Transcript Primary Prevention Initiative: Tobacco Module

Primary Prevention Initiative:
Immunizations Module
Objectives
• Upon completion of this module, learner
will be able to:
– Define levels of prevention
– Describe how to select relevant topic, locate
data, and identify an appropriate intervention
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The Levels of Prevention
PRIMARY
Prevention
SECONDARY
Prevention
TERTIARY
Prevention
Definition An intervention
implemented before
there is evidence of a
disease or injury
An intervention
implemented after a
disease has begun,
but before it is
symptomatic.
An intervention
implemented after a
disease or injury is
established
Intent
Reduce or eliminate
causative risk factors
(risk reduction)
Early identification
(through screening)
and treatment
Prevent sequelae
(stop bad things from
getting worse)
Example
Encourage exercise
and healthy eating to
prevent individuals
from becoming
overweight.
Check body mass
index (BMI) at every
well checkup to
identify individuals
who are overweight
or obese.
Help obese
individuals lose
weight to prevent
progression to more
severe
consequences.
Adapted from: Centers for Disease Control and Prevention. A Framework for Assessing the Effectiveness of Disease and Injury Prevention. MMWR. 1992; 41(RR-3);3 001.
Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00016403.htm
Primary Prevention Initiative (PPI)
• Established by Dr. Dreyzehner in 2012
• Goal is to focus the Department’s energy
on primary prevention—eliminating risk
factors for later problems
• Intent is for all TDH employees to engage
in primary prevention efforts in their
community
• Statewide Roll- out January, 2013
PPI Process
– All counties participating in Primary
Prevention Initiatives
– County forms PPI Team
– PPI Team meets to determine focus areas
– Counties may utilize Community Health
Assessments to determine priority topics
– PPI Team submits PPI Proposal
– PPI Team submits reports on each Activity
– Process continues
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Team Work
• Your county may have multiple teams working
on different community activities
• Teams will spend 5% of their time working on
PPI
– Approximately ½ day every other week
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PPI Teams
• Team members will be:
– Catalysts
– Encouragers
– Resource providers
– Data keepers/providers
• Team members are not sole workers
– Teams will engage community partners to
accomplish activities
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PPI Teams
• Team size will vary
– Teams of 3, 5, or 7 depending on health
department size
• Team composition:
– Include community members
– Teams should be multidisciplinary (clerical,
nursing, clinical, administrative)
– Include Regional office staff
• i.e. Health Promotion Coordinator and/or
Community Health Council Coordinator, county
staff such as Health Educator, Health Care
Provider, and administrative staff
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Topics for PPI Activities
– Tobacco
– Obesity
– Teen Pregnancy
– Infant Mortality
– Substance Use and Abuse
– Immunizations
– Suicide Prevention
– Occupational Safety
– Healthcare Associated Infections
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Selecting a Topic
• There are so many things you could
choose to work on—but time and
resources are limited!
• You will need to prioritize your efforts
based on the specific need(s) in your
community
• Needs (and therefore, projects) will likely
vary across the State
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Selecting a Topic
• What can you use to help you prioritize?
– Community Health Assessment Tools
– County Health Council Priorities
– Needs Assessments
– Strategic Plans
– Ranking/Report Card findings
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Locating Data
• Once you’ve selected the topic on which
you plan to focus, you will need to locate
data that is relevant to the topic
• Data can help you:
– Confirm “suspicions” or “hunches”
– Sharpen your focus on a particular aspect of
the topic
– Identify baseline for measuring improvement
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Locating Data
• Some Potential Data Sources:
– Birth/death certificates
– Hospital Discharge data
– Health Information Tennessee (HIT) website
– Behavioral Risk Factor Surveillance System
(BRFSS)
– Youth Risk Behavior Survey (YRBS)
– Pregnancy Risk Assessment Monitoring
Survey (PRAMS)
– Data from community health assessments
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Identifying An Intervention
• Once you’ve selected your topic and
gathered appropriate data, it’s time to
decide what you’re actually going to do
• There is no need to “re-invent the wheel”
• Explore what others have done, what has
been tested, and what has been shown to
work
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Identifying An Intervention
• Some Sources for Identifying an
Intervention:
– Guide to Community Preventive Service
• http://www.thecommunityguide.org/index.html
– NACCHO Model Practice Database
• http://naccho.org/topics/modelpractices/database/
– Promising Practice Network
• http://www.promisingpractices.net/programs_topic.asp
– SAMSHA National Registry of EvidenceBased Practices and Programs
• http://nrepp.samhsa.gov/
PPI Proposal
• Once determined, submit PPI Proposal in
PPI Proposal Survey Gizmo link:
http://www.surveygizmo.com/s3/1537642/PPI-Proposal
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PPI Proposal contains
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•
•
County
Topic
Objective
Activities
Team members
Primary contact
Community partners
Estimated Start Date
Estimated Completion Date
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PPI Activity Reporting
• As the PPI Team completes each activity, report
in PPI Activity Reporting Survey Gizmo link:
• http://www.surveygizmo.com/s3/1458250/PPI-V3-0
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PPI Activity Reporting Contains
•
•
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County name
Division/Office
Topic
Objective
Activity description
Key Partners/Contributions
Start date of activity
Facilitating factors of success
Barriers encountered
Plans to overcome barriers
Unanticipated outcomes
Impact measures- numbers served
Stage of Change
Success Stories
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Applying
Primary Prevention Principles
to Immunizations
CDC 2012 National Immunization Survey of 19-35
Month Olds, TN vs. US (HP 2020 Objectives Indicated)
100
90
Percent Vaccinated
80
70
60
50
40
30
20
10
0
Tennessee
US
HP2020 Objective
Data source: National Immunization Survey Table Data for 2012.
Available at: http://www.cdc.gov/vaccines/imz-managers/coverage/nis/child/tables/12/tab03_antigen_state_2012.pdf.
Data source: Results of the 2013 Immunization Status Survey of 24-Month-Old Children in Tennessee. Prepared by the Tennessee Department of Health’s
Immunization Program and available at: http://health.state.tn.us/ceds/PDFs/ImmunizationSurvey2013.pdf.
Data source: Results of the 2013 Immunization Status Survey of 24-Month-Old Children in Tennessee. Prepared by the Tennessee Department of Health’s
Immunization Program and available at: http://health.state.tn.us/ceds/PDFs/ImmunizationSurvey2013.pdf.
Data source: 2013 NIS-Teen Vaccination Coverage Table Data.
Available at: http://www.cdc.gov/vaccines/imz-managers/coverage/nis/teen/tables/13/tab16_HPV3Completion_race_2013.pdf.
Proven Primary Prevention
Strategies
• Identify a specific action to address each of
the 3 components of the Community Guide’s
evidence-based intervention packages
– Systematic review of 23 qualifying studies
– Combined interventions were evaluated and found
effective
– Overall, studies found various combinations had a
median impact of 16.5 percentage points on targeted
vaccine coverage
Proven Primary Prevention
Strategies
• Strategies recommended in the Community
Guide to Preventive Services
(www.thecommunityguide.org)
– Enhance access
• A way to improve convenience and/or reduce out of pocket
expense
And
– Provider-oriented intervention
• Examples: standing orders, provider reminders, quality
assessments
And
– Increase client demand
• Examples: a form of patient education, reminders
Proven Primary Prevention
Strategies
• Example 1: Enhance Access
Vaccines for Children
(VFC)
Proven Primary Prevention
Strategies
• Example 2: Help providers
Proven Primary Prevention
Strategies
• Example 3: Increase Client Demand
Additional Resources
• The Community Guide: Vaccinations to Prevent Diseases: Universally
Recommended Vaccinations
– http://www.thecommunityguide.org/vaccines/universally/index.html
• CDC’s Reminder Systems and Strategies for Increasing Vaccination
Rates
– http://www.cdc.gov/vaccines/recs/reminder-sys.htm
• CDC Adult Immunization Improvement Best Practices
– http://www.cdc.gov/vaccines/recs/rate-strategies/adultstrat.htm
• TN Annual Immunization Status Survey of 24 month old Children
– https://twis.tn.gov/twisprod/download/24-month-old_Immunization_Survey_2011.pdf
Technical Assistance Resources
• Catherine Haralson, RN
– Tennessee Immunization Program Manager
– 615-741-7507
• Becky Pearsall, RN
– Adult and Adolescent Immunization Promotion
– 615-532-6608
• Mary Katherine Fortner, RN
– VFC Program Quality Assurance
– 615-532-8509