Evidence Based Chronic Disease Prevention Module Two: Developing An Initial, Concise, Operational St

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Evidence Based ChronicDisease Prevention
Module Two Developing An Initial, Concise,
Operational Statement of the Issue

• Presented by Edie Sternberg, MPH, CHES

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Objectives

• Understand the overall strategic planning process
  for setting priorities in public health.
• Develop a concise written statement of the public
  health problem, issue or policy under
  consideration in a measurable manner.
• Understand why an issue statement(s) is essential
  to the strategic planning process.

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Strategic Planning Overview

• What it is?
• Why do it?
• An overview of Illinois Approaches
• IPLAN
• Public Health Future Illinois
• Indiana Approaches?

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Strategic Planning Overview

• Caveat to spend too much time planning and not
  enough doing
• If you dont know where you are going, you might
  wind up somewhere else.
• Yogi Bera
• If you come to a fork in the road, take it!
• Yogi Bera

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Why do Strategic Planning?

• Yogi If you dont know where youre going . .
  .
• New diseases and treatments
• Population shifts
• Technology
• Social conditions
• Economic factors

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Why do Strategic Planning?

• Yogi If you come to a fork in the road . . .
• Laws/rules/mandates
• Funding opportunities/challenges
• Organized advocacy

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Why do Strategic Planning?

• How can we be effective in the face of all these
  changes?
• Our challenge is to figure out where we want to
  go.

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Strategic Planning

• A decision-making process for identifying
  challenges or opportunities and then developing a
  plan to meet those challenges and move toward
  desired results for the public.

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Strategic Planning

• A decision-making process used to analyze
  environmental challenges and opportunities, set
  goals, and design strategies to move to the
  organizations desired future.

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What do we get fromStrategic Planning?

• Clarity of structure
• What is our core business?
• Clarity of direction
• Where are we going?
• Clarity of measurement
• What are we accomplishing?
• Main focus of this course

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Elements of the Illinois Models

• Vision, mission, values
• Environmental assessment
• Strategic issues goals
• Objectives and strategies
• Outcomes and outcome measures
• Evaluation and results

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Definitions

• Health Program
• A structured intervention with the intent of
  improving the health of the total population or a
  sub-population at particularly high-risk.
• Health Policy
• A law, regulation, rule, practice or norm that is
  adopted on a collective basis to guide individual
  and collective behavior

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Issue Statement

• A concise written statement of the public health
  problem or policy under consideration.
• Hypotheses
• Question

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Issue Statement

• One should ask
• How did the person who identified the
  issue/problem state it?
• Should/could the problem be stated in the context
  of person/place/time?

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Issue Statement - Attributes

• Should have these attributes
• Stated as a question or hypothesis to be tested
• Lead to an analysis of root causes
• Lead to multiple discipline/agency involvement
• Be clear and concise

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Issue Statement Is it . . .

• Epidemiologic
• What is the relationship of x to health condition
  y? (level one ? something should be done)
• Intervention
• What is the best approach to decreasing risk
  factor x? (level two ? this should be done)

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Issue Statement Is it . . .

• Evaluation
• Is program y effective? (level two ? this should
  be done)
• Managerial
• Why did x go wrong? (level two ? this should be
  done)
• Policy-related
• What will be the impact of changing policy z?
  (level two ? this should be done)

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Developing an Issue StatementWhat is Needed?

• If we are going to base our decisions on
  evidence, we must first have the ability to
  concisely state the public health issue.

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Issue Statement Examples

• Epidemiologic Issue
• Nationally, the number of persons with diagnosed
  diabetes increased fivefold from 1.6 million in
  1960 to 8 million in 2000.
• In IL there are approximately 500,000 persons 18
  years of age and older that have been diagnosed
  with diabetes.

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Issue Statement Examples

• Intervention
• How do we get the support for our new risk factor
  recognition program (i.e. diabetes prevention
  program)?
• Are there examples in the literature of effective
  programs to increase community awareness of
  diabetes prevention through recognition of
  potential risk factors?
• Are there examples in the literature of effective
  programs to prevent or reduce risk factors of
  diabetes?

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Issue Statement Examples

• Evaluation
• Is a mass media campaign effective in increasing
  awareness of obesity as a risk factor for
  diabetes?
• Is a structured physical activity intervention
  effective in reducing or maintaining weight in
  individuals at risk for diabetes?

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Issue Statement Examples

• Managerial
• What are the structural, systematic problems that
  have prevented such a program from being
  implemented?
• What are the potential financial and
  organizational costs of such a program?

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Issue Statement Examples

• Policy
• Is required PE in schools effective in reducing
  youth obesity?
• Is insurance for weight loss programs effective
  in increasing program participation?

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Issue Statement Examples

• Solutions being considered
• Program staff, policy makers, and advisory groups
  have proposed numerous solutions, including
• Increased funding for diabetes risk factor
  services.
• A mass media campaign to promote diabetes risk
  factor awareness.
• Education of health care providers on how to
  effectively counsel for diabetes control.

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Issue Statement Examples

• Potential outcome(s) and their Indicators
• Prevalence of obesity
• Prevalence of obesity among high risk groups
• Prevalence of counseling for diabetes prevention
  and screening among primary care providers (PCPs)

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Issue Statement Examples

• Keys in this phase of problem definition
• Avoid early judgments
• Encourage creative thinking
• Make problem statements quantifiable

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Remember the Elements of Strategic Planning

• Vision, mission, values
• Environmental assessment
• Strategic issues goals
• Outcomes and outcome measures
• Objectives and strategies
• Evaluation and results