Actions to Prevent and Control Chronic Diseases in the CNMI - The Commonwealth of the Northern Mariana Islands (CNMI), Commonwealth Healthcare Corporation (CHCC) is submitting this grant application for funding through the Centers for Disease Control and Prevention (CDC) to support and implement the "Advancing in Public Health Actions to Prevent and Control Chronic Disease in the U.S Territories and Freely Associated States" under funding opportunity CDC-RFA-DP-25-0024. The CNMI continues to battle the burden of chronic diseases stemming from obesity, diabetes, tobacco use, and inadequate support for the social determinants of health for non-communicable diseases. According to the 2023 CNMI Non-Communicable Disease and Related Risk Factor Hybrid Survey: •87.9% of CNMI adults consume less than the recommended amount of fruits and vegetables per day •72% of adults are overweight or obese •26.8% of adults have Diabetes; this is an 8.1% increase from 2016 •10% of adults use e-cigarettes •22.5% of adults chew betel nut with tobacco According to the CNMI Cancer Profile from the Pacific Regional Central Cancer Registry, 2007- 2020, 68% of the CNMI's adult cancers are tobacco-related, and 35% are obesity-related. The rising rates of cancer, diabetes, obesity, and heart disease have contributed to an increase in deaths and are often part of a cycle of conditions, with adults usually being diagnosed with more than one chronic condition- chronic diseases are the number one leading cause of death and disease in the CNMI. The underlying factors circle back to tobacco use and diabetes. Therefore, the CNMI Commonwealth Healthcare Corporation (CHCC) aims to reduce the burden of chronic diseases and improve the population's health outcomes. To accomplish this feat, CNMI CHCC will collaborate with key partners, such as the NCD Task Force, to: •Develop and implement sustainable culturally tailored evidence-based or informed prediabetes and diabetes self-management programs •Strengthen the NCD Task Force, which will serve as the CNMI's chronic disease coalition •Implement community-clinical linkage initiatives that support wrap-around care and screening for tobacco and diabetes •Enhance culturally appropriate multi-media campaigns to complement prevention policy, systems and environmental change initiatives to reduce tobacco use •Enhance culturally appropriate multi-media campaigns to complement the initiatives to reduce the prevalence of diabetes, and •Develop and implement an NCD Surveillance Plan in conjunction with the CNMI NCD Strategic Plan, inclusive of Oral Health surveillance, evidence-based preventive dental services (EBPDS), and 3) the promotion of infection prevention and control.
