A Brief History of the
NACDD Rheumatoid Arthritis Project
A 2008 workshop sponsored by Abbott Pharmaceuticals and hosted by NACDD
was a planning workshop, not designed primarily as an educational activity, but as a
needs assessment for improving RA outcomes and to determine strategies necessary to
satisfy the identified needs. Twenty-eight workshop participants comprised of state and
national public health arthritis specialists produced a comprehensive public health
program plan to promote early diagnosis and aggressive treatment of rheumatoid
arthritis. Workshop participants included representatives from newly funded CDC state
Arthritis Programs, NACDD state Arthritis Integration Dissemination grantees,
rheumatologists and other key public health and health care stakeholders.
Guest speakers informed the workshop participants about the clinical importance
of early diagnosis and aggressive treatment for RA and the factors that contribute to
delays in treatment. Presentations were made by Dr. James O’Dell, University of
Nebraska Medical Center – Rheumatoid Arthritis: An Opportunity to make a
Difference, Dr. Martin Bergman of Drexel University College of Medicine – Obstacles to
the Early Diagnosis and Treatment of Rheumatoid Arthritis, and Dr. Patience White,
Chief Public Health Officer, Arthritis Foundation – Patient/Provider Guided Arthritis
Foundation Inflammatory Arthritis Initiative.
This workshop and the plan that was produced there are the foundation from
which all future NACDD efforts have emerged to improve early diagnosis and treatment
of RA are built. The State Public Health Plan to Promote Early Diagnosis and
Treatment of Rheumatoid Arthritis is posted on the NACDD website at
http://www.chronicdisease.org/i4a/pages/index.cfm?pageid=3812.
In 2009 Abbott grant funds were awarded to participating state public health
departments in Michigan, Missouri, Pennsylvania, and Wisconsin to conduct pilot projects in
public and professional education. These projects were supplemented by state health
department chronic disease program infrastructure already in place to address arthritis and
other chronic diseases. Three of the participating states (Michigan, Missouri and Wisconsin)
each have CDC Cooperative Agreement funding to implement Arthritis Program initiatives,
including public and professional education. In addition to the independent activities funded by
Abbott, each of the four states implemented their project activity by integrating RA activities
within other chronic disease programs (e.g., Cardiovascular Health, Diabetes Prevention and
Control, Cancer Control, or Wise Woman programs). This strategy of integration is one that
CDC had been promoting for the past five years and was one that was ideally suited for the
activities of the RA Project. The CDC Arthritis Program activity in state health departments had
not specifically addressed RA, but was instead focused on public education and policy initiatives
on behalf of the larger OA population.
Alerting primary care providers to the importance of early and aggressive treatment for
RA patients and the importance of adopting early detection and aggressive treatment guidelines
(e.g., the HEDIS DMARD measure, Arthritis Foundation Clinical Guidelines) was one of the
primary objectives of these state health department professional education activities. Using
previously established communication channels, established partnerships and capacity of state
health department Arthritis Programs was an efficient and potentially effective means to
improve patient care and outcomes.
In late 2010, after an eight month hiatus in funding, Abbott continued funding NACDD’s
RA Project as a demonstration project with stepped-up evaluation. Unfortunately during this
period of no funds for the initiative the states of Michigan and Pennsylvania had to withdraw
their participation. State efforts in Missouri and Wisconsin have continued, respectively,
through subcontracts from the state public health agencies to the University of Missouri and the
Milwaukee Area health Education Center.
The following is the first quarter progress report of the 2010-2011 RA Project.
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Quarterly Progress Report on the
Rheumatoid Arthritis Demonstration Project
November 2010 – February 2011
November 2010
A November 12th evaluation planning meeting held in Milwaukee, WI produced logic
models for each of the project components of the state demonstration project (see
attachments at the end of this narrative).
The Wisconsin and Missouri project directors reported that Memorandum of
Understanding between the Milwaukee AHEC, Missouri Department of Health and
Senior Services and NACDD would soon be signed and returned to the NACDD offices
in Atlanta. Progress subsequent to the November 12th meeting was reported as follows.
Wisconsin
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Subcontracts for three, 1-hour professional education webinars with evaluation
activities are final. These webinars will be archived for access by health
professionals unable to attend at designated times for live attendance.
Professional education activities are being planned collaboratively with the
Wisconsin Department of Health’s, Diabetes Prevention and Control Program.
Implementation of HEDIS measures for diabetes and heart disease are the
targeted outcomes for these programs.
The University of Wisconsin is planning continuing education grand rounds for
the northwest region of WI. This grand rounds session will focus on
implementation of evidence-based programs and will be a part of the 14th annual
Head of Lakes Symposium on arthritis.
Community public education events are being planned under contracts with
other local Wisconsin AHECs.
Discussions with the WI AHEC media contractor are underway to implement
movie theater promotional ads.
Missouri
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On a conference call with three of the University of Missouri’s professional
education regions, the project director reviewed the logic models developed
during the November 12th meeting. The Southwest Region coordinator shared the
lessons learned with the two new regions added this year for the demonstration
project. She described her experiences implementing RA education activities
during the pilot project period in 2009.
St. John’s hospital in Springfield, MO will focus its 20th annual professional
education arthritis conference on RA. In past years, approximately 600 allied
health professional have attended this conference in past years. Educational
materials have been requested from the Arthritis Foundation (e.g., RA Magazine)
to supplement and support the materials that will be dispersed.
The new regions being added to the Missouri project are planning local activities
with local rheumatologists. The northwest region will be planning activities
around an established annual arthritis conference with the focus being on
rheumatoid arthritis this year. The central region, new to RA professional
education will be hosting its first conference and focusing on RA specifically.
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Discussions with the MO media contractor, Learfield Communications, are
underway to launch a movie theater and radio media campaign. The radio ads
will promote recognition of RA symptoms and the importance of early diagnosis
and treatment.
December 2010
Wisconsin
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Wisconsin Arthritis Program and the Milwaukee AHEC held a conference call
with North Central AHEC to plan professional education webinars and
develop evaluation tools. We were able to collaboratively brainstorm topics
for webinars and effective evaluation measures. North Central AHEC is
moving forward in their implementation of this plan.
In collaboration with the Wisconsin Department of Health’s Diabetes
Prevention and Control Program, the HEDIS measures with Arthritis are
available following this link:
http://www.dhs.wisconsin.gov/health/diabetes/PDFs/HMOAdd2010.pdf.
Community public education events are underway with other Wisconsin
AHEC’s.
Missouri
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Planning for CEUs and CMEs for RA education activities are underway for all
three regions of the state including recruitment of speakers and agenda topics.
Locations have all been secured. Two of the conferences are scheduled to occur
in May/June 2011 while the third will occur in October 2011. All three
coordinators are working closely with other allied health staff on their conference
planning teams to reach out to target audiences using state professional
registration mailing lists and university alumni association lists for invitation.
Patient awareness activities will occur state-wide through all seven regional
arthritis centers using new marketing materials which help refer clients to the
evidence-based programs of the arthritis program. This will occur in March
through May 2011. These materials are not RA specific, rather promotion of
Missouri arthritis resources, including the RA professional conferences. In
addition to the radio and theatre campaign, materials include brochures, posters,
bus/transit ads, trolley ads and newspaper print.
January 2011
Wisconsin
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The University of Wisconsin continues efforts for grand rounds session on
evidence-based programs to be held at the 14th Annual Head of Lakes
Symposium on arthritis. Currently they are gathering information and
seeking qualified speakers.
Missouri
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Conference call discussions have occurred with both Missouri and Wisconsin
Learfield Communications, Inc. offices and the MO/WI Arthritis Programs
regarding collective design and development of radio and theatre ads. MAOP has
been given an estimate of cost for theatre ads by its Learfield contractor and WI is
waiting for the same. Our staff will soon be holding discussions with the staff
evaluator to discuss feasibility of theatre exit interviews in three regions of the
state where ads would be run. The RA public education radio campaign will run
state-wide in May 2011.
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