CDC’s Health Protection Research Initiative Tanja Popovic, MD, PhD, FAAM Acting Associate Director for Science Centers for Disease Control and prevention CDC’s Futures Initiative Health Protection in the 21st Century Achieving maximum health impact is the driving force Two overarching health protection goals – Health protection of people in all communities through preparedness • Infectious disease threats • Environmental threats • Terrorism threats – Health protection through health promotion and prevention of disease, disability and injury • People in all communities will achieve their expected life span with the best possible quality of life in every stag Death …. Illness… Health …. Life …. Public Health Research Workgroup – Phase I Requests for Applications FY2004 Office of Public Health Research Public Health Research Workgroup – Phase II CDC’s Futures Initiative Areas of Emphasis Public Health Research Workgroup Charge Develop a set of strategic directions for CDC-wide research agendasetting process addressing the following: • Research issues and needs that are priorities for CDC’s customers and consistent with departmental policies for an intra-agency stewardship of the health research enterprise • Ways in which CDC needs to adapt its current practices in conducting and supporting public health research • Assurance that CDC-sponsored research is being effectively applied by practitioners and policymakers Guiding Principles • Public health research agenda needs to be developed in concert with the agency’s overall health protection goals. • Gaps in knowledge needed to achieve those goals will be primary driver of research agenda. • Research agenda will be set with external participation. Input Public Health Research Workgroup deliberations Outside-in approach: meetings conferences consultations Fast Track Process & Fast track Meeting Other FI Workgroups Excellence in Science Committee Consultancies with Dr. Gerberding & CDC senior staff Public Health Research Workgroup Options and Recommendations Key Strategic Issues Strategic Direction for Agenda-setting Process Step 1 Public Participation Level of Specificity Criteria Option 1 Option 2 Step 2 Step 3 Step 4 Step 5 Step 6 Option 3 Agenda-setting Process Step 1. Develop a broad public health research framework Step 2. Generate a list of possible research priorities Step 3. Obtain input from broad range of outside groups and CDC staff Step 4. Synthesize input and generate a draft agenda Step 5. Obtain broad public review of draft agenda Step 6. Revise and finalize document Step 1. Research-to-practice Cycle • Attempts to consider research needs which might arise in each of several phases of the PH approach to population health problems • Early phase – problem identification and search for causes • Mid-phase – design and implementation of interventions • Late phase – evaluation Level of Specificity Levels Disease, Injury or Disability-related Cross-cutting topics 1. Broadest Chronic diseases Genomics 2. Very broad Cancer Public health genomics 3. Broad Breast cancer Genetic screening 4. Specific Effectiveness of interventions to prevent breast cancer Effectiveness of family screening programs 5. Very specific Effectiveness of mammography Effectiveness of computerbased family screening programs 6. Most specific Effectiveness of mammography in women 40-49 yrs of age Effectiveness of computerbased family screening programs among Medicaid populations Public Participation • Breadth of participation: How broad? Who plays? -- health organizations considered as traditional partners -- new health and non-health related organizations -- lay representatives from community-based individual public • Depth of engagement: How intense? At what level? -- inform -- consult -- involve -- collaborate -- empower Criteria Option 1. Core set of criteria linked to CDC’s mission -- public health need -- potential impact -- relevance Option 2. Option 1 and widely accepted national goal -- reduction of health disparities and widely accepted unmet need -- cross-cutting across the CIOs CDC Public Health Research Agenda for FY 2004 Expert Panel “Fast Track” Meeting November 2003 Requests for Application (RFAs) for FY 2004 Overall goal for all RFAs is to influence priority health protection research addressing the following: Health protection of all people in all communities through preparedness for • Infectious disease threats • Environmental threats • Terrorism threats Health protection through health promotion and prevention of disease, disability and injury assuring that: • People in all communities will achieve their expected life span with the best possible quality of life in every stage Investigator-initiated (RO1) $ 14M for 20-40 grants Purpose To support investigator-initiated public health research projects that have a high probability of influencing priority public health research. Research objectives •This year priority is given to research that identifies innovative cost-effective health promotion policies, programs and activities in the workplace or that affect the workplace. •Future funding cycles will expand this initiative to address health protection research relevant to other populations and sectors. Strategy Design and evaluation of interventions and identification of determinants affecting the successful implementation of evidence-based cost-effective interventions in the workplace or that have impact on the workplace. Career Development (KO1) $ 10M for 20-30 grants Purpose To support intensive supervised career development experience for researchers in a variety of disciplines engaged in all types of public health research that have a high probability of influencing priority public health issues. Research objectives To develop qualified, experienced, and sustainable cadre of independent public health researchers to support nation’s and CDC’s public health priorities. Institutional Training $ 4M for 2-4 grants Purpose To develop or enhance training opportunities for individuals, selected by the institution, who are training for careers in specified areas of public health research that that have a high probability of influencing priority public health issues. Research objectives To ensure a continuing supply of well-trained scientists prepared to lead efforts in conducting cutting-edge public health research. Career Development (KO1) and Institutional Training Strategies Etiology and needs Social, ecologic and developmental determinants of health Determinants of individual behaviors that impact health Assessing impact of social trends on population health needs Prevention Determinants of successful implementation of evidence-based interventions Reduction of health disparities Effectiveness of community-based interventions Application of genetic information to population health Methods and Infrastructure Impact of infrastructure and policy alternatives on health outcomes Economic factors and health Improved surveillance methods Early detection of public health risks Communication strategies Workforce needs and training issues Centers of Excellence in Health Promotion Economics $ 1M for 1 grant Purpose To develop institutional capacity in Heath Promotion Economics. Research objectives To explore economic barriers, priorities, solutions and impact (including costeffectiveness) of developing, evaluating and implementing health promotion guidelines, recommendations, policies and programs to prevent disease, injury and disability so that all people can achieve their expected life span with the best possible quality of health at every life stage. Strategies Linking key academic, public and private entities across disciplines Conducting and facilitating Health Promotion Economics research Providing Health Promotion Economics training. Office of Public Health Research A. Research Oversight, Strategy, and Evaluation 1. Establish Public Health Research Priorities • Establish and maintain CDC research agenda • Facilitate research agenda processes • Translate agenda into strategic plan for research A. Research Oversight, Strategy, and Evaluation 2. Develop a Balanced Research Portfolio • Translate strategic CDC-wide goals into scientific goals • Ensure balance of research between intramural and extramural • Build focus on outcomes into research planning process A. Research Oversight, Strategy, and Evaluation 3. Evaluate Research Progress and Outcomes • • • • Work on developing evaluations Quality – Use of peer review Relevance – Conduct relevance review Performance – Track research outcomes. Develop research metrics B. Extramural Research and Peer Review • Develop scientific policy for CDC extramural research and peer review • Provide guidance on extramural issues • Develop centralized peer review capabilities • House CDC-wide cross-cutting grants program Futures Initiative Stage II: Implementation Teams • The Organizations Design How we can work faster; be more connected across our agency and with our partners; how we can better respond to our customers needs • The Health Protection Goals • The Strategic Imperatives Implementation of recommendations form the initial 4 Workgroups • The Business Services Improvement Improve our business practices and help create performance-based culture at CDC Public Health Research Implementation Team Two Component Team Structure Core • Team • • Leadership for overall effort Specific charge to Action Teams Responsible for action implementation Action Team Action Team • • Action Team Core Action Team Propose innovative programs Team and initiatives that support workgroup recommendations Present best ideas and Action Action collaborate with other Action Teams Team Team and the Core Team to arrive at “best in class” programs and initiatives Major Charge • Defining public health research agenda and coordination with the agency’s overall health protection goals • Implementation of agenda-setting process CDC ‘treasures” Social determinants of health Workforce Scientific creativity and synergy Information technology and systems to support science Measuring the impact of research http://www.cdc.gov/futures