The proposed project will build and support capacity for the broad dissemination of arthritis-appropriate, evidence-based interventions (AAEBIs) to reduce the burden of arthritis in Iowa.The project will be coordinated by the ISU Translational Research Network (U-TuRN) and be implemented and managed by the Iowa Community HUB, a ‘community-care hub’ led by CHPcommunity, a non-profit agency serving clinical and community partners in Iowa. Consistent with program guidelines, we will work with clinical partners to increase the proportion of adults with arthritis who get counseled for physical activity (and the number that are referred to available AAEBIs). We will also work to increase the capacity of community-based organizations such as the state network of affiliated Area Agencies on Aging sites across the state to plan, promote and deliver AAEBIs. Our innovative technology system and network of state, regional and county-level partners will enable us to increase AAEBI access and capacity in rural communities, targeting populations that are disproportionately affected by arthritis. Over the five-year project, we will build capacity for a sustainable, state wide system to reduce health disparities and improve health outcomes in Iowans with arthritis.
The major strength of our proposed state model is the integration of state agencies, clinical providers and community partners through the Iowa Community HUB. The Agency for Healthcare Research and Quality (AHRQ) and the Administration of Community Living (ACL) have advocated for states to develop this type of hub-like model to facilitate dissemination ofevidence-based programs in efficient and equitable ways. The general advantage of a Hub model is that it centralizes and coordinates an array of administrative functions including
contracting with health care organizations, payment operations, management of referrals, fidelity and compliance functions, data security and reporting. The specific advantage of the Hub model for the proposed project is that it provides a centralized point of reference for coordinating enrollment and delivery of AAEBIs. Providers in the state have a singular point of contact to refer patients that would benefit from AAEBIs. Participants that are referred will also be supported by trained HUB Navigators that can assist in finding options to directly support
individuals based on their needs, interests and geographic location. The HUB already manages referrals for various forms of Walk with Ease (including Camine Con Gusto), as well as Tai Chi for Arthritis and has taken similar steps for the statewide Chronic Disease Self-Management Program (‘Better Choices Better Health’ in Iowa), but our coordinated plan will enable us to build capacity for both broader reach and enhanced efficacy of these programs. Partnerships with state and county-based Extension leaders will facilitate training while engagement with regional YMCA facilities, state health initiatives and coalitions will support more programming. Because we work directly with several integrated health clinics – including the state network of federally
qualified health centers (FQHC) we are also well positioned to reach and support at risk and marginalized individuals that may not otherwise have access to preventive health programming. The project will be coordinated through the Implementation and Translational Research sub-committee of the Iowa Community HUB to ensure effective evaluation and refinement of programming over time. The adoption of implementation science methods and frameworks will promote sustainability and enhance the public health impact of the programming over time.
