Partnerships, gender focus, and systems change: Measuring program performance with Healthy People 2010 Goals

Background: Diverse partners, University of Utah, Utah State Health Department, Association for Utah Community Health and Utah Navajo Health System responded to an Office on Women's Health grant entitled: Advancing System Improvements to Support Targets for Healthy People 2010 (ASIST 2010). Using HP2010 objectives, we measured improvements in exercise and nutrition, health information delivery, and diabetes treatment using a gender focus. Programmatic components included: • Developing health information infrastructure to circulate information for patients and providers on diabetes and cardiovascular disease and a public library-clinic partnership to disseminate health information with the help of trained librarians; and • Providing direct interventions at community health clinics: diabetes prevention interventions to improve diet and exercise using previously validated programs tailored to individual clinics, a program to improve diabetes control in pregnant women with pre-conception or gestational diabetes, and a community health center-based tele-ophthalmology diabetic screening program for underserved patients. Methods: We measured progress by working with Utah's Behavioral Risk Factor Surveillance System (BRFSS) to obtain small area data on relevant HP2010 measures to evaluate our progress in improving health. We collected qualitative data through clinical interviews and secondary data through our own surveys to contextualize our programming in our communities. Conclusions: Using standard performance measures to gauge progress provided us with powerful tools to encourage the adoption of many of our initiatives by the CHCs, the state, and clinics. Having strong academic-state-CHC partnerships has provided a particularly effective system-change mechanism to enhance our ability to measure and track progress toward HP2010 objectives.