Non-Communicable Disease Bureau

The Non-Communicable Disease Bureau (NCDB) mission is to support and empower the people in the CNMI through health promotion and the preventionof non-communicable diseases. The NCDB aims to provide awareness, prevention, and intervention services for the CNMI community to address the NCD epidemic. The NCDB is composed of five (7) programs; Breast & Cervical Screening Program (BCSP), Cancer Registry, Comprehensive Cancer Control Program (CCCP), Diabetes Prevention & Control Program (DPCP), Patient Referral Outreach Advocacy (PROA), Racial and Ethnic Approaches to Community Health (REACH), and the Tobacco Prevention & Control Program (TPCP).

BCSP’s mission is to reduce the diagnosis (morbidity) and death (mortality) of women due to breast and cervical cancer through early detection.

 

Cancer Registry’s goal is to develop a systematic and accurate collection of cancer data in the CNMI.  The University of Hawaii, Department of Family Medicine and Community Health was designated the bonafide agent on behalf of the ten USAPI jurisdictions to plan and implement the Centers for Disease Control (CDC) National Program of Cancer Registries (NPCR) planning program. The CDC cooperative agreement was awarded in July 2007. The majority of USAPI jurisdictions began reporting 2007 data to the CDC NPCR in December 2009 via the Pacific Regional Central Cancer Registry. The Cancer Council of the Pacific Islands, as the Advisory Board to the PRCCR, has included data items within the cancer registry database to capture selected variables on Non-Communicable Diseases (NCDs). By so doing the regional registry system is able to identify cancer patients with coexisting NCDs as well as interface with the public health programs. This ensures that the NCD needs are properly identified and incorporated into care plans and that individuals with cancer and other NCD co-morbidities are included in all NCD and cancer “registries” or databases.

 

The primary tasks and responsibilities of the Pacific Regional Cancer Registry are; 1) To develop the systems and policies which insure proper identification, reporting and recording of all cancers in each USAPI; 2)To develop the capacity and infrastructure for each of the USAPI to manage the rigorous data collection and entry required of a cancer registry; 3) To develop a cancer registry where the data is controlled and owned by each individual jurisdiction and to ensure the data are useful for local program planning and evaluation as well as Tracking local cancer trends over time; 4) To develop a cancer registry system that is sophisticated, flexible and sustainable, i.e. takes into account the relative case load of cancers in each USAPI, the availability of trained; 5) personnel, and the local ability to finance such a system; 6) To link the individual USAPI cancer registries in a synergistic system which allows for economies of scale to make the regional registry project sustainable.

 

CCCP’s is focused on preventing and minimizing the impact of cancer in our island community. It focuses on paying special attention to the needs and concerns of all cancer survivors and their families, developing and implementing strategic plans to address the cancer burden, setting priorities and leveraging resources to implement evidence-based interventions to support behavioral lifestyle changes to prevent cancer; ensure access to screen services to detect cancers early; as well as to ensure access to treatment services.

 

 DPCP aims promote wellness and educate the community about diabetes prevention, intervention, and care while collaborating with internal and external partners. DPCP also tracks and provides data on individuals diagnosed with diabetes.

 

 PROA aims to connect clients with diabetes or those at risk for diabetes to available community resources and programs that provides healthy lifestyle education.

 

REACH aims to reduce racial and ethnic disparities in health. CNMI REACH projects may be funded for up to three years through the subaward from the University of Hawaii. These projects aim to:
  •  Increase access to smoke and tobacco-free environments for 75% of the adult population by September of 2017; and
  • Increase access to healthy food options for 75% of the adult population by September of 2017

 

TPCP’s mission is to promote a healthy, tobacco-free community by reducing tobacco use in the CNMI. The program aims to accomplish goals such as: reducing the use of tobacco by adults and minors, reducing the risk of exposure to secondhand smoke, and eliminating the sale of tobacco to minors. Services under TPCP include Basic Tobacco Intervention Skills certification training and the tobacco cessation program.

 

NCDB is represented by fifteen (15) professionals: 

 Becky Robles – NCDB Administrator

 Jocelyn Songsong – Breast & Cervical Cancer Screening Program Coordinator

 Adela Tado – BCSP Data Management Specialist

 Ling Rabauliman – BCSP Tracking Specialist

 Joanne Ogo – CNMI Cancer Registrar

 Sharina Clark – Comprehensive Cancer Control Program Coordinator

 Kimberly Sablan – CCCP Navigator

 Amber Mendiola – Diabetes Program Coordinator

 Bradwell Batallones – Tobacco Prevention and Control Program Coordinator

Jessica Delos Reyes – Tobacco/Diabetes Technical Advisor

 VACANT – REACH Local Project Assistant

Amy Babauta – Tobacco Project Assistant

NCDFor more information on the Non-Communicable Disease Bureau, please contact Amber Mendiola at 236-8727. 

 

The Blood Pressure Toolkit 

Blood Pressure Toolkit 

With a high burden of heart disease and stroke across the US and its territories, funding from the Centers for Disease Control and Prevention (CDC) and support from the Association of State and Territorial Health Officials (ASTHO) has sustained the efforts of 26 states, the Republic of Palau, the CNMI, Guam, and the U.S. Virgin Islands over the last four years to test, implement, and scale up approaches to address this intractable health problem. In January 2017, the Commonwealth Healthcare Corporation (CHCC) was awarded by the CDC and ASTHO as the lead for the Hypertension Identification and Control (HIC) Project in the CNMI.  The CHCC ASTHO HIC Project aimed to decrease the occurrence of stroke and heart disease by preventing, detecting, and treating high blood pressure.

The main initiative was to identify those (diagnosed and undiagnosed) hypertensive and connect them to a primary care provider (PCP). This was accomplished through blood pressure screenings outside of the clinical setting, such as at religious places of worship, supermarkets, and through outreach events by the CNMI Lions Club. Uninsured participants were given a sliding fee application and a voucher for a low-cost doctor’s visit. As transportation was often a barrier to access of care for many, transportation vouchers were offered to help participants get from their homes to the clinic on COTA buses.

The project recognized the gap between community health screenings and clinics. Although many people seek out screenings, there was no standard to connecting participants to clinics or appropriate resources (e.g. sliding fee discount for those uninsured, COTA, etc). The major outcome of the HIC Project was the creation of the “Blood Pressure Toolkit” which outlines a referral system intended to address this gap. The toolkit will be made available online and in print. After CDC/ASTHO funding concludes in June 2018, the “Blood Pressure Toolkit” aims to sustain an island-wide referral system and serve as a protocol for all blood pressure screenings conducted by other local entities (e.g. CHCC Non-Communicable Disease Bureau, NMC Nursing Department, Lions Club, etc.).

The HIC Project would not exist without our partners: Kagman Community Health Center (KCHC), the Northern Marianas College (NMC) Nursing Department, CNMI State Medicaid Agency, and CHCC ER Department, who have all worked to strengthen the coordination of services to prevent, detect, and treat hypertension. For more information, email the HIC Project Lead, Halina Palacios, at This email address is being protected from spambots. You need JavaScript enabled to view it.

 

The following links are related to the Blood Pressure Toolkit:

Blood Pressure Toolkit Electronic Copy (compatible with Chrome or Firefox only)

Blood Pressure Toolkit Citations (Chrome or Firefox only)

American Heart Association BP Categories

Data Sheets (Please print 2-sided)

Kagman Community Health Center Sliding Fee Application

Additional information