Delaware County Medical Society Summer/Fall 2020 - 13

While there exist prevention opportunities to
improve women's health about these issues,
there is a need to expand the chronic care
model addressing chronic-disease-related
factors on women of reproductive age.

Integrating digital health promotion into the
prevention and management of chronic-disease
related factors among women of reproductive
age is paramount.

Barr et al. (2003) suggest evidence-based and
effective strategies to promote health and
to prevent and manage chronic diseases is
essential. Barr et al. (2003) agree that the most
effective interventions for improvements in
chronic diseases care include the combination
of multi-pronged strategies. This can also serve
as a model approach to address unique health
requirements of women. The multi-pronged
strategy that Barr et al. (2013) suggest is
Chronic Care Model (CCM). According to Barr
et al. (2013), the model has been implemented
by many organizations in the United States,
United Kingdom and Sweden. Barr et al. (2013)
conclude that CCM can be used to direct quality
improvement initiatives for clinical preventive
services. Pregnancy-related chronic illnesses
can be best addressed using such a model.
However, the scope and depth of community
resources and policy-linkage components of
the CCM needs expansion. Barr et al. (2013)
note that the current language of CCM does
not resonate with population health promotion
practitioners who make up an integral
component of publicly funded health systems.
Pregnancy and fertility increase the prevalence
of chronic illnesses in women. For this reason,
pregnancy and fertility essentially form a major
part of these publicly funded health systems.
To address chronic illnesses that emanate from
pregnancy and fertility related issues in women
would require a CCM that considers the role of
population health promotion practitioners.

This integration would increase the scope of
the CCM by directing additional efforts to
reducing the burden of chronic diseases by both
reducing the impact on those with a disease
and supporting the healthiness of women
in communities. Digital health promotion
for women of reproductive age encompasses
increasing epidemiology capacity at the state,
local, territorial and tribal level to effectively
use data related to chronic disease prevalence
and risk (Barfield & Warner, 2011). Integrating
digital health promotion in the prevention
and management of chronic-disease-related
factors among women of reproductive age
requires action on the factors determining the
health of women as well as delivering high
quality healthcare services. One of the key
strategies would be to improve the continuity of
healthcare beyond pregnancy. Having a single
model for the organization of healthcare has
been found more beneficial than having the
CCM and population health promotion as two
separate models. Integrating population digital
health promotion into the Chronic Care Model
brings out a public health approach to chronicdisease prevention based on community efforts
can help address health promotion among
women of reproductive age (Barfield & Warner,
2011).
The Expanded CCM brings a new focus onto
the role of social determinants in the health
of individuals, communities, and population
health (Barr et al., 2003). An Expanded CCM
will serve to address the shift of maternal death
from the traditional causes to chronic-diseaserelated factors because there are working
strategies for containing the traditional causes
while the chronic-disease-related factors remain
a challenge.
continued on next page

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