This document provides an overview of a workshop on population health and community engagement. The workshop uses a case study approach to teach skills for improving population health outcomes. Participants work through the case study in small groups, taking on roles of different stakeholders to understand their perspectives. The goal is for participants to explore collaborative, community-based approaches to address complex health issues like obesity. The workshop guides participants through eight steps, including defining the problem, gathering allies, creating a vision statement, and developing and communicating a strategy. Feedback is solicited on how the case study approach and materials could support training healthcare professionals to work across sectors in transforming health systems.

1. DISCLOSURE: No relevant
financial relationships with any
‘commercial interests’

3. March 17, 2015
@PracPlaybook
Concurrent 5A
A Perfect Storm for Population Health
Denise Koo, MD MPH dkoo@cdc.gov
Lloyd Michener, MD lloyd.michener@duke.edu
Teaching Prevention 2015 | Charleston, SC

4. At the conclusion of this session,
participants should be able to:
• Describe the forces that are coming together for
population health improvement and the
opportunities
that are enabling these partnerships to succeed
• Discuss innovative tools for those in the field to
utilize
in their population health efforts

5. What is population health?

6. Definition of population health
“The health outcomes of a group of
individuals, including, the distribution
of such outcomes within a group”
David Kindig and Greg
Stoddart

7. Why does
population health matter?

8. Why does population health
matter?

9. Why does population health
matter?

10. State Rankings: Healthiness v. Cost

11. State Rankings: Healthiness v. Cost

12. Why does population health
matter?
http://www.countyhealthrankings.org/

13. Why does population health
matter?

14. Why does population health
matter?

15. Percent Difference Between Medicaid Recipients
Enrolled in CCNC and Those Not Enrolled in CCNC,
for Rates of Asthma-Related Emergency Department
Visits and Inpatient Admissions, 2008–2012
Note. CCNC, Community Care of North Carolina. NCMJ September/October 2013, Volume 74, Number 5

16. APTR Population Health Framework
Components

17. SIM Opportunities/Awardees

19. • What are the roles of health care providers
in this health landscape change?
• What are the key knowledge, skills, and
attitudes needed for this change?
Your Thoughts . . .

20. A Practical Playbook:
Public Health and Primary Care Together
http://practicalplaybook.org/

21. Practical Playbook Overview
Practical Playbook Overview

22. The de Beaumont Foundation
• Training the public health workforce
• Building the public health infrastructure
• Improving information and data management

23. Where we’ve been and where we’re
going…Practical Playbook Phase II
• In Phase I, the de Beaumont Foundation, Duke
Community and Family Medicine, and the
Centers for Disease Control and Prevention
launched the Practical Playbook website.
• In our first year of experience with the Practical
Playbook website, it became evident that most
primary care and public health groups need
additional, hands-on guidance in order to
integrate.

24. Where we’ve been and where we’re
going…Practical Playbook Phase II
• To address that challenge, plans were developed
for Phase II of the Practical Playbook.
• The de Beaumont Foundation has committed $5.76
million to fund Phase II of the Practical Playbook.

25. The Practical
Playbook
• Use in public health and
medical training
curricula
• Curriculum Competitions
and Learning Prizes
• Video content
• eBooks

26. • How do we find effective tools to help our learners
learn how to share, collaborate, and rely on the
strengths of others in this changing environment?
• How do we work as a team to achieve this change
in health care?
Your Thoughts . . .
Our task: To partner with communities to
accomplish what they want and need for improved
health outcomes.

27. Doing things differently…
“We cannot solve our
problems with the
same thinking we used
when we created
them”
— Albert Einstein

28. Case Study in Community
Engagement and Improving
Community Health

29. Agenda
• Overview of case study
• Background

30. Background
• Origin of case study: CDC Experience Applied
Epidemiology Fellowship for medical students
• Purpose: empower graduates to participate
collaboratively in community health
improvement (not just within health care
system)

31. Background
• Additional goal: skill-building in leadership
and being change agents
• Critical need: persons with systems thinking
and approaches to solve complex problems
that span the health system

32. Workshop Approach
• Use at CDC: mixed groups of participants
• One-day workshop with small groups
• Facilitators with varied backgrounds
(public health, medical)

33. Workshop Approach
• Need: your feedback on utility of case study
and materials to prepare workforce for health
system transformation
- Format
- Content
- Settings for use

34. Goal of Workshop
• Apply leadership skills and systems thinking
skills to explore novel, population-based
approaches for improving health outcomes
• Introduction/Reflection for participants:
Why did you come today? Does this apply to
your work?

35. Learning Objectives
• Explore the root causes of a complex
health problem
• Identify key values and a shared vision as
guiding principles for community action
• Reflect on how the leadership and systems
thinking skills used to explore this case study
could be applied to your work

36. The Story
• Widowed mother of 3; deceased husband
was
trucker who had MI, smoker
• Children all obese, low physical activity, cared
for by sedentary, overweight grandmother
while mother is at work
• Mother works for fast food company, brings
leftovers home

37. Recap the Story
• What is the problem?
• Is this a preventable problem? (but why?)

38. The Eight “Easy” Steps
For Community Health Improvement
1. Getting Things Started
2. Building a Case
3. Gathering Allies
4. Identifying Stakeholders
5. Walking a Mile in Someone Else’s Shoes
6. Creating a Compelling Vision
7. Developing a Strategy
8. Communicating Your Vision and Mission

39. 1. Getting Things Started
• What do you think of this story? Can you
relate to it based on your own experience?
• Why should we care about obesity in our
communities?
• Whose problem is it? Should health
professionals care about this? If so, why?

40. 1. Getting Things Started
• What are societal impacts of this problem
right now? What will they be if it continues
to grow?
• What do we know about obesity?

41. 1. Getting Things Started
Resources
• Robert Wood Johnson Foundation

42. 2. Building a Case
• Characterize the problem
• What information and data do we need to
ensure the problem of obesity is compelling,
worthy of action, and preventable?

43. 2. Building a Case
• What information and data will provide the
strongest evidence as we build a case for
tackling the problem of obesity in the
community?
• What leadership skills will the clinician and
public health leader need for success?

44. 2. Building a Case
Resources
• Practical Playbook: Finding data
• The Community Tool Box: Analyzing Problems and Goals toolkit

45. 3. Gathering Allies
• What is the difference between “allies”
and “stakeholders”?
• What is the importance of creating alliances
to aid in tackling this problem?
• Who are some people or groups that might
share your desire for change?

46. 3. Gathering Allies:
Resources
• “Tactics for Communicating”

47. 4. Identifying Stakeholders
• Who are some people or groups that are
impacted by obesity?
• If obesity continues on its current path
without an intervention, what groups of
people may be impacted in the future?

48. 4. Identifying Stakeholders
Resources
• Practical Playbook: Community Engagement

49. 5. Walking a Mile in Someone
Else’s Shoes
• The purpose of this step is for participants
to consider unique perspectives and what
someone with this perspective would see as
their goal.
• Each person will play the role of someone
listed as a stakeholder in the previous step

50. 5. Walking a Mile in Someone
Else’s Shoes
• This subset of stakeholders has formed
a coalition team and this is their first meeting
• Take turns sharing the perspectives that
need to be considered as you continue
through the rest of the steps of the case study

51. • Clinician
• Public Health Leader
• Person with Diabetes
• City Council Representative
• Physical Education Teacher from Local
School
• Chamber of Commerce Representative
• United Way Representative
• Others?
5. Walking a Mile in Someone Else’s Shoes
Character Sketches

52. • Name
• Your Agenda
• Motivation
• Friends and Foes (“turf tension”)
• What you hope to achieve
• Questions to consider: Obstacles, resources
needed, resources to offer
• Notes to make it more “real”
5. Walking a Mile in Someone Else’s Shoes
Rubric for Character Sketches

53. 5. Walking a Mile in Someone Else’s Shoes
Resources

54. 6. Creating a Compelling Vision
• Wrap up from prior step: Reflection
• Why is it important to have a vision
statement?
• What are some personal goals that can
contribute to the shared vision?

55. 6. Creating a Compelling Vision
• What words are needed to ensure the
vision statement inspires action and enables
innovation?

56. 6. Creating a Compelling Vision
Resources
• Practical Playbook: Aligned Leadership
• The Community Tool Box: Developing Vision and Mission
Statements

57. 7. Developing a Strategy
• What are the plans and priorities for moving
forward?
• Who is needed to carry out the strategy and
what do they need to do?

58. 7. Developing a Strategy
• What are some key milestones that must be
met in the first 12 months of the project to
assure the effort is making a difference?

59. 7. Developing a Strategy
Resources
• Practical Playbook: The Role of Early Wins
• The Community Tool Box: Developing an Intervention

60. 8. Communicating Your Vision
and Mission
• What is your mission statement? Is it:
- Concise
- Outcome-oriented
- Inclusive

61. 8. Communicating Your Vision
and Mission
• Who, or what groups, do you need to inform,
persuade, coerce, convince, and solicit to
ensure you attain the momentum needed in
the community to bring about desired and
sustainable change?

62. 8. Communicating Your Vision and Mission
Resources
• Practical Playbook: Celebrate/Share

63. Closure/Reflection: Workshop
• What was most surprising/important?
• What leadership tactics/practices contributed
to success?

64. Closure/Reflection: Workshop
• What character made the contribution to help
you gain insight?
• Did you change your mind about an approach
or a particular stakeholder?

65. Workshop Feedback
• How could you apply this in your home
community and state?

66. Workshop Feedback
• How might this exercise be used to support
community health improvement processes?
- What materials are most useful?
- How might the exercise be improved?
- Would a “Meeting in a Box” facilitate the initiation
of this work?

67. • Guidance for this integration work can be found
in the Practical Playbook and the other resources
we have shared with you. Are there other
resources that you are aware of to support it?
• There are national conversations happening
around best practices for this work – let’s
continue to share!
Your Thoughts . . .

68. Other questions?

69. For more information,
connect with us on social media.
Follow us: @PracPlaybook
Like our page: Practical Playbook
Follow us: Practical Playbook
Follow us: Practical Playbook
https://practicalplaybook.org/