TM

Supporting and Expanding Public Health Research: A CDC

Perspective

Presented at Health Professions Network Presented at Health Professions Network Conference, March 17, 2006Conference, March 17, 2006

Robin M. Wagner, PhD, MSRobin M. Wagner, PhD, MSJamila Rashid, PhD, MPHJamila Rashid, PhD, MPH

Elizabeth Skillen, PhDElizabeth Skillen, PhDCindi Melanson, MPH, CHESCindi Melanson, MPH, CHES

Robert Spengler, ScDRobert Spengler, ScD

Office of Public Health ResearchOffice of Public Health ResearchOffice of the Chief Science OfficerOffice of the Chief Science Officer

TM

Overview Developing a national public health research Developing a national public health research

agendaagenda – Why nowWhy now– How theHow the NEWNEW CDC Health Protection Guide, 2006-CDC Health Protection Guide, 2006-

2015 2015 is being developedis being developed– How it will be used to support shorter-termHow it will be used to support shorter-term

Research AgendaResearch Agenda– Which research themes are related to healthcare Which research themes are related to healthcare

professionalsprofessionals

Implementing the research agendaImplementing the research agenda QuestionsQuestions

TM

The Original CDC

TM

Emerging Public Health Threats Health Disparities

Globalization

Public Health InfrastructurePublic Health Infrastructure

Changing DemographicsChanging Demographics

Rising Health Care Costs

Aging Workforce

Information Technology

Human Genome

Why Change? Many External Forces…

TM

CDC Response

New strategic plan: Futures Initiative New organizational structure New health protection goals New strategic imperatives New national public health research

agenda– CDC Health Protection Research Guide, 2006-2015– CDC Research Agenda (shorter-term priorities)

TM

Centers for Disease Control and Prevention

COORDINATING OFFICE FOR

GLOBAL HEALTH

COORDINATING OFFICE

FOR TERRORISM PREPAREDNESS &

EMERGENCY RESPONSE

COORDINATING CENTER FOR

ENVIRONMENTALHEALTH AND

INJURY PREVENTION

COORDINATING CENTER FOR INFECTIOUS

DISEASES

COORDINATING CENTER FOR

HEALTH PROMOTION

COORDINATING CENTER

FOR HEALTH INFORMATION AND SERVICES

NATIONAL INSTITUTE

FOR OCCUPATIONAL

SAFETY AND HEALTH

CDC WASHINGTONOFFICE

OFFICE OF THE CHIEF OF PUBLIC HEALTH

PRACTICE

OFFICE OF THE CHIEF OPERATING OFFICER

OFFICE OF CHIEF OF STAFF

OFFICE OF ENTERPRISE COMMUNICATION

OFFICE OF EQUAL EMPLOYMENT OPPORTUNITY

OFFICE OF STRATEGY AND INNOVATION

OFFICE OF WORKFORCE AND CAREER

DEVELOPMENT

OFFICE OF THE CHIEF SCIENCE OFFICER

OFFICE OF THE DIRECTOR

TM

CDC Overarching Health Protection Goals

HealthyPeople

in Every Stage of Life

HealthyPeople in HealthyPlaces

PeoplePreparedfor EmergingHealthThreats

HealthyPeople

in a HealthyWorld

TM

Specific Health Protection GoalsHealthy People in Every Stage of Life–Infants & toddlers–Children–Adolescents–Adults–Older Adults

Healthy People in Healthy Places–Communities–Homes–Workplaces–Schools–Healthcare settings–Institutions–Travel & recreation

People Prepared for Emerging Health Threats–Event Goals: Investigate & control threats–Post-Event Goals: Recover from threats & improve future responses to threats–Pre-Event Goals: Prevent, detect & report public health threats

Healthy People in a Healthy World–Health promotion–Health protection–Health diplomacy

TM

Strategic Imperatives

Health Impact Focus Customer-centricity Public Health Research Leadership Global Health Impact Accountability

TM

Goals Implementation for CDC

EvidenceInput

MissionFeasibility

Impact

Evidence-based action planAccountability & responsibility

assignmentsResource allocation

Performance Management

Health Impact

GoalsHealthy People, Healthy Places,Preparedness & Global Health

TM

Goals Will Drive Program and Research

GOALSGOALS

RESEARCHRESEARCH

PROGRAMPROGRAM

HealthImpact

TM

CDC Integration of Goals, Research and Program

Public health services,programs and response

Research

HEALTH IMPACT

Achieve goals

Improved services,programs and response

HEALTH PROTECTION GOALSHealthy People, Healthy Places,Preparedness & Global Health

InnovationNew priorities Threats & emergencies

Program

TM

Overview: CDC Health Protection Research Guide, 2006-2015

Provides comprehensive, long-range vision of national & global public health needs– Research Guide will support shorter-term

Research Agenda

Applies to intramural & extramural research

TM

Purpose of CDC Research Guide Identify knowledge gaps to be addressed in

Health Protection Goals Action Plans Describe research needed for critical evidence to

improve public health programs/interventions Support many public health disciplines through

innovative, cross-cutting, foundational research Serve as platform for collaborations with federal

partners Provide basis for collaborations with state/local

partners Create opportunities to partner with other diverse

partner sectors Plan, promote and market CDC research

TM

Workgroup Structure

Research Agenda Steering Subworkgroup

Core Team

Environmental & OccupationalHealth & Injury Prevention

Health Promotion

Infectious Diseases

Community Preparedness& Response

Health Information Services

Global Health

CDC ADVISORY COMMITTEE

Workgroup on Goals & Research Agenda

2015 Health Protection Goals Subworkgroup

TM

Research GuideResearch Guide Development Development Progress and Next StepsProgress and Next Steps

Develop plans & gain approvalDevelop plans & gain approval Form workgroupsForm workgroups Gather CDC and partner inputGather CDC and partner input Create “starter list” for discussionCreate “starter list” for discussion Hold public participation meetingsHold public participation meetings Hold initial federal partners meetingHold initial federal partners meeting Conduct synthesis & prioritizationConduct synthesis & prioritization Produce public comment draftProduce public comment draft Hold 60-day formal public comment periodHold 60-day formal public comment period Finalize Finalize Research GuideResearch Guide (Target date: 4/06) (Target date: 4/06) Develop a strategy to collaborate with partnersDevelop a strategy to collaborate with partners Develop short-term Research AgendaDevelop short-term Research Agenda

TM

Outline of Public Comment DraftOutline of Public Comment DraftII.. OverviewOverview

II.II. Relationship of Research Themes to CDC Health Protection Relationship of Research Themes to CDC Health Protection GoalsGoals

The Proposed GuideThe Proposed Guide

III.III. Prevent and Control Infectious DiseasesPrevent and Control Infectious Diseases

IV.IV. Promote Preparedness to Protect HealthPromote Preparedness to Protect Health

V.V. Promote Health to Reduce the Burden Of Chronic Diseases and Promote Health to Reduce the Burden Of Chronic Diseases and DisabilityDisability

VI.VI. Create Safe Places To Live, Work, Learn, and Play Create Safe Places To Live, Work, Learn, and Play

VII.VII. Work Together to Build a Healthy WorldWork Together to Build a Healthy World

VIII.VIII. Manage and Market Health InformationManage and Market Health Information

IX.IX. Cross Cutting ResearchCross Cutting Research

AppendicesAppendices

TM

Organization of Organization of Research GuideResearch Guide

MAJOR RESEARCH AREA

(Chapter)

Research Category A

Research Category B

Research Category C

Research Theme 1

Research Theme 2

Research Theme 3

TIER 1 TIER 2 TIER 3

Scope of Research

TM

Priority-Setting Criteria

Public health need/importance of problem Relevance to reducing health disparities Potential for broad impact (>1 disease or

subject area) Relevance to CDC mission/health protection

goals

TM

Public ResponsesPublic Responses 3 Sources of Public Comments3 Sources of Public Comments

– WebsiteWebsite– EmailEmail– Postal MailPostal Mail

Nearly 7,000 people submitted commentsNearly 7,000 people submitted comments

Most comments received during comment period Most comments received during comment period (“official” comments) but some were late (“official” comments) but some were late (“unofficial”)(“unofficial”)

Many institutional responses from key partnersMany institutional responses from key partners

TM

Key Partners Who Submitted Key Partners Who Submitted Institutional CommentsInstitutional Comments

NIH Institutes and OfficesNIH Institutes and Offices

Office on Disability, DHHSOffice on Disability, DHHS

Association of Teachers of Association of Teachers of Preventive MedicinePreventive Medicine

Association of State and Association of State and Territorial Health OfficialsTerritorial Health Officials

American Society of American Society of MicrobiologyMicrobiology

Infectious Diseases Society of Infectious Diseases Society of AmericaAmerica

American Hospital AssociationAmerican Hospital Association

American Chemistry CouncilAmerican Chemistry Council

Emergency Nurses AssociationEmergency Nurses Association

American Psychological American Psychological AssociationAssociation

AND OTHERS!AND OTHERS!

TM

Official Public Comments Received Official Public Comments Received DURING Public Comment PeriodDURING Public Comment Period

Source of Source of CommentsComments

# of Website # of Website RegistrantsRegistrants

# of People # of People Who Who Commented*Commented*

# of # of Comments Comments Submitted**Submitted**

WebsiteWebsite 4,3714,371 350350 488488

EmailEmail Not applicableNot applicable 6,6206,620 6,7266,726

Postal MailPostal Mail Not applicableNot applicable 33 33

* Draft #s. May include >1 submission by same person.** # of comments BEFORE the comments were split into discrete ideas.

TM

Unofficial Public Comments Received Unofficial Public Comments Received AFTER Public Comment PeriodAFTER Public Comment Period

Source of Source of CommentsComments

# of Website # of Website RegistrantsRegistrants

# of People # of People Who Who Commented*Commented*

# of # of Comments Comments Submitted**Submitted**

WebsiteWebsite NoneNone NoneNone NoneNone

EmailEmail Not applicableNot applicable 132132 142142

Postal MailPostal Mail Not applicableNot applicable 00 00

* Draft #s. May include >1 submission by same person.

** # of comments BEFORE the comments were split into discrete ideas.

TM

Linking Research Guide to Goals Action Teams

Each Team’s Goals Action Plan will include research component

2006-2015 Research Guide will have identified research to fill knowledge gaps determined as priorities by Teams

Research supporting Teams will form basis of short-term Research Agenda (2-3 year timeline)

TM

Research Theme Examples Mapped to Goals/Teams

Optimal Adolescent Development [ADOLESCENT HEALTH]Develop and evaluate strategies to improve health and fitness levels of U.S. adolescents, and establish health behaviors that promote lifelong health and reduce the leading causes of morbidity, mortality, and disability among youth and adults.

Influenza Pandemic and Interpandemic (Annual) [INFLUENZA] Determine the pathogenesis, transmission, and immune response of highly

pathogenic avian and other influenza viruses with pandemic potential to develop improved preventive and therapeutic measures.

Occupational Diseases [HEALTHY WORKPLACES]Improve understanding of the role and burden of workplace exposures to diseases, and determine sector-specific risk factors, mechanisms, and effective prevention strategies.

Health Marketing and Health Education in Global Settings [GLOBAL HEALTH PROMOTION]Improve strategies for health education and dissemination of health marketing messages and products with the objective of encouraging behaviors that will prevent disease and injury in the developing world.

TM

Research Themes Relevant to Health Professionals - I

Workforce and Career Development Conduct research to improve public health workforce-related recruitment, retention, and training.

Scope of Research addressesScope of Research addresses:: – Knowledge, attitude and skill competencies needed by Knowledge, attitude and skill competencies needed by

the public health workforcethe public health workforce– Career development and entry-level supply lines to Career development and entry-level supply lines to

ensure workforce pool ensure workforce pool – Best practices for workforce recruitment, retention, Best practices for workforce recruitment, retention,

training training – Current and future public health workforce needs Current and future public health workforce needs – Impact of trained public health professionals on Impact of trained public health professionals on

specific health related outcomes specific health related outcomes – Workforce performance and trendsWorkforce performance and trends

TM

Research Themes Relevant to Health Professionals - II

Support for Front-line Personnel Involved in Health Support for Front-line Personnel Involved in Health Protection Functions During Extreme EventsProtection Functions During Extreme Events

Improve and evaluate the countermeasures, personal Improve and evaluate the countermeasures, personal protective equipment, and health policy guidelines that protective equipment, and health policy guidelines that support members of the public health workforce and support members of the public health workforce and maximize safety, personal resilience, self-confidence, and maximize safety, personal resilience, self-confidence, and performance for these workers.performance for these workers.

Proficiency of the Public Health Workforce in the Event of Proficiency of the Public Health Workforce in the Event of DisasterDisaster

Define and assess the knowledge, attitudes, and Define and assess the knowledge, attitudes, and proficiencies needed by the public health workforce to proficiencies needed by the public health workforce to successfully ensure the safety and well-being of the successfully ensure the safety and well-being of the community.community.

TM

Research Themes Relevant to Health Professionals - III

• Healthcare-associated Infections and Patient SafetyHealthcare-associated Infections and Patient Safety

Create novel strategies for preventing healthcare-associated Create novel strategies for preventing healthcare-associated infections, including those occurring among recipients of infections, including those occurring among recipients of blood, organs, and other tissues.blood, organs, and other tissues.

• Human Resources and Health Outcomes in Global SettingsHuman Resources and Health Outcomes in Global Settings

Evaluate the way in which the quality and quantity of human Evaluate the way in which the quality and quantity of human resources in health affects the key determinants of health resources in health affects the key determinants of health outcomes in global settings.outcomes in global settings.

• Integrated Health Marketing Programs

Explore practices and strategies to enable public health professionals to design, create, and evaluate effective and integrated health-marketing campaigns.

TM

Implementing Implementing Research GuideResearch Guide

Develop a strategy to collaborate with federal Develop a strategy to collaborate with federal partnerspartners– Hold second and third federal partners meetings on health Hold second and third federal partners meetings on health

disparitiesdisparities– Plan additional meetings, funding and other mechanismsPlan additional meetings, funding and other mechanisms

Develop a strategy for collaborating with other Develop a strategy for collaborating with other partnerspartners

Develop broad program announcement aligned with Develop broad program announcement aligned with Research Guide, Research AgendaResearch Guide, Research Agenda and Health and Health Protection GoalsProtection Goals

TM

Funding the Funding the Research Agenda Research Agenda Broad research program announcement (continued)Broad research program announcement (continued)

– Emphasis on intervention, translation and dissemination Emphasis on intervention, translation and dissemination researchresearch

– Target publication date: 8/06Target publication date: 8/06– In effect for 3 years using FY07-FY09 fundsIn effect for 3 years using FY07-FY09 funds– Potential applicants directed to updated research Potential applicants directed to updated research

priorities developed over time by Teams and listed priorities developed over time by Teams and listed on Web on Web

– Leverage resources of other interested federal partners Leverage resources of other interested federal partners and across CDCand across CDC

Other funding mechanisms TBD by CDC senior Other funding mechanisms TBD by CDC senior managementmanagement

TM

For More Information

CDC Goals

http://www.cdc.gov/about/goals

CDC Health Protection Research Guide

www.cdc.gov/od/ophr/cdcra.htm

TM

Contact

Robin M. Wagner, Ph.D., M.S.Associate Director for Research Planning and

EvaluationOffice of Public Health Research

Office of the Chief Science OfficerCenters for Disease Control and Prevention

1600 Clifton Rd., NE, Mailstop D72Atlanta, GA 30333

Phone: 404-639-4898Email: RWagner@cdc.gov

TM

We Appreciate Your Support of the Research Guide . . .

To help us fulfill CDC’s vision of healthy people in a healthy world – through prevention!

Thank you!!

TM

QuestionsQuestions

How can we work together to support How can we work together to support research of mutual interest?research of mutual interest?

Other?Other?