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Public Health Practice Council Meeting

SUMMARY NOTES - THURSDAY, MARCH 15, 2007

Roybal Campus, Building 19, Room 232, Auditorium B3

9:00 am -- 10:30 am

Attendees/ Organizational Unit

  -----------------------------------------------------------------------
  Stephanie Bailey / OCPHP

  Grant Baldwin / NCIPC

  Joe Boone / NCPDCID

  Sharunda Buchanan / NCEH/ATSDR/EEHS

  Joan Cioffi / OWCD

  Liza Corso / OCPHP /OSEIP

  Michael Dalmat / NCCDPHP

  Teresa Daub / OCPHP/OSEIP

  Sue Dietz / OWCD

  Donna Garland / OEC

  Maurine Goodman / OCSO

  Mike Herring / NCEH/EEHS

  Dennis Lenaway / OCPHP/OSEIP

  Amy Loy / OCOO/PMP

  Angela Marr / NCIPC

  Tony Moulton /OCPHP/PHLP

  Dara Murphy / NCCDPHP

  Glen Nowack / OEC

  Candice Nowicki / OCOO

  Ursula Phoenix Weir / OCPHP/OSEIP

  Marilyn Radke / NIOSH

  Montrece Ransom / OCPHP

  Mike Sage / OCOO

  Tony Santarserio / NCHM

  Richard Schieber / NCIRD

  Christa Singleton / COTPER

  Karen Steinberg / CCHP

  Andre Verani / OCPHP/PHLP

  Cathleen Walsh / NCHSTP

  Trevor Woollery / OCSO/OPHR
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Logistics

[Adoption of Charter]{.underline}: Ursula Phoenix Weir reviewed recent
changes to the PHPC, including the addition of formal definition of
Public Health Practice (per ASPH), and a new section on the PHPC
decision making process. Dr. Bailey moved for acceptance of the revised
Charter. The motion was carried and the PHPC Charter was formally
adopted.

[Email Address]{.underline}: Ursula Phoenix Weir detailed the
establishment of a new email box dedicated to receipt and dissemination
of general information related to the PHPC. The PHPC can be reached by
emailing [**phpc@cdc.gov**](mailto:phpc@cdc.gov). Agenda items may be
submitted to the email box for consideration by the Chair and
Vice-Chair.

Announcements

[Health Systems Research Work Group (HSRWG)]{.underline}: Joe Boone gave
a short overview of the new HSRWG that, similar to the PHPC, supports
the expanded use of health systems research to public health. Members of
the HSRWG (Joe Boone, Richard Schieber, and Cathleen Walsh) have joined
the PHPC to give advice on ways to enhance both research and the
translation of research findings into practice.

[CLC's Commitment to Translating Science into Practice]{.underline}: Jay
Bernhardt provided information on the Center Leadership Council's new
initiative to translate science into practice. The goals of the effort
are to identify what CDC is already doing as an agency for translation
of science into practice; and develop one or more standardized models
and/or approaches of effective translation systems.

["The Local Health Department Workforce"]{.underline}: Teresa Daub and
Joan Cioffi provided a short overview of NACCHO's recently released
report to their *2005 Profile* study. Funded by CDC, the report entitled
"*The Local Health Department Workforce,"* summarizes information
collected in the *2005 Profile* study to examine several aspects of the
Local Health Department (LHD) workforce: characteristics of workers,
potential workforce shortages, and workforce trainings. To download a
copy of this report, and other LHD reports, visit:
[**http://www.naccho.org/topics/infrastructure/2005Profile.cfm**](http://www.naccho.org/topics/infrastructure/2005Profile.cfm).

Workgroup Activity

Dr. Bailey The body broke into 3 self-selected workgroups organized by
the top public health practice issues. The 3 workgroups are: Group 1)
Translation of Science into Practice; Group 2) Establish Conceptual
Framework of Performance of Public Health Systems; and Group 3)
Facilitate Building Infrastructure at the Local, State, National, and
International Levels. Dr. Bailey charged each group with developing a
work strategy, and discussing and further defining the concept of each
practice issue. A white paper and or policy statement will be developed,
based on recommendations from the workgroups, which will be used to
transform practice.

Below are highlights from each workgroup discussion:

Group 1: Translation of Science into Practice

Team Lead: Cathleen Walsh

Facilitator: Tony Moulton, Co-Director, Public Health Law Program, OCPHP

Workgroup Participants:

Grant Baldwin, Acting Deputy Director, NCIPC

Jay Bernhardt, Director, NCHM

Peter Briss, Associate Director for Science, CCEHIP

Sue Dietz, Acting Associate Director for Program Planning, OCWD

Maurine Goodman, Scientific Review Administrator, OCSO/OPHR

Glen Nowak, Chief of Media Relations, OD/OEC

Rich Schieber, Medical Epidemiologist, NCIRD

Christa Singleton, Associate Director for Science, COTPER/DSLR

Cathleen Walsh, Acting Chief, Health Services Research and Evaluation,
NCHSTP/DSTDP

Workgroup Lead: Cathleen Walsh generously agreed to serve as workgroup
lead.

Principal Discussion Points:

1.  Coordination of Efforts - Workgroup members discussed the
    interrelationship of this Public Health Practice Council (PHPC)
    workgroup with two related efforts at CDC: the new initiative of the
    Center Leadership Council (CLC) to improve translation of science
    into practice, and the Health Systems Research Workgroup (a CDC-wide
    group convened by the Office of the Chief of Science).

> Jay Bernhardt described the CLC initiative. He, Sue Dietz, and Grant
> Baldwin serve on the steering committee of the CLC's translation
> workgroup which is planning the following steps:

a.  In April, convene a meeting of CDC experts in translation to kick
    off the initiative

b.  Inventory and analyze translation-related projects and work
    underway, both at CDC and externally; attempt to identify conceptual
    models of effective translation, possibly in consultation with
    extramural experts

c.  Prepare one or more standardized models of effective translation
    systems

d.  Develop an implementation plan to disseminate models to end users,
    including explanation of their benefits and operation

e.  Engage partners (e.g., ASTHO and NACCHO) in shaping and conducting
    this initiative.

f.  Consider inclusion of "consumer health surveillance" in CDC's
    conventional health surveillance activities.

The CLC workgroup is considering establishing a community-level
"laboratory" to test and refine effective ways to communicate with the
public. This idea potentially could be expanded to include testing ways
to effectively translate science into front-line practice.

It was noted that a major element of the CLC's charter is assurance of
the quality of CDC's science and that the CLC's translation workgroup
likely is more familiar with the conduct of science intramurally than
with extramural practice. Many members of the PHLC, on the other hand,
have had professional experience in public health practice, including
service in state and local health departments, and could bring that
perspective to bear. The two workgroups thus could work together in a
complementary manner, the PHPC workgroup focusing largely on extramural
practice and the CLC workgroup largely on intramural science.

It was suggested that the PHPC could have members on the CLC translation
workgroup and/or serve in an advisory capacity to the CLC workgroup.

The purview of the Health Systems Research Workgroup includes, but is
broader than, translation of science into practice. Further discussion
is needed to explore coordination possibilities.

2.  Scope and End Users - Workgroup members noted that an issue critical
    to CDC's goals of translating science into improved actual practice
    is to correctly identify the end-users who effectuate translation.
    It was pointed out that some scientists consider their work done
    when research findings are published in a peer-reviewed journal.
    While that step can be vital in the translation process, the
    workgroup considered that translation is most effective when
    front-line practitioners and policy makers have access to actionable
    information relevant to their settings.

> The workgroup also believed that CDC's translation initiative should
> seek to identify end-users systematically and, by way of example, that
> they likely are located both in state and local public health agencies
> and also in a range of other public and private settings.

3.  Governance and Institutionalization - Many of the workgroup members
    have been active for some years in CDC's ongoing work to improve
    translation. Members made the point that achieving a new level of
    success---and, crucially, maintaining the momentum
    permanently---will hinge on institutionalizing translation at CDC.
    The work group discussed several alternative approaches and believed
    that this goal itself should be part of the initiative. The
    Community Guide has made important strides in this area and should
    be part of the system.

> Closely related is the need for a governance structure. Members
> pointed out that this initiative is horizontal in scope (cutting
> across most CDC programs) in a largely vertical organization. A
> governance structure for the CDC-wide translation initiative could
> involve connections with the ELB, CLC, and the Excellence in Science
> Committee, among other bodies.

4.  Existing CDC Translation Successes - The point was made, and
    appreciated, that many CDC programs engage in effective translation,
    that their work should be recognized, and that it can serve as a
    valuable foundation for the new initiative.

Next Steps

1.  To take a concrete step toward coordination, Jay Bernhardt
    recommended that members of the PHPC translation workgroup attend
    the April meeting of the CLC workgroup. He will send information
    about the meeting as it becomes available.

2.  Chief of Public Health Practice Dr. Stephanie Bailey requested that
    workgroup lead Cathleen Walsh join her and leads of the other PHPC
    workgroups for planning purposes before the meeting of the PHPC on
    April 19 (9:00-10:30 in the Distance Learning Auditorium of the Tom
    Harkin Global Communications Center/Building 19).

3.  Some of the topics the PHPC workgroup will explore in upcoming
    meetings include:

-   Selecting priority issues the workgroup will address, including
    "quick wins" to jump-start the translation process

-   Considering ways to encourage or require CDC grantees to expand
    their translation efforts (e.g., by including scored criteria for
    translation in grant applications)

-   Considering incentives and other measures for greater attention to
    translation by CDC professionals, e.g., including
    translation-related elements in personal work plans

-   Considering, in addition, whether CDC should develop a cadre of
    "professional translators".

Group 2: Establish conceptual framework of performance of public health
systems

Team Lead: Sharunda Buchanan (NCEH)

Facilitator: Ursula Phoenix Weir (OCPHP)

Workgroup Participants:

Joe Boone, Acting Director, Division of Laboratory Systems (NCPDCID)

Sharunda Buchanan, Director, Division of Emer. & Environmental Health
Services (NCEH)

Liza Corso, Team Lead, Performance Standards & Accreditation (OCPHP)

Donna Garland, Director, Office of Enterprise Communication (OD)

Dennis Lenaway, Director, Office of Standards and Emerging Issues in
Practice (OCPHP)

Dara Murphy, Management Officer (NCCDPHP)

Trevor Woollery, Team Lead, Strategy and Evaluation (OCSO)

Workgroup Lead: A volunteer was solicited to serve as the workgroup team
lead and Dr. Sharunda Buchanan agreed to serve in this capacity.

Principle Discussion Points:

1.  Group Interest - Group members introduced themselves and briefly
    shared what prompted them to self-select the "systems" workgroup.
    Some group members felt compelled to join the "systems" workgroup as
    the topic directly relates to their respective jobs. Others were
    drawn to the workgroup as the topic of "systems" is most often left
    out of, or placed at the end of, many broader public health
    discussions. While others suggested that the workgroup offers an
    opportunity to "bridge the gap" and explore the measurement of
    performance from a practice perspective.

2.  Understanding the Charge -- Workgroup members spent a considerable
    amount of time reviewing the issue topic and attempting to
    understand the author's original intent. The group agreed that the
    issue should be further defined as the whole concept of "conceptual
    frameworks" is not fully understood. The group discussed the
    importance of understanding and defining what is meant by "Establish
    a Conceptual Framework." To achieve appropriate results, the group
    agreed that the issue topic should be re-written to address the
    *"identification of existing frameworks*," rather than
    "*establishing*" frameworks.

3.  Understanding the Landscape of Conceptual Frameworks -- The
    workgroup discussed the need to have an idea of the landscape of
    "conceptual frameworks" in the field. The group agreed that it will
    be important to examine conceptual frameworks that are already in
    place and attempt to understand why they have not received the
    attention. Several members of the group shared information on
    existing conceptual models that may be further explored for
    consideration and analysis. Liza Corso shared examples of existing
    models such as the Turning Point Performance Management Framework
    and their \"*Silos to Systems*\" effort, as well as their new
    version of the Public Health Memory Jogger II that is currently in
    progress. Dara Murphy shared information on a systems dynamics
    framework that may also serve as a candidate for a conceptual
    framework. Liza and Dara agreed to send more information on the
    models for the groups review.

4.  Establishing Our "Quick Wins" - The workgroup discussed the need to
    establish quick wins and then use the wins to advance the issue
    topic. The following quick wins were discussed and agreed upon:

-   Study Landscape: Explore the landscape and pull in existing
    models/tools to better understand what we collectively know about
    conceptual frameworks that exist in the field.

-   Establish Criteria/Filter: Do a cross-comparison of the models/tools
    and establish criteria for rating/ranking the models and materials
    that have been found; also establish a system of filtering to select
    models that warrant more discussion.

-   Examine Findings: Report out and provide an analysis to the larger
    PHPC body on what we have found among the more promising
    models/tools and solicit feedback.

-   Vet: For those tools/models that show promise, have a broader forum
    and invite the Agency to comment; also place the analysis on the web
    to be vetted by the Agency via CDC Connects (i.e. CDC Blog). Other
    formal groups within the Agency will be considered to review and
    comment on the analysis (i.e. the Public Health Systems Research
    Workgroup)

5.  Next Steps - Members agreed to send examples of conceptual
    frameworks for the group to review and discuss at the next PHPC
    meeting on April 19.

Group 3: Facilitate building infrastructure at the local, state,
national, and international levels

Team Lead: Joan Cioffi (OWCD)

Facilitator: Amy Loy (OCOO/PMP)

Workgroup Participants

Joan Cioffi (OWCD)

Michael Dalmat, NCCDPHP\
Teresa Daub, OCPHP/OSEIP\
Mike Herring, NCEH, EEHS/EHSB\
Angela Marr, NCIPC\
Candice Nowicki, OCOO/PMP\
Marilyn Radke, OCSO, OSRS\
Tony Santarsiero, NCHM/DPSA

*\~ GROUP 3 SUMMARY NOTES FORTHCOMING AT A LATER DATE\~*

Next Steps:

Dr. Bailey and Mike Sage requested an interim meeting with workgroup
team leads and facilitators to further discuss workgroup strategy and
assure workgroup conversations are moving and supported at the highest
levels.

Next Meeting:

The next meeting of the PHPC will be Thursday, April 19, 9:00am -
10:30am, Building 19, Distance Learning Auditorium.