Implementing & Sustaining A Focus on Specific Populations Through Systems Change K Moore, J Brandes, B Skidmore, J Hunter, C Satzler, G Park, C Cramer, C Cryer

Background In 2006, Kansas’ Tobacco Use Prevention Program (TUPP) was awarded a grant from Centers for Disease Control and Prevention (CDC) to develop a strategic plan for addressing disparities related to tobacco. Kansas began work on the project in September 2006, with the first workgroup meeting in March The mission of the project was to increase knowledge, training and resources needed to address tobacco-related disparities among specific populations in Kansas. The overall purpose of the workgroup was to produce a strategic plan based on the viewpoints of specific populations in Kansas that identifies and eliminates tobacco-related disparities. Because there were limited resources for implementation, the planning team focused on “system changes”. This poster highlights the system change and integration approach for implementing specific population planning results, including some example system changes. Methods Methods for the integration and systems change approach used by Kansas for the Specific Populations Planning Process include: Lessons Learned Building on lessons learned, planning recommendations, and workgroup infrastructure from other planning state planning processes, particularly Healthy Kansans Building on CDC training resources, materials developed, and lessons learned by other states in their tobacco disparities planning processes. Identifying and implementing systems changes starting at the very beginning of the planning process and continuing throughout rather than waiting until the plan was complete. Seeking out no- and low- cost changes. Focusing on networking and building relationships rather than building new programs. Encouraging workgroup members to think about identifying and implementing system changes in their own organizations. Avoid competing for resources and visibility by implementing changes within current process and program structures, partnering with other organizations, and piggy- backing on other initiatives. Specific Populations Marketing Tag Line: Tobacco Prevention and Cessation. Everyone benefits. Quitline training at Fort Riley What is Systems Change? We interpreted “systems change” as doing business differently! Definition: Systems change refers to achieving comprehensive, sufficiently resourced, sustainable, and integrated systems of research, surveillance, policies and programs that maintain health and prevent chronic disease. Document change “as you go”. This made it much easier to compile and report changes during and at the end of the project. It also gave the planning team a “running list” to expand after the plan was complete. Involve multiple, diverse partners in the planning process who can lead systems changes. Lasting change is often small and incremental. Small, incremental changes can spark bigger, more far-reaching changes. Even the small changes can take more planning, time and resources than anticipated. Utilize earned media to help get the message out and promote integration and systems change. Celebrate changes so everyone can see their successes and be motivated to continue. For more information see Start, Stop, Continue Activity. To start workgroup members thinking about system changes, the facilitator asked each one to identify at least one activity they would start, stop, or continue. Members wrote their committed changes on sticky notes and placed them on the wall. The results are listed in the table at right. Building Relationships and Earned Media. One relationship built through the Specific Populations planning process has resulted in ongoing collaborative efforts with a new contact, a tobacco cessation counselor at Irwin Army Hospital, Fort Riley. Through this relationship, multiple providers have been trained and are referring to the Quitline, and the Kansas Tobacco Use Prevention Program is developing materials targeted for military populations. These efforts were also featured in two Kansas Health Statistics news service articles (right). The Healthy Kansans 2010 planning process provided a valuable foundation for Kansas’ Tobacco Prevention for Specific Populations. Four of the six workgroups and many recommendations were directly related to specific populations and/or tobacco. For more information on Healthy Kansans 2010, see the website at Other Examples of “System Changes” These are only a few of the incremental system changes implemented through the Specific Populations project. This “ecomap” from the Specific Populations Marketing Plan is a pictorial representation of how the Kansas Tobacco Use Prevention Program is collaboratively reaching out to multiple sectors of specific populations and how “everyone benefits” from tobacco prevention and cessation. Specific populations has been included in regular technical assistance conference calls. Two calls on cultural competency have been offered thus far: Engaging the Lesbian, Gay, Bisexual and Transgender Community in Tobacco Control Efforts Building Relations with the American Indian Populations and Health Care Providers Persons with limited mobility are now self-reported on the Kansas Tobacco Quitline intake survey. LGBT populations are now self-identified in both the Quitline intake survey and the Adult Tobacco Survey. The Kansas Tobacco Quitline number and logo were placed on as many materials as appropriate for distribution at the Specific Populations meetings to create brand recognition. The Kansas Tobacco Use Prevention Program is collaborating with the Farmworker Health Program to reach the Low German Mennonite population in a more effective way. Lessons learned related to integration and systems change: