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NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
NCPP Update-July 2010
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NCPP Update-July 2010

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

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

Published in: Health & Medicine
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  • 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.
  • Transcript

    • 1. 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
    • 2. 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)
    • 3. 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
    • 4. 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
    • 5. 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
    • 6. 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
    • 7. 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
    • 8. 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)
    • 9. 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
    • 10. 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)
    • 11. 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
    • 12. 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
    • 13. 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
    • 14. 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
    • 15. 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
    • 16. 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
    • 17. 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
    • 18. 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
    • 19. 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
    • 20. 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
    • 21. 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
    • 22. 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
    • 23. 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)
    • 24. 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
    • 25. 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?
    • 26. 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?
    • 27. 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)
    • 28. 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
    • 29. 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
    • 30. 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

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