Preventive Services Tool Kit Introduction to PSTK Rapid

Preventive Services Tool. Kit Introduction to PSTK Rapid Protocol ATV Exercise Joel L. Nitzkin, MD 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 1

History of PSTK o Funded by CDC in 2004 as curriculum to enable public health professionals to be more effective in preventing budget cuts and developing new programming o Based on o Epidemiology as a policy tool o Principles of public administration o Experience of PSTK faculty in securing outcomes not considered possible before they were achieved 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 2

Goals of Seminar o -- to enable participants to get the bureaucracy and legislature to do what you want them to do – o - - to open the hearts and minds of participants to “out of the box” thinking 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 3

-- the problem o Tradition!!! o “in the box” thinking o o o Researcher Clinician Administrator Legislator Patient/Community Client o Organizational culture hostile to new approaches 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 4

PSTK Response o A ladder to climb out of the box o Policy Analysis skill set o o Epidemiology Public administration Political Science Real life experience 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 5

Root of Most Problems o Mark Twain – “it’s not what people don’t know that worries me – it’s what they know for sure that just aint so” 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 6

MLK on Thinking o “Rarely do we find men who willingly engage in hard, solid thinking. There is an almost universal quest for easy answers and half-baked solutions. Nothing pains some people more than having to think. " 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 7

How to Think o PSTK teaches how to think these bureaucratic and legislative things through 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 8

Lesson 1: Framing and Mindsets o 4 mindsets o o Technical/Scientific Administrative Policy/Political Deeply held belief/Org. culture 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 9

Lesson 3: Stakeholder Analysis o o o Stakeholder Power Leverage Character types Games People play 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 10

Lesson 4: Partnering o -- a bird may love a fish – but where can they make a home together? o (ref: Fidler on the Roof) 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 11

ATV Initial Narrative (all terrain vehicle) o Prominent local legislator o Teenage daughter killed when thrown from ATV o Wants them banned county-wide o Health director asked to write the bill and provide the justification o ? ? How should you, as health director, proceed? ? 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 12

Rapid Protocol – Step 1 Define and Set Up o Specify problem and proposal o Anticipated o o o What intervention? Who pays? Who gets the benefit? 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 13

Step 2: ATV Policy Options o Ban all terrain vehicles (ATVs) o Require warning placards on ATVs o Impose control on ATV events o Prohibit use under age 18 o Safety training and licensure or certification o Posting of hazardous properties o Research and surveillance o Health education 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 14

Step 3: some numbers o Local ATVs o Injuries and deaths o Number and percent that might be prevented by various options o (start with best guestimate – save research for later) 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 15

Step 4: Stakeholder Analysis o Brainstorm obvious stakeholders o Identify key stakeholders who otherwise would have been missed o Select the 1 -5 stakeholders that appear most critically important o 10 -20 minutes (the heart of the brainstorming session) 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 16

Preliminary list of ATV Stakeholders o o o o o Local vendors Manufacturers (none local) Current owners of ATVs Members of ATV clubs Families of kids injured by ATVs Emergency room doctors County legislators State legislators Local police 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 17

Step 5: Brainstorm Partnering o Decide who to partner with o o For leverage and for advocacy For implementation o ATV potential partners o o o Vendors Doctors Parents Police DMV o 3 -5 minutes 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 18

Step 6: Identify Research Needs o (research to be done before initiating advocacy) o Stakeholder research o (per stakeholder analysis) o Evidence and guidelines o (literature review) o Baselines and benchmarks o (project likely benefits) o 3 -5 minutes 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 19

Step 7: Initial and Final Decisions o Options: o o o “Go” “No Go” “Hold until. . . ” o “go” on health education and training “Hold” on ban and legal restrictions o ATV: o o 5 -10 minutes 5/21/2018 Module 1 Intro AAPHP PSTK Advocacy Strategy Seminar Slide 20