Cancer, Cardiovascular Disease and

Pulmonary Disease (CCPD)

Review Committee

Stakeholder Input

Colleen Kapsimalis, MPH

January 13, 2012

colleen.kapsimalis@state.co.us

Why stakeholder input?

• Stakeholder feedback will inform CCPD Review Committee members as they determine funding priorities and a strategic approach

• Goal is to develop a strategic budget that is:

▫ Data-driven

▫ Evidence-based

▫ Compliant with the legislative requirements

▫ Aligned with the role and functions of public health

Stakeholder Input Methods

• CCPD Review Committee Stakeholder Feedback Survey

• Public Comment by stakeholders regarding the strategic direction of the CCPD grants program (January 13, 2012)

CCPD Review Committee

Stakeholder Feedback Survey

• Survey developed by Epidemiology, Planning

and Evaluation Branch of CDPHE’s Prevention Services Division based on discussion by CCPD Review Committee members

• Contained both quantitative and qualitative questions

• Survey administered to stakeholders between December 19, 2011 and January 6, 2012

• 192 respondents started survey; 157 respondents completed survey

Survey Results Stakeholder groups represented

Response Count

Question 1: Please select the stakeholder group that best represents your organizations (select all that apply).

Disease areas of primary interest

Question 3: CCPD Review Committee awards grants in three disease areas. Which of the following is your primary interest? If cross-cutting, select all that apply.

Disease areas in which stakeholders are most

likely to apply for funding

Question 4: In which of the following disease areas of the CCPD Review Committee would you be most likely to apply for CCPD funding?

Question 5: How would you describe the main prevention focus of your organization?

Main prevention focus of organization

Prevention strategies in which stakeholder is most likely

to apply for CCPD funding

Question 6: In which of the following prevention strategies would you most likely to apply for CCPD funding? Select all that apply.

CCPD strategic direction BEFORE ACA implementation

Question 7: ….Please select which of the options below you feel the CCPD Review Committee should consider BEFORE ACA implementation.

CCPD strategic direction AFTER full ACA implementation (2014)

Question 8: ….Please select which option below you feel the CCPD Review Committee should consider AFTER 2014 and full ACA implementation.

Support for CCPD prioritizing funding for primary

prevention strategies

Question 9: If the CCPD Review Committee were to move toward prioritizing funding for primary prevention strategies, would you support this change?

Ability to compete for CCPD funding

18.8%

13.9%

18.8%

13.9%

29.7%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

1 Will not impact ability 2 3 4 5 Will greatly impact ability

Question 10: If the CCPD Review Committee were to move towards prioritizing funding for primary prevention strategies, please rate how this would impact your ability to compete for CCPD funding.

18.8%

10.3%

21.8%

15.8%

28.5%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

1 Will not impact ability 2 3 4 5 Will greatly impact ability

Ability to implement primary prevention strategies

Question 11 If the CCPD Review Committee moves toward prioritizing funding for primary prevention strategies, please rate how this will impact your ability to implement primary prevention strategies.

Survey Results from

Current and Past Grantees

• 20 respondents identified themselves as current grantees

• 53 respondents identified themselves as past grantees

Disease areas of primary interest

Question 3: CCPD Review Committee awards grants in three disease areas. Which of the following is your primary interest? If cross-cutting, select all that apply.

Current Grantees Past Grantees

Disease areas in which stakeholders are most

likely to apply for funding

Question 4: In which of the following disease areas of the CCPD Review Committee would you be most likely to apply for CCPD funding?

Current Grantees Past Grantees

Question 5: How would you describe the main prevention focus of your organization?

Main prevention focus of organization

Current Grantees Past Grantees

Prevention strategies in which stakeholder is most likely

to apply for CCPD funding

Question 6: In which of the following prevention strategies would you most likely to apply for CCPD funding? Select all that apply.

Current Grantees Past Grantees

CCPD strategic direction BEFORE ACA implementation

Question 7: ….Please select which of the options below you feel the CCPD Review Committee should consider BEFORE ACA implementation.

Current Grantees Past Grantees

CCPD strategic direction AFTER full ACA implementation (2014)

Question 8: ….Please select which option below you feel the CCPD Review Committee should consider AFTER 2014 and full ACA implementation.

Current Grantees

78.9%

Past Grantees

Support for CCPD prioritizing funding for primary

prevention strategies

Question 9: If the CCPD Review Committee were to move toward prioritizing funding for primary prevention strategies, would you support this change?

Current Grantees Past Grantees

Ability to compete for CCPD funding

18.8%

13.9%

18.8%

13.9%

29.7%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

1 Will not impact ability

2 3 4 5 Will greatly impact ability

Question 10: If the CCPD Review Committee were to move towards prioritizing funding for primary prevention strategies, please rate how this would impact your ability to compete for CCPD funding.

Overall Past Grantees

19.6%

11.8%

19.6%

9.8%

37.3%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

1 Will not impact ability

2 3 4 5 Will greatly impact ability

18.8%

10.3%

21.8%

15.8%

28.5%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

1 Will not impact ability

2 3 4 5 Will greatly impact ability

Ability to implement primary prevention strategies

Question 11 If the CCPD Review Committee moves toward prioritizing funding for primary prevention strategies, please rate how this will impact your ability to implement primary prevention strategies.

Overall

23.5%

7.8%

15.7%

19.6%

33.3%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

1 Will not impact ability

2 3 4 5 Will greatly impact ability

Past Grantees

General Conclusions

• Slightly less than half (42.9%) of all respondents identified primary prevention as their main prevention focus

• When deciding how to proceed before and after ACA implementation, the majority of stakeholders suggested to make incremental increases in funding for primary prevention strategies while continuing to support secondary and tertiary prevention,

• The majority (79.5%) of respondents answered “yes” to supporting CCPD prioritizing primary prevention strategies.

Qualitative Data Results • 48 survey respondents provided written

comments

• Overall findings

▫ Support for funding primary prevention strategies

▫ Include funding for primary, secondary, and tertiary prevention strategies

▫ Definitions of prevention levels

▫ Evidence-based practices

▫ Focus on specific populations

▫ Application review

Support for funding primary

prevention strategies

“Prevention and wellness have been a major focus of our organization, but it has been difficult to find funding for much beyond small pilot programs. We would welcome a change in emphasizing primary prevention as a way to take what we’ve done and learned to a larger population.” –Survey Respondent, 1/6/12

Include funding for primary, secondary,

and tertiary prevention strategies

“This competitive grants program should provide funding for a wide variety of evidence-based projects and services that the public health community and groups are willing, enthusiastic and able to take on in order to reduce the burden of chronic disease, including primary, secondary, and tertiary prevention.” –Survey Respondent, 1/6/12

Definitions of prevention levels

• Important to be specific and clear about definitions for primary, secondary, and tertiary prevention levels

• Necessary to be in agreement about prevention level definitions

Evidence-based practices

“The evidence for primary prevention for several conditions/diseases are lacking or not from rigorous bodies of evidence. My understanding is that the CCPD program is for the implementation of strong evidence (those based on meta-analysis, systematic reviews and randomized-controlled trials) versus performing research.” –Survey Respondent, 12/19/11

Focus on specific populations

• Underinsured or uninsured residents

• Lesbian, Gay, Bisexual, Transgender (LGBT) community

• Marginalized, hard-to-reach populations

• Populations impacted by health disparity

• Populations impacted by social determinants of health

Application review process

• Fund the best proposed interventions

• Competitive process

• Restore previously approved grants

Overall lessons learned

• Support for funding primary prevention strategies in addition to maintaining funding for secondary and tertiary prevention strategies

• Necessary to clearly define prevention levels and evidence-based practices