Evidence Based Chronic Disease Prevention Module Two: Developing An Initial, Concise, Operational Statement of the Issue

1. Evidence Based ChronicDisease PreventionModule Two: Developing An Initial, Concise, Operational Statement of the Issue Presented by: Edie Sternberg, MPH, CHES

2. 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. Evidence Based Chronic Disease Prevention

3. Strategic Planning Overview • What it is? • Why do it? • An overview of Illinois Approaches: • IPLAN • Public Health Future Illinois • Indiana Approaches? Evidence Based Chronic Disease Prevention

4. Strategic Planning Overview • Caveat to spend too much time planning and not enough doing • “If you don’t 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 Evidence Based Chronic Disease Prevention

5. Why do Strategic Planning? • Yogi: If you don’t know where you’re going . . . • New diseases and treatments • Population shifts • Technology • Social conditions • Economic factors Evidence Based Chronic Disease Prevention

6. Why do Strategic Planning? Yogi: If you come to a fork in the road . . . • Laws/rules/mandates • Funding opportunities/challenges • Organized advocacy Evidence Based Chronic Disease Prevention

7. 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. Evidence Based Chronic Disease Prevention

8. 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. Evidence Based Chronic Disease Prevention

9. Strategic Planning • A decision-making process used to analyze environmental challenges and opportunities, set goals, and design strategies to move to the organization’s desired future. Evidence Based Chronic Disease Prevention

10. 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 Evidence Based Chronic Disease Prevention

11. Elements of the Illinois Models • Vision, mission, values • Environmental assessment • Strategic issues & goals • Objectives and strategies • Outcomes and outcome measures • Evaluation and results Evidence Based Chronic Disease Prevention

12. 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 Evidence Based Chronic Disease Prevention

13. Issue Statement • A concise written statement of the public health problem or policy under consideration. • Hypotheses • Question Evidence Based Chronic Disease Prevention

14. 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? Evidence Based Chronic Disease Prevention

15. 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 Evidence Based Chronic Disease Prevention

16. 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) Evidence Based Chronic Disease Prevention

17. 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) Evidence Based Chronic Disease Prevention

18. Developing an Issue Statement:What 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. Evidence Based Chronic Disease Prevention

19. 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. Evidence Based Chronic Disease Prevention

20. 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? Evidence Based Chronic Disease Prevention

21. 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? Evidence Based Chronic Disease Prevention

22. 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? Evidence Based Chronic Disease Prevention

23. 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? Evidence Based Chronic Disease Prevention

24. 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. Evidence Based Chronic Disease Prevention

25. 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) Evidence Based Chronic Disease Prevention

26. Issue Statement: Examples • Keys in this phase of problem definition • Avoid early judgments • Encourage creative thinking • Make problem statements quantifiable Evidence Based Chronic Disease Prevention

27. Remember the Elements of Strategic Planning • Vision, mission, values • Environmental assessment • Strategic issues & goals • Outcomes and outcome measures • Objectives and strategies • Evaluation and results Evidence Based Chronic Disease Prevention