1. EPE Your partners in data-driven, evidence based public health

2. Colorado Department of Public Health and Environment Strategic Map: 2011-2015 Draft 08/30/11 Align Priorities and Resources to Improve and Sustain Public Health and Environmental Quality A D B E C Create a More Efficient, Effective, Customer-Oriented Department Strengthen the Integrated Public and Environmental Health System Foster a Competent, Empowered Workforce Promote Programmatic Excellence Achieve Targeted Improvements in Colorado’s Winnable Battles Implement the Public Health Improvement Plan Promote Public Health and Environmental Careers Establish Evidence-Based, Data-Driven Strategies Deliver Excellent Customer Service Develop and Implement Strategies to Achieve Winnable Battles 1 Achieve Clear, Specific, Measurable Goals Attract and Retain Talented and Diverse Employees Engage Partners in Programmatic and Policy Decision-Making Employ Lean Methodologies to Improve Business Processes Promote Policies That Support Winnable Battles 2 Value and Share Innovation Align Employee Goals and Roles with Department Priorities Champion Collaboration Among Programs, Departments and Partners Secure Sustainable, Diversified Funding Actively Participate as a Partner in the Community 3 Provide Professional Development and Advancement Opportunities Communicate Winnable Battles to Employees and Identify Linkages to their Work Strengthen Cross-Departmental Collaboration/ Integration Use New and Alternate Technologies to Optimize Employee Performance Create and Support Sustainable, Healthy Communities 4 Meet Regulatory and Statutory Requirements Educate External Partners on Winnable Battles Strengthen Internal and External Communication Develop a Leadership Succession Plan Promote the Value of Public Health and Environmental Protection 5 Consistently Apply Department Policies and Procedures Recognize and Reward Employee Contributions Keep Up with the Speed of Business 6 Influence State HR and Procurement Policies 7 Promote Health Equity and Environmental Justice F Use Performance-Based Measures and Evaluation to Continuously Improve Effectiveness and Prioritize Resources G

3. Topics Insights A bit about Epi and Eval Insights from Karen T. 3 examples of collaboration with EPE Discussion: What would we like to see in a collaborative business model and working relationship with EPE and programs?

4. Good Timing New CDPHE strategic map New leadership in CDPHE & PSD New Colorado Winnable Battles Opportunity to address questions

5. Insights from EPE Strategic Planning… Data driven, evidence-based public health action, with every program, every time Current funding and operations model of EPE is a barrier Our work is more useful when we’ve used a more collaborative model

6. Steps of Evidence-Based Public Health Brownson, RC; Fielding JE; Maylahn CM. Ann. Rev. Public Health 2009.30:189

7. 2. What are the largest problems in the population? Who are at high risk? What is contributing to health? Epi Questions 1. What are the community needs, assets, and values? 3. What potential strategies are relevant? 5. What effective strategies are priorities? 4. What potential strategies are effective? In Colorado? Brownson, RC; Fielding JE; Maylahn CM. Ann. Rev. Public Health 2009.30:189

8. Epidemiology Unit in EPE Indira Gujral Renee Calanan Declan Calanan DOB: 9/29/11 Sue Ricketts, demographer Stephanie Kuhn Ashley Juhl

9. Epi Unit contributes Basic public health science Critique of existing evidence Did the research really work? Was the research done well enough to act on the findings? Assessment of the relationships among assets, protective factors, behaviors, and health in the population Systems thinking Interpretation of real-world data More details at: www.cste.org/competencies.asp

10. Epi Unit contributes Expertise in large data sources: From Health Statistics Section ~ BC, PRAMS, CHS, BRFSS, DC Other state or national sources: WFRS, MEPS, CHA-HDD, MDS, Census, SAIPE, ACS, BSS, YRBS, CIIS,CRCSN, COVDRS,CFPS, FARS, TAR, CSAP, CBI, CDE, PedNSS, NSCH, NS-CSHCN, NHANES, NHIS, TABS, CHKST, NYTS, NIS, NSFG, NVSS, NSDUH, NSRE, HIV/STD, CHP+, COHS, HEDIS, Medicaid, NDI, SHP, HCUP, ESRD

11. We answer the big questions. What matters? What might we do about what matters?

18. EPE provides visual context

19. Intended Pregnancy by Age, Colorado, 2009 Healthy People 2020 target

20. Sexual Behavior Among Colorado Adults A CLOSER LOOK: Long Acting Reversible Contra-ceptive Methods (‘02, ’04, ‘05, ‘06, ‘09) Data Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment

22. EPE provides written context for issues “Unintended pregnancy is defined as one that is either unplanned or mistimed (occurred sooner than desired). Women who are intentional about becoming pregnant are more likely to start prenatal care early, and to adopt healthy behaviors during pregnancy. The national Healthy People 2010 Objective 9‐1 is to increase the proportion of intended pregnancies to 70 percent of all births. “ The highest rates of unintended pregnancies are found in two groups: low-income women and young women. In 2008, only 42 percent of births to women on Medicaid were intended, compared to 72 percent of births to women not receiving Medicaid. 6,viii For younger women (ages 15-19) during the same year, only an estimated 36 percent of births were intended. Similarly, only 41 percent of births to women ages 20-24 years old were intended. Intended pregnancies increased significantly after age 24, where 70 percent of births to women ages 25-34, and 67 percent of births to those ages 35 and older were reportedly intended. 6 Reducing unintended pregnancies among young and low-income women would help Colorado reach the Healthy People 2010 objective for intended pregnancy.” Excerpts from Chapter 2, The Health Status of Colorado’s Maternal and Child Health Population, 2010

25. Evaluation in EPE External Evaluation Oversight Internal Evaluation Julie Graves Carsten Baumann Arthur McFarlane Mario Rivera Kerry Thomson

26. Evaluation, defined “Ultimately, evaluation is concerned with asking questions about issues that arise out of everyday practice. It is a means for gaining a better understanding of what we do and the effects of our actions in the context of society and the work environment.” --Russ-Eft, H. and Preskill, D. (2005)

27. Evaluation Evaluation focuses before the tree sprouts!

28. What is an Evaluator thinking?! Why…? Why…? When…? How…? Under what circumstance…? More detail & context please! Scan of an Evaluator’s Brain

29. Evaluation Questions Needs Assessment Where are the gaps in the community? What does the community feel is important? Outcome Evaluation Were my strategies effective in achieving the desired outcomes? Formative Evaluation How can we improve the program? How effective are my collaborative partnerships? Process Evaluation How much was provided and with what consistency? Did I reach the target population? Am I hitting my benchmarks? Are my strategies being carried out as planned? Evaluability Assessment What type of evaluation is my program ready for based on what we know? Brownson, RC; Fielding JE; Maylahn CM. Ann. Rev. Public Health 2009.30:189

30. The Evaluation Unit Contributes: Collaboration on logic models Helping write SMART objectives Identifying process and outcome measures to determine if you are meeting goals and objectives Collaboration to decide on an appropriate evaluation focus and design (Evaluability Assessment) Design of data collection forms/procedures Analysis and interpretation of evaluation data

31. Collaboration is Key Understanding of the Health Problem Content knowledge and knowledge about strategies Information about the community Stakeholder relationships and needs Understanding of the Health Problem Understanding of data and the complex determinants of health Scientific method Objectivity Outcome-orientation SMART Objectives + Programs EPE = planning & executing the right analysis, intervention, & evaluation at the right time!

32. Collaboration in PSD We are one division. We are working in horizontal teams, because successful public health is multi-disciplined. 3-way partnership: Epi, Eval, Programs Let’s together work on a collaborative business model for EPE.

33. Insights from Karen…

34. Youth Access to Tobacco Celeste Schoenthaler

35. Maternal, Infant and Early Childhood Home Visiting Program Five federal applications, including statewide needs assessment, state plan for home visiting and a competitive “expansion” application, were submitted EPE = critical program partner from planning to execution RFI to identify existing home visiting programs Needs assessment to identify at-risk communities Prioritization for investments based on county strengths and needs Funding formula to distribute money to prioritized counties Logic Models and Smart Objectives Data collection plan for 6 Benchmark areas with 36 constructs CQI plan and implementation Working closely with our partners, the EB model reps Highly academic evaluation plan developed for competitive application Will analyze and help interpret data; prepare reports

36. MCH Local Planning Process Gina Febbraro

37. Facilitated Discussion How can we create a better collaboration? What would you like to see in a collaborative business model for EPE?