• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
NCPP Update-July 2010
 

NCPP Update-July 2010

on

  • 610 views

Presentation slides for update calls on July 6 and July 13, 2010

Presentation slides for update calls on July 6 and July 13, 2010

Statistics

Views

Total Views
610
Views on SlideShare
610
Embed Views
0

Actions

Likes
1
Downloads
6
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.
  • We know that utilization rates are low for many preventive services. And many preventive services are recommended. So where do we start? What do we focus on first? Ideally we would close the gaps in utilization in a targeted way tackling first those services that offer the greatest population health improvements and require the least spending for the health benefits offered.The NCPP has guided work over the past 10 years to identify the highest value clinical preventive services from among those that are currently recommended.What we have learned about priorities can be integrated into clinical practice to take advantage of prevention opportunities in an objective and focused manner—whether it is contact with patients, health care system changes, communications, benefit design, policy changes or what have you.

NCPP Update-July 2010 NCPP Update-July 2010 Presentation Transcript

  • NCPP Update: Projects on Clinical and Community Preventive Services
    Jennifer Jenson, Partnership for Prevention
    Michael Maciosek, HealthPartners Research Foundation
    July 6 and July 13, 2010
  • Outline for Today’s Update
    Quick update on analysis for clinical rankings
    Focus on work on community preventive services
    Scope of work and decisions from last year’s meeting
    Literature review
    Defining interventions for quantitative modeling
    Estimating costs for community interventions
    Update on quantitative modeling
    Presenting results, including qualitative information for decision-makers
    NCPP meeting scheduled for Wednesday, October 27, in Washington, DC (group dinner on Tuesday, October 26)
  • Clinical Update: Overview
    Study objective
    Increase use of high-value, evidence-based clinical preventive services
    Study strategies
    Provide comparable information on the health impact and cost effectiveness of evidence-based services
    Draw attention to high-value services by publishing a ranking based on health impact and cost-effectiveness
    Assist decision-makers by providing as much information on population groups as practical
    Develop and implement a dissemination strategy to make key audiences aware of the study results
  • Clinical Update: Vaccinations
    Human Papillomavirus vaccine
    New service; Markov model complete
    Results pending cancer cost update
    Zoster vaccine
    New service; Markov model structure and primary data collection complete
    Influenza vaccine (adults)
    Update of prior model complete
    Pneumococcal vaccine (adults)
    Update of prior model complete
  • Clinical Update: Vaccinations
    Meningicoccal conjugate vaccine
    New service; to be completed in 2011
    DTaP booster (adolescents)
    New service; to be completed in 2011
    DTaP/Td booster
    Update to be completed in 2011
    • Childhood immunization series
    Includes new vaccines (rotavirus, hepatits A); to be started and completed in 2010
  • Clinical Update: Cardiovascular Disease
    Screening for high blood pressure,
    Screening for lipid disorders in adults,
    Aspirin for the primary prevention of cardiovascular events, and
    Screening for type-2 diabetes mellitus in adults
    New Markov model under construction to evaluate all services
    Completed substantial work on literature review and model structure, including plan for integration with tobacco, physical activity and diet models
    Applying for Framingham Heart Study data from NHLBI, with back-up plan to use data from literature
  • Clinical Update: Health Behaviors
    Counseling to prevent tobacco use,
    Screening for obesity in adults,
    Screening for obesity in children & adolescents (new service), &
    Counseling for a healthy diet (adults at high risk for CHD)
    New Markov models under construction
    Intermediate outcomes to be modeled in 2010
    Integrated with cardiovascular model, cancer models, and other health outcomes modeled in 2011
    Screening for alcohol misuse
    Literature update complete
    Model update to be completed in 2010
  • Clinical Update: Cancers
    Screening for breast cancer,
    Screening for cervical cancer, and
    Screening for colorectal cancer
    New Markov models complete for all cancer screenings (and HPV vaccine)
    Results pending updated cancer costs (data from NHI-funded study expected in 2011)
  • Clinical Update: STDs
    Screening for Chlamydial infection
    New agent-based model substantially complete
    Screening for gonorrhea
    New service; literature review underway
    Agent-based model, based on Chlamydia model, to be completed in 2010
    Screening for syphilis
    New service; new agent-based model to be completed in 2010
    Screening for HIVinfection
    New service; to be completed in 2011
    Behavioral counseling to prevent sexually transmitted infections
    New service; to be completed in 2011
  • Clinical Update: Other Services
    Screening for depression (adults), and
    Screening for depression in children and adolescents
    Literature update started; expected completion in 2010
    Screening for osteoporosis
    New Markov model substantially complete
    Other services not yet started
    Folic acid supplementation to prevent neural tube defects (update)
    Screening for abdominal aortic aneurysms (high risk adults, new service)
    Screening for hearing impairment in older adults (pending USPSTF update)
    Screening for visual impairment in children younger than 5 (update)
  • Community Update: Overview
    Big picture objective
    Improve population health by increasing the use of high-value, evidence-based community interventions
    Other goals
    “Proof of concept” research to develop methods for comparing the value of community interventions
    Develop information and measures that
    Are useful for decision-makers, and
    Could be used to help improve public health accountability
    Provide tools to complement information in the Guide to Community Preventive Services
  • Community Update: Overview
    Study strategy
    Develop quantitative information on the health impact and cost-effectiveness of community interventions
    Provide complementary information and tools to help decision-makers evaluate interventions with their community context in mind
    Scope of work
    15 interventions in two core topic areas: tobacco (7) and physical activity (8)
    Selected from recommended interventions in the Community Guide
    Sought mix of intervention types and actors
  • Community Update: 2009 Decisions
    Defining interventions for quantitative modeling
    Because interventions are broadly defined and may vary considerably
    NCPP recommended analysis on more than one example, including case-studies and prototype interventions
    Measuring health impact and intermediate outcomes
    Because of data limitations, NCPP recommended
    Modeling final outcomes, where possible
    Presenting information on intermediate outcomes, always
    Conducting “what-if-analyses” when evidence or data are insufficient for linking intermediate and health outcomes
  • Community Update: 2009 Decisions
    Estimating costs & resource requirements
    In response to staff ideas on collecting cost information
    NCPP recommended a practical approach
    Don’t use focus groups as a primary strategy
    Don’t complicate data collection by adding other objectives
    Providing qualitative information for decision-makers
    Because estimates of health impact and cost effectiveness will have significant limitations
    NCPP agreed on the need to develop “qualitative” information to help decision-makers interpret and consider quantitative results with their own communities in mind
  • Community Update: Literature Review
    Literature more extensive than anticipated
    Goals of our review include:
    Understanding the character of the evidence-base
    Defining interventions in adequate detail for modeling
    Collecting different types of data, including information on intervention effectiveness, costs, and resource requirements
    Community Guide staff have offered to help reduce the burden of literature review
    Challenges include timing and logistics
  • Community Update: Defining Interventions for Modeling
    Our experience to date suggests:
    For some interventions, a prototype intervention will be most useful
    For other interventions, a case-study makes more sense
    Both approaches have some value for all recommendations
    Some health impacts are likely to be very small
    Next: several examples to illustrate what we mean
  • Community Update: Defining Interventions
    Example 1: Increasing the unit price of tobacco
    Variety of studies using different data sources covering many states
    Prototype intervention-Median increase in tobacco tax from a median base level (median level for US states)
    Shows the impact of a politically feasible tax increase in a state with a moderate existing tax
    Approximates the typical impact of a tax increase
    Case studies-Estimate the impact of recent tax increases in low-tax and high-tax states
    Shows potential variation and helps decision makers think about the likely impact of a tax change in their state
  • Community Update: Defining Interventions
    Example 2: Point-of-decision prompts to increase physical activity
    Many small-scale studies of 1 or 2 prompts within one of 3 location types: malls, transit stations, and office buildings
    Case studies from different locations are likely to show
    Minimal impact on physical activity levels and health
    Little practical variation
    A hypothetical prototype of a larger-scale, community-wide intervention (involving multiple locations in a city)
    Would show the potential impact of point-of-decision prompts
  • Community Update: Defining Interventions
    Example 3: School-based interventions to increase physical activity
    Two major types of studies:
    PE curriculum changes & programs to increase walking or biking to school (typical measure is change in activity from commuting itself)
    Broader curriculum changes & after school programs to promote activity (broader measures of change in activity, such as activity logs, BMI)
    Prototype intervention-Has been elusive due to high variation
    Case studies- Broader curriculum change and more extensive after-school programs are likely to be more informative
  • Community Update: Estimating Costs
    Example 1: Increasing the unit price of tobacco
    Virtually impossible to estimate
    Cost of advocating for legislative change
    Databases of costs for lobbying are neither specific nor complete
    Success rate of lobbying may be difficult to determine
    Cost of implementing policy change
    Incremental costs for changing systems to collect and remit taxes may be small or large, depending on scale
    Tax enforcement budget may not change with policy change
    “Welfare loss” from taxes causing shift of consumption
    Not clear if welfare loss is relevant for addictive products
    Can estimate change in state revenue with data from effectiveness literature
  • Community Update: Estimating Costs
    Example 2: Point of decision prompts to increase physical activity
    Literature includes very little data on costs or resource use
    But ballpark estimate is possible from:
    National data on the number and size of shopping malls, commercial buildings, and transit stations
    Reported estimates of meeting timefor decision-making
    Internet estimates on the cost of signs
    Assumptions about the cost of maintaining signs
  • Community Update: Estimating Costs
    Example 3: School-based interventions to increase physical activity
    Journal articles provide some indication of time requirements and needed professional skills in health and education
    National salary surveys can be used to estimate cost of labor resources
    Will need to supplement literature with interviews to
    Estimate the cost of developing, testing, and producing educational materials, and
    Understand variation in costs
  • Community Update: Quantitative Modeling
    Generally, quantitative modeling for this project includes
    Modeling health and health behaviors over the lifespan, using national data sets
    Modeling how community interventions affect health behaviors and other intermediate outcomes
    Modeling how changes in behaviors and intermediate outcomes impact health
    We’re close to completing work to model the natural history of relevant behaviors (smoking, physical activity, diet) over the lifespan
    Clinical models provide a foundation for modeling the relationship between intermediate outcomes and health
    In October, we’ll show the effect of community interventions on health behaviors (the change from natural history)
  • Community Update: Information for Decision-makers
    General strategy
    Provide different types of information and tools that decision-makers can use as they prefer
    Accomplish this by developing an online tool
    Quantitative information
    On health impact and contributing factors
    Descriptive information, by topic
    About community interventions, health burden, and risk factors
    Tools for self-assessment by decision-makers
    To help them think about the likely impact of specific interventions in their own communities
  • Community Update: Quantitative Information (1 of 2)
    Table with summary information on health impact and contributing factors
    Evidence of effectiveness (strong or sufficient)
    What is the strength of evidence that the intervention works?
    Intermediate outcome affected (high, medium, low)
    How common is the behavior, disease/condition, or environmental exposure in the population?
    Effect size, intermediate outcome (high, medium, low)
    By how much will the intervention change the behavior, disease/condition, or environmental exposure?
  • Community Update: Quantitative Information (2 of 2)
    Health outcome affected (high, medium, low)
    How much of a problem is the condition, disease, or injury that the intervention affects?
    Effect size, health outcome (high, medium, low)
    What is an individual’s expected reduction in risk following a change in behavior or environmental exposure?
    Reach (high, medium, low)
    What proportion of individuals or households will come into contact with the intervention, assuming full-scale implementation?
    Health impact (high, medium, low)
    What is the overall impact on community health?
  • Community Update: Descriptive Information about Interventions
    Organized by topic to provide a menu of interventions for decision-makers to choose from
    For example, for physical activity interventions:
    Community-scale urban design land use policies and practices
    Places for physical activity combined with informational outreach activities
    Enhanced school-based physical education, etc.
    Reference table includes
    More complete descriptive information
    Information about
    Intervention type (built environment, education/information, etc.)
    Actor (community organizations, employers, policymakers, educators, etc.)
    Evidence of effectiveness (from the Community Guide)
  • Community Update: Descriptive Info About Health Burden & Risk Factors
    Reference information about
    Relevant diseases and conditions
    For example, for physical activity interventions:
    National and state data on the prevalence of cardiovascular disease, diabetes, and obesity
    For different population groups (children, adults, older adults; Black, White, Hispanic, American Indian/Native Alaskan, Asian/Pacific Islander)
    Relevant health behaviors
    For example, for physical activity interventions:
    National and state data on the population share that “met physical activity recommendations,” or “engaged in no leisure time physical activity”
    For different population groups (children, adults; Black, White, Hispanic)
    Healthy People 2020 Objectives
  • Community Update: Tools for Self-Assessment by Decision-makers
    To help decision-makers account for the unique characteristics of their own communities
    For example, questions to consider when planning an intervention
    Reach (What are barriers you foresee that will limit your ability to successfully reach your intended population?)
    Effectiveness (What are the potential unintended consequences that may result from this program?)
    Adoption (What percent of your organization will be involved in supporting or delivering this program?)
    Implementation (How confident are you that the program can be consistently delivered as intended?)
    Maintenance (What resources are available to provide long-term support to program participants?)
    Other questions to assess population characteristics
  • What We Expect to Discuss in October
    Clinical
    Analytic results
    Preliminary plan for disseminating findings, given health reform
    Communities
    More on defining interventions (choosing prototypes and case studies) for community services
    Behavior models
    Preliminary quantitative results (pending updates to intervention definitions)forintermediate outcomes, from behavior models
    Qualitative/supplemental information, and how we propose to present it
    Preliminary plan for disseminating findings, given health reform