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Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative

Lauren Smith

"With a coordinated, multisector approach, we can transform our public health system into one that has the resources, capacity and networks to create communities where all people have a just and fair opportunity to be healthy."

Lauren Smith, MD, MPH, Former Chief Health Equity and Strategy Officer, CDC Foundation


Hilary Heishman

“Now is the time to be bold. It is an important time to make changes that create opportunities for everyone in our society to thrive. Strengthening public health with an eye to the future is fundamental to this vision.”

Hilary Heishman, Senior Program Officer, Robert Wood Johnson Foundation


Project Partners


State Partners

We all want to live in a community where everyone has the opportunity to reach their best health and wellbeing, no matter their race, ethnicity or class. Communities, including state health agencies and community-based organizations, have been working toward everyone having opportunities to access health care, clean air, parks, childcare, transportation options and the many other aspects of our lives that impact our overall health. The Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative works to strengthen the foundational relationships imperative to ensuring all members of the community can thrive and improve the structures and processes needed to consistently move this work forward.

State governmental public health currently has an influx of funding to address health inequities and to strengthen the public health workforce and infrastructure. Strengthening partnerships with community-based organizations and community leaders is key to sustainably building change.

The STRETCH initiative offers capacity-building activities to build and strengthen trust and accountability among state public health agencies and community organizations, develop approaches to power sharing, identify community priorities and build a shared set of actions to achieve common goals of advancing opportunities for all community members to live their healthiest lives.

The CDC Foundation, Association of State and Territorial Health Officials (ASTHO) and Michigan Public Health Institute (MPHI) partnered on STRETCH 1.0 to bring together 10 SPHAs and their community partners to build and expand equitable public health practices and strategies.

Building upon the experiences in the first round of the STRETCH initiative, STRETCH 2.0 aims to promote necessary skills, core competencies, power sharing and authentic relationships among state team members and community partners to advance and sustain health equity through systems change.

The STRETCH initiative champions a systems change approach by analyzing the underlying policies, practices, resource allocations, power dynamics, relationships and mental models—our beliefs or assumptions that influence our perceptions—that have created barriers to everyone having the opportunity to live their healthiest life. CDC Foundation, ASTHO and MPHI will provide specialized technical assistance to state public health agencies and their communities to address these underlying root causes of health inequities.

Community-based organizations and state public health agencies are working in partnership to ensure a better future for all. STRETCH is providing additional support to strengthen these relationships with a focus on community needs for long-term changes.


STRETCH National Convenings

Watch our first national convening, Healing Relationships Authentically to Sustain a Healthy Community.


 

The STRETCH Framework

The STRETCH Initiative synthesized different perspectives into an action-oriented framework that emphasizes addressing root causes to achieve health equity.

The STRETCH Framework is a tool for public health practitioners—including state public health agencies, local health departments and community-based organizations—to understand the shifts needed to achieve true systems change. The framework aims to re-imagine standard public health practice by centering equity as a through line throughout all public health domains and deploys a systems change approach.

A systems change approach focuses on the structures that create our health opportunities, such as the policies and procedures, resource allocations and partner dynamics. By focusing on the systems impacting the barriers to everyone having the opportunity to live their healthiest life, sustainable, long-term change can occur in our communities.

The STRETCH Framework guides teams through the three levels of systems change and focuses on five domains of interconnected and necessary functions: community-led approaches, place-based initiatives, workforce development, data-driven management and finance systems.

 

Learn More about the STRETCH Framework


 

STRETCH 2.0

The goal of STRETCH 2.0 is to promote necessary skills, core competencies, power sharing and authentic relationships among state team members and their community partners to advance and sustain opportunities for everyone to live their healthiest life. Governmental public health is currently receiving an influx of funding to strengthen the public health workforce and infrastructure. STRETCH is helping to ensure that the community is at the forefront of these decisions and that state public health agencies are investing in their community partnerships.

STRETCH 2.0 will have three levels of engagement: national, cohort and collaborative. The national tier provides technical assistance resources pertinent to challenges and needs across public health and is open for all public health practitioners to participate, regardless of their participation in STRETCH. The cohort and the collaborative are only available to those accepted to participate through the RFA. The up to seven collaboratives will move through capacity-building activities to develop and achieve their common priorities and goals. Prior participation in STRETCH 1.0 is not required.

 

Initiative Updates

 

STRETCH 1.0 Participating States

The participating state public health agencies in STRETCH 1.0 created teams composed of cross-sector members bringing together key players such as their health equity officer, finance team members, local and county health departments health director or deputy, intermediaries and community members. The SPHA teams each have a core project, developed to align with and address their unique state priorities. These projects centered on building collaborative partnerships to take action to address health equity. Some states adopted a statewide approach, while others will take a place-based approach, focused on specific communities or regions.

 

 

The views expressed here do not necessarily reflect the views of the Robert Wood Johnson Foundation.

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STRETCH Initiative
United States of America
To help state health agencies create effective cross-sector and cross-agency coordination to build a culture of health equity.
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Afghan Evacuee Relief

Afghan Evacuee Relief

Your Urgent Support is Needed for Afghan Evacuee Relief

As the United States has withdrawn from Afghanistan and evacuees have left the country, the CDC Foundation is activating our Emergency Response Fund to meet the immediate public health needs of those individuals and families coming to America. Among the most pressing needs is connecting Afghanistan evacuees with public health networks to facilitate communication about COVID-19 testing and follow-up vaccinations and serve as a connection point for other essential health and resettlement services as these evacuees begin their lives in the United States.

Urgent: Give Now to Support the Afghan Evacuee Emergency Response Fund

In August 2021, the Centers for Disease Control and Prevention (CDC) joined the U.S. government’s evacuation of U.S. and Afghan nationals from Afghanistan, supporting the broader U.S. government response. CDC requested the CDC Foundation activate our Emergency Response Fund to accelerate the public health components of the mission.

While some in-kind donations are needed, the most urgent need is funding so that we can respond rapidly to evolving needs. The CDC Foundation is deploying funding to provide cell phones and basic supplies to help ensure these individuals and families receive access to resources and other essential care. Cell phones will be provided to evacuees and will serve as a reliable, direct and critical connection between individuals, families and public health authorities who can then provide evacuees with essential health and resettlement resources, information on recommended follow-up for vaccinations and access to COVID-19 testing. The phones can also be used to share vital public health alerts and messaging.

For more information on how you can partner with the CDC Foundation, please contact Advancement at the CDC Foundation at advancement@cdcdfoundation.org or 404.653.0790.

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Afghan Evacuee Relief
United States of America
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Southern Alliance: Addressing COVID-19 Among African American Communities

Jasmine Ward

"The Southern Alliance 2.0 places Black communities across the south at the center of COVID-19 priorities, partnerships, programs and outcomes. Broadly, the Southern Alliance 2.0 is a response to the call for community solutions to address community needs."

Jasmine Ward, PhD, MPH; Federal Project Manager


Brittany Oladupipo

“I am grateful to work on the Southern Alliance project and to make an impact serving the non-Hispanic Black and African American communities by dismantling myths and misinformation around COVID-19, providing pertinent public health information and addressing social and health concerns over the pandemic.”

Brittany Oladipupo, MPH; Emergency Response Specialist


 

Capacity Building Associates

This project is supported by eight capacity-building associates who support community partners’ capacity to develop, implement and evaluate community-based COVID-19 activities among priority populations. CBA partners provide support for capacity-building activities including trainings, webinars, subject matter expertise, etc., specific to prioritized geographic areas and/or subpopulation.

 

 

Since 1995, the CDC Foundation has launched over 1,200 programs impacting a variety of health threats, managing partnerships across sectors by building a network of individuals and organizations who are committed to public health and the lifesaving work of the U.S. Centers for Disease Control and Prevention (CDC). The CDC Foundation has in-depth experience collaborating with a federal agency, identifying opportunities for private-sector collaborations and leading strategy to engage non-profit and philanthropic organizations in realizing their abilities to support public health goals through resource mobilization, strategy development and quality program management.

This project allows the CDC Foundation to contract with community-based organizations (CBOs) engaged in leveraging community-based partnerships to assist with the implementation of this work. The title of this project is “Southern Alliance: Addressing COVID-19 among Non-Hispanic Blacks and/or African Americans Living in the Southeast Region of the United States.” The target population is community-based organizations (CBOs). The purpose of this project is to build the capacity of community-based organizations engaging in mobilizing African American communities at high risk for COVID-19 morbidity and mortality to adopt and sustain COVID-19 preventative and community mitigation strategies including, but not limited to, improving chronic disease management, COVID-19 testing, facilitating contact tracing, promoting face covering and social distancing and identifying mental health issues associated with COVID-19.

We are working to put a stop to COVID-19 transmission.

 

Community Partners

These community organizations have worked tirelessly to develop, implement, and evaluate community-based COVID-19 prevention, education, and response activities among the priority populations in African American communities of high need. Their strategies include, but are not limited to, training doulas as COVID-19 health educators, leveraging captive audiences in the ballroom communities by educating them on COVID-19, expanding rapid testing services to offer COVID-19 testing, and broading community outreach to include person-to-person COVID-19 education.

 

COVID-19 Resources

 


 

Funding for this project was made possible in part from the CDC Cooperative Agreement number 6NU38OT000288-04-02 CFDA 93.421, via a sub-award from the CDC Foundation. The views expressed in written materials, media or publications and by speakers and moderators do not necessarily reflect the official policies of the CDC and the CDC Foundation; nor does mention by trade names, commercial practices, or organizations imply endorsement by the CDC Foundation or the U.S. Government.

 

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Southern Alliance 2.0
Southern Alliance: Addressing COVID In African American Communities
United States of America
To build the capacity of community based organizations and institutions engaging in mobilizing African American communities at high risk for COVID-19 morbidity and mortality to adopt and sustain COVID-19 preventative and community mitigation strategies.
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Emergency Response Fund

Fund Provides Speed and Flexibility to Save Lives

The CDC Foundation's Emergency Response Fund provides immediate, flexible resources to CDC experts addressing emergencies that affect the public’s health—whether natural disasters, emerging disease outbreaks or bioterrorist threats. Support through this fund from organizations and individuals provides speed and flexibility, which are essential elements in saving lives during crisis situations.

In the past, support for the CDC Foundation’s emergency response efforts has provided essential funding for CDC in response to many crisis situations, including the West Africa Ebola response, the Zika outbreak, Haiti earthquake, Southern Asian tsunami and Hurricane Katrina. 

Following the events of September 11, 2001, and the anthrax attacks, the CDC Foundation established the Emergency Response Fund to give CDC what it needs most in an emergency: flexibility and access to immediate resources. Federal dollars, even during emergencies, are tied to restrictions and purchasing procedures that can limit CDC’s ability to act quickly. The Foundation’s Emergency Response Fund gives CDC a backup source of funding to fill critical gaps and meet immediate needs and provides donors with the opportunity to help support efforts that address critical, in-the-moment needs that can help bolster population health and save and improve lives.

The fund was activated for the first time in 2005 to support the public health response to Hurricane Katrina in the Gulf Coast region. Donations to the fund from Kaiser Permanente, the Robert Wood Johnson Foundation, and other organizations and individuals enabled the CDC Foundation to immediately respond to requests for help from CDC and their public health partners in the Gulf Coast region. The Foundation was also able to provide new facilities for two public health agencies on the Mississippi coast, replacing buildings that had been destroyed by the storm.

Activating the fund gave CDC responders access to special credit cards connected to the fund, enabling them to immediately purchase the equipment, supplies or services they needed to respond to the outbreak in the field.

Previously, the CDC Foundation had two emergency response funds—a Global Disaster Response Fund and a U.S. Emergency Response Fund. As experience has shown, domestic responses can quickly intersect with global responses. Therefore, these funds were merged in 2017 to create a unified approach to emergency responses.  

 

 

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Ebola Response
Emergency Response Fund
United States, Haiti, Sierra Leone, Guinea, Liberia
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United States of America
The CDC Foundation's Emergency Response Fund enables CDC to respond immediately to changing and unpredictable circumstances and needs. This fund allows CDC to better prepare for and respond to crisis situations in the United States and globally by providing flexibility to meet both immediate and planned needs that would not otherwise be readily available through federally appropriated funds. In the past, support for the CDC Foundation's emergency response efforts has provided essential funding for CDC in response to many crisis situations, including the West Africa Ebola response, the Zika outbreak, Haiti earthquake, Southern Asian tsunami and Hurricane Katrina. The speed and flexibility provided through this funding saves lives.
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CDC’s Office of Public Health Preparedness and Response; CDC’s Center for Global Health; CDC’s Emergency Operations Center
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