Supporting and Expanding Public Health Research: A CDC Perspective Presented at Health Professions Network Conference, M

1. Supporting and Expanding Public Health Research: A CDC PerspectivePresented at Health Professions Network Conference, March 17, 2006 Robin M. Wagner, PhD, MS Jamila Rashid, PhD, MPH Elizabeth Skillen, PhD Cindi Melanson, MPH, CHES Robert Spengler, ScD Office of Public Health Research Office of the Chief Science Officer

2. Overview • Developing a national public health research agenda • Why now • How theNEWCDC Health Protection Guide, 2006-2015 is being developed • How it will be used to support shorter-term Research Agenda • Which research themes are related to healthcare professionals • Implementing the research agenda • Questions

3. The Original CDC

4. Why Change? Many External Forces… Emerging Public Health Threats Human Genome Health Disparities Globalization Changing Demographics Information Technology Rising Health Care Costs Aging Workforce Public Health Infrastructure

5. CDC Response • New strategic plan: Futures Initiative • New organizational structure • New health protection goals • New strategic imperatives • New national public health research agenda • CDC Health Protection Research Guide, 2006-2015 • CDC Research Agenda (shorter-term priorities)

6. Centers for Disease Control and Prevention OFFICE OF STRATEGY AND INNOVATION OFFICE OF THE CHIEF SCIENCE OFFICER OFFICE OF WORKFORCE AND CAREER DEVELOPMENT OFFICE OF THE CHIEF OF PUBLIC HEALTH PRACTICE OFFICE OF THE DIRECTOR OFFICE OF ENTERPRISE COMMUNICATION OFFICE OF THE CHIEF OPERATING OFFICER OFFICE OF CHIEF OF STAFF CDC WASHINGTON OFFICE OFFICE OF EQUAL EMPLOYMENT OPPORTUNITY COORDINATING OFFICE FOR GLOBAL HEALTH COORDINATING OFFICEFOR TERRORISM PREPAREDNESS & EMERGENCY RESPONSE COORDINATING CENTER FORENVIRONMENTALHEALTH AND INJURY PREVENTION COORDINATING CENTERFOR HEALTH INFORMATION AND SERVICES COORDINATING CENTER FOR HEALTH PROMOTION COORDINATING CENTER FOR INFECTIOUS DISEASES NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH

7. CDC Overarching Health Protection Goals Healthy People in Every Stage of Life Healthy People in Healthy Places People Prepared for Emerging Health Threats Healthy People in a Healthy World

8. Healthy People in Every Stage of Life Infants & toddlers Children Adolescents Adults Older Adults Healthy People in Healthy Places Communities Homes Workplaces Schools Healthcare settings Institutions Travel & recreation People Prepared for Emerging Health Threats Event Goals: Investigate & control threats Post-Event Goals: Recover from threats & improve future responses to threats Pre-Event Goals: Prevent, detect & report public health threats Healthy People in a Healthy World Health promotion Health protection Health diplomacy Specific Health Protection Goals

9. Strategic Imperatives • Health Impact Focus • Customer-centricity • Public Health Research • Leadership • Global Health Impact • Accountability

10. Goals Implementation for CDC Goals Evidence Input Mission Feasibility Impact Healthy People, Healthy Places, Preparedness & Global Health Health Impact Evidence-based action plan Accountability & responsibility assignments Resource allocation Performance Management

11. Goals Will Drive Program and Research GOALS Health Impact RESEARCH PROGRAM

12. CDC Integration of Goals, Research and Program HEALTH PROTECTION GOALS Healthy People, Healthy Places, Preparedness & Global Health Program Achieve goals Public health services, programs and response Improved services, programs and response Research Innovation New priorities Threats & emergencies HEALTH IMPACT

13. Overview: CDC Health Protection Research Guide, 2006-2015 • Provides comprehensive, long-range vision of national & global public health needs • Research Guide will support shorter-term Research Agenda • Applies to intramural & extramural research

14. Purpose of CDC Research Guide • Identify knowledge gaps to be addressed in Health Protection Goals Action Plans • Describe research needed for critical evidence to improve public health programs/interventions • Support many public health disciplines through innovative, cross-cutting, foundational research • Serve as platform for collaborations with federal partners • Provide basis for collaborations with state/local partners • Create opportunities to partner with other diverse partner sectors • Plan, promote and market CDC research

15. Workgroup Structure CDC ADVISORY COMMITTEE Workgroup on Goals & Research Agenda Research Agenda Steering Subworkgroup 2015 Health Protection Goals Subworkgroup Core Team Health Promotion Environmental & Occupational Health & Injury Prevention Health Information Services Infectious Diseases Global Health Community Preparedness & Response

16. Research Guide Development Progress and Next Steps • Develop plans & gain approval • Form workgroups • Gather CDC and partner input • Create “starter list” for discussion • Hold public participation meetings • Hold initial federal partners meeting • Conduct synthesis & prioritization • Produce public comment draft • Hold 60-day formal public comment period • Finalize Research Guide (Target date: 4/06) • Develop a strategy to collaborate with partners • Develop short-term Research Agenda

17. Outline of Public Comment Draft I. Overview II. Relationship of Research Themes to CDC Health Protection Goals The Proposed Guide Prevent and Control Infectious Diseases Promote Preparedness to Protect Health Promote Health to Reduce the Burden Of Chronic Diseases and Disability Create Safe Places To Live, Work, Learn, and Play Work Together to Build a Healthy World Manage and Market Health Information Cross Cutting Research Appendices

18. TIER 1 TIER 2 TIER 3 Research Theme 1 MAJOR RESEARCH AREA (Chapter) Research Category A Research Theme 2 Research Theme 3 Research Category B Research CategoryC Organization of Research Guide Scope of Research

19. Priority-Setting Criteria • Public health need/importance of problem • Relevance to reducing health disparities • Potential for broad impact (>1 disease or subject area) • Relevance to CDC mission/health protection goals

20. Public Responses • 3 Sources of Public Comments • Website • Email • Postal Mail • Nearly 7,000 people submitted comments • Most comments received during comment period (“official” comments) but some were late (“unofficial”) • Many institutional responses from key partners

21. NIH Institutes and Offices Office on Disability, DHHS Association of Teachers of Preventive Medicine Association of State and Territorial Health Officials American Society of Microbiology Infectious Diseases Society of America American Hospital Association American Chemistry Council Emergency Nurses Association American Psychological Association AND OTHERS! Key Partners Who Submitted Institutional Comments

22. Official Public Comments Received DURING Public Comment Period * Draft #s. May include >1 submission by same person. ** # of comments BEFORE the comments were split into discrete ideas.

23. Unofficial Public Comments Received AFTER Public Comment Period * Draft #s. May include >1 submission by same person. ** # of comments BEFORE the comments were split into discrete ideas.

24. Linking Research Guide to Goals Action Teams • Each Team’s Goals Action Plan will include research component • 2006-2015 Research Guide will have identified research to fill knowledge gaps determined as priorities by Teams • Research supporting Teams will form basis of short-term Research Agenda (2-3 year timeline)

25. Research Theme Examples Mapped to Goals/Teams • Optimal Adolescent Development [ADOLESCENT HEALTH] Develop and evaluate strategies to improve health and fitness levels of U.S. adolescents, and establish health behaviors that promote lifelong health and reduce the leading causes of morbidity, mortality, and disability among youth and adults. • Influenza Pandemic and Interpandemic (Annual)[INFLUENZA] Determine the pathogenesis, transmission, and immune response of highly pathogenic avian and other influenza viruses with pandemic potential to develop improved preventive and therapeutic measures. • Occupational Diseases [HEALTHY WORKPLACES] Improve understanding of the role and burden of workplace exposures to diseases, and determine sector-specific risk factors, mechanisms, and effective prevention strategies. • Health Marketing and Health Education in Global Settings [GLOBAL HEALTH PROMOTION] Improve strategies for health education and dissemination of health marketing messages and products with the objective of encouraging behaviors that will prevent disease and injury in the developing world.

26. Research Themes Relevant to Health Professionals - I • Workforce and Career Development Conduct research to improve public health workforce-related recruitment, retention, and training. Scope of Research addresses: • Knowledge, attitude and skill competencies needed by the public health workforce • Career development and entry-level supply lines to ensure workforce pool • Best practices for workforce recruitment, retention, training • Current and future public health workforce needs • Impact of trained public health professionals on specific health related outcomes • Workforce performance and trends

27. Research Themes Relevant to Health Professionals - II • Support for Front-line Personnel Involved in Health Protection Functions During Extreme Events Improve and evaluate the countermeasures, personal protective equipment, and health policy guidelines that support members of the public health workforce and maximize safety, personal resilience, self-confidence, and performance for these workers. • Proficiency of the Public Health Workforce in the Event of Disaster Define and assess the knowledge, attitudes, and proficiencies needed by the public health workforce to successfully ensure the safety and well-being of the community.

28. Research Themes Relevant to Health Professionals - III • Healthcare-associated Infections and Patient Safety Create novel strategies for preventing healthcare-associated infections, including those occurring among recipients of blood, organs, and other tissues. • Human Resources and Health Outcomes in Global Settings Evaluate the way in which the quality and quantity of human resources in health affects the key determinants of health outcomes in global settings. • Integrated Health Marketing Programs Explore practices and strategies to enable public health professionals to design, create, and evaluate effective and integrated health-marketing campaigns.

29. Implementing Research Guide • Develop a strategy to collaborate with federal partners • Hold second and third federal partners meetings on health disparities • Plan additional meetings, funding and other mechanisms • Develop a strategy for collaborating with other partners • Develop broad program announcement aligned with Research Guide, Research Agenda and Health Protection Goals

30. Funding the Research Agenda • Broad research program announcement (continued) • Emphasis on intervention, translation and dissemination research • Target publication date: 8/06 • In effect for 3 years using FY07-FY09 funds • Potential applicants directed to updated research priorities developed over time by Teams and listed on Web • Leverage resources of other interested federal partners and across CDC • Other funding mechanisms TBD by CDC senior management

31. For More Information • CDC Goals http://www.cdc.gov/about/goals • CDC Health Protection Research Guide www.cdc.gov/od/ophr/cdcra.htm

32. Contact Robin M. Wagner, Ph.D., M.S. Associate Director for Research Planning and Evaluation Office of Public Health Research Office of the Chief Science Officer Centers for Disease Control and Prevention 1600 Clifton Rd., NE, Mailstop D72 Atlanta, GA 30333 Phone: 404-639-4898 Email: RWagner@cdc.gov

33. We Appreciate Your Support of the Research Guide . . . To help us fulfill CDC’s vision of healthy people in a healthy world – through prevention! Thank you!!

34. Questions • How can we work together to support research of mutual interest? • Other?