The participant list for the 2008 User Study was constructed from multiple sources, with separate sampling frames for state, local, and tribal health organizations/agencies. The state level sample sought responses from two groups within each state’s Department of Health: the Healthy People State Coordinator (HP Coordinator) and the Chronic Disease Director. HP Coordinators were included because they are directly involved in Healthy People and are a primary audience and proprietor of the initiative.
Exhibit 1: Key Research Questions
1. What are the organization/agency characteristics of users and non-users of HP2010, and has this changed since the 2005 User Assessment?
What is the type, size, and location of the organization/agency?
What population(s) does the organization/agency serve?
What health priorities does the organization/agency support?
Who is the target audience for the organization’s health promotion and disease prevention efforts?
Which employees and/or departments within the organization/agency are involved in implementing disease prevention and health promotion programs?
What are the characteristics of the organization/agency?
2. Are organizations aware Healthy People 2010, and if so, how are the organizations/agencies using the initiative? Has the use of Healthy People 2010 changed since the 2005 User Assessment?
Is the organization/agency aware of Healthy People 2010?
If so, how did they receive information about the initiative?
Has the organization/agency incorporated the Healthy People 2010 initiative into its planning of health activities? If so, how did it do this?
If using Healthy People 2010, is the organization/agency measuring changes in health behaviors or health outcomes in targeted populations?
What resources have been most helpful in supporting the organization’s Healthy People 2010 activities?
3. What are the reasons that organizations/agencies are not using Healthy People 2010?
What barriers to using Healthy People 2010 exist at the organization/agency?
What aspects of the initiative pose obstacles or challenges to using Healthy People 2010 at the organization/agency?
What changes to this initiative would increase its usefulness?
What assistance could HHS provide to overcome barriers to organization/agency use?
4. What components of Healthy People 2010 are most useful to users?
Do organizations/agencies use the overarching goals, objectives and indicators? If so, how frequently?
Which of these elements are most useful to the organization/agency?
What process does the organization/agency use to select priority objectives /indicators from Healthy People 2010?
Does the organization/agency use Healthy People 2010 as a source of data for benchmarking or evaluation?
5. What elements would be useful in the final assessment of Healthy People 2010?
Is the organization/agency intending to assess progress towards Healthy People 2010 goals? If so, how?
To what extent should accomplishment of the objectives themselves be the standard by which the initiative’s success is measured?
Should other factors be taken into account in judging the impact of HP2010, such as: enhanced capacity in states and localities; new partnerships among governmental and private sector organizations; or newly developed strategies for achieving the initiative’s overarching goals?
6. What key components should be considered in framing the next iteration of health promotion and disease prevention objectives for the nation?
How can HHS improve the next iteration of national health objectives to be more useful to state/local/tribal organizations/agencies?
To what extent are overarching goals a critical element of Healthy People?
To what extent are focus areas a critical element of Healthy People?
Should the next iteration of Healthy People contain more, fewer, or a similar number of objectives?
Would a reorganization (e.g., by health risks/ determinants, by disease areas, by leading indicators) of objectives be helpful to state/local/tribal entities?
How involved should states, localities, and tribes be in framing the next iteration of Healthy People?
Chronic Disease Directors were included because they work within the state public health agency and may or may not be directly involved with Healthy People, but they are likely to be impacted by Healthy People goals.
As another key stakeholder in the efforts to improve the health of the nation, the views of local health organizations were included as a separate sample. A list of 3,707 members of the National Association of County and City Health Officials (NACCHO) served as the sample frame for the local health organizations.
The study also sought responses from two different types of tribal health organizations: individual tribal health organizations and Multi-Tribal Area Health Boards (MTAHB). Tribal health organizations provide health support to their individual tribe, while MTAHB advise in the development of positions on health policy, planning, and program design for a number of tribes in an area. While not every tribe is affiliated with a MTAHB, these organizations can be an important resource for implementation and outreach to the tribal health community. By including these two types of tribal health organizations, the 2008 User Study was able to more accurately capture the perspective of tribal health organizations and the unique ways in which they use Healthy People 2010.
The final sample included 5172 respondents from the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, local health organizations, and tribal health organizations. The unit of analysis for the sample was the organization, meaning that no more than one survey was sent to each organization. The project took a census of HP Coordinators, Chronic Disease Directors, and MTAHB, and sampled local and tribal health organizations. A list of the 53 HP Coordinators and Chronic Disease Directors (including the District of Columbia, Puerto Rico, and the U.S. Virgin Islands) served as the primary contacts for the states. As noted above, NACCHO’s list of health officials served as the sample frame for the local health organizations, and the tribal health organizations were selected from a frame of 280 tribal health organization contacts provided by Indian Health Services (IHS). Finally, all12 MTAHB were selected from the list provided by IHS.