What To Do

Now that you have identified subproblems that need to be addressed, you need to understand these problems in more detail. You should now conduct more primary or secondary research (descriptive epidemiology).

As with the original problem described in Step 1.1, your ability to describe each subproblem completely is important. This will help you to determine later if and how you might intervene in the problem.

How To Do It

Describe each subproblem in more detail. These descriptions are important to:

• assist in understanding the size and impact of the subproblem
  
• create ideas about how to reduce the impact of the subproblem and the causes of the problem
  
• describe the subproblem clearly to others, including potential partners and stakeholders
  

You can create a picture of the health issue for each subgroup by answering some important questions:

• Who is affected? What makes each subgroup different?
  
• How are members of each subgroup affected?
  
• What general health, environmental, or social conditions are connected to the subproblem?
  
• How common is the subproblem?
  
• How severe is the subproblem?
  
• Where does the subproblem exist geographically?
  
• When and where does the subproblem start?
  
• What trends are related to the subproblem?
  
• Are the resources of your organization big enough to address the subproblem for each subgroup?
  
• Are there other groups who are interested and available to address the subproblems?

You may also want to consider how to address the health problems of each identified subgroup by completing a Changeability Table.

List each problem according to:

• degree of importance (more or less important)
  
• degree of changeability (more or less changeable)

Deciding on the importance of the subproblem(s) and the possible impact of each subproblem will be helpful in writing a description of each subproblem that may require intervention.

Sources

You can describe the subproblem(s) with help from various sources:

Data and information from CDC's website: (http://www.cdc.gov)

• Morbidity and Mortality Weekly Report (http://www.cdc.gov/mmwr/)
  
• Behavioral Risk Factor Surveillance System (http://www.cdc.gov/brfss/)
  
• National Center for Health Statistics (http://www.cdc.gov/nchs/)
  
  

Data and information from other agencies' websites

• Department of Health and Human Services (http://www.os.dhhs.gov)
  
• Department of Justice (http://www.usdoj.gov)
  
• National Highway Traffic Safety Administration (http://www.nhtsa.gov)
  
  

Secondary literature cited in bibliographic databases

• MEDLINE
  
• PSYCINFO
  
• AGELINE
  
• CANCERLIT
  
• UNCOVER
  
• AIDSLINE
  

  Many of these databases can be accessed through the National Library of Medicine's website http://www.nlm.nih.gov.

Statistical Abstracts of the United States Census (http://www.census.gov)

National surveys

Roper Center for Public Opinion Research (http://www.ropercenter.uconn.edu) *

Vital statistics reports and monographs from state health departments

Reports of federal and state agencies

Partners (for example: foundations, associations, drug companies)

Epidemiologists in your organization

Collection of original data using various methods (See Tools for Research)

When you have a better understanding of each subproblem, your next step is to look at the factors or variables that can affect the direction of your project.