Idaho Case Study
Strategic Planning Process to Address Tobacco-Related Disparities in Idaho
|Healthy People 2010 Objectives||Increase the number of tribes, territories and states, and District of Columbia with comprehensive, evidence-based tobacco control programs.|
|OSH Indicator||Strategic plan to address tobacco-related disparities.|
|Goals||Identifying and Eliminating Tobacco-Related Disparities|
|Areas of Policy and/or Program Intervention||Identifying and Eliminating Tobacco-Related Disparities|
|Audience/Population||American Indians/Alaska Natives|
Migrant Farm Workers
Young Adults (18–24)
Other: WIC Women, Medicaid Population, Pregnant Women, Bosnian Refugees
Policy/Program Objectives of the Intervention
The objective was for Idaho to create a statewide strategic plan that included priorities for building the capacity to identify and eliminate tobacco-related disparities.
Description of the Intervention
The Idaho Tobacco Prevention and Control Program with funding from the Centers for Disease Control and Prevention partnered with community members to create a strategic plan for identifying and eliminating tobacco-related disparities. Idaho engaged in an 18-month-long process to hire the facilitator, identify an evaluator, identify and recruit workgroup members, gather and organize data, agree on a strategic planning process, conduct environmental scans, create plan goal areas, and adopt a final strategic plan. An inclusive workgroup met three times over six months to develop a strategic plan that was integrated into the state's five-year tobacco plan. In the time allotted, Idaho was successful in developing a plan that included goals, strategies, tactics, lead person responsible and a timeline.
Personnel/Key Players/Resources Required for Conducting the Intervention
Project Director (20% time, in-kind): 576 hours
Facilitator (Contractor): 100 hours
Meeting Secretary (in-kind): 24 hours
Evaluator(Student, in-kind): 100 hrs
Volunteer Workgroup Members: 13 members volunteering 24 hours per month for six months = 1,872 hours, Workgroup members included:
- Shoshone-Bannock Tribes, Tribal Administration
- Nezperce Tribal Health
- Region X Cancer Information Service, Latino Outreach Coordinator
- Idaho Dept. of Health and Welfare, Research Supervisor for Health Statistics
- Diversity Works, Inc., Executive Director
- Woman of Color Alliance, Black Student Alliance (BSU), Center for Health Policy Graduate Assistant
- Public Education and Outreach Coordinator, Bureau of Health Promotion
- Council on Hispanic Education, Tobacco Coordinator
- Northwest Portland Area Indian Health Board, Director of the Northwest Tribal Epidemiology Center
- Coalition for Healthy Idaho, Smokeless States Program Coordinator
- Boise State University, Dean of College of Health Sciences
- American Indian/Alaska Native Leadership Initiative on Cancer, Project Manager
- Idaho Dept. of Health and Welfare, Indian Child Welfare Act Coordinator
- Northwestern Band of Shoshone Nations, Chief Finance Officer
- Northwest Portland Area Indian Health Board, Technical Writer/IRB coordinator, Northwest Tribal Epidemiology
- Your Family, Friends and Neighbors, Executive Board Member
- Idaho Dept. of Health and Welfare, Disparities Project Director
- Idaho Public Health Districts, Council on Health Promotion Supervisors and Surveillance Liaison
- Idaho Dept. of Health and Welfare, WIC Clinical Operations Coordinator
- Idaho Dept. of Health and Welfare, WIC Breast Feeding Promotion Coordinator
- Nezperce Tribe, Executive Council Member
- Idaho Council on Hispanic Affairs, Executive Director
- Idaho Department of Health and Welfare, Primary Care Program Manager
- Idaho Hispanic Caucus, Executive Committee Member
- Cancer Information Service for the Pacific Region, Partnership Program Coordinator
- Research Analyst Supervisor, BRFSS Coordinator, Bureau of Health Policy and Vital Statistics
- Central District Health Department, Office of Epidemiology and Surveillance
- Boise State University, Nursing Department
- Chief Academic Officer, Idaho State Board of Education
- Idaho Commission on Hispanic Affairs, Outreach Reach Coordinator (Youth Group TEENS)
- Idaho Dept. of Health and Welfare, Prenatal Assessment Tracking System Manager
- Nezperce Tribe, Community Health Programs Director
- Idaho Dept. of Health and Welfare, Asthma Program
Place Where the Intervention was Conducted
The strategic planning workgroup represented all geographical areas of the state of Idaho and held meetings in Boise.
Approximate Time Frame for Conducting the Intervention
The strategic planning process was conducted over 18 months. For six months prior to involving other people in the process, the Idaho Tobacco Education and Control Program gathered, reviewed and synthesized all the demographic and tobacco use related data that was available for Idaho. In addition, the Tobacco Program staff began educating community members and community organizations about the CDC grant for disparities strategic planning. Six months were spent laying the framework for recruiting active and committed members to the Disparities Workgroup. In the next three months the strategic planning process was worked out, the facilitator hired, the evaluator identified and workgroup members recruited. Three strategic planning workgroup meetings were held during a six month period. Revision of the final plan took two months and approval of the plan by the state, including publication, took one month.
Summary of Implementation of the Intervention
The intervention was the development of a statewide strategic plan to address tobacco-related disparities in Idaho. Only $45,000 was available in grant funding for required travel to CDC meetings, contracts with a facilitator and evaluator, and workgroup member travel. The time of the project director and secretary were provided in-kind by the Idaho Tobacco Prevention and Control Program. Idaho succeeded in convening a diverse, representative and inclusive workgroup from diverse populations and geographical areas of the state to develop the plan. Plan development was conducted by consensus and the plan was published prior to December 2002 achieving the original timeline.
Summary of Evaluation/Outcome of Intervention
The evaluation sought to document activities, challenges, milestones reached, and lessons learned; to monitor and report on progress toward achieving planning goals; to discuss evaluation results and make recommendations for future efforts. The final evaluation report consisted of a case study that described and interpreted key activities, players, challenges, and lessons learned.
The outcomes of the disparities strategic planning project were—
- Recruitment of a representative, inclusive and diverse workgroup
- Implementation of a respectful, consensus driven process
- Presentation of Idaho specific, population-based data
- Environmental scan of population groups conducted by workgroup members
- Early agreement on five key issues
- Development of a draft strategic plan based on key issues adopted as goal areas
- Revision and adoption of the final strategic plan within the original timeline
Finally the state Department of Health and Welfare approved the final plan and integrated it into its five-year tobacco strategic plan. Because of the success of the disparities strategic planning process, the state earmarked $57,000 in funding towards its implementation in 2003 and hired a half-time disparities coordinator. The Tobacco Disparities Working Group decided to continue to guide implementation of the plan as a project of the Tobacco Free Idaho Alliance.
The evaluation identified four critical elements that were crucial to the success of the project.
- Established relationships of trust that already existed with many populations
- High quality leadership provided by the project director
- Intensive communication between meetings to solicit input and feedback
- Adherence to the principles of participatory planning
Intervention's Applicability/Replicability/Recommendations for Other Sites
This project is particularly applicable to rural states with a large geographic area and a small population. This strategic planning process is especially applicable to states working within a limited budget with a tight timeline. The workgroup developed an extremely effective process that successfully brought together representatives from diverse populations, acknowledged the unique challenges faced by each and outlined goals that would be of benefit to all.
The success of the development of this strategic plan with restricted funding in a short timeframe was dependent on—
- Prior development of an overview and synthesis of all data sources and data available
- Support from the Tobacco Program Manager for the State of Idaho, Department of Health and Welfare, Bureau of Health Promotion
- Ensuring that the voices of all members of the workgroup were heard and valued
The Workgroup was successful at recruiting leadership from the Lesbian/Gay/Bisexual/Transgender community to be involved in the planning process. This was this community's first participation in the tobacco movement and the respectful, inclusive tone of the meetings helped them become strong committed members.
This case study was written by Colleta Reid, an Office on Smoking and Health Consultant, December 2003.
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