Sustainability of Public Health Programs- The Example of .ppt
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1、1,Sustainability of Public Health Programs: The Example of Tobacco Treatment in Massachusetts Community Health Settings,Nancy La Pelle, Ph.D. University of Massachusetts Medical School February 2007Grant # RO1 CA86282 funded by National Cancer Institute State and Community Tobacco Control Interventi
2、ons Research Initiative,2,Principal Investigator: Judith K. Ockene, PhD UMMSCo-Principal Investigators:Lori Pbert, PhD UMMS Donna Warner, MBA, CAC MDPHCo-Investigators:Nancy La Pelle, PhD UMMSJane Zapka, ScD UMMSSarah Reiff-Hekking, PhD UMMS Harriet Robbins, MEd MDPHProject Directors:Denise Jolicoeu
3、r, MPH, CHES UMMS Mary Jo White, MS, MPH UMMS,3,Sustainability,“Sustainability” contrasts with the notion of “institutionalization” which implies that a service is continued within the original organizational structure and that it is unchanged Sustainability includes adaptations to scope of services
4、 offered, organizational context, and supporting resources,4,Massachusetts Tobacco Treatment Policy Study (MASSTTPS),Sustainability Substudy Qualitative comparative case study Sample Massachusetts Tobacco Control Program (MTCP) statewide Smokers Helpline funded by MDPH 77 of 86 defunded community-ba
5、sed tobacco treatment programs 21 hospitals; 27 community health centers; 9 substance abuse treatment centers; 6 mental health agencies; 14 “other” agencies,5,Data Collection and Analysis,Telephone-based key informant interviews with community agency staff (77) In-person interviews with DPH/MTCP sta
6、ff regarding Smokers Helpline (5) Tape-recorded and transcribed Thematic and relational analysis conducted to idenify strategies used to sustain services,6,Results: Essential Strategies for Sustainability When Defunded,Redefine Scope of Services: Align services with organizational goals Select accep
7、table and affordable services,Creative Resourcing: Find funding sources for services offered Adjust staffing pattern Assign resources to create demand for services,Sustainable Services,7,Align Services with Organizational Goals,Meet needs of high smoking prevalence populations served Meet needs to p
8、rovide tobacco treatment to patients with co-morbid conditions Support staff needs to quit at smoke-free sites Dovetail with cessation-related research at the site,8,Select Acceptable and Affordable Services,Target specific at-risk subpopulationsOffer selected services onlyReduce availability: hours
9、 and sites when/where services are offered,9,Find Funding for Services Offered,Charge fees Use grant-writing expertise to find other funding Get other entities (departments, collaborators, etc.) to fund, share costs, or provide space Bill as encounter that has insurance coverage,10,Adjust Staffing P
10、attern,Reduce tobacco treatment specialist (TTS) staff Find other roles TTS staff can play part-time in other departments Outsource TTS staff Find non-TTS staff resources to provide services,11,Assign Resources to Create Demand for Services,Create referral system from providers and other departments
11、 Educate healthcare providers about services Program staff networks with other community organizations to generate referrals Enlist marketing resources to advertise services,12,Sustainability Results After 9 Months,13,Level 1: 33% Non-Sustaining (Minimal Scope; No Resources),Redefining Scope: Drop t
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