Chronic Disease Management
Resources for prevention and management of pre-diabetes, diabetes, hypertension, high cholesterol and other chronic diseases.
- CHCANYS Diabetes Continuum of Care Conversation with Dr. Natalie Levy: Supporting Patients' Diabetes Management & Optimizing Care Delivery
- CHCANYS Diabetes Toolkit
- Metformin Treatment in Patients with Type 2 Diabetes and Chronic Kidney Disease Stages 3A, 3B, or 4
- National Kidney Foundation eGFR Calculator
- Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes - 2024
- Strategies and Factors Associated with Top Performance in Primary Care for Diabetes
- Diabetes Management in Chronic Kidney Disease: Improving Global Outcomes
- Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024
- Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2024
- Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2024
- Diabetic Neuropathy: A Position Statement by the American Diabetes Association
- Are You Eligible to Join the National DPP Lifestyle Change Program? CDC provides resources for patients to self-evaluate their risk for developing diabetes, evaluate their eligibility to join a Diabetes Prevention Program Lifestyle Change Program – and if they qualify, they can find a program near them. You can also access the CDC’s resources for referring patients to the Lifestyle Change Program and the Diabetes Self-Management Education and Support (DSMES) Toolkit.
Colorectal Cancer:
Explore Findings from a New Study on Colorectal Cancer Screening and Outcomes from the Cancer Intervention and Surveillance Modeling Network (CISNET) here
ACS Webinar Slides & Recording: Cancer Prevention and Screening for Community Health Centers here
2025 National Colorectal Cancer Awareness Month Webcast Slides & Recording here
American Cancer Society Colorectal Cancer Facts & Figures 2023-2025 Report
Colorectal Cancer Screening in Rural Communities Best Practices Guidebook Webinar
- Colorectal Cancer Screening Modality Videos (English | Spanish)
The ACS videos in this collection explain the differences between colorectal cancer screening tests, how they’re done, and the advantages and disadvantages of each screening option. Available videos include: Colonoscopy, Fecal immunochemical test (FIT) & Stool DNA-FIT
- Cancer Treatment and Survivorship Facts & Figures 2025
Latest ACS report shows the number of cancer survivors projected to exceed 22M by 2035. - Communication Strategies to Improve Colorectal Cancer Screening Rates
This online, on-demand training supports primary care providers with improved framing of their messages about colorectal cancer screening and encourage a shared decision-making approach to increase patients’ acceptance of screening that adheres to clinical guidelines. While geared to practitioners, the training is valuable for clinical support staff and others who engage patients in conversations about screening. Continuing education (CE) credit is provided for this activity.
- Using Mailed FIT Outreach to Increase Colorectal Cancer Screening in Community Health Centers
Webinar presented by the New York Citywide Colorectal Cancer Control Coalition (C5)
Cardiovascular Health and Hypertension :
- Check out NACHC’s Accelerating Blood Pressure Control: Guide to Creating a Business Case and Activating Care Teams to Optimize Hypertension Management in Health Centers: Accelerating-Hypertension-Control-Guide
- All sessions from the National Forum for Heart Disease & Stroke Prevention's May 8, 2025, Hypertension Takedown: Raising the Priority on Preventing and Controlling the Worlds' Leading Preventable Cause of Death, are now available online here
- Exercising Your Way to Lowering Your Blood Pressure, a resource from the American College of Sports Medicine, is available here
- The 2025 National Forum Annual Meeting will unite changemakers from across sectors to advance heart health by showcasing proven strategies to prevent cardiovascular and metabolic disease across the lifespan. The event will explore how targeted, evidence-based interventions can drive meaningful, lasting change. View more information and register here.
- New AHA/ACC High Blood Pressure Guideline: On August 14, the new 2025 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults was released.
- American Heart Association’s High Blood Pressure Guideline Hub that houses the updated 2025 AHA High Blood Pressure Guidelines, patient education materials, and additional resources galore to support successful implementation at your sites. Learn more at American Heart Association’s High Blood Pressure Guideline Hub.
Cardiovascular Health & Food as Medicine:
Read about how medically tailored meal programs could yield significant health care savings across 49 US states here
Listen to how medically tailored meals and cutting-edge research are proving that the right food can prevent disease, improve outcomes, and lower healthcare costs here
Hypertension:
Modifiable Lifestyle Risk Factor Policy & Procedure Template
This comprehensive template is designed to help translate hypertension science into practice in outpatient health care settings. It addresses data collection, assessment, and interventions for patients with modifiable risk factors that have strong evidence to reduce blood pressure. It also includes training for health care teams and an inventory of available resources for education, intervention, and referral to consistently incorporate these practices into care.
Care teams can use this resource to quickly access information about self-measured blood pressure (SMBP) monitoring and the tools and resources available to help make impactful change.
Optimizing Hypertension Strategies: Using Data to Drive Improvement
This learning series from the National Association of Community Health Centers (NACHC) combines evidence-based interventions with practical implementation approaches that enhance health equity and prepare health centers for value-based care. The series will build your capacity to identify and deploy implementation strategies for your unique patient population and environment.
Heritage Diets: Adapting Nutrition Recommendations Across Cultures
Identify key health-promoting foods that are common across multiple cultural dietary traditions and how the narrow demographic focus of nutrition research can hinder practical application in diverse patient populations.
Cholesterol:
Cholesterol Management Change Package
- The Cholesterol Management Change Package presents a list of evidence-based process improvements that outpatient clinical settings can implement as they seek optimal cholesterol management.
Cholesterol Communications Toolkit | CDC
- This toolkit can help your audiences understand what cholesterol is and why managing cholesterol is important for reducing the risk of cardiovascular disease (CVD).
Cholesterol Tools and Resources | American Heart Association
- A comprehensive repository of cholesterol-related tools and resources addressing risk factors and treatment.