The AFF Program appears to have commenced with a somewhat narrow focus in health effects research. Despite its stated goal, the AFF Program, particularly the extramural component, came to encompass a wide array of exposures and their effects that contribute to the risk of injury and illness in AFF workers. However, it is possible that NIOSH, because of the discrepancy between the stated goal and program inputs, failed to exert the kind of focused leadership that would be necessary for a cohesive national research agenda. Production inputs reflect the fact that many AFF researchers have understood that, but the AFF Program would have benefited from stronger direction in evolving goals and greater communication, both between the intramural and extramural components and among the university-based NIOSH Ag Centers. The extramurally funded Ag Centers routinely compiled detailed annual reports and generated specific planning documents, but it is difficult to ascertain evidence that the information was used in a constructive manner. An apparent managerial deficiency of the program was the lack of resources allocated by NIOSH to archive documentation and organize such materials for strategic and planning purposes. In fact, one of the challenges that the committee faced was obtaining program information and documentation from the intramural AFF Program or extramural Ag Centers. The apparent lack of resources and staff to adequately catalogue a history of funded projects and their products has lead to an institutional memory deficit that is a major deficiency of the overall AFF Program. Given the size of the task, addressing the needs of the entire AFF worker population is difficult. The requirement for prudent allocation of resources underscores the need for strong leadership.
Information received from the NIOSH AFF Program (NIOSH, 2006a) related to inputs, activities, outputs, intermediate outcomes, and end outcomes in health effects research is summarized in the health effects research logic submodel (Figure 6-1).
Planning, production, and other input data were assessed and found to be adequate in part; however, it was not clear that the data were gathered by NIOSH in an organized manner. Staffing appears to have been adequate in some well-defined subprograms, but resources in many other parts of the AFF Program did not appear to permit adequate staffing. Surveillance data were gathered by intramural and extramural investigators; however, an overall surveillance scheme was not apparent in the evidence. Stakeholder needs of various sectors were taken into consideration