Assessment of the Healthy People Objective-setting Framework and Process

Assessment of the Healthy People Objective-Setting Framework and Process

Each decade since 1979, the U.S. Department of Health and Human Services (HHS) has published a comprehensive set of national public health objectives. Known as Healthy People, this initiative has been grounded in the notion that setting objectives and monitoring progress can motivate action. As it prepares to produce objectives for the next decade, the HHS Office of Disease Prevention and Health Promotion (ODPHP) in the Office of Public Health and Science (OPHS) seeks to ensure that the objectives are scientifically valid, relevant, sustainable, and reasonably limited in number. To gain an independent perspective on how best to achieve these aims, OPHS/ODPHP contracted with NORC at the University of Chicago to conduct the Assessment of the Healthy People Objective-setting Framework and Process.

The goal of the assessment was to provide OPHS/ODPHP with options for choosing a framework (a theoretical structure for organizing the content of objectives) and a process for developing the objectives. Elements of the project included reviewing the successes and shortcomings of three previous iterations of national health objectives (1990 Health Objectives for the Nation, Healthy People 2000, and Healthy People 2010); examining other national and international objective-setting processes; and convening a technical panel of subject-matter experts to help draft a model for developing 2020 objectives. The final product of the assessment is a report that:

Recommends guiding principles for setting health objectives for the year 2020;
Identifies criteria that could be used to evaluate whether particular health objectives should be included in the initiative;
Identifies a process that could be used to develop the draft set of health objectives;
Suggests a method for organizing and winnowing the set of health objectives.

NORC convened a multi-disciplinary technical expert panel to provide input into principles and processes for preparing national objectives. The panel’s work took place at four in-person meetings and via numerous teleconferences and workgroups. Discussion was encouraged to reach agreement on major decision points, and a web-based Delphi process was used to build consensus on certain elements of the draft model.

NORC sought additional input from fifteen public health experts in five subject areas (they testified on critical public health trends for the coming decade; using new technologies to facilitate tracking and maintenance of objectives; strategies to engage a broad group of stakeholders; local and state issues; and involving federal agencies in Healthy People 2010). NORC also conducted key informant interviews with HHS staff who had participated in past iterations of the Healthy People program.

Once a draft model had been created, NORC sought the input of state Healthy People coordinators through focus groups. The draft model was also made available for public comment during late 2006 and early 2007 using a public comment website as well as a wiki website. NORC presented its work at the 2006 American Public Health Association Annual Meeting and to the Assistant Secretary of Health. A draft report has been prepared to present potential options for a framework to structure the content, and approaches to guide the development of national health objectives for the year 2020.