Phase II - Health Education Partners · Phase II: Voting on ... Conference presentations Emerging...
Transcript of Phase II - Health Education Partners · Phase II: Voting on ... Conference presentations Emerging...
Phase II:
Voting on Outstanding Products &
Deciding on Future Activities of the Committee
Secretary’s Advisory Committee on
National Health Promotion &
Disease Prevention Objectives for 2020
Committee Chair: Jonathan Fielding, MD, MPH, MA, MBA
Director, Los Angeles County Department of Public Health
& Health Officer, Los Angeles County
July 26, 2010
Desired Outcomes for the Meeting
Obtain an update from HHS on the timeline for development
of Healthy People 2020
Learn about the HHS Community Health Data Initiative
Discuss and vote on outstanding Subcommittee products
Discuss the future work of the Committee
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Healthy People 2020 Update
RADM Penelope Slade-Sawyer
Office of Disease Prevention and Health Promotion
US Department of Health and Human Services
Secretary’s Advisory Committee
July 26, 2010
Update on HHS Activities
Status of Healthy People 2020
Objectives
Timeline and Launch
Leading Health Indicators
Implementation Activities — 5th Annual Meeting for Healthy People State
and Territorial Coordinators
— State and CBO Awards
— National Meeting in 2012
HHS Community Health Data Initiative
Todd Parks,
Chief Technology Officer
U.S. Department of Health and Human Services
[See separate slides]
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Subcommittee on
Action Steps and Evidence
Jonathan Fielding, MD, MPH, MA, MBA Subcommittee Co-Chair
Los Angeles County Department of Public Health
Steven Teutsch, MD, MPHSubcommittee Co-Chair
Los Angeles County Department of Public Health
Subcommittee on ASE:Two documents to be reviewed
Recommendations of the Subcommittee on
Action Steps and Evidence
Report on Evidence-based Clinical and Public
Health: Generating and Applying the Evidence
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Subcommittee on ASE: Charge
How can HHS best show HP 2020 stakeholders
how to use the exhaustive list of objectives?
How can HHS maximize adoption and use of
HP2020?
What processes can HHS use to ensure that
action steps included in HP 2020 are grounded
in solid scientific evidence?
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Subcommittee on ASE:History of this group’s efforts
Ad Hoc group met once, in June 2009, to
provide input into an earlier draft of the report.
Subcommittee met four times between
2/26/2010 and 5/25/2010 to respond to the
Subcommittee’s charge.
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Ad Hoc Group on ASE: June, 2009 Members
Russ Glasgow, PhD, Kaiser Permanente
J. Michael McGinnis, MD, MPP,
Institute of Medicine
Ned Calonge, MD, MPH,
Colorado Department of Public Health and
Environment
Tracy Orleans, PhD,
Robert Wood Johnson Foundation
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Subcommittee on ASE: March 2010 Members
Alice Ammerman, DrPH, UNC Chapel Hill
Ross Brownson, PhD, Washington University
Martin Fenstersheib, MD, MPH, Santa Clara County
David Fleming, MD, Seattle King County
George Isham, MD, MS, HealthPartners, Inc.
Lynn Silver, MD, MPH,
NYC Department of Health & Mental Hygiene
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Prioritizing Evidence-based Actions
For all objectives, implement interventions that have clear evidence of effectiveness whenever it is available.
If this level of evidence is not available, consider whether intervening against this objective, versus other objectives that have interventions with clear evidence of effectiveness, is the best use of scarce resources.
If objectives must be addressed due to disease/ injury burden and or trends, use best available evidence based on table on the next slide.
If using interventions that lack clear evidence of effectiveness, evaluate carefully to add to the science base.
Interventions should be adapted to the specific context in which they will take place.
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Typology for classifying interventions
by levels of scientific evidence
Category How Established Considerations for Level of
Scientific Evidence
Data Source Examples
Proven Peer review via
systematic or narrative
review
Based on study design and execution
External validity
Potential side benefits or harms
Costs and cost-effectiveness
Community Guide
Cochrane reviews
Narrative reviews based on
published literature
Likely
Effective
Peer Review Based on study design and execution
External validity
Potential side benefits or harms
Costs and cost-effectiveness
Articles in the scientific literature
Research-tested intervention
programs (123)
Technical reports with peer review
Promising Written program
evaluation without
formal peer review
Summative evidence of effectiveness
Formative evaluation data
Theory-consistent, plausible, potentially
high-reach, low-cost, replicable
State or federal government
reports
(without peer review)
Conference presentations
Emerging Ongoing work, practice-
based summaries, or
evaluation works in
progress
Formative evaluation data
Theory-consistent, plausible, potentially
high-reaching, low-cost, replicable
Face validity
Evaluability assessments*
Pilot studies
NIH CRISP database
Projects funded by health
foundations
Recommendations of the
Subcommittee on Action Steps & Evidence
Discussion
Changes needed?
Final Vote
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Report on Evidence-based Clinical and
Public Health: Generating and Applying the Evidence
Discussion
Changes needed?
Final Vote
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Recommendations of the
Subcommittee on Implementation
Adewale Troutman, MD, MPHLouisville Metropolitan Dept. of Public Health and Wellness
Eva Moya, LMSW, PhDProject Concern International
Subcommittee on Implementation
Charge to the Subcommittee:• How do we move from framework recommendations
to action?
• What are users’ needs for tools, aids, and guidance?
• What are the incentives for user groups? What
examples can be put in place for implementation?
• How can we ensure accountability?
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Subcommittee on Implementation:History of this group’s efforts
Subcommittee held 5 meetings between
3/2/09 and 6/26/09• Recommendations for immediate and longer-term
actions for effective implementation were presented in
July, and again in September, 2009.
—Ideas were explored for ways that the recommendations
could be enhanced or reorganized, but the document did not
come up for vote again at subsequent meetings.
—A vote is needed so that the document can be put forward to
the Secretary.
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Immediate Recommendations for
Implementing Healthy People 2020
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Summary of Immediate Recommendations
1. Make the proposed interactive Web site a major priority for resources
2. Foster continuity of HP actions and build on current activities strengths
3. Jump-start and support innovation, and recognize excellence
4. Provide leadership regarding program planning and prioritization
5. Assess and meet technical assistance needs
6. Facilitate evaluation
Longer-Term Recommendations
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Summary of Longer-Term Recommendations
1. Provide more detail about how to implement HP at the state and local levels (toolkit)
2. Identify and disseminate models of excellence
3. Ensure an accountability infrastructure is in place at all levels of government,
including Federal
4. Create a clear, empowered role for the Healthy People State Coordinators
5. Present a self-assessment and planning tool on the Website to help users at the local
and state levels bridge their current programmatic activities to HP2020
6. Leverage resources through partnerships and networks
7. Make participation in the Healthy People consortium significant and meaningful
8. Engage business (esp. business-led coalitions already working with public health) in
educating stakeholders and providing support for the use of Healthy People
9. Ensure that HP is incorporated into the strategic plans of other Federal agencies
10. Use a Health in All Policies approach to map social determinants to health outcomes
Supplementary Report on
Social Determinants of Health
Shiriki Kumanyika, PhD, MPHCommittee Vice-Chair
Supplementary Report on SDOH:History of this report
In July, 2009 the Committee leadership saw
need for a supplementary report to:
• Further explicate ideas and concepts related to
societal determinants of health that had been
discussed in other Committee documents;
• Articulate the rationale for focusing on societal
determinants of health
• Provide guidance for how Healthy People 2020 can
prompt action on societal determinants.
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Supplementary Report on SDOH:History of this report, ct.
SDOH-related content from other Committee
documents was integrated into a single report,
which was then circulated to external reviewers;
Several iterations of the draft have been
developed to yield the current version.
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Supplementary Report on SDOH:Outline of Content
I. HP 2020: New focus on SDOH
II. Rationale for focusing on SDOH
III. Where do we begin?
IV. Specific Actions to Address “Societal
Determinants”
V. Health Impact Assessment: A Tool for Making
Health-informed Decisions
VI. Conclusions
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“Societal” Determinants of Health
“Conditions in the social, physical, and
economic environment in which people are
born, live, work, and age. They consist of
policies, programs, and institutions and
other aspects of the social structure,
including the government and private
sectors, as well as community factors.”
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“Societal” Determinants of Health
The Committee uses the term “societal” to clarify
that aspects of the social structure influence the
health of populations through both the social
and physical environments.
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