Community Health Planning and Policy Development
From the CHPPD Chair: Phenomenal Philly
If you were at our Philadelphia APHA Annual APHA Meeting, then you understand what a great networking opportunity this was, and how welcome we felt in our substitute location. It seemed strange to be doing this in December, but the weather cooperated with us quite well allowing for a pleasurable and rewarding experience.
|Joanne Grossi, Deputy Secretary, Pennsylvani Department of Health with Tom Piper, CHPPD Chair |
We had many highlights this year with wonderful program sessions, interesting business meetings, an exciting awards reception, and terrific speakers throughout. JoAnn Grossi, deputy secretary, Pennsylvania Department of Health, welcomed CHPPD members to the City of Brotherly Love
|Walter Tsou, APHA President, speaking at CHPPD reception |
APHA Past-President Walter Tsou helped start the meeting with a memorable presentation that I wish everyone could have heard (we are working on putting it on the APHA Web site), and he returned to us as his home section at the reception to share his experiences and perceptions (what a wonderful man who even shared his glorious presidential suite for many delightful gatherings).
Another "high light" for us this year was the CHPPD exhibit hall which, was well served by many Section members and new student participants. We all shared in the presentation of interesting information, including our "invisible ink" pen that helped us illustrate our annual theme: "CHPPD: Enlightening our Vision for Life" -- the pens were so popular that we ran out halfway through the show. This effort was pretty labor intensive, but it got a lot of people invested and involved in ways that were educational and entertaining (if you believed in the "magic pen").
HIGXYZ21HIGZYXIt is true that you don't learn what the Chair's responsibility is until you've finished your first year of duty, and that is certainly true in my case. I have learned much about expensive food for receptions, electronic scanning of badges, coordination of printing, juggling of candidate presentations, management of business issues, filling in moderator slots, living on four hours sleep daily, and many other things. In particular, I've learned how valuable effective communication is, and how its 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./P>
In 2006, we have started to rebuild our Section infrastructure by re-evaluating our mission and committee charges, most of which will require rewriting our Section Manual (aka, bylaws) from the ground up. We want to 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.
If you want to be involved, contact me at email@example.com, and visit our Web site at http://www.chppd.org.
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Developing the CDC’s Public Health Research Agenda
One year ago, in January 2005, the Centers for Disease Control and Prevention launched an effort to develop its first ever, agency-wide public health research agenda, reflecting its vision for 2006-2015. The CDC has reorganized itself, through the Futures Initiative, “to become a more effective public health response agency to meet the challenges of the 21st century,” and this was a major effort in updating the agency to meet those challenges.
In The Future of the Public’s Health in the 21st Century (2002), the Institute of Medicine recommended that the “Centers for Disease Control and Prevention should develop a research agenda and estimate funding needed to build the evidence base that will guide policymaking for public health practice.” The CDC’s initiative toward a new research agenda was also the CDC’s response to the need to better relate research to practice, a need addressed in 1999 by the Public Health Foundation:
“For many years, the public health practice community has been frustrated by the apparent disconnect between research studies and practice needs. Where research exists which has application in community settings, it often is not adequately translated or disseminated in a manner to facilitate its application. In addition, an insufficient amount of research in the fields of health and medicine focuses on human behavior, an area of critical importance to public health. There also is a strong perception that the current research agenda is driven by resources, rather than identified needs in communities. Too often, potential users of research at the community level are not involved in identifying information gaps or in establishing research needs.”
It set about developing the agenda through workgroups comprised of CDC staff and “external partners,” including stakeholders and the public at large. As a result of this engagement, it expected to have a draft of the research agenda available for public comment by May 2005. The agenda was to be finalized in August after the public comments were reviewed and integrated.
CDC’s research priorities were to be set according to four criteria[i]:
· Public health need/importance of problem
· Relevance to reducing health disparities
· Potential for broad impact (>1 subject area)
· Relevance to CDC’s mission/goals
The six different areas of research interests that reflect CDC’s new organizational structure are:
- Infectious Diseases;
- Health Promotion;
- Environmental and Occupational Health and Injury Prevention;
- Health Information and Services;
- Global Health;
- Community Preparedness and Response.
The process went public with a series of four meetings around the country to gather input for CDC’s research agenda from stakeholders, researchers, and representatives of partner organizations invited to attend along with the public-at-large. I was a member of the Community Preparedness and Response Research workgroup that met in Columbus, Ohio at the end of March. Its charge was to focus on developing research areas or themes associated with preparedness and response to both natural disasters and naturally occurring disease outbreaks such as influenza, and those events associated with human made disasters including terrorism.
There were six of us comprising this workgroup, and about a month prior to the meeting, we had been given a list of 18 Research Themes representing potential research priorities. Out of these overlapping areas, I identified two in which I thought that health planning could make a signal contribution:
- Community Actions: Describe and explain how diverse communities detect, interpret, respond to, and communicate perceived and actual public health threats.
- Public Health, Mental Health, and Medical Response Systems: Assess and identify strategies and model practices for integration of public health, mental health, and medical response systems to respond to terrorism, other disasters, and public health emergencies.
HIGXYZ29HIGZYXIt seemed obvious to me that the first theme should address the potential of community health planning processes in preparing communities to deal with emergencies. We agreed to recommend the following Research Activity: “Can public health planning approaches, e.g., MAPP (Mobilizing for Action through Planning and Partnerships), be effective for community engagement and public participation in emergency preparedness planning?” Related Research Themes addressed strategies for communicating information to communities so as to maintain trust, and here we recommended the use of social marketing to establish the efficacy of the strategies. I think that communities must be engaged by planners if they are to be protected, for they are best protected from within by the empowerment that comes from being informed. Four years ago, I wrote an article that addresses this, and it is accessible at: http://www.ahpanet.org/Health_policies.html#Protecting.
The difficulty of protecting communities is succinctly stated in the following passage from almost a decade ago:
“If the public understands the limitations within which crisis management must operate BEFORE a crisis occurs, then public trust can be maintained despite the constraints that a crisis inevitably imposes on government openness and accountability, and even in the face of emergency measures that suspend the rule of law in certain areas. On the other hand, in an era of deficit reduction and cost-cutting, publics who vote for governments who promise tax cuts, deregulation and privatization should be educated in the consequences these trends may hold for public safety and security. If those agencies and companies that take over government responsibilities are less publicly accountable or less subject to legal controls, and if profitability and the interests of stock-holders take precedence over the public interest, people should not be surprised when governments have little control over the prevention of future crises.” [ii]
HIGXYZ33HIGZYX The second theme addresses the heart of the system response to emergencies. What I thought it overlooked was the need to identify means to implement emergency preparedness and management strategies in rural areas without effective local health departments. In most such areas, it will be incumbent upon local community hospitals to play the role of a public health agency, and JCAHO has issued guidelines for what is expected of them. I recommended that CDC ensure that JCAHO’s standards for hospitals engaging in emergency preparedness planning in their communities reflect best practices in public health. Of course, this raises the perennial issues reflecting the age-old barrier between public health and personal health, but I don’t think there will be effective preparedness without the seamless integration of medicine and public health.
The draft research agenda we were given presented research questions about planning for emergency preparedness, but those questions look quite different when seen from the perspective of a practitioner who must implement the planning. We were well aware of the practical considerations surrounding the emergency measures, considerations unanticipated in how those research questions were framed for us. A further deficiency in CDC’s process was that we were not given sufficient information about CDC’s current research and planning activities, nor any information about what similar research was being undertaken and sponsored by other federal agencies, e.g., AHRQ and NIH.
Questions About CDC
Inexplicably, CDC did not release its public comment draft until November, fully six months behind schedule. The draft was available for public comment for 60 days from November 18, 2005 to January 15, 2006. Out of this, the new CDC Health Protection Research Guide, 2006-2015 is expected to be completed during Spring 2006. The Research Guide will serve as a resource for defining the prioritized CDC Health Protection Research Agenda, in support of its Health Protection Goals and Priorities. In addition, portions of the Research Guide will be used to inform research initiatives that address other critical public health needs and research priorities of other agencies.
Unfortunately, neither of my two themes found their way into the draft. In fact, planning WITH communities is totally missing here.
Last July, the Atlanta Journal-Constitution reported on a survey conducted in April, 2005 among CDC employees. When asked if they were confident that the Futures Initiative would result in positive changes at the CDC, 65 percent said no, citing an "inappropriate" business focus to the CDC's public health mission, low employee morale, increased bureaucracy, loss of trust, loss of key staff, and damage to the agency's reputation.[iii]
[ii] Ronald D. Crelinsten (1997), “Television and Terrorism: Implications for Crisis Management and Policy-Making,” Terrorism and Political Violence, 9(4): 8-32, p. 30.
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Call for position papers on APHA Priority Areas: Universal Health Care, Disparities, and Infrastructure
|No Free Lunch: Kathleen Witgert at the special policy session in Philly |
Community Health Planning and Policy Development Section members are invited to write position papers or resolutions on APHA priority and related areas.
APHA’s priority areas are: role of public health in universal health care, health disparities, and rebuilding the nation’s infrastructure.
Deadline for submission is March 15, 2006. Members who are considering writing and looking for support or assistance should contact CHPPD Section Chair Tom Piper at firstname.lastname@example.org
or (573) 751-6403.
HIGXYZ22HIGZYX In addition, some areas APHA is looking to members to write position papers are:
- Asbestos disease compensation
- Clean Water Act
- Medicare Reform (Financing, prescription drugs post the Medicare Modernization Act)
- Mid- and late-term abortion
- Pandemic Influenza
- Long-Term Care (Medicaid/Medicare/Financing)
- Women’s health (incl. Aging issues)
- The role of the pharmacist in public health
- Health care financing/reform (Health Savings Accounts, Association Health Plans, tax credits)
- Medical malpractice
- Immunity/liability of companies who develop or produce drugs, vaccines or devices
- Other immunity/liability concerns (gun manufacturers, alcohol and tobacco companies)
- Prioritization of public health funding
How APHA uses written policies
Policies are the foundation of APHA’s advocacy work. Whenever APHA is asked to participate in briefings, join coalitions, or write letters to policy-makers, the organization looks to its approved policies to support its position. The Governing Council votes on proposed policies each year at the Annual Meeting.
But where do these policies come from? They come from us! APHA issues an annual call for proposed policy statements. Individual members or Sections respond with draft policy statements on issues that they feel are import and should be addressed by APHA. These drafts are posted on the web for comment, giving individuals and Sections another opportunity for involvement. Draft policies and comments are then reviewed by the Joint Policy Committee, which may work with authors to refine policies. Additional discussion and amendments may take place at the Annual Meeting, prior to the Governing Council’s vote.
At the 2005 Annual Meeting, APHA conducted its first-ever training on “Navigating the Ins and Outs of the APHA Policy Proposal Process.” At this session, APHA staff and members of the Joint Policy Committee explained the steps and the timeline for the APHA policy process.
What are policies?
APHA policies come in two flavors. A resolution is a concise statement of the Association’s stance on a particular issue affecting the health of the public. It describes and endorses a defined course of action, directed toward a particular individual, organization or event. A position paper is a longer statement describing the Association’s viewpoint on a broad issue affecting the public’s health. It may call for action, though it need not do so.
What makes a good policy?
The Joint Policy Committee shared the following tips for writing a good resolution or position paper:
· Work with your Section and Action Board representative. Reach out to other Sections for comment.
· Write broadly, so that the policy can be applied to more than one particular situation.
· Conduct a review of the scientific literature and provide references that support the statements in the policy.
· Ensure that action statements are externally focused, rather than focused on what APHA should do.
· Give the policy a short, specific, and reflective title.
Linda Quick, email@example.com, is CHPPD's Action Board Representative, and CHPPD's Policy Committee representatives are Doc Lumpkins, firstname.lastname@example.org, and Harry Perlstadt, email@example.com.
2006 Policy Development Timeline
December 2005: Call for 2006 proposed new policy statements is issued
Mar 15, 2006, 5pm EST: Proposed new policy statements due to APHA
March 24, 2006: Proposed new policy statements posted on APHA’s Web site for review and comment
April 7, 2006: Last day to submit comments on proposed policies
May 12, 2006: Authors of proposed policies will receive comments from the Joint Policy Committee
June 16, 2006, 5pm EST: Revised policy statements due to APHA
Nov. 5, 2006: Public hearings at the APHA Annual Meeting
Nov. 7, 2006: Governing Council votes on policy statements at the APHA Annual Meeting
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Universal Health Care III
Just last week, I was once again reminded that the American public is in the dark on national health policy. Being in the dark makes it so much easier for entrenched interests – the pharmaceutical and insurance industries in the lead – to lobby against whatever progressive measures are proposed, not to even mention public health. Yet everyday, headlines scream ever louder about our growing public health problems, and about the disparities in access fueled by educational and financial disparities.
And that is particularly unfortunate at this time when a critical mass of policy experts, columnists, and legislators seem finally to be serious about doing the right thing: Designing a national health care system that rights all the wrongs that we’ve known only too well, for too long.
HIGXYZ40HIGZYX What reminded me about our national blindness was a column by Paul Krugman in the Jan. 27, 2006 New York Times, entitled “Health Care Confidential.”[i] Krugman, a professor of economics at Princeton, calls the success of the Veterans Health Administration "one of the best-kept secrets in the American policy debate," and asserts that it provides a "useful" example for reform, adding that VHA provides evidence "that a government agency can deliver better care at lower cost than the private sector." The VHA’s success, he writes, is "completely counter to the pro-privatization, anti-government conventional wisdom that dominates today's Washington," and "pundits and policy makers don't talk about the veterans' system because they can't handle the cognitive dissonance." He adds that "farsighted thinkers are already suggesting" that VHA "represents the true future of American health care," not "President Bush's unrealistic vision of a system in which people go 'comparative shopping' for medical care the way they do when buying tile."
Now that the VHA has been rediscovered, I feel that I’m back where I started in health policy, in the early 1970s in New York City. At that time, community leaders believed that the country was on the verge of developing a national health care system, and they wanted it to embody the progressive principles and values characteristic of the City. The Community Council of Greater New York established a Health Task Force composed of policy experts and stakeholders representing the major constituencies, and I served on its Delivery System Subcommittee. The Health Task Force was charged with drafting a plan for an ideal national health care system, and what we designed was a totally public system without a role for private insurance. It seemed much easier then to reach consensus on such issues. Our Subcommittee chair was a physician who was employed by the VHA. In 1978, while I was assistant director in the Health Systems Agency of New York City, the whole professional staff (numbering 140 at the time) believed we were the advance unit for the same impending development, and that it was already long overdue.
My approval in seeing what Prof. Krugman wrote is not only because the VHA model offers a universal, integrated system, but because the profit motive is nowhere to be found within it. In place of the marketing imperative to compete, it has a moral imperative to excel. In Northern California, Kaiser Permanente has many features in common with the VA system, and many patients select Kaiser as their provider of choice.
HIGXYZ42HIGZYX Proof of its success is manifest. Krugman’s column was preceded by a news article about that success in The Washington Post (“VA Care Is Rated Superior to That in Private Hospitals,” by Rob Stein, 1-20-06).[ii] For the last six consecutive years, customer satisfaction with its system exceeded that for the private sector in an annual survey conducted by the National Quality Research Center (University of Michigan). Those customers are a categorical constituency, providing it with an incentive to invest in prevention and more effective disease management. And in 2003, the New England Journal of Medicine published a study that compared VHA facilities on 11 measures of quality with fee-for-service Medicare, for 1997-99. On all 11 measures, the quality of care in its facilities proved to be “significantly better.” In 2000, the VA outperformed Medicare on 12 of 13 indicators.[iii] And the health plan industry’s National Committee for Quality Assurance that ranks health-care plans on 17 different performance measures that reflect good, evidence based medicine, has found that in every single category, the VHA system outperforms the highest rated non-VHA hospitals.
This important story was first reported in an excellent article entitled, “The Best Care Anywhere,” by Phillip Longman in The Washington Monthly (Jan/Feb, 2005). Longman writes,
“The system's doctors are salaried, which also makes a difference. Most could make more money doing something else, so their commitment to their profession most often derives from a higher-than-usual dose of idealism. Moreover, because they are not profit maximizers, they have no need to be fearful of new technologies or new protocols that keep people well. Nor do they have an incentive to clamor for high-tech devices that don't improve the system's quality or effectiveness of care.
And, because it is a well-defined system, the VHA can act like one. It can systematically attack patient safety issues. It can systematically manage information using standard platforms and interfaces. It can systematically develop and implement evidence-based standards of care. It can systematically discover where its care needs improvement and take corrective measures. In short, it can do what the rest of the health-care sector can't seem to, which is to pursue quality systematically without threatening its own financial viability.
… The system runs circles around Medicare in both cost and quality. Unlike Medicare, it's allowed by law to negotiate for deep drug discounts, and does. Unlike Medicare, it provides long-term nursing home care. And it demonstrably delivers some of the best, if not the best, quality health care in the United States with amazing efficiency. Between 1999 and 2003, the number of patients enrolled in the VHA system increased by 70 percent, yet funding (not adjusted for inflation) increased by only 41 percent. So the VHA has not only become the health care industry's best quality performer, it has done so while spending less and less on each patient.”[iv]
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Patients in Central Louisana’s Cenla Medication Access Program show health improvement
The Cenla Medication Access Program is a program that has been working for four years to help improve health care in rural Central Louisiana. CMAP provides prescription medications to over 16,000 people who cannot afford them, and also provides medication education about the importance of appropriate medication usage. CMAP was recognized as the 2005 National Rural Health Program of the Year.
|Emergency room visits dropped among CMAP patients |
Recently, several findings of the Cenla Medication Access Program were presented at the 2005 APHA Annual Meeting in Philadelphia. One talk focused on the reduction in hospital admissions and emergency department visits for participants of CMAP. Data showed that CMAP participants were admitted less often, and visited the emergency room less frequently in the six months after joining the program, compared to the six months before joining the program.
In the other talk, diabetic participants' blood sugar levels were discussed. Analysis of hospital chart data indicated that diabetic participants had significantly lower blood glucose levels in the six months after joining the program, compared to the six months before joining the program. The data from both talks suggest that the CMAP is helping to improve the health of its participants.
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CHPPD’s Fall Newsletter was the 2005 “Wow” Issue
Past CHPPD Chair Paul Meissner's e-mail described the September issue with one simple word - “Wow”. The post-Katrina issue had relevant and thoughtful articles.
As you view the charts, it may be helpful to know the acronyms used:
CHW = Community Health Worker, a Special Primary Interest Group (SPIG)
Epi = Epidemiology Section
HA = Health Administration Section
Int. Health = International Health Section
MCH = Maternal Child Health Section
CHPPD newsletter statistics were compared against some of the larger sections.
The September issue of the CHPPD Section was among the most-read of the APHA section and SPIG newsletters, with 386 pages viewed (opened by viewers) as compared to 91 for the previous issue. Viewers spent about seven minutes on the Spring and Fall issues, compared to about 1 ½ minutes more viewing the Annual Meeting issue. This indicates that at least a couple of news items were of interest to readers.
|Graph showing number of times newsletter pages were viewed |
On a sobering note, even the “Wow” September issue was read by about 21 percent (n=1637) 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. At the same time, it is interesting to note that the Community Health Worker June issue of the newsletter was visited by 89 percent (n=173) of members who identify the Community Health Workers as their primary Special Primary Interest Group.
|Number of visits per 100 primary section members |
If you are wondering what made September a “Wow” issue, here are some of possible reasons. My hypothesis is timing and member involvment. A CHPPD member survey was sent out and completed in August, and members were told that the results would be posted in the Fall newsletter. A little over 100 members completed the survey. In early August, members were invited to submit articles. Sharon McCarthy, APHA's very efficient section affairs liaison, sent out an e-mail to CHPPD members in the last week of August reminding them about the newsletter submission deadline. About half a dozen members responded to the second e-mail, submitting information about past or upcoming events. A couple of CHPPD members submitted very relevant and substantive articles, e.g. Katrina experiences of EMT staff, book reviews, and commentary on health care access. All these factors played a role in making the September issue the most read.
Sharon McCarthy has said that she will continue to share newsletter statistics on a regular basis with editors, and this information will be published in the newsletter. So, please do submit articles, and if you read something interesting in the newsletter, please send the link to your colleagues. The deadline for the next newsletter is May 12, 2006
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Online Tutorial Review
From Evidence to Practice: Using a Systematic Approach to Address Disparities in Health Outcomes
|Online tutorial screen shot |
The online tutorial “from Evidence to Practice: Using a Systematic Approach to Address Disparities in Health Outcomes Web site” at http://www.ebph.org
uses an interactive tutorial format to teach the first four steps of the evidence-based public health practice process. This tutorial reviews the steps to implementing an evidence-based approach to a public health issue using the scenario of a county that wants to apply for a grant to improve its high infant mortality rate. This online tutorial is funded by the Centers for Disease Control and Prevention Assessment Initiative, the CDC's Pregnancy Risk Assessment Monitoring System, and the New York State Department of Health.
|Holly Tutko (left) at her poster session in Philly |
The user plays the role of the deputy commissioner and grantwriter working with a county maternal and child health coalition to: develop an initial statement of the issue, examine data to understand the county’s high infant mortality rate and existing literature for what is known about factors associated with poor birth outcomes, clarify the root causes and consequences of the issue by comparing data for the county to the literature, search for and prioritize potential interventions.
HIGXYZ28HIGZYX This online tutorial possesses many convenient features to facilitate learning. The tutorial is designed so that a user can stop at any point and return to the tutorial where s/he left, allows the user to “drop” pages of information into a folder for easy access at a later time, provides “real time” information and constructive feedback to help the user think through decisions, requires the user work with a community coalition to address the problem (how most public health improvement work is structured) and provides a dynamic learning experience since the decisions the user makes effects how the course unfolds.
Opportunities to enhance website A few opportunities to enhance the website exist. Since the tutorial is released for review through Feb. 26, 2006, technical kinks are still being identified and addressed (hence, the Web site includes the opportunity for users to provide feedback). The Web site does not cover the last few steps of the evidence-based public health practice process of action planning and evaluation. Perhaps in the future, links to a couple of useful resources on action planning and evaluation could be added to complete user learning. The website does take a block of time to complete, however the ability to stop and pick up the tutorial at a later point helps to address this issue.
Given the hectic schedules of public health practitioners, if possible, it may be useful to build in a feature to send a message to a user who has not completed the entire tutorial and has not logged into the website in a while to encourage him/her to revisit the tutorial. The Using a Systematic Approach to Address Disparities in Health Outcomes tutorial provides a vehicle for busy public health practitioners to learn about evidence-based decision making in public health at a time and place convenient for them. Its interactive case study approach takes into account that adults grasp concepts best by actually doing them. It is well worth a visit to this Web site at http://www.ebph.org!
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Sixteenth Annual Public Health Materials Contest
The Public Health Education Health Promotion Section is soliciting your best health education, promotion and communication materials for the 16th annual competition. The contest provides a forum to showcase public health materials during the APHA Annual Meeting and recognizes professionals for their hard work. All winners will be selected by panels of expert judges prior to the 134th APHA Annual Meeting in Boston. A session will be held at the Annual Meeting to recognize winners, during which one representative from the top materials selected in each category will give a presentation about their material. Entries will be accepted in three categories; printed materials, electronic materials, and other materials. Entries for the contest are due by April 7, 2006. Please contact Allison Leppke at firstname.lastname@example.org
for additional contest entry information.
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CHPPD 2005 Program Service Awards Presented to Gorbach and Meissner
|Program Chair Judy Gorbach accepting the award from Tom Piper, Chair |
Judith Gorbach was presented with the Section Award for Outstanding Service, Support and Motivation as Program Chair from 2000 to 2005 (and beyond).
|Paul Meissner, past chair, accepting award from Tom Piper |
Paul Meissner was presented the Section Award for Outstanding Service, leadership and support as Program Chair from 2002 to 2004.
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2005 Kimmey and Blum Awards Presented to Utter and CDC Assessment Initiative
|Cheryl Utter accepting the Kimmey Award from Priti Irani |
Cheryl Utter, MS, MBA, manager of health program administration at the Monroe County Department of Health in New York, was recognized for her work in influencing and shaping useful Community Health Assessments in New York state. She is recognized for her ability to bring diverse groups together to work on a common purpose. Cheryl is active with the Health Action Committee in Monroe County, N.Y., and in local-state workgroups that advise on Community Health Assessment and Performance Management Workgroups. The Report Cards by the Health Action Committee in Monroe County is identified an example of good Community Health Assessment Practice.
Cheryl was presented the Kimmey Award plaque at a recognition dinner organized by the New York Association of County Health Officials at the picturesque Canandaigua Inn in Upstate New York in June 2005. The CHPPD Section thanks NYSACHO for providing the perfect setting for recognizing Cheryl.
|Alex Charleston accepting the Blum Award for the CDC Assessment Initiative from Priti Irani |
The CDC Assessment Initiative was recognized for creating linkages between health care and public health, and for maximizing resources. Since 1992, the Assessment Initiative has entered into cooperative agreements with 15 states to develop new systems and methods to improve how data are used in the public health policy- and decision-making process. The project’s budget of approximately $2.5 million currently funds seven states for a five-year period and also supports CDC project staff and an annual conference focused on practical issues relating to community health assessment practice, data access and data utilization. Specific examples of their activities include using data to influence public heath policy: The Missouri Department of Health and Senior Services (DHSS) used Assessment Initiative funds to develop an integrated data warehouse and a Web-based, interactive health data query system (see http://www.health.state.mo.us/MICA/nojava.html
). Among the users of this system was a report for a foundation that was in turn formed a basis for a statewide grant program. In 2002, data generated from this system was presented to the Missouri Health Foundation. The Foundation’s Board of Directors was tasked with identifying health priorities to form the basis for a statewide grant program. Linking disparate data sets to understand public health issues: Assessment Initiative resources were used by the Oregon Department of Human Services to form a partnership with the state's Office of Medical Assistance Program to facilitate the availability and use of data on health risks, health status, preventive services, and clinical outcomes in the Medicaid population. Using information to strengthen infrastructure and foster collaboration: Through the CDC Assessment Initiative, the New York State Department of Health developed an evaluation tool to rate the overall completeness and usability of community health assessments completed by local health departments. One outcome of this process was the development of an electronic CHA Clearinghouse designed to share examples of promising assessment practices, CHA data sources/tools, and links to evidence-based community health practices.
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Vojvodic and Steele Presented 2005 Best Student Abstract Awards
|Charles E. Begley, PhD accepts the award on behalf of Rachel Westheimer Vojvodic |
Rachel Westheimer Vojvodic, MPH, was awarded the doctoral student abstract submission award for "Methods for analyzing emergency department use as an indicator of primary care access problems: Evidence from Houston, Texas." Rachel is a PhD student in the Management, Policy, and Community Health program at the University of Texas School of Public Health, where her research interests regard how health system structure and policies translate into the delivery of services. Rachel received her BS in health professions and health care administration from Texas State University, and her MPH in health services organization from the University of Texas School of Public Health. Unfortunately, Rachel was unable to join us at the Annual Meeting in Philadelphia, due to her baby’s impending due date. But we wish her much luck with her new family and graduate work, and look forward to another excellent submission next year.
|Natalie Steele accepts award from Judy Gorbach |
Natalie Steele won the 2005 CHPPD Masters Student Abstract Submission Award for "Peer-centered services for homeless youth: Creating effective systems." Natalie just completed her MPH degree in Health Administration and Policy from Portland State University, which is part of the larger Oregon MPH Program. Her research interests lie in continuous quality improvement and safety and health care finance, and her community interests center on access to quality health care and promoting prevention and healthy lifestyles. Since graduation, Natalie is working with the Oregon Department of Human Services' Office of Medical Assistance Programs (OMAP), as the quality improvement coordinator and contracts administrator. OMAP administers the Oregon Health Plan, an innovative program that operates Medicaid with expanded eligibility to provide medical assistance to more community members in need.
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Submit nominations for 2006 Blum, Kimmey and Section Service Awards by April 30
Do you admire the planning or policy work done of a colleague or a group? If so, you should consider nominating her or him for a Community Health Planning and Policy Development Section award. Each year, the CHPPD Section, working in conjunction with the American Health Planning Association, accepts nominations until April 30 in order to present three awards at its annual meeting.
The Henrik L. Blum Award for Excellence in Health Policy 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. The award is in honor of Henrik L. Blum, MD, MPH, Professor Emeritus of Health Policy and Planning in the School of Public Health at the University of California at Berkeley.
The James R. Kimmey Award for Excellence in Health Planning Practice recognizes an individual who has demonstrated excellence, creativity, and/or innovation in health planning practice that constitutes a significant contribution to health planning which goes beyond the expectations of routine job performance and is evidenced by accomplishments. This award is given jointly with the American Health Planning Association. The CHPPD Section Service Award is given to a Section member who has made a significant contribution to the Section's operations and/or other activities.
These awards are presented at an Awards Ceremony during the APHA Annual Meeting. All Section members are welcome and encouraged to submit nominations for any of these awards. The award nomination forms are available at http://www.ahpanet.org/CHPPD/Planning_awards.html. Please fax or e-mail a copy of the completed form to to both Ann Umemoto email@example.com, fax: (914) 997-4501, phone: (914) 997-4496 and Tom Piper firstname.lastname@example.org, fax: (573) 751-7894, (573) 751-6403.
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Program Chair Report: Deadline for 2006 APHA Annual Meeting in Boston is Feb 17 and Philly Update
|Judith Gorbach, CHPPD Program Chair |
All the CHPPD sessions went off quite successfully especially considering the many changes of speakers required by the change of date and location due to Katrina. CHPPD Section members were most helpful volunteering as moderators. CHPPD did have two invited sessions cancelled, from Texas, due to the involvement of students and faculty with Katrina evacuees.
Although APHA reported their numbers down for attendance at the Annual Meeting by only a few thousand, the attendance at our sessions was considerably down from past years. Sessions usually having 150-175 participants had only 60-75. However, those attending reported that they felt the sessions were up to the high standards we have come to expect from our Section.
We are now preparing for 2006. This is the time for gathering reviewers, and we still need reviewers for this year. I expect a large number of submissions, as the meeting will be in Boston, usually a popular site for APHA meetings. If anyone is interested in reviewing, please contact Judith Gorbach by e-mail at email@example.com. It usually takes an hour or so and is done online. Most reviewers report enjoying the process. The deadline for abstract submissions to CHPPD is Feb. 17, so all reviewers must be in place at that time.
The time for invited sessions to be organized is NOW. All of those sessions must be accepted as a session by our Section Chair Tom Piper, and the session abstracts submitted by the deadline. If you intend to request an invited session, contact Judith Gorbach at <firstname.lastname@example.org> as soon as possible.
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CHPPD to Recognize Students with Awards in 2006
The CHPPD leadership will recognize the best submission by a masters and a doctoral student for awards this year. Each award recipient will be chosen on the basis of their abstract review scores and invited to present in a CHPPD oral session. The students will also be given a $200 travel scholarship to the Annual Meeting and an award presented at the CHPPD evening reception. Students receiving scores below the acceptance level will be offered constructive feedback on their abstract from volunteer CHPPD faculty members. The purpose of this new process is to provide new student members and first-time submitters with feedback to help them improve their future APHA abstracts. The student abstract awards were instituted in 2005.
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Student Perspective: CHPPD is a "Fun and Diverse" Group
HIGXYZ24HIGZYX With the APHA conference coming up around my school finals, I was hesitant to commit to attending, but after the fact, I am glad that I made the journey from Louisiana to Philadelphia. The new surroundings were an experience in themselves. The architecture, landscape, and history were a wealth to take in. Coming from a state where snow is a rarity, I found the white mush most impressive. It was a treat to see, but definitely not to walk on.
|Aubrey Lipham (right) talking with Monica Chan at the CHPPD awards dinner |
During my time at the conference, I was pleasantly surprised to encounter a few familiar faces, but was even more delighted to meet the members of my recently-joined section, CHPPD. I found this group was truly as it had been described to me: “fun and diverse.” After having the opportunity to converse with several members, I discovered a large variety of backgrounds, fields, and an even larger assortment of interests and goals. I enjoyed just about every aspect of my first conference: the booths, presentations, people, and most of all how the whole meeting put my field of research into perspective. I am grateful for the opportunity to attend the conference and look forward to attending them in the future.Aubrey Lipham is a first year MPH student from Louisiana State University (LSU). Biostatistics is her favorite course. Her area of interest is nutrition. She works full-time as a research associate for Dr. William Cassidy, associate professor, LSU Health Sciences Center Medical School. They work a variety of things. Right now, they are conducting a flu shot research program in the emergency department in coordination with the CDC. Aubrey also helps to coordinate a pediatric study for another doctor involving RSV in high-risk children. In her spare time on the job (if there is any), Aubrey does data entry for another study that is taking place in prisons dealing with hepatitis C treatment.
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For Lara, Business Meetings are the Best Part of the Annual Meeting
HIGXYZ23HIGZYX Most people spend their time as members of APHA blissfully unaware of the inner workings of the organization. However, any organization this large has to have a bureaucracy, complete with politics and rules, personalities and inconsistencies. It is a great, and fairly non-threatening, way to get your feet wet if you are interested in leadership. It is also a wonderful way to meet and get to know fascinating people from around the country who share an interest in public health. Fortunately, it is simple to get involved in APHA leadership -- just attend your section meetings at the Annual Meeting and run for a section position.
|Lara Jone (right) listening in on a CHPPD business meeting |
My first APHA Annual Meeting was in 1994. I was an MPH student at the University of Minnesota, with a desire to strengthen efforts at prevention. However, I recognized that the country doesn’t value prevention nearly as much as it reveres treatment. Attending the Annual Meeting was exhilarating for me. I didn’t have a background in health, and so was overwhelmed and pleased by the feeling that there were so many others in the country who also believed in public health. For several years that fortification was the main reason I attended the conference. Now I attend because I participate in the APHA leadership. Each year I see familiar faces and meet new people. I learn more and more about how the organization works; I still know little. However, APHA is a primary face of pubic health at the national level, and it is important to keep it running. While I always feel I should do more, I also know that my involvement is one of the things that keep APHA a vibrant and living organization. While many people prefer to spend their time attending sessions, visiting the exhibit hall, and catching up with old friends, I spend a great deal of my time in meetings. It’s not for everyone. However, if you are thinking about how you could enhance your career in a busy world, I would suggest participating in the CHPPD Section leadership as a great place to start. You will be welcomed.
Lara Jones is involved in so many different things at her job that she says, it's hard to describe exactly what she does. Lara is responsible for managing the mini-grant programs, staffing the School Systems Work Group, and administering the annual survey of programs that address child overweight. She works for the Consortium to Lower Obesity in Chicago Children, http://www.clocc.net. Also, Lara is a PhD candidate at the University of Illinois in Chicago School of Public Health in Health Policy and Administration investigating the role of the built food environment on eating behaviors.
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The Magic Pen
|The invisible ink writing could only be seen if the light was shone on it |
“Would you like to see our magic pen?” Those of us who sat at the booth know that line well. It drew people, albeit some suspiciously, to the Community Health Planning and Policy Development Booth Number 127 at the APHA Annual Meeting in Philadelphia. Exhibit visitors would try to write with the pen, the kind-hearted ones saying, “sometimes these new pens take a while to start writing.”
"It is a magic pen,” CHPPD Section Chair Tom Piper would say when he was staffing the booth. “You write on paper,” he demonstrated writing the person’s name on a grey copy of the “Irreverent Guide,” “and you don’t see anything, right? Now you shine the light. And voila! You see your name written down. It is meant to symbolize what CHPPD stands for, and that is, "Enlightening Our Vision for Life." If you let me swipe your badge on the badge reader, you can have a pen with extra replacement batteries for free.” Most folks let CHPPD booth staff swipe their badge, while others needed an assurance that they would not be bombarded with marketing information.
|Paul Meissner, past chair, talking to a visitor at the CHPPD booth |
So what was the magic of the pen? Was it the invisible writing? Was it the fact that it made it fun to volunteer at the booth? Ask Ed Hsu, Associate Professor from the University at Maryland, who volunteered at a whim. Was it the care that Tom Piper showed when he crafted the card holder for the pen and batteries? Was it the fact that it was voted one of the coolest giveaways by our colleagues in the Community Health Worker booth who sat across from us? If you volunteered at the booth, you know.
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The APHA Diet
You haven’t heard of the APHA diet? Just ask Karen Ho, CHPPD member from Honolulu, Hawaii. Karen was so busy attending meetings and sessions at the APHA Annual Meeting in Philadelphia that she barely found time to eat.
|Karen Ho scanning the APHA program |
So finally, on the third day of the meeting, she was determined to get to the corner Dunkin Donuts, and buy some breakfast. And she did.
Just as she unwrapped the sandwich and was getting ready to take a bite, she noticed a gentleman, who seemed homeless or at least fallen on hard times, gesturing at her. She figured he was asking her for money. So she gestured back, asking if he would like her sandwich. And he shrugged and said, “That will do.” So she gave him her sandwich. Aloha to the APHA diet.
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Submit nominations for CHPPD leadership positions by February 28
Members are invited to send in nominations for four governing council positions, a chair-elect and a secretary-elect positions. Job descriptions of each of these positions are in the CHPPD manual. If you wish to nominate yourself or a colleague, please complete nomination forms and email the completed forms to Paul Meissner. Please note the person nominated must be an APHA member on Feb. 1, 2006. If you are interested in helping the nominating committee identify leaders for various positions, please contact Paul Meissner. Your assistance will be appreciated by Section members.
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It takes a village to build an e-community
|Priti Irani (left) with APHA Section Affairs Liaison Sharon McCarthy at the Newsletter Editors Meeting in Philadelphia |
What do you think was the single-most factor that made the Fall issue the most read of the Community Health Planning and Policy Development (CHPPD) newsletters? I am referring to the articles "CHPPD's Fall Newsletter was the 2005 Wow Issue" in this newsletter. There was a 24% increases in visitors to the newsletter. In all, the CHPPD newsletter had 91 visitors in June, 386 visitors in Fall and 129 visitors in November for the special annual meeting issue. The number of pages viewed also jumped proportionately in Fall by 24%.
My hypothesis is that newsletter readership is a indicator of membership involvement. More than 100 members completed the survey sent out in August. About half a dozen members sent in requests to post articles related to events and conferences. So when the newsletter was published, they were looking at the issue with a specific agenda in mind. It takes a interested village of "CHPPDers" to build an e-community.
Even so, the Fall newsletter was read by less than a quarter of the members who identify CHPPD as their primary section. Does that mean that less than a quarter of CHPPD members are paying membership dues and are not actively engaged in section and APHA activities? I don't know.
Here is an opportunity to test out the member involvement hypothesis. This Winter (January-February 2006) issue of the newsletter has about half a dozen new contributors. Thank you to all of you who contributed to this issue - Judy Gorbach, Karen Ho, Aubrey Lipham, Lara Jones, Tom Piper, Wendy Roy, John Steen, Holly Tutko, and Kathy Witgert. I expect the readership level to be between the numbers for the Fall and the November issue. Whether you agree with the hypothesis or not, would you please do consider writing a short article for the next newsletter. Submit photos, charts or graphs because as we know "it is worth more than a 1,000 words". The deadline for the next issue is May 12.
You may want to summarize work that you do, or bring our attention to some interesting journal articles. You may want to write a book or course review - I hope there will be at least one review article in every issue. We are also hoping to have a piece from a student perpective.
Or, you may want to react to an article in this issue, and write a letter to the editor. At the least, it will stop me from talking so much. I look forward to hearing from you.
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CHPPD Members invited to join in bi-monthly conference calls
CHPPD members are invited to participate in the bi-monthly conference calls. At these calls, CHPPD members discuss issues such as the annual meeting, how to involve and strengthen networking among members, and other strategies.
The 2006 conference calls are on the dates listed below at 12 noon Central Time, 1:00 p.m. Eastern, and 10:00 a.m. Pacific. To connect, dial (800) 411-7650 to reach the March of Dimes Conference Center, and when prompted, enter 0863, then “#” sign, which will join you to the call.
- Wed., Mar. 22
- Wed., May 17
- Wed., July 19
- Wed., Sep. 13
- Wed., Oct. 25 (APHA conf. only - Nov. 4-8)
Meeting minutes of previous CHPPD meetings are usually posted on the Web site at http://www.chppd.org. For more information, contact CHPPD Section Chair Tom Piperat email@example.com or at (573) 751-6403.
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Community Health Planning and Policy Development Newsletter Archives