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.

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.

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.

Collective impact is a community development framework by which multiple agencies collaborate to create a common vision, align strategies and activities and use a common set of indicators to measure progress.  This framework is used successfully by the Strive Partnership in Cincinnati in making progress toward their collective goal of improving student achievement.  Collaborations in Colorado, including One Community Pueblo and the Colorado Coalition for Healthy Schools, are in the early stages of using this framework to create a shared vision and common measurement system to improve the health and well being of children and to create healthy school environments respectively.

John Kania and Mark Kramer have identified five conditions of collective success for collective impact initiatives. The conditions that successful collective impact initiatives have include: (1) common agenda and vision for change, (2) shared measurement systems to track progress, (3) mutually reinforcing activities/interventions, (4) continuous communication among agencies, and (5) backbone support organizations to dedicate staff to coordinate and support the initiative logistics and activities.

Initiatives using a collective impact framework require funding to support their work over a multi-year process.  The work of the Strive Partnership has been in progress over four years, compared to the Colorado based initiatives that are in the early stages of their work.  Communities and organizations that have a long term commitment to making change within their community, should consider using a collective impact framework to leverage resources to maximize program impact.

In collaboration with the Center for Research Strategies, DBH is conducting a comprehensive evaluation of the CJCS program.  CRS recently completed the Client Satisfaction portion of the evaluation.  Starting in June 2011 and continuing through October 2011, Clinical Specialists at all 10 program sites were instructed to distribute a client satisfaction survey to any client they had seen more than one time. The client satisfaction survey distributed was a modification of the Mental Health Statistics Improvement Program (MHSIP) Consumer Survey.  This instrument was chosen because it is distributed annually to consumers receiving public mental health services state wide by the Division of Behavioral Health (DBH).  Using the same survey allows for comparison between the CJCS clients and the overall community mental health population.

A total of 158 surveys were returned by clients in the CJCS program.  In contrast with system wide MHSIP respondents, the majority of the CJCS respondents were male (63.3%), whereas in the entire community mental health center sample the majority of respondents were female (62.8%).  Twenty-two percent of the CJCS respondents described their ethnicity as Hispanic/Latino.  Race distribution was quite similar to that of the community mental health center sample with the majority being White/Causation (61.2%).  Over 95% of the CJCS clients who responded to the survey expressed positive attitudes on all five domains of the MHSIP survey.  The percent agreement ranged from 95.1% in the outcomes domain to 98.7% in both the access and general satisfaction domains.  The overall satisfaction with the program is substantially higher than the satisfaction ratings found in the overall community mental health sample.  The high degree of client satisfaction coupled with the findings from the Community Stakeholder Satisfaction survey conducted earlier in 2011 suggest that the CJCS program is perceived as beneficial to its clients and valuable to the communities it serves.

Statistics for Colorado show that the rates of reportable STDs among young people ages 15-24 are high.   In 2010, Colorado reported 13,413 cases of chlamydia and 1,708 cases of gonorrhea per 100,000 youth.

Unfortunately STDs such as gonorrhea are becoming harder to treat as the disease is becoming resistant to available antibiotics. The National Coalition of STD Directors (NCSD) reports that those infected with gonorrhea and chlamydia are also at greater risk for contracting HIV at a rate that is five times more likely than those uninfected.

Other STDs are also widespread and of concern.  The Denver Post reports that one in four people are living with herpes worldwide and an estimated 80% of those that are infected are not aware that they carry the virus.

For a list of resources in Colorado and testing options, please visit JustGetTested.com or visit CDC.gov for additional information.

Dr. Helayne Jones, President and CEO of the Colorado Legacy Foundation, has acknowledged the accomplishments of these schools, saying “We know that healthy students learn better. These Score Card Winners serve as a model for the state.   We are proud to honor their leadership in health and wellness.”

Champion schools completed an online Score Card that identified how they are promoting the connection between health and learning through the use of the Coordinated School Health model. The Healthy School Champions Score Card tool has been designed to showcase the wide variety of the healthy activities that enable students to be healthy learners.

The 2012 Healthy Schools Summit is one of the highest profile school wellness events in Colorado. This third summit will bring together close to 500 teachers, district leaders, health experts, policymakers and community stakeholders with a focus on policies and best practices for creating, enhancing and maintaining healthy, safe and welcoming schools for all students. For more information or to register for the summit, visit colegacy.org.  The 2012 Healthy School Champions’ Breakfast and Healthy Schools Summit are sponsored by the Colorado Health Foundation, and the Western Dairy Association, and supported by the Colorado Department of Education and the Colorado Department of Public Health and Environment.

Filmed on location at a Colorado county jail, the video highlights the stories from those infected with hepatitis C that are culturally appropriate and broadly acceptable to inmate populations. HEP C: Inside and Out has been designed to raise awareness of the disease, how it is transmitted and how those at risk can avoid getting infected. It also details how HCV damages the liver and how those who have been diagnosed with the disease can seek treatment options.  Information provided through the video can be helpful not only towards those incarcerated in jail, prisons, and community correction programs, but to staff members in those facilities as well.

In particular, HEP C: Inside and Out covers the following topics:

• Know the difference between hepatitis A, B, C
• List ways that hepatitis C and other blood borne viruses are spread
• List behavior changes that can reduce the risk for infection or the progression of the disease if already infected, both inside and outside the corrections system
• Discuss the impact of the virus on health and long-term consequence of the disease, and
• Locate resources in the community for testing, treatment, and ongoing support and education.

HEP C: Inside and Out, is available on VHS and DVD from the Center for Research Strategies. Discounts are available for those interested in buying in bulk. To get your copy, please contact Lezlie Frank at lezlie.frank@crsllc.org.

CREATE Health Scholars

In addition to the four-week intensive program, scholars participate in a year-long student driven community-based project that addresses a regional health challenge.  Scholars receive a $500 stipend upon completion of all activities.

The CREATE Health Scholars program cultivates integrated teams of health professions and engages students in collaborative community-based projects.  The program helps students develop personalized health career goals and strengthens their applications to professional school by improving knowledge and performance in pre-health core curriculum and graduate entrance exams.

The mission of the CREATE Health Scholars program is to create healthcare professionals in Colorado who are dedicated to rural and urban underserved communities.  The Center for Research Strategies provides evaluation services for this program.

For detailed information on the application process, visit http://www.ucdenver.edu/life/services/AHEC/ProgramAreas/CREATEHealth/Pages/StudentsInterestedintheProgram.aspx.  For program related questions or concerns, contact Marsha Wheatcraft at 303.724.0343 or marsha.wheatcraft@ucdenver.edu.

Space is limited - Apply Today.  Application Deadline: Friday, March 16, 2012    

Rise Up!, is just one of many celebrations in Colorado that will be occurring.  Organized by Café Cultura, the event will take place at the Denver Indian Center on March 9, at 6:30, on behalf of the National Native American AIDS Prevention Center, and will feature an open microphone, free HIV testing, free food, vendors and raffle items.

The Center for Research Strategies supports these efforts to raise awareness about HIV/AIDS prevention. The Colorado Department of Public Health and Environment (CDPHE), estimates that as of 2008, there are more than 10,000 people living with HIV/AIDS in Colorado, and as many as 25% of people in Colorado are not aware they have the disease, according to the Colorado Aids Project.  Education and testing are critical to stopping the deadly spread of HIV/AIDS in our state.