Links to proven best practices for community health improvement are provided so that we may work toward solutions to Miami-Dade County's top ten most pressing concerns regarding health.

1. Uninsured
Goal: decrease the rate of persons under 65 who are uninsured/without health insurance

• Health Coverage for Low-Income Americans: An Evidence-Based Approach to Public Policy, Kaiser Family Foundation
  http://www.kff.org/uninsured/7476a.cfm
• The Role of Consumer Copayments for Health Care:  Lessons from the RAND Health Insurance Experiment and Beyond, Kaiser Family Foundation
  http://www.kff.org/insurance/upload/7566.pdf
• State Coverage Initiatives for Children, Kaiser Family Foundation (includes state-by-state summaries)
  http://www.kff.org/uninsured/kcmu051607oth.cfm
• Beneath the Surface: Barriers Threaten to Slow Progress on Expanding Health Coverage of Children and Families: A 50 State Update on Eligibility, Enrollment, Renewal, and Cost-Sharing Practices in Medicaid and SCHIP, Kaiser Commission on Medicaid and the Uninsured
  http://www.kff.org/medicaid/upload/Beneath-the-Surface-Barriers-Threaten-to-Slow-Progress-on-Expanding-Health-Coverage-of-Children-and-Families-pdf.pdf
• Health Coverage and Access to Care for Hispanics in “New Growth Communities” and “Major Hispanic Centers” Kaiser Commission on Medicaid and the Uninsured
  http://www.kff.org/uninsured/upload/7551.pdf
• Improving Access to Health Care: Building A Community-Based Program: A Manual Based on Experiences from the Robert Wood Johnson Foundation’s Communities In Charge Initiative, Robert Wood Johnson Foundation
  http://www.communitiesincharge.org/manual.pdf
• JAXCARE (community-supported health benefits for the working uninsured; former Communities in Charge Initiative)
  http://www.communitiesincharge.org/Documents/PhaseII%20PressRelease/Jacksonville.htm
• Community-Based Health Coverage Programs: Models and Lessons, A Series of Community Voices Publications, W.K. Kellogg Foundation
  http://www.wkkf.org/Pubs/Health/CommunityBasedCoverageFINAL_00250_03763.pdf
• Evaluation of Community Voices Miami: Affecting Health Policy for the Uninsured, RAND Corporation
  http://www.rand.org/pubs/technical_reports/2004/RAND_TR177.sum.pdf
• The Miami Action Plan (MAP) for Access to Health Care, Community Voices of Miami
  http://www.communityvoicesmiami.org/map/Miami_Action_Plan.pdf
• Community Access Program of Miami-Dade, Community Voices of Miami (used health navigators, disease managers, and community outreach to link people to care)
  http://app.communityvoicesmiami.org/Community/Communit.nsf/Featured_pub lications/359F4C6BBFE673B803257020004F1F87/$file/CAP%20FACT6-13-2005.pdf
• Community Health Centers in Florida: A Guide to Understanding Florida’s Federally Qualified Health Centers and 330 Expansion Opportunities, Florida Association of Community Health Centers and State of Florida, Department of Health
  http://www.fachc.org/cd_FACHC%20Guide%20to%20Florida%20CHCs%20Final.pdf
• Communicare: Statewide Volunteer Network of Care Providers (Columbia, SC), Best Practice Initiative, U.S. Department of Health and Human Services
  http://phs.os.dhhs.gov/ophs/BestPractice/communicare.htm
• CareNet, Health Choices (discount medical plan created by Community Health Centers, community-based, consumer-governed corporations that operate in areas of high medical need) promising practice
  http://www.mycarenet.com/us/
• Neighborhood Health Clinic, Naples, Honorable Mention, Blue Cross Blue Shield Sapphire Award promising practice
  http://www.bcbsfl.com/DocumentLibrary/AboutOurCompany/SapphireAward2006Profile.pdf#page=10
• AIDS Insurance Continuation Program (AICP), Health Council of South Florida
  http://www.healthcouncil.org/aicp/cba.pdf

2. Chronic Diseases
Goal: decrease 1) hospital admission rates and 2) long-term complication rates for people with chronic conditions, e.g., asthma, diabetes

• Chronic Disease Self-Management Program, Stanford University
   http://patienteducation.stanford.edu/programs/cdsmp.html
• Evidence-Based Disease Prevention Program, Florida Department of Health/Florida Department of Elder Affairs (current grant to implement and evaluate the Stanford Chronic Disease Self-Management Program and the Spanish Arthritis Self-Management Program in South Palm Beach, Little Havana in Dade County, and Broward County)
  http://www.aoa.gov/prof/evidence/media/FL%20Project%20Summary.doc
• Promising Practices in Chronic Disease Prevention and Control: A Public Health Framework for Action, Centers for Disease Control and Prevention (includes state- and community-based examples)
  http://www.cdc.gov/nccdphp/publications/PromisingPractices/pdfs/PromisingPractices.pdf
• Improving Chronic Illness Care, Robert Wood Johnson Foundation (includes Evidence for Better Care for Asthma, Diabetes, and Hypertension, and a Framework for Creating a Regional Health Care System)
  http://www.improvingchroniccare.org/
• Building Peer Support Programs to Manage Chronic Disease: Seven Models for Success, California Health Care Foundation
  http://www.chcf.org/documents/chronicdisease/BuildingPeerSupportPrograms.pdf
• It Takes a Region: Creating a Framework to Improve Chronic Disease Care, California Health Care Foundation
  http://www.chcf.org/documents/chronicdisease/CreatingAFrameworkToImproveChronicDiseaseCare.pdf
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Racial and Ethnic Approaches to Community Health, Centers for Disease Control and Prevention (includes cancer, diabetes, HIV, and cardiovascular disease)
  http://www.cdc.gov/nccdphp/publications/exemplary/pdfs/Reach.pdf
• Chronic Disease Program Integration: Putting the Pieces Together, Florida Department of Health, Bureau of Chronic Disease Prevention and Health Promotion
  http://www.doh.state.fl.us/Family/chronicdisease/integration.zip
• The Road to Performance Excellence: Transforming a County Health Department “Tips on Getting Started and Staying Focused,” Miami-Dade County Health Department (Governor’s Sterling Award)
  http://www.floridasterling.com/pdf/MDCHDPresentation.pdf
• HealthConnect Evaluation Recommendations, ABT Associations Inc., for The Children’s Trust
  http://www.thechildrenstrust.org/images/content/Healthiniative/HealthConnectEval%20Final%20050206.pdf
• Grandmothers as Lay Health Outreach Workers, TeleHealth Connections for Children and Youth, University of Florida’s Institute for Child Health Policy promising practice
  http://telehealthconnections.ichp.ufl.edu/grandmothers.asp
• Farmworker Case Management Across Borders, Putnam County Health Department, Palatka, Florida promising practice
  http://www.raconline.org/success/success_details.php?success_id=12
• Design of Enhanced Primary Care Case Management Programs Operating in Rural Communities: Lessons Learned from Three States, The Shep Center for Health Services Research, University of North Carolina (one of the three states is Florida)
  http://www.shepscenter.unc.edu/research_programs/rural_program/fb_77.pdf

ASTHMA

• Achieving Better Care for Asthma Toolkit: Best Clinical and Administrative Practices for Medicaid Health Plans, Center for Health Care Strategies
  http://www.chcs.org/usr_doc/AchievingBetterCareforAsthmaToolkit.pdf
• Improving Asthma Care for Children Toolkit: Best Practices in Medicaid Managed Care
  http://www.chcs.org/usr_doc/IACC_Toolkit.pdf
• Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Vol. 5: Asthma, Stanford-UCSF Evidence-based Practice Center and the Agency for Healthcare Research and Quality
  http://fsi.stanford.edu/publications/closing_the_quality_gap_a_critical_analysis_of_quality_improvement_strategies_vol_5_asthma/
• PediatricAsthma.org:  Models for Advancing Asthma Care (formerly an initiative of the Robert Wood Johnson Foundation)
  http://www.pediatricasthma.org

DIABETES

• Diabetes: A National Plan for Action, U.S. Department of Health and Human Services (2004, includes a list of federal diabetes activities/highlights)
  http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
• The Diabetes Initiative: Stories and Descriptions of 14 Programs to Improve Self Management, Robert Wood Johnson Foundation (includes Open Door Health Center in Homestead, FL)
  http://diabetesnpo.im.wustl.edu/programs/documents/GranteeBooklet-ALLPAGES_000.pdf
• Best Practices from the Special Diabetes Program for Indians, Indian Health Service (a consensus model based on scientific research and outcome studies)
  http://www.ihs.gov/MedicalPrograms/diabetes/resources/irc2004_ch5.pdf
• Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Vol. 2: Diabetes Mellitus Care, Stanford-UCSF Evidence-Based Practice Center and the Agency for Healthcare Research and Quality
  http://fsi.stanford.edu/publications/closing_the_quality_gap_a_critical_analysis_of_quality_improvement_strategies_vol_2_diabetes_mellitus_care/
• Diabetes, Guide to Community Preventive Services, Centers for Disease Control and Prevention (assesses effectiveness of population based interventions to manage diabetes)
  http://www.thecommunityguide.org/diabetes/default.htm
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Diabetes, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/publications/exemplary/pdfs/Diabetes.pdf
• Comprehensive Diabetes Control Program: Michigan Department of Community Health
  http://phs.os.dhhs.gov/ophs/BestPractice/MI.htm
• Closing the Gap Diabetes Education Program, Manatee County, Florida (dubbed a promising program by the National Association of County and State Health Officials)
  http://archive.naccho.org/modelpractices/Result.asp?PracticeID=330

3. Preventable Hospitalizations
Goal: decrease preventable hospital admission rates, e.g. hypertension

• Reducing Inappropriate Emergency Room Use among Medicaid Recipients by Linking Them to a Regular Source of Care, Partnership for Medicaid
  www.clinicians.org/advocacy/ER%20Reduction%20Proposal%20-%20FINAL%208.25.05.pdf
• Self-Help Manuals Cut Use of Unneeded Health Care Half of the Time, Robert Wood Johnson Foundation and Oregon Health Sciences University
  http://www.rwjf.org/reports/grr/033265.htm

HYPERTENSION

• Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Vol. 3: Hypertension Care, Stanford-UCSF Evidence-based Practice Center and the Agency for Healthcare Research and Quality http://fsi.stanford.edu/publications/closing_the_quality_gap_a_critical_analysis_of_quality_improvement_strategies_vol_3_hypertension_care/
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Heart Disease and Stroke, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/publications/exemplary/pdfs/Heart.pdf
• Hypertension Initiative of South Carolina, Best Practice Initiative, U.S. Department of Health and Human Services
  http://phs.os.dhhs.gov/ophs/BestPractice/SC_hypertension.htm
• Florida Cardiovascular Health Strategic Plan 2003-2007
  http://www.doh.state.fl.us/Family/heart/PDF/cardio_strategic_plan.pdf
• Florida Cardiovascular Health Council Work Plan 2003-2007
  http://www.doh.state.fl.us/Family/heart/PDF/council_workplan.pdf

4. HIV/AIDS
Goal: decrease newly reported HIV case rate

• Best-Evidence Interventions, Centers for Disease Control and Prevention (includes examples by population) http://www.cdc.gov/hiv/topics/research/prs/best-evidence-intervention.htm
• CAPS Model Projects, Center for AIDS Prevention Studies, UCSF (includes examples by population)
  http://www.caps.ucsf.edu/projects/
• Diffusion of Effective Behavioral Interventions (DEBI), Academy for Educational Development (AED)
  http://effectiveinterventions.org
• HIV/AIDS Prevention and Outreach Strategies, U.S. Conference of Mayors promising practices
  http://www.usmayors.org/hivprevention/hivbest2001.pdf
• Miami CARES (Community AIDS Research and Evaluation Studies), Comprehensive Drug Research Center, University of Miami
  http://cdrc.med.miami.edu/x27.xml

5. Maternal and Child Health
Goal: decrease rate of low birth weight babies

• Programs that Work: Healthy Start, Promising Practices Network/RAND Corporation
  www.promisingpractices.net/program.asp?programid=118
• Healthy Start Coalitions Legislative Report 2006 promising practices
  http://www.doh.state.fl.us/family/mch/hs/hscreport2006.pdf
• Group Prenatal Care and Preterm Birth Weight: Results from a Matched Cohort Study at Public Clinics (Obstetrics and Gynecology, 2003; 102: 1051-1057, full article online) promising practice
  http://www.greenjournal.org/cgi/content/full/102/5/1051
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Healthy Mothers, Healthy Babies , Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/publications/exemplary/pdfs/HealthyMothers.pdf
• Prevention of Low Birth Weight/Pre-term Birth, Canadian Guide to Clinical Preventive Health Care, Public Health Agency of Canada (includes descriptions and evaluation results for several programs in the U.S.)
  http://www.phac-aspc.gc.ca/publicat/clinic-clinique/pdf/s1c4e.pdf

6. Physical Activity and Nutrition
Goal: decrease rate of adults with no physical activity in past month, and decrease rate of adults who consumed less than 5 fruits and vegetables per day

• Physical Activity, Guide to Community Preventive Services, Centers for Disease Control and Prevention
  www.thecommunityguide.org/pa/default.htm
• Physical Activity for Everyone, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/dnpa/physical/everyone.htm
• Weight Management Research to Practice Series, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/dnpa/nutrition/health_professionals/practice/index.htm
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Nutrition and Physical Activity, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/publications/exemplary/pdfs/Nutrition.pdf
• Research-Tested Intervention Programs: Individually-Adapted Physical Activity Intervention Programs, National Cancer Institute
  http://rtips.cancer.gov/rtips/index.do
• My Bright Future: Physical Activity and Healthy Eating (target population young women), Health Resources and Services Administration, Maternal Child Health Bureau
  http://www.hrsa.gov/WomensHealth/mybrightfuture/menu.html
• National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older, Robert Wood Johnson Foundation
  http://www.activeforlife.info/about_the_program/files/blueprint.pdf
• Commit 2 B Fit! School Board of Broward County and the Commit 2 B Fit Foundation, Inc. (target population: youth, parents, and teachers)
  www.commit2bfit.org
• Family Health Self-Empowerment Project, University of Florida promising pilot program
  http://www.clas.ufl.edu/events/news/articles/20060829_pepsi.pdf
• Improving Access to Healthy Food: A Community Planning Tool, Columbus [OH] Health Department (includes case studies of programs in other states)
  http://www.publichealth.columbus.gov/Asset/iu_files/Planning_and_Preparedness/Improving_Access_to_Healthy_Foods.pdf
• Start Living Healthy, Hawaii Department of Health (includes Start Walking and Eating Healthy)
  http://www.healthyhawaii.com/about/about_start_living_healthy/about_start_living_healthy.htm
• Healthy Hispanic Foods Resource Kit, Florida Department of Health (currently being implemented with evaluation requirements)
  http://doh.state.fl.us/Family/DCP/hispanic/index.html
• WIC/Farmers Market Nutrition Program, Florida Department of Agriculture and Consumer Services
  http://www.florida-agriculture.com/pubs/pubform/pdf/WIC_FMNP_Brochure.pdf
• Elder Farmers Market Nutrition Program Evaluation, Florida Department of Agriculture and Consumer Services
  http://elderaffairs.state.fl.us/english/Stats/DOCS/FarmersMarketEvaluation2006.pdf

7. Cancer Screening
Goals:  1) increase rate of women age 18+ who had a pap test in the past 3 years; 2) increase the rate of women 40+ who had a mammogram in the past 2 years; and 3) increase the rate of men 50+ who have ever had a sigmoidoscopy or colonoscopy

• Research-Tested Intervention Programs: Cancer, Guide to Community Preventive Services, National Cancer Institute
  www.thecommunityguide.org/cancer/screening/default.htm
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Cancer, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/publications/exemplary/
• States Take Action Against Cancer, National Comprehensive Cancer Control Program, Centers for Disease Control and Prevention (state examples)
  http://apps.nccd.cdc.gov/cancercontacts/ncccp/pia

PAP TESTS AND MAMMOGRAMS

• The Forsyth County [GA] Cancer Screening Project (FoCaS), Research-Tested Intervention Programs: Cancer, National Cancer Institute
  http://rtips.cancer.gov/rtips/index.do
• Community-Based Early Detection Program (EDP), University of Miami School of Medicine
  http://ssrg.med.miami.edu/documents/A_Community_based_Cancer.pdf

SIGMOIDOSCOPY/COLONOSCOPY

• Screening for Colorectal Cancer in Adults at Average Risk: A Summary of the Evidence, Agency for Health Care Research and Quality (AHRQ)
  http://www.ahrq.gov/clinic/3rduspstf/colorectal/colosum.pdf
• A Community-Based Model for Promoting Long-Term Utilization of Screening Sigmoidoscopy By Primary Care Providers, National Colorectal Cancer Roundtable
  http://www.nccrt.org/BestPractices/BPDetail.aspx?article_id=271
• Disparities Program Successfully Reaches Older, Minority Adults With Education and Screening Services, Centers for Disease Control and Prevention (Growing Older Well program, Pinellas County, Florida)
  http://apps.nccd.cdc.gov/cancercontacts/ncccp/pia/default.asp?id=34

8. Health and Safety
Goals: decrease 1) the motor vehicle traffic crash death rate and 2) the falls death rate

• Motor Vehicle Occupant Injury Prevention, Guide to Community Preventive Services, Centers for Disease Control and Prevention
  http://www.thecommunityguide.org/mvoi/default.htm
• Guidance for Implementation of the AASHTO Strategic Highway Safety Plan, Volume 14: A Guide for Reducing Crashes Involving Drowsy and Distracted Drivers, National Cooperative Highway Research Program
  http://www.ncdot.org/doh/preconstruct/traffic/echs/groups/docs/DSA/Volume14.pdf
• Florida Reduces Small Business Illness and Injury Rates:  The Seven Up Safety and Health Program, University of South Florida
  http://0-www.cdc.gov.mill1.sjlibrary.org/niosh/sbw/national_state/pdfs/nesbitdoc.pdf
• Safety Alliance of Tampa Bay (businesses/members from construction trades work with USF’s Occupational Training Institute to develop best practices for on-the-job safety) promising practice
  http://www.usfsafetyflorida.com/index.aspx?tabid=230
• Traumatic Occupational Injuries: Falls from Elevation, National Institute for Occupational Safety and Health
  http://www.cdc.gov/niosh/injury/traumafall.html

9. Dental Health
Goal: increase the rate of residents who visited a Dentist or dental clinic in the past year

• Oral Health, Guide to Community Preventive Services, Centers for Disease Control and Prevention
  http://www.thecommunityguide.org/oral/default.htm
• State and Community Models for Improving Access to Dental Care for the Underserved—A White Paper (2004) American Dental Association
  www.ada.org/prof/resources/topics/topics_access_whitepaper.pdf
• State Innovations to Improve Access to Oral Health Care for Low-Income Children: A Compendium Update (2005) (includes a clickable map of state programs)
  http://www.prnewswire.com/mnr/ada/20973/
• State Programs in Action: Exemplary Work to Prevent Chronic Disease and Promote Health: Oral Health, Centers for Disease Control and Prevention
  http://www.cdc.gov/nccdphp/publications/exemplary/pdfs/OralHealth.pdf
• Community-Based Oral Health Programs: Lessons from Three Innovative Models, W.K. Kellogg Foundation
  http://www.wkkf.org/oralhealth/OralHealth.aspx
• Bright Futures in Practice: Oral Health Toolbox (resources for clinicians, includes materials developed in multiple states), National Maternal and Child Oral Health Resource Center
  http://www.mchoralhealth.org/Toolbox/professionals.html

10. Elder Access to Care
Goal: increase the rate of adults 65+ who had a flu shot in the past year

• Vaccines, Guide to Community Preventive Services, Centers for Disease Control and Prevention (assesses effectiveness of evidence based interventions to increase vaccination rates)
  http://www.thecommunityguide.org/vaccine/default.htm
• Adult Immunization Programs in Nontraditional Settings: Quality Standards and Guidance for Program Evaluation, MMWR 1993;42[No. RR-5], Centers for Disease Control and Prevention
  http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4901a1.htm
• Racial and Ethnic Adult Disparities in Immunization Initiative (READII), Centers for Disease Control and Prevention
  http://www.cdc.gov/omh/AMH/factsheets/immunization.htm
• Public Health Communications Response to the Influenza Vaccine Shortage, The Pinellas County Health Department, Best Practice Initiative, U.S. Department of Health and Human Services
  http://phs.os.dhhs.gov/ophs/BestPractice/FL_fluvaccine.htm
• Promising practice: Two articles discussing vaccination of children as a strategy to prevent community-level transmission and reduce flu mortality among the elderly: 
  • Long-standing influenza vaccination policy is in accord with individual self-interest but not with the utilitarian optimum, Galvani AP, Reluga TC, and Chapman GB. (Department of Epidemiology and Public Health, Yale University School of Medicine), Proceedings of the National Academy of Sciences, 2007 Mar 27;104(13):5692-7. Epub 2007 Mar 16. (abstract)
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17369367&query_hl=8&itool=pubmed_docsum
  • Strategy for distribution of influenza vaccine to high-risk groups and children, Longini IM Jr, Halloran ME. (Department of Biostatistics, The Rollins School of Public Health, Emory University), American Journal of Epidemiology, 2005 Feb 15;161(4):303-6. (full text article)
    http://aje.oxfordjournals.org/cgi/content/full/161/4/303

Related Links:
Miami-Dade County Community Health Report Card: Full Report
Miami-Dade County Living Healthy, Living Longer Survey: Full Report