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Center of Excellence to Prevent Chronic Diseases and Promote Health on the U.S. - Mexico Border

What is the COE?

The Center of Excellence (COE) is a partnership of academic, research, and service institutions along the U.S.-Mexico Border. The strategic agenda is based on the experiences of the participating institutions, building on their strengths and their collaborative efforts and adapting theoretical designs and models to the context and culture of the Border communities. COE members are involved in evaluating a chronic disease prevention model in each site, establishing a health services and resources observatory including a data registry and a data base of information generated in each site. The COE, led by its member institutions, and coordinated by the Pan American Health Organization U.S.-Mexico Border Office, generates and provides education and training for health professionals and community health workers (CHW), also known as promotores de salud, with emphasis on chronic disease prevention, control, and management tailored to Border populations. The COE enhances and supports health promotion as a sustainable way of achieving lifestyle changes to prevent and reduce risk factors for chronic diseases as well as augment protective health factors. To this end, the COE develops, proposes, and promotes purposeful research and translates evidence into knowledge and practice to address the health needs and priorities of the Border communities.

The global health initiative of the COE was created to counter the growing chronic disease pandemic in the world, especially in developing countries. The PAHO/WHO U.S.-Mexico Border Office convened eight academic institutions and coordinated the elaboration of the project proposal submitted with the Pan American Health and Education Foundation (PAHEF) to OVATIONS in response to the call for proposals in 2007 for the purpose of creating a Center of Excellence on the U.S. - Mexico Border.  The proposal was approved in 2008 and work on piloting an educational material called Camino a la Salud, an adaptation from Su Corazon Su Vida, began in 2009.

The COE is comprised of strategic Binational Border Teams with researchers, teachers, and students from the leading academic institutions on the Border, as well as primary health care personal and local health service providers, in each of three sites:

  • The Baja California/California Team consisting of the Universidad Autónoma de Baja California (UABC).
  • The Chihuahua/Texas Team with the Universidad Autónoma de Ciudad Juárez (UACJ) and the University of Texas at El Paso (UTEP).
  • The Tamaulipas/Texas Team with the Universidad Autónoma de Tamaulipas (UAT) and Texas A & M University.

The Mexican Health Secretariat (SSA), health centers and clinics are members of the COE in the mexican border cities of Tijuana, Ciudad Juarez and Reynosa.


To be the major body of expertise, convener, facilitator, and catalyst in strengthening the evidence base and supporting the implementation of effective strategies ensuring that all the people on the border enjoy optimal health and well being for their families and communities.


To lead strategic collaborative efforts, foster and advocate for the implementation of policies and programs to effectively prevent chronic diseases and improve health and quality of life with the people on the US-Mexico border;

  • Generate evidence of effectiveness in prevention and control of chronic diseases;
  • Develop and strengthen leadership among border health institutions, stakeholders, and communities;

  • Strengthen multi-disciplinary teaching and research in the training and development of the health workforce;
  • Advocate for policy and environmental change and increased investment in chronic disease prevention and health promotion; and
  • Mobilize resources to ensure the sustainability of the COE and of the partnership.

The Objectives of the COE are:

  1. Strengthen institutional and community capacity to implement community based models for the prevention of chronic diseases and to promote health on the U.S.- Mexico Border.
  2. Build and strengthen capacity of the public health workforce at all levels to manage and prevent chronic diseases.
  3. Build on and maintain a data base of evidence on chronic diseases, as well as models and policies to effectively counter, prevent and manage, chronic diseases.
  4. Advocate for a broad spectrum of policy and environmental changes to counter and prevent chronic diseases along the border and promote health including policy makers at the local, state, federal, and international levels.

The U.S.-Mexico Border COE is a member of an international network of COEs:   
  • Governance and management of the COE is conducted through the Executive Steering Committee (ESC). The ESC consists of one representative from each partner institution with the support of the PAHO/WHO Border Office.
  • The Technical Advisory Committee (TAC) consists of members invited for their technical and scientific expertise, experience and specialized knowledge. The TAC will only include participants from outside of the COE with expertise in chronic diseases care, prevention, control, and health promotion.
  • The COE is not a closed partnership, other institutions may join by submitting a request to become a member.

Partners and teams

  • Sites of the participating COE teams: Tijuana, Ciudad Juarez and Reynosa.

The Memorandum of Understanding (MOU)

The PAHO/WHO U.S. - Mexico Border Office, the Universidad Autónoma de Baja California (UABC) in Tijuana, the Universidad Autónoma de Ciudad Juarez (UACJ), the University of Texas at El Paso (UTEP), the Universidad Autónoma de Tamaulipas (UAT) in Reynosa and the Texas A&M University School of Rural Public Health (TAMHSC-SRPH) signed the Memorandum of Understanding with the explicit purpose of creating a Center of Excellence for the Prevention of Chronic Diseases along the United States-Mexico border considering the importance of increased collaboration and sharing of information and experiences in the prevention and control of chronic diseases.

The Camino a la Salud Project

The PAHO/WHO U.S. - Mexico Border Office coordinates the implementation of various chronic disease prevention projects. The purpose of the operational research project is to pilot an educational intervention and document the effectiveness of implementing this Camino a la Salud family and community-based model delivered by Community Health Workers (CHW) in coordination between the Mexican Secretariat of Health (SSA) clinics and health centers and the Universities members of the COE in the United States Mexico border. The aim of this action research project is to reduce the burden of diabetes and complications among vulnerable persons with type 2 diabetes and prevent the risk of developing diabetes with adolescents and persons with pre-diabetes, as well as complications leading to cardiovascular disease and death. The objectives are to improve prevent the risk of chronic disease including improving the care of the persons with diabetes, ensure appropriate diabetic foot and eye care. Reducing acute and chronic complications as well as to increasing community outreach and early detection is a critical strategy to prevent the development of chronic disease, diabetes, especially among persons overweight, obese and with other risk factors. This demonstration project seeks to strengthen CHWs effectiveness to improve preventive, self-management behavior among persons with diabetes and pre-diabetes, as well as to decrease risk behaviors of family members of persons with diabetes and other persons with risk factors for diabetes and other chronic illness.

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