- There is a need for a more collaborative business model between EPE and programs to better integrate epidemiology, evaluation and programmatic expertise from the beginning of planning through implementation and evaluation. - An ideal model would have epidemiologists, evaluators and program staff working more as horizontal partners at each stage of the public health process. - This could involve co-locating staff when possible, as well as better aligning goals and communication across divisions. - Developing joint logic models and sharing data more openly were discussed as ways to break down barriers between groups and improve multi-disciplinary work.

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

2. Colorado Department of Public Health and EnvironmentStrategic Map: 2011-2015Draft08/30/11Align Priorities and Resourcesto Improve and Sustain Public Healthand Environmental QualityADBECCreate a MoreEfficient, Effective,Customer-OrientedDepartmentStrengthen theIntegrated Publicand EnvironmentalHealth SystemFoster a Competent,EmpoweredWorkforcePromoteProgrammaticExcellenceAchieve TargetedImprovements inColorado’sWinnable BattlesImplement thePublic HealthImprovement PlanPromotePublic Health andEnvironmentalCareersEstablishEvidence-Based,Data-DrivenStrategiesDeliverExcellentCustomer ServiceDevelop andImplement Strategiesto AchieveWinnable Battles1AchieveClear, Specific, Measurable GoalsAttract and RetainTalented andDiverse EmployeesEngage Partners in Programmaticand PolicyDecision-MakingEmploy LeanMethodologies to Improve BusinessProcessesPromote PoliciesThat SupportWinnable Battles2Valueand ShareInnovationAlign EmployeeGoals and Roleswith DepartmentPrioritiesChampionCollaboration AmongPrograms, Departmentsand PartnersSecureSustainable,Diversified FundingActively Participateas a Partnerin the Community3Provide ProfessionalDevelopment andAdvancementOpportunitiesCommunicateWinnable Battles toEmployees and IdentifyLinkages to their WorkStrengthenCross-DepartmentalCollaboration/IntegrationUse New and AlternateTechnologies toOptimizeEmployee PerformanceCreate and SupportSustainable, HealthyCommunities4Meet Regulatoryand StatutoryRequirementsEducate ExternalPartners onWinnable BattlesStrengthen Internaland ExternalCommunicationDevelop aLeadershipSuccession PlanPromote the Valueof Public Health andEnvironmentalProtection5ConsistentlyApply DepartmentPolicies andProceduresRecognize andReward EmployeeContributionsKeep Up withthe Speed of Business6InfluenceState HR andProcurementPolicies7Promote Health Equity and Environmental JusticeFUse Performance-Based Measures and Evaluationto Continuously Improve Effectiveness and Prioritize ResourcesG

3. TopicsInsightsA bit about Epi and EvalInsights from Karen T.3 examples of collaboration with EPEDiscussion: What would we like to see in a collaborative business model and working relationship with EPE and programs?

4. Good TimingNew CDPHE strategic mapNew leadership in CDPHE & PSDNew Colorado Winnable BattlesOpportunity to address questions

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

6. Steps of Evidence-Based Public HealthBrownson, 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 Questions1. 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 EPEIndira GujralRenee CalananDeclan CalananDOB: 9/29/11Sue Ricketts,demographerStephanie KuhnAshley Juhl

9. Epi Unit contributesBasic public health scienceCritique of existing evidenceDid 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 populationSystems thinkingInterpretation of real-world dataMore details at: www.cste.org/competencies.asp

10. Epi Unit contributesExpertise in large data sources: From Health Statistics Section ~BC, PRAMS, CHS, BRFSS, DCOther 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, 2009Healthy People 2020 target

20. Sexual Behavior Among Colorado AdultsA 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 soonerthan desired). Women who are intentional about becoming pregnant are more likely to startprenatal care early, and to adopt healthy behaviors during pregnancy. The national HealthyPeople 2010 Objective 9‐1 is to increase the proportion of intended pregnancies to 70 percentof 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 EPEExternal Evaluation OversightInternal EvaluationJulie GravesCarsten BaumannArthur McFarlaneMario RiveraKerry 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. EvaluationEvaluation focuses before the tree sprouts!

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

29. Evaluation QuestionsNeeds AssessmentWhere are the gaps in the community?What does the community feel is important?Outcome EvaluationWere my strategies effective in achieving the desired outcomes?Formative EvaluationHow can we improve the program?How effective are my collaborative partnerships?Process EvaluationHow 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 AssessmentWhat 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 modelsHelping write SMART objectivesIdentifying process and outcome measures to determine if you are meeting goals and objectivesCollaboration to decide on an appropriate evaluation focus and design (Evaluability Assessment)Design of data collection forms/proceduresAnalysis and interpretation of evaluation data

31. Collaboration is KeyUnderstanding of the Health ProblemContent knowledge and knowledge about strategiesInformation about the communityStakeholder relationships and needsUnderstanding of the Health ProblemUnderstanding of data and the complex determinants of healthScientific methodObjectivityOutcome-orientationSMART Objectives+Programs EPE= planning & executing the right analysis, intervention, & evaluation at the right time!

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

33. Insights from Karen…

34. Youth Access to TobaccoCeleste Schoenthaler

35. Maternal, Infant and Early Childhood Home Visiting ProgramFive federal applications, including statewide needs assessment, state plan for home visiting and a competitive “expansion” application, were submittedEPE = critical program partner from planning to executionRFI to identify existing home visiting programsNeeds assessment to identify at-risk communitiesPrioritization for investments based on county strengths and needsFunding formula to distribute money to prioritized countiesLogic Models and Smart ObjectivesData collection plan for 6 Benchmark areas with 36 constructsCQI plan and implementation Working closely with our partners, the EB model repsHighly academic evaluation plan developed for competitive applicationWill analyze and help interpret data; prepare reports

36. MCH Local Planning ProcessGina Febbraro

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