Objectives

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2. Understand the relationship between the Core Functions and Ten essential Services of Public (NPHPS) health to MAPP to the NPHPS. Understand the purpose and benefits of the MAPP process. Recognize how the Core Functions and Ten Essential Services of Public Health relate to the phases and assessments of the MAPP model of public health practice. Objectives Welcome to the �Core Functions and ten Essential Services of Public Health and MAPP�. The goal of this module is to understand the relationship between the Core Functions and Ten Essential Services of Public Health (National Public Health Performance Standards-NPHPS) and the MAPP (Mobilizing for Action through Planning and Partnerships) model of public health planning. When the module is complete you will: Be familiar with the relationship between the NPHPS-The Core Functions and Ten Essential Services of Public Health and the MAPP model. Be familiar with the concepts on which the MAPP model is based. Understand the purpose and benefits of the MAPP process. Recognize the assessments and phases of MAPP. Understand how the skills of MAPP lead to the practice of public health planning in keeping with the Core Functions and Ten Essential Services. Welcome to the �Core Functions and ten Essential Services of Public Health and MAPP�. The goal of this module is to understand the relationship between the Core Functions and Ten Essential Services of Public Health (National Public Health Performance Standards-NPHPS) and the MAPP (Mobilizing for Action through Planning and Partnerships) model of public health planning. When the module is complete you will: Be familiar with the relationship between the NPHPS-The Core Functions and Ten Essential Services of Public Health and the MAPP model. Be familiar with the concepts on which the MAPP model is based. Understand the purpose and benefits of the MAPP process. Recognize the assessments and phases of MAPP. Understand how the skills of MAPP lead to the practice of public health planning in keeping with the Core Functions and Ten Essential Services.

3. The Core Functions Assessment Surveillance of disease/injury Monitor trends, analyze causes Policy Development Plans and policies for public health in general and priority health needs Assurance Implementation of statutory mandates and responsibilities Working independently and with partners to assure that public health activities are carried out The Core Functions of Public Health In 1988 the Institute of Medicine (IOM), in their landmark report, The Future of Public Health, critically assessed the status of public health in the United States. The IOM formulated a three-part statement of the fundamental purpose of public health. These core functions are: Assessment The regular collection, analysis, interpretation and communication of information about health conditions, risks and assets in a community Policy Development The development, implementation, and evaluation of plans and policies, for public health in general and priority health needs in particular, in a manner that incorporates scientific information and community values Assurance Implementation of statutory mandates and responsibilities Working independently and with partners to assure that public health activities are carried out In 1988 the Institute of Medicine (IOM), in their landmark report, The Future of Public Health, critically assessed the status of public health in the United States. The IOM formulated a three-part statement of the fundamental purpose of public health. These core functions are: Assessment The regular collection, analysis, interpretation and communication of information about health conditions, risks and assets in a community Policy Development The development, implementation, and evaluation of plans and policies, for public health in general and priority health needs in particular, in a manner that incorporates scientific information and community values Assurance Implementation of statutory mandates and responsibilities Working independently and with partners to assure that public health activities are carried out

4. How Do the Core Functions and Ten Essential Services Relate to MAPP? MAPP is a strategic planning model with a framework that encourages and facilitates public health practice based on forming partnerships to accomplish the core functions of assessment, policy development and assurance for improved public health outcomes. MAPP is unique in that it includes the local public health system assessment, an assessment process which leads to system wide policy development and assurance activities. The component that makes MAPP unique from other strategic health planning models used in the past is MAPP�s emphasis on a system-wide broader definition of public health- the local public health system, LPHS. One of the four assessments of the MAPP model is the Local Public Health System Assessment. It is this assessment which strongly ties the MAPP model to the NPHPS. The NPHPSP standards identify the optimal level of performance for state and local public health systems (all organizations that contribute to public health in a given area) and governing bodies. The NPHPSP seeks to ensure that strong effective public health systems are in place to deliver essential public health services. MAPP provides the framework and process for improving upon the strengths and weaknesses of the LPHS. The process of organizing system partners and conducting the assessment and collecting and analyzing the results together can be a strong catalyst for developing system wide improvement plans and progress monitoring. All of these activities fall under the Core Functions of Assessment, Policy Development and Assurance. 

5. How Do the Core Functions and Ten Essential Services Relate to MAPP? The local public health assessment instrument of the NPHPS is used in the local public health assessment, one of the four assessments in the MAPP model. The tool used with the local public health system assessment- LPHSA, one of the four assessments of MAPP is the NPHPSP Local Instrument. The LPHSA assessment helps community partners determine the system's areas for improvement which should be included as part of the overall MAPP action plan. It also provides information about system strengths and capacities, which will help the community to determine its capability to accomplish its health improvement plan. It is the LPHSA which provides the strongest link between the NPHPS and the MAPP model. The tool used with the local public health system assessment- LPHSA, one of the four assessments of MAPP is the NPHPSP Local Instrument. The LPHSA assessment helps community partners determine the system's areas for improvement which should be included as part of the overall MAPP action plan. It also provides information about system strengths and capacities, which will help the community to determine its capability to accomplish its health improvement plan.

6. How Do the Core Functions and Ten Essential Services Relate to MAPP? The MAPP model includes three other assessments that address the strengths, weaknesses, challenges and opportunities that exist in the community and are usually identified during the LPHSA. Also, because MAPP includes three other assessments in addition to the information collected in the local public health system assessment, the community health improvement plan truly addresses the gamut of strengths, weaknesses, challenges and opportunities that exist in the community. Through out this training we will learn about each of the assessments and phases of MAPP and how they relate to the Core Functions and Ten Essential Services of public health practice.Also, because MAPP includes three other assessments in addition to the information collected in the local public health system assessment, the community health improvement plan truly addresses the gamut of strengths, weaknesses, challenges and opportunities that exist in the community. Through out this training we will learn about each of the assessments and phases of MAPP and how they relate to the Core Functions and Ten Essential Services of public health practice.

7. MAPP is��. A community-wide strategic planning tool for improving public health. A method to help communities prioritize public health issues, identify resources for addressing them, and take action. The MAPP model provides a framework for public health practice in accordance with the Core Functions and Ten Essential Services. Now let�s look at MAPP in more detail in order to understand how it serves to foster public health planning according to the Core Functions and Ten Essential Services of Public Health. The MAPP acronym stands for Mobilizing for Action through Planning and Partnerships. MAPP was developed through a cooperative agreement between the National Association of County and City Health Officials (NACCHO) and the Centers for Disease Control and Prevention (CDC) in 2001. MAPP is a community-wide strategic planning tool for improving public health, as well as an action oriented process to help communities prioritize public health issues, identify resources for addressing them, and take action. The MAPP model was also intended to be used as a strategic planning tool by internal partners of public health to improve public health practice in accordance with the National Public Health Performance Standards.Now let�s look at MAPP in more detail in order to understand how it serves to foster public health planning according to the Core Functions and Ten Essential Services of Public Health. The MAPP acronym stands for Mobilizing for Action through Planning and Partnerships. MAPP was developed through a cooperative agreement between the National Association of County and City Health Officials (NACCHO) and the Centers for Disease Control and Prevention (CDC) in 2001. MAPP is a community-wide strategic planning tool for improving public health, as well as an action oriented process to help communities prioritize public health issues, identify resources for addressing them, and take action. The MAPP model was also intended to be used as a strategic planning tool by internal partners of public health to improve public health practice in accordance with the National Public Health Performance Standards.

8. MAPP Overview Both of the graphics depicted above are widely used on MAPP materials. The roadmap graphic is a familiar metaphor for people in the broader community. Note that the destination, �A Healthier Community,� appears to be a long way off! There are really many destinations between where you begin and �A Healthier Community.� MAPP helps local public health system partners prioritize, set realistic action plans, and celebrate successes along the way. Put another way, using MAPP is like taking a trip. MAPP can help you figure out where you want to go, how to get there, what resources you will need and who needs to come along! The arrow model may be more appealing to those in the public health workforce because they may have more understanding of the importance of assessments and the role of formulating goals and strategies and implementing action plans to improve population based health outcomes. The arrow model lists the MAPP steps down the center and is surrounded by the four assessments. MAPP is not a project with a beginning and end date. MAPP is an iterative process, meaning the steps are repeated again and again. The steps and phases of MAPP are not performed in a linear manner. Some steps and phases may be conducted simultaneously, but most importantly, MAPP is most effective when the beliefs and priorities of the local public health system as a whole are considered rather than the select views and agendas of individuals or single health agencies. MAPP is a process that fosters consensus building and sharing of ideas and resources for maximum output.Both of the graphics depicted above are widely used on MAPP materials. The roadmap graphic is a familiar metaphor for people in the broader community. Note that the destination, �A Healthier Community,� appears to be a long way off! There are really many destinations between where you begin and �A Healthier Community.� MAPP helps local public health system partners prioritize, set realistic action plans, and celebrate successes along the way. Put another way, using MAPP is like taking a trip. MAPP can help you figure out where you want to go, how to get there, what resources you will need and who needs to come along! The arrow model may be more appealing to those in the public health workforce because they may have more understanding of the importance of assessments and the role of formulating goals and strategies and implementing action plans to improve population based health outcomes. The arrow model lists the MAPP steps down the center and is surrounded by the four assessments. MAPP is not a project with a beginning and end date. MAPP is an iterative process, meaning the steps are repeated again and again. The steps and phases of MAPP are not performed in a linear manner. Some steps and phases may be conducted simultaneously, but most importantly, MAPP is most effective when the beliefs and priorities of the local public health system as a whole are considered rather than the select views and agendas of individuals or single health agencies. MAPP is a process that fosters consensus building and sharing of ideas and resources for maximum output.

9. Three Keys to MAPP Strategic Thinking Community Driven Process Focus on the Local Public Health System-Partnership Building There are three keys or main concepts to MAPP. The first key is strategic thinking. MAPP is unique because it is based on strategic planning concepts, and - in order to be successful - requires creative, long-term strategic thinking. The second key to MAPP is that MAPP is a community, partner and team driven process. MAPP relies on participation from a wide range of individuals, groups, and constituencies in the community and the public health workforce. Since the partnership drives the process, the process has credibility, ensures buy-in and creates sustainability over time. It can also create greater advocacy for public health. The third key to making MAPP successful is the use of a broad definition of the Local Public Health System. This recognizes that public health is provided by more than just the local health department. Other organizations such as hospitals, businesses, faith organizations, and community-based organizations play a critical role in assuring the public�s health. MAPP supports the concept of �no one knows everything and everyone knows something!� There are three keys or main concepts to MAPP. The first key is strategic thinking. MAPP is unique because it is based on strategic planning concepts, and - in order to be successful - requires creative, long-term strategic thinking. The second key to MAPP is that MAPP is a community, partner and team driven process. MAPP relies on participation from a wide range of individuals, groups, and constituencies in the community and the public health workforce. Since the partnership drives the process, the process has credibility, ensures buy-in and creates sustainability over time. It can also create greater advocacy for public health. The third key to making MAPP successful is the use of a broad definition of the Local Public Health System. This recognizes that public health is provided by more than just the local health department. Other organizations such as hospitals, businesses, faith organizations, and community-based organizations play a critical role in assuring the public�s health. MAPP supports the concept of �no one knows everything and everyone knows something!�

10. Strategic Thinking Requires broad-scale information gathering Encourages exploration of alternatives Places emphasis on future implications of present decisions Facilitates communication and participation Accommodates divergent interests and values Let�s focus on strategic thinking by looking at strategic planning. MAPP is different from previous public health planning tools in that it introduces strategic thinking - via strategic planning - into public health planning efforts. Strategic thinking requires broad-scale information gathering: An exploration of alternatives And an emphasis on the future implications of present decisions.� It can facilitate communication and participation, And accommodate divergent interests and values, and foster orderly decision-making and successful implementation. For example, in traditional public health planning you may have only taken into consideration public health data and contributing health determinants to determine priority public health issues. But thinking strategically means looking at multiple sources of information - such as local perceptions about health and the community, public health data and trends, information about how the public health system is operating, gaps in services, and forces of change such as new legislation or funding decreases. When thinking strategically you take into consideration the kinds of things that MIGHT happen if you implement certain activities intended for predetermined solutions to public health concerns. Using the MAPP model requires maximum input from individuals representing diverse organizations and perspectives. By looking at multiple sources of information, thinking about future implications of decisions, and using broad input, you�ll develop a stronger community health improvement plan that has a better likelihood for success and sustainability.Let�s focus on strategic thinking by looking at strategic planning. MAPP is different from previous public health planning tools in that it introduces strategic thinking - via strategic planning - into public health planning efforts. Strategic thinking requires broad-scale information gathering: An exploration of alternatives And an emphasis on the future implications of present decisions.� It can facilitate communication and participation, And accommodate divergent interests and values, and foster orderly decision-making and successful implementation. For example, in traditional public health planning you may have only taken into consideration public health data and contributing health determinants to determine priority public health issues. But thinking strategically means looking at multiple sources of information - such as local perceptions about health and the community, public health data and trends, information about how the public health system is operating, gaps in services, and forces of change such as new legislation or funding decreases. When thinking strategically you take into consideration the kinds of things that MIGHT happen if you implement certain activities intended for predetermined solutions to public health concerns. Using the MAPP model requires maximum input from individuals representing diverse organizations and perspectives. By looking at multiple sources of information, thinking about future implications of decisions, and using broad input, you�ll develop a stronger community health improvement plan that has a better likelihood for success and sustainability.

11. Community Driven Process Mobilizing and engaging the community Action with and by the community Planning driven by the community Partnerships to strengthen the community The second key to MAPP is that it is a community driven process. The community helps bring about collective thinking that results in effective, sustainable solutions to complex problems that are relevant to a given community. When people with different points of view come together they develop solutions to problems that may be better and more creative than those designed by a select group of public health professionals working internally. MAPP serves as a tool for including diverse portions of the community and thereby maximizes the creative resources of the community. When ownership of the problems and solutions includes a broad base of the community, the effort is sustainable, actions build on collective wisdom, and resources from throughout the community contribute to health improvement planning and long term healthy outcomes. Example: For example, a hospital in a rural Georgia was going to close for financial reasons. The community pulled together, and assembled a broad base of citizens, business representatives, and local government officials. These partners were able to keep the hospital open. By collecting and assessing data, the community worked together to identify additional problems and contributing factors. Through the efforts of the bank, businesses, citizens, and local government the county was successful in not only preserving the hospital, but recruiting new physicians to the community and creating a hospital oversight committee (NACCHO). MAPP provides this kind of strategic thinking and creative planning. The second key to MAPP is that it is a community driven process. The community helps bring about collective thinking that results in effective, sustainable solutions to complex problems that are relevant to a given community. When people with different points of view come together they develop solutions to problems that may be better and more creative than those designed by a select group of public health professionals working internally. MAPP serves as a tool for including diverse portions of the community and thereby maximizes the creative resources of the community. When ownership of the problems and solutions includes a broad base of the community, the effort is sustainable, actions build on collective wisdom, and resources from throughout the community contribute to health improvement planning and long term healthy outcomes. Example: For example, a hospital in a rural Georgia was going to close for financial reasons. The community pulled together, and assembled a broad base of citizens, business representatives, and local government officials. These partners were able to keep the hospital open. By collecting and assessing data, the community worked together to identify additional problems and contributing factors. Through the efforts of the bank, businesses, citizens, and local government the county was successful in not only preserving the hospital, but recruiting new physicians to the community and creating a hospital oversight committee (NACCHO). MAPP provides this kind of strategic thinking and creative planning.

12. Local Public Health System The third component that makes MAPP unique - after strategic thinking and community participation - is MAPP�s emphasis on system-wide involvement, and a broader definition of public health. The local public health system includes all public, private and voluntary entities, as well as individuals and informal associations that contribute to public health services. MAPP brings all of these diverse interests together to determine the most effective way to conduct public health activities. No organization singularly provides health services in a community. MAPP recognizes the important contributions of all entities involved in the local public health system and provides a process for coming together and planning how to provide better health services. The third component that makes MAPP unique - after strategic thinking and community participation - is MAPP�s emphasis on system-wide involvement, and a broader definition of public health. The local public health system includes all public, private and voluntary entities, as well as individuals and informal associations that contribute to public health services. MAPP brings all of these diverse interests together to determine the most effective way to conduct public health activities. No organization singularly provides health services in a community. MAPP recognizes the important contributions of all entities involved in the local public health system and provides a process for coming together and planning how to provide better health services.

13. The MAPP Paradigm Shift MAPP is said to be a paradigm shift in public health practice. MAPP is a paradigm shift in how we think about public health planning. It is a shift from operational to strategic planning; from a focus on the agency to a focus on the community and the entire public health system; from needs assessment to an emphasis on assets and resources; from a medically or service oriented model to a model that encompasses a broad definition of health; and from an �agency knows all� perspective to the belief that �everyone knows something.� MAPP is a way of bringing everyone�s collective wisdom together. By gathering all of the assets and resources within the community, the community is able to determine how best to use collective wisdom to create a healthier community. Such a paradigm shift means that MAPP is a �new way of doing business.� MAPP is said to be a paradigm shift in public health practice. MAPP is a paradigm shift in how we think about public health planning. It is a shift from operational to strategic planning; from a focus on the agency to a focus on the community and the entire public health system; from needs assessment to an emphasis on assets and resources; from a medically or service oriented model to a model that encompasses a broad definition of health; and from an �agency knows all� perspective to the belief that �everyone knows something.� MAPP is a way of bringing everyone�s collective wisdom together. By gathering all of the assets and resources within the community, the community is able to determine how best to use collective wisdom to create a healthier community. Such a paradigm shift means that MAPP is a �new way of doing business.�

14. MAPP Overview Six phases Organize for Success and Partnership Development Build commitment, engage participants, develop plan Visioning �What would we like our community to look like in 10 years?� There are six phases in the MAPP process. The phases are shown in the center of the model, while the four MAPP assessments�the key content areas that drive the process�are shown in the four outer arrows. To initiate the MAPP process, lead organizations in the community begin by: Organizing themselves and preparing to implement MAPP (Organize for Success and Partnership Development). These first two phase allow you to plan a MAPP process that builds commitment, engages participants, uses their time well, and results in a plan that can be implemented successfully. Community-wide health improvement planning requires a high level of commitment from partners, stakeholders, and the community residents who are recruited to participate. Partnership development is the foundation of a successful MAPP process. Without strong partnerships, the processes will flounder and action planning will stall. The third phase is Visioning. A shared vision and common values provide a framework for pursuing long-range community goals. During this phase, the community answers questions such as �What would we like our community to look like in 10 years?� Because visioning takes place early in the MAPP process, it is a useful mechanism for convening the community and building enthusiasm for the process.There are six phases in the MAPP process. The phases are shown in the center of the model, while the four MAPP assessments�the key content areas that drive the process�are shown in the four outer arrows. To initiate the MAPP process, lead organizations in the community begin by: Organizing themselves and preparing to implement MAPP (Organize for Success and Partnership Development). These first two phase allow you to plan a MAPP process that builds commitment, engages participants, uses their time well, and results in a plan that can be implemented successfully. Community-wide health improvement planning requires a high level of commitment from partners, stakeholders, and the community residents who are recruited to participate. Partnership development is the foundation of a successful MAPP process. Without strong partnerships, the processes will flounder and action planning will stall. The third phase is Visioning. A shared vision and common values provide a framework for pursuing long-range community goals. During this phase, the community answers questions such as �What would we like our community to look like in 10 years?� Because visioning takes place early in the MAPP process, it is a useful mechanism for convening the community and building enthusiasm for the process.

15. MAPP Overview (cont.) Six phases (cont.) Four MAPP Assessments Community Themes and Strengths �What is important to our community?� Local Public Health System �How are the Essential Services being provided?� Next, the four MAPP Assessments are conducted, providing critical insights into challenges and opportunities throughout the community. The Community Themes and Strengths Assessment provides a deep understanding of the issues residents feel are important by answering the questions, �What is important to our community� and �How is quality of life perceived in our community?� and �What assets do we have that can be used to improve community health?� The Local Public Health System Assessment is a comprehensive assessment of all of the organizations and entities that contribute to the public�s health. This assessment answers the questions, �What are the activities, competencies, and capacities of our local public health system?� and �How are the Essential Services being Provided to our community?�Next, the four MAPP Assessments are conducted, providing critical insights into challenges and opportunities throughout the community. The Community Themes and Strengths Assessment provides a deep understanding of the issues residents feel are important by answering the questions, �What is important to our community� and �How is quality of life perceived in our community?� and �What assets do we have that can be used to improve community health?� The Local Public Health System Assessment is a comprehensive assessment of all of the organizations and entities that contribute to the public�s health. This assessment answers the questions, �What are the activities, competencies, and capacities of our local public health system?� and �How are the Essential Services being Provided to our community?�

16. MAPP Overview (cont.) Four MAPP Assessments (cont.) Community Health Status �How healthy are our residents?� Forces of Change What is occurring or might occur that affects the health of our community or LPHS?� The Community Health Status Assessment identifies priority issues related to community health and quality of life. Questions answered during the phase include, �How healthy are our residents?� and �What does the health status of our community look like?� Activities that take place include accessing health data on CHARTS, reviewing and interpreting data and compiling a community health profile report for sharing and presentation. The Forces of Change Assessment focuses on the identification of forces such as legislation, technology, and other issues that affect the context in which the community and its public health system operates. This answers the questions, �What is occurring or might occur that affects the health of our community or the local public health system?� and �What specific threats or opportunities are generated by these occurrences?�The Community Health Status Assessment identifies priority issues related to community health and quality of life. Questions answered during the phase include, �How healthy are our residents?� and �What does the health status of our community look like?� Activities that take place include accessing health data on CHARTS, reviewing and interpreting data and compiling a community health profile report for sharing and presentation. The Forces of Change Assessment focuses on the identification of forces such as legislation, technology, and other issues that affect the context in which the community and its public health system operates. This answers the questions, �What is occurring or might occur that affects the health of our community or the local public health system?� and �What specific threats or opportunities are generated by these occurrences?�

17. MAPP Overview (cont.) Six phases (cont.) Identify Strategic Issues Formulate Goals and Strategies Action Cycle Plan Implement Evaluate Once a list of challenges and opportunities has been generated from each of the four assessments, the next phase is: Identify Strategic Issues. During this phase, participants identify linkages between the MAPP assessments to determine the most critical issues that must be addressed for the community to achieve its vision. After issues have been identified, participants Formulate Goals and Strategies for addressing each issue. During this phase it is important to look at a range of alternatives strategies and consider barriers to implementation before selecting from among the choices. The final phase is the Action Cycle during which participants plan, implement, and evaluate. These activities build upon one another in a continuous and interactive manner and ensure continued success. While this is the last phase, it is not the end. During this phase previous efforts may begin to show results. This can be a challenging phase because it may be difficult to sustain the process over time.Once a list of challenges and opportunities has been generated from each of the four assessments, the next phase is: Identify Strategic Issues. During this phase, participants identify linkages between the MAPP assessments to determine the most critical issues that must be addressed for the community to achieve its vision. After issues have been identified, participants Formulate Goals and Strategies for addressing each issue. During this phase it is important to look at a range of alternatives strategies and consider barriers to implementation before selecting from among the choices. The final phase is the Action Cycle during which participants plan, implement, and evaluate. These activities build upon one another in a continuous and interactive manner and ensure continued success. While this is the last phase, it is not the end. During this phase previous efforts may begin to show results. This can be a challenging phase because it may be difficult to sustain the process over time.

18. Monitor Health Status to Identify Community Health Problems Diagnose and Investigate Health Problems and Health Hazards in the Community Inform, Educate, and Empower People about Health Issues The MAPP Phases - Organize for Success, Partnership Development, Visioning and the Four Assessments provide a system for achieving the standards of the core function of Assessment. MAPP and The Core Function and Essential Services Most Associated with Assessment MAPP provides a system for accomplishing the standards of performance for the three Core Functions of Public Health and the associated Essential Public Health Services. The Essential Public Health Services have been incorporated into the MAPP model. From the early phases of organizing for success, partnership development and visioning to assessment, identifying and prioritizing issues to the action cycle, MAPP is a framework for practicing the Essential Public Health Services that should be undertaken by local public health systems. Standards for optimal performance of each service by the county health department and partners can be monitored utilizing the MAPP model. The first essential service most associated with the core function of Assessment is to �Monitor health status to identify and solve community health problems.� This service includes accurate diagnosis of the community�s health status; identification of threats to health; and determination of health service needs. An example of this service in practice would be the review of public health data and other local agency data. The second essential service associated with Assessment is �Diagnose and investigate health problems and health hazards in the community�. This service includes epidemiologic identification of emerging health threats; evaluating public health laboratory capacity, and evaluating active infectious disease epidemiology programs. The third essential service associated with Assessment is �Inform, educate, and empower people about health issues�. This service involves social marketing and targeted media communication; providing accessible health information resources at the community level and facilitating active collaboration with personal health care providers to reinforce health promotion messages and programs. This essential service is also associated with the next Core Function of Policy Development. MAPP provides a system for accomplishing the standards of performance for the three Core Functions of Public Health and the associated Essential Public Health Services. The Essential Public Health Services have been incorporated into the MAPP model. From the early phases of organizing for success, partnership development and visioning to assessment, identifying and prioritizing issues to the action cycle, MAPP is a framework for practicing the Essential Public Health Services that should be undertaken by local public health systems. Standards for optimal performance of each service by the county health department and partners can be monitored utilizing the MAPP model. The first essential service most associated with the core function of Assessment is to �Monitor health status to identify and solve community health problems.� This service includes accurate diagnosis of the community�s health status; identification of threats to health; and determination of health service needs. An example of this service in practice would be the review of public health data and other local agency data. The second essential service associated with Assessment is �Diagnose and investigate health problems and health hazards in the community�. This service includes epidemiologic identification of emerging health threats; evaluating public health laboratory capacity, and evaluating active infectious disease epidemiology programs. The third essential service associated with Assessment is �Inform, educate, and empower people about health issues�. This service involves social marketing and targeted media communication; providing accessible health information resources at the community level and facilitating active collaboration with personal health care providers to reinforce health promotion messages and programs. This essential service is also associated with the next Core Function of Policy Development.

19. Inform, educate, and empower people about health issues. Mobilize community partnerships to identify and solve health problems Develop Policies The MAPP Model The Essential Services Most Associated with Policy Development Policy development, the second of the core functions in public health, is the creation of comprehensive public health policies based on scientific knowledge. The essential services most associated with policy development are: 1. Inform, educate, and empower people about health issues. 2. Mobilize community partnerships to identify and solve health problems 3. Develop Policies Policy development activities conducted at federal, state, and local levels include the development of plans, priorities, statutes, ordinances, resource allocation, and program requirement identification. , Policy development also includes the development, implementation, and evaluation of plans and policies, for public health in general and priority health needs in particular, in a manner that incorporates scientific information and community values. The phases of MAPP that provide the guidance, tools and resources for accomplishing the core function of Policy Development are Identifying Strategic Issues and Formulating Goals and Strategies. Identifying strategic issues and forming goals and strategies is necessary for developing a plan of action which usually results in decisions made at the community level that reflect agreed upon policies and community norms or standards. It is also at this point in the MAPP process that partners within the local public health system assume roles and responsibilities for activities and strategies to be implemented in order to achieve the grander vision of �A Healthy Community�. When partners assume these roles and responsibilities, a cycle of planning is then set in motion which includes mechanisms for monitoring progress and tracking activities that didn�t work as well as those that do and for recognizing successes and unintended outcomes. Tracking action, monitoring, and documenting outcomes leads to the final phase of MAPP, the Action Cycle. Activities of the action cycle correspond to the core function of Assurance. Policy development, the second of the core functions in public health, is the creation of comprehensive public health policies based on scientific knowledge. The essential services most associated with policy development are: 1. Inform, educate, and empower people about health issues. 2. Mobilize community partnerships to identify and solve health problems 3. Develop Policies Policy development activities conducted at federal, state, and local levels include the development of plans, priorities, statutes, ordinances, resource allocation, and program requirement identification. , Policy development also includes the development, implementation, and evaluation of plans and policies, for public health in general and priority health needs in particular, in a manner that incorporates scientific information and community values. The phases of MAPP that provide the guidance, tools and resources for accomplishing the core function of Policy Development are Identifying Strategic Issues and Formulating Goals and Strategies. Identifying strategic issues and forming goals and strategies is necessary for developing a plan of action which usually results in decisions made at the community level that reflect agreed upon policies and community norms or standards. It is also at this point in the MAPP process that partners within the local public health system assume roles and responsibilities for activities and strategies to be implemented in order to achieve the grander vision of �A Healthy Community�. When partners assume these roles and responsibilities, a cycle of planning is then set in motion which includes mechanisms for monitoring progress and tracking activities that didn�t work as well as those that do and for recognizing successes and unintended outcomes. Tracking action, monitoring, and documenting outcomes leads to the final phase of MAPP, the Action Cycle. Activities of the action cycle correspond to the core function of Assurance.

20. Enforce Laws Link to and provide care Assure a competent workforce Evaluate The MAPP Model The Essential Services Most Associated with Assurance Assurance is the third core function of public health. The essential services most associated with assurance are: *Enforce Laws * Assure a competent workforce *Link to and provide care * Evaluate Assurance is defined as �Ensuring- by encouragement, regulation, or direct action- that programs and interventions that maintain and improved health are carried out.� (Institute of Medicine (1988) and Washington State Department of Health (1994). While the Action Cycle of MAPP primarily focuses on the essential public health service of evaluation, the other three essential services can also addressed during this phase. For example, during the assessment phases of MAPP the county health department staff and partners might identify issues such as low immunization rates among kindergartners or seventh graders or it may be recognized that tobacco use laws are not being complied with by local businesses. Other examples could include low compliance with environmental health laws. It would be at this stage of the MAPP process that health department officials would use their leadership and authority to assure enforcement with public health law. The local public health system assessment and the health status assessment results might reveal that particular population groups in the community do not have access to health coverage or may experience barriers to accessing health services. Through the MAPP processes, strategies for addressing or assuring these population groups are linked to and provided care can be developed and implemented. Assuring a competent workforce is also critical to a well functioning local health system. It is the responsibility of the leadership of the local public health system partners to assure employees are well trained and able to respond to disasters and disease outbreaks. The Action Cycle links three key activities�planning, implementation and evaluation. Each of these builds upon each other in a continuous and interactive manner. While the Action Cycle is the final phase of MAPP, it is by no means the �end� of the process. Some community partners may view this as just the beginning, especially those whose energy and expertise is in implementation. During this step, the work of previous phases begin to produce results, as your local public health system partners develop and implement an action plan for addressing priority goals and objectives. This can be one of the most challenging phases, as it may be difficult to sustain the process and continue with implementation over time. Assurance is the third core function of public health. The essential services most associated with assurance are: *Enforce Laws * Assure a competent workforce *Link to and provide care * Evaluate Assurance is defined as �Ensuring- by encouragement, regulation, or direct action- that programs and interventions that maintain and improved health are carried out.� (Institute of Medicine (1988) and Washington State Department of Health (1994). While the Action Cycle of MAPP primarily focuses on the essential public health service of evaluation, the other three essential services can also addressed during this phase. For example, during the assessment phases of MAPP the county health department staff and partners might identify issues such as low immunization rates among kindergartners or seventh graders or it may be recognized that tobacco use laws are not being complied with by local businesses. Other examples could include low compliance with environmental health laws. It would be at this stage of the MAPP process that health department officials would use their leadership and authority to assure enforcement with public health law. The local public health system assessment and the health status assessment results might reveal that particular population groups in the community do not have access to health coverage or may experience barriers to accessing health services. Through the MAPP processes, strategies for addressing or assuring these population groups are linked to and provided care can be developed and implemented. Assuring a competent workforce is also critical to a well functioning local health system. It is the responsibility of the leadership of the local public health system partners to assure employees are well trained and able to respond to disasters and disease outbreaks. The Action Cycle links three key activities�planning, implementation and evaluation. Each of these builds upon each other in a continuous and interactive manner. While the Action Cycle is the final phase of MAPP, it is by no means the �end� of the process. Some community partners may view this as just the beginning, especially those whose energy and expertise is in implementation. During this step, the work of previous phases begin to produce results, as your local public health system partners develop and implement an action plan for addressing priority goals and objectives. This can be one of the most challenging phases, as it may be difficult to sustain the process and continue with implementation over time.

21. Benefits of MAPP Creates a healthy community and better quality of life Increases visibility of public health Anticipates and manages change Creates a stronger public health infrastructure Builds stronger partnerships Builds public health leadership Creates advocates for public health MAPP has many benefits. The MAPP process: Creates a healthy community and a better quality of life Increases visibility of public health within the community by implementing a participatory and highly publicized process Anticipates and manages change Creates a stronger public health infrastructure Builds stronger partnerships Builds public health leadership from the ground up Creates advocates for public health In the next modules of this training you will learn in detail how the phases and assessments of MAPP correspond and relate to the three Core Functions and ten Essential Services of Public Health.MAPP has many benefits. The MAPP process: Creates a healthy community and a better quality of life Increases visibility of public health within the community by implementing a participatory and highly publicized process Anticipates and manages change Creates a stronger public health infrastructure Builds stronger partnerships Builds public health leadership from the ground up Creates advocates for public health In the next modules of this training you will learn in detail how the phases and assessments of MAPP correspond and relate to the three Core Functions and ten Essential Services of Public Health.