Community Health Planning and Policy Development
Section Newsletter
Spring 2006

Message from the Chair
The Splendor of Spring

 
Daffodils blooming
Spring Daffodils
The glorious splendor of spring's flowers and the lush greens of new growth are all around us. It is a time of rebirth, new growth and recommitment to the hopeful seeds that we have planted. Careful tending and cultivation is very important to give these dreams and visions the solid foundation needed.


We are methodically and carefully rebuilding our Section infrastructure by re-evaluating our mission and committee charges, most of which requires rewriting our Section Manual (aka, Bylaws) from the ground up. We will repopulate our various committee and liaison efforts to accommodate the interests and participation of more members, and to enlarge our size and vitality through increased membership building. This rebuilding effort will capture the energy and resources of our diverse membership into an effective channel of influence on planning and policy development. Your new ideas will help.

 
2005 CHPPD Award Winners
2005 CHPPD Award Winners

We must continue to recognize those among us who have consistently demonstrated how excellence in health planning and policy development is done, like the CHPPD award winners.


I've learned how valuable effective communication is, and how it's a continual effort to maintain, not just a goal to achieve. Section relationships are also fragile and need sincere attention and resources in order to benefit as many members as possible.


Our spring has not only been filled with opportunity, but also the hazards of tornados, thunderstorms, damaging hail and high winds. The art at the Philadelphia Convention Center stylized these forces of nature in an attempt to show that we have control if we plan carefully. Our true power is in working together toward common goals, like CHPPD.


If you want to be involved, contact me at macquest@mchsi.com , and visit our Web site at http://www.chppd.org .


CHPPD recognizes legacy of Dr. Henrik Blum
Ecce Homo!

 
Henrik Blum. Photo courtesy UC Berkeley.
Henrik Blum. Photo courtesy UC Berkeley.
Dr. Henrik L. Blum, professor emeritus of health administration and planning at the University of California, Berkeley, and a champion of public health as social justice, died on Jan. 3, 2006 at his home in Oakland, Calif. Among his contributions is that of using community organizing skills along with social and economic concepts in the development and implementation of healthcare delivery and health policy.

Of particular significance to our Section is that he is considered to be one of the true fathers of health planning.

From 1950 to 1966, he served as health officer of the Contra Costa County (California) Health Department. There he learned principles, novel to planning at the time, that he taught concurrently as a lecturer at UC Berkeley: Effective health planning requires a thorough knowledge of the many environmental, social, cultural, economic, and educational forces that shape a community, and the community's participation is essential to the resolution of its problems. Health services should be located where most needed so as to best serve as resources in those communities.

It was in 1966, when he joined the faculty of Berkeley's School of Public Health as a clinical professor, that Blum foresaw the development of a national health system, one that would involve consumers and providers in shaping health care policy and health care delivery. In 1968, Blum became a professor of community health planning. In 1970, he established the school's Program in Planning and Policy, chairing the program until his retirement in 1984.

An example of his influence in health planning is the Orange County Health Planning Council, which was the designated Health Systems Agency for Orange County, Calif. under Public Law 93-641 (1974). Several members of the Council staff were his graduates, and Dr. Blum's planning concepts were incorporated into much of its work. Its publications served, in turn, as teaching materials for his classes in health planning. He was also one of the founders of the Western Center for Health Planning in San Francisco.

 
Henrik Blum at the Sedgwick Medal Award ceremony
Henrik Blum speaking at the 1985 Sedgwick Medal Award ceremony. Courtesy APHA Archives.
He was the author of three seminal texts focusing on the health needs of communities: Public Administration: A Public Health Viewpoint, Planning for Health (1974), and Health Planning; Notes on Comprehensive Planning for Health (1968), which was the first set of readings ever published on health planning, and a landmark in its field.

Dr. Blum served as consultant to, or member of committees of the National Institutes of Health, APHA, U.S. Public Health Service, U.S. Department of Health and Human Services, USAID, and the World Health Organization. He served as APHA's Vice President in 1990. Dr. Blum was interim Chairman of the Health and Medical Sciences Program that includes an experimental medical school, the UC Berkeley-UCSF Joint Medical Program, between 1991 and 1994. He also held teaching appointments at Johns Hopkins and Stanford University Medical Schools, received a Fulbright Scholarship to Sweden in 1986, and was a visiting professor at West China University of Medical Sciences, Chengdu, China, in 1987.

Among his many awards were APHA's Sedgwick Memorial Medal and the American Health Planning Association's Schlesinger Award, both in 1985.

Our Section awards the Henrik L. Blum Award for Excellence in Health Policy annually. It recognizes an individual, group of individuals, or an organization who/that has demonstrated excellence, creativity, and innovation in the development and/or implementation of health policy.

By John Steen, Consultant in Health Planning, Health Regulation, and Public Health jwsteen@expedient.net

Student Perspective
Building A Solid Foundation From The Ground Up: The CHPPD Student Committee Outlines their Goals for 2006 and Beyond

 
Pattricia Peretz
Patricia Peretz

The Community Health Planning and Policy Development Student Committee got off to a great start during the first committee meeting held in March. Chaired by Amy Carroll Scott, CHPPD Section Liaison to the Student Assembly, the CHPPD Student Committee is comprised of MPH and PhD students representing six different schools, in six different regions. During this initial meeting, the members focused on ways in which the CHPPD Student Committee could add value for the students in the CHPPD Section, as well as the larger APHA student membership. The members were united in their goal to develop a solid committee foundation and structure that would be sustainable in the years to come.

As the members discussed their familiarity with APHA, it became apparent that the level of APHA visibility and activity on campuses ranged from very high on some campuses to almost non-existent on others. In most cases, the lack of activity was a result of not having an APHA student campus liaison. As a result, the committee concluded that they had a unique opportunity to develop a sustainable committee structure, to increase awareness of and involvement in APHA and CHPPD by student members, and to work alongside other committees to bridge gaps in student outreach on university campuses.

In an effort to enrich the experience of CHPPD student members, the committee will develop a document introducing students to the basic structure and governance of APHA and CHPPD, as well as outlining the benefits of becoming more involved in leadership roles. The committee also decided to coordinate with the Student Assembly's mentorship program to facilitate matching CHPPD student members with mentors in the CHPPD section. The goal is to have this program in place in advance of the Annual Meeting in Boston so that students will have the opportunity to meet and socialize with their mentors at the meeting.

Off to a great start, and with no shortage of ideas and creativity, this is sure to be an exciting and productive year for the CHPPD Student Committee.

Patricia Peretz graduated in May, 2006 with an MPH degree from the Joseph L. Mailman School of Public Health, Columbia University, New York. Her interests involve examining health disparities in the context of obesity, and she is particularly interested in the relationship between the built environment and obesity among young children. During her two years at Columbia, Patricia worked on a child obesity study at the New York City Department of Health and Mental Hygiene, developed an evaluation tool for a school-based obesity prevention program in Washington Heights, and worked alongside Mailman School of Public Health faculty to develop and implement a health promotion initiative. In addition to her involvement with CHPPD, Patricia is a student member of the APHA Student Assembly Programming Committee.

CHPPD Members Invited to Send Comments on Uniform Emergency Volunteer Healthcare Services Act by July 1

Uniform Law Commissioners Logo 
One of the most unique aspects of the Community Health Planning and Policy Development Section is the diversity of its membership’s professional preparation, perspective and commitment to systems thinking. We have been invited by the Center for Law and the Public’s Health at Georgetown and Johns Hopkins Universities and the National Conference of Commissioners on Uniform State Laws to join them in crafting a model state law to address the very critical issue of how to handle interstate emergency health care services during disasters such as Hurricane Katrina.


James G. Hodge, Jr., JD, LLM, Executive Director of the Center for Law and the Public’s Health, is excited about providing CHPPD members with the opportunity to provide comment based on their experience. “Where else could we find such an expert panel as the membership of CHPPD and others in APHA?”, he said. The full working title of the draft Act is: “Uniform Emergency Volunteer Healthcare Services Act.” CHPPD members may remember hearing of the Center or Hodge based on the work surrounding the development of the Turning Point Model State Public Health Act. The draft Act can be found at: http://www.nccusl.org/Update/CommitteeSearchResults.aspx?committee=271 .


HIGXYZ62HIGZYX CHPPD members are encouraged to be pro-active and join forces with NCCUSL and the Center for Law and the Public’s Health in this very important policy endeavor. Members are requested to provide their comments via email in care of: myers@telerama.com with this acronym in the subject heading “UEVHSA” by July 1, 2006.


 

hurricane graphic 
Here is a brief excerpt from the preface remarks associated with the draft Act: “…The human devastation in the Gulf Coast states from Hurricanes Katrina and Rita demonstrated significant shortcomings in the ability of the nation’s emergency services delivery system to efficiently and expeditiously incorporate into disaster relief operations the services provided by private sector health care professionals. This includes employees and volunteers of non-governmental disaster relief organizations who were needed to meet surge capacity in affected areas and provide timely health care assistance to hundreds of thousands of victims of the disaster. The magnitude of the disaster swamped the ability of organizations to effectively handle relief operations. Additional resources were readily available throughout the country and thousands of healthcare professionals immediately volunteered to provide assistance. However, state-based emergency response systems lacked a uniform process and legal framework to recognize out-of-state professional licenses and other benefits necessary to authorize and encourage these volunteers to provide healthcare services in many affected areas. In some jurisdictions, volunteer health personnel were not adequately protected against exposure to tort claims or injuries or deaths suffered by the workers themselves.”

Enhanced Interpreter Program Uses Video Technology to Overcome Language Barriers, Offer Health Care Access

 
Bruce Occena at the poster session in Philadephia
Bruce Occena at the poster session, APHA in Philadephia 2005
More than 8,000 patients have used the "Enhanced Interpreter" Programs at the Alameda County Medical Center and San Francisco General Hospital / Department of Public Health in California to access care since the collaborative project began a little over three years ago. The innovation project has been made possible primarily through funding from the California Endowment and the Federal Office of Minority Health. The program involves connecting patients of Limited English Proficiency (LEP) with trained medical interpreters using "real time" video technology.

When a practitioner identifies a patient needing interpreter services, they can access the interpreter by video units that are mounted on mobile carts. A busy clinic might have two or three video units. These units can connect to interpreter stations at the hospital in question, or at the collaborating hospital 50 miles away -- in either case the call can be connected within 30 seconds. The provider, patient and interpreter work together in a "real time" videoconference situation with the benefit of visual "body language" cues similar to having an "in person" interpreter present. The use and set up of the video units is simple, and training practitioners only takes about 15 minutes.

The benefit from patient and practitioners' perspectives is improved quality of service. Both participating medical centers have what are considered "mature" interpreter service departments – offering "in person" interpreter services for over two decades in about 35 languages including Spanish, Chinese dialects, Russian, and Vietnamese. Prior to the technology enhancement project, services were primarily provided "in person," and the average wait time for an interpreter was between 30 to 45 minutes. In addition, at times when the interpreters were late, LEP patients would often loose their turn in queue and be skipped over in favor of an English-speaking patient. Or at such times, practitioners might resort to the use of untrained clerical or janitorial staff with inadequate medical vocabulary.

 
Comparing Quality of Care Performance Indicators
Comparing Quality of Care Performance Indicators
Preliminary evaluation indicators of the program showed substantial administrative benefits in terms of reduction in "wait time" for LEP patients and increase in productivity of interpreter resources. Prior to the enhanced use of video and phone interpretation, an average "in person" session took approximately 37 minutes (including the time it took for interpreters to travel to the clinic venue and wait for the provider to be ready) – whereas the average videoconference session takes approximately 15 – 17 minutes, completely eliminating non-value added interpreter travel and wait times. From the provider point of view, the wait time for interpreter service has dramatically decreased from between 30 to 45 minutes to approximately 5 minutes. However, the most important service improvement indicator has been that the previous routine practice of skipping over LEP patients while waiting for the arrival of the interpreter has been functionally eliminated – currently the skipping of LEP patients out of queue has become a rare and extraordinary occurrence.

The enhanced interpreter services enables practitioners to treat LEP patients with dignity, fairness and respect. More than 46 million people in the United States do not speak English as their primary language, and more than 21 million speak English less than "very well" according to the 2000 Census. Persons who have limited English proficiency are less likely to have a regular source of primary care, and are less likely to receive preventive care. They also are less satisfied with the care that they do receive, are more likely to report overall problems with care, and may be at increased risk of experiencing medical errors.1

The national demographics are changing. Public health centers, in particular, have to meet the needs of increasing number of people with limited English proficiency. Fortunately, at the same time, technology enhancements are getting more affordable. A videoconferencing unit with high quality video images costs about $ 5,000. While traditional interpretative services, where a practitioner, patient and interpreter sit in the same room, are excellent when available – they are often logistically and financially prohibitive. The Enhanced Interpretive program being beta-tested at Alameda Medical Center and San Francisco General Hospital provides encouraging evidence that the need to expand access to trained interpreter services can successfully be met with the application of new video technologies.

Bruce Occena is the Program Coordinator for the Enhanced Interpreter Program and works for the Health Access Foundation. Phone: 510-506-0775. Email: BNOcc@aol.com . Related and Edited by Bruce Occena; Written by Priti Irani.

1 Jacobs E, Shepard D, Suaya J, Stone E. Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services. American Journal of Public Health. 2004;94 (5):866-869

The End of the Social Contract

This article was written by John Steen in February, 2006 for the AHPA publication, Health Planning TODAY. Reprinted with permission.

 
Justice scales
In the 4th Quarter 2004 issue of [Health Planning TODAY] (pp.6-8), we published a critique of the fall 2004 report from the Federal Trade Commission entitled Improving Health Care: A Dose of Competition. A fuller critique of this document is accessible online at: http://www.ahpanet.org/files/AHPAcritiqueFTC.pdf. The executive summary of the FTC report concluded with the following statement: "The Agencies do not have a pre-existing preference for any particular model for the financing and delivery of health care. Such matters are best left to the impersonal workings of the marketplace." (p.11)

In this brief but remarkable statement is contained the federal government's position on health care delivery in America, a position that was introduced within the conservative economic agenda during the Reagan years. "Impersonal" here is tantamount to "unthinking," and that rules out all forms of planning and regulation save those aimed at attempting to secure and support marketplace health care, were there such a thing. And so with health policy, we are given a policy that is the very negation of all health policies.

Health care delivery is not provided in the "impersonal working of the marketplace." It is provided in local communities by community-oriented providers, it should reflect community values and needs, and it should lead to empowering communities through planning. Additionally, it is provided in a highly regulated and controlled environment that is not consistent with a free market. "Free market competition" is inconsistent with:

  • Patient demands for care that are not discretionary;
  • Purchasers' lack of information about prices and costs;
  • The assurance of third-party reimbursement;
  • Philanthropic subsidization of services;
  • Caregivers' control of services received by patients;
    • Community input for more appropriate, acceptable, and accountable services;
  • Mission-directed and/or status-building institutional health care delivery;
    • Legislatively mandated health care services;
    • Ensuring the safety and efficacy of health care services and avoiding malpractice;
    • Legislatively mandated health insurance benefits;
    • "Social safety net" services like Medicare and Medicaid;
    • Measures to serve under-served populations and meet unmet needs;
    • Priority for public health;
    • Equity in a health care system that embodies principles of social justice.

In May 1999, the Board of Directors of AHPA adopted a Mission Statement that had this to say about competition:

"The longstanding commitment of providers to a community mission which built public trust is being eroded by corporate business practices which generate profits, often without any community benefits. The reliance on market competition for "healthcare reform" is a political and economic experiment which is resulting in dislocations throughout society. The challenge to public policy is to facilitate the development of a responsible marketplace, one in which the sought-after benefits of competition are realized. …

"To achieve benefit from this process for all residents, it is necessary for legislators to take a more active role in shaping the transformation of the market. Government is obligated to exercise sound stewardship of the public's resources, much of which it controls as the primary payer of services. Health care is a social good like safety and education which, in a democratic society, requires intelligent government oversight in order to balance competing needs and priorities."

To see all of our Board-adopted policy statements, go to: http://www.ahpanet.org/Policy_perspective.html. And for a cogent discussion of the illogic of reliance on market forces to improve the efficiency of health systems, see "Are Market Forces Strong Enough To Deliver Efficient Health Care Systems? Confidence Is Waning," by Len M. Nichols, Paul B. Ginsburg, Robert A. Berenson, Jon Christianson and Robert E. Hurley, in Health Affairs, Vol 23, Issue 2 (March/April 2004), pp. 8-21, accessible at http://content.healthaffairs.org/cgi/content/abstract/23/2/8 .

In my Policy Perspective (3-06), the report on specialty hospitals illustrates how competition plays out in delivery systems, emphasizing once more that there are no private (profit-making) solutions to public problems. Yet this is the mantra of the Bush administration, that government should deed to private investment all functions where there is profit to be made. The excellent publicity that the VHA has gotten for its achievements in solving the quality/cost conundrum must be driving conservatives nuts. May they suffer a fatal case of ideological dissonance. (See my article at http://www.ahpanet.org/files/Universal%20Health%20Care%20II.pdf  ) . What I see as one of the worst applications of their marketplace ideology is the shift of health care information itself from government to the private sector, a threat to states like New York, Pennsylvania, and California that consider information about health care to be a civil right, and to planning and regulatory programs everywhere. In an address to the Healthcare Information and Management Systems Society on Feb.13, David Brailer, national coordinator for health information technology, Department of Health and Human Services, said, "We have ensured that the federal government will not build, own or operate the infrastructure of America's health information." ( http://www.healthimaging.com/content/view/3839/85/  ).

The current administration's position on an unregulated marketplace is much more than the denial of a health care system. It amounts to the denial of a role for government itself, and of the very concept of government on which our founding fathers established this nation. And government functions that are supportive of communities and social values are compromised in order to condemn them as dysfunctional (post-Katrina New Orleans is a case in point), thereby preparing the way for their elimination.

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Thomas Hobbes

 
Portrait of Thomas Hobbes
Portrait of Thomas Hobbes
Thomas Hobbes (1588-1679) traveled to other European countries several times during his lifetime to meet with scientists and to study different forms of government. During his time outside of England, Hobbes became interested in why people allowed themselves to be ruled and what would be the best form of government for England. In 1651, Hobbes wrote his most famous work, entitled Leviathan. In it, he argued that people were naturally wicked and could not be trusted to govern. Therefore, Hobbes believed that an absolute monarchy - a government that gave all power to a king or queen - was best. He came to believe that giving power to the individual would create a dangerous situation that would start a "war of every man against every man" and make "the life of man, solitary, poor, nasty, brutish, and short."

Hobbes finds three basic causes of the conflict in this state of nature: competition, diffidence, and glory. By contrast, "the passions that incline men to peace are fear of death, desire of such things as are necessary to commodious living, and a hope by their industry to obtain them." Man forms peaceful societies by entering into a social contract. The only escape from danger is by entering into contracts with each other — mutually beneficial agreements to surrender our individual interests in order to achieve the advantages of security that only a social existence can provide.

Hobbes provides us with a useful insight into better understanding the promotion of unfettered competition when he quotes Cicero who approved the Roman practice in criminal cases of asking, "cui bono; that is to say, what profit, honour, or other contentment the accused obtained or expected by the fact. For amongst presumptions, there is none that so evidently declareth the author as doth the benefit of the action."

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For a half-century, we had traditional indemnity insurance that supported our use of healthcare, a threat the industry labeled a "moral hazard." From the supply side, the industry introduced "managed competition" to reduce service utilization. The newest trend reduces utilization from the demand side by making it unaffordable to the consumer. Known as "consumer-directed health care" (or "consumer-driven health care"), it is being promoted as the new market-based solution to cost inflation. Consumer-directed care refers to health plans in which employees have personal health accounts from which they pay medical expenses directly. It threatens important societal values -- in particular, the goal of establishing relationships between patients and clinical professionals based on trust. See, "Which Way For Competition? None of the Above," by Robert A. Berenson, Health Affairs, Vol. 24, Issue 6 (Nov/Dec 2005), 1536-1542. Online at: http://content.healthaffairs.org/cgi/content/abstract/24/6/1536 .

The Administration is spinning its health savings accounts as introducing competition into the pricing of health care, the idea being that once patients are forced to pay more costs out-of-pocket, they will begin to comparison shop and request quality data, eventually driving down the cost of health care. But the information consumers need to most effectively manage these accounts is how much their out-of-pocket costs will be for a particular service and not how much, for example, a hospital charges for a particular service. Here we have an artifact of insurance marketing, not an indicator of health system cost, and it's an artifact designed to promote a race-to-the-bottom in health insurance coverage while getting consumers to think they are saving money. As with almost all of the administration's health policy initiatives, it is hard to tell how much they are driven by incompetence, and how much by meanness. Calling this Bushcare is Bushit.

The justification for having any government at all is to have a way of satisfying needs that cannot be satisfied adequately by individuals. The leaders we elect, and the people they employ, are the stewards whose responsibility it is to meet our needs. What we have here is the perversion of that contract, where our burdens are magnified and returned to us at the very time when we are least able to handle them.

"Markets are designed to facilitate the free exchange of goods and services among willing participants, but are not capable, on their own, of taking care of collective needs. Nor are they competent to ensure social justice. These 'public goods' can only be provided by a political process." (The Bubble of American Supremacy, George Soros, 2003).

Let us not miss the greatest insult in this love of market competition. When we promote competition at the expense of all other motivation, we depreciate the interest we have in compassion, thereby depreciating our own humanity. That our collective humanity is already depreciated is evident in daily news reports. On Valentine's Day, The Washington Post reported on the administration's proposed budget, and the news was dire. Staff Writer Ceci Connolly wrote that Bush "has requested billions more to prepare for potential disasters such as a biological attack or an influenza epidemic, but his proposed budget for next year would zero out popular health projects that supporters say target more mundane, but more certain, killers."

The president's 2007 budget would wipe out federal support for such key public health programs as "inner-city Indian health clinics, defibrillators in rural areas, an educational campaign about Alzheimer's disease, centers for traumatic brain injuries, and a nationwide registry for Lou Gehrig's disease. It would cut close to $1 billion in health care grants to states and would kill the entire budget of the Christopher and Dana Reeve Paralysis Resource Center."

Portrait of Thomas Hobbes was taken from http://www.politicalinformation.net/encyclopedia/Thomas_Hobbes.htm.

The Healthy Development Model Strives to Align Economic Development with Public Health

In response to the pressures on public health and human services, the Healthy Development Model was conceived as a training and learning process to address the disconnect between economic development and human well-being. It presents an innovative, integrative model that addresses determinants common to a successful economy and healthy population - human capital and social capital. The slogan: "Creating a culture of prevention" encapsulates the program's goal of building the "immunity of the community" by utilizing and strengthening its inherent human and social capital. It advocates a primary prevention orientation to public policy-making.

 
Nilesh (facilitator on left) leading a training se
Nilesh (facilitator on left) leading a training session

Healthy Development calls for recognition of the conflict between the forces of the market and the needs of population health by using a public health lens to review policy-development and community programming. The Healthy Development Model enables facilitators to ask questions related to democratic deliberation in the training sessions such as:

  • How can we align the health and wellness of the people with the demands of the economy?
  • What is the purpose of economic and technological development?
  • How can we create social arrangements that enable educated choices and participation for the people within a community and prevent problems rather than fix them?
  • Can a renewed public health be the reagent that enables democracy and commerce to co-exist in a manner that allows achievement of human health, human rights, and human potential?

Healthy Development methods are entrenched in community planning methods such as ZOPP from the German term "Zielorientierte Projektplanung" meaning "Objectives-Oriented Project Planning" and community based participatory research methods. Healthy Development Project ultimately aspires to increase a community's buy-in and ownership of decisions, actions, and programs that impact their own community's health and development.

A Healthy Development Case Study in Coahuila, Mexico

This project was unique because of the personal involvement of then-governor Enrique Martinez y Martinez in engaging the ministries of his government. Two separate orientation sessions involving the governor and secretaries of education, health and social development were conducted at Texas A&M University in fall 2003. A special Inter-Institutional Technical Committee was established as a direct result of those meetings. This committee reported directly to the governor's office and focused on integrated action of three different ministries (secretariats) of the state government (namely health, education, and social development), between the state level secretariats and local municipality departments, and between government and local communities. The Coahuila project spanned the borders of two sovereign nations (United States and Mexico), and reached across disciplinary boundaries of sociology, public health, medicine, education, community development, and political science.

The Healthy Development process engaged important sectors of society in Coahuila. About 12 to 16 members of 12 selected municipalities (including local leaders from three government ministries and community leaders) met for eight sessions, each session lasting for two hours at the public plaza of the municipality. Members defined problems prioritized by the community, and created an action plan that was addressed collaboratively by community and government secretariats.

The Healthy Development Manual specifics and provides participatory and consensus building tools and methods. In Coahuila, participants created their unique vocabularies for health and development; identified roles and interaction of state, market, and civil society in creating pressures on health and welfare sectors; discussed the importance of civil society in addressing public health problems; and thought of ways to align economic development with population health goals and foster a culture of primary prevention.

 
Community member being interviewed
Community member being interviewed

Community leaders and local government staff from health, education, and social development ministries in each municipality identified a specific public health problem in their community from a broad spectrum including unemployment. They listed its underlying causes and consequences, and incorporated community input they had gathered as part of homework exercises. Community-based and group exercises helped participants understand disparities and vulnerabilities; differentiate multiple, interconnected consequences and causes (visible and invisible) of a specific local public problem; identify and tap local human and social capital resources; analyze stakeholders; and prepare and commit to an action plan addressing the local problem.

After completing the training, participants implemented the action. They received technical assistance from the academic unit, and were also promised help from local and state governments. However, the crucial goal was to increase local capacity and self-reliance.

Participants from all 12 municipalities attended a conference in Saltillo, the state's capital city, and presented their plans to the governor and the secretaries of health, education, and social development. All the action plans and the training manual will soon be available on the web at http://www.healthydevelopment.net . The completion of the objectives identified in the action plan will serve as outcomes for evaluation purposes. Participants received certificates and also badges designating them as local promotors/promotoras of Desarrollo Saludable.

Process monitoring revealed beneficial effects of training on interactions between community members and governmental staff. Despite positive feedback for the training itself, there are challenges to action plan implementation. These include apathy in communities, lack of trust in institutions, and inadequate follow-up from governmental liaison. Intensive measures combining morale boosting, trust-building, and civic engagement are required from community and government leaders to sustain a culture of prevention.

Conclusion

Healthy Development is a community engagement process. We found that communities were more committed to the change process, while policy- and decision-makers had stakes that impeded public health oriented policy-making. New models of community health planning and policy development such as Healthy Development will have to continue to work at three levels:

    1. Academic institutions should develop and test similar models that align economic development with population health.
    2. Re-education of policy-makers and decision-makers on the importance of aligning population health goals with economic development is required.
    3. Public health agencies should supply local communities with planning tools and participatory opportunities for creating comprehensive and acceptable solutions for community problems.

References:

Israel BA, Schulz AJ, Parker EA, Becker AB. "Review of community-based research: Assessing partnership approaches to improve public health." Annual Review of Public Health, 1997; 19:173-202.

Minkler M. (2000). Using participatory action research to build healthy communities. Public Health Reports 115: 191-197.

United Nations Development Program (UNDP) (2002). Deepening democracy in a fragmented world.Human Development Report, 2002,UNDP.

Wallerstein N. (1999). Power dynamics between evaluator and community: research relationships within New Mexico's healthier communities. Social Science Medicine, 49:39-53.

By Nilesh Chatterjee, PhD, MA, MA, MBBS, PGDPC
nileshchatterjee2@gmail.com ; nileshchatterjee@yahoo.com
Director, Kalyani Media Group, Mumbai, India and Adjunct Asst Professor, University of Texas School of Public Health, Houston.

Nilesh has worked in various capacities in the academic institutions, in the media, in the non-profit and for-profit sector, including on various contracts from U.S. federal agencies. Until January 2006 he served as national coordinator of The Loka (samagraha) Institute (www.loka.org), a non-profit agency dedicated to making science and technology, and development responsive to democratically-decided social and environmental concerns. He has served as assistant professor of public health education and promotion in the Division of Health & Safety, College of Education and Human Development, Texas A&M University, adjunct faculty of medical sociology at Texas Woman’s University, and facilitator of problem-based learning at University of Texas Health Science Center. He is currently adjunct asst. professor in behavioral sciences at University of Texas School of Public Health, Houston and Director, Kalyani Media Group, Mumbai. Nilesh has a PhD in Public Health from the University of Texas School of Public Health, Houston, two masters’ degrees in social sciences from the University of Maryland Baltimore County Campus, where he obtained a fellowship in 1993 to study sociology of health, illness and medicine, and quantitative social research, and from Nehru Institute of Social Studies in Pune, India in 1994 where he studied sociological theories. He also has a medical degree from Bombay University, Mumbai, where he worked as private practitioner, resident in psychiatry, and lecturer in preventive & social medicine.

BRFSS – An Increasingly Common Data Source for Local Policy-Makers

 
Brad Walsh with Director, Sue Pickens
Parkland's Strategic Planning Office Director Sue Pickens, and staff member Brad Walsh
Most public health professionals know the Behavioral Risk Factor Surveillance System (BRFSS), the annual phone survey meant to gauge the health behaviors and health status of Americans. The BRFSS survey effort is a triumph of public health information gathering, and an invaluable source of data for needs assessments and planning efforts. The survey helps us know, state by state and nationally, the prevalence rates of a dozen chronic diseases, as well as the effectiveness of flu vaccine efforts, the health insurance coverage rates and BMI statistics in all parts of the country.

But the BRFSS survey is typically designed with a state-level sampling frame in mind, meaning that analyses at the regional, MSA or county level are problematic. Even if you're lucky enough to live in an MSA large enough that your BRFSS data are on the CDC Web site, the margins of error are usually large, and the data are often summaries of multiple years. Given the nature of the BRFSS question sets, many questions are not asked every year, making combining data from multiple years even more difficult.

But increasingly, BRFSS special studies are also being planned, paid for and conducted at the county and regional level. In Texas, special studies have been produced for Dallas County, Harris County (Houston) and Tarrant County (Fort Worth) in the past two years. County-level studies have recently been done in Pennsylvania and Michigan, and tribe-level studies have been done in North Dakota. In Columbus, Ohio, a coalition including the health department and a number of hospitals contracts for a county-level BRFSS survey every three years. In most of these cases the sampling frame is the county and sub-county level, although there is no reason a study couldn't cover multiple counties or cross state lines.

These studies were paid for by different groups. In Dallas County, a coalition of hospitals and community advocacy organizations raised the funds to do the special study, and provided the technical workers to handle much of the data analysis. In Tarrant County, funding came mostly from the county health department. The BRFSS office staff at the Texas Department of State Health Services, Center for Health Statistics, provided valuable advice and assistance along the way.

 
BRFSS data - Adults who lacked health insurance
BRFSS isn't the only show in town. The U.S. Department of Health and Human Services' Steps to a Healthier U.S. program also has fostered several telephone survey campaigns. The New York state health department's Steps to a Healthier New York is conducting telephone surveys in four New York counties. Other Steps-funded telephone survey programs are in place for Philadelphia and the Minneapolis/St. Paul area. These surveys are similar in intent to the BRFSS, covering multiple chronic disease topics and behavioral risk factors.

The robust BRFSS survey methodology, as well as the training programs and assistance available from the CDC and many state health departments, mean that there are fewer hurdles to conducting sub-state level BRFSS surveys than ever before. At the Texas Department of State Health Services the BRFSS staff list a range of options and prices, from adding a question or increasing the number of calls in a county on their annual statewide survey, to technical assistance with independent local studies. Their Web site (http://www.dshs.state.tx.us/chs/brfss/partners/partners.shtm) has more details. Your own state may offer similar assistance.

If you choose to carry out a special study, you may need to plan for data analysis, too. Your state BRFSS office or the survey company you hired can generate your results tables for you, for an additional fee. But remember that once the work is done, you may be called upon to examine the data in new ways later on down the road. If you have the staff to do it yourself, you can save costs and have more control over your output. Because these surveys usually require a sample plan with many demographic parameters, data analysis software with complex samples capability is required to generate accurate results tables. SUDAAN, SPSS and SAS are three software choices, although the complex samples procedures may require a separate module from the basic software package.

Data from the BRFSS survey are important for public health policy, hospital marketing and planning, health needs assessments, grant proposal writing, even police and emergency services planning. The types of data the BRFSS survey provides are available from few other places, and serve as an important addition to census, vital statistics and other data in informing public health policy. The numerous survey studies already being done, using both BRFSS and Steps methodologies, show that a regional, county level and sub-county level special study can add a needed dimension to public health policy work.

Brad Walsh is the strategic planning project director for the Office of Strategic Planning and Population Medicine of Parkland Health & Hospital System. Parkland is a county-owned hospital committed to serving the health needs of all Dallas County residents, regardless of ability to pay. Walsh's office conducts health needs assessment activities to help system administrators in planning and policy work, to use county funds more efficiently to carry out Parkland's charge. Parkland has taken its mission out into the community in a number of ways, building one of the first and largest outpatient clinic systems run by a county hospital, coordinating trauma services and helping build trauma capacity among hospitals across the region, assembling a fleet of vans providing complete primary care services for the homeless, supporting other non-profit clinics with supplementary services such as mobile mammography vans and specialty referrals, and partnering with school districts to build school-based clinics for both students and their families. Our innovative array of programs requires a rich basis in community health status and health needs data, and Strategic Planning and Population Medicine strives to fill that need.

Review of ExpectMore.gov Web site
Great Design, Good Intentions, but is Performance linked to Results?

 
ExpectMore website logo
In spring 2006, the U.S. Office of Management and Budget and federal agencies unveiled a new Web site http://www.ExpectMore.gov. This is a collaborative review of the Web site by three Community Health Planning and Policy Development Section members, Azella Collins, Mat Despard and Priti Irani. It is organized in four parts. (1) Description of the Web site; (2) Review criteria and comments from each of the three reviewers; and (3) Reviewer's Rating of the ExpectMore Web resource; and (4) Suggested Improvement Plan for the ExpectMore Web resource.

I. Description of ExpectMore Web site

"The Federal Government is working to ensure its programs perform well. Here we provide you with information about where we're successful, and where we fall short, and in both situations, what we're doing to improve our performance next year," states the introduction on the Web site.

Users can search for programs by "performing", "not performing", "keyword" or pre-determined "topics".

Programs are rated as "Performing" or "Not Performing". "Performing" programs have three ratings: "Effective", "Moderately Effective", and "Adequate". The main difference between "performing" and "not performing" programs seems to be existence of measurable performance objectives, "achievement of results" and "improved efficiency".

 
Table 1: ExpectMore Program Performance Ratings
Table 1: ExpectMore Program Performance Ratings
To date, 80 percent of all Federal programs, according to information on the Web site, have been rated. Table 1 shows the distribution by rating.

The federal government uses a standard questionnaire called the Program Assessment Rating Tool, or PART, for short. The PART asks approximately 25 questions about a program's performance and management. For each question, there is a short answer and a detailed explanation with supporting evidence. The answers determine a program's overall rating. Once each assessment is completed, each program develops a program improvement plan so program's performance can be tracked and improved upon.

II. Criteria for Review

The three reviewers looked for two criteria. Each of their comments are listed below

  1. Is the information regarding programs easy to find?
  2. Is the information consistent with what we know about the program? Is the rating system transparent and consistent?

1. Is the Information Easy to Find?

Azella – It is very easy to find the programs. I looked for HIV/AIDS prevention, HIV/AIDS care services, and lead elimination programs.

Mat - Very easy to locate information, though results should be sorted by department.

Priti – Very clean and thoughtfully designed Web site. It is relatively easy to find information about programs reviewed, and not reviewed. As I am funded under the Prevent Block, I looked for it, and it was not reviewed. I could not locate Special Supplemental Nutrition Program for Women Infants and Children. My colleague looked for asthma, and found it listed under "Environmental Health". There are buttons for each program such as "View Similar Programs", and "About Improvement Plans" that provides more details, and "Details and Current Status of this Programs".

2. Is the information consistent with what we know about the program?

Azella - I reviewed findings on DHHS four programs:

    • Domestic HIV/AIDS Prevention
    • Ryan White HIV/AIDS
    • HIV/AIDS Research
    • Environmental Health

Domestic HIV/AIDS Prevention - Assessment rating - Not Demonstrated

The overall scores were what the reviewer had expected, because HIV incidence is increasing, lack of rates for various units of service, and overall low funding levels needed to combat increasing HIV incidence. (unable to discern how points are assigned -- no score sheet available).

Having worked with programs within the CDC domain, the writer has witnessed a shifting of personnel, an increased focus on program accountability, and the use of program surveillance data to drive selection of interventions. Ryan White HIV/AIDS— Assessment rating: Adequate

The overall scores were higher than what the reviewer had expected, because HIV incidence is increasing and there are no RW acuity levels to guide service planning. (unable to discern how points are assigned -- no score sheet available). Anecdotally, when I first entered the prevention arena (1995) I learned that Prevention case managers could not talk about and document Care communications with their patients and vice versa for Care case managers. I thought, "how do you not have safe sex discussions with people who are HIV positive and document that encounter?"

Having observed activities within this arena this writer believes the rating is line with the programs end results.

HIV/AIDS Research - Assessment rating - Moderately Effective

The assessment rating is in line with how the program is operationalized.

Environmental Health - Assessment rating - Adequate

The overall scores were higher than what the reviewer had expected. In 2005 this writer organized a Lead Detection activity in Chicago; parents of children who tested positive for lead had nightmarish stories about vendors who were sent to rehabilitate their properties. After making various complaints it was clear that the national administrators were unaware of how lead removal procedures were locally implemented.

Mat - I was surprised to see a program of interest to me, the Housing Opportunities for People With AIDS under HUD listed as "not performing" because results have not been demonstrated. The impact of HOPWA has been clearly felt here in North Carolina, yet it is deemed as "not performing" only because HUD has not been collecting sufficient performance data from grantees.

Priti – I looked at five programs. They were: Department of Health and Human Services Health Centers rated as effective; DHHS - Office of Child Support Enforcement rated as effective; FEMA Disaster Response rated as performing-adequate; DHHS – National School Lunch as "not performing – results not demonstrated"; Department of Education – Even Start rated as "not performing – ineffective".

The Health Centers were evaluated in 1998 and users experienced 22 percent lower hospitalization than Medicaid users receiving care from other sources (I wondered what these sources were, and why). Also an increasing proportion of health center patients are insured according to a 2000 Government Accountability Office report. This seemed consistent with the "effective" rating.

The Office of Child Support Enforcement received an effective rating because they aim to increase the cost-effectiveness ratio (dollars collected per dollar spent) from $4.38 in FY 2004 to $4.63 in FY 2008. In short, they can sustain themselves. None of the other program goals were measurable or achievable. If the only purpose of the program is to collect child support, then it is effective. How can this be tied to results that relate to positive outcomes for children?  The effectiveness rating, in my perception, is tied only to cost-effectiveness.

The FEMA Disaster Response received an adequate rating -- it is the only federal program of integrated emergency management and coordination that responds to domestic disaster contingencies. It was also acknowledged that the program was reorganized in 2004 (the time when this survey was put together) and was developing baseline measures.

The National School Lunch Program was rated as "Not Performing – Results not demonstrated" because (1) the program did not have a reliable measure of the level of erroneous payments it makes. The number of children approved for free meals each year exceeds estimates of the number of children who should be eligible; and (2) While periodic evaluations show progress towards improved meals, the programs lacks short-term measures that can demonstrate progress on an annual basis. The "not-performing" rating, in my perception, is tied only to erroneous payments.

Even Start was a unified family literacy program that integrated early childhood education, adult literacy, and parenting education into a unified family literacy program. The Department of Education conducted three major evaluations of this program, and none showed greater educational gain for Even Start children and parents. Hence the plan was to eliminate funding for the program. When I clicked "Similar Programs," a public diplomacy and adult education program came up, and no family support programs showed up.  Family support program deal with complex issues and are difficult to evaluate. There is something unsettling about the prospect of Child Support Program being funded because they are effective, but having a vacuum with regard to Family Support programs.

My colleague who looked for asthma was led to Environmental Health that is rated as Performing-Adequate, and the note on asthma read "The program addresses the specific need to reduce and mitigate human exposure to a variety of toxic substances and hazardous environmental conditions. There were an estimated 434,000 children with elevated blood lead levels in 1999-2000. Twenty million Americans had asthma in 2001, and 12 million had an attack in the previous year. There were no performance measures listed for asthma.

III. Reviewers' Rating of the ExpectMore.gov site

Mat: Performing – Adequate. Good start, but key improvements are needed.

Priti: Performing – Adequate.

Azella: Performing - Adequate.

IV. Improvement Plan

  1. It seems the dividing line between "Performing – Adequate" and "Not performing – results not demonstrated" is fuzzy, and non-existent. One suggestion is to have "Results not Demonstrated" as a separate category.
  2. Share the detailed description of how the information is analyzed and weighed. It was clear that there was desire to assess each federal program, the connection between how the information was analyzed and how the improvement plan was developed was unclear.
  3. Ensure that federal agencies are working with state and local partners to collect performance data, or you may not have the full picture.
  4. Place emphasis on program impact (results) and on budget management (performance). They are both important. Programs that do not demonstrate program impact cannot be "effective". Programs the demonstrate positive impact cannot be "not performing". Also, there are programs that may can perform effectively, but not get results.
  5. Placing a rating on broad-based programs such as Environmental Health, rather than on specific programs within Environmental Health, is not meaningful. Such broad programs, must be rated in sub-categories.
  6. Can there be a special note or bonus points for programs that take risks, are innovative, and evaluated well?

    Reviewers Profile

    Azella Collins: Works at the Illinois Department of Public Health and coordinates  the Perinatal HIV Elimination Program Administrator, which is a CDC funded initiative. Under her leadership and advocacy Illinois implemented a Rapid HIV Counseling and Testing program in all Illinois birthing hospitals. Professional interests include community program development, evaluation, strategic and business planning.

    Mat Despard: Works at the Health Inequalities Program of the Center for Health Policy at Duke University in Durham, N.C. He is a project coordinator working on two (2) different federally funded projects (both out of the Health Resources and Services Administration of DHHS) to improve HIV care coordination using information technology and to increase access to specialty medical care for the uninsured. He is a social worker by training with interests in non-profit management, collaborative community problem solving initiatives, program evaluation and research-to-practice efforts.

    Priti Irani: Works at the New York State Department of Health, and is the project director, Assessment Initiative, a CDC-funded cooperative agreement funded by the Prevent Block. She enjoys the planning and evaluation process, reviewing articles among other things. She is also the editor of the CHPPD newsletter.

CHPPD Section Has More Sessions/Abstracts at Annual Meeting

 
Boston at dusk
This year we have received more abstracts than any year since the last time APHA was in Boston in 2000. We will also have more sessions this year than ever before. The topics that received the largest number of submissions once again were Methodologies and Partnerships. However, a new topic addressing bioterrorism, epidemics and disasters received a similar number of submissions. The subjects of Human Rights and HIPPA received extremely few abstract submissions.

We had 474 abstracts reviewed and will be accepting 352 of them. This year we will have 15 invited sessions, 9 poster sessions, 5 roundtables and 30 oral sessions. The scheduling of some of these sessions are unfortunately not at the most popular times. The lunch hour of 12:30-2:00 will have many sessions each day. We have a full day of sessions scheduled for Wednesday. So please plan to be at the meeting through the 2:30-4:00 p.m. session on Wednesday.

Twenty-Six Policies Submitted to APHA on Disparities, Environmental Health, Access to Care and Public Health Science/Infrastructure

Twenty-six policy papers submitted to APHA in four categories of disparities, environmental/occupational health, access to care and public health science/infrastructure can be reviewed by members. The revised policy statements are due to APHA by June 16; public hearings at the APHA Annual Meeting will be on Nov. 5; and the Governing Council will vote on policy statements at the APHA Annual Meeting on Nov. 7.

More information on the policy development process is available in an article written by Kathy Witgert entitled Call for position papers on APHA Priority Areas: Universal Health Care, Disparities, and Infrastructure.

The policy papers submitted for review are listed below.

GROUP - A: Health Disparities

GROUP - B: Environmental and Occupational Health

GROUP - C Access to Health Care

GROUP D - Public Health Science and Infrastructure

New Evidence-Based Public Health Web Course

 
ebph course logo
"From Evidence to Practice: Addressing Disparities in Birth Outcomes", the new course released by The New York State Department of Health and the University at Albany School of Public Health, is for practitioners who have to make decisions related to improving birth outcomes.  This free course at http://www.ebph.org was developed with support from the Centers of Disease Control and Prevention Assessment Initiative and the Pregnancy Risk Assessment Monitoring System Program, New York State Department of Health, and the New York New Jersey Public Health Training Center.

A recent report by the organization Save the Children highlighted that the United States has among worst neonatal mortality rates in the developed world. This report also found higher neonatal death rates among U.S. minorities and disadvantaged groups. For black Americans, the neonatal mortality rate at 9.3 per 1,000 live births is more double that of Wwites at 3.9 per 1,000 live births and Hispanics or Latinos, with 3.8 deaths per 1,000 live births.

 
snap shot of page
"From Evidence to Practice" is an engaging, self-paced online course, that teaches the evidence-based public health decision-making process by plunging learners into a realistic situation. In the course, learners are asked to use the evidence-based framework to research and identify an intervention strategy that addresses disparities in birth outcomes in a local community. Learners makes a series of choices about finding data to accurately describe the problem, evaluate interventions based on evidence  and applicability to the community, and defend their choices. The course outcome - securing funding for interventions chosen - depends on sound evidence-based decision-making. As learners work through their assigned tasks in the course, feedback alerts them to how well they have understood the material presented. Upon finishing the course, that is estimated to take about three hours, users may print out a certificate of completion or receive continuing education credits.The course is approved for continuing education credits for health education, nursing and medical education.

The course, developed by NYSDOH with the University at Albany, is being offered free in partnership with the NYNJ Public Health Training Center. More information is available at http://ebph.org/overview.cfm.

Researchers Invited to Submit Nominations for HSR Impact Award by July 28

Has your research made a difference, or do you know research that has? The HSR Impact Award recognizes health services research that has made a positive impact on health policy and/or practice that has been successfully translated into health policy, management, or clinical practice.


Submit your nominations today. The lead researcher receives $2,000. Winning research is published and disseminated as part of the AcademyHealth "HSR Impact" series. The award will be presented at National Health Policy Conference, Feb. 12-13, 2007. The selections are based on quality of research, effectiveness of research dissemination and translation approach, and impact of the research


Nominations must be received by Friday, July 28, 2006. For more information on the HSR Impact Award, please visit http://www.academyhealth.org/awards/hsrimpactsnominations.htm  or contact Jennifer Muldoon at (202) 292 6700.  

APHA 2006 Annual Meeting Attendees in Boston should Register to Vote with Absentee Ballot

absentee ballot image 
This year's election day of Tuesday, Nov. 7, 2006 will happen during the APHA Annual Meeting in Boston. Make your voice heard in the ballot box by registering to vote and requesting an absentee ballot before your state deadline! For more information, go to: https://ssl.capwiz.com/apha/e4/?

Local Public Health Officials Detail Pandemic Flu Plans

Public health officials from Washington state and California described their efforts to prepare their communities for pandemic flu at a Capitol Hill briefing hosted by the National Association of County and City Health Officials. Noting that pandemic flu could affect between 25-35 percent of the workforce and last for at least two months, Dorothy Teeter, a public health officer in King County, Wash., met with local business leaders to discuss potential implications of school closings, human resource policies for workers isolated or quarantined and unable to work, and continuity and contingency plans. Marty Fenstersheib, a health officer with the Santa Clara County (Calif.) Department of Public Health, stressed the need to educate the public and discussed a pocket information guide the county is giving residents that explains pandemic flu and steps that they can take, such as washing hands and keeping sick children home from school, to contain a potential outbreak.

This article was published in AHA News NOW on May 22, 2006. Reprinted with permission from the American Hospital Association.

Call For Papers: AIDS and Behavior Special Supplement and HIV/AIDS Research Summit

Submission Deadline: August 1, 2006.

There is increasing evidence that unstable or inadequate housing places vulnerable persons at heightened risk of HIV infection and complicates access to care and treatment for persons living with HIV/AIDS, contributing to negative outcomes for individuals and communities. AIDS and Behavior seeks submissions for a special supplement issue of the journal on the role of housing with regard to prevention, consequences, social impact, and response to HIV/AIDS. The goal of the special supplement is to bring together state of the art research on housing, homelessness, and HIV, and analyses of program and policy implications of research findings. For questions about the issue, please contact Special Editor, Angela Aidala at (212) 305-7023 or aaa1@columbia.edu. Further information at: http://www.springer.com/cda/content/document/cda_downloaddocument.pdf?SGWID=0-0-45-275489-p35538888

*******
Submission deadline: July 1, 2006


What: Abstracts for National Housing and HIV/AIDS Research Summit
Conference Dates: October 20 and 21, 2006
Location: Mt. Washington Conference Center, Baltimore, Maryland
Conference fee waived for presenters.
For more information contact Nancy Bernstine, National AIDS Housing Coalition Executive Director at (202) 347-0333, or at nahc@nationalaidshousing.org, or visitNational Housing and HIV/AIDS Research Summit web site at http://www.nationalaidshousing.org/HousingandHIV-AIDSResearchSummit.htm.

New CDC Community Guide Web Site Launched

The Centers for Disease Control and Prevention, Coordinating Center for Health Information and Service, National Center for Health Marketing, Community Guide Branch has just launched a newly formatted Web site that includes direct links to research tested intervention programs and product examples from the National Cancer Institute's Research-Tested Intervention Programs in the cancer, nutrition, physical activity and tobacco sections. The site also features new audience specific introduction pages and can be accessed at:  http://www.thecommunityguide.org/  .

 

All-Hazards Training Resources and Services Available from ASPH

The 52 CDC-funded Centers for Public Health Preparedness, which span the United States, work with state and local agency partners to assess training needs so as to strengthen capacity in all-hazards preparedness and emergency public health response. The CPHP are united by the Association of Schools of Public Health in a network that enables the centers to share expertise and resources while reducing duplication in trainings across state and local jurisdictions.

Evaluations show that the capacity for public health response at the state and local level has increased due to the simultaneous investments in infrastructure, personnel, and training made possible both by the state bioterrorism grants and the CPHP funding. For more information about the CPHP network, see http://www.asph.org/acphp .

Free network resources available to the state and local public health workforce and academics members include:

  • The Resource Center: a free online repository of over 750 terrorism and emergency response training and educational resources searchable by keyword, available at http://www.asph.org/acphp/phprc.cfm .
  • CPHP National Public Health Preparedness Referral Service: a service ( http://www.asph.org/acphp/expertise/search.cfm ) that connects national subject-matter experts on over 30 diverse topics in emergency preparedness and response to respond to needs in the field. This service is designed to match preparedness needs of state and local agencies and national organizations with available expertise, trainings and other useful services found at CPHP.
  • CPHP Education Calendar: an up-to-date, searchable, Web-based resource center of training products, programs, and educational services developed by CPHP ( http://www.asph.org/acphp/calendarDisplayOnly.cfm ).
  • CPHP Education Resource Guides: compilations of national CPHP education resources, lessons learned and expertise around specific preparedness-related topics:  http://www.asph.org/acphp .

If you do not find the information that you require, or need additional assistance, contact ASPH directly at CPHP@asph.org .

CHPPD Winter Newsletter Second-Most Read Newsletter of the Year, but Read by Only 12% of Members

 
CHPPD Newsletter Readership Trend
CHPPD Newsletter Readership Trend
In the Winter issue of the Community Health Planning and Policy Development Newsletter, I suggested a hypothesis. The hypothesis was: Based on member contributions to the newsletter, that the readership levels would fall between the numbers for the Fall and the November issue. That was proved right. After the September issue, it was the second-most read newsletter. I was also curious about another issue – whether sending out two e-mails reminding folks to submit articles as was done last Fall was much more effective than just one email. So, with Section Liaison Sharon McCarthy's help, two e-mails were sent. It did get a few more contributors, but not as much as last fall. I think there is a seasonal effect to member contributions that peaks in fall.

 
CHPPD Newsletter Readership Trend
CHPPD Newsletter Readership Trend
Twelve percent of members who identified CHPPD as their primary section read the newsletter. This is higher than the eight percent of the members who read the CHPPD annual meeting newsletter. When CHPPD is compared to sections with similar membership numbers such as Maternal and Child Health (21 percent) and Nursing (28 percent), it fared poorly with 12 percent. The smaller Community Health Worker Special Primary Interest Groupwith 63%, and Environmental Health Section with 56 percent fare much better. Even the larger sections, such as Epidemiology with 21 percent and Public Health Education and Health Promotion with 28 perent fared better than CHPPD for visits per 100 members.

HIGXYZ61HIGZYX

While more CHPPD members are contributing content in the newsletter, we have a long way to go. In this issue, we have six new contributors. Usually we have two or three, and last September we had about six. If we would like close to 100 percent of CHPPD members to read the newsletter, it will take us a little under 100 - 800 years to engage all CHPPD members based on the current rate. That goal, however is unrealistic, and there are members who do not read the newsletter, and are active in Section activities. I would like to suggest a goal of 25 percent readership rate for at least one of three newsletters we will be publishing through June 2007. The highest we have reached in the past year is 21 percent in September 2006.

If you have ideas about how we can engage members, do e-mail your ideas to me, or contact any one of the leadership team members whose contact information is available at http://www.chppd.org/CHPPDroster.htm .

Gear up for Summer with the CHPPD Reading Club

 
Post messages at the "CHPPD Reading Club"
Post messages at the "CHPPD Reading Club"
Reading about Community Health Planning and Policy Development can be serious, sexy, funny or mysterious. The newsletters are published only three a year. There are so many interesting CHPPD members, and so little time.  So, why don't we start a “CHPPD Reading Club” - that is what John Steen and I thought

The "CHPPD Reading Club" is a forum for sharing interesting resources - a journal article, a Web article, and books, among other resources.  All you have to do is:

  1. Register for the “CHPPD Reading Club” at http://www.chppd.org
  2. Post your reading suggestion, or respond to a CHPPD member's suggestion, or take up the suggestion (don't forget to comment if you do read a suggested resource).

I have posted informaton on a book and a journal article that I like.  I invite you to post information on the "CHPPD Reading Club" and gear up for the summer.

Remember to Vote in 2006 APHA Section Elections by June 15

 
Reminder graphic
On May 12, you received an e-mail from “Election Services Corporation for APHA” with the subject line “Important APHA Section Election Information” announcing 2006 election polls are now open.  The ballots have to be cast by Thursday, June 15 by 11:59 p.m. EDT. You will need your unique PIN number and APHA Member ID Number to vote. The  ballots are tallied by an outside vendor - to ensure that the votes are confidential.  If you did not receive an e-mail or have lost it, please call (866) 720-4357 to speak with an Election Services Corp. customer service representative

Letter to the Editor
Read your CHPPD Newsletter

In the current newsletter, I read Priti's comments about how few of us are bothering to read our own newsletter, and it was hard for me to believe. Maybe it's a bit easier to believe now. She writes: "On a sobering note, even the “Wow” September issue was read by about 21 percent (n=1,637) of members who identify CHPPD as their primary section. The newsletter statistics combines numbers of readers who click on the newsletter link that does not require a password, and those that do access the newsletter from the members-only page. Hence the number of visitors includes those who may not even be APHA members." Read Your Newsletter!

This letter was written in response to an exchange among members urging to participate in Citizens' Health Care Working Group's public hearings. John Steen brought members’ attention to the article Citizen’s Health Care Working Group published in the Fall 2005 CHPPD newsletter.

Winter 2006 CHPPD Issue Corrections/Clarifications

The Winter 2006 CHPPD Issue of the Newsletter has two clarifications.

The APHA Diet article was related to Newsletter Editor, Priti Irani at the Annual Meeting in Philadelphia by Karen Ho, Comprehensive Health Planning Coordinator, Hawaii State Health Planning & Development Agency. Priti wrote the article, and Karen edited it.

The Online Tutorial Review "From Evidence to Practice: Using a Systematic Approach to Address Disparities in Health Outcomes" should have been "From Evidence to Practice: Using a Systematic Approach to Address Disparities in Birth Outcomes."  An article on the release of this Web course is included in this issue.

.