Spread, Scale, and Sustainability in Population Health Workshop Summary (2015) / Chapter Skim
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Appendix C: Background Questions and Panelist Responses
Appendix C: Background Questions and Panelist Responses
Pages 77-116
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d. What proportion of your target population have you reached?
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iv. id you need to make organizational changes to bring D something to scale?
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is a five-year project of the Office of Health Systems of the USAID Global Health Bureau designed to: • Improve health and social services at scale • Strengthen host country capacity to improve care • Learn and share knowledge about improvement globally Project technical areas Care and support for vulnerable children and families QAP I QAP II QAP III HCI ASSIST 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 HIV and AIDS The USAID ASSIST Project is the fifth in a series of preceding contracts that have built on each other: Quality Assurance Projects (QAP) : QAP I (16 countries)
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12 facilities Lesotho MOH, 3 IPs 3 417,129 of 1.9 million 3 of 10 districts MOGCSW, MOH, Office of President 12 facilities Malawi 17 402,664 of 587,214 & Cabinet 72 communities 153 facilities Mali MOH, 1 IP 203 2.3 of 2.9 million 50 communities 7 facilities Mozambique MMAS, 80 IPs 95 1.8 of 11.8 million vulnerable children 8 communities Niger MOPH 16 facilities 16 239,255 of 971,115 100 communities 200,000 of 2.5 million Nigeria MWA&SD, 2 IPs 10 of 36 states vulnerable children 2420 facilities South Africa DOH, 15 IPs 7 2 of 51 million 30 communities Swaziland MOH 85 TB facilities 30 841,752 of 1.1 million 378 facilities Tanzania MOHSW, 11 IPs 580 19.6 of 45 million 152 communities 142 facilities Uganda MOH, MGLSD, 20 IPs 176 2.8 of 36 million 24 communities 8 facilities Zambia MOH, 3 IPs, 2 global partners 8 30,000 of 88,000 1 of 89 districts EURASIA & ASIA All health professions councils: Medical, Cambodia 5 councils 20,000+ health workers Nursing, Midwifery, Pharmacists, Dentists Georgia MOLHSA, 5 IPs 20 facilities 19 1.3 of 4.5 million India MOHFW 263 facilities 263 32 million of 1.2 billion 10 facilities Ukraine MOH 11 2500 of 890,000 women (15-49 yrs) 5 cities LATIN AMERICA & CARIBBEAN 6 facilities Haiti MSA, IBESR, 4 IPs 5 1.0 of 10.7 million 48 communities UNAN Managua, UNAN Leon, BICU, Nicaragua 8 of 13 universities 8 5,157 of 6,192 students POLISAL, UPOLI, URACCAN, UCAN, UAM Maternal HIV Family Tuberculosis Health Chronic Nutrition Orphans and Newborn and Planning Workforce Care Assessment Vulnerable Child Health Counseling Children and Support USAID Applying Science to Strengthen and Improve Systems University Research Co., LLC, 7200 Wisconsin Ave., Bethesda, MD 20814-4811 USA TEL 301-654-8338 • FAX 301-941-8427 • www.usaidassist.org • assist-info@urc-chs.com
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This includes preschool, elementary school, and middle school–aged children and adolescents. Specifically, strategies for healthy eating and physical activity that are supported and managed through the CATCH Global Foundation.
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I've been working on CATCH since 1992, as a professor interested in development and evaluation of child health promotion programs. As a professor, the dissemination of CATCH is one of many professional obligations and has not been my full-time job, and funding is incon sistent year to year.
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Flaghouse markets and warehouses the CATCH program materials and UT faculty maintains quality control over training. The CATCH Global Foundation is now licensed to conduct CATCH trainings and will soon take over maintenance of training and program quality control.
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to the development of the CATCH Global Foundation.
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(the Pioneer ACO model) , comprehensive primary care, bundled payments for care improvement, state-based innovation models focused on Medicaid, numerous health care innovation awards, and broad based system transformation (e.g., the Partnership for Patients)
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Model 1: Retrospective Acute Care Hospital Inpatient Stay Model 2: Retrospective Acute Care Hospital Inpatient Stay & Post-Acute Care Model 3: Retrospective Post-Acute Care Model 4: Prospective Acute Care Hospital Inpatient Stay Comprehensive Public–private partnership to Section 1115A of the Primary Care enhance primary care services, Social Security Act Initiative including 24-hour access, creation (section 3021 of the of care management plans, and care Affordable Care Act) coordination Federally Care coordination payments to Section 1115A of the Qualified Health FQHCs in support of team-led care, Social Security Act Center Advanced improved access, and enhanced (section 3021 of the Primary Care primary care services Affordable Care Act)
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the infrastructure of the Innovation Center to engage individuals to test and support models of payment and care delivery to improve quality and reduce cost through continuous improvement processes Million Hearts This initiative is not a payment Section 1115A of the and service delivery model for Social Security Act purposes of section 1115A, but (section 3021 of the rather is an initiative that is part of Affordable Care Act) the infrastructure of the Innovation Center.
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and service delivery models that have the potential to reduce health care costs in Medicare, Medicaid, and CHIP Strong Start for Strategy I: Testing the effectiveness Section 1115A of the Mothers and of shared learning and diffusion Social Security Act Newborns activities to reduce the rate of early (section 3021 of the elective deliveries among pregnant Affordable Care Act) women Strategy II: Testing and evaluating a new model of enhanced prenatal care to reduce preterm births (less than 37 weeks)
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In July 2010 the national 100,000 Homes Campaign was launched with the help and support of the Institute for Healthcare Improvement (IHI)
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The boot camps were first used to introduce communities to prioritization and Housing First, and subsequently they were used to dramatically increase housing placements and system redesign. Following the successful completion of the 100,000 Homes Campaign, Community Solutions launched a new initiative, Zero: 2016.
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Since the federal campaign, supported by the 100,000 Homes campaign, we have seen a 33 percent reduction in the number of homeless veterans and a 20 percent reduction in chronic homelessness. This reduction has been a direct result of a national turn toward the use of evidence-based practices, a reliance on what the data show us, and the amazing federal–private collaborations that have been established along the way.
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This includes coalition development among organizations, organizing community residents in Northern Manhattan, leveraging relationships through community–academic partnerships, and even engaging local elected officials to create opportunities to improve community health and planning processes. Examples of this include, but are not limited to, the engagement of local residents in the climate march; the engage ment of local business owners and residents around garbage, pests, and pesticide issues; negotiation and discussion with the Metropolitan Transportation Authority; and leveraging community organizations, residents, and businesses to close an environmentally hazardous facility.
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WE ACT's goal is to improve community health in Northern Manhattan.
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WE ACT uses a variety of ways to disseminate information, and the details vary based on the campaign, initiative, or program. This can relate directly to social marketing, civil disobedience, social media, or just community organizing.
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No, we did not make organizational changes.
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Please explain what spread and scale means in the context of what you do. We engage in active efforts to disseminate CTI directly to pro vider organizations (e.g., social services agencies, health and mental health providers, housing and homelessness service providers)
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• lack of a single funding mechanism that can support model A implementation across service delivery sectors and in a variety of local communities. • ifficulty in getting the word out to potential funders and D adopters.
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d. id you need to make organizational changes to bring some D thing to scale?
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National public education to prevent tobacco use is now under taken by three main entities: truth®, which is back on the air at a fairly high paid media buy level; the U.S. Food and Drug Administration youth smoking prevention campaign; and the Centers for Disease Control and Prevention (CDC)
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have been reached by the scale up effort? For truth® about 75 percent of teens could describe at least one ad during 2000–2004, about 50 percent during 2004–2007, and less thereafter as the campaign relied more on social media and had less to spend on the national media buy.
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The tobacco industry sues to disrupt public education and works against tobacco control in a variety of ways. The tobacco industry seeks to obstruct blunt public education.
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1. f you needed to find additional resources, how did you I do it?
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Research has documented the effectiveness of laws and policies in a compre hensive tobacco control effort to protect the public from secondhand smoke exposure, promote cessation, and prevent initiation, including increasing the price of tobacco products, implementing and enforc ing smoke-free laws, warning about the dangers of tobacco use with antismoking media campaigns, and increasing access to help quitting. Additionally, research has shown greater effectiveness with multi component interventional efforts that integrate the implementation of programmatic and policy initiatives to influence social norms, sys tems, and networks.
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The reach of proven tobacco prevention and control interventions varies by state, with implementation being greater in states with lower tobacco use and secondhand smoke exposure. At present, more than 150 million U.S.
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on com prehensive tobacco control programs, which is less than 15 per cent of the CDC-recommended level of funding. Moreover, only Alaska and North Dakota currently fund tobacco control programs at CDC-recommended levels.
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know what works to effectively reduce tobacco use, and We if we were to fully invest in and implement these proven strategies, we could significantly reduce the staggering toll from tobacco use. States that have made larger investments in comprehensive tobacco control programs have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking among adults and youth has declined faster as spending has increased.
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territories, 6 national networks, and 8 tribal support centers. However, state resources are also required to fully fund and sustain comprehensive tobacco con trol programs; this funding varies by state.
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. As Latino networks and as part of the Phoenix Equity Group we promote reducing tobacco use, healthy eating, active living, and health equity.
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Networks are ineffective if groups do not have funds to act locally. In Minnesota with Blue Cross/Blue Shield of innesota M and Department of Health funding, Latinos and others have adopted tobacco-free policies in more than 200 apartment build ings; in churches, day care centers, restaurants, businesses; in two colleges; as well as healthy eating and active living policies (healthy options, labels, bike racks, built environment, farmers markets, etc.)
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counted towns, cities with large minority populations that went We smoke free, housing developments, schools, churches, etc., and the prevalence of youth and adult in Behavioral Risk Factor Surveil lance System and household surveys done by federal agencies. But these surveys do not gather data by subgroups or report on Asian Americans, Native Hawaiians, Native Americans, or LGBTs.
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Many national Latino and minority organizations and political leaders have received tobacco, fast food, alcohol, and soda indus tries funding or sponsorship and therefore are beholden to them. At the local, state, and federal levels, policy initiatives have been opposed by these groups and politicians.
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We promote all strategies recommended by the Guide for Community Preventive Services and CDC's Best Practices for Comprehensive Tobacco Control Programs -- 2014. This includes changing social norms through policy, particularly to raise the price of tobacco products, making all work places and public places smoke free, and adequately investing in tobacco prevention and control strategies, including state and com munity nterventions, mass reach health communication, tobacco i cessation interventions, surveillance and evaluation, and infrastruc ture, administration, and management.
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of North Carolina community colleges are 100 percent tobacco free.
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Engaged data include the sound science of the health and eco nomic impact of secondhand smoke on populations, communities at risk, and maps and charts of where policies have been passed. Effective champions often include not only experts and officials, but also survivors and victims.
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Skilled state and local public health partners worked closely with skilled outside-government advocates from the North Carolina Alliance for Health and the North Carolina Association of Local Health Directors to educate the public and deci sion makers. After 3 years of education and building support, a strong bipartisan law was passed making all North Carolina restaurants and bars smoke free as of January 2, 2010.
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116 SPREAD, SCALE, AND SUSTAINABILITY IN POPULATION HEALTH policy, media, and grassroots development. This included small sums of funding, pieced together on an annual and sometimes monthly basis from voluntary health organizations, the Robert Wood Johnson Foundation, Americans for Nonsmokers' Rights, and Campaign for Tobacco-Free Kids.
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