265382 Pilot testing and legislation: Unpacking two health department skills sets needed to change communities

Tuesday, October 30, 2012

Kirsten Wysen, MHSA , Director's Office, Public Health-Seattle & King County, Seattle, WA
James Krieger, MD, MPH , Prevention, Public Health - Seattle and King County, Seattle, WA
Ryan Kellogg, MA , Local Hazardous Waste Management Program in King County, Public Health-Seattle & King County, Seattle, WA
Sarah Ross-Viles, MPH , Prevention Division, Public Health - Seattle & King County, Seattle, WA
INTRODUCTION: Local health departments are increasingly being called upon to work on policy and system changes to transform communities so residents can more readily live healthy lives. Health departments can improve their ability to foster these changes by considering when to deploy two distinct strategies: a quality improvement approach with rapid testing of pilot projects or a legislative approach to change state or local government policy.

METHODS: The Seattle/King County health department used two methods to accomplish policy and system changes in Communities Putting Prevention to Work grants from 2010 to 2012. In the first method, a quality improvement approach offered a team of four contractors technical expertise on quality improvement processes and access to skilled consultants. Second, health department staff worked with county legislative staff to prepare staff reports for Board of Health members who crafted legislation prohibiting the sale of electronic cigarettes to minors.

RESULTS: In the first example, a farm-to-institution project used a short series of pilot tests to develop and disseminate food purchasing system changes among child care centers and senior meal programs. In the second, a Board of Health ordinance restricted the sales of “e-cigarettes” only to people 18 and older. Lessons learned will be discussed.

DISCUSSION: Analyzing the challenges and opportunities of a particular policy or system change so that the most effective change approach can be implemented is an important skill for health departments. Eventually a sequential approach that starts with pilot tests and ends in legislation can lead to sustained community changes.

Learning Areas:
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
1. Describe two ways policy and system changes can be carried out by local health department. 2. Identify under what circumstances to use a quality improvement or a legislative approach. 3. List health department core capacities that support policy and system changes.

Keywords: Policy/Policy Development, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a policy analyst for 20 years. My policy interests center around public health performance, community improvement and how to address health inequities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.