The results from the 2008 User Study indicate that Healthy People 2010 is a highly visible initiative—with awareness of the initiative among responding organization/agencies increasing between 2005 and 2008. This increase appears to be due to a rise in awareness among local and tribal health organizations and may be related to the aforementioned focused outreach efforts undertaken by HHS and its partners since the 2005 study. Degree of use among those aware of the initiative also increased from 71 percent in 2005 to 77 percent in 2008. Although tribal and local health organizations continue to be less likely to use the initiative than states, there have been gains in use among the local health organizations. These results suggest that recent efforts on the part of HHS to target outreach to local groups and to disseminate implementation tools have been effective in encouraging local usage of Healthy People 2010. The gains in awareness and use seen by local and tribal health organizations may also be related to concurrent work by these organizations/agencies to develop their capacity to implement programs that cross specific disease and behavior areas like Healthy People 2010 does. In fact, tribal health organizations were substantially more likely than the other sample types to report that Healthy People 2010 resulted in the development of new programs and the expansion of existing programs. HHS should continue its focused outreach and dissemination efforts to these groups.
Specific uses of Healthy People 2010remained largely unchanged between 2005 and 2008. The 2008 results continue to show that the percentage of respondents reporting that they use the initiative as a guide to set spending priorities is low. This finding identifies a potential barrier to the initiative’s effectiveness since it may not be reasonable to expect that organizations/agencies will achieve outcomes related to the Healthy People 2010 objectives if they are not using the initiative to direct funding within their organization/agency. In a follow-up discussion with a HP Coordinator who does not use Healthy People 2010, the respondent explained “Since the health department receives 80 percent of funding from grants or reimbursement, we’re driven by funding agencies, so basically we do whatever we’re told to do based on funding. So everything goes back to funding. When staff applies for funding, they don’t go to Healthy People 2010, they go to documents from the funding agencies and submit a grant application that is built on the needs of the funding agencies.” This HP Coordinator’s experience is consistent with the reality that external funding availability may drive priorities for programming, rather than the overall priorities of Healthy People 2010. If the priorities of the funding organizations are not consistent with Healthy People 2010 goals, there may be an impediment to meeting the goals and objectives of Healthy People 2010.