50. Violence prevention - The Committee encourages the CDC to support development of community plans to prevent violence and implementation of coordinated community violence intervention and prevention activities. The Committee encourages the CDC to collaborate with community organizations with established programs for families and communities in urban, low-income settings. Action Taken or to be Taken CDC will continue to work with partner organizations to develop local community plans of action to prevent family violence and to design and implement coordinated community responses. Funding for nine community-based primary prevention projects will be continued to address intimate partner violence including dating violence, intimate partner violence witnessed by children and adolescents in the home, and public awareness and community education efforts. Some of these projects target ethnic and racial minority populations. One of these projects funded through Metropolitan Family Services in Chicago received additional funding to begin planning a comprehensive coordinated response to address violence prevention broadly. In addition, CDC is evaluating programs in three state health departments and three communities to help answer questions regarding the effectiveness of specific interventions and primary prevention strategies and how to effectively combine interventions for communities, workplaces, schools and other settings. The health department evaluations will assess (a) efforts to inventory existing data sources and prevention programs; (b) systematically collect data on the incidence of intimate violence; and (c) plan, implement, and evaluate interventions and primary prevention strategies. The three community programs being studied are multifaceted, allowing researchers to examine both the effectiveness of the interventions and the ability of multifaceted programs to reduce rates of family and intimate violence. The programs under study are a project in two metro Atlanta, Georgia counties to develop a zero-tolerance policy for battering; a program in Milwaukee, Wisconsin that will develop and implement a public awareness campaign, employ differing treatment models for batterers, and engage adolescents ages 12+ and young on their knowledge, attitudes, behavior and beliefs; and a Duluth, Minnesota project that expands existing coordinated community-based approach to victim services. 51. Family violence Intervention programs - The Committee encourages the CDC to expand family violence intervention and prevention programs coordinated with substance abuse treatment centers serving female clients. Action Taken or To be Taken CDC recognizes the importance of collaborating with substance abuse treatment centers to enhance activities linking family violence intervention. CDC will continue to work with the Women's Alcoholism Center in San Francisco, CA, a clinical treatment facility, to screen female clients at risk of family violence. One of the primary prevention projects mentioned under number 50 above, was funded through this Center. In addition, CDC has funded a project which looks at suicide and violence against women which also looks at substance abuse issues. 52. Family violence intervention programs - The Committee encourages the CDC to support violence intervention and prevention programs that are developed within the communities they are designed to serve. Action Taken or To be Taken Most of the projects funded by CDC are developed and implemented by community based organizations. CDC will continue to work with partner organizations to develop local community plans of action to prevent family violence and to design and implement coordinated community responses. Funding for nine communitybased primary prevention projects will be continued to address intimate partner violence including dating violence, intimate partner violence witnessed by children and adolescents in the home, and public awareness and community education efforts. Some of these projects target ethnic and racial minority populations. One of these projects funded through Metropolitan Family Services in Chicago received additional funding to begin planning a comprehensive coordinated response to address violence prevention broadly. In addition, CDC is evaluating programs in three state health departments and three communities to help answer questions regarding the effectiveness of specific interventions and primary prevention strategies and how to effectively combine interventions for communities, workplaces, schools and other settings. The health department evaluations will assess (a) efforts to inventory existing data sources and prevention programs; (b) systematically collect data on the incidence of intimate violence; and (c) plan, implement, and evaluate interventions and primary prevention strategies. The three community programs being studied are multifaceted, allowing researchers to examine both the effectiveness of the interventions and the ability of multifaceted programs to reduce rates of family and intimate violence. The programs under study are a project in two metro Atlanta, GA counties to develop a zero-tolerance policy for battering; a program in Milwaukee, WI that will develop and implement a public awareness campaign, employ differing treatment models for batterers, and engage adolescents ages 12+ and young on their knowledge, attitudes, behavior and beliefs; and a Duluth, MN project that expands existing coordinated community-based approach to victim services. Significant items in the House and Senate FY1999 Appropriations Committee Reports General Departmental Management House Report 1. Diabetes-Diabetes continues to devastate the lives of over 16 million Americans, 8 million of whom are not even aware that they have the disease. The Committee continues to be concerned about the disproportionately high rates of diabetes in people of color, especially among African Americans and Hispanics. The Committee is also concerned about the excessive amputations that both populations have suffered from the disease. The Committee expects the Secretary to strengthen diabetes efforts across the CDC, NIH, AHCPR, and other appropriate components of the Department. Action Taken or to be Taken CDC's diabetes prevention and control program effort is extensive and has established a multifaceted framework upon which to address the burden of diabetes, particularly within disproportionately affected populations. The focus of CDC's effort is on (1) supporting the state-based diabetes control programs in all 50 states and the District of Columbia to develop or expand diabetes control efforts that increase awareness and education about diabetes, promote early detection and treatment of diabetes complications, improve the quality of diabetes care and enhance access to diabetes care by improving and expanding services in the state, (2) conducting applied translational research focusing on the application of findings from recent randomized control trials in real world settings; (3) initiating the National Diabetes Education Program (NDEP) in concert with the National Institutes of Health to ensure that patients, providers, and the public become aware that diabetes is a very serious illness, and that its tragic complications can be prevented with new and existing prevention and control strategies; (4) developing surveillance systems for use at state and local levels, especially for monitoring the diabetes burden among certain racial and ethnic populations; and (5) developing and implementing innovative interventions and prevention strategies for eliminating racial and ethnic health disparities (President's Initiative on Race). In FY 1998, CDC conducted several activities to further address the burden of diabetes in racial and ethnic minorities, particularly African Americans and Hispanics. CDC launched the NDEP media campaign, "Control Your Diabetes. For Life." with public CDC selected six national minority organizations to help the NDEP reach African Americans, CDC's state-based diabetes control programs along the U.S.-Mexico border are collaborating CDC established the National Diabetes Prevention Center to address the serious epidemic of diabetes in Native Americans. The center will promote diabetes prevention and control strategies among the Navajo Tribe and the Pueblo of Zuni near Gallup, New Mexico. In FY 1999, CDC will concentrate its efforts on strengthening and refining these programmatic approaches to reduce the burden of diabetes in disproportionately affected populations, particularly racial and ethnic minorities. Item 2. Funding a program of health promotion in schools - The Committee strongly believes that prevention is the key to maintaining and improving the health of the American people, and that to be most effective outreach and public education must start at the earliest level possible. Our Nation's school children are critical to this effort. The Committee encourages the Secretary of Health and Human Services and the Secretary of Education to work in a collaborative effort to establish and fund a program of health promotion and disease prevention in our Nation's schools that is especially designed to teach children health promotion and disease prevention strategies and techniques. The Departments are expected to report to the Committee on the status of this effort during next year's appropriations hearings. Action Taken or to be Taken CDC supports coordinated school health programs to prevent youth health risk behaviors that contribute to the leading causes of mortality and morbidity in the U.S. In 1987, CDC established a national framework to help implement HIV prevention education in schools nationwide by helping every state provide youth with the information and skills they need to avoid HIV infection. Using this framework, CDC has begun to help implement coordinated school health programs to prevent other serious health problems in 15 states. These 15 states provide youth with the information and skills they need to avoid risk behaviors such as tobacco use, unhealthy dietary behaviors, and inadequate physical activity. This national framework is implemented through four interrelated strategies: (1) Surveillance -- CDC monitors six categories of priority health risk behaviors among youth through the Youth Risk Behavior Surveillance System. CDC also employs the School Health Policies and Programs Study to monitor the extent to which schools are implementing effective health policies and programs. Data from both surveillance systems are used at the national, state, and local level to improve health-related policies and programs for youth; (2) Research Application - CDC maintains an ongoing database on effective prevention programs for youth and analyzes research to determine best practices. CDC disseminates this information nationwide through guideline development and through a network of training programs; (3) Enabling Constituents - CDC provides financial and technical support to every State Education Agency, the District of Columbia, Puerto Rico, 6 territories, 18 local education agencies to provide locally determined HIV prevention programs to school-aged youth. Major activities include training teachers, developing and disseminating educational materials, and monitoring and evaluating program activities. These programs are designed to help young people develop the skills they will need to avoid HIV infection, other STDs, and other health problems. CDC works with more than 30 national non-governmental organizations to help schools and other agencies that serve youth implement effective HIV prevention education for youth. CDC also provides funds to 15 states to help build infrastructure to support coordinated school health programs and to help prevent chronic diseases related to tobacco use, physical inactivity, and unhealthy diet. In an optimal national program, every state would be funded to implement coordinated school health programs; (4) Evaluation -- CDC provides technical assistance to state and local education agencies to help them evaluate the quality and effectiveness of their HIV-related policies, teacher training, and curricula. CDC also conducts evaluation research to test the effectiveness of school-based interventions designed to prevent HIV/STD infection among adolescents. CDC maintains partnerships with a wide range of governmental and nongovernmental organizations to help schools implement effective health promotion and disease prevention strategies. CDC also coordinates the development of Healthy People 2010 Objectives for adolescents and young adults and convenes the federal interagency Committee on School Health, which is co-chaired by the Assistant Secretaries from the Department of Health and Human Services, the U.S. Department of Education, and the Department of Agriculture. CDC also maintains a staff person who works at the U.S. Department of Education to help build collaboration between the two agencies. |