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CDC Policy Process

Overview

Introduction

Policy is one potentially effective way to improve the health of populations.

This document provides public health practitioners with a summary of the domains of the CDC policy process (See Figure 1). The goal of this overview is to foster a common understanding of what policy is and the process by which it is conceptualized, developed, adopted, and evaluated. Policy development is rarely a linear process; often the domains of the policy cycle overlap or occur out of order. However, in the ideal scenario, a problem is defined, potential policy solutions are identified, analyzed, and prioritized, and the best solution is adopted and evaluated.

Public health professionals play an important role in the policy process, for example, by conducting policy analysis, communicating findings, developing partnerships, and promoting and implementing evidence-based interventions. The intended audience for this document is CDC staff; therefore, we have highlighted the potential role of CDC for each of the policy domains. The secondary audience is CDC grantees and public health partners who may find this document useful in their efforts to translate evidence and science into policy. Note that federal law prohibits lobbying related activities by CDC at the federal, state and local level. There may be other restrictions on lobbying related activities of which public health professionals should be aware.


"Policy" is defined as a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions. CDC guidelines and recommendations are examples of CDC policies.


Figure 1 Policy Process

CDC’s Policy Process consists of the following domains: problem identification, policy analysis, strategy and policy development, policy enactment.  The process also has two overarching domains that should be considered throughout the policy cycle: stakeholder engagement and education and evaluation. no where no where no where I. Problem Identification: Clarify and frame the problem or issue in terms of the effect on population health. Stakeholder Engagement and Education IV. Policy Enactment: Follow internal or external procedures for getting policy enacted or passed. no where III. Strategy and Policy Development: Identify the strategy for getting the policy adopted and how the policy will operate.  V. Policy Implementation: Translate the enacted policy into action, monitor uptake, and ensure full implementation. no where II. Policy Analysis: Identify different policy options to address the problem/issue and use quantitative and qualitative methods to evaluate and the policy options to determine the most effective, efficient, and feasible option. Evaluation

Domain Descriptions

Potential Role of CDC*: Collect and analyze data and information related to the problem or issue; synthesize historical context around problem or issue.

I. Problem Identification: Clarify and frame the problem or issue in terms of the effect on population health.
  • Collect, summarize, and interpret information relevant to a problem or issue (e.g., nature of the problem, causes of the problem)
  • Define the characteristics (e.g., frequency, severity, scope, economic and budgetary impacts) of the problem or issue
  • Identify gaps in the data
  • Frame the problem or issue in a way that lends itself to potential policy solutions


Potential Role of CDC*: Review literature and conduct an environmental scan to identify and describe policy options; assess policy options according to health impact, feasibility, and economic and budgetary impacts; model potential health, economic and budgetary impacts of policies; identify evidence-based policy solutions and gaps in the evidence base.

II. Policy Analysis: Identify different policy options to address the problem/issue and use quantitative and qualitative methods to evaluate and the policy options to determine the most effective, efficient, and feasible option.
  • Research and identify policy options
  • Describe: a) how the policy will impact morbidity and mortality (health impact), b) the costs to implement the policy and how the costs compare with the benefits (economic and budgetary impacts) and c) the political and operational factors associated with adoption and implementation (feasibility)
  • Assess and prioritize policy options







Potential Role of CDC*: Provide science and evidence to inform policy development; draft federal guidelines, regulations, standards, and organizational policies

III. Strategy and Policy Development: Identify the strategy for getting the policy adopted and how the policy will operate.
  • Identify how the policy will operate and what is needed for policy enactment and implementation (e.g., understand jurisdictional context and identify information and capacity needs
  • Define strategy for engaging stakeholders and policy actors
  • Possibly draft the policy (law, regulation, procedures, actions, etc.)


Potential Role of CDC*: Monitor policy enactment by others, enact regulation, publish guidelines and recommendations, enact procedures, administrative actions, incentives and voluntary practices

IV. Policy Enactment: Follow internal or external procedures for getting policy enacted or passed
  • Enact law, regulation, procedure, administrative action, incentive, or voluntary practice









Potential Role of CDC*: Build capacity of states, territories, tribes, and communities to implement policy (e.g., education, training, technical assistance, guidance); support post-implementation sustainability of policy (e.g., continued educational efforts)

V. Policy Implementation: Translate the enacted policy into action, monitor uptake, and ensure full implementation.
  • Translate policy into operational practice and define implementation standards
  • Implement regulations, guidelines, recommendations, directives and organizational policies
  • Identify indicators and metrics to evaluate implementation and impact of the policy
  • Coordinate resources and build capacity of personnel to implement policy
  • Assess implementation and ensure compliance with policy
  • Support post-implementation sustainability of policy



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Overarching Domains

Potential Role of CDC*: Identify and engage relevant individuals and organizations throughout the process (e.g., provide information and education on the state of the science); assess needs and gather information throughout the process (e.g., understand how a problem is defined, identify barriers and solutions to policy implementation or enforcement)

Should be considered as appropriate through all domains.

Stakeholder Engagement and Education: Identify and connect with decision-makers, partners, those affected by the policy, and the general public.

  • Identify key stakeholders, including supporters and opponents (e.g., community members, decision-makers, nonprofit, and for-profit agencies)
  • Assess relevant characteristics (e.g., knowledge, attitudes, needs)
  • Implement communication strategies and deliver relevant messages and materials
  • Solicit input and gather feedback



Potential Role of CDC*: Evaluate the process, impact, and outcomes of the policy; build the capacity of others to evaluate policy (e.g., training and technical assistance); use evaluation results to inform the evidence base.

Evaluation: Formally assess the appropriate steps of the policy cycle, including the impact and outcomes of the policy.

  • Define evaluation needs, purpose, and intended uses and users
  • Conduct evaluation of prioritized evaluation questions (e.g., was the problem defined in a way that prioritized action, how were stakeholders engaged, is the policy being implemented as intended, what is the impact of the policy)
  • Disseminate evaluation results and facilitate use


* The text boxes are only intended to provide clarifying examples; these are not intended to list all of the roles CDC can play. Please note that federal law prohibits certain lobbying related activities by CDC at the federal, state and local level.


CDC’s Policy Process


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  • Office of the Associate Director for Policy
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