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MCH Federal/State Partnership Meeting October 2005 Robert J. Nystrom Adolescent Health Manager

Development and Use of the Brief Local Health Department Adolescent Health Capacity Assessment Tool. MCH Federal/State Partnership Meeting October 2005 Robert J. Nystrom Adolescent Health Manager Office of Family Health Oregon Department of Human Resources. Oregon Adolescent Health.

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MCH Federal/State Partnership Meeting October 2005 Robert J. Nystrom Adolescent Health Manager

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  1. Development and Use of theBrief Local Health Department Adolescent Health Capacity Assessment Tool MCH Federal/State Partnership Meeting October 2005 Robert J. Nystrom Adolescent Health Manager Office of Family Health Oregon Department of Human Resources

  2. Oregon Adolescent Health • State Title V, Office of Family Health (OFH), Public Health Services, Oregon Department of Human Services (DHS) • Coordinator (1994-1999) • Adolescent Health Section (2000-Present) • School-Based Health Centers • Coordinated School Health (Healthy Kids Learn Better) • Teen Pregnancy Prevention • Nutrition & Physical Activity • Resources • 10 staff total [Manager (1), Program (8), Support (1)] • Combined budget ($4.0M per biennium)

  3. Oregon

  4. Oregon Adolescents • About 21.0% (742,803) of the Oregon population is between the ages of 10 and 24 • Racially and ethnically more diverse compared to population as a whole • Almost 33% of all adolescents age 18 to 24 report not having any kind of health care coverage • 1 in 4 adolescents report forgone care in the last year • 1 in 2 did not see their primary care provider for a well adolescent check in the last year

  5. Wild, Wild West

  6. Think Globally, Act Locally • Same Thinking – Local Level • Reframe the Question • Would not the local health department’s ability to focus on multiple adolescent health issues/priorities be reflective of their local-level public health capacity to address adolescent health ???

  7. Local Health Department (LHD) • County system of public health authority • 36 counties, 35 public health authorities • LHD Annual Plan (contract) • Adolescent Health Program Element • Assessment (28 health issues/areas) • Technical Assistance requests • Funding streams • Title V CAH flexible funds • Program funds (e.g. SBHCs)

  8. What Don’t I Know? • What is the real capacity for Oregon’s local health departments to… • focus specifically on the adolescent health population • participate in local activities and planning efforts ….in order that we in Oregon may be more successful in improving our adolescent health outcomes?

  9. Development • Phase I Design • Phase II Initial Drafting • Phase III Pilot Test / Revision • Phase IV Roll-Out / Data Collection • Phase V Analysis / Reporting • GOAL: <2hr Self-Assessment, 80% response

  10. Capacity Assessment Packet • Cover letter (1-page) • Request & rationale • Instructions (1-page) • Tool (1-page) • Definitions of terms (2-pages) • Resources (1-page) [plus copies of Conceptual Framework & National Initiative Guide] • Ten essential health services to promote adolescent health matrix (1-page)

  11. Design/development Pilot/communications Final revisions Mail -LHD administrators Telephone follow-up Completion due by Data entry/analysis Follow-up Preliminary report Final report June -Aug 2004 Sept-Oct 2004 Nov-Dec 2004 December 2004 January 2005 March 2005 Mar-May 2005 Mar-May 2005 Jun-July 2005 Aug-Sept 2006 Roll-Out / Data Collection

  12. Analysis / Reporting • Excel data entry template • Stratification decisions • County size • Qualitative assessment limitations • Self-report / subjective • Local-level variability of teams • Lack of comparisons / standard

  13. Results • Participation • 27 of 35 LPHA had responded (77%) • Overall Capacity • Mean 57% (total of 34 of 60 possible points) • Range 17-87% • Sections Elements Mean • Formal commitment 1,2 2.2 (55%) • Effective partnership 3,4,5 2.5 (63%) • Plan and evaluate 6,7,8,9 2.1 (53%) • Policy and advocacy 10,11 2.3 (58%) • Data systems 12,13 2.3 (58%) • Technical assistance 14,15 2.5 (63%)

  14. Results • Highest rated element questions • Q. 3 Formal/informal partnerships 3.0 (75%) • Q. 5 Youth serving partnerships 3.0 (75%) • Q.11 Advocacy efforts 2.6 (65%) • Q.14 Public education 2.6 (65%) • Lowest rated element questions • Q. 4 Family/youth partnerships 1.8 (45%) • Q. 9 Evaluation strategies 1.9 (48%) • Q. 6 Monitor needs/assets/assessments 2.0 (50%) • Q. 10 Policy development 2.0 (50%)

  15. Results • Variability found within some capacity areas • Partnerships • High informal (3.0) • Low family and youth involvement (1.8)

  16. Results

  17. Potential Outcomes • Local Health Departments have a measure of their current capacity and a baseline for future assessment / evaluation • Promote dialogue and improvement of systems capacity at the local level • State Public Health has local capacity assessment data to seek funding and to plan resource allocation • State Public Health has better ability to plan and focus technical assistance for adolescent health to Local Public Health authorities

  18. What It’s Really All About… • To promote the health of all adolescents in Oregon…

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