Community HUB

Statewide Efforts – Community Integrated Hub

Two girls lifting their thumbs, one girl with disability

The Agency for Healthcare Research and Quality (AHRQ) recommends Hub infrastructure to connect people with meaningful evidence-based programs, while avoiding duplication of effort and keeping individuals from falling through the cracks.

The Community HUB will grow to provide a neutral and centralized ‘one-stop-shop’ across Iowa for identifying at-risk individuals, connecting them to appropriate programs, facilitate statewide data collection, and provide trainings and support to community partners.

HISTORY – CHPcommunity (CHP)

In 2017, the National Association of Chronic Disease Directors funded CHP as the Walk With Ease (WWE) hub for the state of Iowa. The WWE hub provided administrative support, connections to referral networks, and instructor trainings in efforts to expand the WWE program across the state.

In 2018, CHPcommunity helped lead the Iowa Falls Prevention Coalition strategic plan that supports the need for a statewide organizational hub for the expansion and sustainability of falls prevention programs across Iowa.

In 2019, the NACDD contracted with CHP to be the anchor institution for Iowa and collaborate with the Iowa Department of Public Health to help expand the national Diabetes Prevention Program (DPP) throughout the state with a focus on reaching populations with disability.

In September 2019, CHP was selected along with 10 other national organizations by the National Council on Aging for a ten-month Network Development Learning Collaborative focused on training and education for the hub model. Through these experiences, CHP has refined the purpose of the Community HUB to be a state-wide support network focused on strengthening the expansion of evidence-based programs (EBPs) across the state addressing chronic disease in Iowa.

The Community HUB

The Community HUB connects a network of partners consisting of public and private community stakeholders—including health and social service providers, municipalities, businesses, and representatives of the at-risk populations being served—together to determine local health needs and the most effective evidence-based interventions for addressing those needs. Through improved coordination, communication, and a built-in support system for partners delivering evidence-based programs (EBPs), the HUB strives to increase the effectiveness of care coordination services across multiple organizations to ensure that those at risk are identified and connected to evidence-based programs and services in a timely manner.

The Community HUB supports the “screen-detect-refer” approach by working with health systems and health plans to identify those at risk and coordinate an integrated, central referral system that directs individuals into critical EBPs close to home or in the home. The HUB’s primary goal is to ensure the timely provision of appropriate, high-quality, cost-effective,evidence-based programs and services that will have a meaningful impact on those served. The intent of the HUB is to bring greater equality in service delivery and health outcomes.

Meeting Jackie Joyner-Kersee at a Martin Luther King Prayer Breakfast.

Hub Goals:

  • Increase timely access to chronic disease management and prevention programs
  • Improve sustainability of evidence-based programs
  • Eliminate duplication of services
  • Strengthen clinic to community coordination including referrals into evidence-based programs
  • Provide a support system for partners delivering evidence-based programs

Interested in learning more?

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Role of the Community HUB

The Community HUB will continue to learn from community partners what the needs are for a centralized, coordinated support hub that enhances care coordination and collaboration among community partners towards the sustainable delivery of EBP’s in Iowa. 

The Community HUB will evolve to provide the following benefits to community partners providing EBP’s:

  • The HUB, as a statewide and community-based hub, builds capacity to support community partners in delivering EBP’s with a one-stop website, referral system, marketing activities, and centralized process for training, workshops, and resource development to expand skills and share information.
  • The HUB supports community initiatives and drives sustainability through data analysis and reporting, alignment with quality care measures, and application of best practices through synthesis of scientific evidence and translational research.  
  • The HUB annually produces fact sheets and statistics in Iowa on chronic disease strategies that advance person-centered awareness and education with a focus on priority populations, health equity, health literacy, disabilities, and self-efficacy.  

Community HUB Partnerships

The Community HUB Advisory Group

The Community HUB is a collaborative effort from key community stakeholders with an interest in improving the delivery and sustainability of evidence-based programs. These community stakeholders make up the HUB Advisory Group. This team works together to focus on priority needs and target populations with a goal of improved care coordination into EBPS across the state.

The Community HUB is in Phase 1 of 4 development stages. Accomplishments to date:

  • Community HUB website
  • Established a HUB Advisory Group
  • Ready to promote programs across the state (contact us for more details)
  • Purchased statewide database system for data collection, tracking, and reporting
  • Launching this October, the Walk With Ease self-directed statewide program as the first program to go through the new database system
  • Beginning work with healthcare systems to integrate with HUB centralized referral system into statewide community EBPs
  • Establishing partnerships with providers of EBPs and other stakeholders to support these efforts

Partnerships in the Development of the HUB

The U-TuRN program at Iowa State University is a transdisciplinary network that integrates expertise from multiple departments (and through the ISU Extension and Outreach program) to support the development and translation of evidence-based programs (EBP’s) focused on health into community practice. 

CHPcommunity has a collaborative agreement with Iowa State University U-TuRN team to work in partnership to build capacity and add enhanced support services to our community and statewide initiatives through ISU’s expertise in behavioral research, implementation science, mobile health applications, and clinical health coaching.

For the development and sustainability of the Community HUB, ISU U-TuRN will help:

  • Facilitate the scientific direction of EBP’s and related initiatives
  • Facilitate training of leaders/instructors across the state to ensure quality of EBP delivery and continued professional development
  • Assist with the development of training materials/resources for EBP’s and related initiatives
  • Coordinate the evaluation of EBP’s and other related initiatives
  • Collaborate on grant writing efforts that support sustainability of EBP’s
  • Assist with technology integration to enhance data collection, reporting, distance learning, and virtual health coaching services