A Field Guide

to Health Planning

2nd printing, February 2002
Developed by the Public Health Foundation,

under contract with the Office of Disease Prevention and Health Promotion,

Office of Public Health and Science, U.S. Department of Health and Human Services

First Printing, August 1999

Second Printing, February 2002

“Healthy People 2010 Toolkit: A Field Guide for Health Planning” was reprinted in February 2002. All web

addresses were updated as of 2/11/2002. The list of Healthy People State, Territorial, and Tribal Action Contacts

(Appendix B) was updated in August 2001. All other resources remain as published in August 1999. To see

additional examples of state Healthy People tools, please visit the State Healthy People 2010 Tool Library at

http://www.phf.org/HPtools/state.htm.

View and search the Toolkit on the web at http://www.health.gov/healthypeople/state/toolkit.

To order additional printed copies of the Toolkit for $39 (item RM-005), contact the Public Health Foundation

toll-free at (877) 252-1200 or visit the online bookstore at http://bookstore.phf.org.

Duplication and adaptation, with credit, are encouraged.

Please address all comments, questions, and corrections to:

Public Health Foundation ▪ 1220 L Street, NW, Suite 350 ▪ Washington, DC 20005

Phone: (202) 898-5600 ▪ Fax: (202) 898-5609 ▪ Email: hp2010@phf.org ▪ http://www.phf.org
Acknowledgments

This publication was developed by the Public Health Foundation (PHF), under contract with the

Office of Disease Prevention and Health Promotion (ODPHP), Office of Public Health and

Science, U.S. Department of Health and Human Services.

Primary PHF authors were Stacy Baker, M.S.Ed.; Dianna Conrad, M.H.P.E; Michon Béchamps,

M.H.S.; and Michael Barry. Deborah Maiese, M.P.A., in ODPHP, served as the Project Officer.

The Public Health Foundation thanks the ODPHP staff for their guidance and review, as well as

their contribution of examples from the national process. PHF also thanks the many Healthy

People State Action Contacts, Regional Health Administrators, Association of State and

Territorial Health Officials staff, and tribal contacts who provided assistance, reviewed drafts,

and contributed tools and examples from the field.

All feedback and examples inspired the final document. We regret that space constraints did not

permit us to include all examples and suggestions.
Table of

Contents

Explanation and Overview of the Toolkit .............................................................. i

Action Areas

Building the Foundation: Leadership and Structure............................................... 1

Identifying and Securing Resources..................................................................... 23

Identifying and Engaging Community Partners .................................................. 37

Setting Health Priorities and Establishing Objectives.......................................... 51

Obtaining Baseline Measures, Setting Targets, and Measuring Progress............ 79

Managing and Sustaining the Process ................................................................ 107

Communicating Health Goals and Objectives ................................................... 133

Appendices

A. Resources

B. Healthy People State, Territorial, and Tribal Action Contacts

C. State and National Healthy People Web Sites
i Overview

Explanation

and Overview

of the Toolkit

"If the only tool you have is a hammer, all of your problems will look like nails."

—Mark Twain

Welcome to the Healthy People Toolkit! The Toolkit provides guidance, technical tools, and

resources to help states, territories, and tribes develop and promote successful state-specific

Healthy People 2010 plans.1 It can also serve as a resource for communities and other entities

embarking on similar health planning endeavors.

This Toolkit is organized around seven major "action areas," which were derived from national

and state Healthy People initiatives.2 With the assistance and guidance of the Office of Disease

Prevention and Health Promotion, U.S. Department of Health and Human Services (HHS), the

Public Health Foundation reviewed both year 2000 and year 2010 initiatives and identified

these seven areas as common elements of most health planning and improvement efforts. The

seven action areas are:

• Building the Foundation: Leadership and Structure

• Identifying and Securing Resources

• Identifying and Engaging Community Partners

• Setting Health Priorities and Establishing Objectives

• Obtaining Baseline Measures, Setting Targets, and Measuring Progress

• Managing and Sustaining the Process

• Communicating Health Goals and Objectives

 

1

The term “state plan” will be used throughout the Toolkit to indicate “state-, territory-, or tribal-specific Healthy

People 2010 plan.”

2

 The hundreds of local health planning initiatives could fill a separate volume and were not reviewed for inclusion

in the Toolkit. However, a small selection of local resources is included for local Toolkit users.
Healthy People 2010 Toolkit ii

Each action area includes:

• a brief explanation and rationale

• a checklist of major activities, which are taken from the comprehensive planning checklist

tool in "Managing and Sustaining the Process"

• tips for success

• national and state examples to illustrate Healthy People processes in action

• recommended “hot picks" of resources for further information, designated by a star !

• planning tools that can be easily adapted to state or local needs, designated by a tool 

The suggested processes, tools, and resources in the seven action areas can help states build on

past successes and round out their approaches to planning and developing year 2010 objectives.

An effective planning initiative should reflect the state's unique needs, resources, and buy-in

from a broad constituency.

Attached as appendices are comprehensive listings of resources; State, Territorial, and Tribal

Action Contacts; and state and national Healthy People web sites.3 

A web-based version of the Toolkit offers users enhanced access, navigation, and search

capabilities and is available at: http://www.health.gov/healthypeople/state/toolkit. The web

version contains direct links to state Healthy People web pages, up-to-date listings of state

Healthy People action contacts, Healthy People 2010 lead agency content experts, and HHS

Regional Health Administrators.

Because this Toolkit is in the public domain, we encourage you to copy the Toolkit to share

with your state and local partners.

The Public Health Foundation would like to hear about your year 2010 initiative, how you are

using the Toolkit, and what additional resources or examples would be helpful to you. Please

contact us at:

Public Health Foundation

Healthy People Initiative

1220 L Street, NW, Suite 350

Washington, DC 20005

202-898-5600 (T)

202-898-5609 (F)

hp2010@phf.org

 

3

 The Public Health Foundation made every reasonable effort to confirm the accuracy of all web site addresses,

resource listings, and contact information as of February 2002. PHF apologizes for any inconvenience caused by

inaccurate listings.
1 Leadership and Structure

Building the

Foundation:

Leadership

and Structure

"All 'players' need to be involved in the process

from its inception. Top leadership needs to

constantly reinforce support for the process."

—Utah Department of Health, Utah Tomorrow

In This Section

! Action Checklist 2

! Tips 2

! Process in Action:

Examples from the Field 4

! Creating a Structure 7

! Sample State Statutes 12

! Sample Planning Structures 13

! Roles & Responsibilities 15

! SWOT Worksheet 19

" Hot Picks: Resources 21

Involvement of and support from the state health

officer, other agency heads, top political leaders,

and key policy makers in a state significantly

improves and strengthens the state planning

process. Effective leadership is necessary to

inspire a shared vision and enlist appropriate

partners and staff in the development process.

Once leaders' commitments and buy-in are

secured, planning structures, resources, and other

essential elements often fall into place more easily.

The suggestions and tools in this section can help

you build a strong foundation for planning.

Implementation will, of course, depend on the

unique characteristics of each state.
Healthy People 2010 Toolkit 2

Action Checklist:

Leadership & Structure

(See page 113 for a complete planning and development checklist.)

# Secure commitment from senior health

department staff

# Identify potential barriers and

facilitators to success

# Form preparation team to identify goals and

guide early stages of development

# Present state plan development process

to political leaders for support

# Create a planning structure

# Examine policy/political environment

# Identify related initiatives to integrate

or consider coordination with state plan

# Engage partners early and maintain their

involvement

# Define functions and composition of

advisory and/or steering group

Tips Don’t pass GO before gaining leadership support.

Enlisted leaders can:

► Influence public opinion

► Mobilize support and engage partners

► Inspire action to get things done

► Facilitate finding, obtaining, and allotting resources

► Guide decision making

► Advocate for the state plan's goals and objectives

► Set policy and ensure that objectives are monitored

and considered in policy matters

Begin within your own agency

► State health officer

► Senior health department staff and program

managers (e.g., women's health, minority health,

long term care)
3 Leadership and Structure

Include the governor and key legislative leaders

► Governor’s health policy advisors, advisory

councils, cabinet members

► Political and policy leaders, including legislators on

health and human services and fiscal subcommittees

► Key health supporters as well as potential

adversaries

Enlist heads of other state agencies

► Mental health, substance abuse, environmental,

social services, children and families, aging,

disabilities, education, agriculture, transportation,

and other agencies

► Work with the governor and cabinet members to

determine which office(s) will officially issue the

plan, and bring those leaders in early

Know the playing field

► Conduct a SWOT (strengths, weaknesses,

opportunities, and threats) analysis (see page 19)

► Know how your state plan activities will align with

other planning and improvement efforts

► Learn from past successes and mistakes

► Define how the state plan can support and advance

leaders’ current policies and priorities

Be explicit about what you are requesting from others

► Identify shared values and common goals

► Identify specific roles and responsibilities

► Share responsibilities and decision making

► Establish accountability mechanisms
Healthy People 2010 Toolkit 4

Process in Action: Examples from the Field

Below are examples of how the nation and states have made connections with leadership to

develop health objectives and establish planning structures.

From the National Initiative

Secretary’s Council

The Secretary’s Council on National Health Promotion and Disease Prevention Objectives for

2010 is the advisory structure for Healthy People 2010. The membership of the Council

promotes leadership commitment and involvement in the development process. The Council,

which meets annually, is comprised of former Assistant Secretaries for Health and the current

heads of operating divisions in HHS. The Secretary of HHS serves as the chair, and the current

Assistant Secretary for Health and Surgeon General is the vice chair.

The Council is charged to do the following, according to the Healthy People 2010 Charter:

• Provide to the Secretary advice and consultation to facilitate the process of

developing national health promotion and disease prevention goals and objectives;

• Provide links with the private sector to ensure their involvement in the process of

developing national health promotion and disease prevention objectives;

• Through those links with the private sector, enhance the prospects of tying together

similar health promotion and disease prevention efforts throughout the private and

voluntary sectors.

Healthy People Steering Committee and Work Groups

The Steering Committee is comprised of representatives of all operating divisions of HHS. The

members are joined in these discussions by work group coordinators from the lead agencies in

the Public Health Service which have been designated to be responsible for the achievement of

the Healthy People targets. A list of the Healthy People 2010 Work Group Coordinators can be

found in Appendix E of Healthy People 2010, Volume II at:

http://www.health.gov/healthypeople/Publications.

The report, Stakeholders Revisit Healthy People 2000 to Maximize the Impact of 2010,

describes the Steering Committee retreat proceedings which began the 2010

development process. The report includes summaries of the five Consortium member

breakout groups and is available at: http://www.health.gov/HPcomments/Stakeholder.
5 Leadership and Structure

From State Initiatives

Governor’s office leads planning process

By Executive Order, North Carolina’s governor

established the Task Force on Health Objectives

for the year 2000. The governor's Task Force

engaged 25 North Carolina leaders representing

health care providers, consumer organizations, and

public representatives. This broad coalition

helped to foster public and private sector

ownership of the state's health objectives. A state-level Office of Healthy North

Carolinians offered assistance to local community leaders and involved the majority of

counties in Healthy Carolinians activities. In April of 1999, the governor signed a

second executive order, establishing and expanding a successor Task Force for year

2010 health objectives. The goal is to review the national objectives for year 2010 and

involve North Carolina counties in establishing the state’s 2010 objectives. North

Carolina believes that the state’s "decentralized" public health system will lead to

success with this approach.

The Louisiana legislature passed a bill to create the Louisiana Healthy People 2010

Planning Council in the Department of Health and Hospitals. The task of the Council

will be to design a process for developing a state plan. The bill states that the Council

shall be composed of a variety of public, private, professional, educational, trade,

volunteer and advocacy organizations to ensure that all citizens are represented. It also

requires that a paid staff person assist the activities of the Council.

In 1996 South Dakota’s governor signed an Executive Order establishing the Governor’s

Health Advisory Committee to provide recommendations and advise the Secretary of

Health on health priorities. The Health Advisory Committee serves as a think tank on

emerging and priority health issues and helps to foster partnerships to improve geographic

and financial access to health care. The Committee uses the Healthy People objectives

when applicable. Included in the advisory committee are key members of the healthcare

community including providers, administrators, educators, and consumers.

In 1993 the Utah Legislature enacted legislation to create a statewide strategic plan with

performance measurements. State legislators, local government representatives, state

agency heads, other governor-appointed members, and a state coordinator participated in

the Utah Tomorrow strategic planning committee. By centralizing planning through the

governor's office, Utah achieved among various state agencies a common planning

language for performance measures and objectives. The governor's Office of Planning and

Budget provided technical assistance and hands-on skills training to state agencies, which

were asked to participate voluntarily in planning and performance measurement efforts.
Healthy People 2010 Toolkit 6

Incorporating health objectives into other strategic planning and

evaluation efforts, such as performance-based budgeting

Florida’s year 2000 planning occurred in the context of the state’s 1992 Health Care Reform

Act. This Act requires the state to develop biennial health plans that include population health

status data, specific health status objectives, and outcome measures. These responsibilities

were transferred to the Department of Health when the Department was created in 1997 and

resulted in the development of the Florida State Health Plan. In addition, since Florida statutes

mandated implementation of performance-based program budgeting, the Florida Department of

Health integrated performance-based budgeting into the planning process for its Agency

Strategic Plan, which is updated annually with five-year forecasts.

The 1993 Oregon legislature directed all state agencies to develop performance measures with

ties to the state’s indicators of well being, called Oregon Benchmarks. A Progress Board

presents biennial progress reports to the legislature and public. The benchmarks and progress

reports help to keep state agencies focused on results and help leaders evaluate and reset

priorities. Many Oregon local governments have initiated their own benchmark planning

systems.

In Ohio, the director of the Department of Health initiated a strategic planning process

designed to strengthen Ohio’s public health system. It was called Ohio’s Public Health Plan.

The plan targeted five initiatives, one of which was Healthy People Ohio. Ohio Department of

Health senior staff and representatives of public health associations guided the planning

process with a Work Group on Healthy People Ohio.

Using strategic plans and progress reports to evaluate proposed policies

and funding allocations

Utah’s annual budget cites relevant Utah Tomorrow goals, and state agencies must reference

relevant performance standards for their department proposals. The Utah Legislature’s

Appropriations Subcommittees annually receive reports detailing updated objectives and

performance measures for relevant subject areas. Utah legislators are encouraged, but not

required, to correlate legislation with the state's strategic plan and to use Utah Tomorrow to

evaluate proposed legislation.

Influencing health legislation

Vermont, Delaware, Guam, and Utah attribute state success in passing clean indoor air

legislation to the state health objectives. In addition to clean indoor air laws, Vermont's

legislative successes have been numerous, including passage of bills related to lead abatement,

immunizations, and seat belt usage.

The Rhode Island Department of Health was successful in using year 2000 objectives to win

legislative approval for new requirements related to automobile and boat safety and radon

control, as well as new minority health programs funded by a tobacco tax.
7 Leadership and Structure

Creating a Structure for

Success

1. Preparation

A carefully organized and well-defined planning structure will position the 2010

planning process for success. There are several options for developing steering

committees, advisory committees, and other structures to carry out planning work and

involve people in the process. This tool can be used to structure government leadership

or community involvement. (See the action area, “Identifying and Engaging

Community Partners.”)

This tool will give you ideas on how to structure your process, identify participants, and

delineate participant roles and responsibilities. A small group, or 2010 preparation

team, can help make structural decisions before the official steering group is formed. In

just one or two meetings, this team can ensure that invitations are sent to the right

people and their charge is clear from the beginning.

An existing health advisory group or public health management team can serve as a

preparation team.

2. Align the planning structure with state goals

Consider first what the desired results of the 2010 process are, then build a planning

structure around those goals. For example, if

the state's goal is for policy makers to use the

2010 plan to propose legislation, a planning

structure involving the legislative branch or

the governor's office may be desirable. If

state goals emphasize local use of the plan, a

planning structure with local involvement

would be ideal.

3. Write down what the state wants to achieve, then consider the

structural issues and options on the following pages by asking,

"Which option will give us these results?"

Know what

you want to

build before

bringing in

the crew.
Healthy People 2010 Toolkit 8

Issue 1: Authority: Advisory vs. Steering Responsibilities

In any planning structure, participants should know:

Who has an advisory role? Persons in an advisory role may provide informed

input on topics such as the 2010 planning process, priority or focal areas, target

populations, scope of objectives, marketing, and other aspects of the 2010 plan.

Who has a steering role? Persons in a steering role navigate the course of the

planning process, establish work groups, determine input processes, and make

decisions about the content of the state plan.

Who makes final decisions, weighing all input?

Who will be held accountable for the plan and see the plan through?

Advisory Structure Options

# Single, state-wide advisory group that meets throughout the

process

# Two or more advisory groups to ensure input from specific

constituencies (e.g., geographic areas, racial and ethnic

populations, or local health officers), periodically convened

# Consortium of various advisory groups, (e.g., maternal and

child health, mental health, substance abuse)

# No formal advisory group, but planned events or activities

to gain input from key constituencies (see options in

"Public Input and Involvement," page 10)

Steering Structure Options

# Steering group with full authority to develop and adopt the 2010 plan

# Steering group with significant authority to develop the 2010 plan, subject to the final

approval of the governor, state health officer, or others

# Steering group with specific authority over certain tasks (such as the development of

objectives), with other tasks (such as marketing and publication of the plan) under the

authority of the state health agency or governor's office

How can advisory and

steering structures fit

together?

For a visual overview of

potential relationships

among various structures,

see the four sample

organizational charts on

pages 13-14.
9 Leadership and Structure

Leadership Options

# Chaired by the governor or his/her designee

# Chaired by an official or appointed by the legislature

# Chair elected by the group

# Chaired or co-chaired by state public health, mental health, substance abuse, or

environmental health director(s)

# Co-chaired by the state health officer and a community representative (appointed or

elected)

# Rotating chair

# No chairgroup received direction and guidance from staff

Membership Options

# State agency staff only

# State and local public agencies staff

# Members of the private, public, and voluntary sectors — e.g., academia (schools of public

health, social work, nursing, medicine), community health and social organizations,

business, legislatures, etc.

# Community members excluding state agencies and academia

Issue 2: Distributing the Work

The options below may apply to distributing the work of advisory groups, as well as steering

groups, according to the planning structure in your state. (See “Participant Roles and

Responsibilities,” page 15, for additional ideas on ways to coordinate the work of developing

the state plan.)

Delegation Options

# The steering group does all the work in steering group meetings

# The steering group divides its members into work groups or subcommittees

# The steering group establishes work groups to be chaired by a steering group member, with

work group membership open to non-steering group members who have expertise or

interest

# The steering group charges the state health agency with forming work groups as needed

Work Group Options

Number

# Limited number of work groups

# Unlimited number of work groups
Healthy People 2010 Toolkit 10

Organization

# By focal areas (e.g., tobacco, infectious diseases, infrastructure), so that work groups are

responsible for all aspects of developing the plan for their areas of expertise

# By functions (e.g., objectives, strategies, marketing, public input), so that work groups

oversee one aspect of the process for all focal areas

# By populations (e.g., grouped by life stage, gender, race/ethnicity, people with disabilities)

# By target audience (e.g., business, government, community organizations)

# Combination of work group types

Communication

# Work groups operate independently, reporting only to the steering group

# All work groups are periodically convened with steering and advisory groups, sharing

progress and discussing priorities of common concern

# Certain, related work groups periodically meet

# Staff, materials, web site, or electronic newsletters facilitate communication among groups

Staffing Options

# Members, or their respective staffs, do all the work

# Public agencies jointly support the process

# State health agency shares technical support (e.g., data, program expertise, or references)

and administrative support responsibilities with members.

# State health agency provides unlimited technical and administrative support, as delegated

by the group

# State hires contractual staff for administrative or technical support, funded by state or

private grants

Issue 3: Public Input and Involvement

Options

# Public meetings with formal testimony

# Public meetings with informal discussion with steering committee members

# Public meetings with break out rooms for structured input or activities

# Dissemination (via e-mail, web site, fax, or mail) of requests for specific input or comment

# Surveys

# Focus groups

# Internet discussion group
11 Leadership and Structure

Scheduling public input

# One location (such as the state capital)

# Multiple locations (meetings in every region)

# Single point in the process

# Multiple points in the process (see options below)

Potential opportunities for public input in the 2010 planning process

Adapted from: Healthy Delaware 2010 Project. Public Health Foundation, 1999.

General questions to consider for 2010 planning groups:

1. How many members do you want, and what type of skills do they need to have?

2. What will be their time commitment? (How many hours per month for how long?)

3. How will member travel arrangements and expenses be handled?

4. Where, when, and how often will they meet?

5. Will the meetings be open or closed? (Check state regulations.)

6. What rules of order will be followed?

7. Will the members be expected to represent their agencies, community, or constituencies?

8. Which population groups should be represented?

9. Will the group sustain itself once the plan is developed? If so, how? What will the role of

members be after the release of the state plan?

10. How will you evaluate the effectiveness of the groups?

11. How will you reward great efforts?

Determining

focal areas and

priorities

Identify strategies & resources

to include in plan

Beginning the

2010 process

Comment on

final draft plan

Setting

objectives

Kick-off events or

action meetings to

monitor plans
Healthy People 2010 Toolkit 12

Sample State Statutes

State legislation may help to establish planning authority and build policy makers' support for

the development and implementation of a state plan. Under the two sample statutes below, the

Florida Department of Health has been given specific responsibility for the development of a

state health plan. Building Healthy Communities: Florida's Public Health Plan is the Florida

Department of Health's state health plan for 1998-2000.

SECTION 408.601, FLORIDA STATUTES:

"The Department of Health and Rehabilitative Services [now the Department of Health or

DOH] shall develop a biennial Healthy Communities, Healthy People Plan that shall be

submitted to the Governor, the President of the Senate, and the Speaker of the House of

Representatives by December 31 of each even-numbered year.

“The plan must include data on the health status of the state's population, health status

objectives and outcome measures, and public health strategies, including health promotion

strategies. The plan must also provide an overall conceptual framework for the state's health

promotion programs that considers available information on mortality, morbidity, disability

and behavioral risk factors associated with chronic disease and conditions; proposals for

public and private health insurance reforms needed to fully realize the state's health

promotion initiative; the best health promotion practices of the county health departments

and other states; and proposed educational reforms needed to promote healthy behaviors

among the state's school-age children.”

SECTION 20.43 (1) (L), FLORIDA STATUTES:

The Department of Health is required to “biennially publish, and annually update, a state

health plan that assesses current health programs, systems, and costs; makes projections of

future problems and opportunities; and recommends changes needed in the health care

system to improve the public health.”
13 Leadership and Structure

Sample 2010 Planning

Structures

State Agency Steering

Group

• Final decisions

• Establishes and staffs

state 2010 work

groups

• Focal point for all

input

Advisory Committee

• Recommendations on

2010 process &

priorities

• Includes public and

private members

• Non-state agency chair

or co-chair

Work

Group

Work

Group

Work

Group

Work

Group

State Agency Support

Team

• Coordinates and staffs

work groups

• Provides technical and

administrative support

to the steering group

Steering Group

• Makes final decisions

• Includes public and private members

• Establishes work groups

• Public or private; potentially honorary

chair

Work

Group

Work

Group

Work

Group

Work

Group

1

2
Healthy People 2010 Toolkit 14

Governor's Steering Committee

• Final decisions ● Engages cabinet leaders

• Guides and manages process ● Establishes work groups

State Agency

Support Team

• Technical support

• Coordinate and staff

work groups under

Steering Committee

Work

Group

Work

Group

Work

Group

3

State Agency Steering

Committee

• Makes decisions

• Establishes work

groups of staff or mix

of public and private

members

Work

Group

Work

Group

Work

Group

Work

Group

Work

Group

Work

Group

4

KEY

Reports to

Reports to,

receives

guidance from

Support role

Adapted from: Healthy Delaware 2010 Project. Public Health Foundation, 1999.
15 Leadership and Structure

Participant Roles &

Responsibilities (Sample)

All participants’ responsibilities

• Contribute personal and professional experience and expertise to the group.

• Speak up for and faithfully represent community, professional, or constituency perspectives.

• Identify work group decisions that may present a conflict of interest and abstain from committee

votes on these matters.

Steering Group

Composition

# Comprised of approximately 20-30 private and public sector leaders, community members,

and experts. Includes 5-10 members from state agencies.

# Co-chaired by the state health officer and a private sector leader.

# All members have an equal say in decisions and an equal vote in the plan's adoption.

Roles

# Develop and adopt the state’s 2010 plan.

# Guide a well-coordinated, sound, inclusive, and efficient process to develop the plan.

# Determine a process to select priority or focal areas, decide priorities, set the parameters,

and choose a format for objectives.

# Establish work groups, delegate tasks, and approve work group recommendations.

# Identify technical assistance and data needs for the steering group.

# Serve as the focal point for all community input and review data needed to make decisions.

# Help secure commitments from community partners needed to oversee the plan.

# Plan ways to sustain and monitor the state 2010 plan.

Member responsibilities

# Participate in steering group meetings (meeting frequency to be established by the group).

# Participate in at least one work group.
Healthy People 2010 Toolkit 16

Executive Committee of the Steering Group

Composition

# Comprised of the steering group co-chairs and work group chairs.

Roles

# Ensure the steering group and work groups accomplish tasks on schedule.

# Make decisions and manage details between meetings, as referred by the steering group.

# Help the co-chairs plan an agenda and methods to accomplish group goals.

# Identify ways to improve the process and resolve problems.

# Plan an evaluation of the process.

Member responsibilities

# Participate in teleconference meetings monthly, or as needed.

# Communicate with work groups, staff, and others to fulfill the Executive Committee’s

coordination function.

Work Groups

Composition

# Comprised of the steering group members and others who have interest or expertise in the

subject.

# Chaired by a steering group member.

Roles

# Develop objectives, recommend strategies, and draft other components of the plan as

assigned by the steering group.

# Gather and review detailed information needed to develop priority areas of the plan.

# Help ensure the plan is a practical guide for community action.

# Identify technical assistance needs of members and communicate these to the state Healthy

People Coordinator or work group staff.

Member responsibilities

# Participate in meetings by teleconference or in person as determined by the work group.
17 Leadership and Structure

State Healthy People 2010 Coordinator

(The state’s designated representative to the national Healthy People 2010 process)

Roles

# Serves as lead state health agency (SHA) staff support to the steering group.

# Provides guidance and helpful national, state, or local resources to the steering group.

# Serves as link to SHA management team (see roles below).

# Coordinates requests and feedback to state plan contractors, if any (e.g. data experts,

consultants, marketing companies, graphic designers, printers).

# Manages SHA resource contributions to support the 2010 process.

# Edits and prepares the plan and any companion documents for publication.

# Manages the time line for 2010 planning.

# Organizes steering group meetings and mailings. Ensures meetings are open and

accessible.

Responsibilities

# Attends steering group meetings as lead state agency staff support (not as a voting

member).

# Updates agency management team and the governor on the state plan.

State Health Agency (SHA) Management Team

Composition

# Comprised of senior SHA staff and section chiefs.

Roles

# Coordinate SHA staff technical support to the steering group, including data analysis and

expertise.

# Assign one SHA staff member, who is not a member of the steering group, to provide

technical support to each work group.

# Coordinate administrative support for the steering group and fill administrative support

gaps in work groups.

# Coordinate efforts to identify and secure resources for state plan.

# Facilitate involvement of leaders.

# Develop and handle details of the marketing plan, with input from the steering group.
Healthy People 2010 Toolkit 18

State Health Agency Support Staff

Roles

# Assist the steering group or work groups as assigned.

# Ensure that members have the information they need to make decisions.

# Compile and analyze data, offer expert opinion, present options, and draft text based on

group suggestions, as requested.

# Assess whether the chair or co-chair requires administrative or technical assistance to

prepare for each meeting.

Responsibilities

# Regularly attend meetings as assigned.

# Respond to technical assistance requests and communicate additional requests to the SHA

Healthy People Coordinator.

# Allow members to fully discuss and vote on priorities. Offer members input and

information when requested or essential.

Adapted from: Healthy Delaware 2010 Project. Public Health Foundation, 1999.
19 Leadership and Structure

SWOT Worksheet

SWOT is an examination of a group’s internal strengths and weaknesses, as well as the

environment’s opportunities and threats. It should be used in the beginning stages of decision

making and strategic planning.

Strengths What are your state’s particular strengths? Do you do something particularly

unique? What could be an asset in developing objectives for your state plan?

Weaknesses Where is your state lacking? What do others seem to accomplish that you

cannot? What could limit your state planning efforts?

Potential Internal Strengths Potential Internal Weaknesses

1. 1.

2. 2.

3. 3.

4. 4.
Healthy People 2010 Toolkit 20

Opportunities What is happening in your state that could provide opportunities?

Threats What is happening that could pose threats to the process or your goals?

Potential External Opportunities Potential External Threats

1. 1.

2. 2.

3. 3.

4. 4.

5. 5.

Adapted from: Balamuralikrishna R., Dugger J.C. “SWOT Analysis: A Management Tool for

Initiating New Programs in Vocational Schools.” Scholarly Communications Project, University

Libraries, Virginia Tech. http://borg.lib.vt.edu/ejournals/JVTE/v12n1/Balamuralikrishna.html
21 Leadership and Structure

Resources for

Building the

Foundation:

Leadership and

Structure

" Williams-Crowe S.M., Aultman T.V. “State Health Agencies and the Legislative

Policy Process.” Public Health Reports, 109(3):361-7, 1994.

Provides specific strategies for dealing with state legislatures based on the experiences of state

legislative liaison officers. Organized into five key areas—agency organization, staff skills,

communications, negotiation, and active ongoing involvement.

" Civic Practices Network–Community Section.

http://www.cpn.org/sections/topics/community/index.html

Provides information on community building through “community organizing, social capital, and

urban democracy.” It also provides information on the Consensus Organizing Model, which

explains ways one can bring together all the players in a community.

" Civic Practices Network–Health Section.

http://www.cpn.org/sections/topics/health/index.html

Provides perspectives on building community involvement, as well as “how to put health reform

on more solid civic foundations.”

" Public Health Resources on the Internet – Legislative and Regulatory Resources.

http://www.lib.berkeley.edu/PUBL/regs.html

Links to California, federal, and other legislative and regulatory resources that can be helpful.

Please see Appendix A for more resources on building the foundation: leadership and

structure.

picks
22
23 Identifying Resources

Identifying and

Securing

Resources

“It takes a village to raise a child (or develop a

state plan).”

—adaptation of African proverb

In This Section

! Action Checklist 24

! Tips 24

! Process in Action:

Examples from the Field 26

! Sample Budget Line Items 31

! Finding Other Resources 34

" Hot Picks: Resources 35

Identifying and securing resources for state

planning is a constant challenge. Yet as the

examples in this section show, there are many

creative options for ensuring adequate resources.

Having dedicated resources helps facilitate a

successful state planning initiative. A helpful

strategy is to identify how the goals of the state

plan may be aligned with the goals of potential

resource contributors. In addition, a detailed

budget for planning activities facilitates securing

both public and private resources. The budget

should cover all aspects of the development

process, including resources needed to carry out

each of the seven action areas outlined in this

Toolkit.
Healthy People 2010 Toolkit 24

Action Checklist:

Identifying and Securing Resources

(See page 113 for a complete planning and development checklist.)

# Identify resources needed to develop

state plan

# Identify existing internal resources

# Develop budget # Identify potential external resources,

including potential donated resources

# Plan to integrate the plan into state

planning, budgeting, and programming

processes

# Develop staff and technical support plan

# Secure identified resources and develop

alternative resources if necessary

Tips Ask the right questions early

► What is the scope of the state planning process?

► What does the state want to accomplish through this

process?

► Why should taxpayers or others fund the

development of the state plan?

► What will it take to support the planning initiative?

Recognize up front that planning takes money

► Find examples of what other state initiatives have

included and required in funding

► Develop a plan for supporting the process,

identifying both people and dollars

► Think about developing a separate budget for state

plan development

► Be realistic — do not underestimate your costs

(think through the potential budget items, page 31)

Capitalize on what you have

► Investigate the uses of available resources such as

the Prevention Block Grant or categorical funding

► Negotiate reallocation of existing agency staff

► Identify and secure assistance from internal

development experts (e.g., grant writers)
25 Identifying Resources

You can’t get it if you don’t ask for it

► Investigate availability of new state-based funding

sources, such as tobacco settlement money and

hospital conversion foundations

► Research potential external funding sources, such as

the federal government, private foundations,

hospitals, governor-funded initiatives, and other

public or private sources whose purposes may be

aligned with state plan

► Consider self-sustaining funding sources, such as

forming a Healthy People coalition and collecting

dues from its members or creating a non-profit

organization to raise and distribute funds for Healthy

People initiatives

► Ask businesses or community groups to donate

services or other non-financial resources (check state

regulations first!)

Don’t forget to plan for the future—it’s not over when

the plan is released

► Identify resource needs to carry out a ten-year plan

to monitor progress, publish periodic reviews, and

sustain activities

► Keep a wish list ready for future funding (e.g.,

resources for a business companion document, a

special health disparities consortium, or other ideas

generated during 2010 planning)

Coordinate your resources with local initiatives

► Identify local Healthy People initiatives and ways to

include them in resource proposals

► Assist local public health agencies in identifying

resources
Healthy People 2010 Toolkit 26

Process in Action: Examples from the Field

Below are examples of how the nation and states identified and secured resources for

assessment, development, and implementation of a Healthy People plan.

From the National Initiative

Federal statutes

Many federal funding streams can be utilized for development of state plans. HHS grant

announcements reference the relevant Healthy People 2000 priority areas and encourage

applicants to obtain the document. In addition, the Indian Health Care Improvement Act

requires reporting on progress toward Healthy People objectives.

Preventive Health and Health Services Block Grant

Commonly known as Prevention Block Grants, these grants are allocated by the Centers for

Disease Control and Prevention (CDC) and give states wide discretion in fund distribution to

ensure the best use of resources. States are mandated to show how the funds are aligned with

Healthy People Objectives. States are also directed to use the block grants in areas of greatest

need, which can mean developing a state plan.

Maternal and Child Health Services Block Grants

The Maternal and Child Health Bureau, HHS, distributes Maternal and Child Health Services

Block Grants. Money from these block grants is directed toward improving the health of

mothers and children. This grant application requests funds from Title V of the Social Security

Act. Program goals are to be linked to the nation’s Healthy People goals. There is also an

extensive set of reporting requirements that states must follow for their annual reports.

Resource Development Guide

In 1991 ODPHP published the reference, Locating Resources for Healthy People 2000 Health

Promotion Projects. This 46-page guide helps make the connection between Healthy People

2000 objectives and searching for funding and other assistance. It is available from the U.S.

Government Printing Office, Superintendent of Documents, Mail Stop SSOP, Washington, DC

20402-9328. ISBN # 0-16-035928-7.
27 Identifying Resources

From State Initiatives

Allocate Prevention Block Grant funds

Alabama, Colorado, Maine, Kentucky, Illinois,

and West Virginia are among several states that

have used their Prevention Block Grants to fund

initiatives tied to their state objectives. These states

require state and local jurisdictions to specify which

of the Healthy People objectives will be

addressed with grant funds.

For year 2000, the Colorado Department of Public Health and Environment allocated

Prevention Block Grant funds to help local health departments, county nursing services, and

local sanitarians develop strategic plans based upon the year 2000 objectives.

In Maine private community agencies under contract to deliver public health services must

base program funding requests on the state’s objectives, similar to the requirements of health

department applicants for Prevention Block Grant funds.

Illinois used a portion of its Prevention Block Grant to fund the Illinois Project for the Local

Assessment of Needs (IPLAN) initiative. The state set aside funds to actualize local needs

assessment projects, including a statewide, computerized data system and training workshops

to support local planning. The IPLAN process allows local public health jurisdictions to set

priorities and monitor interventions related to year 2000 and year 2010 objectives.

Develop new sources of funding

Iowa’s Barn Raising II, held in June 1999, promoted the state’s 2010 plan with over 700

participants. With an anticipated budget of approximately $100,000 for the two-day event,

fundraising efforts to support this event started early in the year. The governor, lieutenant

governor, and Iowa Department of Public Health Director signed a letter requesting

organizations to partner with the state by providing assistance or financial support. The major

benefit to the organizations was the opportunity to showcase their organizations' activities and

to network. Iowa received commitments for support ranging from $50 to $11,500. The

Wellmark Foundation awarded Iowa a grant for $40,000. In order to assist local agency

participation, registration costs were kept low. The $40 registration fee covered the cost of

food. However, the fee did not cover most other costs, including materials and promotion.

The Rhode Island Prevention Coalition has leveraged over $550,000 in public and private

resources to address physical activity through grants programs. The Coalition’s focus on

physical activity resulted from a careful review of Rhode Island’s year 2000 health objectives.

The Department of Health initiated the Coalition in 1995 in partnership with Rhode Island

HMOs, health insurers, hospitals, and voluntary health agencies. A private organization, the
Healthy People 2010 Toolkit 28

Rhode Island Public Health Foundation, serves as the Coalition’s fiscal agent. The Coalition

issues requests for proposals (RFPs) to stimulate local programs promoting physical activity.

Coalition-funded programs have additionally contributed over $225,000 worth of local in-kind

resources to address physical activity. In-kind resources include staff resources from various

agencies, as well as materials and public relations services.

A South Carolina coalition became an independent 501(c) 3 organization, providing the

umbrella for single purpose coalitions and linking their activities. This coalition has now

become an important component of a hospital-supported partnership in the community with

continued staff and linkage support.

Oregon secured external state and local private funders, such as the Oregon Community

Foundation and the Portland Area United Way, by using its benchmarks to focus grantmaking

priorities.

Reallocate other types of existing resources

Missouri, New Jersey, and Wyoming identified and categorized existing resources that were

being used to address health objectives. These resource assessments provided a basis for

reallocating resources to priority areas. For example, Wyoming supplemented carryover funds

and human resources for planning, with some redirection of discretionary funds to oversee

some of the priority areas.

For both year 2000 and year 2010 plans, the Connecticut Department of Health has committed

funds for internal staff resources and production costs. The Department of Health dedicated

two full-time staff to the year 2000 planning process, who were funded by the agency budget.

Kansas used grant funds awarded by the Kansas Health Foundation to help support its Healthy

Kansans 2000 process. There is no funding set aside for Healthy Kansans 2010, however

enough funds remain from year 2000 planning to start the 2010 plan. The state also plans to

help other organizations better utilize their funding by incorporating Healthy Kansans 2010

objectives into their workplace objectives.

The Nebraska State Department of Health reallocated existing resources to develop its year

2000 plan. The Director adopted the plan as a high priority and strongly advocated using the

objectives for local planning efforts. The objectives were used to structure the guidance for

grant applications as well.

Texas Healthy People 2000 planning activities were supported primarily through existing

program budgets. In 1992, the Texas Department of Health was one of six states awarded a

five-year grant by the CDC to assess progress toward achieving Healthy People 2000

objectives.
29 Identifying Resources

Assist local public health agencies in identifying resources

North Carolina has established two foundations that provide money to counties to implement

Healthy Carolinians projects. The Office of Healthy Carolinians alerts counties to requests for

proposals (RFPs) and other available money.

In California the Office of County Health Services (OCHS) administers the Health Incentive

Program, which provides funding to local health agencies for disease prevention and health

promotion programs and services in priority areas designated by the federal Healthy People

2000 initiative. OCHS also provides approximately $300 million in federal, state, and private

funding for these services and related administrative activities, as well as technical assistance to

local health programs.

Generate in-kind support

Vermont did not have specific budget for either development of a year 2000 plan or year 2010

planning. Although there is no coordinator or other personnel specifically designated for this

job, the state’s publicity campaign pulls in enough human resources to sustain the Healthy

Vermonters project.
30
31 Identifying Resources

Sample Budget Line Items

Line Item

Internal

Resources

(new agency

budget

allocation)

Internal

In-kind

(reallocation

of existing

agency staff,

shared

budgets, or

resources)

External

Resources

(grants or

financial

resources:

public or

private

sources)

External

In-kind

(donated

services or

non-financial

resources)

Personnel

(Staff or Contractors)

Coordinator

Data manager

Administrative support staff

Technical support/consultants

Subject matter experts

Meeting facilitators

Graphic designer

Marketing/PR specialist

Copy writer/editor

Web site designer

Fringe benefits

Services (Non-Personnel)

Duplication and Printing

Steering/advisory group

materials

State plan publication

Companion documents

Letterhead

Press kits, marketing materials

Rental

Conference and meeting rooms

Conference booth rental

Computer equipment rental

Equipment and Maintenance

Audio equipment

Presentation equipment

Other equipment purchase

Computer/copier maintenance
Healthy People 2010 Toolkit 32

Line Item

Internal

Resources

Internal

In-kind

External

Resources

External

In-kind

Advertising

Public meeting notices

Promotion of state plan in

small media (newsletters,

conference programs)

General media placement

(radio, print, web,

television)

Postage

Steering/advisory group

mailings

Overnight delivery services

Meeting announcements

Circulation of drafts

Correspondence to partners

Dissemination of plan and

companion documents

Marketing materials

Utilities, Telecommunications

Conference call services

Long distance services

Web site service

Electric

Supplies

Office supplies

Meeting supplies

Computer supplies

Graphic design software

Data software

Plaques or certificates of thanks

for steering group members

Travel

Staff meeting travel, lodging, and

per diem

Steering group travel and lodging
33 Identifying Resources

Line Item

Internal

Resources

Internal

In-kind

External

Resources

External

In-kind

Other Direct Costs

Meeting refreshments

Literature search/retrieval fees

Incentives for focus group

 participation

Indirect Costs

TOTAL
Healthy People 2010 Toolkit 34

Finding Other Resources

Important toExplore (

$) Responsible Party Potential Strategies to Ensure Resources

for Planning and/or Implementation

Request legislators to appropriate additional funds to implement

priority activities based upon state-plan objectives.

Private and public partners create a non-profit organization to

raise and distribute funds for Healthy People initiatives.

Ask public agencies to voluntarily adopt policies to focus their

current human and financial resources on priorities or certain

objectives.

Ask private groups to voluntarily redirect current program

resources to address health objectives.

Encourage legislators to evaluate budgets against the plan's

priorities.

Use policy and regulation to focus private sector and public

sector efforts on priorities in the plan.

Ask private foundations to consider state public health priorities

when developing grant making programs and awarding funds.

Request private organizations to provide technical assistance,

leadership, administrative support, and donated services to

planning efforts, programs, and policy initiatives.

Require local health departments or community agencies to

address health objectives as a condition of using certain public

funds. (Recipients choose which objectives to address.)

Earmark state funding for particular Healthy People activities,

objectives, or strategies in the plan, in order to ensure certain

priorities are addressed.

Request local and state health agencies contribute in-kind

resources such as personnel to planning efforts.

Set aside state funding and technical assistance resources to help

local jurisdictions with planning efforts.

Charge dues to organizational members of the state Healthy

People coalition.

Apply for private or public grants to support Healthy People

efforts.
35 Identifying Resources

Resources for

Identifying and

Securing Resources

" U.S. Department of Health and Human Services, Public Health Service, Office of Disease

Prevention and Health Promotion. Locating Resources for Healthy People 2000 Health

Promotion Projects, 1991. Available from Superintendent of Documents, U.S. Government

Printing Office, Washington, D.C. 20402. (202) 512-1800.

This publication is a guide to locating financial assistance for projects related to the Healthy

People 2000 goals. It reviews principles and procedures of grant seeking and discusses ways to

locate potential funding through local, state, and federal agencies, as well as the private sector.

" Department of Health and Human Services – GrantsNet. http://www.hhs.gov/grantsnet/

GrantsNet is a tool for finding and exchanging information about HHS and other selected federal

grant programs. This site provides access to up-to-date government resources available to the

general public.

" Office of Minority Health Resource Center. Funding Guide. Available at

http://www.omhrc.gov/omhrc/publications/publications5.htm

This guide was developed to assist grantseekers in their search for funding sources for healthrelated activities. It includes resources to enhance knowledge of public funding, private funding,

and the basics of getting started in the search for funding sources.

" National Library of Medicine HSRProj - http://www.nlm.nih.gov/nichsr/db.html#hsrp

HSRProj is one of the information products developed by the National Information Center on

Health Services Research and Health Care Technology (NICHSR), a component of the National

Library of Medicine. HRSProj contains descriptions of research in progress funded by federal

and private grants and contracts for use by policy makers, managers, clinicians, and other

decision-makers. It provides access to information about health services research in progress

before results are available in a published form.

picks
Healthy People 2010 Toolkit 36

" Robert Wood Johnson Foundation. http://www.rwjf.org/index.jsp

The Robert Wood Johnson Foundation’s mission is "to improve the health and health care of all

Americans." To stay up-to-date about RWJF program developments —- new ideas and recent

calls for proposals, subscribe to the Foundation's free quarterly newsletter, ADVANCES®, read

their annual report, or regularly visit their web site where all new publications and requests for

proposals are posted.

" W. K. Kellogg Foundation. http://www.wkkf.org/

The mission of the W. K. Kellogg Foundation is "to help people help themselves through the

practical application of knowledge and resources to improve their quality of life and that of future

generations." The searchable grants database is organized around the W. K. Kellogg

Foundation’s programming interests.

" Grantmakers in Health. http://www.gih.org/

“This is a non-profit organization serving funders throughout the country who make grants in

health and related human services. Grantmakers in Health serves these constituents through

convening, publishing, providing education/training, conducting research, developing and making

accessible databases and other information resources, providing technical assistance and

consultation, making referrals, and helping grantmakers build professional relationships.”

Please see Appendix A for other links to funding sources and references for identifying

resources for developing a state plan.
37 Engaging Partners

Identifying &

Engaging

Community

Partners

“Never doubt that a small group of committed

citizens can change the world; indeed it is the

only thing that ever has!”

—Margaret Mead

In This Section

! Action Checklist 38

! Tips 38

! Process in Action:

Examples from the Field 40

! Defining Meaningful

Citizen Participation 45

! Potential Partners 46

! Partnership Agreements 47

! Consortium Pledge 48

" Hot Picks: Resources 49

The health status of community residents is not

the sole responsibility of the public health

agency or health service providers. While

public health agencies may bear responsibility

for leading community health improvement

efforts, their success hinges on their ability to

establish and maintain effective partnerships

throughout the state. The public health agency

needs to identify and work with all entities that

influence community health––from other

government agencies to businesses to not-forprofit organizations to the general citizenry.

Healthy People initiatives should begin with a

commitment to collaboration among diverse

constituencies so that everyone feels a sense of

ownership in the state plan.
Healthy People 2010 Toolkit 38

Action Checklist:

Identifying and Engaging

Community Partners

(See page 113 for a complete planning and development checklist.)

# Define target audiences

# Identify key individuals and organizations

# Develop accountability and evaluation

plans

# Design strategies for engaging partners

# Identify roles for partners and assign

responsibilities

# Develop a communication vehicle to

highlight partner activities

# Establish formal partnership agreements

where appropriate

# Reassess and evaluate partner

involvement and satisfaction

Tips

There is strength in numbers—community input does not

burden, but strengthens, the planning process. Community

partners can:

► Advocate for the goals and objectives of the state plan in the

community and recruit other partners

► Contribute particular skills and talents

► Help monitor progress and achieve objectives

Be inclusive, not exclusive (Don't invite just your friends!)

► Strive for broad representation, and regularly assess gaps

► Identify individuals and organizations who look at problems

and solutions differently

► Look for partners who have a stake in healthy communities,

will contribute to the process, and help achieve objectives

Create and define useful roles for partners

► Confirm commitmentsin writing where possible

► Give credit where credit is due

► Accept that some partners will have different levels of

commitment
 Engaging Partners 39

Don’t just meet for the sake of meeting

► Be clear about the purpose and desired results of meetings

► Choose an effective facilitator (not always the chair)

► Show respect for other people’s time

► Plan the meeting from the participants’ perspective

Nobody likes to be a rubber stamp

► Provide a continual feedback mechanism and consider all

feedback received

► Report back to partners how comments were addressed

► Give people a voice before priorities are set

► Ensure that groups have options and understand their

implications before making big decisions

► Strive to understand all parties' concerns and perspectives

► Allow time for meaningful discussion

► Establish ground rules that are fair to all

► Establish partners' sense of ownership of the process

Re-visit lessons learned from your year 2000 planning process

► Assess partner contributions and gaps in the 2000 initiative

► Share how year 2000 plans did and did not lead to action

► Be candid with partners to establish trust and share

responsibilities for improvement

Find creative and flexible ways to engage partners and

community members

► Consider rotating meeting places and times to accommodate

different schedules and give participants a chance to see

other regions and communities

► Offer meeting options that accommodate different

preferences and levels of comfort with groups, such as:

informal discussions, conference calls, anonymous surveys,

provider forums, focus groups, independent work groups,

and kick-off events with kiosks or small break-out groups

► Use electronic communications, list servers, and web sites
Healthy People 2010 Toolkit 40

Process in Action: Examples from the Field

Below are examples of approaches that the nation and states used to identify and involve

partners in the Healthy People planning process.

From the National Initiative

Healthy People Consortium

Established in 1987, the Healthy People Consortium is comprised of more than 350 national

membership organizations and the state public health, mental health, substance abuse, and

environmental health agencies. The Consortium includes organizations that are national in

scope and whose members (individuals, institutions, or affiliates) are interested in improving

health and well being for all. Consortium member organizations represent older adults,

racial and ethnic coalitions, educators, businesses, providers, scientists, and many others.

The Consortium uses the Internet, quarterly newsletters, and annual meetings to support

ongoing communication and collaboration. In the initial stages of the Healthy People 2010

development process, Consortium members were asked to renew their commitment to

Healthy People and to the development of year 2010 objectives. See page 48 for a copy of

the pledge. Visit the Consortium website for how to join, as well as the most current listing

of members, newsletters, and summaries of annual meetings:

http://odphp.osophs.dhhs.gov/pubs/hp2000/consort.htm.

Activities

Consortium members engage in a broad range of activities that support achievement of the

national health objectives. Nearly all members have publicized the objectives to their

members; and many have used their newsletters and journals to solicit comments on the

draft Healthy People 2000 and 2010 objectives. Many others have highlighted the

objectives at their annual conferences or devoted sessions to discuss how the organization

and individuals can help achieve the objectives.

Focus Groups

In 1996, the Consortium used professionally facilitated focus group sessions with key

partners to examine the perceived value and functions of Healthy People objectives, both

current and future. The findings from the Consortium focus groups can be found in Chapter

Two of the report, Stakeholders Revisit Healthy People 2000 to Maximize the Impact of

2010 at the following web site: http://www.health.gov/HPComments/Stakeholder.

Clear themes and suggestions emerged from the analysis of the focus groups. Consortium

members were unanimous in valuing the Healthy People 2000 document as a "voice for

public health.” The value of the document was not debated, only the extent and nature of
 Engaging Partners 41

revisions to be made for the next version. Although most Consortium members did not

want major changes in the structure and content of the document, they did want to take

advantage of new information and communication technology to create not only a single

"reference" document, but also a flexible "database" that would permit multiple versions of

the document to be produced.

Healthy People State Action Contacts

The Healthy People State Action Contacts are the states' representatives to the Healthy

People Consortium. They receive national Healthy People resources and communicate to

the nation information about state activities. An updated list is available in Appendix B

and at the following web site:

http://www.health.gov/healthypeople/Contact/StateContact.htm.

Business Advisory Council

In 1997, with funding from the Robert Wood Johnson Foundation, the Partnership for

Prevention (a Healthy People Consortium member) created a Healthy People Business

Advisory Council. This Council is engaging the leaders of America’s businesses, both

large and small, in evaluating Healthy People as a tool for both worksite based and

general community health promotion. The Council also participated in Healthy People

2010 development. For information on Council activities, visit: http://www.prevent.org.

From State Initiatives

Form a statewide coalition of partners

In 1991 South Carolina formed the Healthy People

Coalition as an independent organization with

members elected to a governing council. The

Coalition's mission is to promote an environment

where all South Carolinians have the ability to

achieve and maintain maximum health and well

being. The Coalition’s strategies included raising public awareness of the national health

objectives, identifying the focus for action in communities throughout the state, and

focusing attention on reducing health status disparities among population groups. The

Coalition worked with the Department of Health and Environmental Control and other

organizations to track changes in health status, behaviors, and other indicators against the

national Healthy People objectives and promoted their findings. Local communities also

formed their own coalitions, which meet annually to learn about activities in other

localities.
Healthy People 2010 Toolkit 42

Formed in 1990, the Healthy West Virginia Coalition is comprised of 18 organizations

representing public health, health care providers, school health programs, universities,

worksites, and networks. The Coalition fosters collaboration among various sectors to

help advance the goals of Healthy People 2000 and 2010 in West Virginia. West Virginia

also planned a two-day Summit, scheduled for summer 1999, to bring together hundreds

of West Virginians for a meeting on the Healthy People goals and objectives. Another

instrumental group for pulling together key partners has been the State Health Education

Council, founded in 1977, an organization of more than 300 individuals working in the

areas of health promotion and health education in the state of West Virginia.

To achieve its year 2000 objectives, the Rhode Island Department of Health initiated the

Worksite Wellness Council of Rhode Island. Rhode Island focused on increasing health

promotion and disease prevention activities in work sites, where most adults spend the

majority of their time. The state Wellness Council entered into an agreement with the

Wellness Council of America (WELCOA) to make Rhode Island the first Well State in

the U.S. Through this agreement, Rhode Island aims to have 20 percent of its workforce

in WELCOA-certified Work Well Sites. The Wellness Council obtained a non-profit tax

status and is governed by its own Board of Directors. While the Council works toward

financial independence, the Council is staffed by the Department of Health and supported

by financial and in-kind contributions of its business members. The Council will continue

to be involved in Rhode Island's year 2010 activities.

Develop multiple levels of participation

Iowa organized multiple levels of participation in the development of year 2000

objectives. Iowa’s governor appointed a 19-member Healthy Iowans Task Force,

comprised of state agencies, academic institutions, voluntary agencies, consumers, health

professional associations, and the state board of health. Iowa's governor assured gender

and political party balanced the group. A consortium of 80 professional and voluntary

organizations assisted in the development of sections and action steps. The state mailed

several hundred copies of the draft Healthy Iowans 2000 to interested groups and

individuals for comment. Written comments, as well as testimony at public meetings,

informed the Task Force’s final deliberations with the governor over the objectives.

According to the Iowa Department of Health, the private and voluntary sector has or

shares major responsibility for 20 percent of the 338 action steps in Healthy Iowans 2000.

The state’s year 2000 plan designated specific state agencies, voluntary organizations, and

companies that would be involved in the realization of each objective.

In 1995 Vermont adjusted Vermont’s health status objectives to the community level.

This created a more meaningful document to local organizations and helped to further

engage the people at the community level.
 Engaging Partners 43

In the spring of 1996, the Texas Department of Health, the Texas Health Foundation, and

the CDC sponsored a two and a half-day conference entitled “Mobilizing for Health: The

ABCs of Community Assessment.” Over 700 persons attended the conference. The

conference goal was to provide communities with the planning, data collection,

community organizing, and policy analysis tools needed to successfully undertake the

community assessment process. It attracted a wide variety of private, public, and

nonprofit organizations and encouraged them to work together to improve the overall

health of Texas communities.

Minnesota formed the Minnesota Health Improvement Partnership, a group of individuals

representing a broad sector of both public and private organizations, including members

from local departments of health. This group was charged with the responsibility to

develop Healthy Minnesotans: Public Health Improvement Goals for 2004.

Influence strategic plans of external community organizations, both private

and public

Maine and Tennessee were among several states whose year 2000 objectives influenced

the planning and activities of private health organizations. As examples, the American

Cancer Society in Maine redesigned their core activities to reflect the state's health

objectives. Tennessee’s Health Facilities Commission incorporated the state's objectives

into its Certificate of Need Process.

Since 1995 Minnesota law has required managed care organizations to submit

Collaboration Plans to the state's Commissioner of Health. Plans must describe actions

that the health maintenance organizations or community-integrated networks have taken

or intend to take to achieve public health goals. The Minnesota legislation helps

communities utilize the combined efforts of the public and private sectors to address

priority health problems of shared concern.

In South Dakota individual programs seek input from partners within and outside state

government. The state’s Public Health Alliance Program is a cooperative effort involving

the Department of Health, local health care providers, and county government. These

entities work together to ensure the delivery of public health services. Through this

project, community councils are formed and actively participate in program planning and

implementation. County-specific health indicators are presented to community health

councils. During these presentations, the county-specific indicators are compared to

statewide indicators, national measures, and relevant Healthy People objectives.
Healthy People 2010 Toolkit 44

Methods of Community Input in the Development of

State-Specific Healthy People 2000 Plans

(N=43)

19

15

11

8

6

6

4

3

0 2 4 6 8 10 12 14 16 18 20

Included communities in

development of state plan

Assisted in development of

local groups

Worked with advisory group

(specified disease area)

Assisted in development of

Healthy Communities

projects

Worked with statewide

health associations

Provided grants or assisted

localities with grants

process

Worked with coalitions that

serve specific populations

Worked with communities

on community assessment

projects

Note: States may be counted more than once since some provide more than one type

of assistance in objectives planning, development, and tracking.

Source: Public Health Foundation. Measuring Health Objectives and Indicators:

1997 State and Local Capacity Survey. March 1998.

Number of states engaging in a specific collaborative activity
 Engaging Partners 45

How Do You Define

Meaningful Citizen

Participation?

! Power to make decisions and affect outcomes

! Citizen driven; from the community up, not top down

! Proactive, not reactive

! Encourages and facilitates broad community involvement

! Inclusive, not exclusive; accessible to all

! Balanced representation in the participation process; not just major “partners”

! Consensus-oriented decision making

! Compromise; give and take

! Opportunities for involvement in all levels of activity, which include creating a

vision, planning, prioritizing, deciding, evaluating

Source: Dever, G.E.A. Improving Outcomes in Public Health Practice: Strategy and

Methods. Aspen Publishers, Inc., Maryland, 1997.
Healthy People 2010 Toolkit 46

Potential Partners

Below is a partial listing of the many public, private, and voluntary sector partners that

states have engaged in Healthy People initiatives. Which are most important to you?

Health

# Prevention Research Centers

# Coroner, medical examiner

# Emergency medical system

# Health departments – city, county, state

# Health professional associations

# Hospitals

# Health maintenance organizations

# Medical societies

# Mental health organizations

# Substance abuse agencies

# Primary Care Associations

# Community Health Centers

# Nursing homes, home health agencies

# Nutrition centers

# Red Cross chapters-local, state

Funding Resources

# Philanthropic institutions

# United Way, foundations

Select Populations

# Area Agency on Aging

# Corrections

# Day care facilities/Head Start

# Disabled citizens' alliance

# Health department clients

# Multicultural community centers

# Shelters/soup kitchens/bars

# Youth coalitions/teen centers

# Migrant worker groups

# Minority and gay/lesbian organizations

Planning/ Regulatory Agencies

# Area Health Education Center

# Human resources council

# Regional Planning Councils

Voluntary Groups

# American Association of Retired

Persons

# Faith communities and organizations

# Civic groups

# Fire and rescue service

# Interagency coalitions and councils

# Service providers

# Water Patrol

Business

# Private businesses

# Chamber of Commerce

# Economic development directors

# Insurance companies

Education

# Colleges and universities

# Public schools - elementary, secondary

# Teachers and administrators

# Parent organizations

Communication

# Health advocacy newsletters

# Media (TV, radio, print)

# State/local web sites

Government

# Army Corps of Engineers

# Dept. of Environmental Protection

# Military installations

# Mayor’s office

# Empowerment Zone/Enterprise

Community office

# Law enforcement agency

# State legislators

# HHS Regional Health Administrators
 Engaging Partners 47

Forming Partnership

Agreements

How can partnerships effectively assist the development and implementation of the state

plan? The following provides factors to consider when delineating the roles and

responsibilities of partners.

What are partnership agreements?

► Memoranda of understanding and/or informal agreements between state agencies

and public or private partners that establish relationships or formalize existing

relationships of benefit to both partners

What are essential components of partnership agreements?

► Mutually agreed upon, clearly defined purpose

► Clearly defined roles, responsibilities, and operating procedures

► Shaped by mutual respect and trust

What are potential roles for partners?

► Link and consult with civic groups, health organizations, planning councils, and

other groups to address community health issues

► Lead community initiatives, including fundraising and policy development

► Facilitate community input through meetings, events, or advisory groups

► Provide technical assistance and guidance for program planning and policy

development

► Collect and analyze data; conduct literature reviews, research, or assessments

► Develop and present education and training programs

► Educate elected officials and policy makers on health issues 

► Market the plan

► Publish companion documents or midcourse review

► Provide resources (for ideas, see sample budget line items, page 31)

► Monitor/analyze health-related legislation

► Evaluate components of state plan

► Provide long-term support to sustain health initiatives
Healthy People 2010 Toolkit 48

Consortium Pledge

►

Healthy People 2010 Pledge

Recognizing that 50% of premature deaths in the United States can be prevented through

clinical and other preventive services as well as behavior change, and that prevention is

integral to the general health and well-being of all Americans,

_________________________ pledges to support Healthy People an Initiative of

 (Organization Name)

the Surgeon General, as it moves into the next century.

Specifically, we promise to:

1) Engage our membership in the development of the objectives for Healthy People 2010.

2) Work towards the achievement of health for all Americans by developing health

promotion and other programs that utilize Healthy People goals and objectives.

3) Have our organization listed as a member of the Healthy People Consortium in Healthy

People publications.

4) Be an active participant in the Healthy People Initiative.

Signed:

______________________________________________________________________

(Organization)

______________________________ ______________________________

(Name Printed) (Title)

_____________________________ ______________________________

(Name Signed) (Date)
 Engaging Partners 49

Resources for

Engaging

Community

Partners

" National Association of County Health Officials. Assessment Protocol for Excellence in

Public Health (APEXPH), 1991.

The tool is an eight-step process for assessing community health status and planning for

improvement. It is based on the principles of environmental justice, community collaboration,

and locally appropriate decision making. Guidance is designed to be easily accessible and

flexible enough to meet the needs of a variety of communities with differing health concerns.

For more information, see http://www.naccho.org.

" Coalition for Healthier Cities and Communities, Norris T. & Howell L. Healthy People in

Healthy Communities: A Dialogue Guide. 1999.

This guide assists communities in hosting dialogues leading to action and policy on what

makes healthier communities. It is a part of the Healthy Communities Agenda, the 1999 –

2000 campaign of the Coalition for Healthier Cities and Communities and its partners. For

more information contact the Healthy Communities Agenda “Dialogue Coach” at 1-800-803-

6516 or contact the Coalition for Healthier Cities and Communities, One North Franklin,

Chicago, IL 60606. http://www.healthycommunities.org

" Community Tool Box, http://ctb.lsi.ukans.edu/

The mission of the Community Tool Box is to promote community health and development by

connecting people, ideas, and resources. The website provides tools needed to build healthier

and stronger communities. The web site also provides information for those interested in a

variety of community health and development issues and connects individuals to personalized

assistance for improving community change efforts.

picks
Healthy People 2010 Toolkit 50

" Institute of Medicine (Committee on Public Health). Healthy Communities: New

Partnerships for the Future of Public Health. National Academy Press, Washington, D.C.,

1996. http://www.nap.edu/catalog/5475.html

"The Committee’s analysis [concludes that] the public’s health depends on the interaction of

many factors; thus, the health of a community is a shared responsibility of many entities,

organizations, and interests in the community, including health delivery organizations, public

health agencies, other public and private entities, and the people of a community."

" U.S. Department of Health and Human Services, Centers for Disease Control and

Prevention (CDC/ATSDR Committee on Community Engagement). Principles of

Community Engagement. Atlanta, Georgia, 1997.

Principles of Community Engagement provides public health professionals and community

leaders with a science base and practical guidelines for engaging the public in community

decision-making and action for health promotion, health protection, and disease prevention.

" Civic Practices Network. http://www.cpn.org/sections/topics/community/index.html

The community section of this web site provides information on community building through

“community organizing, social capital, and urban democracy.” It also provides information on

the Consensus Organizing Model, which explains some ways one can bring together all the

players in a community.

Please see Appendix A for other resources about engaging community partners.
51 Setting Priorities and Objectives

Setting Health

Priorities and

Establishing

Objectives

“Put first things first.”

—Stephen Covey

In This Section

! Action Checklist 52

! Tips 52

! Process in Action:

Examples from the Field 54

! Defining the Terms 60

! Worksheets 1 and 2 64

! Priority Setting Worksheet 66

! Priority Setting in Maryland 67

! Criteria for Objectives 70

! Defining Assets 71

! Leading Health Indicators 73

! Developing Priority Areas 74

" Hot Picks: Resources 77

Determining health priorities helps direct resources

to the areas that matter most to community partners

and that will have the greatest impact on

community health status. With so many competing

needs, selecting priorities and establishing

objectives may seem like an arduous task.

However, there are numerous models and resources

to use to identify state priorities. Develop

consensus among steering group members on what

models will be used, and how qualitative data,

quantitative data, assets, community opinion,

political agendas, or other factors will inform the

priority setting process. Striking an effective

balance among these sources of information will

make for a smoother process. When well

publicized, documented, and endorsed by

communities, a sound priority setting process helps

achieve widespread support for the plan.
Healthy People 2010 Toolkit 52

Action Checklist:

Setting Health Priorities and

Establishing Objectives

(See page 113 for a complete planning and development checklist.)

# Evaluate input from community partners

and experts

# Collect and review previous health needs

and assets assessments

# Conduct assessments of health needs and

assets, if necessary

# Plan for transitions from year 2000 to

year 2010 health objectives

# Decide where changes from year 2000

are needed and what should be retained

# Define the scope of the state plan

# Set criteria for establishing potential

priority or focus areas

# Establish a process for final

determination of priorities

# Identify and obtain information to

evaluate areas according to criteria

# Select final priority or focus areas

# Determine types of objectives desired

and establish criteria for adopting them

# Outline standard information to include

with all priority areas and objectives

# Specify intervention points; identify

potential topics and indicators for

objectives

# Develop draft objectives

Tips

Perception is reality for many people

► Learn what the community and key partners see as important

health issues (see action area, "Communicating Health Goals

and Objectives," for ideas on learning from target audiences)

► Review comments your state residents submitted on the draft

Healthy People 2010 focal areas and objectives (see page 54)

► Obtain qualitative data, where possible, to assess and describe

community perceptions

► Build on perceptions to gain broader support for priorities
53 Setting Priorities and Objectives

Define the “rules of the game” up front—before trying to

establish priorities and objectives

► Make sure everyone understands and accepts the process for

recommending and adopting final priorities

► Set a cut off date for proposing changes to the "rules"

► Determine what other plans and objectives should be explicitly

considered or incorporated into the state plan (e.g., national

Healthy People 2010 draft objectives, state performance plans,

existing tobacco or HIV/AIDS plans)

► Determine how priority areas should be related to the agreed

vision and scope of your plan

Be clear about your criteria for determining priorities and

establishing objectives

► Communicate important characteristics of objectives (e.g.,

feasibility, effectiveness, short-term/long-term, measurability)

to work groups

► Make simple worksheets or checklists to help planning group

members consistently consider criteria and see relevant

information at a glance

► Strive for measurable objectives, but don’t neglect important

health areas where measures need to be developed and

objectives may drive new data sources

You're not starting from scratchbuild on your assets, not just

your needs

► Align priorities, objectives and strategies with your state’s

strengths, assets, and opportunities where possible

► Look to other sources for information such as leading causes of

death, Basic Priority Rating or other ranking systems,

surveillance systems, or outcomes from your state’s Healthy

People 2000 plan

► Show respect for what already has been accomplished to

address priorities
Healthy People 2010 Toolkit 54

Process in Action: Examples from the Field

Below are examples of how the nation and states have identified priorities and set the

parameters for health objectives.

From the National Initiative

Regional meetings

Six public hearings were held to provide opportunities for the public to comment on the

draft of the Healthy People 2010 objectives. For more information on where these

meetings were held and a summary of the critical issues discussed, visit the following web

site: http://www.health.gov/hpcomments/default.htm.

Leading Indicators for Healthy People 2010

This report from the Health and Human Services Working Group on Sentinel Objectives

includes potential models, candidate sets of leading health indicators, available data

sources, and considerations for implementation. Information on the Leading Health

Indicators can be found at: http://www.health.gov/healthypeople/LHI.

In 1999, the Institute of Medicine (IOM) Committee on Leading Health Indicators for

Healthy People 2010 released the “Leading Health Indicators for Healthy People 2010:

Final Report.” It is currently available through the Division of Health Promotion and

Disease Prevention and IOM at: http://books.nap.edu/catalog/9436.html.

Internet

In 1997 the consultation on the Healthy People 2010 framework took place on the Internet.

Individuals from 46 of the 50 states “let their voices be heard.” New focus areas on public

health infrastructure, health communication, and disability and secondary conditions were

added to the existing framework. Many additional areas of focus were suggested and

provided the background for further discussions.

In 1998 more than 11,000 comments were received from people in every state, the District

of Columbia, and Puerto Rico. While 43 percent of the comments were placed

electronically, all the paper comments and regional testimony were scanned into the

Healthy People web site. This makes the Internet the complete repository of all comments.

They are available for use in setting state priorities and are searchable by key words and

zip codes of persons commenting: http://www.health.gov/hpcomments/.
55 Setting Priorities and Objectives

Other public forums

Presentations on Healthy People 2010 have been made at numerous conferences,

symposia, and meetings sponsored by Consortium members and other groups. These

speaking engagements offered an opportunity to describe the Healthy People 2010

development process to thousands of people in the public health community. Questions

from the audience provided opportunities for exchanging ideas, which have helped refined

the process, concepts, and content of the initiative.

From State Initiatives

Develop and use standardized

methodology or formulae

Delaware used a formula to identify its Healthy

Delaware 2000 priorities, based on the size of a

health problem (A), the seriousness the problem

(B), and the potential for interventions to

impact the public's health (C). The

seriousness of the health problem was weighted as twice the importance of its size.

Planners used several questions to determine the seriousness of a problem. The most

important criterion was the effectiveness of available interventions according to a review

of the scientific literature. To calculate the formula [(A + 2B) C], Delaware assigned

numeric scores to each defined criteria. Finally, the Governor's Advisory Committee on

Public Health categorized health problems as having the “most opportunity,” “some

opportunity,” or “less opportunity” to intervene.

Maryland developed a matrix (see pages 67-69) to rank priorities (1 to 5) that compared

state-specific health indicators to national health indicators as “better than,” “same as,” or

“worse than” for both trends and average ratings. Priorities were examined for each local

jurisdiction as well, comparing counties to Maryland. While this matrix was used

internally to set year 2000 priorities, the year 2010 process will incorporate much wider

input from the community in how to translate the priorities into objectives.

Utilize several resources for input

Kansas determined priority health issues through its Healthy Kansas 2000 Steering

Committee, who evaluated health data, sought expert opinions, invited public comments,

and conducted an opinion survey of residents. Kansas used a consensus method to limit

the scope of its objectives to seven priority health areas and four disease risk factors. The

seven priority health areas included alcohol and drug abuse, cancer, heart disease, HIV and

other STDs, infectious diseases and immunizations, injuries and violence, and maternal

and infant health. The focal risk factors were lack of access to preventative care, tobacco
Healthy People 2010 Toolkit 56

use, poor nutrition, and lack of physical activity. Work groups recommended strategies to

achieve most objectives. Where work group recommendations differed from the Kansas

Department of Health and Environment policy, the Kansas plan identified the source of

strategy recommendations.

For year 2010 plans Kansas is using input from committees and groups that were formed

during year 2000 implementation. For example, Kansas intends to use the objectives from

the state’s Injury Plan and Tobacco Control Plan. The state plans to incorporate objectives

developed through the state Cancer Plan funding into the Healthy Kansans 2010 plan.

The Montana Department of Public Health and Human Services completed the

prioritization process in order to allocate block grant dollars. For this process,

methodologies delineated in Public Health Administration and Practice by G.E. Pickett

and J.J. Hanlon, and the Assessment Protocol for Excellence in Public Health Manual,

published and distributed by the National Association of County and City Health Officials,

were used. The first method takes into account major diseases/conditions in terms of

mortality, morbidity, years of potential life lost, economic burden, proportion of the

population affected and other measures.

In 1997 and 1998, Montana also developed and published a state health plan, The Montana

Health Agenda. This plan served as a “road map” to identify and prioritize health needs in

Montana, provide health services, and direct program activities. The next publication of

The Montana Health Agenda will be January 2000. It will provide an update and progress

report on each of the priority issues. Plans are in place to expand the health objectives to

include issues of environmental health, mental health, the elderly population, and

disabilities.

Two Native American Tribes in Wisconsin went through the APEXPH process by

forming committees consisting of Tribal health clinic staff, teachers, Tribal community

leaders, and others. The results gave each of them the starting point for setting priorities.

Each committee identified priority issues and used the Healthy People 2000 document to

formulate their objectives. Experts from the field also came to talk to the committees

about activities that were already taking place and made suggestions on how to proceed.

Solicit input from community

Alabama involved more than 2,000 organizations and individuals in the development of

Healthy Alabama 2000. Testimony from seven public meetings throughout the state

guided the selection of priority areas for Alabama’s health objectives. Alabama convened

a statewide conference to further define the state’s health needs and priorities. State

conference planners secured co-sponsorship from over 60 organizations and attracted over

700 participants. A task force drafted specific health objectives for final review by all

conference co-sponsors. Alabama limited its state health objectives to 60, organized under

four broad headings.
57 Setting Priorities and Objectives

Nebraska involved only government program staff in the development of objectives and

strategies for the first version in 1989. But in 1992, the state held public forums with

speakers and presented their data findings to involve the community in the final version.

The Health Policy and Planning Office in the state Department of Health worked with

community action agencies and with local health departments. One of their lessons

learned was to make a better effort to include the rural area health departments.

Solicit input from key leaders

Arizona convened a technologically innovative gathering of leaders to determine their 10

priority health areas for the year 2000. Twenty-five state health leaders reached consensus

on the 10 priorities after a one-day meeting, the Arizona Year 2000 Town Hall. A

computer-equipped meeting room with terminals for each person enabled leaders to

anonymously brainstorm health priorities for the group’s master list. Arizona credits the

computer-based method of input with a more honest identification of the state's priority

needs and the ability to reach consensus quickly. However, one lesson learned was that

roundtable discussions in addition to the computer-based input method were needed to

help foster collaboration. Another lesson learned was that the one-day process left out a

few important areas such as environmental and behavioral health.

Divide up tasks among different groups

To set priorities for year 2000 objectives, Rhode Island's task force first analyzed and

discussed available baseline data in each of the nation's priority areas. The task force

identified health issues that had the greatest impact on the state's population, then

established five issue-specific committees: 1) Disease Control, 2) Environmental Health,

3) Family Health, 4) Disability Prevention, and 5) Injury Prevention. Each committee

identified achievable objectives and specified target populations by age group, gender,

socioeconomic status, race/ethnicity, or other at-risk categories.
Healthy People 2010 Toolkit 58

*Illinois was unusual with 790 objectives/sub-objectives and was excluded from this analysis.

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State and

Local Capacity Survey. March 1998.

Number of Year 2000 Objectives and Sub-Objectives

Among States (N=39)

Total objective/sub-objectives* 4,397

Range 20 to 308

Mean 113

Median 103

 Number of Objectives by State

Alabama 103 Iowa Nevada 61 Tennessee 120

Alaska 308 Kansas 214 New Hampshire 93 Texas 110

Arizona 50 Kentucky 185 New Jersey 120 Utah 35

Arkansas 144 Louisiana 74 New York 40 Vermont 61

California 110 Maryland 93 North Carolina 54 Virginia 30

Connecticut 161 Massachusetts 90 Ohio 119 Washington 38

Delaware 101 Minnesota 121 Oklahoma 199 West Virginia 59

Florida 86 Mississippi 288 Oregon 47 Wisconsin 253

Hawaii 122 Montana 64 Rhode Island 74 Wyoming 164

Indiana 20 Nebraska 107 South Carolina 141 Total: 4,397
59 Setting Priorities and Objectives

Number of States with and without Year 2000 Objectives/SubObjectives or Implementation Plans for Mental Health, Substance

Abuse, Environmental Health, or Occupational Health (N=47)



































































































































































































































































































19

29

31

23

11 11

8

19

9

7

14

9

0

5

10

15

20

25

30

35

Mental Health Substance Abuse Environmental Health Occupational Health



 In current state plan

In separate document

No objectives within the respective area

Number of States

Note: Some states may include objectives in their year 2000 plan and in a separate

document and may be counted twice.

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997

State and Local Capacity Survey. March 1998.
Healthy People 2010 Toolkit 60

Defining the Terms

Before beginning work on setting priorities, it is a good idea to develop a common

understanding of terms. The terms vision, goals, objectives, baselines, and targets often are

used differently by participants in planning processes.

Vision

Examples

Create healthy people in

healthy communities

through shared

responsibility

Provide citizens and

leaders with opportunities

to impact and measure the

health of the state

Create a sustainable

structure for coordinated,

interdisciplinary health

planning

Why is a plan being established?

(describes the overall goal of the state plan, a common

purpose and shared values)

Tips

• To begin crafting a vision ask, "what would a healthy

state be like?" or "what would make this plan a

success?"

• Publish the vision at outset of document with vision

statement or guiding principles.

• Use the vision to guide choices in the planning process

and to communicate priorities.

Goal

Examples

Increase regular exercise

among older adults

Ensure all children have

access to health care

Eliminate second hand

smoke in public places

What do you want to happen?

(broad and lofty statement of general purpose to guide

planning around a health issue)

Tips

• Use goals to clarify what is important within a priority

area, before drafting objectives.

• Begin with action words such as reduce, increase,

eliminate, ensure, establish, etc.

• Focus on the end result of the community's work

• Consider whether the goal is community-wide or if

specific to a particular population (by age, race,

gender, ability, etc.).
61 Setting Priorities and Objectives

Objectives

Examples

By 2010, increase the use

of safety belts and child

restraints to at least 93% of

motor vehicle occupants.

(Baseline: 69% in 1997)

By 2010, increase to at

least 95% the proportion of

people who have a specific

source of ongoing primary

care. (Baseline: 84% of

adults 18 years and over in

1994.)

By 2005, increase to 100%

the proportion of health

plans that offer treatment

of nicotine addiction.

(Potential data source:

state managed care survey)

How will we know if we reached the goal?

(offers specific and measurable milestones, or targets; sets

a deadline; narrows the goal by adding "who, what, when,

and where;" clarifies by how much, how many, or how

often)

Tips

• Consider a wide range of things that could indicate

state progress toward achieving health goals. Among

these are individual behaviors, professional practices,

service availability, community attitudes and

intentions, insurance status, service enrollment, policy

enactment, voluntary participation in employer

programs, organizations that offer particular programs,

policy compliance/enforcement findings, results of

population screening or environmental testing, or the

occurrence of events that suggest breakdowns in the

public health system.

• Be specific. What is to be achieved? (e.g., What

behavior or what outcome? Who is expected to

change, by how much, and by when)?

• Get ideas for objectives from year 2000 objectives or

other state plans, other state objectives, and the

nation's draft year 2010 objectives and comments.

• Set short-term as well as long-term objectives as a

motivational strategy.

• Be clear with numbers and percentages (e.g., know

your denominator). There is a big difference in

increasing enrollment by 20 percent, to 20 percent, or

by 20 people.

• Throughout drafting of objectives, ask are they

relevant to the goal and vision? Do they show what

the state hopes to accomplish and why? Are they

timed? Do they include a time line by which they will

be achieved? Who is held accountable for meeting

and updating the time line? Are they challenging? Do

they stretch the public health agency to set its aims on

significant improvement of importance to the

community?
Healthy People 2010 Toolkit 62

Baseline and

Target

• Objectives need a target (the desired end point

amount of change, reflected by a number or

percentage) and a baseline (where the community is

now, or the first data point in the tracking continuum).

Exceptions include policy or organizational objectives

that can be measured simply by being established.

• If data are not available about a particular priority

area, determine if there are alternative types of data

available or ones that realistically can be developed.

Strategy

Examples

Increase tax on cigarettes by

at least 75 cents.

Provide skills training to

physicians on effective

physical activity counseling

Enforce laws prohibiting

tobacco sales to minors

Expand sites promoting

CHIP and application

assistance to employers,

neighborhood agencies,

parish nursing, YWCA, and

others

.

How will the objective be reached?

(specifies the type of activities that must be planned, by

whom, and for whom)

Tips

• Generate a list of strategies that gives various sectors a

job to do (e.g., businesses, voluntary organizations,

government, health care organizations, social services,

faith communities, and citizens). Consider strategies

that require sectors to work together.

• Consider the specific assets of the state to choose

strategies that are achievable.

• Ask whether the strategy addresses known risk factors

and how it will reduce risk and/or increase health

factors.

• Provide known effective (efficacious and possible)

interventions and strategies.

• Seek individuals affected directly or indirectly by the

health threat. Enlist their support in responding to

getting policy maker or partner support for strategies.

• Seek guidance from those who may carry out

strategies on the most effective, efficient, and "doable"

activities.

• Consider strategies recommended in year 2000 state

plan and by other groups (such as PATCH, Planning

Councils, HIV Prevention Community Planning

Groups, and the Tobacco Prevention Coalition).

• Provide examples of state or local programs that work.

See HRSA's “Models that Work,”

http://bphc.hrsa.gov/mtw
63 Setting Priorities and Objectives

• Ask external consultants for technical assistance if you

need more information on strategies that have worked

around the country to address objectives. Effective

strategies may include:

$ targeted economic development

$ health education

$ social marketing

$ assessment and referral

$ policy (legislation, regulation, program policy)

$ enforcement

$ capacity building (new or improved systems)

$ coordination of services

$ changing the social or physical environment

$ employer programs

• Determine if the strategy is likely to reach the target

population.

• Work with evaluation in mind. Is the strategy set up in

a way in which its effectiveness in reaching the state

objectives can be evaluated?
Healthy People 2010 Toolkit 64

Worksheet 1

Initial Assessment

A tool as simple as a questionnaire completed by partners will help clarify priorities and

potential strategies. As an initial step after reviewing needs assessment data, ask members of

the planning group to describe the three most important health areas of concern for the state in

the next decade. For each issue, list the primary goal and the primary strategy that has been or

could be used to approach it. After consensus on the priorities has been achieved, consider this

input in ranking potential goals and issues to address.

1) Issue: 

 

Primary Goal: 

 

Strategy: 

 

2) Issue: 

 

Primary Goal: 

 

Strategy: 

 

3) Issue: 

 

Primary Goal: 

 

Strategy: 

 
65 Setting Priorities and Objectives

WORKSHEET 2

Writing Objectives

Priority Area: 

Goal

Available

Data

Sources

Potential

Objectives A.

B.

C.

Potential

Strategies

%

%

%
Healthy People 2010 Toolkit 66

 Priority Setting Worksheet

Potential criteria and methods to weigh the importance of a health event

(e.g., cancer, HIV, substance abuse)

Health Event: ________________________________________________________

To

Use

&

Sample Criteria

(tailor to ensure criteria can be applied

to all health issues being weighed)

Measure

(cite specific

measure and

data source if

available)

Score

(score data,

assign points,

or rank using

identified

method)

Weight*

(assign value

to criteria if

desired)

Weighted

Score

(score

multiplied by

weight)

Prevalence

Mortality rate

Community concern

Lost productivity, e.g., beddisability days

Premature mortality, e.g., years

of potential life lost

Medical costs to treat (or

community economic costs)

Feasibility to prevent

Other:

Other:

Other:

*A weight ensures that certain characteristics have a greater influence than others

have in the final priority ranking. A sample formula might be: 2(Prevalence

Score) + Community Concern Score + 3(Medical Cost Score) = Priority Score.

In this example, the weight for prevalence is 2 and medical cost is 3. Users

might enter data or assign scores (such as 1-5) for each criterion and use the

formula to calculate a total score for the health event.

Priority

Score (sum

of weighted

scores for each

criterion used)

Note: These criteria work only for health events. Separate criteria and methods may be needed to

weigh the importance of process or system issues (e.g., transportation, workforce development, business

participation in health promotion), particularly to compare across many types of health issues.
67 Setting Priorities and Objectives

Priority-Setting in Maryland

In Maryland, the 2010 initiative will attempt to build on its year 2000 process. The focus of

Healthy People efforts will be on eliminating health disparities for minority populations as well

as on improving the public health system’s infrastructure. Maryland’s Health Pledge to its

citizens is the basis for outlining shared goals and vision for health care delivery in Maryland.

The Department's Health Pledge addresses three focal areas: 1) creating healthy communities;

2) strengthening and expanding partnerships; and 3) creating a world class organization,

including an infrastructure that supports quality, access, efficiency, and cultural sensitivity.

Maryland is in the process of determining community-based priorities in partnership with its 24

local jurisdictions. The state and local collaboration and network of resources has allowed

monitoring of the population health needs by using centrally organized data collection and

analysis. In addition, many Maryland counties and Baltimore have completed the Assessment

Protocol for Excellence in Public Health (APEXPH) and/or Planned Approach to Community

Health (PATCH) process, and have produced strategic plans, with the help of local health

planning councils.

Maryland has assessed the needs of the population and set priorities, both at the state and local

levels, using a consensus set of health indicators. The basis for these indicators is behavioral

and preventive service data from the Behavioral Risk Factor Surveillance System (BRFSS),

mortality and natality data from vital statistics, and morbidity data such as STDs and AIDS

from the Infectious Disease Reporting System.

Maryland developed a set of indicators derived from a report of consensus indicators by

Maryland's "Committee 22.1" (named for its charge to address the Healthy People 2000

objective 22.1). Maryland used the indicators in a model referred to as the “golden diamond.”

This diamond model (see page 68) allows the Department of Health and Mental Hygiene

(DHMH) to examine morbidity and mortality rates and trends to determine high priority areas

at the state and local levels. These comparative analyses, along with review of state and local

information and input by local health officers, are used to help assess where state and local

resources should go. Information on local resources and services is used and factored into the

final determination of how funds and other resources will be utilized.

Two documents that communicate and clarify what Maryland has accomplished in the

development of goals and objectives are Healthy Maryland, Volumes I and II. Volume I

focuses on benchmarking the health status of Maryland as compared to national measures.

Volume II focuses on specific objectives for both the state and local areas and includes details

about the local programs in operation.
Healthy People 2010 Toolkit 68

A Local Example in Maryland Using the PEARL Framework

The Cecil County Community Health Advisory Committee (Committee) was formed to assess

the health status of Cecil County and develop a Community Health Plan for improving health

status. Task forces, which drew from beyond the Committee membership, were formed to

analyze and plan interventions for each of seven priority health problems. The task forces

identified factors important to Cecil County through existing data, quick surveys, focus groups,

and background community familiarity. The involvement of other agencies made available

much more data and information than the Cecil County Health Department usually had

accessible. The task forces also reviewed goals and objectives from Healthy Communities

Heart Disease 

T uberculosis 

Syphilis 

Low Birth Weight 

Breast Cancer 

Homicide 

AIDS 

All-Causes Mortality 

Lung Cancer 

Hepatitis B Infant Mortality – W 

Infant Mortality – NW 

Late/No Prenatal Care 

Stroke 

Measles 

Suicide 

% Birth to < 18 yr. Old 

Motor Vehicle Mort. 

Priority 

Ranks 

Worse than 

Maryland RATE compared to U.S. RATE for the past 5 years

Worse than 

5-year 

TREND in Maryland Compared to 5-year TREND in U.S. 

Consensus Set of Disease Indicators by Comparisons of Rate and Trend, and Priority Ranks for 

Maryland and the U.S., 1989-1994 

Better than

Same as

Better than

Same as

5 

4 

3 

2 

1 
69 Setting Priorities and Objectives

2000 and chose those appropriate to the priority health problems and local contributing factors.

They then modified each for Cecil County. Locally appropriate interventions were developed

by the task forces using an evaluation framework known as PEARL (Vilnius and Dandoy): a

socio-economic, legality, and political viability tool.

P = propriety; is an intervention suitable?

E = economics; does it make economic sense to address this problem?

A = acceptability; will this community accept an emphasis on this problem and will

they accept the proposed intervention?

R = resources; are funding and other resources available or potentially available?

L = legality; do the current laws allow the intervention to be implemented, and if

not, is it worthwhile to expend time, energy, and resources working for

legislative or regulatory change?

The results of the task forces were specific plans for each of the seven priority health areas.

These plans were combined into an overall summary plan that recognized interventions that

would address more than one problem. Priority interventions were grouped by the level of

community involvement in the spectrum of prevention: individual knowledge, community

education, provider education, meeting treatment needs, building coalitions and networks, and

changing organizational practices, policy, and legislation.

Source: Vilnius D., Dandoy S. "A Priority Rating System for Public Health Programs."

Public Health Reports, 105(5):463-470, 1990.
Healthy People 2010 Toolkit 70

Criteria for Objectives

Development

♦ The result to be achieved should be important and understandable to a broad audience

and relate to the Healthy People 2010 goals and focus areas.

♦ Objectives should be prevention oriented and should address health improvements that

can be achieved through population-based and health-service interventions.

♦ Objectives should drive action and suggest a set of interim steps that will achieve the

proposed targets within the specified timeframe.

♦ Objectives should be useful and relevant. States, localities, and the private sector should

be able to use them to target efforts in schools, communities, work sites, health practices,

and other settings.

♦ Objectives should be measurable and include a range of measures–health outcomes,

behavioral and health service interventions, and community capacity–directed toward

improving health outcomes and quality of life. They should count assets and achievements

and look to the positive.

♦ Continuity and comparability are important. Whenever possible, objectives should build

upon Healthy People 2000 and those goals and performance measures already adopted.

♦ There must be sound scientific evidence to support the objectives.

Source: U.S. Department of Health and Human Services, Office of Disease Prevention and Health

Promotion. Developing Objectives for Healthy People 2010, 1997.
71 Setting Priorities and Objectives

Defining Assets

Defining your assets and capacities will help with the efficiency of your planning efforts. It

will assist in setting the criteria for your objectives as well as prevent duplicate efforts. It will

also identify strengths that may be used to your advantage and weaknesses that may need

addressed.

PRIMARY BUILDING BLOCKS

Individual Assets

Skills, talents, and experience of residents

Individual businesses

Home-based enterprises

Personal income

Gifts of labeled people (handicapped,

mentally ill, etc.)

Organizational Assets

Associations of businesses

Citizens associations

Cultural organizations

Communications organizations

Religious organizations

SECONDARY BUILDING BLOCKS

Private and Non-profit Organizations

Higher education institutions

Hospitals

Social services agencies

Public Institutions and Services

Public schools

Police

Libraries

Fire departments

Parks

Physical Resources

Vacant land

Commercial and industrial structures

Housing

Energy and waste resources

POTENTIAL BUILDING BLOCKS

Welfare expenditures

Public capital improvement expenditures

Public information

Source: McKnight J.L., Kretzmann J.P. Mapping Community Capacity. The Asset-Based Community

Development Institute, Institute for Policy Research, Northwestern University, 1996.
Healthy People 2010 Toolkit 72

Examples of Assets

Source: The Neighborhood Resource Center of Metropolitan Denver. What Makes a Community

Healthy? Principles and Ideas for Building Strong Neighborhoods. Doug Likhart, Executive

Director.

Involved Institutions

Well-attended community-based churches Service clubs

Interactive neighborhood theatres and cultural museums Business associations

School-to-community relationships Thriving neighborhood-oriented businesses

Hospitals dedicated to community interests

Community centers with diverse participants and activities

Involved Community

Phone trees Newsletters

Regular meetings of the neighborhood association

Relationship between neighbors and police

Intergenerational activities Community bulletin board

Relationship between neighbors, cities and elected officials

Involved Residents

Block captain Garden/book clubs, etc.

Strong P.T.A Interest in block parties

Neighborhood co-ops Active neighborhood watch
73 Setting Priorities and Objectives

 Leading Health Indicators

A short list of leading health indicators can help focus attention on a small number of key

issues, define measures that indicate overall progress toward achieving health objectives, and

communicate priorities to communities and leaders.

The indicator sets proposed by the Institute of Medicine Committee on Leading Health

Indicators for Healthy People 2010 are:

1. Health Determinants and Health Outcomes Set – multifaceted

2. Life Course Determinants Set – at every age there are measures of good health

and means to achieve it

3. Prevention Oriented Set – prevention is the goal

Criteria Guiding Selection of Leading Health Indicators

1. Worth Measuring - the indicators represent an important and salient aspect of the public’s

health

2. Can be Measured for Diverse Populations - the indicators are valid and reliable for the

general population and diverse population groups

3. Understood by People Who Need to Act - people who need to act on their own behalf or

that of others should be able to readily comprehend the indicators and what can be done to

improve the status of those indicators

4. Information Will Galvanize Action - the indicators are of such a nature that action can be

taken at the national, state, local and community levels by individuals as well as organized

groups and public and private agencies

5. Actions That Can Lead to Improvement Are Known and Feasible - there are proven

actions (e.g., personal behaviors, implementation of new policies, etc.) that can alter the

course of the indicators when widely applied

6. Measurement Over Time Will Reflect Results of Action - if action is taken, tangible

results will be seen indicating improvements in various aspects of the nation’s health

Source: Committee on Leading Health Indicators for Healthy People 2010. Leading Health Indicators

for Healthy People 2010: Final Report. Division of Health Promotion and Disease Prevention, Institute

of Medicine, 1999.
Healthy People 2010 Toolkit 74

 Developing Priority Areas

SAMPLE GUIDANCE TO WORK GROUPS

Healthy Iowans 2010: A Guide to Chapter Team Discussion

The following information has been prepared as a guide for teams as discussion of each

[Healthy Iowans 2010] chapter’s contents begins. Use this information to guide your teamwork

today and at future meetings as consensus is reached regarding the final content for your team’s

chapter. As work progresses, your team will want to concentrate on several components that

are expected from each team for the “finished product” chapter narrative. These components

include an introduction followed by goals with a trend line where appropriate, and a rationale

and action steps for each goal.

I. Dimensions of the Problem – The following questions can be used to open the

discussion of the problem:

• What are the compelling public health reasons for people to be concerned about the

problem?

• How can the problem be documented with supporting data?

• What interventions are effective in solving the problem?

• Why is common action important?

• Who needs to be involved in the action?

• What system do we have in place now to prevent the problem and promote health?

• What stages within the health system need to be mobilized? (for example, health

promotion, disease prevention, acute treatment, aftercare)

• What health disparity and quality of life issues need to be considered?

• What will happen if the problem is not addressed? What are the societal costs?

II. Goals and Action Steps – The goals and action steps are the outline of what needs

to be done to address the problem. When making an assessment of the need,

consider the following:

• Prevalence (the number of proportion of cases or events or conditions in a given

population; often further distinguished as point prevalence–a single point in time or

period prevalence–over a period of time.)

• Frequency (the number of times an event occurs within a stated period of time)

Examples: rate of children immunized, facilities to be inspected, food-borne

outbreaks, requests for assistance, results of screening)
75 Setting Priorities and Objectives

• Incidence Rate (a measure of the frequency with which an event, such as a new case

of illness, occurs in a population over a period of time)

• Seriousness

$ High risk exposure or environmental conditions

$ Urgency

$ Severity of disability/disease

$ Survival rate after exposure

$ Case fatality rate

$ Direct impact on others (likely or not and to what degree)

$ Comparative risk information

• Any other information to demonstrate the importance of the problem

In setting goals and action steps, consider these questions:

• What are the expected outcomes?

• What are the cost and time to accomplish the goals and take action?

• Is there any research demonstrating that interventions are effective?

• Are there baseline data so the goals and action steps can be tracked?

• If there are no data available for tracking, is a developmental goal needed at the

outset to establish baseline information? (This goal will be addressed immediately.)

• What agency or group is willing to assume responsibility for achieving the goal or

taking action?

• What kinds of communication in social marketing strategies as well as in

technology will be needed to reach the goals of take action?

• To insure a broad-based document, identify the targeted populations and the

channels for reaching them. Are there populations experiencing disparities in health

status?

III. Writing the Goals and Action Steps for the Chapter

The goal statement. The goal statement includes the level to which a health problem should

be reduced or maintained within a specified time period of 10 years. Set a baseline for each

goal so progress can be tracked. (We will follow the federal decision to do age adjustment

based on the 1940 census and readjust the baseline to our year 2000 population in 2001.) List

the national objective reference. In some cases, Iowa will set goals which are unique to this

state with no national equivalent. This should be noted.

The rationale for the goal statement. The rationale provides answers to why the goal needs

to be achieved and what needs to happen. What regulatory or policy requirements apply? Who

is the target audience and why? What resources will it take to achieve the goal? What are the

internal strengths and weaknesses and the external opportunities and threats (SWOT analysis)?
Healthy People 2010 Toolkit 76

A trend line chart. Where possible, using the baseline and the 2010 goal, develop a trend line.

The action step. The action step explains what will be done to achieve the goal, who or what

agency will be responsible for taking the action, and when the action will be taken. The action

should be taken within the first five years of the decade. (This will require a midcourse

review in 2005 with new action steps for the next five years of the decade.)

Source: Iowa Department of Public Health and Healthy Iowans. Contact: Louise Lex, 515-281-4348,

llex@idph.state.ia.us.
77 Setting Priorities and Objectives

Resources for

Setting Health

Priorities and

Establishing

Objectives

" CDC WONDER – The CDC Prevention Guidelines Database.

http://wonder.cdc.gov/wonder/prevguid/prevguid.shtml

The database is a comprehensive compendium of all of the official guidelines and

recommendations published by the Centers for Disease Control and Prevention (CDC) for the

prevention of diseases, injuries, and disabilities. This compendium was developed to allow

public health practitioners and others to quickly access the full set of CDC's guidelines from a

single point, regardless of where they were originally published.

" Maiese D, Fox C.E. “Laying the Foundation for Healthy People 2010.” Public Health

Reports, January 1998.

This article summarizes activities implemented to gain input from people on Healthy People

2010, with hopes that these efforts would be duplicated by states and communities in their own

planning processes. Available at: http://www.health.gov/hpcomments/2010article.htm.

" Committee on Leading Health Indicators for Healthy People 2010. Leading Health

Indicators for Healthy People 2010: Final Report. Division of Health Promotion and Disease

Prevention, Institute of Medicine, 1999.

This report is a compilation of the committee’s efforts to establish leading health indicator sets

that could “focus on health and social issues as well as evoke response and action from the

general public and the traditional audiences for Healthy People.” Available at:

http://books.nap.edu/catalog/9436.html.

picks
Healthy People 2010 Toolkit 78

" U.S. Department of Health and Human Services, Office of Disease Prevention and Health

Promotion. “Developing Objectives for Healthy People 2010.” 1997.

Provides information on the process for developing the Nation’s third set of disease prevention

and health promotion objectives and includes a 1997 Summary List of Objectives. It describes

how to get involved. Also available at:

http://www.health.gov/healthypeople/publications/hppublist.htm

Please see Appendix A for other resources for setting health priorities and establishing

objectives.
79 Setting Targets and Measuring Progress

Obtaining Baseline

Measures, Setting

Targets, and

Measuring

Progress

“What gets measured, gets done.”

 —Unknown

In This Section

! Action Checklist 80

! Tips 80

! Process in Action:

Examples from the Field 82

! Potential Health Measures 91

! Setting Targets for

Objectives 93

! Measuring Progress 97

! Evaluating Data 99

! Explaining Data Changes 101

! Existing Data Systems 103

" Hot Picks: Resources 104

Data are the foundation of any effective

objectives-setting or benchmarking initiative. As

shown in the previous section, the collection and

analysis of both quantitative and qualitative data

are critical for setting health priorities. Once a

state identifies the priority health areas and

potential indicators, a baseline must be set (may

require collecting new data) to determine where

the state or community currently is on a given

problem or indicator and set the stage for

determining where it wants to be by the turn of the

next decade (target). Setting targets (determining

the desired amount of change over a given time

interval) is the next critical step. Finally,

monitoring progress toward meeting objectives,

through collection and analysis of tracking data,

should be done on a scheduled basis. Regular

reporting and analysis of progress can help state

planning groups and leaders refocus resources

where they are needed most.
Setting Targets and Measuring Progress 80

Action Checklist:

Obtaining Baseline Measures,

Setting Targets, and Measuring Progress

(See page 113 for a complete planning and development checklist.)

# Consult with state experts on census,

age-adjustment, ICD-10, and other data

changes

# Set criteria for evaluating existing public

and private data sources

# Inventory relevant public and private

data sources to measure objectives

# Review progress in achieving state

Healthy People 2000 objectives

# Develop targets with appropriate

baselines and measures and finalize

objectives

# Develop methods for measuring

objectives without existing data sources

# Gather and evaluate other data and

information to include in state plan

# Plan regular intervals to measure and

track achievement of targets

Tips

Look out your front door for help with your data needs;

there are many able and willing partners

► State center for health statistics

► Health information unit

► Health department statisticians, epidemiologists, and program

directors

► Health data analysts at the local, state, and national levels

► Other local and state government agencies

► Academic partners

Address major data issues up front, and be prepared to explain

impact of data changes

► Age-adjustment to the year 2000 standard

► Census classification changes (stay tuned)

► New International Classification of Diseases, 10th Edition

(ICD-10)
81 Setting Targets and Measuring Progress

► Need for and creation of new data sources

► Standards for the quality of information sources

► Analysis of trends

► Year 2000 computer problems

► Measurement of incidence/prevalence of health problem

Use a variety of sources for baseline measures

► Healthy People 2010 draft

► National, state, and local surveys, surveillance systems, and

registries

► Private community partners with their own databases (e.g.,

hospitals)

Set challenging, yet realistic, targets for your objectives

► Identify lessons learned from the year 2000 targets (e.g., how

many were too ambitious or not ambitious enough, how many

had to be reset and why)

► Use previously identified statewide performance

measurements

► Use existing state agency or program-specific benchmarks

► Set targets to eliminate population health status disparities

► Use applicable national Healthy People 2010 targets

► Use other statistical methods (see page 93)

Plan your approach to track the progress of your objectives

► Maintain consistency of terms and data definitions

► Produce progress reports focusing on: racial and ethnic

populations, geographic areas, stages of life, and/or priority

issues

► Incorporate objectives in regular reports (e.g., HMO report

cards)

► Plan an annual Healthy People 2010 update

► Coordinate press releases with other reports and updates
Healthy People 2010 Toolkit 82

Process in Action: Examples from the Field

Below are examples of how the nation and states addressed data issues.

From the National Initiative

Obtaining Baseline Measures and Identifying Data Needs

Monitoring data

In 1991, the Health Promotion Statistics Division was established at CDC/National

Center for Health Statistics (NCHS) to monitor Healthy People 2000. Staff in this unit

coordinate with the HHS lead agencies in collecting and reporting on the national

Healthy People objectives. This division produces the Healthy People 2000 Review,

available at: http://www.cdc.gov/nchswww/products/pubs/pubd/hp2k/hp2k.htm.

Developing new data

Healthy People 2000 spearheaded the development of new data throughout the past

decade. In 1991, nearly one-third of the national objectives had no baselines when they

were initially set. By 1998, 82 of these 91 objectives had measures. These include

areas such as school health, health provider activities, and work-site health.

Selecting indicators, setting targets, and tracking progress

Promoting continuity between plans

The initial draft of Healthy People 2010 disseminated for public comment continued many of

the objectives from Healthy People 2000. In fact, 138 objectives were maintained from

Healthy People 2000, while 96 objectives were revised and 297 new objectives were

introduced. The continuity between the plans helps to confirm trends and promotes long-term

analysis of the same subjects.

Setting targets that are challenging, but necessary

The Healthy People 2010 draft proposed a goal of eliminating health disparities resulting in one

target for all population groups to achieve. In fact, for behaviors, risk factors, and services

objectives, the target is better than the best population group. For most outcomes, national

averages were used with explicit recognition that all groups should improve.

Healthy People 2000 Newsletters: Statistical Notes and Statistics and

Surveillance

Two NCHS newsletters address technical issues related to assessing progress toward the year

2000 objectives. Visit: http://www.cdc.gov/nchswww/products/pubs/pubd/hp2k/hp2k.htm.
83 Setting Targets and Measuring Progress

From State Initiatives

Obtaining Baseline Measures and

Identifying Data Needs

Assessing data and data needs in order to

set objectives

The Connecticut Department of Public Health

responded to the year 2000 national initiative

with a coordinated, internal data-oriented

review of Healthy People 2000 and development of state objectives. In 1992, the

Department of Public Health produced Healthy Connecticut 2000 Baseline Assessment

Report, as a framework for program planning, evaluation, policy development, and

assurance activities. The report originally contained 112 objectives in 18 priority areas

that focused on health status and risk reduction. The Department of Public Health

updated the Baseline Assessment Report in 1997 with 42 service and protection

objectives. The objectives set targets for the services needed to address the health status

and risk reduction objectives.

In the District of Columbia, the State Center for Health Statistics was given the task of

working with Program Administrators and staff to produce a comprehensive review of

progress from 1993 to 1998 toward meeting Healthy Residents Year 2000 Objectives.

In January of 1999, the Progress Review was completed and released. Following the

evaluation and documentation of progress, program administrators and staff working

with their Advisory Board members, community-based contacts, and collaborating

federal agencies developed the draft year 2010 objectives for both internal review and

public comment.

In Ohio, as a part of Ohio’s Public Health Plan, the Data System Work Group assisted

the Healthy People Ohio (HP Ohio) Work Group by preparing a Data Inventory. The

inventory specifies the data source and whether data are available for each HP Ohio

objective. The Data System Work Group also identified baseline data for some of the

HP Ohio objectives, and made recommendations for data collection for objectives with

no data source. The HP Ohio objectives are included in the Ohio Department of

Health’s data warehouse.

The Great Lakes Inter-Tribal Council of Wisconsin and the Inter-Tribal Council of

Michigan serve Tribes in both states through a Cooperative Agreement Epidemiology

Project (The EpiCenter). The EpiCenter developed Tribal-specific community health

profiles based on health indicators by making use of Indian Health Service’s Base Line

Measures, a needs assessment, and Healthy People 2000. Data in the community health

profiles serve as baseline measures and descriptions of changing health status for the

Tribes in the project service area.
Healthy People 2010 Toolkit 84

In South Dakota, data activities begin at the program level with programs following the grant

proposal/reporting process for developing baseline measures, setting targets, and determining

methods for progress measurement. Many grants, such as the Maternal and Child Health Block

Grant, use Healthy People performance measures, grant-specific performance measures, and

state-specific performance measures.

In 1995 Minnesota developed objectives to improve its data systems' ability to measure

progress toward the year 2000 objectives. Among these objectives, Minnesota sought to collect

and disseminate data from state agencies, local agencies, health plan companies, and other

health care providers. The state planned to identify significant gaps in disease prevention and

health promotion data, as well as establish methods to collect and analyze health status

indicators.

Identifying and communicating data sources and data needs specific to

the measurement of each objective in the plan

Healthy New Jersey 2000 details state data needs for each goal and corresponding

objectives. New Jersey expanded its list of relevant data needs beyond health status

objectives. As examples, the plan calls for better patient socioeconomic and clinical

outcome data, standardized definitions of certain conditions, evaluation data on

prevention interventions, and economic impact data.

In Texas, through a grant from the CDC, the department received staff assistance to

develop a series of on-going reports tracking state progress according to the 18 Health

Status Indicators recommended by CDC in conjunction with the Healthy People 2000

initiative. The preparation of this series of reports was institutionalized within the

department and is continued as an important component of its ongoing assessment of

the state’s health status.

The Illinois Project for Local Assessment of Needs (IPLAN) was developed to assist

local health departments to complete community health needs assessments. The system

utilizes Healthy People 2000 and Healthy People 2010 objectives as reference points,

where applicable, and provides over 100 state- and county-level population-based

health indicators. For some indicators, community-level data are available. Originally

designed as a stand-alone PC-based data system, the current IPLAN system is available

through the Internet and can be viewed at: http://app.idph.state.il.us/index.htm.

Selecting indicators, setting targets, and tracking progress

Selecting indicators based upon previously identified performance

measures or benchmarks

The Colorado Statewide Outcomes/Indicators Task Force established a defined set of

measures to rate the performance of the Colorado Department of Public Health and

Environment (CDPHE). Performance was measured in terms of outcomes (e.g., heart
85 Setting Targets and Measuring Progress

disease death rates), rather than processes (e.g., number of adults who have had their

blood pressure checked). Task Force members represented public health agencies,

managed care organizations, academia, and philanthropic organizations. Populationbased objectives were developed to reflect the Healthy People 2000 national plan and

the CDPHE budget requests.

Rhode Island’s Minority Health Information Improvement Project aimed to strengthen

the state’s ability to assess and respond to the health needs of its diverse population.

The project developed methods to use existing data sources to measure progress toward

year 2000 objectives for racial and ethnic minority populations. Through a

collaboration between the Rhode Island Health Department and the Minority Health

Advisory Committee, the project published a minority health status sourcebook that

established baselines and identified data gaps for minority populations.

To provide continuity with earlier statewide health improvement plans, Washington

based its primary health indicators on existing “performance measures” in six public

health areas. Each indicator has a primary measure (e.g., the mortality rate) followed by

other measures of impact and burden (e.g., hospitalization, years of potential life lost).

To assist a wide range of audiences engaged in local planning and implementation,

Washington compiled for each health area existing data on population risk factors,

protective factors, and intervention effectiveness from research and practice.

The Oregon Legislature directed all state agencies to develop performance measures

with ties to the state’s indicators of well being, called Oregon Benchmarks. From 1992

through 1997, Oregon used funding from a CDC grant (Assessment Initiative) to

compile valid existing data and measure their benchmarks. These results were

submitted to the legislature in an annual progress report.

Tracking and communicating progress toward objectives

For its 1996 and 1999 updates to the state’s year 2000 objectives, New Jersey’s

statistical and program staff assessed progress and analyzed trends. Based on their

trend analysis, staff categorized each objective and sub-objective as “likely to be

achieved,” “unlikely to be achieved,” or “uncertain.”

Washington analyzed data from local, county, state, and national sources in its 1996

statewide assessment of health status, health risks, and health systems. The state used a

standard format to present data on its progress in each priority area, including analyses

of time trends, geographical variation (including numerous objectives tracked at the

county level), variation by age, gender, race, ethnicity, income, and education (where

available).

California created individual county health status profile tables, containing 26 Healthy

People health status indicators. Data for the profiles are provided by the state Center for

Health Statistics, the Division of Communicable Disease Control, and the Office of
Healthy People 2010 Toolkit 86

AIDS of the Department of Health Services. The Demographic Research Unit and the

Census Data Center of the Department of Finance provided the 1990 census data and

the 1996 race/ethnic population estimates, by county, with age and sex detail.

In addition, as part of its strategy for addressing data needs, California has the Health

Information and Strategic Planning Division (HISP) of the California Department of

Health Services (DHS). This division takes the lead in making the DHS health data

systems more integrated, accessible, and useful for policy development and program

management. It also develops uniform health data systems to promote the collection of

information on health status outcomes, provides technical assistance and support to

local health agencies, organizes strategic planning and special initiatives in support of

DHS priorities, and builds strong relationships with public health organizations and

schools of public health.

In 1992 the Michigan Department of Community Health (MDCH) established a

strategic planning process, which linked state-level health assessment to the

identification of priorities, goals, objectives, and strategies to improve health. Healthy

Michigan 2000, issued in 1993, provided a guide for improving health by the year 2000.

The foundation of the plan was an assessment of not only health status and health

system trends, but also the economic, demographic, public perception, and management

trends likely to influence the public’s health. In 1996 Healthy Michigan 2000, Second

Edition, re-affirmed the goals documented in the first edition and streamlined the

objectives to reflect the areas most in need of significant emphasis or change in order to

reach the goals.

Between 1992 and 1996, MDCH created an agency-wide Surveillance and Data

Strategic Work Group to promote greater use of surveillance data in policy and program

decision-making and to determine the data needed to monitor progress toward reaching

Healthy Michigan 2000 objectives. The work group drafted a “Health Surveillance

Plan” to enhance the capacity for the collection, analysis, interpretation and

dissemination of information on health status, health risks, and health systems. The

“Health Surveillance Plan” established variables for monitoring objectives contained in

Healthy Michigan 2000, identified gaps in data and potential problems, and suggested

possibility for new and enhanced data sources. The plan also recommended a set of

critical health indicators as a means of communicating the overall health of the state’s

population. Based on the “Health Surveillance Plan,” the state initiated annual

reporting on selected critical health indicators in 1996. Michigan Critical Health

Indicators are linked to both key Healthy Michigan 2000 objectives and related

interventions.

In Utah the governor’s Office of Planning and Budget coordinates data collection and

monitoring of performance measures for all state agencies, as specified in the Utah

Tomorrow strategic plan. The governor’s office maintains performance measurement

data in their information base. In 1995, with funding from the CDC, the Utah
87 Setting Targets and Measuring Progress

Department of Health, Office of Public Health Data published data to track the 18

Healthy People 2000 health status indicators by local health department district.

On July 1, 1993, the North Dakota Department of Health began to assess the state’s

progress toward meeting the year 2000 objectives. A point-in-time study was

conducted from July 1, 1993, through March 11, 1994. The report was published in

June 1994 and helped the state health department and local communities to identify

high priority needs. Some of the findings included: 22 percent of the Healthy People

2000 objectives had been met, 23 percent were unmet, 5 percent were moving away

from the HP 2000 target, and 49 percent had no data available.

Alaska completed two Healthy Alaskans 2000 data reports. One report was released in

March 1997 which updated the health status objectives for Healthy People 2000

objective 22.1. The second report was released in December 1998 which was a

complete update on all Healthy Alaskans 2000 objectives. The December 1998 report

also emphasizes that data collection is the first step in public health planning and an

interim step in developing a comprehensive review of Healthy Alaskans 2000.
Healthy People 2010 Toolkit 88

Percentage of State Year 2000 Objectives/Sub-Objectives

Tracked Using States' Identified "Top Five" Data Sources

Total Objectives/Sub-Objectives Using "Top Five" Sources = 3,130

(N=36)























 

























 





















































Notifiable Disease 

Reports

16%

Hospital Discharge 

Data

2%

Youth Risk 

Behavior Survey

3%

Vital Statistics

33%

Other

25%

Behavioral Risk 

Factor Surveillance 

System

21%

Note: Each state was asked to identify its "top five" data sources used for tracking objectives and

to identify the number of objectives/sub-objectives tracked by those five data sources. Data

sources not appearing in a state's "top five" list were captured in the "other" category.

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State and

Local Capacity Survey. March 1998.
89 Setting Targets and Measuring Progress

Extent that Availability of Baseline Data Influenced the

Selection of States' Year 2000 Objectives/Sub-Objectives

4

5

14

23

0 5 10 15 20 25

Not at all

Little

Some

Substantially

Number of States

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State

and Local Capacity Survey. March 1998.
Healthy People 2010 Toolkit 90

Number of States that Provided Assistance to Local Health

Departments for Year 2000 Initiatives, by Type of Assistance

4

7

13

21

28

30

0 5 10 15 20 25 30 35

Technical

assistance/training

Report/survey

information

Online

clearinghouse/bulletin

board/web site

State office dedicated to

LHD tracking needs

Surveillance/Resource

Guides

Conferences

Number of States

Note: States may be counted more than once since some provided more than one 

type of assistance

Note: States may have been counted more than once because some provided more than one type of

assistance.

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State and

Local Capacity Survey. March 1998.
91 Setting Targets and Measuring Progress

Potential Health Measures

The following is intended to assist you in identifying different types of measures for your

state's health plan. It is not meant to be an exhaustive list, but provides types of measures many

communities have found beneficial in developing and monitoring health objectives.

COMMUNITY MANAGEMENT

Interagency networks

Open city council meetings

Planning - economic development, social

planning council

Policy environment

Readiness - fire escape plans, CPR training,

retirement preparation

Representation in community groups

Responsiveness - emergencies

Volunteerism level

Voter turnout

DEMOGRAPHICS

Age distribution

Education levels

Median income

Occupations

Population stability

Poverty levels

Unemployment rates

GROWTH AND NUTRITION

Breastfeeding prevalence

Developmentally delayed children

Fruit and vegetable consumption

Disability prevalence

Enrollment in entitlement programs

Elders who participate in fitness programs

Life expectancy

Self-reported health status

Women, Infants and Children (WIC)

HEALTH BEHAVIORS

Exercise levels

Overweight prevalence

Tobacco use

Alcohol use/abuse prevalence

Substance abuse treatment need

HEALTH CARE RESOURCES

Insurance status

Medicaid/Medicare providers

Managed care penetration

HEALTH CARE UTILIZATION

Hospital use rate

Preventable hospitalizations rate

HEALTH OF EMPLOYEES

Sick days used

Workmen’s compensation claims

Worksite injuries and deaths

HEALTH OF MOTHERS AND

CHILDREN

Contraceptive services and need

Low birth weight babies percent

Prematurity prevalence

Prenatal care percent

Teen parenting prevalence

MORBIDITY

Dental caries among children

Communicable diseases rates

Vaccine preventable disease/deaths

Mental illness prevalence
Healthy People 2010 Toolkit 92

MORTALITY

Infant mortality - neonatal, post-neonatal

Major killers - CHD, cancer, stroke, homicide,

suicide, motor vehicle injuries,

unintentional injuries, diabetes,

COPD, AIDS

Overall and age-level

PHYSICAL ENVIRONMENT

Environmental conditions - air, water,

recreational water site quality

Environmental hazards

Epidemics

Household smoke detectors

Households on water and sewage treatment

systems, septic systems

Household fuel efficiency

Household recycling

Industrial waste recycling

Lead paint housing vulnerability, soil

Natural disasters

Nuisance index - noise, dirt, odors

PREVENTIVE MEASURES

Blood pressure checks

Childhood immunization rates

Cholesterol checks

Colon cancer screening prevalence

Diabetic eye and foot exams

Flu vaccine use among the elderly

Mammography screening prevalence

Pap test prevalence

SOCIAL SUPPORT MEASURES

Bike path mileage

Recreation center use

Child abuse investigations

Domestic violence services

Family and friend support networks

Religious center use

Law enforcement

Neighborhood Watch Programs

Self help group participation

Suicide prevention services

Transportation services

Source: Empowerment Zone/Enterprise Community Health Benchmarking Project. Public Health

Foundation, 1998-1999.
93 Setting Targets and Measuring Progress

Setting Targets for Objectives

One of the central issues many states struggle with when developing objectives is how to set

achievable, realistic targets for outcome, performance, and process objectives. The guidance

below focuses primarily on setting targets for health outcomes and performance.

$ Using an absolute percent decline

Some Healthy People 2000 objectives used an absolute percent decline based on “best

guesses”/expert opinion. Calculations can be made based on the percent of the target

population reached and change expected. For example, a decline in mortality of 30

percent expected in two-thirds of the women with breast cancer.

[Start Amount x (1-.30) x 2/3] + [Start Amount x 1/3] = End Amount

Example: Breast cancer rate of 33/100,000

[33 x (1 - .30) x 2/3] + [33 x 1/3] = 15.4 + 11 = 26.4/100,000

$ Using peer communities

You can set targets by comparing your community to others like it. Age and poverty

distribution and population size and diversity may define peer communities. The

following may be used to describe one’s peers: typical values for a specific objective,

means or medians, or the variation among peers. Visit the Public Health Foundation web

site for more information on the Community Health Status Indicators Project, which is

utilizing this strategy: http://www.phf.org/data-infra.htm#Community.

$ Using the pared-mean method to set data driven benchmarks

The pared-mean method determines “top performance.” This is defined as the best

outcome accomplished for at least 10 percent of the population.

Steps to Compute the Pared-Mean (The article cited below uses an example of

mammography screenings)

1. Rank order providers or other units of analysis (e.g., health departments,

jurisdictions) in descending order of adherence. In this example, metropolitan

statistical areas were ranked according to average mammography rates.

2. Order providers in descending sequence until you have a subset that equals or

exceeds 10 percent of all patients in the survey. In this example it was 10 percent of

women over the age of 50 in the survey.

3. Calculate the benchmark based on the subset of units analyzed, dividing the total

number of patients in the subset receiving the recommended intervention (e.g.,

mammography screenings by the population).
Healthy People 2010 Toolkit 94

In the example of the mammography screenings, a benchmark rate of 71 percent was

found, exceeding the Healthy People 2000 target of 60 percent.

Data sources to use for the pared-mean method include vital statistics and the Behavioral

Risk Factor Surveillance System.

This method is not feasible for all Healthy People objectives. Data may not be

available for some objectives, or the nature of the objective may not lend itself to

using the pared-mean method. For example, access to preventive care should be

available for 100 percent of the population, regardless of what the data show.

Source: Allison J., Kiefe C.I., Weissman N.W. “Can Data-Driven Benchmarks be Used to Set

the Goals of Healthy People 2010?” American Journal of Public Health, 89(1):61-5, 1999.

$ What if areas in the state have already achieved or surpassed the national

Healthy People target for an objective?

You can calculate a new, higher state target that will be challenging for local areas that

have achieved or surpassed the national target. You also may wish to note in your plan

the jurisdictions that have not achieved your previous targets and redouble your efforts in

these areas as well as set equally ambitious targets for year 2010.

$ Setting targets for process objectives

Many process objectives, particularly those that pertain to infrastructure (data systems,

workforce, and research), are new this year in Healthy People 2010. These should be

examined carefully by states to determine their applicability to the state plan. Setting

measurable targets for process objectives requires judgment and is not an exact science.

To set process targets, planners should consider the current status (baseline) of the state's

public health infrastructure, seek stakeholder input on the desired level of improvement,

and make a realistic assessment of what can be accomplished given the state's experience,

resources, political opportunities, and partner commitment.

$ Using performance measures

“Performance measurement responds to the need to ensure efficient and effective use

of resources, particularly financial resources. It links the use of resources with health

improvements and the accountability of individual partners.” (Prevention Report, Winter

1997) This is of particular importance since the inception of the Government

Performance and Results Act of 1993, which aims at holding Federal agencies

accountable for spending public dollars. This extends to states, local jurisdictions, and

other organizations that receive Federal funding. Performance measures can be

incorporated into or based upon Healthy People objectives. Please see the following

pages for a detailed description of setting performance measures.
95 Setting Targets and Measuring Progress

Setting Performance Measures Step by Step

These examples are based on the State of Maryland’s Healthy Maryland 2000 document

STEP EXAMPLE

1. Relate the performance

measure to an important

national, state, or local health

priority area.

Maryland has undertaken work related to the

national health objective to reduce coronary heart

disease deaths to no more than 100 per 100,000

people.

2. Measure a result that can be

achieved in 5 years or less.

Maryland has identified an achievable result that is

linked scientifically to the Healthy People 2000

Heart Disease and Stroke priority area: Increase

the proportion of people who engage in light to

moderate physical activity to at least 30 percent of

the population.

3. Ensure that the result is

meaningful to a wide audience of

partners.

Target partners are essentially all Marylanders,

with an emphasis on school-age children and

people at high risk for diseases and medical

conditions associated with physical inactivity (for

example, persons with hypertension and high

cholesterol). Partners include principals, teachers,

students, parent-teacher associations, the state

education department, state and local health and

recreational agencies, public health and medical

professionals, and others.

4. Define the strategy that will be

used to reach a result.

The state of Maryland has selected four strategies:

1. Implement a combination of strategies that

include consumer education and skills

development, health assessment, professional

training, and environmental changes.

2. Reinforce risk reduction messages and

promote programs and policies in schools,

work-sites, faith communities, and other

settings.

3. Focus on youth and families so that healthy

habits are started early and nurtured in the

family.

4. Use a health promotion approach tailored to

reach diverse ethnic and socioeconomic

groups.
Healthy People 2010 Toolkit 96

STEP EXAMPLE

5. Define the accountable

entities.

The accountable entities depend upon the

strategies selected and the way in which a

particular community is organized. For

Maryland’s strategy 2, these entities include

schools, work sites, and community centers. For

example, the Cecil County Public Schools have

agreed to be accountable for specific tasks related

to strategy 2 and are working in partnership with

the Cecil County Health Department to offer

healthy lifestyle programs to elementary school

children. The programs, such as the Heart

Challenge Course, bring teachers and food

service workers together to promote healthy eating

habits and physical fitness through educational

games, classroom projects, and other activities that

appeal to children.

6. Draft measures that meet

statistical requirements of

validity and reliability and have

an existing source of data.

In consultation with biostatisticians and

epidemiologists, organizations can draft measures

that are statistically sound. One of Maryland’s

performance measures might be “Increase to 30

percent the proportion of students in each Cecil

County elementary school who engage in light to

moderate physical activity for 30 minutes or

longer every school day by participating in school

physical fitness activities.”

Source: U.S. Department of Health and Human Services. “Improving the Nation’s Health with

Performance Measurement.” Prevention Report, 12(1):1-5, 1997.

http://odphp.osophs.dhhs.gov/pubs/prevrpt/97winfoc.HTM.
97 Setting Targets and Measuring Progress

Measuring Progress

Annual Percent Change

This measure can be used to track whether progress is on course and determine if the 2010

objectives will be reached. It provides the amount of decline each year that is needed to reach

the target.

Formula:

{(Target rate ÷ Baseline rate)[1/ (Target year-Baseline year)]

 - 1} x 100 = Annual Percent Change

Example Data Showing

Percentage Change Needed to

Reach Healthy People Goal

Year Rate

Target 2010 7/1,000

Baseline 2000 10/1,000

Calculations:

(Target rate ÷ Baseline rate) = 7/1,000 ÷ 10/1,000 = 0.700

[1/ (Target year-Baseline year)] =1/ (2010-2000) = 1/10 = 0.100

(Target rate ÷ Baseline rate)[1/ (Target year-Baseline year)] = 0.70 0.10 = 0.965

{(Target rate ÷ Baseline rate)[1/ (Target year-Baseline year)]

 - 1} = 0.965 – 1 = -0.035

{(Target rate ÷ Baseline rate)[1/ (Target year-Baseline year)]

 - 1} x 100 = 0.035 x100 = -3.5%

A decline of 3.5% per year between year 2000 and 2010 is needed to reach the target.
Healthy People 2010 Toolkit 98

Measuring Progress

This equation is used in measuring progress for each objective, adapted from Healthy People

2000 Midcourse Review and 1995 Revisions:

 (Current Status – Baseline) x 100 = Percentage of

 (Year 2000 Target – Baseline) Target Achieved

Note: You will get a negative percentage when the baseline has gotten worse.
99 Setting Targets and Measuring Progress

Evaluating Data:

Data Issues and Uses

What are some general data issues that you may want to address?

✔ Data Quality – When using new data collection systems, be sure to check for

standardization of data collection and recording, data management and analysis, and

structure and content of questions.

✔ Limitations of Self-Reported Data – When relying on self-reported data such as income

level, exercise frequency, or health screening behaviors, be aware of self-reporting bias.

Measures will vary based on the type of data collection alone (written survey, telephone

interview, direct observation, etc.).

✔ Data Validity and Reliability – Revision of survey questions and the development of new

data collection systems will require careful validity and reliability testing. In monitoring

efforts, the validity of responses over time may also become an issue.

✔ Periodicity of Data Availability – Data collection efforts are not always performed on a

regular basis. Take this into consideration when planning your dissemination and

communication efforts.

✔ Timeliness of Data Availability – As previously stated, this is not always possible, but still

important. It helps to be able to regularly identify progress and areas that may need

additional efforts.

✔ Representativeness of Data – Special considerations need to be made when collecting data

for specific population groups or local communities. Do responses collected represent

those individuals of interest?

✔ Small-Area Analysis – Take into account the limitations of applying national data to the

state, local and community levels. This pertains to using small numbers in one’s statistics.

Poisson distribution, non-parametric statistics, and standardized mortality rates/ratios

(SMRs) may be appropriate methodologies.

Source: Committee on Leading Health Indicators for Healthy People 2010. Leading Health Indicators

for Healthy People 2010: Final Report. Division of Health Promotion and Disease Prevention,

Institute of Medicine, 1999.
Healthy People 2010 Toolkit 100

Evaluate your existing data collection methods using these guidelines:

✔ Simplicity

✔ Sensitivity

✔ Timeliness

✔ Predictive value positive

✔ Flexibility

✔ Representativeness

✔ Acceptability

Source: Klaucke D.N., Buehler J.W., Thacker S.B., Parrish R.G., Trowbridge F.L., Berkelman R.L.,

and the Surveillance Coordination Group. “Guidelines for Evaluating Surveillance Systems.”

Morbidity and Mortality Weekly Report. 37(S-5):1-18, 1988.

Characteristics of High-Quality and Effective Data for Policy Making

Technical Characteristics

Content Cover one or more major health policy or program concerns

with sufficient detail to clarify the implications of alternative

policy choices.

Currency (Timeliness) Appear on a sufficiently timely basis and with the appropriate

frequencies that they provide a relatively current profile and can

be credibly used.

Completeness Achieve sufficiently high submissions, reporting, or response

rates and item completion, to limit biases leading to distorted

conclusions.

Reliability Provide classification and coding consistency to enhance

interpretability and reduce confusion.

Analytical Flexibility Support both routine and special analyses, particularly on an

interactive or real-time basis.

Strategic Characteristics

Cross-System Flexibility Allow users to merge, compare, or jointly use data from

complementary systems; include compatible and consistent

variable definitions, coding categories, and a linkage

mechanism.

Adaptability Allow data content and/or reporting to be readily modified to

address changing needs.

Accessibility Provide clear reports to a non-technical audience; make

available diverse reports or information tailored to different

decision needs or users, and provide access to public-use data

sets at a reasonable cost so they can be independently analyzed.

Translation and Policy

Applicability

Effectively translate technical data to policy-relevant

information.

Dissemination Accurately and fully inform potential users or decision-makers

about the resources and how to access it effectively.

Source: Feldman P., Gold M., Chu K. “Enhancing Information for State Health Policy.” Health

Affairs, 13(3):238, 1994.
101 Setting Targets and Measuring Progress

Explaining Data Changes

Age-Adjusting to Year 2000:

State and Local Age-Adjusted Rates Will Increase

Explanation of Age-Adjustment: Age-standardization is a practice of adjusting for differing

age composition of populations. Age-standardization is useful when comparing disease

outcomes across time, place, or populations. Prior to 1998, the conventional standard

population used for adjustment was the U.S.1940 population. As of 1998, the National Center

for Health Statistics (NCHS) will use and has recommended that others use the year 2000

standard. [The year 2000 standard resembles the current population structure and for many

geographic areas is close to the crude (unadjusted) disease rate.] Healthy People 2010 uses the

year 2000 adjusted rate for baselines and target rates.

Impact of Changes: For most disease categories, especially where disease rates increase with

increasing age, year 2000 adjusted rates will increase substantially. Diseases that occur among

young people, such as homicide, will decline while others which affect the age extremes will

stay the same using the new age standard. Users of the year 2000 standardized rates will not be

able to readily compare them to prior years’ statistics that were calculated using the 1940

standard.

Resources: The year 2000 population standard and a brief explanation of the age-adjustment

issues are found at http://www.cdc.gov/nchs/data/nvsr47_3.pdf and in the NCHS publication,

NVSS (Vol 47, number 3, 10/7/98). The web site also provides examples of how this change

affects the size of rates, relative to rates adjusted to the former 1940 standard.

Changing from ICD-9 to ICD-10:

Comparability of Data Will Be Impacted

Explanation of Disease Classification: International Classification of Diseases (ICD) codes

are used for vital statistics, hospital discharge, and a variety of other health services data sets

(including data sets used to measure Healthy People objectives). The World Health

Organization maintains and revises disease codes used widely in the health care field.

Revisions are necessary when new diseases are identified and old diseases redefined.

Impact of Changes: A new 10th edition (ICD-10) has been released and will produce noncomparability between some statistics aggregated based on ICD-9 and the new ICD-10. Users

are cautioned that some differences in disease statistics calculated using one version and then

the other may reflect merely the change in rubrics. As causes of mortality, Alzheimer's Disease

is expected to increase and pneumonia decrease as a result of the change in coding.

Resources: For more information about the ICD, revisions, training resources, and

publications, visit the following site: http://www.who.int/whosis/icd10/. See also the National

Center for Health Statistics: http://www.cdc.gov/nchs/data/20manual.pdf.
Healthy People 2010 Toolkit 102

Race and Ethnicity for Year 2000 Census:

Individuals Can Select More than One Race

Explanation of Race and Ethnicity Data Standards: The Office of Management and Budget

(OMB) issues standards for data collection, including race and ethnicity data. These standards

have been developed to provide a common language for the collection and use of data on race

and ethnicity by federal agencies. To be consistent with national race and ethnicity data, many

researchers, businesses, and other units of government may also use the standards.

Impact of Changes: The year 2000 U.S. Census will use new Office of Management and

Budget (OMB) categories for capturing the self-report of race by Americans. In addition to

being able to choose among five race categories and Hispanic ethnicity, persons who report

being of more than one racial group may specify their racial heritage and be counted in a “more

than one race” category. Interpretation of race distribution will be complicated by the fact that

persons reporting any one race can be included in the “more than one race” category. For

example, persons who report white and Asian background will be counted in each category or

in a broad group called “multiracial.”

Resources: A discussion of the change and concepts of race and ethnicity are found at the

American Anthropological Association site: http://www.aaanet.org/gvt/ombdraft.htm and the

Association of MultiEthnic Americans, Inc. site

http://ameasite.org/classification/omb15v97.asp. "Provisional Guidance on the Implementation

of the 1997 Standards for the Collection of Federal Data on Race and Ethnicity (12/15/00)"

may be found at http://www.whitehouse.gov/omb/inforeg/r&e_guidance2000update.pdf.
103 Setting Targets and Measuring Progress

Existing Data Systems

Data are the foundation of Healthy People objectives. While the national Healthy People

initiative has stimulated the development of new data systems, there are still areas where

information is missing. These areas constitute the developmental objectives, where efforts are

being made over the next decade to measure these indicators. In the meantime, how do you

manage the data presently available? There are approximately 200 data sources used to track

the national Healthy People objectives.

Health and Human Services Data Systems and Sets

Most Critical to Monitoring Healthy People

% Vital Statistics*

% National Health and Nutrition Examination Survey***

% National Health Interview Survey***

% Youth Risk Behavior Survey***

% National Survey of Worksite Health Promotion Activities

% National Survey of Family Growth

% Behavioral Risk Factor Surveillance System**

% National Household Survey on Drug Abuse***

% National Hospital Discharge Survey***

% National Notifiable Disease Surveillance System*

% Census Data*

KEY:

* Measures are available at state and local levels

** Provides state and possibly local measures

*** May provide state or local measures

Source: Leading Indicators for Healthy People 2010. A Report from the HHS Working Group on

Sentinel Objectives. U.S. Department of Health and Human Services, March 1998.

http://odphp.osophs.dhhs.gov/pubs/LeadingIndicators/ldgindtoc.html
Healthy People 2010 Toolkit 104

Resources for

Obtaining Baseline

Measures, Setting

Targets, and

Measuring Progress

" Committee on Leading Health Indicators for Healthy People 2010. Leading Health

Indicators for Healthy People 2010: Final Report. Division of Health Promotion and Disease

Prevention, Institute of Medicine, 1999.

This report includes the criteria for selection of leading health indicators, as well as proposed

indicator sets for Healthy People 2010. Available at: http://books.nap.edu/catalog/9436.html.

" ICD-10 – The following sights provide information on the ICD-10.

http://www.healthmkt.com

http://www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm

" National Association of Health Data Organizations. http://www.nahdo.org

The National Association of Health Data Organizations (NAHDO) is the “premier national health

information organization dedicated to improving health care through the collection, analysis,

dissemination, and use of health care data.”

" National Center for Health Statistics. http://www.cdc.gov/nchs/products.htm

Publications and information products with links to Healthy People 2000 Reviews (in PDF

format). The home page for the National Center for Health Statistics is available at

http://www.cdc.gov/nchs/.

" Morbidity and Mortality Weekly Report. http://www.cdc.gov/mmwr/

“The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for

Disease Control and Prevention (CDC). The data in the weekly MMWR are provisional, based

on weekly reports to CDC by state health departments.”

picks
105 Setting Targets and Measuring Progress

" U.S. Census Bureau. http://www.census.gov

Under the Department of Commerce, The Census Bureau's mission is to be the preeminent

collector and provider of timely, relevant, and quality data about the people and economy of the

United States. Their Goal is to provide the best mix of timeliness, relevancy, quality, and cost for

the data they collect and services they provide.

Please see Appendix A for other resources for obtaining baseline measures, setting targets,

and measuring progress.
106
107 Managing the Process

Managing and

Sustaining the

Process

“Even if you're on the right track, you'll get run

over if you just sit there.”

 —Will Rogers

In This Section

! Action Checklist 108

! Tips 108

! Process in Action:

Examples from the Field 110

! Planning and Development

Checklist 113

! Sample Time Line

Overview 126

! Sample Time Line

Detailed View 127

" Hot Picks: Resources 131

The success of a Healthy People initiative

(national, state, or local) depends on sustaining

the process, particularly as leadership,

administrations, and policy makers change.

Initial commitment and energy of community

partners in identifying needs and setting

objectives or targets is only the beginning of

the process. Sustainability and

institutionalization of Healthy People in dayto-day activities of many people in diverse

organizations is necessary in order to achieve

objectives. Commitment is not a one-time

event, but must grow throughout the next

decade.
Managing the Process 108

Action Checklist:

Managing and Sustaining the Process

(See page 113 for a complete planning and development checklist.)

# Designate staff and organizational unit

for coordinating state plan development

# Create a work plan and time line to

develop and release the plan

# Coordinate expertise and staff support

# Assign development tasks to teams or

individuals

# Establish and implement processes for

ongoing input

# Market development process (see the

action area, "Communicate Health

Goals and Objectives")

# Plan periodic reviews

# Integrate state plan into ongoing

planning, budgeting, programming, and

legislative processes

# Develop a ten-year monitoring and

implementation plan

Tips

A car without a driver can’t go anywhere

► Identify a person (single point of contact) to manage the

process and ensure that things get done

► Consider establishing an office, with an annual budget,

dedicated to the Healthy People initiative

► Designate a state contact to liaison with the national Healthy

People 2010 initiative

Let everyone know the final destination and stops along the way

► Develop a time line and designate responsible parties

► Distribute the time line and tasks to all partners

► Establish a means of continuous communication to report

progress among those involved (consider electronic

possibilities)

► Display the relevant time line tasks at each meeting

► Make sure major partners see tasks on the time line for them

► Share management responsibilities across agencies and

possibly with the private sector
109 Managing the Process

Integrate the state plan initiative into many ongoing activities

► Incorporate in strategic and annual plans of agencies, (e.g.,

objectives, performance measures, data collection plans)

► Encourage agencies to use the state's Healthy People logo in

their documents that refer to the state plan

► Tie to agency policies and legislative initiatives

► Link to funding proposals and allocations (e.g., foundations,

state grant funds, legislative budgeting)

Schedule internal, interagency, and public reviews of the state

plan and progress

► Monitor progress toward objectives, legislative actions, and

organizational commitments in the plan

► Time opportunities to review plan with new leaders and after

elections for new terms in office

► Use reviews to revitalize or redirect the initiative

► Identify successes and areas of focus for public and private

audiences

► Convene periodic summits or conferences around the state plan

to maintain momentum

Remember to celebrate milestones, and recognize groups and

individuals for their contributions

► Use kick-off events to showcase community, government, and

business partners and their commitments

► Find time and resources for certificates of recognition, plaques,

and personal notes

► Invite the governor, respected state leaders, and national

leaders to participate in milestone events (kick-off,

announcement of priorities, draft objectives, etc.)

Be prepared for "postpartum" blues

► Plan activities to follow the "labor and delivery" of the plan

► Redefine roles of the steering group, work groups, and others

in phases following the release of the plan

► Bring in new partners for a boost of energy
Managing the Process 110

Process in Action: Examples from the Field

Below are examples of how the nation and states have managed and sustained the development

and implementation process for Healthy People plans.

From the National Initiative

Dedicated staff

The Office of Disease Prevention and Health Promotion (ODPHP) is designated as the

coordinator of the Healthy People initiative. A staff office reporting to the Assistant

Secretary for Health and Surgeon General, ODPHP supports the Secretary’s Council on

National Health Promotion and Disease Prevention Objectives for 2010, Healthy People

Steering Committee, and the Healthy People Consortium.

Steering Committee

The Healthy People Steering Committee, which meets quarterly, is composed of

representatives from all HHS operating divisions. The group is responsible for overseeing

the drafting, revisions, and final modifications of the Healthy People document. A list of

the Healthy People 2000 Steering Committee members is available at the following web

site: http://www.health.gov/hpcomments/Guide/Steering.htm.

Lead agencies

The Assistant Secretary for Health has designated lead agencies in HHS to be accountable

for the achievement of Healthy People targets. Each lead agency is responsible for

monitoring, tracking, and reporting the nation's progress on the objectives in its focus area.

For some areas, two agencies act as co-leads. HHS agency heads in turn have designated

work group coordinators to assume day-to-day responsibilities for the objectives.

Broad participation and mobilization

ODPHP staff attribute much of the sustained interest in Healthy People 2010 to the

widespread year 2000 participation and buy-in, particularly among public sector partners

and private non-profit groups. With virtually all states and 70 percent of local

communities participating in the year 2000 initiative, vested communities create a strong

demand for continuing the 2010 objectives. A critical mass of participation and positive

peer pressure fuel partners' continued desire to be "on board" this popular initiative.

Another reason for the sustainability of the Healthy People Initiative is the many

Consortium members from the private and voluntary sectors who have used and promoted

the objectives as a framework for their constituents' action. As an example, the American

Hospital Association developed Healthy People 2000: America's Hospitals Respond, a
111 Managing the Process

resource kit for hospital administrators to help mobilize health promotion initiatives. The

American Dietetic Association (ADA) developed Call to Action to inspire its more than

64,000 members to pursue the nutrition objectives. These and other initiatives of

Consortium members continue to sustain Healthy People at multiple levels.

From State Initiatives

Identify key staff to manage the state plan

All states and territories identify Healthy People state

action contacts. Among these, four have appointed

staff solely devoted to Healthy People coordination.

These four state action contacts have been

instrumental in establishing a development plan

early and sustaining the effort throughout the

decade. A current listing of the state action contacts is included in the Toolkit and

available at: http://www.health.gov/healthypeople/Contact/StateContact.htm.

As another example, North Carolina has established an Office of Healthy Carolinians that

is responsible for keeping the initiative on track. Staff are available to North Carolina

counties for support and training, particularly coalition building. There is also a

governor’s task force that certifies counties in the Healthy Carolinians project. The

counties do an assessment and then implement an action plan.

The Connecticut Department of Health kept year 2000 planning on track with the help of

two staff assigned to the process and an internal advisory committee. The year 2000

process was expanded with the development of Looking Toward 2000 – An Assessment of

Health Status and Health Services. Connecticut formed the state health planning

coordinating committee responsible for analyzing health status data, service data, program

plans, and objectives for the Assessment. The committee reconvened to review and

coordinate the Department's response to Healthy People 2010 – Draft for Public Comment.

Although desirable, an official coordinator is not imperative to success. Because of

funding deficiencies, Wyoming lost its Healthy People 2000 coordinator. However, due to

individual efforts from key personnel who had “bought into” the process, Wyoming was

able to carry on with year 2000 activities.

The Delaware Division of Public Health used a combination of state and grant funds to

hire a private consulting group to help manage the development of Healthy Delaware

2010. The Division of Public Health retained responsibilities for convening and leading

the steering group, as well as providing technical and administrative support to work

groups. The consultants will assist by managing the time line, identifying technical tasks

for staff, developing a marketing plan, coordinating community meetings, and preparing

the plan for publication.
Managing the Process 112

Maintain communications among partners

The Iowa State Department of Health is working with the Hardin Library for the Health

Sciences and College of Medicine at the University of Iowa in establishing listservers by

teams, by team leaders and facilitators, and for all chapter team members with e-mail

addresses, so they can interact via the Internet. This is a key component in the

communication process. (See "Communicating Health Goals and Objectives.")

Since June 1998, Kentucky has been working on their year 2010 plans. The state has

assigned 26 team leaders to form committees around each year 2010 chapter, with a key

contact appointed to oversee each committee’s progress. Monthly meetings are held with

most of the team leaders with regular phone contact in between. A majority of the team

leaders hold monthly meetings with their committees as well.

Share management responsibilities across departments

New Jersey’s health department formed an Interdepartmental Steering Committee to

oversee development of the year 2010 public health agenda. The committee established a

work plan with specific target dates for each step required to complete the document. The

committee consists of key staff from within the health department as well as other state

departments such as Human Services, Environmental Protection, Education, and Law and

Public Safety.

Vermont began with work groups for its identified priority areas. These groups consisted

of both Department of Health employees and other agency people. However, these formal

groups did not work effectively, and the state discovered that more informal meetings and

discussion with these groups worked better.

Integrate Healthy People initiative with other key projects

The Benchmarks Project was a part of Oregon’s strategic plan and is therefore supported

by the governor. State Healthy People objectives influenced the selection of Oregon

benchmarks. The Oregon Progress Board monitors the benchmarks and reports on

progress toward long term performance targets. Oregon Benchmarks are part of the

biennial budget process. Agencies must identify benchmark links and report on progress

toward achieving the performance targets. Results are reported in a biennial report to the

legislature.

By combining the planning processes for the Agency Strategic Plan, mandated

performance-based program budgeting, and the State Health Plan, the Florida Department

of Health was able to create an ongoing planning process that encompasses both long- and

short-range program planning. Through performance based program budgeting, specific

outcomes were linked to resource requirements in budgets submitted to the state

legislature.

(See also state examples, page 5)
113 Managing the Process

Planning and Development

Checklist

The Planning and Development Checklist is a tool for organizing and tracking the

development of a state health plan. The Checklist outlines potential tasks under each of

seven critical action areas to develop, manage, and promote a successful state plan. The

seven action areas were identified as the common threads found in the national and state

Healthy People processes. This list serves as a menu of activities and processes from the

beginning of the development process through the final evaluation of the plan in the next

decade, as well as a tool for monitoring progress of plan development.

Individual activities listed for each component should be evaluated and adapted for use in a

way that best fits the needs of the state. Additional activities may be added in the space at

the end of each section's checklist.

Because many activities run well concurrently, skillful integration of these components

will lead to an efficient and effective process. For example, identification and engagement

of partners can help in engaging leaders and securing resources. Refer to the sample time

line page 126, which illustrates concurrent activities.

Tasks for which tools are available in the Toolkit are identified by page number and

with the tool icon.
Managing the Process 114 Activity Deemed Relevant Process Initiated

Process

Completed

Comments

Build the Foundation: Leadership and Structure

$ Secure buy-in and

commitment to develop

state plan from senior

health department staff

(including state health

official, state epidemiologist, vital statistics director,

chronic disease coordinator,

and the Healthy People

2010 Coordinator)

$ Meet internally and form

preparation team to identify

goals and guide early stages

of development

$ Create a structure for the

planning process

 page 7

 page 13

$ Examine policy/political

environment (e.g., current

policies, governor’s

priorities, legislative

agenda, legislative

mandates)

$ Define functions and

composition of an advisory

group and/or steering

committee

 page 15
115 Managing the Process

Activity

Deemed

Relevant

Process

Initiated

Process

Completed

Comments

$ Identify potential barriers

and facilitators to success,

including lessons learned

from year 2000 activities

 page 19

$ Present state plan

development process to

political leaders (executive

and legislative) and

leadership of other agencies

for support

 page 12

$ Identify related initiatives

to integrate or consider

coordination with state plan

$ Engage partners early in

process and maintain

involvement as appropriate

 page 46

$ Other activities:

Identify and Secure Resources

$ Identify staff, financial, and

technical resources needed

to develop state plan

$ Develop budget to plan,

publish, market, and (if

desired) support implementation of state plan

 page 31
Managing the Process 116 Activity Deemed Relevant Process Initiated

Process

Completed

Comments

$ Plan to integrate the plan

into state planning,

budgeting, and

programming processes

$ Identify existing resources

(e.g., block grants) that

could be used to support

proposed tasks

 page 34

$ Develop staff and technical

support plan

$ Identify potential external

funding sources and

organizations or businesses

that can offer printing,

supplies, other donated

services, and/or dollars

 page 34

$ Secure identified resources,

(including staff expertise in

other agencies, organizations, foundations, etc.) and

develop alternative

resources, if necessary (See

resource listings in

Appendix A, page A-3.)

$ Other activities:
117 Managing the Process

Activity

Deemed

Relevant

Process

Initiated

Process

Completed

Comments

Identify and Engage Community Partners

$ Define target audiences

 page 145

$ Identify key individuals and

organizations that can

provide connections to the

community or specific

expertise

 page 46

$ Design strategies for

engaging all partners in

development and

implementation processes

$ Identify roles for partners

and assign responsibilities

$ Establish formal

partnership agreements

where appropriate to

sustain activities and

involve partners

 page 47

 page 48

$ Develop accountability and

evaluation plans, including

identification of specific

persons or groups of people

responsible for each action

item with target dates

$ Develop a communication

vehicle to highlight partner

activities as they relate to

the state plan
Managing the Process 118 Activity Deemed Relevant Process Initiated

Process

Completed

Comments

$ Reassess and evaluate

partner involvement and

satisfaction in plan

development

$ Other activities:

Set Health Priorities and Establish Objectives

$ Evaluate input received

from community partners

and expert advisors

 page 64

 page 143

$ Collect and review

information from previous

community/state health

needs and assets

assessments and determine

if new ones are needed

$ Conduct assessments of

health needs and assets, if

necessary

 page 71

$ Examine and plan for

transitions from year 2000

to year 2010 health

objectives (e.g., updates,

integration, progress

reviews)
119 Managing the Process

Activity

Deemed

Relevant

Process

Initiated

Process

Completed

Comments

$ From previous activity,

decide where changes from

year 2000 plans need to be

made and what should be

retained. Identify specific

health priorities,

contributing factors, and

other issues that have

emerged and should be

addressed.

$ Define the scope of the

state plan, (e.g., racial

disparities, public health

infrastructure, mental

health, environmental

health, substance abuse,

and behavioral factors)

$ Set criteria for establishing

potential priority areas or

focus areas

 page 66

 page 67

 page 73

$ Establish a process for final

determination of priorities

$ Identify and obtain

information to evaluate

areas according to criteria

$ Select final priority or focus

areas
Managing the Process 120 Activity Deemed Relevant Process Initiated

Process

Completed

Comments

$ Determine types of

objectives desired [e.g.,

measurable vs. in need of

data (developmental),

qualitative vs. quantitative,

process vs. outcome] for

each area and establish

criteria for adopting them

 page 70

$ Outline standard

information to include with

all priority areas and

objectives, (e.g., trend data,

targets, accountable or

committed partners, policy

and regulation issues,

populations to target,

standards or guidelines,

intervention strategies,

exemplary programs)

 page 74

$ Specify intervention points;

identify potential topics and

indicators for objectives

(what you want to measure,

such as health status,

behaviors, or interventions)

 page 91

$ Develop draft objectives

 page 60

 page 65

$ Other activities:
121 Managing the Process

Activity

Deemed

Relevant

Process

Initiated

Process

Completed

Comments

Obtain Baseline Measures, Set Targets, and Measure

Progress

$ Consult with state vital

statistics division, or other

appropriate agencies to

provide information on

census changes, data

changes/requirements for

age-adjustment, ICD-10,

and other data changes

 page 101

$ Set criteria for evaluating

the quality and

appropriateness of existing

public and private data

sources

 page 99

$ Inventory relevant public

and private data sources to

support measurement of

objectives

 page 91

 page 103

$ Review progress and

successes in achieving state

Healthy People 2000

objectives

 page 97
Managing the Process 122 Activity Deemed Relevant Process Initiated

Process

Completed

Comments

$ Develop targets with

appropriate baselines and

measures (i.e., determine

the desired amount of

change for each objective),

and finalize objectives

 page 93

$ Develop methods for

measuring objectives

without existing data

sources (e.g., new data

sources, estimation

techniques, attainable

proxies)

$ Gather and evaluate other

data and information to

include in state plan

$ Plan regular intervals to

measure and track

achievement of targets via

identified data sources (e.g.,

annual progress reviews)

 page 97

$ Other activities:

Manage and Sustain the Process

$ Designate staff and

organizational unit for

coordinating state plan

development
123 Managing the Process

Activity

Deemed

Relevant

Process

Initiated

Process

Completed

Comments

$ Create a work plan and

time line to develop and

release the plan

 page 113

 page 126

$ Coordinate expertise and

staff support to carry out

identified tasks in work

plan

 page 15

$ Assign development tasks

to teams or individuals

$ Establish and implement

meaningful, ongoing

processes for input from

key staff, partners, stakeholders, and communities

 page 45

$ Market development

process and time line both

internally and externally

(see “Communicate Health

Goals and Objectives”)

$ Plan reviews to update

baselines and targets, add

objectives to meet

emerging issues, and report

on progress

$ Plan to integrate state plan

into ongoing planning,

budgeting, programming,

and legislative processes
Managing the Process 124 Activity Deemed Relevant Process Initiated

Process

Completed

Comments

$ Develop a ten-year plan and

time line to release, implement, and monitor the plan

$ Other activities:

Communicate Health Goals and Objectives

$ Establish marketing and

communication goals and

objectives

 page 145

$ Conduct target audience

research

 page 143

$ Develop a publication and

dissemination plan

$ Design state-specific

Healthy People identity

(e.g., logo, color scheme,

web site, spokesperson)

$ Develop and implement

marketing and communication plan (e.g., strategies for

using the media and other

available resources to

engage the community and

influence actions or beliefs)

 page 145

$ Prepare state plan for

publication and

dissemination
125 Managing the Process

Activity

Deemed

Relevant

Process

Initiated

Process

Completed

Comments

$ Develop supporting

companion documents that

target specific audiences,

focus areas, or strategies

$ Manage document review

process

$ Publish and release state

plan

$ Collect and disseminate to

community partners

exemplary practices from

local plans throughout state

$ Continue to promote

interest in meeting targets

and health improvement

(e.g., web sites, press

releases, newsletters, TV

spots, speeches, etc.)

$ Periodically report progress

to partners, policy makers,

and community partners

$ Evaluate marketing plan

 page 147

$ Other activities:
Sample Time Line—Overview

Percent Time Elapsed (tailor to your 

ACTION AREA 25% 50% 

Build the Foundation: Leadership and Structure... X X X XIdentify and Secure Resources... X X X XIdentify and Engage Community Partners... X X X X X X X XSet Health Priorities and Establish Objectives... XXXXXObtain Baseline Measures, Set Targets, and MeasureProgress...

XXX

Manage and Sustain the Process... X X X X X X X X Communicate Health Goals and Objectives... X X X X X X X 

Managing the Process 126
Sample Time Line—Detailed View

Percent Time Elapsed (tailor to your project 

ACTION AREA 25% 50% 7

Build the Foundation: Leadership and StructureSecure senior staff commitment to develop state plan XMeet internally and form preparation team to identifygoals and guide early stages of development X XCreate a structure for the planning process X XExamine policy/political environment X XIdentify potential barriers to success, includinglessons learned from 2000 X XDetermine composition and function ofadvisory/steering groups X XPresent process to leaders and agency colleagues forsupport X XIdentify initiatives to integrate with state plan X XIdentify and Secure ResourcesIdentify staff, financial, and technical resourcesneeded to develop the state plan X XDevelop budget to plan, publish, market, and (ifdesired) support implementation of state plan X XDevelop staff and technical support plan X XIdentify potential funding sources aligned with goalsof planning and implementation X XSecure or develop alternative resources X X X X

 127 Managing the Process
Sample Time Line—Detailed View

Percent Time Elapsed (tailor to your project 

ACTION AREA 25% 50% 7

Identify and Engage Community PartnersDefine target audiences X XIdentify key individuals and organizations X XDesign strategies to engage partners X X XEstablish partnerships and clarify roles X X X X X XDevelop a plan to evaluate partner involvement XSet Health Priorities and Establish ObjectivesEvaluate input from partners X X X X X Review available needs assessments and data sources.Conduct needs and assets assessment, if needed X XExamine and plan for transitions from year 2000 toyear 2010 objectives

X

Describe scope of state plan X XSet criteria for determining priority or focus areas X XIdentify and obtain information to evaluate areasaccording to criteria X XDetermine types of objectives desired for each areaand objectives for adopting them XXXOutline standard information to include with allpriority areas and objectives, such as trend data,strategies, and model programs

X X

Select priority or focal areas

X

Develop draft objectives X XDraft final text for each priority area 

Managing the Process 128
Sample Time Line—Detailed View

Percent Time Elapsed (tailor to your project 

ACTION AREA 25% 50% 7

Build the Foundation: Leadership and StructurePartner with vital statistics or others for technicalassistance on data issues XXXSet criteria to evaluate public and private data sources X XInventory public and private data sources to supportmeasurement of objectives XXXReview progress in achieving state Healthy People2000 objectives

X

Develop final objectives with appropriate baselines,targets, and measures XDevelop methods to measure objectives withoutexisting data sources, as needed Gather and evaluate other information to include withobjectives in state plan XXManage and Sustain the ProcessDesignate staff and organizational unit to coordinatestate plan activities

X

Create a work plan for planning process, release, andmonitoring of plan

X

Assign development tasks to teams or individuals X X X X Establish and implement processes for input from keystaff, partners, and community members XXXXXXXMarket the development process X X X X X X Plan to integrate 2010 objectives into strategic plansand the evaluation of proposed programs, policies, andfunding allocations

XXX

Develop a 10-year plan to implement, evaluate, andrevise the state plan 

 129 Managing the Process
Sample Time Line—Detailed View

Percent Time Elapsed (tailor to your project 

ACTION AREA 25% 50% 7

Communicate Health Goals and ObjectivesEstablish marketing goals and objectives XConduct audience research X XDevelop a publication or dissemination plan X XDesign state-specific Healthy People identity and logo X X XDevelop a marketing plan X XDraft state plan publication Develop supporting companion documents that targetspecific audiences Manage the document review process Develop a plan to report progress and promote interestin meeting targets Publish and release state planImplement and evaluate marketing plan X X X X 

Managing the Process 130
131 Managing the Process

Resources for

Managing and

Sustaining the

Process

" Change Project. http://www.well.com/user/bbear

From this main page, follow the link to Healthy Communities, then to "How to create one," then

to “Sustaining the Effort.” This will take you to the article, "Sustaining The Effort: Building a

Learning Community" from the healthcare forum. The table of contents includes areas such as

governance, structure, and leadership; process; maintaining participation and inclusion; resources;

staff support; measurement; and celebration.

" National Civic League. The Healthy Communities Handbook. Available from National

Civic League, 1445 Market Street, Suite 300, Denver, CO 80302. (303) 571-4343.

This manual is intended for the use of community groups, business people, individuals, or local

governments that are concerned with their communities. It incorporates the goals and objectives

of the Healthy People 2000 initiative into a community-based health planning process.

Appendices include listings of tools, models, definitions for health indicators, resources, and a

bibliography.”

" Revisiting the Critical Elements of Comprehensive Community Initiatives.

http://aspe.os.dhhs.gov/hsp/cci.htm

The study focuses on lessons and insights gained through the experience of Comprehensive

Community Initiatives. The study defines the characteristics of a good leader and staff, how to

develop and maintain a sense of hope and momentum, and how planning and action can be

blended and balance.

Please see Appendix A for other resources for managing and sustaining the process.

picks
132
133 Communicating Objectives

Communicating

Health Goals

and Objectives

“There is no acting or doing of any kind, till it be

recognized that there is a thing to be done; the

thing once recognized, doing in a thousand

shapes becomes possible.”

—Thomas Carlyle

In This Section

! Action Checklist 134

! Tips 134

! Process in Action:

Examples from the Field 136

! Simple "Market Research"

Strategies 143

! How to Develop a

Marketing Plan 145

! Evaluate Your

Marketing Plan 147

" Hot Picks: Resources 148

Developing a vision of healthy people in healthy

communities, and establishing goals and objectives

to meet that vision, can be nothing more than an

academic exercise if the vision, goals, and

objectives are not effectively communicated to and

“owned by” the community. Identifying the target

audiences, crafting clear messages, and effectively

communicating these messages to the target

audiences will increase the likelihood of the state

plan being accepted and used by state and

community partners. Enlisting key advocates, or

“champions,” early in the process is another

important ingredient for success. (See "Building

the Foundation: Leadership and Structure" and

"Identifying and Engaging Community Partners.")

Just as private sector companies conduct market

research long before they try to produce or sell a

product, state and community Healthy People

initiatives should begin planning their marketing

efforts in the earliest stages of development.
Healthy People 2010 Toolkit 134

Action Checklist: Communicating

Health Goals and Objectives

(See page 113 for a complete planning and development checklist.)

# Establish marketing and communication

goals and objectives

# Conduct target audience research

# Develop publication/dissemination plan

# Design state-specific identity and logo

# Develop and implement marketing and

communication plan

# Prepare state plan for publication and

dissemination

# Develop companion documents that

target specific audiences or focus areas

# Manage document review process

# Publish and release state plan

# Evaluate marketing plan

Tips

Clear messages begin with clear thinking

► Identify priority audiences—intended users of the plan

► Clearly define what you want people to do with the plan

► Identify the most important ideas to convey

Create a marketing plan

► Involve your public information officer or marketing director

► Consider asking or hiring an outside group to gather your

marketing information and help you develop a marketing plan

► Write down your strategy—even if it’s just one page

► Talk through the marketing steps at a steering committee

meeting or assign to a new committee

Learn how to target your message

► Learn about the objectives important to individuals who are

familiar and unfamiliar with Healthy People, the role of public

health, and government planning efforts

► Learn about the objectives important to individuals with both

favorable and unfavorable opinions about past planning efforts

► Look for the intersection of what you want to say and what

people want to hear

► Recruit marketing partners to find the best “selling points” for

different audiences
135 Communicating Objectives

A picture is worth a thousand words

► State Healthy People logos and letterhead build recognition,

generate excitement, and create a unique identity

► Make your logos and marketing materials available to partners

Don’t leave your objectives hanging. Surround them with the

information and inspiration your audiences need to act.

► Stories of real people that illustrate the issue

► Trend data

► Specific strategy and policy ideas

► Examples of state and local programs that work

► Contact persons

► Committed partners in the public and private sectors

One size rarely fits all

► Communicate your plan and messages in formats your

different audiences prefer (e.g., print, web, conferences)

► Consider the “bang for the buck” in producing two or three

targeted versions of the plan, compared to one plan for

everyone

► Targeted executive summaries or “companion documents” can

highlight or expand upon objectives and strategies for

audiences such as policy makers, business leaders, or schools

► Get partners to distribute your plan to their members,

highlighting in a cover letter the areas in which their members

have a role
Healthy People 2010 Toolkit 136

Process in Action: Examples from the Field

Below are examples of how the nation and states utilized communication to achieve sustained

action, published plans, and marketed the initiative.

From the National Initiative

Sustained Action through Communication

Internet

All Healthy People materials published since 1995 are placed on the Healthy People web

site: http://www.health.gov/healthypeople/Publications/hppublist.htm. Prior to the

January 2000 release of the final Healthy People 2010 document, the web site will be

redesigned. It will continue to be maintained throughout the implementation phase. In

1997 HHS launched the Healthy People 2010 web site: http://www.health.gov/hpcomments/.

This web site is the complete repository of all public comments received during two

Healthy People 2010 public comment periods in 1997 and 1998.

Consortium Exchange

ODPHP publishes a quarterly newsletter for Consortium members to share news about

prevention activities related to achieving the nation’s health objectives.

http://www.health.gov/healthypeople/Implementation/Consortium/Newsletter/default.htm.

Consortium members spreading the word

Consortium members share news of Healthy People activities via their organizational

newsletters, web sites, and list servers. For example, COSSMHO, the National Coalition

of Hispanic Health and Human Services Organizations, used its newsletter to announce to

its constituency the invitation to submit conference abstracts for the launch of Healthy

People 2010, at the “Partnerships for Health in the New Millennium.” The 1998 Annual

Report of the Asian and Pacific Islander American Health Forum highlighted their role in

hosting the first Healthy People progress review held outside of Washington, D.C.

Progress review reports

The national initiative has produced two-page summaries to communicate progress on

either a Healthy People focus area or crosscutting population objectives. These reports

document data objectives, barriers, and successes in meeting the year 2000 objectives.

http://www.health.gov/healthypeople/Publications/hppublist.htm
137 Communicating Objectives

Midcourse Review and 1995 Revisions

This report communicated the progress made toward the year 2000 objectives at the midpoint of the decade. The report was a call to action, renewing the Healthy People effort. It

assessed the challenges that remained and confirmed that the occasion for achieving a

healthier America was at hand. The chapter on Consortium Action describes the efforts of

both national and state organizations to achieve health improvement.

Publication Plans

Healthy People 2010 Objectives: Draft for Public Comment

This draft includes a background section on the Healthy People initiative, a description of

the two overarching goals and an overview of the proposed objectives for Healthy People

2010. The draft also lists e-mail addresses, phone numbers, and fax numbers for all the

individuals involved in the national development process. The final document will be

released in January 2000 in Washington, DC. The draft for public comment is available on

the Internet: http://www.health.gov/hpcomments/2010Draft/object.htm.

Healthy People 2010

Healthy People 2010 will be a three-volume set. Volume 1 is directed toward policy

makers and will be short (approximately 50 pages). Volume 2 will contain the objectives

and supporting text with scientific references. Volume 3 will contain information on

tracking the objectives with operational definitions and data source information, so that

states and localities can replicate the measures.

Companion documents

Several HHS agencies are planning to produce companion documents to Healthy People

2010 in partnership with private organizations. These companion documents will focus on

specific populations or settings and will be released over the decade.

Marketing

Professional assistance

HHS has evaluated the Healthy People audiences with the assistance of communication

professionals. Outreach to new constituencies continues with the Healthy People

Consortium and is continuing to expand. In addition, the development of the Healthy

People initiative has maintained a highly visible presence at all national and many local

meetings throughout the past few years.
Healthy People 2010 Toolkit 138

Surgeon General’s Launch of Healthy People 2010 Conference,

January 24 - 28, 2000

The Partnership for Health in the New Millenium is a joint conference sponsored by the

Healthy People Consortium and the Partnerships for Networked Consumer Health

Information, celebrating the launch of Healthy People objectives for 2010. For more

information, visit the following web site: http://www.health.gov/partnerships.

Healthy People logo competition

The Department of Health and Human Services has initiated a public competition for a

new Healthy People logo to use for the next set of Healthy People objectives. The goal of

the graphical representation is to show progress, growth, and success.

From State Initiatives

Sustained Action through

Communication

Delaware organized its publication, Healthy

Delaware 2000, to offer a plan of action for

many people and agencies throughout the state.

The plan's chapters include Opportunities,

Health Problems and Objectives (containing

background information on each health problem with measurable objectives) and

Strategies.

In its mid-decade review of Healthy Kentuckians 2000, the Kentucky Department for

Health Services detailed implementation activities conducted by public health agencies, the

Kentucky Legislature, voluntary organizations, universities, businesses, citizens, and other

active partners. The 1996 publication also communicated to its partners additional action

steps to achieve the year 2000 objectives.

To aid implementation of the Healthy Iowans 2000 plan, Iowa state agencies responsible

for priority activities are listed in each chapter. When the Iowa Department of Public

Health conducted its mid-course review of all Iowa goals and action steps, groups with

primary responsibility for implementation were asked to make an assessment of their

progress.

The Healthy Hoosiers 2000 (Indiana) plan listed private and public agency partners, called

Primary Implementers, to help the state achieve each section. To help communities link to

key individuals, names and contact information for public and private sector contacts were

also listed for each section.
139 Communicating Objectives

Publication Plans

Design multiple documents or print sections of a single document for

distribution to different target audiences.

In Iowa, all chapters of the Healthy Iowans 2000 plan are available as separate

publications available from the Department of Public Health. By distributing smaller

sections, the Department of Public Health can focus audiences’ attention on areas that

interest them and can be used for action. While the Department saves resources, they also

avoid overwhelming recipients with more information than they require.

Format a single document to appeal to a broad range of audiences,

including the general population.

Texas formatted its brief Healthy Texans 2000 publication to be easily understood by a

wide range of audiences. Photographs, charts, and color enhance the publication's appeal.

The content of the report was developed from background papers developed by

workgroups, which were focused on specific health topic areas.

Maryland and North Carolina both produced brochures about the state plans that

summarized the pertinent information for a more general audience. The brochures were

distributed to audiences at various public health displays and meetings as a more portable

version to take home and reference.

Marketing

Many states, including Maine, use the Department of Health’s web site to inform

professionals and the public about health objectives and progress toward achieving them.

Users of the Maine web site can access graphs to track Maine's year 2000 objectives and

compare the Maine Health Status Indicators to the U.S.

West Virginia developed and released a Healthy West Virginians 2010 logo and motto

several months in advance of their planning process.

The Delaware Division of Public Health hired a private marketing subcontractor to

develop a marketing plan and identity campaign for the state's 2010 objectives and plan.

The District of Columbia released its Healthy People 2010 Objectives: Draft for Public

Review and Comment during National Public Health Week 1999.

The South Dakota Department of Health communicates its goals and objectives through

periodic publications, news releases, a web page, presentations at health care conferences,

and ongoing meetings with partners.

The Iowa Department of Public Health is using social marketing principles to help focus

outreach. The Department of Public Health is also using its web site to publicize the

Healthy Iowans 2010 time line, public comment period, staff contact information,
Healthy People 2010 Toolkit 140

technical assistance opportunities, and summaries of progress toward each area in the

state's year 2000 plan.

Two South Carolina Healthy People Coalitions used the Healthy People 2000 objectives

for worksites as criteria for awards to businesses that were promoting health through their

policies and activities. Annually, businesses qualifying for the Healthy People Worksite

Awards are recognized at a ceremony and presented with Healthy People plaques. The

local coalitions sent out press releases about the businesses and their awards. Newspapers

in their areas have also reported these.

Another South Carolina coalition developed a partnership with the local NBC affiliate for

one year. The television station produced three public service messages on health

objectives each quarter and ran them during prime time at no cost to the coalition. They

also highlighted the health issues in their newscasts, using the Healthy People logo and

name.

Vermont continuously raised awareness of the Healthy Vermonters 2000 plan and its

progress through a variety of mechanisms. Any event such as publishing an annual report,

achieving a goal, or receiving a grant that was related to an objective was publicized.

Vermont also created a logo that was used extensively. The state relied heavily on the

media (newspaper, television, radio, etc.) for its promotional efforts. Through this public

awareness, citizens came forth to volunteer their help. Vermont also publicized areas that

were weaknesses, which recruited even more volunteers. In 1996, Vermont held a second

kick-off meeting to re-energize the year 2000 process.
141 Communicating Objectives

Number of States that Cited Methods for Disseminating Information

About Year 2000 Objectives by Dissemination Method (N=44)

3

5

18

23

25

39

0 5 10 15 20 25 30 35 40 45

None

CD ROM/disk

On-line

Informal report/fax

Conference

Published Report

Number of States

Note: States may be counted more than once since some provided information by more than 

one method.

Note: States may have been counted more than once since some provided information by more

than one method.

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State and

Local Capacity Survey. March 1998.
Healthy People 2010 Toolkit 142

State Likelihood of Using Year 2000 Objectives

by Purpose (N=45)

0.3

1.3

1.7

1.8

1.8

1.9

2

2

2

2.1

2.2

2.3

0 0.5 1 1.5 2 2.5

Other

Develop/target worksite health promotion programs

Allocate resources

Formulate data collection and analyses plans

Develop/target school health promotion programs

Develop/target disease awareness campaigns

Develop/target direct intervention efforts

Develop policies or stimulate legislation

Develop performance measures

Collaborate with other agencies/associations

Develop/target health promotion campaigns

Request resources

<<Less Likely More Likely>>

Note: The following conversion of frequency from words to numbers allowed for weighted averagin

Not at all=0, Infrequently=1, Somewhat=2, and Frequently=3.

Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State and

Local Capacity Survey. March 1998.
143 Communicating Objectives

Simple "Market Research"

Strategies

Learning the needs, desires, and preferences of the target audiences does not need to be time

consuming. Whether this learning takes place at the water cooler or from a marketing

consultant, the point is to know your audience. Below are some of the many ways to learn

from and about the people and organizations considered partners in state plan development, as

well as those who will use and implement the plan.

Telephone Strategies Face-to-Face Strategies Electronic Strategies

Brief, informal calls to

partners

Conduct face-to-face

interviews with key partners

Email or post requests for

ideas

Structured conference calls

with groups or individuals

Hold structured discussions at

scheduled association, staff,

or community group meetings

Research known audience

perspectives, exposure to

similar initiatives, and

communication preferences

Telephone surveys Convene focus groups Put draft materials or surveys

on the web for feedback
Healthy People 2010 Toolkit 144

Sample "Market Research" Questions

Carefully designed questions will help focus learning on the most important areas. The right

questions will depend upon the audience, project goals, level of input desired and the stage in

the 2010 planning process. For example, if the steering committee and work groups were

already formed, planners would focus questions on how to develop and implement the plan

rather than how to engage key partners and the community in the planning process.

Planning Process

• How does your organization participate in

planning processes?

• What kinds of organizations have

approached you to be a part of an advisory

committee? How do you choose which

ones you will join?

• If you were inviting others (members of

the target audience) to attend a work group

meeting for this project, what would you

say to get them to come? What would you

avoid saying?

• What was your impression of the state's

year 2000 planning process? What

worthwhile came out of it?

• Tell me about a good experience that you

have had working with public health.

Design and production

• What makes a plan useful? What kinds of

plans are not useful?

• If you need detailed information about a

topic, do you prefer to have it included at

the back of a publication, in a separate

publication, or on a web site?

• Which of these formats is easy to use

(present two or more visual formats)?

• What do you think the people who wrote

this page want you to do?

Marketing

• Where do you get ideas for your work or

community activities?

• What kinds of published recommendations

and plans have you seen from other state

agencies?

• What impression do you have of

government planning efforts?

• When you receive plans from other

agencies, what do you do?

• If you were in charge of marketing the

state's health plan to others (members of

the target audience), what would you do?

• What do you read?

• How do you like to get information about

emerging objectives in public health?

Implementation

• What makes a healthy community?

• How do you contribute to your

community’s health? In what areas would

you like to do more?

• Have you ever used another agency’s plan

or objectives in your own work? What

was the most important factor in your

decision?

• How important are goals and plans to your

daily work? What would be an incentive

to tie your program activities to the state

health objectives?

• What would it take for you to commit to

help achieve a state health objective?

• If your supervisor asked you about how

you used the states’ year 2000 objectives,

what would you say?
145 Communicating Objectives

How to Develop a

Marketing Plan

A marketing plan clarifies how a state can share the 2010 vision with others, promote the

published plan, and “make things happen.” To develop marketing goals and objectives,

planners must determine priority audiences, desired results, key messages, strategies and

tactics, and marketing partners.

1. Priority audiences

Whose opinions or actions are most important to the success of the 2010 process and the

implementation of objectives? Identify potential target audiences and choose two to three

of most importance.

Sample Target Audiences for 2010 Marketing Plans:

# policymakers, including elected officials

# private sector health organizations,

including managed care organizations

# private sector employers

# medical societies and other health

professional associations

# school and education leaders

# state voluntary organizations with local

affiliates

# public health leaders and program managers

# front-line public health staff

# grass roots groups with the capacity to address

health objectives

# potential community advocates for priorities

2. Desired Results

What do you want each target audience to do or believe? Be specific! The final 2010 plan

and marketing materials should, explicitly or subtly, be designed to achieve the desired

outcome.

As examples, you might want the target audience to...

(do)

... use the state's 2010 objectives to

develop policies to improve public

health infrastructure

... use objectives and recommendations in

the 2010 plan to evaluate proposed

legislation relevant to focus areas

... incorporate components of the plan

into agency strategic plans

...commit resources and staff to develop

new data sources

(believe)

... be eager to work toward achieving

objectives in their communities

... support the planning and evaluation

role of public health

... believe the plan boosts accountability

... feel personal responsibility to be

healthier for a healthy state

... think the 2010 priorities are fair

... believe that state and local resources

should be tied to objectives
Healthy People 2010 Toolkit 146

3. Key Messages

For each audience, what are the main messages to communicate? Perhaps your main

message is that this is a “people’s plan,” a governor’s plan, a call to action, or a measure

of the current path to success. Whatever your message, be sure to identify key words and

phrases that support it. If your market research has identified that your target population

responds favorably to “milestones,” “action plans,” and “steps to success”but turns off

when they hear “objectives” or “benchmarks”include the preferred words in your key

messages. Remember to be consistent with vocabulary. Key messages should be

reinforced in all communications about the plan, including slogans, conference

presentations, press releases, and executive summaries.

4. Marketing Strategies and Tactics

How will you reach each audience?

Strategies describe your general marketing approach. For some audiences and purposes,

the best strategy may be to blanket the audience with messages about 2010 in a short

period of time. For others, your strategy might be to selectively promote 2010 in

connection with timely events (e.g., budget hearings) over several years.

Tactics are the methods of communication, such as:

• posters

• television ads

• newspaper articles, editorials

• conference booths

• training and presentations

• letterhead

• bumper stickers

• fax or electronic newsletters

• individual meetings

• brochures

• calendars

• web sites

Assess the communication environment of the target audience. The way to reach policy

makers may be through their staff or targeted newsletters, whereas the way to reach

public health program managers may be through an annual conference or posters at work.

List marketing strategies with a budget in mind. However, a longer menu of marketing

options can help identify marketing opportunities and resources in the future.

5. Marketing Partners

General media, special interest media, advocacy organizations, public relations offices,

health education units, graphics departments, private health care organizations, and

professional organizations with newsletters or web sites may be excellent partners in

promoting year 2010 objectives. Healthy People steering committees may include many

potential marketing partners who have experience with campaigns and already have an

interest in promoting the 2010 plan.

Exclusive arrangements with a few marketing partners who are committed (e.g., “Channel

12 Cares”) may sometimes be more effective than multiple, less focused partners.

Explore options with marketing professionals and check your agency policies.
147 Communicating Objectives

Evaluate Your Marketing Plan

Just as a marketing plan can clarify how a state can share the 2010 vision with others, the

marketing evaluation plan can identify whether efforts were effective. The following factors

can be used throughout the process internally as well as periodically be posed to the target

audience throughout the decade.

# Was the planning process effective in preparing the marketing goals and action plan?

# Was there timely follow-through on marketing activities such as information requests?

# Is the marketing strategy a clear representation of the primary vision of the state plan?

# Is the marketing plan sensitive to the community’s cultural dynamics?

# Did the development process include input from a diverse group of people?

# Were various media employed effectively to promote the state plan’s goals, actions, and

accomplishments? Was there media coverage (e.g., newspaper articles)? Did associations

and other community partners use the logo, articles, or other marketing materials in their

communications?

# How was input from partners used in developing and refining the marketing plan? Through

what mechanisms was input collected (e.g., surveys, focus groups, consultants)?

# Has the marketing process assisted progress in meeting the state plan’s specific objectives?

# How does the marketing plan mirror the goals and objectives of the overall state’s plan?

# Has marketing generated funding or other resources for the initiative?

# Were messages designed to clarify what audiences should do with the state plan or what

they should believe? Were marketing messages clear to targeted audiences?

# Did marketing efforts meet state objectives to influence the actions or beliefs of target

audiences? (e.g., Did policy makers propose or pass legislation based on or using the state

plan?)
Healthy People 2010 Toolkit 148

Resources for

Communicating

Health Goals and

Objectives

" American Public Health Association, Model Standards Project. “Media Relations.”

Available from American Public Health Association, 800 Eye Street, NW, Washington,

D.C. 20001-3710. (202) 777-2742. 1993.

This manual provides local governments with strategies to obtain media coverage for their efforts

to develop local health programs that integrate the “Healthy Communities 2000: Model

Standards’ Principles.” It considers the interrelated needs of the local health departments for

coverage and the local media for news of local interest. The manual provides strategies and tips

for working with local media and reviews basic procedures for developing news releases.

" National Cancer Institute. Making Health Communication Programs Work: A Planners

Guide. 1992. http://oc.nci.nih.gov/services/HCPW/HOME.HTM

The guide includes information on planning and strategy selection, determining target audiences,

writing program plans and developing a timetable, selecting channels and materials,

characteristics of mass media channels, developing materials and pre-testing. It also includes

sections on implementing a program, establishing process evaluation measures, steps for

involving intermediaries in a program, assessing effectiveness, evaluating outcomes, conducting

impact studies, and revising the program.

" Siege M., Doner L. Marketing Public Health: Strategies to Promote Social Change. Aspen

Publications, Maryland. 1998.

This book focuses on marketing principles for public health practice, including challenges and

opportunities for marketing social change and public health. It also uses case studies and focuses

on using marketing principles to design, implement, and evaluate public health interventions.

Please see Appendix A for other resources for communicating health goals and objectives.

picks
A - 1 Appendix A: Resources

!

Appendix A:

Resources

Building the Foundation: Leadership and Structure

! Bryson J.M., Crosby B.C. Leadership for the Common Good: Tackling Public Problems in a

Shared-Power World. Jossey Bass Publishers, Inc. San Francisco, CA, 1993.

Focuses on leadership in the public sector by explaining the dynamics of change in a shared-power

world. It offers guidance for public leadership and decision-making when public problems are

addressed.

" Civic Practices Network–Community Section.

http://www.cpn.org/sections/topics/community/index.html

Provides information on community building through “community organizing, social capital, and

urban democracy.” It also provides information on the Consensus Organizing Model, which

explains how one can bring together all the players in a community.

" Civic Practices Network–Health Section. http://www.cpn.org/sections/topics/health/index.html

Provides perspectives on building community involvement, as well as “how to put health reform on

more solid civic foundations.”

! Education and Healthcare Policy: Perspectives on Goals 2000, IASA, IDEA and Healthy People

2000. http://www.ed.gov/databases/ERIC_Digests/ed390023.html

Addresses education and health care reform due to the unmet health needs of children reported in

Healthy People 2000.

" Denotes a recommended "Hot Pick" resource
Healthy People 2010 Toolkit A - 2

! Feldman P., Gold M., Chu K. “Enhancing Information for State Health Policy.” Health Affairs,

13(3):236-250, 1994.

Essay on development of credible data, active policy champions, using data to gain the support of

key constituencies, choosing staff with entrepreneurial and bridging skills, and taking advantage of

short term policy windows.

! “Government and Private Sectors Join Forces for Food Safety.” Prevention Report, Winter 1998.

http://odphp.osophs.dhhs.gov/pubs/prevrpt/98winpr/98winfoc.htm

Summary of the 1997 Food Safety Initiative, which shows the collaboration between Federal, state

and local agencies, and private organizations engaged in food production, marketing, preparation,

and consumption.

! Healthy Policy – Idea Central. http://www.epn.org/ideacentral/health/

A virtual magazine of the electronic policy network.

! Marando V.L., Melchior A.C. “Public Health As A County Government Priority: Problems And

Solutions For The Political Arena.” American Journal of Preventive Medicine, 11(6 Suppl):17-23,

1995.

“This article addresses the priority issue given to public health by top county government officials.

We determine that public health is generally a low priority issue for county government leaders.

The low priority given to public health is, in part, linked to top county officials’ lack of recognition

of important public health problems and low levels of community group advocacy for public health

issues.”

! Najera A.P. “History of Successful Ballot Initiatives—California.” Cancer, 83(12):2680-4, 1998.

This article gives a brief history of California’s tobacco legislation.

" Public Health Resources on the Internet – Legislative and Regulatory Resources.

http://www.lib.berkeley.edu/PUBL/regs.html

Links to California, Federal, and other legislative and regulatory resources.

! Shelton D.M., Alciati M.H., Chang M.M., Fishman J.A., Fues L.A., Michaels J., Bazile R.J.,

Bridgers J.C. Jr., Rosenthal J.L., Kutty L., et al. “State Laws on Tobacco Control—United States,

1995.” Morbidity and Mortality Weekly Report: CDC Surveillance Summary, 44(6):1-28, 1995.

! Stateline.org. http://www1.stateline.org/index.do)

“Stateline.org was founded in order to help journalists, policy makers and engaged citizens become

better informed about innovative public policies.” The web site covers welfare reform, healthcare

especially as it relates to children and the right to die, and education especially the manner in which

public schools are financed, among other issues.
A- 3 Appendix A: Resources

! Wallack L., Dorfman L. “Media Advocacy: A Strategy for Advancing Policy and Promoting

Health.” Health Education Quarterly, 23(3):293-317, 1996.

“This article uses two case studies to illustrate key aspects of media advocacy. The first is a 5-year

statewide violence prevention initiative for young people in California. The second focuses on the

activities of a mothers’ group working to improve public housing. The “new public health,” with its

focus on participation, policy development, and political processes could benefit from incorporating

media advocacy.”

! Weller J. “History of Successful Ballot Initiatives—Oregon.” Cancer, 83(12):2693-6, 1998.

This article gives a brief history of Oregon’s tobacco legislation.

" Williams-Crowe S.M., Aultman T.V. “State Health Agencies and the Legislative Policy Process.”

Public Health Report, 109(3):361-7, 1994.

“Based on the experiences of state legislative liaison officers, specific strategies for dealing with

state legislatures have been identified and are organized into five key areas—agency organization,

staff skills, communications, negotiation, and active ongoing involvement. A public health agency

must be organized effectively to participate in the legislative policy process.”

Identifying and Securing Resources

! Agency for Health Care Policy and Research. http://http://www.ahcpr.gov/fund

Links to funding opportunities, grant announcements, policy notices, and research training grants.

" Department of Health and Human Services – GrantsNet. http://www.hhs.gov/grantsnet

“Tool for finding and exchanging information about Federal grant programs.”

" Grantmakers in Health. http://www.gih.org

“This is a non-profit organization serving funders throughout the country who make grants in health

and related human services. Grantmakers in Health serves these constituents through convening,

publishing, providing education/training, conducting research, developing and making accessible

databases and other information resources, providing technical assistance and consultation, making

referrals, and helping grantmakers build professional relationships.”

! The Grantsmanship Center. http://www.tgci.com

Provides a list of links to funding sources.

! Meadows M. “Looking for Money: Common Mistakes People Make in the Search For Funding.”

Closing the Gap. April 1998. Available at http://www.omhrc.gov/ctg/money.pdf

A quick summary of mistakes people make in their search for funding and what to do to avoid those

mistakes.
Healthy People 2010 Toolkit A - 4

! Mickey’s Place In the Sun. Grants and Grant Writing Resources.

http://Mickeys-Place-in-the-Sun.com/

Information and links for grants and grant writing, funding information on arts and humanities,

children and youth, community development, crime, justice, law enforcement, disabled, education,

environment, evaluation, and government. Information from grant-maker associations, health and

medical organizations, philanthropy, research funding, rural funding, science, social services and

welfare, substance abuse, telecommunications and technology, and training.

! Nonprofit Resources Catalog: Foundations.

http://www.fundsnetservices.com/index3.htm

Links to various foundations and funders.

" Office of Minority Health Resource Center. Funding Guide.

http://www.omhrc.gov/omhrc/publications/publications5.htm.

A guide to “assist grantseekers in their search for funding sources for health related activities.

Includes resources to enhance one’s knowledge of public funding, private funding, and the basics of

getting started in the search for funding sources.”

! Office of Minority Health Resource Center: Funding Materials Database.

http://www.omhrc.gov/OMH/fundingdb.htm

A searchable database of “funding resources that can help support minority health projects and other

health related programs.”

! Public Health Resources on the Internet. http://www.lib.berkeley.edu/PUBL/regs.html.

Links to California, Federal and other legislative and regulatory resources.

" Robert Wood Johnson Foundation. http://rwjf.org/index.jsp

“The Robert Wood Johnson Foundation’s mission is to improve the health and health care of all

Americans. Remaining faithful to our mission means keeping our commitment to the American

People in everything we do from encouraging healthier living and the conditions that promote better

health to promoting positive changes in the way health care is delivered in this country.”

! Rural Health Services Funding: A Resource Guide. http://www.nalusda.gov/ric/richspub/ric41.htm

A revised edition of Rural Health Services Funding: Resource Guide. Additional directories and

resources have been added along with an update of the section on Electronic Funding Resources.

Publishers' information, listed in Section VIII, gives the reader the necessary information to

purchase a publication.

! The Foundation Center. http://fdncenter.org/research/trends_analysis/pdf/health_hi.pdf)

Highlights of the 1998 Study: Health Policy Grant Making: A Report on Foundation Trends.
A- 5 Appendix A: Resources

! University of Pittsburgh. http://www.hsls.pitt.edu/

Provides links to grant and funding information on the World Wide Web and print resources which

are available at the Health Sciences Library System at the University of Pittsburgh.

" U.S. Department of Health and Human Services, Public Health Service, Office of Disease

Prevention and Health Promotion. “Locating Resources for Healthy People 2000 Health Promotion

Projects.” Available from Superintendent of Documents, U.S. Government Printing Office,

Washington, D.C. 20402. (202) 512-1800, 1991.

“This publication is a guide to locating financial assistance for projects related to the Healthy People

2000 goals. It reviews principles and procedures of grant seeking, and discusses ways to locate

specific groups in the private sector and local, state, and federal agencies that might provide

funding. A list of information resources is included, along with a glossary, bibliography, and

sample application form.”

" W. K. Kellogg Foundation. http://www.wkkf.org

The mission of the Kellogg Foundation is "to help people help themselves through the practical

application of knowledge and resources to improve their quality of life and that of future

generations." The Foundation was established 1930 and has “continuously focused on building the

capacity of individuals, communities, and institutions to solve their own problems.”

Identifying and Engaging Community Partners

! Adams C.F., ed. “Voices from America: Healthy Community Stories from Across the Nation.”

American Hospital Association, 1998.

http://www.healthycommunities.org/us_healthycities.cfm

This is a collection of 10 case stories which highlight collaborations between local communities and

neighborhoods which have defined health and quality of life for themselves, and designed initiatives

to achieve these goals. Each community profile highlights lessons learned and outcomes.

! Assessment and Health Information: Planning and Community Partnerships. Columbus Health

Department, Ohio. http://www.cmhhealth.org/communityhealthinfo/planning_community.html

“Planning and Community Partnerships focuses on coordination and collaboration in order to assess

and assure the health of the community.”

! Baker E.A., Brownson C.A. “Defining Characteristics of Community-Based Health Promotion

Programs.” Journal of Public Health Management and Practice, 4(2): 1-9, 1998.

This article examines some of the defining characteristics of community-based health promotion

programs and the challenges faced by practitioners who wish to engage in this type of work.
Healthy People 2010 Toolkit A - 6

" Civic Practices Network. http://www.cpn.org/sections/topics/community/index.html

Civic Practices Network–Community Section provides information on community building through

“community organizing, social capital, and urban democracy.” It also provides information on the

Consensus Organizing Model, which explains how one can bring together all the players in a

community.

! Coalition for Healthier Cities and Communities. c/o Health Research, Education, and Trust, One

North Franklin, Chicago, Illinois 60606 (312) 422-2635

The coalition is a partnership of entities from the public, private and non-profit sectors collaborating

to focus attention and resources on improving the health and quality of life of communities through

community-based development.

" Coalition for Healthier Cities and Communities, Norris T. & Howell L. Healthy People in Healthy

Communities: A Dialogue Guide. 1999.

This guide assists communities in hosting dialogues leading to action and policy on what makes

healthier communities. It is a part of the Healthy Communities Agenda, the 1999 – 2000 campaign

of the Coalition for Healthier Cities and Communities and its partners. For more information

contact the Healthy Communities Agenda “Dialogue Coach” at 1-800-803-6516 or contact the

Coalition for Healthier Cities and Communities, One North Franklin, Chicago, IL 60606.

http://www.healthycommunities.org

" Community Tool Box, http://ctb.lsi.ukans.edu/

The Community Tool Box’s mission is to promote community health and development by

connecting people, ideas, and resources. The web site provides tools to build healthier and stronger

communities. The web site also provides information for those interested in a variety of community

health and development issues and connects individuals to personalized assistance for improving

community change efforts. Sections of the web site include step-by-step guidelines, real-life

examples, checklists of points to review, and training materials for practitioners. The Tool Box also

includes success stories, innovative practices, trouble-shooting guides, and links.

! Chandler Center for Community Leadership. http://crs.uvm.edu/nnco/collab/wellness.html

“Community Based Collaboration – Community Wellness Multiplied”

“The Chandler Center for Community Leadership is concerned with the practical application of

research, proven success, and action to solve community problems. Attention is centered on

achieving positive community conditions, which include: helping communities to become vision

and mission driven, tailoring services to fit the community, developing preventative solutions,

emphasizing the value of citizen leadership, collaborative use of resources, and the democratic

formation of public policy.”
A- 7 Appendix A: Resources

! Goodman R.M., Speers M.A., et al. "Identifying and Defining the Dimensions of Community

Capacity to Provide a Basis for Measurement.” Health Education and Behavior, 25(3): 258-278,

1998.

The article identifies dimensions of community capacity for program development, implementation

and evaluation.

! Healthy Communities, “What Is Happening in My State?”

http://www.healthycommunities.org/us_healthycities.cfm

This web site is maintained by the State Network for Healthy Communities, a network of state and

regional level initiatives that support the Coalition for Healthier Cities and Communities. Its two

main objectives are to 1) encourage state-level collaboration between partners from various sectors;

and 2) encourage state-level stake holders to make their presence and resources better known

throughout their own state. The network has links to the following states and includes information

from the healthy communities within them: Colorado, Florida, Louisiana, Massachusetts, Michigan,

Missouri, Montana, New Mexico, Pennsylvania, Utah, Washington, and Wyoming.

" Institute of Medicine (Committee on Public Health). Healthy Communities: New Partnerships for

the Future of Public Health. National Academy Press, Washington, D.C., 1996.

http://www.nap.edu/catalog/5475.html

"The Committee’s analysis...the public’s health depends on the interaction of many factors; thus,

the health of a community is a shared responsibility of many entities, organizations, and interests in

the community, including health delivery organizations, public health agencies, other public and

private entities, and the people of a community."

! Kegler M.C., Steckler A. et al. "Factors That Contribute to Effective Community Health Promotion

Coalitions: A Study of 10 Project ASSIST Coalitions in North Carolina." Health Education and

Behavior, 25(3): 338-353, 1998.

“The results suggest that coalitions with good communication and skilled members had higher

levels of member participation and member states. Coalitions with more staff time devoted to them

and more complex structures had greater resource mobilization. Coalitions with more staff time,

good communication, greater cohesion, and more complex structures had higher levels of

implementation.”

! Lasker R.D., and the Committee on Medicine and Public Health. Medicine and Public Health: The

Power of Collaboration. The New York Academy of Medicine, New York, 1997.

Includes a history of relationships between medicine and public health and previous attempts to

bridge the gap. Also includes models of medicine and public health collaboration as well as case

studies.
Healthy People 2010 Toolkit A - 8

! Milio, N. "Priorities and Strategies for Promoting Community-Based Prevention Policies." Journal

of Public Health Management and Practice, 4(3): 14-28, 1998.

“Policy making requires a grasp of the interplay among stakeholders, policy makers, the press, and

the public. A framework for gathering relevant information and guiding strategic action is a useful

tool for participation in community, state, and national arenas in the interests of population health.”

" National Association of County Health Officials. Assessment Protocol for Excellence in Public

Health (APEXPH), 1991.

The tool is an eight-step process for assessing community health status and planning for

improvement. It is based on the principles of environmental justice, community collaboration, and

locally appropriate decision making. Guidance is designed to be easily accessible and flexible

enough to meet the needs of a variety of communities with differing health concerns. For more

information, see http://www.naccho.org.

! National Association of County and City Health Officials. Protocol for Assessing Excellence in

Environmental Health (PACE), June 1997.

PACE’s methodology consists of eight steps that are designed to walk a local health department

through a process of engaging community residents in identifying environmental health priorities.

Health departments working in concert with the community to design and direct the assessment

from the earliest stage through completion is integral to the methodology of PACE. Only in this

manner can the process accurately represent the needs and wishes of the people it will most directly

affect. For more information, see http://www.naccho.org.

! Norris T. "Healthy Communities." National Civic Review, 86(1): 3-10, 1997.

The author suggests that what works best to create and sustain positive community change can

ultimately be defined in a local context. Successful communities: recognize that the health and

sustainability of a community are products of the whole community working, and not as a result of

isolated interventions in any single sector. Instead, they engage everybody and build ownership and

civic engagement; take a regional and a local approach simultaneously; know how they are

performing; start with a shared vision and follow with a specific action plan and implementation

strategy; build on existing resources; and look at systemic change.

! Ohioline: Community Organizing.

http://ohioline.osu.edu/lines/comun.html#comorg

Provides links to community organizing and coalition building fact sheets and bulletins.

! Revisiting the Critical Elements of Comprehensive Community Initiatives.

http://aspe.hhs.gov/hsp/cci.htm

The study focuses on lessons and insights gained by Comprehensive Community Initiatives. The

study describes effective outreach, how to sustain involvement, how to address cultural issues, and

how to address the challenges of collaboration.
A- 9 Appendix A: Resources

" U.S. Department of Health and Human Services, Centers for Disease Control and Prevention

(CDC/ATSDR Committee on Community Engagement). Principles of Community Engagement,

Atlanta, Georgia, 1997.

Principles of Community Engagement provides public health professionals and community leaders

with a science base and practical guidelines for engaging the public in community decision-making

and action for health promotion, health protection, and disease prevention.

! U.S. Department of Health and Human Services, Public Health Service, Office of Public Health and

Science, Office of Disease Prevention and Health Promotion. Healthy People 2000: Healthy

People in Healthy Communities – A Guide for Community Leaders. June 1998.

This publication provides information on defining healthy cities and communities, how to begin

creating a healthy community, using Healthy People 2000 Objectives to set priorities, measure

progress, and improve your community’s health. It also provides a list of resources.

Setting Health Priorities and Establishing Objectives

! Brown W.J., Redman S. “Setting Targets: A Three-Stage Model for Determining Priorities for

Health Promotion.” Australian Journal of Public Health, 19(3):263-9, 1995.

Describes a three-stage model for setting targets for health promotion. The model enables

“epidemiological data and views from the community to be synthesized and integrated with those of

experts from health and social services, using a nominal group process.”

" CDC WONDER – The CDC Prevention Guidelines Database.

http://wonder.cdc.gov/wonder/prevguid/prevguid.shtml

“Comprehensive compendium of all the official guidelines and recommendations published by the

Centers for Disease Control and Prevention for the prevention of diseases, injuries, and disabilities.

This compendium was developed to allow public health practitioners and others to quickly access

the full set of CDC’s guidelines using a single financial support from the Information Network for

Public Health Officials project.”

" Committee on Leading Health Indicators for Healthy People 2010. Leading Health Indicators for

Healthy People 2010: Final Report. Division of Health Promotion and Disease Prevention, Institute

of Medicine, 1999.

This report is a compilation of the committee’s efforts to establish leading health indicator sets that

could “focus on health and social issues as well as evoke response and action from the general

public and the traditional audiences for Healthy People.” http://books.nap.edu/catalog/9436.html
Healthy People 2010 Toolkit A - 10

! Committee on Using Performance Monitoring to Improve Community Health. Division of Health

Promotion and Disease Prevention, Institute of Medicine. “Improving Health in the Community: A

Role for Performance Monitoring.” 1997. http://books.nap.edu/books/0309055342/html/416.html.

! Conway T., Hu T.C., Harrington T. “Setting Health Priorities: Community Boards Accurately

Reflect the Preferences of the Community’s Residents.” Journal of Community Health, 22(1):57-

68, 1997.

This article describes the process used to determine if the views of the District Health Councils

(DHCs) members agreed with those of community members. The purpose was to determine the

effectiveness of community advisory boards, which are often used as a vehicle for community input

regarding health planning.

! Health Care Forum Outcomes Toolkit. http://www.act-toolkit.com

“The Outcomes Toolkit provides a comprehensive approach to planning and evaluating

collaborative, cross-sectoral efforts. The Toolkit integrates the process of defining mission and

outcomes, setting performance goals over time, linking budget to performance, reporting results,

and ensuring accountability.” In particular, the toolkit establishes a process for setting priorities and

tracking progress against strategic goals.

! Hertzman C., Torres E., Subida R., Martins J. “Identifying Environmental Health Priorities for A

Whole Nation: The Use of Principal Environmental Exposure Pathways in the Philippines.”

International Journal of Occupational Environmental Health, 4(2):114-20, 1998.

Summarizes an approach to establishing environmental health priorities based on the concept of

principal environmental exposure pathways (PEEPs). This extends the concept of a causal pathway

backward from the health outcome to the cause.

" Maiese D., Fox C.E. “Laying the Foundation for Healthy People 2010.” Public Health Reports,

January 1998.

Summarizes activities implemented to gain input on Healthy People 2010, with the hopes that these

efforts would be duplicated by states and communities in their own planning processes.

! McGinnis J.M., Foege W.H. “Actual Causes of Death in the United States.” Journal of the

American Medical Association, 270(18):2207-12, 1993.

“The purpose of the study was to identify and quantify non-genetic factors that contribute to death

in the United States. Approximately half of all deaths that occurred in 1990 could be attributed to

the factors identified.” They represent a major health burden on our society and their identification

offers guidance for shaping health priorities.
A- 11 Appendix A: Resources

! Robine J.M., Romieu I., Cambois E. “Health Expectancy Indicators.” Bulletin of the World Health

Organization, 77(2):181-5, 1999.

Summarizes the “progress in the development of health expectancy indicators, which are growing in

importance as a means of assessing the health status of populations and determining public health

priorities.”

" U.S. Department of Health and Human Services, Office of Disease Prevention and Health

Promotion. “Developing Objectives for Healthy People 2010.” 1997.

Provides information on the process for developing the Nation’s third set of disease prevention and

health promotion objectives and includes a 1997 Summary List of Objectives. It describes how to

get involved. Also available at: http://www.health.gov/healthypeople/publications/hppublist.htm.

! U.S. Department of Health and Human Services, Public Health Service. “Healthy People 2000:

State Action.” 1992.

“The report reflects the diversity of ways in which states have used the Healthy People 2000

objectives as a guide for developing state-specific health objectives.”

! U.S. Department of Health and Human Services “Healthy People 2010: What Next?” Prevention

Report, 13(4), 1999.

Provides a summary of what has been done to date on the Healthy People 2010 Initiative. It also

provides literature resources, online resources, in print resources, funding information resources,

and educational aids resources.

! Vilnius D., Dandoy S. “A Priority Rating System for Public Health Programs.” Public Health

Reports, 105(5):463-70, 1990.

This article describes a priority rating system which ranks public health issues according to size,

urgency, severity of the problem, economic loss, impact on others, effectiveness, propriety,

economics, acceptability, legality of solutions, and availability of resources.

Obtaining Baseline Measures, Setting Targets, and

Measuring Progress

! Agency for Health Care Policy and Research. http://www.ahcpr.gov/data/

Data page includes links to websites on data, surveys , and healthcare information standards.

! Allison J., Kiefe C.I., Weissman N.W. “Can Data-Driven Benchmarks be Used to Set the Goals of

Healthy People 2010?” American Journal of Public Health, 89(1):61-5, 1999.

Provides an explanation of the “pared-mean” method, which helps identify from data the best health

care practices. “For Healthy People 2010, benchmarks derived from data reflecting the best

available care provide viable alternatives to consensus-derived targets.”
Healthy People 2010 Toolkit A - 12

! Baker E.L., Ross D. “Information and Surveillance Systems and Community Health: Building the

Public Health Information Infrastructure.” Journal of Public Health Management Practice, 2(4):58-

60, 1996.

Discusses the purpose of public health surveillance and information systems, examples from states

with strong public health information infrastructures, and the CDC INPHO initiative as a capacity

building process. Identifies some future surveillance and information system challenges.

! Bengson C. “The Year 2000 Issue: Implications for Public Health Information and Surveillance

Systems.” NACCHO NEWS, January/February:11, 1998.

Highlights the basics of the “2000 date” hardware issue (Y2K) and provides essential contact

information.

! Birkhead G.S. “Recognizing and Supporting the Role of Public Health Surveillance: Intensive Care

for a Core Public Health Function.” Journal of Public Health Management Practice, 2(4)vii-ix,

1996.

This editorial helps to define surveillance, the surveillance demands that have evolved, and the

difficulty in recognizing and addressing public health surveillance needs.

! Bureau of Labor Statistics – Safety and Health Statistics. http://www.bls.gov/iif/

Links to data web sites, news releases, and documentation related to safety and health statistics.

! Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention

and Health Promotion. “Public Health and Managed Care: Data Sharing for Common Goals.”

Chronic Disease Notes & Reports, 10(1):1-8, 1997.

Describes benefits and barriers of data sharing, the intended effects of Kennedy-Kassebaum

Legislation (HIPPA), and the HMO Research Network.

! CDC WONDER – Healthy People DATA2000 Request Screen. http://wonder.cdc.gov/health.shtml

“The DATA2000 System contains national baseline and monitoring data for each Healthy People

2000 objective. In WONDER the available baseline and updated data are shown for 520 objectives

and sub-objectives. Output options include simple tables and graphs.”

! Chin T.L. “Internets/Intranets: A New Public Health Tool.” Health Data Management, February

1998.

Discusses the use of the Internet and intranets by health departments around the nation including a

focus on the CDC Information Network for Public Health Officials (INPHO) initiative.
A- 13 Appendix A: Resources

" Committee on Leading Health Indicators for Healthy People 2010. Leading Health Indicators For

Healthy People 2010: Final Report. Division of Health Promotion and Disease Prevention, Institute

of Medicine, 1999.

This report includes the selection criteria for leading health indicators, as well as proposed indicator

sets for Healthy People 2010. Available at: http://books.nap.edu/catalog/9436.html.

! Committee on Using Performance Monitoring to Improve Community Health. Division of Health

Promotion and Disease Prevention, Institute of Medicine. “Improving Health in the Community: A

Role for Performance Monitoring.” 1997. http://books.nap.edu/books/0309055342/html/416.html.

! Envirofacts Warehouse. http://www.epa.gov/enviro/index_java.html

Provides access to the Environmental Protection Agency’s environment data.

! Feinleib M. “Setting and Monitoring Health Objectives for the Nation.” Public Health Reviews,

23(2):127-38, 1995.

“Reviews the progress toward accomplishing the objectives of the Healthy People 2000 national

disease prevention effort. The National Center for Health Statistics has the responsibility for

gathering information needed to monitor the progress toward these targets. The NCHS does so by

ensuring that timely and accurate data are available, by constant monitoring of the trends, and by

efficient communication with those responsible for implementing the programs and those who

provide the resources for supporting the programs. This is to enhance the likelihood of achieving

national objectives.”

! Feldman P., Gold M., Chu K. “Enhancing Information for State Health Policy.” Health Affairs,

13(3):236-50, 1994.

Essay on development of credible data, active policy champions, using data to gain the support of

key constituencies, choosing staff with entrepreneurial and bridging skills, and taking advantage of

short term policy windows.

! Health Forum Outcomes Toolkit. http://www.act-toolkit.com/

The toolkit’s data capabilities:

# Allows for the development of a community-wide database on health, quality of life, economic

vitality and community capacity

# Supports multiple users and facilitates information sharing among users

# Provides charting and graphing capabilities

# Responds to public and private sector demands for demonstrating measurable results

# Browse through any database that is accessible online

# Cut-and-paste information into your own database from anywhere, including from other

communities

# Customize reports about activities and results

# Equipped with the power to locate and use a vast array of relevant information, including

secondary data, via Web access
Healthy People 2010 Toolkit A - 14

" ICD-10 – The following sights provide information on the ICD-10.

http://www.healthmkt.com

http://www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm

! Information Clearinghouse (Health Care Financing Administration). http://www.hcfa.gov/stats/

Links to information on Medicare financing, public use data files, and national healthcare indicators

and expenditures.

" Morbidity and Mortality Weekly Report. http://www.cdc.gov/mmwr/

“The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for

Disease Control and Prevention (CDC). The data in the weekly MMWR are provisional, and are

based on weekly reports to CDC by state health departments.”

! National Association of County Health Officials. Assessment Protocol for Excellence in Public

Health (APEXPH), 1991.

The tool is an eight-step process for assessing community health status and planning for

improvement. It is based on the principles of environmental justice, community collaboration, and

locally appropriate decision making. Guidance is designed to be easily accessible and flexible

enough to meet the needs of a variety of communities with differing health concerns. For more

information, see http://www.naccho.org.

" National Association of Health Data Organizations. http://www.nahdo.org

“The National Association of Health Data Organizations (NAHDO) is the premier national health

information organization dedicated to improving health care through the collection, analysis,

dissemination, and use of health care data.”

! National Cancer Institute SEER Cancer Statistics.

http://www.seer.ims.nci.nih.gov/Publications/CSR7394/index.html

A review of cancer statistics from 1973-1995.

" National Center for Health Statistics. http://www.cdc.gov/nchs/products.htm

Publications and information products with links to Healthy People 2000 Reviews (in PDF format).

The home page for the National Center for Health Statistics is available at

http://www.cdc.gov/nchs/.

! Sondik E. “Healthy People 2000: Meshing National and Local Health Objectives.” Public Health

Report, 111(6):518-20, 1996.

Summarizes the successes and problems with data collection as it relates to the Healthy People

initiative. Urges action on the national, state and local levels.
A- 15 Appendix A: Resources

! Stevens P.E. “Focus Groups: Collecting Aggregate-Level Data to Understand Community Health

Phenomena.” Public Health Nursing, 13(3):170-6, 1996.

The article discusses the potential benefits of focus groups when studying community health. It

explores the advantages and uses of a focus group as well as purposes and processes of focus group

facilitation. It goes on to explain how to analyze focus group results, their limitations, and their

implications for health planning.

! Torres I.M. “Assessing Health in an Urban Neighborhood: Community Process, Data Results and

Implications for Practice.” Journal of Community Health, 23(3):211-26, 1998.

Summarizes the development process of the Health Assessment Project (HAP). This was a health

assessment conducted by the University of Massachusetts School of Public Health faculty, students

and community organizations and residents. The article gives an overview of the community

process, data results, and implications for public health practice.

! Turnock B., Handler A. “Measuring Effective Local Public Health Practice.” Available from B.J.

Turnock, Center for Public Health Practice, School of Public Health, University of Illinois at

Chicago, Box 6998, Chicago, IL 60680. (312) 996-6620. 1994.

“This paper proposes a framework for describing and measuring local public health practice to track

progress toward Objective 8.14 of Healthy People 2000. Performance measures consisting of

performance expectations/standards and associated performance indicators for each of the 10

collective public health practices developed at the Centers for Disease Control in 1989 are included.

The appendices include preliminary and revised standards and indicators. The effectiveness of local

health departments in addressing the core functions of public health is discussed. Roles for local

health liaisons in the surveillance of local public health practice and capacity building are also

addressed.”

" U.S. Census Bureau. http://www.census.gov

! U.S. Department of Health and Human Services. “Improving the Nation’s Health with Performance

Measurement.” Prevention Report. http://odphp.osophs.dhhs.gov/pubs/prevrpt/97winfoc.HTM

This article looks at how the “U.S. Department of Health and Human Services and state and local

communities are applying performance measurement. It describes and shows how states can

develop performance measures based on Healthy People Objectives.”

Managing and Sustaining the Process

! American Public Health Association, Model Standards Project. “Community Strategies for Health:

Fitting in the Pieces.” Available from the American Public Health Association, 800 Eye Street,

N.W., Washington, D.C. 20001-3710. (202) 777-2742. 1993.

This manual indicates ways that local health agencies can reach out to organizations that are

concerned with the health of their community. The principles contained in the “Healthy

Communities 2000: Model Standards,” are emphasized. The use of the Assessment Protocol for
Healthy People 2010 Toolkit A - 16

Excellence in Public Health (APEXPH) and the Planned Approach to Community Health (PATCH)

in reaching the goals of the model standards is considered. The manual highlights steps that local

health departments, the medical community, community organizations, local employers, the

academic community, and local media can take to obtain commitments from community members.”

! American Public Health Association, Model Standards Project. “The Guide to Implementing Model

Standards: Eleven Steps Toward a Healthy Community.” Available from Jenne Glass, Model

Standards Project, American Public Health Association, 800 Eye Street, N.W., Washington, D.C.

20001-3710. (202) 777-2742. 1993.

“This manual provides local health departments with 11 steps for implementing the “Healthy

Communities 2000: Model Standards” within their programs to help achieve the goals of Healthy

People 2000.”

! Bronheim S.M., Keefe M.L., Morgan C.C. “Building Blocks of a Community-Based System of

Care: The Communities can Campaign Experience.” Available from Mary Deacon, Georgetown

University Child Development Center, 3307 M Street, N.W., Suite 401, Washington, D.C. 20007.

(202) 687-8635. 1993.

“This report is part of a series focused on the details of how individual communities can realize the

vision of providing family-centered, community-based, coordinated care for children with special

health needs and their families. Winning strategies included fostering interagency collaboration,

establishing public/private partnerships, identifying non-monetary resources, promoting active

participation by physicians and families in system development, building on existing programs,

developing generic systems of care to serve all children, and developing cultural competence. This

campaign was implemented as part of the Healthy People 2000 objectives for the nation, and funded

by the Maternal and Child Health Bureau, U.S. Department of Health and Human Services, and by

the American Academy of Pediatrics.”

" Change Project. http://www.well.com/user/bbear

From this main page, follow the link to Healthy Communities, then to Sustaining the Effort. This

will take you to the article, “Sustaining the effort: building a learning community from the

healthcare forum.” The table of contents includes areas such as governance, structure, and

leadership; process; maintaining participation and inclusion; resources; staff support; measurement;

and celebration.

! Committee on Using Performance Monitoring to Improve Community Health. Division of Health

Promotion and Disease Prevention, Institute of Medicine. “Improving Health in the Community: A

Role for Performance Monitoring.” 1997. http://books.nap.edu/books/0309055342/html/416.html

! Johnson K. “Building Capacity Through Collaborative Leadership.” International Journal of

Health Planning and Management, 11(4):339-44, 1996.

“This paper is based upon material from the manuals and training program underpinnings of the

‘Sustaining community-based initiatives’ from the Healthcare Forum with the W.K.Kellogg
A- 17 Appendix A: Resources

Foundation in the USA. The use of organizational management principles and practices in

community involvement and strengthening community leadership is illustrated through practical

examples.”

" National Civic League. “The Healthy Communities Handbook.” Available from National Civic

League, 1445 Market Street, Suite 300, Denver, CO 80302. (303) 571-4343.

“This manual is intended for the use of community groups, business people, individuals, or local

governments that are concerned with their communities. It incorporates the goals and objectives of

the Healthy People 2000 initiative into a community-based health planning process. The manual

notes the standards and principles from various programs to develop a baseline for planning local

programs. “

" Revisiting the Critical Elements of Comprehensive Community Initiatives.

http://aspe.os.dhhs.gov/hsp/cci.htm

The study focuses on lessons and insights gained through the experience of Comprehensive

Community Initiatives. The study defines the characteristics of a good leader and staff, how to

develop and maintain a sense of hope and momentum, and how planning and action can be blended

and balance.

! U.S. Department of Health and Human Services, Office of Disease Prevention and Health

Promotion. “Healthy People 2000: Turning Commitment into Action.” 1993.

Provides activity ideas for mobilizing the Healthy People 2000 initiative.

Communicating Health Goals and Objectives

" American Public Health Association, Model Standards Project. “Media Relations.” Available from

American Public Health Association, 800 Eye Street, N.W., Washington, D.C. 20001-3710. (202)

777-2742. 1993.

“This manual provides local governments with strategies to obtain media coverage for their efforts

to develop local health programs that integrate the ‘Healthy Communities 2000: Model Standards’

principles. It considers the interrelated needs of the local health departments for coverage and the

local media for news of local interest. The manual indicates methods for gaining media attention

while operating on a limited budget and it highlights the parts of the Model Standards that are

related to current media issues.”

! International Health Communication Hotline.

http://www.vscc.cc.tn.us/academic/humanities/com100/inhome.html

“It is dedicated to serving the community of health communication researchers, educators,

practitioners and administrators by offering a variety of links to health and communication-related
Healthy People 2010 Toolkit A - 18

sites.” Provides general communication links, health communication/general health and medicine

links, health communication commercial sites, and other useful and interesting sites.

! The International Journal of Nonprofit and Voluntary Sector Marketing.

http://www.henrystewart.co.uk/journals/nvsm

Provides information on the latest innovations in: fundraising, social and healthcare marketing,

education marketing, customer retention and loyalty, advertising and promotion, campaigning and

lobbying, database marketing, and marketing software.

! Journal of Health Communication: International Perspectives.

http://www.tandf.co.uk/journals/tf/10810730.html

This journal provides information on “the latest developments in the field of health communication,

including research in social marketing, shared decision making, communication (from interpersonal

to mass media), psychology, government, and health education in the United States and the world.”

" Making Health Communication Programs Work: A Planners Guide.

http://oc.nci.nih.gov/services/HCPW/HOME.HTM

Includes information on planning and strategy selection, determining your target audiences, writing

program plans and developing a timetable, selecting channels and materials, characteristics of mass

media channels, developing materials and pre-testing, implementing your program, establishing

process evaluation measures, steps for involving intermediaries in your program, assessing

effectiveness, outcome evaluation, impact studies, and revising the program.

! Morgan D.L., Krueger R.A. The Focus Group Kit. Sage Publications, California, 1998.

A set of six short books that take you through the focus group process. The books include: The

Focus Group Guidebook, Planning Focus Groups, Developing Questions for Focus Groups,

Moderating Focus Groups, Involving Community Members in Focus Groups, and Analyzing and

Reporting Focus Group Results.

! National Association of County and City Health Officers. Providing Culturally Appropriate

Services: Local Health Departments and Community-Based Organizations Working Together.

Washington D.C.: National Association of County and City Health Officials. 1994.

This report describes three case studies which implemented activities to address language and

cultural needs in their communities. It includes recommendations for health departments along with

information about other resources, references, and contacts on multi-cultural health.

" Siegel M., Doner L. Marketing Public Health: Strategies To Promote Social Change. Aspen

Publications, Maryland, 1998.

This book focuses on marketing principles for public health practice, including challenges and

opportunities for marketing social change and public health. It also focuses on using marketing
A- 19 Appendix A: Resources

principles to design, implement, and evaluate public health interventions. In addition, it includes

case studies.

! Social Marketing Quarterly.

A publication of Best Start, Inc. and The Department of Community and Family Health, College of

Public Health, University of South Florida. All articles in the journal “focus on social marketing, or

emphasize a component of social marketing and demonstrate how the components(s) fit into and/or

apply to a complete social marketing program.”

! “Social Marketing Can Enhance Prevention Programming.” Prevention Alert.

http://www.health.org/govpubs/prevalert/html-p43/v1page01.htm

A brief overview of why the Social Marketing Theory can work in public health. It is adapted from

the following article: Ling J. C., Franklin B. A. K., Lindsteadt J. F., Gearon, S. A. N. "Social

marketing: its place in public health." Annual Review of Public Health, 13: 341-362, 1992.

! The United States Conference of Local Health Officers and the United States Conference of

Mayors. Language and culture in health care: Coping with Linguistic and Cultural Differences:

Challenges to Local Health Departments. The United States Conference of Local Health Officers

and The United States Conference of Mayors. (Copies can be obtained from 1620 Eye Street, N.W.,

Washington, D.C. 20026, Tel: (202) 293-7730. 1993.

This reports addresses the barriers encountered in the provision of services to non-English speaking

groups at the local level. It also provides recommendations for actions and descriptions of several

case profiles.

! Walsh D.C., Rudd R.E., Moeykens B.A., Moloney T.W. “Social Marketing for Public Health.”

Health Affair, 12(2):104-19, 1993.

“Marketing techniques and tools, imported from the private sector, are increasingly being advocated

for their potential value in crafting and disseminating effective social change strategies. This paper

describes the field of social marketing as it is used to improve the health of the public. A

disciplined process of strategic planning can yield promising new insights into consumer behavior

and product design. However, the “technology” cannot simply be transferred without some

translation to reconcile differences between commercial marketing and public health.”

Other Useful Resources

! American Association for Health Education. http://www.aahperd.org/aahe/template.cfm

“Serves health educators and other professionals who promote the health of all people. AAHE

encourages, supports, and assists health professionals concerned with health promotion through

education and other systematic strategies.”
Healthy People 2010 Toolkit A - 20

! Association of State and Territorial Directors of Health Promotion and Public Health Education.

http://www.astdhpphe.org/index.html

“The mission is to promote the quality practice of health education and health promotion as core

disciplines of public health practice and to advocate for quality health education/health promotion

programs and strategies to address the nation’s leading health problems.”

! Centers for Disease Control and Prevention. (CDC) http://www.cdc.gov

The mission of the CDC is, “to promote health and quality of life by preventing and controlling

disease, injury, and disability.” The web site contains information ranging from research to funding

issues and from various guidelines to health information. This site is searchable by key word.

! National Institutes of Health. (NIH) http://www.nih.gov

Contains various information on health, news, funding opportunities, and scientific resources. It

also has its own search engine.

! National Library of Medicine http://www.nlm.nih.gov

The National Library of Medicine (NLM), the world's largest medical library, collects materials in

all areas of biomedicine and health care. NLM produces a number of free online databases that can

be searched to identify publications (books or journal references) on specific health related topics

including topics of interest to public health. NLM is a national resource for all U.S. health science

libraries through a National Network of Libraries of Medicine. The public can call toll-free for

referral to a network library member in their area: 888-346-3656.

MEDLINE – http://www.nlm.nih.gov/databases/freemedl.html

MEDLINE is the National Library of Medicine's online database that contains almost 10 million

references to journal articles in the health sciences. Approximately 4,000 medical journals are

indexed in MEDLINE. The time period covered is 1960 to the present. Seventy-six percent of the

articles have abstracts. NLM has developed two interfaces for searching MEDLINE: (1) PubMed

and (2) Internet Grateful Med. Both services have online instructions available (under Help in

PubMed and the Internet Grateful Med User's Guide from the IGM homepage) to assist users in

searching MEDLINE effectively.

LOCATORplus – http://locatorplus.gov/

LOCATORplus is the National Library of Medicine's new Web-based catalog. LOCATORplus

allows anyone with Internet access to find out what books, journals, audiovisuals, manuscripts, and

other items are contained in the NLM collections.

HSR Search – http://www.nlm.nih.gov/nichsr/nichsr.html

HSR Search is the National Library of Medicine's search interface designed to give users a single

access point to several NLM databases with health services research-specific information. This new

feature is accessible from the National Information Center on Health Services Research and Health
A- 21 Appendix A: Resources

Care Technology (NICHSR) homepage. HSR Search allows users to enter one or more terms that

are then ANDed together for them. HSR Search runs a query against the following NLM databases:

HealthSTAR, HSRProj, DIRLINE, HSTAT, and a prototype HSR Tools database. Users may select

all or some of these when sending a query. It is expected that in the future that the HSR Search will

be replaced by an NLM gateway that is currently being developed by Library staff. This gateway,

which will be a much more sophisticated state-of-the-art access mechanism, will provide access to

NLM's databases beyond the HSR suite.

National Information Center on Health Services Research and Health Care Technology –

http://www.nlm.nih.gov/nichsr/nichsr.html

NICHSR is the National Library of Medicine's focal point for health services research information.

The goals of NICHSR are to make the results of health services research, including practice

guidelines and technology assessments readily available to health practitioners, health care

administrators, health policy makers, payers, and the information professionals who serve these

groups; to improve access to data and information needed by the creators of health services

research; and to contribute to the information infrastructure needed to foster patient record systems

that can produce useful health services research data as a by-product of providing health care. See

the NICHSR Related Web Sites (links) for important resources.

Partners in Information Access for Public Health Professionals –

http://nnlm.gov/partners/

This is a new collaborative project to provide public health professionals with timely and

convenient access to information resources to help them improve the health of the American Public.

Project partners include the: Association of State and Territorial Health Officials (ASTHO); Centers

for Disease Control and Prevention (CDC); Health Resources and Services Administration (HRSA);

National Association of County and City Health Officials (NACCHO); National Library of

Medicine (NLM); National Information Center on Health Services Research and Health Care

Technology (NICHSR), NLM; National Network of Libraries of Medicine (NN/LM); and the

Public Health Foundation (PHF). This resource includes special sections on: (1) Tools to aid in

identifying Grants and Grant Writing, (2) Tools for Education and Training , and (3) information

about libraries within your own local geographic areas to assist you in obtaining documents and

related library services or for developing local partnerships.

Current Bibliographies in Medicine – http://www.nlm.nih.gov/pubs/resources.html

Current Bibliographies in Medicine is the National Library of Medicine's publication series which

contains selected references on a distinct subject area of medicine of current popular interest, e.g.,

domestic violence assessment by health care practitioners. See especially the CBM on Public

Health Informatics (http://www.nlm.nih.gov/pubs/cbm/phinform.html) and health literacy related

bibliographies (forthcoming).
Healthy People 2010 Toolkit A - 22

HSRProj – http://www.nlm.nih.gov/nichsr/db.html#hsrp

HSRProj is one of the information products developed by the National Information Center on

Health Services Research and Health Care Technology (NICHSR), a component of the National

Library of Medicine. HRSProj contains descriptions of research in progress funded by federal and

private grants and contracts for use by policy makers, managers, clinicians and other decision

makers. It provides access to information about health services research in progress before results

are available in a published form. Records cover both grants and contracts awarded by several major

public and private funding agencies and foundations.

Users can retrieve names of performing and sponsoring agencies, names and addresses of the

principal investigator, beginning and ending years of the project, level of funding, information about

study design and methodology (including demographic characteristics of the study group), number

of subjects in the study population, population base of the study sample, and source of the project

data. Project descriptions are also included whenever possible.

HSTAT - http://hstat.nlm.nih.gov/

HSTAT is a free, electronic resource developed under the auspices of the National Library of

Medicine (NICHSR office) that provides access to the full-text of documents useful in health care

decision making. STAT includes: clinical practice guidelines, quick-reference guides for clinicians,

consumer brochures, and evidence reports sponsored by the Agency for Health Care Policy and

Research (AHCPR); AHCPR technology assessment reports; National Institutes of Health (NIH)

consensus development conference and technology assessment reports; NIH Warren G. Magnuson

Clinical Center research protocols; HIV/AIDS Treatment Information Service (ATIS) resource

documents; Substance Abuse and Mental Health Services Administration, Center for Substance

Abuse Treatment (SAMHSA/CSAT) treatment improvement protocols; and the Public Health

Service (PHS) Preventive Services Task Force Guide to Clinical Preventive Services. It also

provides a link to the Centers for Disease Control and Prevention (CDC) Prevention Guidelines

Database.

MEDLINEplus – http://www.nlm.nih.gov/medlineplus/

MEDLINEplus is the National Library of Medicine's new consumer health information service. See

links for health consumers to libraries participating in this project

(http://medlineplus.nlm.nih.gov/medlineplus/libraries.html).

! Public Health Foundation Healthy People 2010 Audioconference Series.

http://www.phf.org/hp2010/2010ac.htm

The materials in the audioconference series “serve as reference materials for states as they build

their own health objectives plan.” The topics in the series include: Building State and Local Health

Objectives; Using Data to Set and Measure Health Objectives; Making the Link; Translating

Healthy People Objectives into Local Targets; Lessons Learned for 2010: The Good , the Bad, and

the Ugly.
A- 23 Appendix A: Resources

! Society for Public Health Education. http://www.sophe.org

“The mission is to provide leadership to the profession of health education and health promotion to

contribute to the health of all people through advances in health education theory and research,

excellence in health education practice, and the promotion of public policies conducive to health.”

! U.S. Department of Health and Human Services. http://www.hhs.gov

“The Department of Health and Human Services is the United States government's principal agency

for protecting the health of all Americans and providing essential human services, especially for

those who are least able to help themselves. The department contains more than 300 programs,

covering a wide spectrum of activities.” The web site contains a plethora of information and you

are able to search the sight by key word.
B - 1 Appendix B: Contacts

Appendix B:

Healthy People

State, Territorial,

and Tribal

Action Contacts

State Contact Information

Alabama

Mr. Jim McVay

Director of Health Promotion and Chronic

Disease

Alabama Department of Public Health

P. O. Box 303017

Montgomery, AL 36130-3017

E-mail: jmcvay@adph.state.al.us

Voice: (334) 206-5600

Fax: (334) 206-5609

Alaska

Ms. Debbie Lowenthal

Health and Social Services Planner

Data and Evaluation Unit

Division of Public Health

Alaska Department of Health and Social

Services

Alaska Office Building

P.O. Box 110618

Juneau, AK 99811-0618

E-mail: Debbie_Lowenthal@health.state.ak.us

Voice: (907) 465-5663

Fax: (907) 465-8637

Arizona

Ms. Geri Tebo

Healthy Communities Coordinator

Arizona Department of Health Services

2927 North 35th Avenue, Suite 100

Phoenix, AZ 85017

E-mail: gtebo@hs.state.az.us

Voice: (602) 542-1918

Fax: (602) 542-1265

Arkansas

Ms. Christine Patterson, MSW

Director of the Office of Minority Health

Arkansas Department of Health

Slot #52

4815 West Markham Street

Little Rock, AR 72205

E-mail: cpatterson@healthyArkansas.com

Voice: (501) 661-2193

Fax: (501) 661-2414

California

Fred Richards

Research Analyst

Center for Health Statistics

California Deparment of Health Services

304 S Street, 3rd Floor

Sacramento, CA 95814

E-mail: frichard@dhs.ca.gov

Voice: (916) 445-6338

Fax: (916) 324-5599

Colorado

Chuck Bayard

Advisor to the Director

Colorado Department of Health

Office of Health

4300 Cherry Creek Drive South, OH-05

Denver, CO 80222-1530

E-mail: chuck.bayard@state.co.us

Voice: (303) 692-2015

Fax: (303) 782-0095
Healthy People 2010 Toolkit B - 2

Connecticut

Dr. Michael Hoffmann

Director of Research and Planning

Office of Policy, Planning and Evaluation

Connecticut Department of Public Health

410 Capitol Ave., Mailstop # 13PPE

Hartford, CT 06134-0308

E-mail: michael.hofmann@po.state.ct.us

Voice: (860) 509-7120

Fax: (860) 509-7160

Delaware

Dr. Terrance Zimmerman

Director of Administration

Division of Public Health

Delaware Dept. of Health & Social Services

P.O. Box 637

Dover, DE 19903-0637

E-mail: tzimmerman@state.de.us

Voice: (302) 739-3034

Fax: (302) 739-3008

District of Columbia

Ms. Patsy Theiss

Public Health Advisor

District of Columbia Department of Health

825 N. Capitol St., Suite 2100

Washington, DC 20002

E-mail: ptheiss@dchealth.com

Voice: (202) 442-9039

Fax: (202) 442-4833

Florida

Mr. William Alfred

Operations Management and Consultant

Manager

Florida Dept. of Health & Data Analysis

4052 Bald Cypress Way, Bin #A05

Tallahassee, FL 32399-1706

E-mail: B_Alfred@doh.state.fl.us

Voice: (850) 245-4009

Fax: (850) 921-1898

Georgia

Mr. Jack Kirby

Deputy Director

Division of Public Health

Georgia Department of Human Resources

Two Peachtree St N.W., Suite 15-470

Atlanta, GA 30303

E-mail: jkirby@dhr.state.ga.us

Voice: (404) 657-2700

Fax: (404) 657-2715

Georgia

Ms. Michele Mindin

Director for Grant Development and

Management

Georgia Division of Public Health

2 Peachtree Street

15th Floor

Atlanta, GA 30303

E-mail: mbmindlin@dhr.state.ga.us

Voice: (404) 657-2758

Fax: (404) 657-2715

Hawaii

Dr. Betty J. Wood

Director, Healthy Hawaii 2000

Hawaii Department of Health

1250 Punchbowl St., Room 227

P.O. Box 3378

Honolulu, HI 96801

E-mail: phhsbg01@health.state.hi.us

Voice: (808) 586-4530

Fax: (808) 586-4444

Idaho

Mr. Richard H. Schultz, MS

Administrator

Division of Health

Idaho Department of Health and Welfare

450 W. State St., Box 83720

Boise, ID 83720-0036

E-mail: schultzr@idhw.state.id.us

Voice: (208) 334-5945

Fax: (208) 334-6581

Illinois

Ms. Patti Kimmel

Chief, Division of Health Policy

Illinois Department of Public Health

525 West Jefferson Street

Springfield, IL 62761-0001

E-mail: pkimmel@idph.state.il.us

Voice: (217) 782-6235

Fax: (217) 785-4308

Indiana

Ms. Hazel Katter

Director, Local Liaison Office

Indiana State Department of Health

2 North Meridian Street, Section 8B

Indianapolis, IN 46204

E-mail: hkatter@isdh.state.in.us

Voice: (317) 233-7679

Fax: (317) 233-7761
B - 3 Appendix B: Contacts

Iowa

Dr. Louise Lex

Program Coordinator for Healthy Iowans

Division of Substance Abuse Prevention and

Health Promotion

Iowa Department of Health

Lucas State Office Building, 3rd Floor

321 East 12th Street

Des Moines, IA 50319-0075

E-mail: llex@idph.state.ia.us

Voice: (515) 281-4348

Fax: (515) 281-4535

Kansas

Ms. Deborah M. Williams

Director, Special Services

Bureau of Health Promotion

Kansas Department of Health and Environment

Landon State Office Building, Room 901N

900 Southwest Jackson

Topeka, KS 66612-1290

E-mail: dwilliams@kdhe.state.ks.us

Voice: (785) 291-3743

Fax: (785) 296-8059

Kentucky

Mr. Charles Kendell

Manager, Health Policy Development Branch

Division of Epidemiology and Health Planning

275 East Main Street, MSH S1EB

Frankfort, KY 40621-0001

E-mail: charles.kendell@mail.state.ky.us

Voice: (502) 564-9592

Fax: (502) 564-9205

Louisiana

Ms. Jorli Wales

Office of Public Health Communications

Director

Louisiana Department of Health and Hospitals

Louisiana Office of Public Health

1201 Capital Access Road, 5th Floor

Baton Rouge, LA 70821

E-mail: jwales@dhh.state.la.us

Voice: (225) 342-8096

Fax: (225) 342-4848

Maine

Dr. Dora Anne Mills

State Health Officer

Maine Human Services Department

11 State House Station

157 Capitol Street

Augusta, ME 04333

E-mail: dora.a.mills@state.me.us

Voice: (207) 287-3270

Fax: (207) 287-9058

Maryland

Ms. Jeanette Jenkins, MHS

Director

Office of Health Policy

Maryland Department of Health and Mental

Hygiene

201 West Preston Street, Room 316

Baltimore, MD 21201

E-mail: jenkinsj@dhmh.state.md.us

Voice: (410) 767-5045

Fax: (410) 333-7703

Massachusetts

Dr. Cynthia Boddie-Willis

Acting Director, Division of Community Health

Promotiion

Bureau of Family and Community Health

Massachusetts Department of Public Health

250 Washington Street, 4th Floor

Boston, MA 02108

E-mail: cynthia.boddie-willis@state.ma.us

Voice: (617) 624-5434

Fax: (617) 624-5075

Michigan

Mr. Lonnie Barnett

Manager for the Community Assessment

Section

Health Legislation and Policy Development

Michigan Department of Community Health

320 South Walnut Street

Lansing, MI 48913

E-mail: barnettl@state.mi.us

Voice: (517) 241-2966

Fax: (517) 241-0084

Minnesota

Ms. Debra Burns

Section Manager

Division of Community Health Services

Minnesota Department of Health

P.O. Box 64975

St. Paul, MN 55164

E-mail: debra.burns@health.state.mn.us

Voice: (651) 296-8209

Fax: (651) 296-9362

Mississippi

Dr. David Buchanan

Director, Policy and Planning

Mississippi State Department of Health

576 East Wodrow Wilson Drive

Jackson, MS 39215-1700

E-mail: dbuchanan@msdh.state.ms.us

Voice: (601) 576-7428

Fax: (601) 576-7208
Healthy People 2010 Toolkit B - 4

Missouri

Ms. Lois Heldenbrand

Strategic Planning

912 Wildwood

Missouri Department of Health

Jefferson City, MO 65102

E-mail: HeldeL@mail.health.state.mo.us

Voice: (573) 526-6001

Fax: (573) 526-6041

Montana

Mr. Todd Harwell

Montana Department of Public Health and

Human Services

Cogswell Building, 1400 Broadway

Post Office Box 202951

Helena, MT 59620

E-mail: tharwell@state.mt.us

Voice: (406) 444-1437

Fax: (406) 444-7465

Nebraska

Mr. David Palm

Office of Public Health

Nebraska Department of Health and Human

Services

Post Office Box 95044

Lincoln, NE 68509

E-mail: david.palm@hhss.state.ne.us

Voice: (402) 471-2337

Fax: (402) 471-0180

Nevada

Dr. Mary Guinan

State Health Officer

Nevada Health and Human Resources

Department

505 East King Street, Room 201

Carson City, NV 89701-4797

E-mail: mguinan@govmail.state.nv.us

Voice: (775) 684-4200

Fax: (775) 684-3859

New Hampshire

Ms. Patricia Baum

Program Manager, Bureau of Health Promotion

Office of Community & Public Health

New Hampshire Department of Health and

Human Services

6 Hazen Drive

Concord, NH 03301-6527

E-mail: pbaum@dhhs.state.nh.us

Voice: (603) 271-4828

Fax: (603) 271-4160

New Jersey

Ruth Charbonneau

Director, Office of Policy and Research

New Jersey Department of Health and Senior

Services

CN360, 8th Floor, Room 801

Trenton, NJ 08625

E-mail: rcharbonneau@doh.state.nj.us

Voice: (609) 984-2177

Fax: (609) 984-5474

New Mexico

Dr. Doris Fields

Health Liaison to Office of African-American

Affairs

New Mexico Depatment of Health

1190 St. Francis Drive

Santa Fe, NM 87502-6110

E-mail: dorisapoet@aol.com

Voice: (505) 841-4844

Fax: (505) 841-4839

New York

Ms. Michelle Cravetz

MCHBG Coordinator

New York State Department of Health

Empire State Plaza, Room 890, Corning Tower

Albany, NY 12237

E-mail: mwc01@health.state.ny.us

Voice: (518) 473-7922

Fax: (518) 473-2015

North Carolina

Ms. Mary Bobbitt-Cooke

Director, Office of Healthy Carolinians

Division of Public Health

North Carolina Department of Health & Human

Services

1330 St. Mary's Street, Suite G103

Raleigh, NC 27626-0605

E-mail: mary.bobbitt-cooke@ncmail.net

Voice: (919) 715-0416

Fax: (919) 715-3144

North Dakota

Ms. Darleen Bartz

Chief, Health Resources Section

North Dakota Department of Health

600 East Boulevard Avenue

State Capitol -- Judicial Wing

Bismarck, ND 58505-0200

E-mail: dbartz@state.nd.us

Voice: (701) 328-2352

Fax: (701) 328-1890
B - 5 Appendix B: Contacts

Ohio

Mr. Tom Moore

Health Planning Manager

Office of Policy and Leadership

Ohio Department of Health

246 North High Street, 7th Floor

P.O. Box 118

Columbus, OH 43266-0118

E-mail: tmoore@das.state.oh.us

Voice: (614) 644-3543

Fax: (614) 644-7740

Oklahoma

Mr. Neil E. Hann

Deputy Chief

Health Promotion and Policy Analysis

Oklahoma State Department of Health

1000 Northeast 10th Street

Oklahoma City, OK 73117-1299

E-mail: neil@health.state.ok.us

Voice: (405) 271-560

Fax: (405) 271-2865

Oregon

Dr. Jennifer A. Woodward

Healthy People 2000 Contact

InFHO Unit

Center for Health Statistics

Oregon Health Division

800 Northeast Oregon Street

Suite 225

Portland, OR 97232

E-mail: Jennifer.A.Woodward@state.or.us

Voice: (503) 731-4109

Fax: (503) 731-3076

Pennsylvania

Ms. Darlene B. Sampson

Executive Assistant to the Secretary of Health

Pennsylvania Department of Health

Post Office Box 90

Harrisburg, PA 17108

E-mail: bsampson@state.pa.us

Voice: (717) 787-6436

Fax: (717) 772-6959

Rhode Island

Dr. William J. Waters

Deputy Director

Rhode Island Department of Health

Three Capitol Hill

Providence, RI 02908

E-mail: william_waters@health.state.ri.us

Voice: (401) 222-2231

Fax: (401) 222-6548

Rhode Island

Dr. Robert J. Marshall Jr.

Assistant Director of Health (Community

Affairs)

Rhode Island Department of Health

Three Capitol Hill, Cannon 401

Providence, RI 02908-5097

E-mail: BobM@doh.state.ri.us

Voice: (401) 222-2231

Fax: (401) 222-6548

South Carolina

Mr. Joe Kyle

Coordinator of Planning Research

South Carolina Department of Health and

Environmental Control

2600 Bull Street

Columbia, SC 29201

E-mail: kyleja@columb60.dhec.state.sc.us

Voice: (803) 898-0777

Fax: (803) 898-3335

South Dakota

Mr. Jerry C. Hofer

Director, Division of Administration

South Dakota Department of Health

600 East Capitol Avenue

Pierre, SD 57501-2536

E-mail: jerry.c.hofer@state.sd.us

Voice: (605) 773-3361

Fax: (605) 773-5683

Tennessee

Ms. Ann Duncan

Deputy Commissioner for the

Department of Health

Tennessee Department of Health

3rd Floor, Cordell Hall Building

425 5th Avenue, North

Nashville, TN 37247-0101

E-mail: aduncan@mail.state.tn.us

Voice: (615) 741-3111

Fax: (615) 741-2491

Texas

Mr. Dan Smith

Community Development Coordinator

Public Health Promotion

Texas Department of Health

1100 West 49th Street

Austin, TX 78756-3199

E-mail: dan.smith@tdh.state.tx.us

Voice: (512) 458-7405

Fax: (512) 458-7476
Healthy People 2010 Toolkit B - 6

Utah

Dr. Lois Haggard

Director

Bureau of Surveillance and Analysis

Utah Department of Public Health

288 North 1460 West

P.O. Box 142101

Salt Lake City, UT 84114-2101

E-mail: Lhaggard@doh.state.ut.us

Voice: (801) 538-6108

Fax: (801) 538-4346

Vermont

Dr. Burton W. Wilcke, Jr.

Director, Division of Health Surveillance

Vermont Department of Health

108 Cherry Street

P.O. Box 70

Burlington, VT 05402-0070

E-mail: bwilcke@vdh.state.vt.us

Voice: (802) 863-7246

Fax: (802) 865-7701

Ms. Linda Fox Dorey

Public Affairs Director

Vermont Department of Health

108 Cherry Street

P.O. Box 70

Burlington, VT 05402-0070

E-mail: Ldorey@vdh.state.vt.us

Voice: (802) 863-7281

Fax: (802) 865-7754

Ms. Nancy Erickson

Public Affairs Director

Vermont Department of Health

108 Cherry Street

P.O. Box 70

Burlington, VT 05402-0070

E-mail: nericks@vdh.state.vt.us

Voice: (802) 863-7281

Fax: (802) 865-7754

Virginia

Mr. Henry Murdaugh

Healthy People 2010 Contact

Virginia Department of Health

P.O. Box 2448, Room 227

Richmond, VA 23218

E-mail: hmurdaugh@vdh.state.va.us

Voice: (804) 371-8619

Fax: (804) 371-0116

Washington

Dr. Juliet VanEenwyk

State Epidemiologist for Noninfectious

Conditions

Epidemiology, Health Statistics & Public

Health Laboratories

Washington Department of Social and Health

Services

P.O. Box 47811

Olympia, WA 98504-7811

E-mail: juliet.vaneenwyk@doh.wa.gov

Voice: (360) 236-4250

Fax: (360) 236-4245

West Virginia

Mr. Tom Sims

Director, Division of Health Promotion

Public Health Bureau

West Virginia Health & Human Resources

Department

350 Capitol Street, Room 319

Charleston, WV 25301-3715

E-mail: tomsims@wvdhhr.org

Voice: (304) 558-0644

Fax: (304) 558-1553

Wisconsin

Ms. Margaret Schmelzer

Public Health Nursing Director

Chief, Wisconsin Turning Point Initiative

Wisconsin Division of Public Health

Department of Health and Family Services

1 West Wilson Street

P.O. Box 2659

Madison, WI 53701-2659

E-mail: schmemo@dhfs.state.wi.us

Voice: (608) 266-0877

Fax: (608) 266-8925

Wyoming

Mr. Jimm Murray

Administrator, Community and Family Health

Division

Wyoming Department of Health

2300 Capital Avenue, Hathaway Building,

Room 478

Cheyenne, WY 82002

E-mail: jmurra@missc.state.wy.us

Voice: (307) 777-6004

Fax: (307) 777-3617
B - 7 Appendix B: Contacts

Territorial Contact Information

American Somoa

Mr. Joseph Tufa

Director

Department of Public Health

Government of American Samoa

Pago Pago, AS 96799

E-mail: jtufa@hotmail.com

Voice: 011-684-633-4606

Fax: 011-684-633-5379

Guam

Mr. Dennis G. Rodriguez

Director of Health

Guam Department of Public Health &

Social Services

Government of Guam

P.O. Box 2816

Hagatna, GU 96910

E-mail: dennisr@mail.gov.gu

Voice: (671) 735-7102

Fax: (671) 734-5910

Mariana Islands

Mr. Joseph K.P. Villagomez

Secretary of Health & Environmental Svcs

Department of Public Health &

Environmental Services

Commonwealth of the Northern Mariana

Islands

P.O. Box 500409

Saipan, MP 96950

E-mail: jkpvillagomez@saipan.com

Voice: 011 670 234-8950

Fax: 011 670 234-8930

Marshall Islands

Mr. Tom D. Kijiner

Minister of Health & Environmental Svcs

Republic of the Marshall Islands

Majuro Hospital

P.O. Box 16

Majuro, MH 96960

Voice: (692) 625-3355

Fax: (692) 625-3432

Micronesia

Dr. Eliuel K. Pretrick

Secretary of Health

Department of Health Services

FSM National Government of the Federal

Palikir Station, P.O. Box PS70

Pohnpei, FM 96941

E-mail: fsmhealth@mail.fm

Voice: (691) 320-2619

Fax: (690) 320-5263

Palau, Republic of

Mr. Masao Ueda

Minister of Health

Ministry of Health

Republic of Palau

P.O. Box 6027

Koror, PW 96940

E-mail: mueda@belau.com

Voice: (680) 488-2813

Fax: (680) 488-1211

Puerto Rico

Dr. Gabriel Diaz Rivera

State Coordinator

Puerto Rico Department of Health

Commonwealth of Puerto Rico

Building A

San Juan, PR 00936

E-mail: esantos@salud.gov.pr.

Voice: (787) 274-5500

Fax: (787) 274-5523

Virgin Islands

Dr. Jose F. Poblete

Commissioner of Health

Virgin Islands Department of Health

Services

Governor's Office

21-22 Kongens Gade

St. Thomas, VI 00802

Voice: (809) 776-8311

Fax: (809) 776-0610
Healthy People 2010 Toolkit B - 8

Tribal Area Contact Information

Aberdeen Area Indian Health Service

Federal Building

115 Fourth Ave., Southeast

Aberdeen, SD 57401

Serving: ND, SD, IA, NE

Voice: (605) 226-7581

Fax: (605) 226-7670

Alaska Area Indian Health Service

4141 Ambassador Drive

Anchorage, AK 99508-5928

Serving: AK

Voice: (907) 729-3686

Albuquerque Area Indian Health Service

5338 Montgomery Blvd., NE

Albuquerque, NM 87109-1311

Serving: NM, CO, TX

Voice: (505) 248-4501

Fax: (505) 248-4500

Bemidji Area Indian Health Service

128 Federal Building

Bemidji, MN 56601

Serving: MN, MI, WI

Voice: (218) 759-3412

Fax: (218) 759-3511

Billings Area Indian Health Service

2900 4th Avenue North

Billings, MT 59101

P.O. Box 2143

Billings, MT 59103

Serving: MT, WY

Voice: (406) 247-7107

Fax: (406) 247-7230

California Area Indian Health Service

1825 Bell Street

Suite 200 Sacramento, CA 95825-1097

Serving: CA

Voice: (916) 566-700

Fax: (916) 566-7053

Nashville Area Indian Health Service

711 Stewarts Ferry Pike

Nashville, TN 37214-2634

Serving: Eastern United States

Voice: (615) 736-2400

Fax: (615) 736-2391

Navajo Area Indian Health Service

P.O. Box 9020

Window Rock, AZ 86515-9020

Serving: NE, AZ, NM, UT

Voice: (520) 871-5811

Oklahoma City Area Indian Health

Service

Five Corporate Plaza

3625 NW 56th Street

Oklahoma City, OK 73112

Serving: OK, KS, TX

Voice: (405) 951-3768

Fax: (405) 951-3780

Phoenix Area Indian Health Service

Two Renaissance Square

40 North Central Avenue

Phoenix, AZ 85004

Serving: AZ, NV, UT

Voice: (602) 364-5039

Portland Area Indian Health Service

1220 S.W. Third Avenue - Room 476

Portland, OR 97204-2892

Serving: ID, OR, WA

Voice: (503) 326-2020

Fax: (503) 326-7280

Tucson Area Indian Health Service

7900 South “J” Stock Road

Tucson, AZ 85746-7012d

Serving: AZ

Voice: (520) 295-2405

Fax: (520) 295-2602
C - 1 Appendix C: Healthy People Web Sites

Appendix C:

State and National

Healthy People

Web Sites

State Web Sites

[An asterisk (*) denotes that the state's Healthy People 2000 and/or 2010 plan is available on

the state web site.]

Alabama*

http://www.adph.org/administration/ha2010.pdf

Alaska*

http://www.hss.state.ak.us/dph/deu/ha2010/default.htm

American Samoa

http://www.samoanet.com/asg/

Arizona*

2000: http://www.hs.state.az.us/plan/2000/az2000.htm

2010: http://www.hs.state.az.us/phs/healthyaz2010/index.htm

Arkansas

http://www.healthyarkansas.com/

California*

http://www.dhs.ca.gov/chs/ohir/yr2000/yr2000.htm

Colorado

http://www.cdphe.state.co.us/
Healthy People 2010 Toolkit C - 2

Connecticut*

http://www.state.ct.us/dph/OPPE/sha99/shacontents.htm

Delaware*

http://www.healthydelaware.com

District of Columbia*

http://dchealth.dc.gov/information/healthy_people2010/index.shtm

Federated States of Micronesia

http://www.fsmgov.org/ngovt.html

Florida

http://www.doh.state.fl.us

Georgia

http://health.state.ga.us/

Guam

http://mail.admin.gov/gu/pubhealth/index.html

Hawaii*

http://www.state.hi.us/health/resource/Healthy_Hawaii/opdh2000.htm

Idaho

http://www2.state.id.us/dhw/

Illinois

http://www.idph.state.il.us/home.htm

Indiana

http://www.state.in.us/isdh/

Iowa*

http://www.idph.state.ia.us/sa/h_ia2010/contents.htm

Kansas

http://www.kdhe.state.ks.us/bhp/

Kentucky*

http://publichealth.state.ky.us/healthy_ky_2010.htm

Louisiana*

http://www.dhh.state.la.us/OPH/pub.htm
C - 3 Appendix C: Healthy People Web Sites

Maine*

http://www.state.me.us/dhs/boh/healthyme2k/healthyme2k.htm

Mariana Island

http://www.mtccnmi.com/community/CHCSaipan/index.htm

Maryland*

2000: http://mdpublichealth.org/ohp/html/hm2000.html

2010: http://mdpublichealth.org/ohp/html/hip.html

Massachusetts

http://www.state.ma.us/dph/fch1.htm

Michigan

http://www.mdch.state.mi.us/

Minnesota*

http://www.health.state.mn.us/divs/chs/phg/intro.html

Mississippi

http://www.msdh.state.ms.us/

Missouri*

http://www.health.state.mo.us/PreventionAndWellness/welcome.html

Montana

http://www.dphhs.mt.us/index.htm

Nebraska*

http://www.hhs.state.ne.us/profiles/nebraska/profile.htm

Nevada

http://www.state.nv.us/health/

New Hampshire*

http://www.healthynh2010.org/

New Jersey*

2000: http://www.state.nj.us/health/hcsa/rmtoc.htm

2010: Vol. 1: http://www.state.nj.us/health/chs/hnj2010vol1.pdf

Vol. 2: http://www.state.nj.us/health/chs/hnj2010vol2.pdf

New Mexico

http://www.health.state.nm.us/website.nsf/frames?ReadForm
Healthy People 2010 Toolkit C - 4

New York*

http://www.health.state.ny.us/nysdoh/phforum/hlthcomm.pdf

North Carolina*

http://www.healthycarolinians.org/healthobj2010.htm

North Dakota*

http://www.health.state.nd.us/ndhd/pubs/hlthrisk/intro.htm

Ohio*

http://www.odh.state.oh.us/Resources/repts1.htm

Oklahoma*

http://www.health.state.ok.us/program/planning/obj2000/summary.html

Oregon*

http://www.ohd.hr.state.or.us/chs/hsi/or_hsi.htm

Pennsylvania*

http://www.health.state.pa.us/hpa/ship/ship.htm

Rhode Island*

http://www.healthri.org/chic/healthypeople/home.htm

South Carolina

http://www.scdhec.net/

South Dakota

http://www.state.sd.us/doh/

Tennessee

http://www.state.tn.us/health/

Texas*

http://www.tdh.state.tx.us/dpa/HP2000A.htm

Utah*

http://hlunix.hl.state.ut.us/action2000/hsind.html

Vermont*

2000: http://www.state.vt.us/health/hv2k.htm

2010: http://www.state.vt.us/health/_admin/pubs/2000/hv2010/hv2010.htm

Virgin Islands

http://www.gov.vi/health/
C - 5 Appendix C: Healthy People Web Sites

Virginia*

2000: http://www.vdh.state.va.us/commish/healthy/index.htm

2010: http://www.vdh.state.va.us/hv2010/index.html

Washington*

http://www.doh.wa.gov/Publicat/96_HWS/hws-intr.htm

West Virginia*

2000: http://www.wvdhhr.org/bph/hp2000/updates/hp2000.htm

2010: http://www.wvdhhr.org/bph/hp2010/objective/contents.html

Wisconsin

http://www.dhfs.state.wi.us/

Wyoming

http://wdhfs.state.wy.us/wdh/

National: Office of Disease Prevention and Health Promotion Web Sites

Office of Disease Prevention and Health Promotion

http://odphp.osophs.dhhs.gov/

Environmental Health Policy Committee

http://www.health.gov/environment

healthfinderTM

http://www.healthfinder.gov/

Healthy People 2000

http://odphp.osophs.dhhs.gov/pubs/hp2000/

Healthy People 2010 Home Page

http://www.health.gov/healthypeople/

National Health Information Center

http://nhic-nt.health.org

Partnerships Conference

http://www.health.gov/partnerships/

Public Health Functions Project

http://www.health.gov/phfunctions/

Science Panel on Interactive Communication and Health

http://www.scipich.org
Healthy People 2010 Toolkit C - 6

U.S. State and Local Government Gateway, Health

http://www.health.gov/statelocal/

U.S. State and Local Government Gateway, Families and Children

http://www.hhs.gov/families/

HHS Partner Gateway

http://www.hhs.gov/partner/