Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103849

Jeanne Alongi, MPH¹, Jaya K. Rao, MD, MHS², Lynda A. Anderson, PhD³, Larry Jenkins, MPH¹, Mary Kane, MS⁴, and George-Ann Stokes⁵. (1) National Association of State and Territorial Chronic Disease Program Directors, 4301 Breuner Avenue, Sacramento, CA 95819, 916-452-2440, jeanne@alongi.org, (2) Health Care and Aging Studies Branch, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS K-45, Atlanta, GA 30341, (3) Prevention Research Centers (MS K-45), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Atlanta, GA 30341-3724, (4) Concept Systems Incorporated, 401 East State Street, Suite 402, Ithaca, NY 14850, (5) NCCDPHP/DCPC, CDC, 4770 Buford HWY, NE MS K-57, Atlanta, GA 30341

Objective: Recently, end-of-life (EOL) issues have begun to capture the attention of the public health community. We conducted a project to help state health departments achieve a greater understanding of their potential role in addressing EOL issues and develop initial priorities.

Methods: The project involved 2 phases. Phase I involved a concept mapping process to solicit recommendations from the stakeholders. Concept mapping integrates qualitative group processes (brainstorming and sorting) with multivariate statistical analysis to represent the ideas of stakeholders visually through maps. A key informant approach was used to identify stakeholder participants with expertise in aging, cancer, public health, and EOL issues. In 2 in-person meetings, stakeholders developed short-, intermediate, and long-term recommendations for EOL initiatives based on the maps. Phase II involved a modified Delphi process with three iterations to identify priorities for action from among a group of short-term recommendations.

Results: Phase I resulted in 103 recommendations for EOL initiatives across 9 domains. Phase II resulted in consensus on 5 initial priorities from 3 domains: educating the public about palliative care and the importance of advance directives; identifying an EOL point person in health departments; analyzing and collecting data; and incorporating EOL principles into state comprehensive cancer control plans. The short-term recommendations from Phase I will be compared to 4 Institute of Medicine reports on EOL.

Conclusions: By soliciting diverse perspectives from key public health partners, we have begun developing initiatives to address EOL issues in state health departments and other public health agencies.

Learning Objectives: At the conclusion of the presentation, participants will be able to

• Articulate the relevance of public health to end of life issues.
• Identify appropriate contexts for use of concept mapping and Delphi methodologies for priority activities.
• Describe 5 priorities for public health action in end of life.

Keywords: End-of-Life Care, Public Health

Related Web page: www.chronicdisease.org/EOL%20web%20post.pdf

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation