State Public Health Approaches to Addressing Arthritis - Purpose: The North Carolina Center for Health and Wellness (NCCHW) at the University of North Carolina Asheville proposes a project to address the arthritis burden in North Carolina (NC). This is an important project for NC, considering more than 27% of adults in NC have arthritis, with many being limited in their activities and suffering from severe joint pain. Further, arthritis disproportionately impacts older adults, rural residents, and adults with cardiovascular disease, diabetes, and obesity in NC. Strategies and Activities: Key strategies and activities will include sustainably expanding upon Arthritis Appropriate Evidence-Based Intervention (AAEBI) delivery by enhancing statewide AAEBI locators and enrollment portals, establishing opportunities for AAEBI reimbursement, engaging large employers’ worksite wellness programs to offer AAEBIs, and embedding AAEBIs into statewide, multi-site community organizations. NCCHW also proposes working with new and existing healthcare partners to promote the adoption of the Exercise is Medicine (EIM) model of Physical Activity (PA) assessment, PA counseling, and referrals to AAEBIs as well as the embedding the PA vital sign in electronic health/medical record systems. The EIM approach will also be adopted by our Health Coaching program and reimbursement opportunities for Health Coaching and AAEBIs will be pursued via our Community Care Hub which serves as a centralized contracting entity with health payors. Across all activities, NCCHW will emphasize engagement with and monitor the reach of the disproportionately impacted populations outlined above. We will collect and utilize data to raise awareness, ensure effective reach of selected populations, guide programmatic activities, and report on the impact of our efforts. NCCHW has committed to working collaboratively with the Centers for Disease Control and Prevention and the National Association of Chronic Disease Directors to ensure quality improvement
throughout the duration of the project. Outcomes: NCCHW will increase AAEBI enrollment, increase the percent of adults with arthritis in NC who receive provider counseling about PA for arthritis management, decrease the percent of adults diagnosed with arthritis who report being physically inactive, increase the percent of adults diagnosed with arthritis who report walking for exercise among their top 2 forms of exercise, and decrease the percent of adults diagnosed with arthritis who report severe joint pain within the past 30 days. Outcomes will be stratified by populations disproportionately impacted by arthritis mentioned above to monitor and reduce health disparities.