The Minnesota Chronic Disease Genomics Project

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The Minnesota Chronic Disease Genomics Project

• Building Capacity, Strategic Planning
• Kristin Peterson Oehlke, MS CGC
• MN State Genomics Coordinator
• kristin.oehlke_at_health.state.mn.us

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What Does Genomics Have to Do With Health?

• The genome is a set of boundary conditions that
  limits the nature of the organism, not a
  blueprint that defines it.
  
• Peter Parham NEJM 2000 343(9)668.

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Overview

• Overview of Component 7 (Genomics)
• Overview of Minnesota project
• Genomics activities in Minnesota
• Ongoing activities
• Progress so far
• Whats next

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CDC Chronic Disease Prevention and Health
Promotion Program Components

• Tobacco Use
• Nutrition, Physical Activity, Overweight
• Public Health Infrastructure
• Oral Health
• Arthritis
• Osteoporosis
• Back Conditions

• Educational and Community-Based Programs
• Cancer
• Diabetes
• Genomics
• Surveillance and Data Systems (BRFSS)

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Genomics Component of Chronic Disease Prevention
Program

• Develop genomics leadership and coordination
  capacity
  
• Assure effective planning, implementation and
  evaluation of genomics tools in public health
  policy and programs
  
• Integrate genomics tools into ongoing and new
  population-based strategies to address public
  health goals

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Genomics Component What are the parameters?

• Plan and coordinate within agency and with other
  partners for genomics integration
  
• Coordinate genomics activities within agency to
  enhance chronic disease prevention activities
  
• Enhance genomic data collection via existing
  surveillance systems
  
• Develop competency in the use of genomics by the
  public health workforce
  
• Develop leadership capacity in the use of
  genomics in the public health agency

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The Goal of the Minnesota Chronic Disease
Genomics Project

• To develop capacity and leadership to achieve
  a coordinated and appropriate integration of
  genomic information and tools in public health
  planning, programs and policy development.

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The Minnesota Chronic Disease Genomics Project

• To plan for genomics integration into public
  health activities with input from stakeholders
  and partners
  
• To identify opportunities for integrating
  genomics in chronic disease and health promotion
  programs through an assessment, analysis and
  prioritization process

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The Minnesota Chronic Disease Genomics Project

• To develop genomics competency and capacity in
  the public health workforce
  
• To assess public perceptions and knowledge of
  genomics to guide education planning
  
• To evaluate data sources and systems for genomics
  data and for new opportunities for genomics data
  collection and applications

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Its About Public Health

• Public health culture, traditions, approaches,
  priorities
  
• How does genomics fit?
• What is public health role?
• Engaging people and programs
• Assessing opportunities and barriers
• Building Capacity
• Collecting ideas, identifying issues

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Its About Public HealthEngaging Ongoing
Processes

• Crosscutting teams and projects
• Womens health
• Perinatal health
• MDH Data Taskforce
• Public health planning
• Diabetes
• Cardiovascular Health
• Comprehensive Cancer Control
• Arthritis

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Its About Public Health Program Assessment

• What do programs do?
• Purpose
• Populations
• Policy
• Approaches and activities
• Pressures
• What makes sense?
• Looking for opportunities, identifying barriers

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Its About Public Health Building the Genomics
Team

• Representation is agency-wide
• Health Promotion and Chronic Disease
• Family Health
• Environmental Health
• Infectious Disease Epidemiology
• Community Health
• Public Health Laboratory
• Policy and Communication
• Office of Minority Health
• MDH Executive Office

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MDH Genomics Team Activities

• Advise the project to assure relevance
• Guiding principles for genomics integration
• Process for prioritizing opportunities and
  barriers
  
• Advise on genomics capacity needed and
  organizational positioning within MDH
  
• Strategic planning for genomics integration
• Identify and address ELSI
• Advise on genomics education / training

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Building Genomics Capacity in the Public Health
Workforce

• What capacity already exists?
• What do workers need / want to know?
• What resources / tools exist?
• What are delivery options?
• What new systems are needed?
• How to deal with information overload?

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Multiple Paths to Increased Capacity

• Program Assessment
• Education / Training Agenda
• Genomics Brownbags
• Distance Learning Events
• Webcasts and Other Online Resources
• Family Matters MN Colorectal Cancer Consortium
  Summit
  
• Genomics Resource Center

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Collecting Ideas

• Analyzing family history data collected from
  cancer screening programs
  
• Maternal influences on offspring risk of chronic
  disease
  
• Using family history in womens health chronic
  disease prevention project
  
• Including genomics questions on PRAMS
• Include genomics in breast and cervical cancer
  written materials
  

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Collecting Ideas

• Communicating efficiently
• Within MDH
• Outside MDH
• New ways of working
• How do we stop going to each others meetings?
• Public Health as trusted source of information
• State of development of science
• Premature or inappropriate applications
• Data stewardship and dissemination

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Identifying Issues

• Proceed With Caution
• Data Privacy and Government Role
• Genetic Discrimination
• Role of Public Health in Genomics
• Role of Genomics in Public Health
• Public Knowledge, Support and Acceptance
• Practical Considerations, Barriers, Limitations
• Gaps in Knowledge

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Lessons Learned

• Great interest in genomics and role for / in
  public health
  
• Capacity in genomics exists across agency
• Coordination, capacity building and search for
  opportunities is well supported
  
• Concern for ELSI
• assuring appropriate applications
• Many small steps build the foundation and lead to
  real progress

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Only the Start

• Continue program assessment
• Assess public perceptions and knowledge
• Identifying and evaluating data sources
• Choosing most promising opportunities and acting
• Addressing barriers, filling gaps, answering
  objections
  
• Developing a forum for building collaborative
  relationships with outside partners
  
• Continuous evaluation of project
• Engaging local public health agencies
• Documenting Minnesotas experience

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Its About Public Health Program Assessment

• Using genomics for population health
• Identify opportunities and barriers
• Identify benefits and risks
• Identify information needs, resources, gaps
• Identify ELSI
• Analyze assessment information to shape public
  health policy and practice