NORC Final Report: Healthy People User Study. Use of the Initiative

03/28/2010

Overall, 78 percent of the 327 organizations/agencies that were aware of Healthy People 2010 reported using the initiative. This is an increase over the 71 percent of organizations/agencies that reported use of the initiative in the previous study. One-hundred percent of the Chronic Disease Directors and MTAHB who were aware of Healthy People 2010 reported using the initiative compared to 96 percent of HP Coordinators9, 74 percent of local health organizations, and 43 percent of tribal health organizations. These results show a statistically significantn increase in the percentage of local health organizations that reported using the initiative from the 2005 User Assessment, while also showing that states are significantly more likely than local and tribal health organizations to use the initiative, and local health organizations are significantly more likely than tribal health organizations to use the initiative. Between HP Coordinators and Chronic Disease Directors, the results indicate that all 49 responding states use Healthy People 201010. Exhibits 8-11 display the variation of use across sample type, region, and organization/agency size. These results indicate a general tendency of higher use of Healthy People 2010 among larger organizations. None of the differences in use between the 2005 and 2008 studies are statistically significant by sample type.

Exhibit 8: Use of Healthy People 2010 among Those Aware of the Initiative

Sample Type 2005 User Assessment
(%)
2008 User Study
(%)
Healthy People State Coordinators 100 96
State Chronic Disease Directors Not Surveyed 100
Local Health Organizations 65 74
Tribal Health Organizations 48 43
Multi-Tribal Area Health Boards Not Surveyed 100
Total 71 77
*Local Health Organizations’ reported use of HP2010 has grown significantly since at p<0.05
†Local Health Organizations are significantly less likely to use than States at p<0.05
‡Tribal Health Organizations are significantly less likely to use than Local Health Organizations and States at p<0.05

 

Exhibit 9: Use of Healthy People 2010 among Those Aware of the Initiative11

 

Exhibit 9: Use of Health People 2010 among Those Aware of the Initiative

Exhibit 9 is a bar chart showing the percent of small, medium, and large organizations among HP Coordinators, Chronic Disease Directors, Tribal Health Organizations, and Local Health Organizations that are aware of Healthy People 2010.


Exhibit 10: Percent of Respondents Who Use Healthy People 2010 by Size of Population Served

Exhibit 10 is a bar chart showing the percent of small, medium, and large organzations among all respondents that use Healthy People 2010.

Exhibit 10 is a bar chart showing the percent of small, medium, and large organzations among all respondents that use Healthy People 2010.


Exhibit 11: Percent of Respondents Who Use Healthy People 2010 by Census Region

Exhibit 11 is a bar chart showing the percent of respondents that use Healthy People 2010 by census region. The regions are Northeast, Midwest, South, and West.

Exhibit 11 is a bar chart showing the percent of respondents that use Healthy People 2010 by census region. The regions are Northeast, Midwest, South, and West.


Healthy People 2010 users reported the different ways in which they use the initiative at their organization/agency in terms of use for research, collaboration and outreach, and for internal planning. Exhibit 12 presents the type of use by respondent type. MTAHB and tribal health organizations were more likely than the other organization/agency types to report using Healthy People 2010 for research purposes. Tribal health organizations have greatly increased their use of Healthy People 2010 for research purposes, with only 55 percent of tribal health organizations reporting use for research in 2005 compared to over 80 percent in 2008.


Exhibit 12: Healthy People 2010 Types of Use by Organization Types2

Exhibit 12 is bar chart showing the percent of HP Coordinators, Chronic Disease Directors, MTAHB, Tribal Health Organizations, and Local Health Organizations that use Healthy People 2010 for research, collaboration/outreach, and for setting internal priorities (among users of Healthy People 2010).

Exhibit 12 is bar chart showing the percent of HP Coordinators, Chronic Disease Directors, MTAHB, Tribal Health Organizations, and Local Health Organizations that use Healthy People 2010 for research, collaboration/outreach, and for setting internal priorities (among users of Healthy People 2010).


Over 81 percent of respondents in each sample type reported using Healthy People 2010 as a data source, as well as a framework for planning, goal-setting and decision making. Organizational/agency uses also include using the initiative to help legislators and as a surveillance tool. While 85 percent of overall users reported using Healthy People 2010 to support applications for grants or other funding and 84 percent reported using the initiative to guide priorities for the organization/agency, only 37 percent used it as a guide to set spending priorities within the organization/agency.

Variations in how the use of Healthy People 2010 changed over time did exist among respondents in the different sample types. Approximately 40 percent of states and 47 percent of tribal health organizations reported their use of the initiative changing over time, while only 26 percent of local health organizations and 29 percent of MTAHB reported any change. Of those that did report changes in usage, the types of changes included increased use for performance measurement and priority/goal setting as well as greater use for program planning and evaluation. Many also reported increased use for forging community partnerships and coalitions and conducting community health assessments. Also noted was greater use of the Healthy People 2010 initiative in directing and writing grant applications.

Healthy People 2010 users were asked to select the most useful aspect of the program to the organization/agency (see Exhibit 13). Both of the state respondent groups cited the specific health objectives as the most useful aspect, with the overarching program goals and leading health indicators ranking second and third, respectively. MTAHB reported leading health indicators to be the most useful aspect, while tribal health organizations cited the overarching goals as the most useful. Local health organizations also varied from the other respondent types, citing data resources and leading health indicators as the most useful; however the overarching goals and specific health objectives also received high rankings from this group.

  HP Coordinator (n=43) Chronic Disease Director (n=44) Multi-Tribe Area Health Board (n=7) Tribal Health Organizations (n=15) Local Health Organizations (n=144)

Exhibit 13: Healthy People 2010 Most Useful Aspect

Overarching Goals 16% 16% 29% 47% 19%
Specific Health Objectives 28% 34% 0% 7% 17%
Data Resources 14% 9% 14% 7% 21%
Leading Health Indicators 14% 21% 57% 7% 22%
Focus AreasNo Opinion/Response 12% 9% 0% 7% 6%
Participatory Goal Setting 2% 0% 0% 0% 2%
Other 14% 9% 0% 27% 11%

Healthy People 2010 users also reported on ways the initiative impacted development of new programs and expanded existing programs within their organization/agency. While all respondent types indicated they used Healthy People 2010 to develop new programs, and expand existing programs, tribal health organizations were the only group for which Healthy People 2010 served this role for the majority of users. Seventy-three percent of tribal health organizations have developed new programs resulting from Healthy People 2010, while only 37 percent of HP Coordinators, 23 percent of Chronic Disease Directors, 43 percent of MTAHB and 43 percent of local health organizations reported using Healthy People 2010 in this manner. Similarly, 80 percent of tribal health organizations expanded existing programs. This is in contrast to the 37 percent of HP Coordinators, 41 percent of Chronic Disease Directors, 57 percent of MTAHB and 51 percent of local health organizations that indicated their organizations/agencies have expanded programs as a result of Healthy People 2010. Organizations/agencies were most likely to cite new or expanded programs in the areas of nutrition, physical activity and obesity, cancer, and diabetes prevention and education. In addition, several organizations/agencies mentioned new or increased programming in the area of health disparities. Exhibit 14 displays the Healthy People 2010 focus areas that have garnered program planning by organizations/agencies. For example, 72 percent of users reported they planned programs around the nutrition and overweight focus area.

Exhibit 14: Program Planning around Healthy People 2010 Focus Areas

51% or more planned around… Between 25% and 50% planned around… Less than 24% planned around…
  • Nutrition and Overweight (72%)
  • Tobacco Use (72%)
  • Immunization and Infectious Diseases (70%)
  • Maternal, Infant, and Child Health (66%)
  • Diabetes (66%)
  • Physical Activity and Fitness (64%)
  • Cancer (59%)
  • Heart Disease and Stroke (57%)
  • Oral Health (56%)
  • Education and Community-Based Programs (54%)
  • Sexually Transmitted Diseases (54%)
  • Environmental Health (51%)
  • Access to Quality Health Services (49%)
  • Family Planning (47%)
  • HIV (47%)
  • Injury and Violence Prevention (47%)
  • Public Health Infrastructure (44%)
  • Health Communication (42%)
  • Food Safety (40%)
  • Substance Abuse (29%)
  • Arthritis, Osteoporosis, and Chronic Back Conditions (22%)
  • Respiratory Disease (21%)
  • Vision and Hearing (17%)
  • Mental Health and Mental Disorders (15%)
  • Occupational Safety and Health (13%)
  • Chronic Kidney Disease (11%)
  • Disability and Secondary Conditions (12%)
  • Medical Product Safety (4%)

A total of 229Ninety-two percent of Healthy People 2010 users reported they were aware of at least one objective. They were asked to indicate how relevant the objectives were to their organization/agency’s work, on a scale of 1 to 5; 1 meaning not relevant and 5 meaning significantly relevant. Overall, the mean rating was 3.9. The highest percentage within each respondent type rated the relevancy of objectives at 4 or 5 (see Exhibit 15). The degree of relevancy reported in 2008 is similar to that reported in 2005. Relevancy has increased for tribal health organizations, from an average of 3.3 in 2005 to 4.3 in 2008. The reasons among those rating the objectives as highly relevant to the work of their organization/agency were that the objectives allowed for a comparison of state progress to national objectives, and the objectives assisted in planning, goal setting, and benchmarking. Among those rating the objectives as not very relevant to the work of their organizations/agencies the reasons included not having appropriate state or county level data sources to measure the objectives, objectives being too specific, and organizations/agencies lacking the resources and funds to support efforts to measure the objectives.

1=Not Relevant 5=Extremely Relevant HP Coordinators N=39 Chronic Disease Directors N=42 Multi-Tribal Area Health Boards N=6 Tribal Health Organizations N=13 Local Health Organizations N=126

Exhibit 15: Relevancy of Healthy People 2010 Objectives

Mean 4.2 4.1 4.0 4.3 3.7

To further assess how Healthy People 2010 impacted organizations/agencies’ program development, and the extent to which Healthy People 2010 objectives were used, respondents were asked about program planning around specific objectives. Eighty percent of tribal health organizations reported planning programs intentionally around one or more Healthy People 2010 objectives. This was higher than the 57 percent of Chronic Disease Directors, 54 percent of HP Coordinators, 49 percent of local health organizations and 43 percent of MTAHB reporting use for planning purposes.

View full report

Preview
Download

"report.pdf" (pdf, 382.37Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®