Colorado is facing a “perfect storm” that will leave the state with a serious shortage of health professionals.  On the supply side, our current health professions workforce will decline as workers in the Baby Boomer generation reach retirement age.  On the demand side, the numbers of Coloradans seeking health care will increase as our population ages and as efforts continue to expand access to health services.  Rural communities that now face limited access to health providers are likely to be especially impacted.

In light of this serious problem, the Center for Research Strategies applauds the passage of House Bill 12-1052, the Health Care Workforce Data Collection bill by the Colorado General Assembly. Pending a signature from Governor Hickenlooper the bill will request certain healthcare professionals such as practical and professional nurses, addiction counselors, marriage and family therapists, pharmacists, physicians, and physician assistants, to provide information regarding their practice location, specialty, education and training when they apply for or renew their professional license. The resulting information will be compiled by the Division of Registrations and will be available by request from the Primary Care Office (Colorado Department of Public Health and Environment) in a format that protects the identity of the provider. http://www.cdphe.state.co.us/pp/primarycare/index.html

Since 2008, the Colorado Health Professions Workforce Policy Collaborative has been working to inform and educate policy makers regarding a health professions workforce policy agenda while building the state’s primary care workforce.  As of July 2011, the collaborative has grown from the original 35 participants to 127 members representing 90 organizations.  Participants have included representatives from the Colorado Department of Public Health and Environment, the Colorado Department of Labor, the Commission on Higher Education and the U.S. Regional Office of the Health Resources and Services Administration, as well as those who are responsible for the education, recruitment and retention of health professionals, particularly in the primary care field.

Priorities defined by the Collaborative are detailed in the report:  Public Policy Agenda:  Addressing Colorado’s Primary Care Workforce Shortage, Recommendations from Colorado’s Health Professions Workforce Policy Collaborative, 2010. The Health Care Workforce Data Collection bill has been one of the Collaborative’s priorities.  http://specialdeliveryonline.blogspot.com/2010/11/2011-public-policy-agenda-from-colorado.html

Having this type of provider information compiled will provide an ongoing perspective on Colorado’s supply of health care workers and its ability to meet the needs of all Coloradans.  CRS recognizes the important work of the Colorado Health Professions Workforce Policy Collaborative and congratulates the many members who advocated for improved health professions data in Colorado.

An alarming number of America’s teenagers are putting themselves at risk for HIV, other sexually transmitted diseases and unwanted pregnancy through early sexual activity.  According to recent figures, nearly half (or 46%) of high school students have had sexual intercourse.  In response, the National HIV/AIDS Strategy for the United States and The Community Preventive Services Task Force (SPSTF) is now recommending that education regarding HIV and pregnancy prevention be made available before teens begin engaging in behaviors that place them at risk.

Yet according to the Centers for Disease Control and Prevention (CDC) in its recently released report “HIV, Other STD, and Pregnancy Prevention Education in Public Secondary Schools-45 States, 2008-2010,” little progress has been made in increasing the percent of public middle and high schools that offer education that address specific HIV, other STD and pregnancy risk reduction topics.

Compared with 2008, the percent of middle schools offering this type of education in a required course did not increase and was in fact significantly lower in 2010 in 11 states.  Similarly, the percent of high schools teaching three condom-related topics in a required course was significantly lower in eight states and only significantly higher in three states.”

Colorado. Rev. State. 22-1-110.5 states: A school district that offers a human sexuality curriculum shall maintain content standards for the curriculum that are based on scientific research. Curriculum content standards shall also be age-appropriate, culturally sensitive, and medically accurate according to published authorities upon which medical professionals generally rely.

Siecus reports that, Colorado schools are not required to teach sexuality or sexually transmitted disease education; but that districts can decide whether to teach sexuality education and may address the subject in preschool through 12^th grade, focusing on abstinence as the only certain way to avoid pregnancy and sexually transmitted diseases. As of 2009, at least 82% of high school students in Colorado reported having been taught about AIDS/HIV in school compared to a national average of 87%

While teen pregnancy rates have been declining in Colorado and the rest of the country, Colorado Youth Matter  reports that a baby is born to a Colorado teen every 84 minutes, with almost 9 percent of births to 18 and under youth being second births.

With May being Teen Pregnancy Prevention month, The Healthy Colorado Youth Alliance offers activities to engage the community in raising awareness on teen pregnancy:

• Start a “Did you Know” Campaign with facts about unintended teen pregnancy.
• Host a Brown Bag Series featuring different aspects of teen pregnancy
• Screen a Movie that starts the conversation
• Create an Earned Media Event that will get positive media attention and
• Write an Opinion Piece in your local newspaper.

CRS encourages these options and strives to consistently support positive change in our community, particularly as it relates to protecting young people from avoidable risks.

You believe in the work you do and the public health programs you offer.  But how do you know your programs are having high impact in your community?  If you are ready to take your program to the next level, think about using a high impact evaluation approach to get there.

High impact evaluation employs a socio-ecological approach to assess the impact of a program on the population it is serving.  Modeled after the Development Spiral of Non-Profit Organizational Performance (authored by Paul Light), this evaluation approach helps assess and measure program  impacts over five developmental stages that lead to the development of a model program that can serve as a leader in its field.

• During Stage 1, the program documents the difference it is making in terms of reach by measuring factors such as the number of participants and other program services.
• In Stage 2, a program expands as it establishes partnerships and works to integrate its activities within a larger context of best practices and standards.
• A program reaches Stage 3 as it focuses more intentionally on what it does best so that it can target its expected impacts on those whom it aims to serve.
• The goal of Stage 4 is to strengthen program infrastructure so that it can be sustained over time.
• Finally, a program reaches Stage 5 when it can reflect on what it has accomplished and aim for long-term success and establishing a well-grounded legacy.

Using a high impact approach builds program capacity and maximizes impact.  It allows you to think beyond your discrete program efforts and outcomes, to focus on implementing your program in concert with other community programs and efforts, and to develop and implement improvement processes to revise and improve your program continuously over time so that it can ultimately reach Stage 5. Program planners employing a high impact approach conduct a variety of evaluation efforts, such as developing a theory of change and program specific logic model, conducting a review of best practices, creating measurement tools that assess a program’s current stage of development, creating and implementing an improvement process, and developing a measurement system to track progress and outcomes over time.

As public health funding sources shrink and the risk of reducing or terminating programs increases, it becomes paramount for program planners to not only document activities and outputs, but to show impact.  Utilizing a high impact evaluation approach builds the capacity of public health program planners to design programs that can be sustained over time and have lasting impact on the populations and communities they serve.