1. Sustaining Local Public Health and Built Environment Programs Fit Nation NYC November 3, 2011 Annaliese Calhoun

2. Overview  Defining Sustainability  Sustainability Framework and Tool  Action Planning

3. Acknowledgements  Development of the framework was led by a team at the Center for Tobacco Policy Research, Washington University in St. Louis  Input was provided by a panel of funders, researchers, and practitioners  Funded by the National Association of Chronic Disease Directors

4. What is Sustainability?

5.  Sustainability is… the existence of structures and processes which allow a program to leverage resources to most effectively implement evidence-based policies and activities. Everything a program needs to keep it going over time

6. Sustainability is… NOT just

7. Why Sustainability?

8. The Sustainability Challenge  Episodic nature of public health funding and prioritization  The capacity for programs to plan for and maintain their efforts over time  Determining what and how to sustain- everyone speaks a different sustainability language

9. Framework Development

10. How Was the Framework Developed? Formative Work:  Evaluation of over 20 state tobacco control programs  Why were some programs able to sustain efforts despite significant cuts to program funding?  Evaluation of community obesity prevention programs and policy efforts  Lessons learned translate well to other public health programs 6

11. How Was the Framework Developed? LITERATURE REVIEW EXPERT INPUT FRAMEWORK DEVELOPMENT EXPERT PANEL CONCEPT MAPPING

12. Sustainability Framework

14. Strategic Planning Funding Stability Political Support Partnerships Organizational Capacity Program Improvement Surveillance & Evaluation Communications Public Health Impacts

15. Sustainability Framework Strategic Planning Funding Stability Political Support Partnerships Organizational Capacity Program Improvement Surveillance & Evaluation Communications Public Health Impacts

16. Sustainability Domains

17. Funding Stability The ability to make long-term plans based on a stable funding environment Funding Stability

18. Political Support An internal and external political environment which influences program funding, initiatives, and acceptance Funding Stability Political Support

19. Partnerships The connection between program and community Funding Stability Political Support Partnerships

20. Organizational Capacity The resources to effectively manage the program and its activities Funding Stability Political Support Partnerships Organizational Capacity

21. Program Improvement The ability to adapt and enhance the program to ensure its effectiveness Funding Stability Political Support Partnerships Organizational Capacity Program Improvement

22. Surveillance and Evaluation The monitoring and evaluation of process and outcome data associated with program activities Funding Stability Political Support Partnerships Organizational Capacity Program Improvement Surveillance & Evaluation

23. Communications The strategic dissemination of program outcomes and activities with stakeholders, decision-makers, and the public Funding Stability Political Support Partnerships Organizational Capacity Program Improvement Surveillance & Evaluation Communications

24. Public Health Impacts Effect on the health attitudes, perceptions, and behaviors in the area it serves Funding Stability Political Support Partnerships Organizational Capacity Program Improvement Surveillance & Evaluation Communications Public Health Impacts

25. Strategic Planning The process to define program direction, goals, and strategies Strategic Planning Funding Stability Political Support Partnerships Organizational Capacity Program Improvement Surveillance & Evaluation Communications Public Health Impacts

26. A Sustainable Program...  Has a supportive environment  Is able to plan ahead due to stable funding  Has broad and deep organizational and community ties  Uses surveillance and evaluation tools to guide program activities and enhance political and public support  Is able to recover more quickly from challenges

28. Sustainability Assessment Tool

30. How do you Complete the Tool?

31. Strategic Planning Score: 3.8 How do you Complete the Tool?

32. How Can You Use the Tool?  Prioritizing areas for improvement  Sustainability planning  Ongoing evaluation

33. Questions

34. It’s your turn!

35. Key Definitions  Program  What do you want to sustain?  Organization  Who has oversight for your program?  Community  Who are your stakeholders?

36. Sustainability Planning

37.  What are the benefits of completing a plan?  What will be the challenges?  How can you leverage work you’re already doing?

38. Where to Start  Assess program capacity for sustainability  Identify the highest priority domains  Determine which components should be sustained  Plan actions that may enhance sustainability  Monitor progress  Re-assess needs

39. Action Planning

40. Template

41. Action Planning  Priority Domain: Communications  Indicator(s) to focus on : #5—Program staff communicate the benefit of the program to policymakers

42. Action Planning  What are next 3 steps to address this domain? (include timeframe) 1. Offer individual communications technical assistance on an ongoing basis to local partners and Local Public Health/Statewide Health Improvement Program grantees to increase their capacity to communicate their work to stakeholders and decision makers. Technical assistance will include Great Trays workshops, communications planning, key messaging, story collection and dissemination, and product creation. Timeframe: beginning June, 2011—ongoing 2. Create an Office of Statewide Health Improvement Initiatives GovDelivery newsletter. … 3. Improve storytelling capacity through better organization, collection, and training of ABC staff, local partners and ABC grantees...

43. Action Planning  Which agencies or individuals need to be involved?  ABC evaluation team, communications team, staff meeting team, leadership team  Local partners and local public health/ABC grantees  What resources will be needed?  We have collected all the tools and information needed via NPAO communications channels and the 2009 assessment of local public health capacity and the 2010 communications best practices report.

44. Prioritizing Issues to Address

45. Sustainability Framework

46. Priority Domains  Which 1 domain do you most need to address?  Which domain seems to be the most modifiable?  Keep in mind- which program components should be sustained, which should not?

47. Small Group Discussions  What indicators do you think you need to focus on the most in order to sustain your program? (You can think about this question from the perspective of your agency/organization or your CPPW Built Environment team overall)  What are the next three steps to address these indicators/domain? How can you use your existing CPPW Built Environment workplan to help address these indicators/domain?  What agencies, organizations, or individuals need to be involved?  What resources will be needed and how could you obtain these resources?  How will you know you have succeeded?

48. Session Recap  Today we…  Defined sustainability  Assessed sustainability  Action planned for sustainability

49. CONTACT INFORMATION: Center for Tobacco Policy Research Annaliese Calhoun 314.935.3740 acalhoun@brownschool.wustl.edu http://ctpr.wustl.edu