At the conclusion of the public comment period, the Federal Workgroup Coordinators would review all public comments received and would consider revisions to the objectives. HHS hopes to release Healthy People 2020 in the final quarter of 2010. RADM Slade-Sawyer expressed her gratitude for the Advisory Committee's strong commitment to improving the health of the nation. She turned the meeting over to Dr. Jonathan Fielding, Advisory Committee Chair.
II. Desired Outcomes of the Meeting
Dr. Fielding explained that the main goals of the meeting would be to finalize the structure and organization of topic areas as well as the target-setting recommendations for Healthy People 2020. There would also be some discussion of the work of the Subcommittee on Priorities. After providing a general overview of the range of issues to be discussed and resolved, he introduced Advisory Committee member Patrick Remington.
III. Healthy People 2020 Topic Area Recommendations
Dr. Remington, Chair of the Subcommittee on Topic Areas, gave an overview of three issues for discussion: 1) the process for considering the role of topic areas in Healthy People 2020 and how they should be structured; 2) the relationships among objectives within topic areas; and 3) the relationships among objectives across topic areas. Recognizing that Healthy People 2020 could include over 1,000 objectives, the Subcommittee had recommended 50 topic areas that could be used to organize them. He explained that decisions about which objectives should be placed within each topic area would require understanding of a conceptual model to guide such decision-making processes. This would be a challenge.
He presented a slide that showed one option for how the Committee's originally proposed Action Model for Healthy People 2020 could be used as a simplifying structure to help users understand the logic of the topic areas. The model's main categories, "interventions, determinants, and outcomes," could organize the list of topic areas. These categories shouldd not be viewed as mutually exclusive silos that distinguish some types of topic areas from others. They would offer a way to group a large number of topics into sets for ease of use. Dr. Remington opened the floor for discussion of and voting on the Subcommittee's draft topic areas report.
Responding to a question from Dr. Fielding, Dr. Remington said the central question for discussion would be, "What is the benefit of having and organizing topic areas? How would that process be put into practice?" He explained Healthy People in terms of layers, where the main categories of the model are the top layer, the middle layer is the topic areas, and the inner layer is the objectives. The question of topic areas is one of information management, so that users are not overwhelmed by thousands of objectives when they look for information on a particular issue that affects their community.
Dr. Fielding asked whether it is essential to think about how to group topics. It might be enough to say that topics fit into three categories, some fit into more than one category, and there is no "wrong door" for users to go through because all doors open onto the objectives. If a user entered into the cancer "door," that person would gain access to an understanding of determinants as well as the specific cancer-related objectives and resources for evidence-based policies and programs. Users could enter through any layer of Healthy People (i.e., broad categories, topic areas, or objectives).
Dr. Fielding said there may not be a need for a matrix to understand how objectives and topics fit together; topics and objectives flow across categories of the framework. Dr. Kumanyika replied that such an approach might not be intuitive for users. Using this kind of an indexing approach might be more useful. Objectives would be coded in relation to other things to permit linkage across categories. This would help to translate the Web site content into supplementary materials in printed, book form, and would require less effort than generating logic models. To create logic models, someone would need to think through how the different elements fit together. If there are thousands of objectives this woud not be feasible.
- Dr. Fielding said the Committee would keep the approach that has been suggested by the Subcommittee on Topic Areas, but add the idea of an index. He asked if there was any disagreement. No disagreement was voiced, and Dr. Fielding said a formal vote was not necessary.
Dr. Remington posed the question of whether the number of topic areas is important. One could argue that moving from 28 to 50 topic areas is unimportant, since the number of topics would not change the number of objectives. The FIW may or may not accept the Committee's approach. Dr. Remington agreed and said that rather than locking into a specific list of 50 topics, it is more important to clarify the process. The topics presented in the Subcommittee's report represent a good starting point. He suggested it would not be necessary for the Committee to vote to approve the Subcommittee's specific report. Dr. Fielding asked if there was disagreement on this issue. None was voiced. He asked ODPHP staff members if they were comfortable with the change. RADM Slade-Sawyer requested that he clarify what was being recommended.
Dr. Fielding said the Committee had decided to recommend that: 1) there is no need to try to organize topic areas within broad categories (e.g., interventions, determinants, and outcomes); 2) a list of 50 topic areas is presented with the understanding that there are different ways to manage and aggregate material; and 3) indexing should be used to help people understand cross-cutting issues.
- Dr. Fielding asked for a vote of the Committee members. All members who were present voted in favor of the recommendations, and none were opposed.