In both 2005 and 2008, users of Healthy People 2010were most likely to cite barriers related to their organization/agency as opposed to barriers related to Healthy People 2010when asked about issues preventing their organizations/agencies from using Healthy People 2010 more. These findings are not surprising, but are very important to note when considering the difficulties encountered by Healthy People audiences and the appropriate mechanisms for addressing these difficulties. One mechanism by which HHS could increase familiarity and use of the Healthy People initiative is by funding micro grants directed towards Healthy People 2010 use, as they have in the past. In the event that providing direct funding to these organizations/agencies may not be an option for HHS, another suggestion is for HHS to use its resources and influence to increase exposure of the Healthy People initiative to other potential funders and key stakeholders including state legislatures. For barriers related to the initiative itself, the most commonly reported barrier for users overall was lack of data to track objectives. Future research could seek to gather information on particular focus areas and/or objectives where more data is needed. This information could then be used to aid in the identification of the health objectives (sub-objectives and developmental objectives) and data sources to be included in Healthy People 2020.
As in 2005, non-users of the initiative were comprised almost entirely of local and tribal health organizations. Specific reasons for non use mirror the barriers faced by users of the initiative—organization/agency issues such as limited resources in terms of staffing and funding, and competing priorities continue to top the list, though at notably lower levels than in the 2005 User Assessment. However, unlike the findings of the 2005 User Assessment, a lack of implementation guidance and the amount of materials (too much material) also received a large response from non-users in the 2008 User Study. These barriers are directly related to Healthy People and should be considered when assessing areas of improvement to target for the next iteration. Non-users and users alike would benefit from increased technical assistance focused on translation and comprehension of the materials. Also, it may be helpful for HHS to develop and disseminate more implementation and data collection tools that could be used to help organizations/agencies utilize the initiative. The anticipated usefulness of these types of tools and guides were highlighted in a number of follow-up discussions. One Healthy People 2010 local user said “If there is a way to include a section in each topic area on some best practices for implementation that would be wonderful. It would be helpful without costing us anything.” Another local user asked for the inclusion of real examples, saying it is “always useful to see what others do, even though we will have to morph it to fit our community. But it would be an opportunity to see other creative thinking, and an opportunity to provide information on things we have done well.”