The Component Model of Infrastructure (CMI): An Infrastructure Model for Evaluating Tobacco Control Programs René Lavinghouze, CDC s Office on Smoking and Health Patricia Rieker, Boston University and Harvard Medical School Kim Snyder, ICF International Paul Davis, Washington State Tobacco Control Program Poster #352, August 2012 The findings and conclusions in this presentation are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.
We have outcome measures and know where we are going
Best Practices tell us how to get there
But do we ever consider the foundation for achieving outcomes?
Eliminating Nonsmokers Exposure to Secondhand Smoke Inputs Activities Outputs Outcomes State health department and partners Counter Marketing Community mobilization Policy and regulatory action Short-term Intermediate Long-term 1 Completed activities to disseminate 3 information about secondhand smoke Increased and tobacco free knowledge of, policies improved 6 attitudes toward, Compliance What are we really and increased saying with tobacco free support for the policies 2 Completed activities about creation and active to create and enforce infrastructure or the enforcement of tobacco free tobacco free policies policies inputs box 7 8 Reduced exposure to secondhand smoke Reduced tobacco consumption Targeted to populations with tobaccorelated disparities 4 Creation of tobacco free policies 9 Reduced tobacco related morbidity and mortality 5 Enforcement of tobacco free public policies 10 Decreased tobacco related disparities
Are our achievements sustainable? Can tobacco control programs weather the storm?
What s Missing?
Public health s thoughts on infrastructure DHHS should develop a comprehensive investment plan for a strong public health infrastructure at all levels with a timetable, clear performance measures, and regular progress reports to the public.
Tobacco Institute
Building the Evidence-Based Model
OSH CPPW Evaluation What does success look like that drives policy and environmental change? What is the foundation for effective tobacco control programs?
Methods To-Date Previous case study in 8 year chronic disease program infrastructure development project other than tobacco control Review of public health and tobacco control literature Data from state tobacco control programs (n=18) Review of infrastructure model by experts
OSH CPPW Evaluation Sites WA ~ OR NV CA AK ID AZ UT MT WY CO NM ND SD NE KS OK TX MN IA MO AR LA WI IL MS MI IN OH KY TN AL GA VT NY PA WV VA NC SC FL ME NH RI CT NJ DE MD D.C. MA HI HI Case Study States Call Study States (Process Evaluation/Success Story) ~ CPPW TA Site Visits N= 18
Component Model of Infrastructure Continued Support Networked Partnerships Responsive Plans/ Planning Multi-Level Leadership Capacity Outcomes Managed Resources Engaged Data Core Components Lavinghouze, S. Rene, Snyder, Kim, and Rieker, Pat
Networked Partnerships Responsive Plans/ Planning Networked Partnerships Multi-Level Leadership Managed Resources Engaged Data Core Components Diversity Nurtured beyond "fundee Extend reach of program Fit program needs, structure, and political context Relationships take time to mature All levels with multiple types of organizations, content areas & groups Multiply the work program can accomplish Fill different roles Selected examples of defining characteristics
Multi-Level Leadership Responsive Plans/ Planning Networked Partnerships Multi-Level Leadership Managed Resources Engaged Data Core Components Connected to a vision, plan or direction Includes champions Ownership of programs at multiple levels Formal and informal leadership People and their expertise Dynamic process Succession planning Selected examples of defining characteristics
Engaged Data Responsive Plans/ Planning Networked Partnerships Multi-Level Leadership Managed Resources Engaged Data Core Components Use of data Increase program visibility Attract partners Secure and manage scarce resources Igniting passion Facilitates evolution of initiatives and overall sustainability Knowledge management Ready communication Selected examples of defining characteristics
Managed Resources Responsive Plans/ Planning Networked Partnerships Multi-Level Leadership Managed Resources Engaged Data Core Components Diversified funding streams Leveraging Integration Staff expertise Technical assistance Training Coordination Selected examples of defining characteristics
Responsive Plans/Planning Responsive Plans/ Planning Networked Partnerships Multi-Level Leadership Managed Resources Engaged Data Core Components Dynamic Evolving Responsive Flexible Shared ownership Direction/roadmap Used, doesn't sit on a shelf Education and recruitment tool Progress yardstick Living document(s) Specific goals, objectives, actions, time frames, and resources Evidence-based and context appropriate Selected examples of defining characteristics
What s Next?