National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health

The Component Model of Infrastructure

1 CDC Office on Smoking and Health 2 Boston University and Harvard Medical School

OSH Surveillance and Evaluation Webinar, October 23, 2014

Erika Fulmer1, MHA; Rene Lavinghouze1, MA; Patricia Rieker2, PhD

The findings and conclusions in this presentation are those of the author and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

What I’ll Cover

Define program infrastructure Clarify the utility of program infrastructure in the

context of public health and tobacco prevention and control

Describe the methodology used to develop the Component Model of Infrastructure

Provide an overview of the elements within the Component Model of Infrastructure

Implementation Programmatic Capacity

What is “Program Infrastructure”?

Definition: “The foundation or platform that supports capacity, implementation, and

sustainability of program initiatives”

Lavinghouze SR, Snyder K, Rieker PP. The component model of infrastructure: a practical approach to understanding public health program infrastructure. Am J Public Health. 2014 Aug;104(8):e14-24.

Functioning Infrastructure Components

Inputs/ Infrastructure Outcomes Activities Outputs

Sustainability

Capacity

Role of Program Infrastructure in Public Health

Outcomes Inputs/ Infrastructure Activities Outputs

Sustainability

Capacity

Program Infrastructure in Tobacco Prevention and Control

Inputs/ Infrastructure Outcomes Activities Outputs

Sustainability

Capacity

Program Infrastructure in Tobacco Prevention and Control

Inputs/ Infrastructure Outcomes Activities Outputs

Sustainability

Capacity

Role of Program Infrastructure in Public Health

OSH Infrastructure-Related Evaluation Questions

• What is the foundation for effective tobacco prevention and control programs?

• What elements drive beneficial environmental change?

Phase 1: State TCP Evaluation Case Study

Phase 2: State TCP Infrastructure Evaluation

Call Study Phase 3: State TCP

Evaluation Site Visits States participating Colorado, Massachusetts,

Michigan, Washington Kansas, Kentucky, Minnesota, Mississippi, Oklahoma, Oregon, Texas, Utah

Idaho, New Hampshire, North Carolina, North Dakota, Ohio,

Data collection methods 60-90 minute in-person group discussions

60-90 minute telephone group discussions

30 minute to 8 hour in-person discussions

Data Recorded and transcribed verbatim conversations and field notes

Recorded and transcribed verbatim conversations and field notes

Field notes

Number of interviews conducted

43 (Including one combined group discussion with all 4 sites at a CPPW technical assistance meeting in Atlanta, Georgia)

9 phone calls with each state plus 4 group calls with 2-3 of the same 9 states participating on each call

5 site visits (ranging from 2-4 days)

Dates of data collection 3/2011-5/2011 4/2011-6/2011 5/2011-9/2011

Overview of Data Collection during the Three Phases of Infrastructure Evaluation Study

Component Model of Infrastructure

Outcomes

Managed Resources

Engaged Data

Multi-Level Leadership

Networked Partnerships

Responsive Plans/

Planning

Continued Support

Capacity

Core Components

Multi-Level Leadership

Includes both people and processes

Multiple levels of interaction and impact

Includes both internal and external decisionmakers

Managed Resources

Engaged Data

Promotes action

Promotes public health goals

Requires development, support and use of data sources at multiple levels

Reponsive Plans and Planning

“A dynamic process that evolves and responds to contextual influences such as changes in

the science, health department priorities, funding levels, and external support from the

public and leadership.”

Networked Partnerships

Strategic partnerships All levels (national, state,

local) Multiple types of

organizations Multiple content areas Interconnected to

promote achievement of public health goals

Component Model of Infrastructure

Outcomes

Managed Resources

Engaged Data

Multi-Level Leadership

Networked Partnerships

Responsive Plans/

Planning

Continued Support

Capacity

Core Components

Component Model of Infrastructure

Outcomes

Managed Resources

Engaged Data

Multi-Level Leadership

Networked Partnerships

Responsive Plans/

Planning

Continued Support

Capacity

Core Components

Component Model of Infrastructure

Outcomes

Managed Resources

Engaged Data

Multi-Level Leadership

Networked Partnerships

Responsive Plans/

Planning

Continued Support

Capacity

Core Components

Summary

Program infrastructure is the foundation that supports capacity, implementation, and sustainability of program initiatives A multi-phase infrastructure evaluation study was launched to develop the Component Model of Infrastructure The core components of the Component Model of Infrastructure interact with each other and with the supporting components to create the capacity to successfully implement evidence-based activities and achieve public health goals

For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

CDC Office on Smoking and Health

National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health

Contact

www.cdc.gov/tobacco

Erika Fulmer, MHA

efulmer@cdc.gov

References Board on Health Promotion and Disease Prevention, Institute of Medicine. The Future of the Public’s

Health in the 21st Century. Washington, DC: Institute of Medicine; 2002. Center for Tobacco Policy Research, Washington University in Saint Louis. Program sustainability

assessment tool project. Available at: http://cphss.wustl.edu/Projects/Pages/Sustainability-Project.aspx. Accessed May 11, 2012.

Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs-2014. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2014.

Green LW. Public health asks of systems science: to advance our evidence-based practice, can you help us get more practice-based evidence? Am J Public Health. 2006;96(3):406---409.

Institute of Medicine. Living Well With Chronic Illness: A Call for Public Health Action. Washington, DC: Institute of Medicine; 2012.

Lavinghouze SR, Snyder K, Rieker PP. The component model of infrastructure: a practical approach to understanding public health program infrastructure. Am J Public Health. 2014 Aug;104(8):e14-24.

National Cancer Institute. Greater Than the Sum: Systems Thinking in Tobacco Control. Bethesda, MD: National Cancer Institute; 2007. Tobacco Control Monograph 18.

Preventing Initiation of Tobacco Use: Outcome Indicators for Comprehensive Tobacco Control Programs–2014. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

US Department of Health and Human Services. Healthy People 2020—public health infrastructure. Available at: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=35. Accessed May 4, 2012.

Photography Credits

Slide 2: halifaxlight. Aguedict. 2012. Photograph. flckr.comWeb. 18 Sep 2014 Slide 13: 401(k)2012. money. 2012. Photograph. flckr.comWeb. 19 Sep 2014 Medeiros, Larry. Hr-human-resources. 2011. Photograph flckr.comWeb. 19 Sep 2014 KB. Audience. 2011. Photograph. flckr.comWeb. 20 Aug 2013 Slide 14: infocux Technologies. La technologia de big data…2013. Photograph flckr.comWeb. 19 Sep 2014 Slide 16: rebberzz. Business netwok and multilevel concept. 2012. Photograph flckr.comWeb. 19 Sep 2014