Choose Effective Policies and Programs
The key concepts below can guide you in creating a balanced portfolio of community-based interventions as you choose effective policies and programs. Also, keep in mind that you will need to Evaluate Actions and the outcomes of these interventions.
When selecting policy and program interventions to address your CHI priorities, consider a combination of activities that address socioeconomic factors, the physical environment, health behaviors, and clinical care to maximize your impact.
- A coordinated plan of action and alignment, where partners may pursue different but complementary activities that are consistent with their strengths and capacities, is developed
- A selection of evidence-informed interventions from databases that have a clear ratings system, and can match the unique populations and stakeholders to appropriately matched interventions, is identified
- Activities and actions chosen for implementation include a mix of individual-based, environmental-change, and policy/systems-change interventions
- Where evidence is lacking, select new and innovative solutions, combined with adequate resources for impact evaluations (see Evaluate Actions section)
Tools for Getting Started
Tools are listed below in an order roughly aligned with the order of the key concept(s) they support above.
For developing a plan of action and alignment:
Upstream Investment Resolution of Alignment Template External
- Click on the Resolution of Alignment Template for a declaration that can be filled out with your partners to confirm the mission, vision, goals, and indicators for your collaborative effort.
Action Plan Worksheet External
- This customizable template can help you create a detailed action plan organized by goals, objectives, and activities with expected results.
Action Plan Form Cdc-wordExternal
- This template can be populated with a breadth of detail ranging from priority issues and audiences to interventions already at work in the community, allowing you to better understand and address Community Health Needs Assessment priorities and meet the needs of your community.
Developing Strategic and Action Plans External
- Go to the Outline and Examples tabs for guidance for developing a vision, mission, objectives, strategies, and action plan for your CHI effort(s).
For selecting evidence-informed interventions
Database of Interventions
- This interactive database will help you create a balanced portfolio of evidence-based strategies focusing on four action areas for the greatest impact on community health: socioeconomic factors, physical environment, health behaviors, and clinical care. This database currently includes interventions that address determinants of health associated with greatest disease burden in the United States.
For choosing a mix of individual-based, environmental-change, and policy/systems-change interventions:
A Practitioner’s Guide to Advancing Health Equity—Selecting, Designing, and Implementing Strategies Cdc-pdf
- Go to pages 22–25 for a collection of health-equity considerations for policy, systems, and environmental strategies. Included are questions to consider and examples of how to integrate health equity into local practice.
Policy, Systems, and Environmental Strategies Decision-making Resource Cdc-pdfExternal
- This resource provides information on how to select, carry out, and evaluate policy, systems, and environmental strategies for population health programs and interventions.
For evaluating new and innovative interventions:
A Conceptual Framework for Planning and Improving Evidence-Based Practices
- This framework provides guidance on how to identify and build an evidence base for best practices. Included are a conceptual framework for defining best practices and questions to consider when assessing quality of evidence and impact.
Relevant Excerpts from the Internal Revenue Service (IRS) Final Rule
The IRS Final Rule on Community Health Needs Assessments (CHNA) for Charitable Hospitals Cdc-pdfExternal contains language related to select key concepts above. An excerpt of this language is provided below. To see the full regulation, click on the hyperlinked references below this paragraph.21
The “final regulations adopt the proposed provision allowing for joint implementation strategies.”22 “[S]uch collaboration is an important way to conserve resources, promote cross-system strategies, and yield better outcomes.”23 This “approach [also] avoids the need to create duplicative separate documents while still ensuring that information for each hospital facility is clearly presented.”24
“These needs may include, for example, the need to address financial and other barriers to accessing care, to prevent illness, to ensure adequate nutrition, or to address social, behavioral, and environmental factors that influence health in the community.”25
Note: The above statements do not constitute legal advice or regulatory guidance from CDC. Questions regarding the application of law to a specific circumstance or circumstances should be submitted to an attorney or other qualified legal professional.
21Additional Requirements for Charitable Hospitals; Community Health Needs Assessments for Charitable Hospitals; Requirement of a Section 4959 Excise Tax Return and Time for Filing the Return, 79 Fed. Reg. 78,953 (December 31, 2014) (to be codified at 26 C.F.R. pts. 1, 53, and 602), available at IRS Final Rule on Community Health Needs Assessments (CHNA) for Charitable Hospitals Cdc-pdfExternal .
22Id. at 78,970.
25Id. at 79,002.