7
Future Activities of the IOM Committee

In the interval between the third and fourth meetings of the IOM committee, members and IOM staff will be working on 5 priority activities in order to prepare for the recommendation of a minimum of 2 sets of leading health indicators for the final report to be released April 1, 1999. These include: (1) refinement of the 6 sample indicator sets included in the second interim report; (2) continued search for and review of potential indicator sets, measures and data sources; (3) convening a public forum to elicit comments from the public health community; (4) review of electronic comments from the public and the public health community regarding the second interim report; and (5) conducting ten focus group sessions with representatives of the general population, select population groups, community groups, academia, and the media to determine if the various indicator sets will engage interest, motivate action at the individual and community levels, and elicit support for dissemination through the media. Details about these 5 activities are provided below.

Refinement of Six Sample Indicator Sets

As noted in the discussions preceding each of the six sample indicator sets, there remains a need to review each set carefully to ensure that it is responsive to the full charge to the committee and that they each meet the 14 essential criteria established by the committee. Much of this review will focus on reduction of the sample sets to more manageable numbers of suggested measures and discussion of the issue of weighting. The committee recognizes the importance of determining whether each indicator and suggested measure is equivalent to all others in assessing the health of the public and of select population groups. If it is determined that a weighting scheme will refine interpretation of the indicators and its associated measures, the committee will then have to identify the most effective strategy to calculate such weights. Strategies could range from simply ranking the indicators in order of importance and assigning weights reflective of the rankings, to a more complicated statistical analysis in which coefficients could be calculated for each indicator and suggested measure that would reflect their independent contribution to the health of the general population and select population groups. In addition, once an indicator set has been reduced to its essential measures (weighted or not), the committee will conduct a careful



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--> 7 Future Activities of the IOM Committee In the interval between the third and fourth meetings of the IOM committee, members and IOM staff will be working on 5 priority activities in order to prepare for the recommendation of a minimum of 2 sets of leading health indicators for the final report to be released April 1, 1999. These include: (1) refinement of the 6 sample indicator sets included in the second interim report; (2) continued search for and review of potential indicator sets, measures and data sources; (3) convening a public forum to elicit comments from the public health community; (4) review of electronic comments from the public and the public health community regarding the second interim report; and (5) conducting ten focus group sessions with representatives of the general population, select population groups, community groups, academia, and the media to determine if the various indicator sets will engage interest, motivate action at the individual and community levels, and elicit support for dissemination through the media. Details about these 5 activities are provided below. Refinement of Six Sample Indicator Sets As noted in the discussions preceding each of the six sample indicator sets, there remains a need to review each set carefully to ensure that it is responsive to the full charge to the committee and that they each meet the 14 essential criteria established by the committee. Much of this review will focus on reduction of the sample sets to more manageable numbers of suggested measures and discussion of the issue of weighting. The committee recognizes the importance of determining whether each indicator and suggested measure is equivalent to all others in assessing the health of the public and of select population groups. If it is determined that a weighting scheme will refine interpretation of the indicators and its associated measures, the committee will then have to identify the most effective strategy to calculate such weights. Strategies could range from simply ranking the indicators in order of importance and assigning weights reflective of the rankings, to a more complicated statistical analysis in which coefficients could be calculated for each indicator and suggested measure that would reflect their independent contribution to the health of the general population and select population groups. In addition, once an indicator set has been reduced to its essential measures (weighted or not), the committee will conduct a careful

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--> review of the actual language of each measure to ensure that it is recognizable and engaging to the general population and select population groups. These efforts will be facilitated by comments received from the public health community and, more important, by the results of proposed focus group discussions with representatives of the target populations. Search for Additional Sample Indicator Sets The IOM staff will continue to provide committee members with examples of indicator sets published in the extant literature during the interval between the October 1998 and January 1999 meetings. This is intended to ensure that the committee reviews as many plausible sets of leading health indicators as possible, prior to selecting sets that will be recommended to the Secretary of Health and Human Services. Public Workshop Tentative plans have been made for a public workshop to be convened during the morning session of the first day of the January 1999 meeting (January 27, 1999). It is unlikely that members of the “public” for whom these sets of leading health indicators are being developed will be recruited in great numbers (if at all) for this workshop. Rather, it is expected that “traditional” members of the public health community and Healthy People Consortium will attend the workshop as an opportunity to react to the second interim report and learn about the findings from the electronic commentary and focus group discussions. Results from the regional meetings convened by DHHS during September through December 1998 will supplement commentary received at this public workshop. IOM staff have attended all of the regional meetings, and 2 committee members have participated in 3 of the 5 meetings. Electronic Commentary A Web site has been established for both the first and the second interim reports to elicit comments and suggestions for modifications. A direct message will be sent to community level groups such as rotary clubs, faith groups, local media, and volunteer organizations to elicit their opinions of the sample indicator sets described in the second interim report as well as any additional sample sets that are developed during November and December 1998. The targeted request for comments will be released on or around December 15, 1998, which will allow a full four weeks for responses before the January committee meeting. Focus Group Discussions with Target Audiences. At the strong recommendation of the IOM committee, IOM staff have sought additional funds from external sources to support the conduct of a number of focus group discussions with members of the general population and select population groups throughout the country. These groups will also include members of the print and electronic media. Results of the focus groups will facilitate selection of the final sets of indicators, as well as guide formulation of effective dissemination and evaluation plans for the recommended leading health indicator sets during the decade 2000 to 2010. The committee acknowledges that the public health community has been, and will continue to be, an essential player in selection of the indicator sets recommended in the final report. However, in order to meet the committee's charge to select indicators that engage and motivate the general public and select population groups, it will be necessary to solicit input from these primary target groups. Focus group discussions conducted throughout the United States will help to ensure that selection of the final indicator sets is moderated

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--> by comments from the audiences that will actually be targeted by the indicators. Consequently, the final selection of indicator sets will rely on testimony from the public, media, public health community, and science. This will ensure that the committee does not simply look at the science and make judgments based on scientific evidence about the selection of indicator sets. The outcomes of these 5 processes will lead to the development of a minimum of 2 sets of leading health indicators to be recommended to the Secretary of Health and Human Services. These sets will be accompanied by dissemination plans and recommendations for the sources and frequency of data collection, analysis, and reporting. The final report will be submitted to the Secretary of Health and Human Services on April 1, 1999.

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