Marie_Senatus_Policy Evaluation Worksheet

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Dec 6, 2023

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PUBH 6012 Policy Evaluation Memo Planning Worksheet This worksheet will help you organize your thinking and plan the components of your policy evaluation memo. 1. Who is the policymaker? [hint: at state level, Governor usually has wider authority] Miriam E. Delphin-Rittmon, Ph.D., Assistant Secretary for Mental Health and Substance Use, Substance Abuse and Mental Health Services Administration (SAMHSA). a. What are their priorities? Their priorities revolve around reducing health disparities and enhancing mental health services among underserved communities. b. What are their powers? They are responsible for managing programs and initiatives aimed at improving mental health services and addressing substance use disorders. They work to raise public awareness, reduce stigma, and promote understanding of these matters within communities and on a national level. Considerations: Do not list stakeholders. Choose only one who has authority to work on the problem and act on your options. Identify a decisionmaker with authority over an organization or geographic area where the problem is most acute, or you may want to focus on a decisionmaker with the most power to make change happen. 2. What is the urgent, quantifiable, public health problem you want to address? [e.g., reduce cervical cancer rates in Bexar County] The public health problem to be addressed is the alarming rise in suicide rates among various minority populations in the United States. This problem disproportionately affects minority communities such as Native American, LGBTQ+, African American, and Latinx populations. The increase in suicide rates within these groups surpasses national averages and represents a critical public health concern. Addressing this issue is vital in reducing health disparities and improving mental health services for underserved communities. a. Is this based on trends, comparative data (e.g., vs state/national), other? The suicide rates among various minority populations, such as Asians, Hispanics, LGBTQ+, and African American communities, have shown a significant increase over recent years, exceeding national averages.
b. What evidence do you have this is an urgent problem? Describe the data and include your sources here. While the number of suicide has decreased among native Americans and children between age 10 and 24, the suicide rate in the country has increased. There is at least 1 death by suicide every 11 minutes. 12.3 millions adults in the United States have thought about suicide. 3.5 millions made plans to commit suicide and 1.7 millions individuals have attempted suicide. According to the CDC, suicide rates has increased from the year 2000 to 2020. c. Do the policymaker and problem you are presenting both exist at the local, state, or national level? [HINT: They should be the same] The problem is both national and local, affecting numerous minority communities across the United States, necessitating federal and state-level interventions.
3. What are some policy options the decisionmaker could take to address the problem? You will analyze three in your paper but feel free to consider more options while brainstorming. Community-Based Mental Health Awareness Programs: Invest in community outreach initiatives to reduce the stigma around mental health in minority populations through education, workshops, and peer support groups. A study by Jorm et al. (2012) published in PLOS One showed that enhanced mental health literacy through community interventions leads to better recognition of mental health problems and improved responses to mental health issues within communities. Integration of Mental Health Education in School Curriculums: Implementing mental health education as a mandatory component of school curriculums for all grade levels, tailored to address the specific mental health challenges faced by minority students. The Centers for Disease Control and Prevention (CDC) in their report on "School Health Guidelines for Preventing Suicide" highlight the importance of integrating mental health education in school curriculums. It emphasizes that such programs can contribute to fostering mental health awareness and resilience among students, potentially reducing suicide risk factors. Enhanced Training for Healthcare Providers in Culturally Competent Care: Mandating specialized training for healthcare providers focusing on culturally competent care to address the unique mental health needs of minority populations. A study by Betancourt et al. (2003) in the American Journal of Public Health emphasizes the significance of culturally competent care in healthcare settings. It demonstrates that training healthcare providers in culturally competent care enhances their ability to effectively engage and address the mental health needs of diverse patient populations, reducing disparities in care. a. List your sources Prevention strategies by the CDC: https://www.cdc.gov/suicide/prevention/index.html “Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497553/ “Evidence for effective interventions to reduce mental-health-related stigma and discrimination” https://pubmed.ncbi.nlm.nih.gov/26410341/ “Suicide rates of migrants in United States immigration detention (2010–2020)”
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8334629/#:~:text=(Figure%201).-,When %20calculating%20suicide%20rate%20based%20on%20admissions%20per%20FY%2C%20the,Figure %201 . CDC data trend on Suicide: https://www.cdc.gov/suicide/suicide-data-statistics.html PBS article: “CDC data shows U.S. teen girls ‘in crisis’ with unprecedented rise in suicidal behavior”: https://www.pbs.org/newshour/health/cdc-data-shows-u-s-teen-girls-in-crisis-with- unprecedented-rise-in-suicidal-behavior Considerations: Research the underlying issues or factors contributing to the problem to identify policy options that would address those issues. Then see if any of those options were already implemented and why they may not be limited or not working. Also consider what options haven’t been tried for your area/population (based on the research of underlying or contributing factors). Has something been changed that improved the problem in another geographic area or another population, which could be an option in your memo for your area or population? The problem statement must be an urgent AND quantifiable public health issue. It cannot be just a social determinant (without specific link to a health problem) or public policy issue. It cannot be a general topic like cleaner air or safer drinking water; while they are important public health issues generally, the problem statement must be tied to a specific community/state/population and a quantifiable health problem or health indicator. Each option must be a policy action, which means that a new policy is implemented, an old policy is removed, funding is changed, or the way a program or system operates is changed (such as a change in licensure requirements or conditions for a grant program). What is the policy status quo? Be clear what will change from the status quo and how the change will be implemented. 4. What criteria will you use to evaluate your options? [Note: we strongly recommend using a measure of cost and a measure of effectiveness (impact or outcome).] a. How do you plan to define cost? [Cost can be defined as a relative measure, e.g., option 1 cost is highest because….] Option 1: it may generally involve moderate costs in terms of material development, personnel, and outreach compared to broader institutional changes.
Option 2: This might involve moderate to higher costs due to the need for curriculum development, training, and the potential need for additional resources within schools. Option 3: This could involve moderate to higher costs due to the training process and the need for ongoing education and support for healthcare professionals. Option 1 might be perceived as the less expensive option among the three. While all three options involve costs, the community-based initiatives may involve fewer structural changes and can potentially leverage existing community resources, making it relatively less expensive compared to altering school curriculums or instituting specialized training programs for healthcare providers. b. How do you plan to define effectiveness (hint: it should be relative impact on the public health measure you are using in your problem statement, e.g., highest effectiveness in reducing low birth weight because…) Effectiveness will be gauged by the increased access to and utilization of mental health services specifically designed for minority communities. Tracking the number of individuals seeking help and engaging with mental health resources is a crucial measure. Considerations: You should have a measure of effectiveness as one of your criteria since improving the problem is probably the decisionmaker’s priority. This means that you must show how each policy option will improve the public health problem you identified You may have two measures of effectiveness, such as reduction in deaths and a reduction in injuries, if you think those are the most significant criteria to help the decisionmaker choose between the options. Your measures must be the same across all three of your options. For example, if you want a criterion to be effectiveness, you must indicate how you will measure that and apply the same measure of effectiveness across all three options. For example, if your memo is addressing hospital quality improvement, you could not measure the effectiveness of Option 1 by reduction in ER wait times and Option 2 by rate of hospital-acquired infections and Option 3 by nurse-to-patient ratio. These are all measures of quality, but they do not allow the decisionmaker to compare how well the options would improve quality in the hospital because they are all different aspects of quality. DO NOT use high, medium, and low by themselves as measures unless you define what you mean by that. For example, “High impact means that childhood obesity will be greatly reduced because…..” It’s best to use a specific measure where you have it. No need to quantify or estimate impact (you’ll have the opportunity to learn in other advanced coursework)
General tips: BE SPECIFIC AND BE CLEAR: Make sure you’re clearly explaining exactly what would happen under each option, what would the policy change be, how would it affect the problem, who would be implementing that change, where the money is coming from, etc. Avoiding passive voice makes your writing clearer, as does good paper organization (headers, paragraphs, etc.). Summary tables don’t count toward your page limit and can help illustrate your analysis for the reader and ensure that you’re clear in your thinking. REVISE: Don’t hesitate to change your problem identification or any other part of your memo if you find that your analysis is going in a different direction. Or you might start with one policy option and then realize that it’s not within the decisionmaker’s power, so you can either change your decisionmaker or change the option. You should give yourself time to revise your memo so that everything is consistent and clear.
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