outcomes
- A research agenda
specific to the major focus of preventing atherosclerosis and high
blood pressure is developed and implemented.
- A detailed
research agenda is developed and supported, in alignment with the
Research Themes and Research Priority Areas of the U.S. Department of
Health and Human Services, with special emphasis on policy and
environmental change related to CVH promotion and CVD prevention.
- A broad array of
relevant research questions is developed and prioritized to balance
the research agenda.
- The research
agenda includes studies to identify potential points of intervention
to improve preventive services and access to and use of these
services. This agenda supports the four goals for preventing heart
disease and stroke as distinguished by the Healthy People 2010 Heart
and Stroke Partnership. These goals are prevention of risk factors,
detection and treatment of risk factors, early detection and treatment
of heart attacks and strokes, and prevention of recurrent
cardiovascular events.
- The research
agenda includes studies involving the proposed matrix of settings,
life stages, and priority populations to determine the most effective
interventions within and across populations (including population–wide
approaches and those aimed a specific subgroups).
- The research
agenda is supported by education to assure that funding is a national
priority.
- Prevent risk
factors in youth and beyond.
- Develop and support
detailed research agendas that specifically address prevention in youth
and early adulthood. Include studies that assess the impact of known
interventions in preventing risk factors, atherosclerosis, and high
blood pressure.
- Identify subclinical
indicators of CVD and potentially useful genetic and other biomarkers
that can be applied in population studies and prevention programs. Work
with appropriate health service and industry partners.
- Identify other
outstanding concerns in preventing risk factors.
Expected
Outcomes
- A detailed
research agenda is developed and supported to design, implement, and
evaluate intervention programs to prevent CVD risk factors,
atherosclerosis, and high blood pressure, beginning in childhood.
- This agenda
includes research to develop assessment methods for subclinical
atherosclerosis and to evaluate new candidate biomarkers in population
studies, especially during adolescence and early adulthood.
- The agenda
includes research on underlying determinants of CVD risk factors.
Examples include how fetal development affects later risk and how
nutrition and physical activity affect obesity, blood lipids, and
blood pressure.
- Conduct and
facilitate monitoring and evaluation research.
- Support monitoring
and evaluation research to determine how best to measure policy and
environmental change interventions.
- Incorporate these
measures into surveillance systems.
- Respond to
technological developments and regulations that restrict access to
personal health information to assure the appropriate levels of
participation and representation in surveillance activities.
Expected
Outcomes
- The research
agenda includes studies of methods and data requirements for
monitoring and evaluating approaches to policy and environmental
change.
- Surveillance
methods that incorporate the relevant data elements are developed and
implemented.
- Methods that
assure adequate participation rates and representative population
samples are continuously investigated, addressing technical and policy
concerns about access to health information.
- Conduct and support
marketing research.
- Support marketing
research on how to inform the public effectively and bring about health
behavioral change.
- Support research to
demonstrate the economic feasibility of and appropriate business models
for private–sector investment in prevention (e.g., in food production,
manufacturing, or marketing).
Expected
Outcomes
- The research
agenda includes studies of what influences the way people respond to
population–wide and individual interventions to prevent heart disease
and stroke in the community at large, in specific cultural
communities, and in specific organizational settings.
- The research
agenda includes studies of how consumer products could be changed to
support policies and programs to reduce risk for heart disease and
stroke and still be viable commercially. This research includes
partners in business and industry.
- Strengthen the
prevention research workforce.
- Inventory current
prevention research training programs and research opportunities in view
of the expanding need for new health research skills.
- Emphasize policy and
environmental change, health behavioral change, and risk factor
prevention when seeking to identify training needs and develop
responsive plans.
Expected
Outcomes
- Workforce
requirements for establishing and maintaining broad–based CVH
prevention research programs are documented. Training programs to meet
current and future requirements are identified and evaluated.
- Gaps in training
resources are identified, and detailed plans for filling them are
developed. Resources are identified and committed to support the
needed training in CVH prevention research.
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Engaging in Regional and Global Partnerships:
Multiplying Resources and Capitalizing on Shared Experience
- Provide global
leadership, partnerships, and organization.
- Develop and
effectively support a global mission and vision of the United States for
CVH.
- Inventory existing
and potential partners for global CVH collaboration, with support from
public health agencies and other partners. Include governmental
agencies, nongovernmental organizations, and foundations (e.g.,
especially the World Health Organization, World Heart Federation, and
World Bank).
- Evaluate current CVH
research and training programs of these potential partners. Evaluate
their interest in receiving information and technical support from
public health agencies to enhance these programs and in planning joint
projects or programs. Include entities with policy roles that might
conflict with CVH priorities, but who could become effective partners
(e.g., the food and agriculture sector).
Expected
Outcomes
- A statement of the
U.S. position, role, and interest regarding global CVH needs and
opportunities has been published and serves as a point of reference
for partnership development in this area.
- Inventories of
existing regional and global CVH partnerships, potential
nontraditional CVH partnerships, and foundations that support
international activities for medical and public health training are
established and maintained.
- An inventory of
current agendas for integrated CVH research, linked with other chronic
conditions of public health importance, is established and maintained.
Joint projects with regional and global partners are planned and
implemented.
- Establish and
support global policies.
- Establish a
partnership for global heart disease and stroke that develops, monitors,
and evaluates global CVH strategy.
- Focus on eliminating
inequalities in CVH in the United States and globally, and assess the
contribution of this country’s global strategy in reducing CVH
inequalities worldwide.
- Assess the impact of
globalization and trade policies (e.g., related to tobacco, food and
agriculture, and pharmaceuticals) on national and international trends
in CVD and suggest improvements that could favorably affect CVH.
Expected
Outcomes
- A partnership on
global CVH strategy is established. Its implementation plan is guided
by a commitment to work toward eliminating inequalities in CVH.
- A framework to
assess progress on equity in national and global CVH programs is being
used.
- Study results are
published on the impact of globalization and trade policies
(especially those related to tobacco, food, and pharmaceuticals) on
CVH, as well as the opportunities to harness these policies to promote
CVH nationally and globally.
- Develop a global
communications strategy.
- Establish
relationships between transnational media organizations and public
health agencies and partners to identify models of collaboration that
can help improve media content and coverage on the need for global CVH
promotion and CVD prevention.
- Effectively
communicate to health professionals throughout the world that they
should promote CVH by supporting effective policies and by serving as
role models for positive behavioral patterns.
Expected
Outcomes
- Consensus
development meetings are conducted among CVH partners and media
representatives. Better CVH messages are communicated through the
media.
- Programs are
undertaken to reach health professionals throughout the world with
effective messages about their role in preventing heart disease and
stroke.
- Strengthen global
capacity.
- Develop tailored
programs to 1) assist and support decision makers interested in
developing and implementing effective national policies, 2) develop
methodology and tools to analyze the health impact of policy
interventions, and 3) analyze the social and economic costs of heart
disease and stroke and the benefits of preventing them.
- Promote the exchange
of information and experiences on policies that promote CVH.
- Collect existing
tools for assessing policy and environmental change and program
effectiveness, synthesize an integrated assessment tool, apply this tool
to identify best practices, and increase information sharing through
technology.
- Develop and
implement strategies to assure that changes that support the Action
Plan are institutionalized.
Expected
Outcomes
- Development of
capacity for heart disease and stroke prevention is recognized as a
long–term requirement for transforming public health agencies. The
proposed training programs and workshops are available and being used.
International conferences are conducted on the economics of heart
disease and stroke prevention and the links between economic
conditions and CVH.
- Information and
experience related to CVH promotion are effectively disseminated and
applied (e.g., the International Action on Cardiovascular Disease:
A Platform for Success, published by the World Heart Federation
and the International Heart Health Society).
- Tools for
analyzing how policies affect the global dimensions of CVH are
developed and disseminated.
- Capacity is
developed in a way that assures institutionalization of change.
- Strengthen global
monitoring and evaluation.
- Inventory existing
surveys, programs, and agreements relevant to global activities in heart
disease and stroke prevention and control.
- Identify existing
programs that could be expanded and areas where new collaborations could
be created. This activity could be conducted by organizations such as
CDC, the World Health Organization (WHO), the World Heart Federation,
the Pan American Health Organization, and the InterAmerican Heart
Foundation.
- Support monitoring
of heart disease and stroke globally by working with existing and new
partners (especially WHO) to develop standard data elements. These
elements should include 1) mortality, morbidity, and risk factors; 2)
nontraditional elements such as clinical factors (e.g., patterns of
diagnosis, treatment, use); 3) preventive and health promotion programs;
and 4) social, cultural, environmental, and policy factors. Assure
effective dissemination of the resulting information and its translation
into action.
Expected
Outcomes
- A Web–based
inventory is available and routinely updated.
- New regional and
global collaborative activities are established, and new opportunities
are being identified.
- Guidelines for
standard data collection and methods for planning and evaluating heart
disease and stroke prevention and control programs are developed and
being used. Training programs for technical assistance/collaboration
on CVD projects are receiving needed financial support.
- Promote and support
global research.
- Collaborate in
developing a research agenda on CVH policy. Identify appropriate
international partners to design research and mobilize resources.
Expected
Outcomes
- Public health
agencies are actively designing and conducting policy research to
identify best practices for preventing heart disease and stroke in
diverse socioeconomic settings, both nationally and globally.
Next Section: Steps Toward Implementation
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Contents
Date last reviewed:
05/12/2006
Content source: Division for Heart Disease and Stroke
Prevention,
National Center for Chronic Disease Prevention and
Health Promotion |
|