Today, heart disease, stroke, diabetes, asthma, and other chronic diseases account for about 70 percent of all deaths in the United States and restrict daily living activities for 25 million people. They also impose huge costs on families and the economy, gobbling up an estimated 75 percent of the money Americans spend on health care. Unless we can reach people at risk of chronic disease with the right interventions, these largely preventable diseases threaten to halt or even roll back gains in Americans’ health and life expectancy.

Enter national nonprofit networks. The YMCA of the USA (Y) and other such networks don’t employ doctors and nurses, provide clinical services, or treat patients. What they offer are features that are both hard to replicate and uniquely suited to the task of changing thinking and behavior on a national scale: a presence in communities across the nation; large numbers of people already coming through their doors; and staff and volunteers with deep knowledge and expertise about the communities they serve.

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The 160-year-old Y is now flexing its distribution muscle to address diabetes. It has adapted the Diabetes Prevention Program, a lifestyle intervention for people at high risk of type 2 diabetes, whose effectiveness was demonstrated in a National Institutes of Health study and is now delivering it at 70 local Y associations across the nation.

OASIS, a national network that serves adults age 50 and older, is using its network to combat childhood obesity. It has adapted an evidence-based curriculum called Coordinated Approach to Child Health (CATCH), originally designed for schools, and is successfully using older adult volunteers to deliver it to thousands of youth in after-school programs in 14 states.

Of course many nonprofits attempt to scale up their programs. What sets the scaling efforts of the Y and OASIS apart is that they are using a preexisting distribution infrastructure for something other than its original purpose.

The experiences of OASIS and the Y suggest that na­tional nonprofit networks must undertake four key tasks to success­fully scale up public health interventions.

  • Find an intervention that fits the mission and the capacities of the organization.
  • Adapt the intervention for community-based deliv­ery.
  • Maintain fidelity to the intervention as it scales up.
  • Secure funding to scale up the intervention.

Read the full article about national networks at The Bridgespan Group.