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Data for Decision Making Workshops
Holiday Resort Conference Center, Guam, May 4-15, 2015
DDM-3: Intermediate level epidemiology & data analysis- Review/Retake
DDM-4: Public Health Surveillance
DDM-5: Individual mentored PH surveillance or data analysis project kickoff
DDM Partners' Retreat
DDM Program Background The Data for Decision Making series of courses is a multi-partner initiative designed to address the deficit in epidemiology and data related skills in the Pacific islands workforce, and to build the data and surveillance systems of Pacific islands health agencies. Data for Decision-Making originated in a series of outbreak-prone disease surveillance and control modules by the same name from the US CDC in the early 2000’s. Initially PIHOA/CDC developed a discussion paper on DDM in the Pacific following a request by the PIHOA Directors of Health. This was endorsed in September 2004, in Majuro, Marshall Islands, by PIHOA, CDC, SPC, WHO, and Fiji School of Medicine (FSM). PIHOA/CDC, WHO and SPC then adapted the CDC DDM program to the Pacific, under the guidance of Narendra Singh (of FSM) and Michael O’Leary (of WHO), then facilitated accreditation through FSM in 2005. The project began in 2013, with funding from PIHOA, the SPC, and the WHO, led by a group of epidemiologists from SPC, PIHOA, the RAPID project (including Hunter-New England Health District/Univ. of Newcastle), WHO, CDC, and FNU. A large part of this project has been re-design of the DDM courses, including revision of presentations, and development of new exercises and resources. The re-design is aimed at a sharper focus on the production of tech-level practitioners (“Epi Technicians”) through DDM, to broaden DDM so that it prepares participants to address NCDs and other components of the data system in addition to outbreak-prone diseases, and to sharpen the hands-on components of the courses to assure delivery of useful products to participants’ home agencies, and to situate it within a continuum of skills development which includes the community-college level
general public health programs on the one hand, and the rest of the SHIP (Field Epidemiology Training Program) that is proposed to develop a smaller cohort of fully qualified field epidemiologists on the other hand. The re-invigoration followed on PIHOA resolutions #7-031506 (“Recognizing the importance of improving the region’s surveillance system”), and #48-01 (”Declaring a regional state of health emergency due to the epidemic of non-communicable diseases”), and Communiques #51-01 and 51-02, requesting assistance from WHO and SPC for “developing an NCD surveillance system to allow monitoring of the course of the regional NCD epidemic, and the impact of response measures”. This project also responds to the 20th Micronesian Chief Executives Summit Communique, which calls for the “identification of resources to support current and joint efforts amongst SPC, PIHOA, US CDC, FNU, UOG and WHO to establish and implement regional epidemiology training programs”. In addition, at the Pacific Health Ministers’ meeting in 2011, one of the key recommendations was “to address the lack of trained and experienced epidemiologists in the region...... development of comprehensive training programmes to develop core competencies in “data techs”, “epi techs” and epidemiologists”. The DDM is delivered in four modules plus a research project. The four modules are: outbreak surveillance and response; basic epidemiology and data analysis; more advanced epidemiology and data analysis; and public health surveillance. The DDM program is accredited by FNU for a post-graduate certificate in epidemiology (DDM). The USAPI has served as a testing ground for all of the re-designed courses, starting in August, 2013 with DDM-1; May, 2014 with DDM-2; October, 2014 for DDM-3. With the delivery of DDM-4, Public Health Surveillance, this month pilot testing is now complete.
The Guam Workshops Teaching methods The workshop emphasized participatory learning through practical ‘hands on’ group-work activities (see Agenda, Annex A). Sessions were structured so that theoretical understanding was presented in an interactive way, then, taught concepts were reinforced through case studies, practical activities or other interactive learning methods. Didactic material was taught in plenary sessions. Hands-on work was conducted in small groups, usually by country, with individual facilitators working one-on-one with each group. Concepts were graded by written exams while hands-on work was presented by groups toward the end of the DDM-3 and DDM-4 courses, and graded according to a standard rubric.
Participants There were 29 participants in the DDM-4 course. Seven of these also took the DDM-3 retake sessions for credit, with another three taking the DDM-3 sessions for their interest. One participant dropped out of the class on day #2 of DDM-4 for family reasons. All of the remaining 29 took part in the DDM-5 kick-off day. A list of participants (with their DDM-5 projects) is in Annex D. Facilitators
Yvette Paulino—Univ of Guam
Mina Kashiwabara -- WHO
Damian Hoy– Secretariat of the Pacific Community
Adam Roth—Secretariat of the Pacific Community
Bev Paterson – Hunter New England Population Health (HNEPH), and the University of Newcastle- RAPID Project
Thane Hancock – CDC-PIHOA
Haley Cash – CDC-PIHOA
Mark Durand-- PIHOA
Christelle Lepers - Secretariat of the Pacific Community In addition, Alden Henderson- CDC-FETP attended the partners’ retreat at the end of the workshop, and Kunhee Park- WHO-POLHN joined part of the partners’ retreat by Skype. Logistical support Provided by Regie Tolentino of PIHOA
Acknowledgements- By their contributions, the following partner organizations made the Guam workshop possible, and further development of DDM for the benefit of Pacific island peoples possible.
Funding of DDM- Guam, May 2015 Development of DDM5 materials Delivery of DDM Guam, 2015
PIHOA-ASTHO-CDC SPC PHD SPC PHD
SPC PHD PIHOA PIHOA
RAPID CDC RAPID
RAPID Univ of Guam
WHO CDC
FNU
Workshop activities and results This workshop was a composite of four related activities as outlined below (also see Appendix 1 – Agenda).
First held was a DDM-3 (Intermediate Level Epidemiology & Data Analysis) retake course (May 4-5- led by Haley Cash).
DDM-3 was pilot tested in Guam in October. The pilot test revealed that the course was too demanding with too much
content for the 6 days allotted. As a result, approximately half of the participants did not reach a passing grade for DDM-
3 in October. We gave the participants who were close to a passing mark a chance to retake the course this time. The re-
take consisted of self-study materials sent out in advance, a diagnostic self-test before coming to Guam this time. During
the two day face-to-face review, the self-test was covered point by point, summary lectures and slide shows were used
to present key points, one-on-one tutoring was given to re-inforce these key points, a group-work analysis of a prepared
dataset was done and presented by groups, and a formal, repeat final examination was given. Seven participants re-took
the class for credit, and all seven successfully passed the course. An additional three participants sat in on the two-day
review for their own benefit. Results are shown in Figure 1 below.
Figure 1:
Second The major activity for the two weeks was the pilot test of the newly re-designed DDM-4 (Public Health
Surveillance), May 6-12- [led by Mark Durand and Damian Hoy]. Course learning objectives are presented in Annex B.
Like the other DDM courses, DDM-4 consisted of both a didactic component wherein concepts were set forth, coupled
with lots of hands-on work to apply the concepts to building systems in participants’ home jurisdictions. For the pilot we
presented two tracks for the hands-on activities: one centered on routine surveillance and reporting for communicable
diseases, and the other for monitoring and surveillance of NCDs. We used a Health Metrics Network-based HIS
assessment and planning grid to examine strengths and weaknesses of existing surveillance systems and to develop a set
of recommendations for participants to share back with their agency leaders. Hands-on course outputs for the two
(Passing grade= 70%)
tracks consisted of: 1) Routing communicable disease surveillance and reporting SOPs and weekly routine surveillance
report templates, and 2) NCD monitoring & surveillance plans and annual NCD status dashboards customized to each
jurisdiction. Some of the participants came into this course with much of the work in their track already done; others
were starting from scratch. Those who came in with better developed SOPs/Plans spent more of their time refining their
information products. Toward the end of the week each jurisdiction group presented the work they had done regarding
identified gaps in existing systems, recommendations to take back to their leadership, progress mad on their
SOPs/Plans, and the information product (weekly CD surveillance report or annual NCD Progress Dashboard). The
information products were populated by the most recent data from the participants’ home jurisdictions and were
presented as though to their target audiences at home. Presentations were graded according to a standardized rubric,
which was shared with participants in advance (40% of grade). Participants also took a written final exam to test for
mastery of course concepts (60% of grade). Results of the combined student assessments are shown in Figure 2. All 29
students passed the course.
Figure 2:
Evaluation of DDM-4 was led by Beverley Paterson. Participants’ evaluations of the course were generally positive (see charts in Annex C). They felt that their knowledge of PH surveillance advanced considerably (Chart A), and that the course was highly useful to their jobs (Chart B). Opinions were split between those who thought the course was easy and those who thought it difficult (Chart C). In general, participants found the tools presented (surveillance system assessment tool, sample SOPs/NCD monitoring plan, and reporting templates) useful (Charts D, E,F). Participants especially liked the course facilitation (Chart H), but felt that some concepts still needed more reinforcement (Surveillance types, steps, principles behind information products, and data management- Chart G). Several suggestions for improving the course were made (Charts I and J). These results were discussed during the Partners Retreat and a number of assignments made among the facilitators to address identified issues. There were also several useful products that came out of the DDM-4 pilot:
Let’s Do It for Our Kids; Let’s Do It for Our Future; Let’s do It for Guam: A VideoScribe animation that emphasizes the central importance of applying NCD policy measures to improve NCD related risk factor and disease indicators. Prototype was done for Guam but can be adapted to fit the policy agendas of other Pacific jurisdictions (developed by Thane Hancock. Available at: https://youtu.be/jbdCuRcaQiw )
DDM-4 a Love Story: Captures the “spiritual essence” of DDM as a mechanism for improving monitoring & surveillance efforts in the Pacific. For fun and promotion of interest in applying DDM. (developed by Beverley Paterson. Available at: https://www.youtube.com/watch?v=MFbce5ISuHQ&feature=youtu.be )
NCD Dashboard Template: Presents a “report card” of NCD trends as captured by core indicators, juxtaposed with a stock-take of the country’s adoption of best practice NCD interventions. Designed to link information with action (developed by Yvette Paulino, Mark Durand and the Guam DDM team. See NCD Dashboard Template in
the “Tool Box” folder at: https://drive.google.com/folderview?id=0BzBO-f4S00c6fmJuOXpKNnRJNmlzMDVMbUlvU0JxdzVxeS1pS1ZJanBLS0FFZTM2dURZSFU&usp=sharing )
Third DDM-5, the Guided Individual Surveillance or Data Analysis Project was kicked off during an all-day session after the completion of DDM-4 (May 13- led by Mina Kashiwabara). Participants were required to bring ideas regarding their independent project selection with them to Guam. During the kick off day, course logistics, tools (including a Blackboard virtual classroom, Facebook Page), and expectations were reviewed. Each participants were paired with one or more course faculty members to guide them through their projects. The remainder of the day was spent refining written plans for each project, including milestones and expected deliverables. DDM-5 will run through August. The projects will be mentored entirely by distance, except at sites where faculty and participant are co-located. Participants are expected to sign in to the Blackboard classroom to give a progress update each week through the course period (. Fourth The DDM partners retreat was convened to review progress at the end of the DDM pilot test phase, to capture lessons learned, to agree upon adjustments to the DDM course order, curriculum, and hands-on products, to define next steps for broader roll-out of DDM and linking with additional SHIP-FETP courses, and exploring avenues for funding support of DDM and SHIP [May 14-15- led by Adam Roth]. Some of the key points that came out of this two day discussion were:
Consensus to re-name and re-order the sequence of DDM courses (to start with PH Surveillance and end with Intermediate Epi and Data Analysis);
Clearer focus on useful “products” that should come out of each course: (PH Surveillance: a) SOPs or Surveillance Plan and b) routine CD weekly report templates/dashboards; Outbreak Course: Outbreak Situation Report; Basic Epi: Information Brief & Presentation; Intermediate Epi: Data Analysis Poster & Presentation; Independent Project: can be either a) Weekly reports or annual report from implementation of surveillance systems from PH surveillance course, or b) analysis of a dataset and write-up of results);
Decision to out-source refining of course materials and preparation of DDM facilitators guide if possible to an experienced DDM facilitator;
Decision engage Franklyn Prieto of CDC and Kunhee Park of WHO-POLHN to move forward with preparation of on-line self-study DDM 1-4 “pre-courses”, possibly with the assistance of an experienced Pacific DDM facilitator;
Decision to create a framework for evaluation of DDM-SHIP beyond the pilot phase and in preparation for funding proposal submission;
Decision to develop a standard consultation process and “tool box” for conducting in-country leadership consultations toward applying DDM for strategic epi and data capacity building;
Development of an outline for a manuscript to capture lessons learned in the DDM pilot courses and for use in funding applications;
A number of excellent suggestions from Dr Henderson were also captured based on his experience with multiple FETP start-ups.
See Annex E for additional notes from the partners’ retreat.
Annex A – Workshops Agenda
Data for Decision Making Program Activities, Guam 2015: SPC- FNU- CDC-WHO-HNE- PIHOA
I. INTERMEDIATE LEVEL EPI AND DATA ANALYSIS REVIEW COURSE (DDM3) - COURSE AGENDA
SCHEDULE ACTIVITY SPECIFIC CONTENT AND/OR NOTES
Day 1: May 4
All Day DDM3 Review and tutoring
Day 2: May 5
8am-12noon DDM3 Review and tutoring
12noon-1pm Lunch
1pm-3:30pm
3:30pm-5pm DDM3 Exam Retake
II. PUBLIC HEALTH SURVEILLANCE (DDM4) - COURSE AGENDA
SCHEDULE ACTIVITY SPECIFIC CONTENT AND/OR NOTES
Day 1
8.00am Registration
8:30am Opening remarks
8.30am Welcome and introductions
8.45am Presentation 1. Course background Review of DDM1-3 content (incl. data flow chart); expectations of this course; assessment procedures (exam 50%; group participation/presentation and completed recommendations 50%).
9.00am Presentation 2. Introduction to public health surveillance 1
See specific objectives (1, 2, 3, 10, 11, 15, 16); Define public health surveillance; Describe the purpose and the uses of public health surveillance; Describe the process (flowchart, cycle, surveillance wheel) of carrying out public health surveillance; Describe the different types of surveillance.
9.45am Icebreaker
10.00am MORNING TEA
1.30am Presentation 3. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): introduction to Public Health Surveillance Mapping, Assessment, and Improvement
Introduction of the exercise that will take place over coming two days, including template for mapping, assessment, improvement plans and recommendations. (and information product template for NCD track)
11.30am Presentation 4. Introduction to public health surveillance 2
Regional/global surveillance (PPHSN, WHO, CDC, PIHOA, SPC, IHR, PHIN, MANA); WHO surveillance standards; attributes of a good national public health surveillance system (e.g., intended purposes and objectives of the system, frequency of data collection, reporting, links with laboratory surveillance, links with response and control, planned uses, legal authority, organizational home, integration, timeliness, representation, specification of population
under surveillance); limitations; prioritisation; ethical considerations; resourcing.
12.30pm LUNCH
1.15pm Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): purpose and resourcing of your surveillance system
Group work on mapping, assessing and improving purpose and resourcing of your surveillance system
2.30pm Presentation 5. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): types of data and indicators
Ensure inclusion of HMN domains of measurement; ensure consistency with DDM2 and 3; mention the broader definition of data that includes any information eg quantitative and qualitative.
3.15pm AFTERNOON TEA
3.30pm Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): types of data and indicators
Group work on mapping, assessing and improving types of data and indicators
4.30pm Daily summary/wrap up
Day 2
8:15am Recap Day 1 sessions
8.30am Presentation 6. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data sources (institution-based)
Including the different types (e.g., notifiable diseases, syndromic, event-based, hospital, laboratory, birth/death registries, other), active versus passive surveillance, ICD, strengths, limitations and common reasons for bias
9.30am Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data sources (institution-based)
Group work on mapping, assessing and improving institution-based data sources
10.30am MORNING TEA
11.00am Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data sources (institution-based) - continued
Group work on mapping, assessing and improving institution-based data sources
12.30pm LUNCH
1.15pm Icebreaker
1.30pm Presentation 7. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data sources (population-based)
Including strengths, limitations and common reasons for bias
2.30pm AFTERNOON TEA
2.45pm Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data sources (population-based)
Group work on mapping, assessing and improving population-based data sources
4.30pm Daily summary/wrap up
4:45pm Adjourn
Day 3
8.00am Arrival
8:15am Recap Day 2 sessions
8.30am Presentation 8. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data management
Setting up a database (linelist), unique identifiers, data standards, summary of 5 data management steps from DDM2 and 3
9.30am Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data management
Group work on mapping, assessing and improving data management
10.30am MORNING TEA
11.00am Icebreaker
11.15am Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): data management (continued)
Group work on mapping, assessing and improving data management
12.30pm LUNCH
1.15pm Presentation 9a. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): information products, data dissemination and use (Part 1)
Overview of theory and examples on information products (e.g., graphs, maps, short reports, policy briefs, regular update reports, annual health reports, posters, presentations, papers, website products)? Designing information products, etc
2.00pm Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): information products, data dissemination and use (Part 1)
Group work on mapping, assessing and improving information products
3.15pm AFTERNOON TEA
3.30pm Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): information products, data dissemination and use (Part 1) (continued)
Group work on mapping, assessing and improving information products
4.30pm Daily summary/wrap up
Day 4
8:15am Recap Day 4 sessions
8.30am Presentation 9b. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): info products, data dissemination and use (Part 2
Data dissemination, use, communication, data ownership, sharing.
9.30am Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): information products, data dissemination and use (Part 2)
Group work on mapping, assessing and improving data dissemination and use
10.30am MORNING TEA
11.00am Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): information products, data dissemination and use (Part 2) (continued)
Group work on mapping, assessing and improving data dissemination and use
12.00pm Presentation 10. Public Health Surveillance Mapping, Assessment, and Improvement (SURV-MAI): revisit attributes of a good surveillance system and finalise improvement planning
Group work to revisit attributes of a good surveillance system, wrap up assessment, and finalise improvement planning
1.00pm LUNCH
1.45pm Exam preparation Facilitators roving
3.15pm AFTERNOON TEA
3.30pm Exam 50% of assessment
4.30pm Daily summary/wrap up
Day 5
8:15am Recap Day 5 sessions
8.30am Group presentation preparation
10.30am MORNING TEA
11.00am Group presentations (Mapping, Assessment, and Improvement and NCD presentation of information product)
50% of assessment - this includes individual participation in the presentation and group work through the week, and completed recommendations/plans
12.30pm LUNCH
1.15pm Group presentations (Mapping, Assessment, and Improvement and NCD presentation of information product) - continued
50% of assessment - this includes individual participation in the presentation and group work through the week, and completed recommendations/plans
3.30pm AFTERNOON TEA
4.00pm Icebreaker
4.15pm Special session: Overview of this week's Syndromic Surveillance Data
4:30pm Daily summary/wrap up and Module Evaluation
4:45pm Adjourn
III. EPI INDEPENDENT PROJECT (DDM5) - COURSE AGENDA
13-May
All Day DDM5 Orientation, Pairing with Faculty, One-on-one work on projects, Planning for further work and completion of projects.
IV. DDM FACILITATORS' RETREAT
May 14-15
All Day DDM Facilitator's retreat (Review lessons learned with course pilot tests, plan for further roll-out of DDM and system changes, planning toward further progress to SHIP, preparation of DDM journal manuscropt)- Adam Roth facilitating
Annex B: DDM-4 Public Health Surveillance, Course Learning Objectives
1. Define Public Health Surveillance
2. Describe the purpose and the uses of Public Health Surveillance
3. Describe the process (cycle or surveillance wheel) of carrying out Public health surveillance
4. Describe the different types of Surveillance.
5. Compare and list the advantages of active versus passive surveillance.
6. Explain situations where routine health service delivery data can be used for surveillance vs. situations where other sources such as community-based surveys must be used
7. Interpret surveillance data, including trends and patterns
8. List and describe local and other sources of surveillance data. Identify strengths, limitations and common reasons for bias from data sources used in your surveillance system.
9. Explain the use of surveillance data to improve health status of the populations in the Pacific.
10. Describe the attributes of a good surveillance system and also selection criteria for conditions or diseases, which may benefit or get prioritised for surveillance.
11. Describe the limitations of Public health surveillance.
12. Evaluate and map an existing surveillance system for a notifiable disease or for NCDs in the local setting and apply quality control mechanisms.
13. Explain ways of improving surveillance system of Public Health importance in the Pacific and develop a disease surveillance system improvement plan for a Pacific island country or territory.
14. Describe the process of setting up a new surveillance of Public Health Importance
15. Familiarise with local, regional, and global surveillance networks, their functions and services, in particular the Pacific Public health surveillance Network (PPHSN) and its functions.
16. Familiarise with WHO recommended surveillance standards.
17. Describe the concept of burden of disease (DALYs). Explain how communicable diseases, NCDs, and injuries all compare with one another in your country in terms of burden. What NCDs contribute most to the burden of disease in your country? What NCD risk factors contribute most to the burden of disease in your country? Prepare a summary report of your country/territory's NCD situation based upon data from your health information system; d) Develop a plan for monitoring the uptake and implementation of the major elements (e.g. NCD policies) called for in your country/territory's NCD response plan.
18. To practice communicating the results of data analysis to a variety of target audiences.
Annex C: Participants’ evaluation of DDM-4 Public Health Surveillance
0102030405060708090
100
Didn't know howto use
Some knowledge Reasonableknowledge
Good knowledge Excellentknowledge
Percentage of participants
DDM-4 Guam, Surveillance knowledge before and after the course (n=28)
Percent Before Percent After
0 1 2 3
More time for activities
Share drive
Split participant…
Mix of theory and practice
More networking…
More individual work
Number of participants
How can we improve the course?
Annex D- Workshop Participants and DDM-5 Project Topics
Name Country
Name of Project
Primary advisor (Secondary advisors-
subject to agreement for on-site
advisors marked with “*”)
Delpihn Abraham FSM-PNI Update NCD Mon & Surv Plan and
produce 1st annual Core NCD Profile
for Pohnpei
Cash <[email protected]> (Johnson* <
Anette Aguon Guam Vaccine preventable diseases SOPs
for Guam (integrated with CD
surveillance SOPs)
Hoy <[email protected]> (Hancock
Jesse Aguon CNMI Finalize NCD Core Monitoring &
Surveillance Plan and produce 1st
annual Core NCD Profile for CNMI
Cash <[email protected]> (Monteiro
Estelle-
Marie
Alig Guam CD SOPs and weekly CD routine
surveillance reports for Guam
(including use of new EHRs for CD
surveillance)
Hoy <[email protected]> (Hancock
<[email protected]>, Durand
Suzette Brikul Palau Finalize NCD Mon & Surv Plan and
produce annual core NCD Profile for
Palau
Cash <[email protected]>
(Udui*<[email protected]>)
Doris Cruz CNMI CD SOPs and weekly CD routine
surveillance reports for CNMI
Hancock <[email protected]> (Hoy
<[email protected]>, Durand
<[email protected]>, Monteiro*
Wincener David FSM Compute NCD Cause Specific
Mortality Rates for FSM states and
entire FSM
Cash <[email protected]> (Hoy
Gopalani*<[email protected]>
Katherine Del
Mundo
Guam Food-Borne Surveillance SOPs for
Guam (integrated with CD
surveillance SOPs)
Hancock <[email protected]>
Fesili Foifua A Samoa Do yearly “EpiNet & Communicable
Disease Refresher” (and update CD
SOPs for based on changes with new
EHR) for American Samoa
Durand <[email protected]> (Anesi*
Ardina George FSM-PNI CD SOPs and weekly routine CD
surveillance reports for Pohnpei
Durand <[email protected]>
(Gopalani*<[email protected]>,
Johnson < [email protected]>)
Daisy Glimatam FSM-Yap Develop CD SOPs and weekly routine
CD surveillance reports for Yap
Hancock <[email protected]> (Durand
Tareg*<[email protected]>)
Jolie Gurtmag FSM-Yap Merge most recent Yap proper and
neighboring islands CHA datasets to
get NCD core surveillance indicators
for Yap total; help prepare annual
core NCD Profile for Yap (together
with A. Rungun)
Durand <[email protected]> (Hancock
Tareg*<[email protected]>)
Leiema Hunt A Samoa Update of NCD Mon & Surv Plan (to
take account of new hybrid survey)
and annual core NCD Profile for Am
Samoa
Cash <[email protected]> (Durand
<[email protected]>, Anesi*
Eliaser Johnson FSM-PNI Evaluation of mass gathering
syndromic surveillance system for
8th Micronesia Games
Hoy <[email protected]> (Durand
Gopalani*<[email protected]>,
Roth <[email protected]>)
Michelle Lastimoza Guam Prescription Controlled Drug
Monitoring & Surveillance Plan (for
tracking impact of new Medical
Marijuana law)
Roth <[email protected]> (Paulino
Christelle Lepers SPC Event Based Surveillance SOPs for
Pacific Region- PacNet
Hoy (Roth <[email protected]>, Soares
Carolee Masao FSM-
Kosrae
CD SOPs and weekly routine CD
surveillance reports for Kosrae
Durand <[email protected]> (Hancock
Gopalani*<[email protected]>)
Monaliza
S
Melayong Palau Reportable disease SOPs and routine
reports for notifiable diseases (?
Integrated with larger CD
surveillance SOPs)
Hancock <[email protected]>
(Udui*<[email protected]>,
Durand <[email protected]>)
Helene Paulino Guam Analysis of substance abuse
indicators in BRFSS and YRBS
<coordinate with Grace Rosadino>
Paulino
Israella Reklai Palau Global Youth Tobacco Survey
Analysis
Kashiwabara <
[email protected]> (Cash
<[email protected], Udui*
Arlynn Roby
Linny
FSM Results of Kosrae’s Substance Abuse
Prevention NOMs Survey
Kashiwabara <
[email protected]> (Cash
Grace Rosadino Guam Analysis of substance abuse
indicators in BRFSS and YRBS
<coordinate with Helene Paulino>
Paulino
Angelina Rungun FSM-Yap Update NCD Monitoring Plan (to
include regular school surveys); help
prepare annual core NCD Profile for
Yap (together with J. Gurtmag)
Durand <[email protected]>
(Tareg*<atareg@[email protected]>, Hancock
Jeffrey Sablan CNMI Add “surveillance system
referesher” part of CD SOPs, and
conduct annual referesher for CNMI
Hancock <[email protected]> , (Durand
<[email protected]>, Hoy
<[email protected]>, Monteiro*
Marilou Scroggs Guam Mosquito Surveillance SOPs for
Guam (integrated into CD
surveillance SOPs)
Hancock <[email protected]> (Hoy
Mindy Sugiyama Palau Analyze data from Children with
Special Health Care Needs survey
and prepare epi profile of these
children
Cash <[email protected]>,
(Udui*<[email protected]>),
Kliu Basilius
Irish Tutii Palau Prepare Cancer Epi Profile for Palau Cash <[email protected]>,(Udui*
Alyssa Uncangco Guam <?project selected> Paulino
Willa Wong Palau Prepare HIV/STI Epi Profile for Palau Cash <[email protected]>, (Udui *
Annex E: DDM-SHIP Partners Retreat Notes
May 14 to 15, 2015
Present: Mina Kashiwabara (WHO), Damian Hoy (SPC), Adam Roth (SPC), Mark Durand (PIHOA), Haley Cash (CDC-
PIHOA), Thane Hancock (CDC-PIHOA), Alden Henderson (CDC-FETP), Beverley Paterson (RAPID), Kunhee Park (WHO-
POLHN)
Objectives:
1. Capture lessons learned through pilot phase of DDM curriculum
2. Plot the way forward for SHIP
Summary notes:
Discussion and agreement on the following DDM flowchart
General SHIP key points
1. Core target group for DDM is aspiring Epi Technicians and for the Masters level aspiring epidemiologists. 2. Do French translation/adaptation (with back-translation) once English curricula is finalized 3. Need to add a name for the masters-level of SHIP. ACTION: Damian/Adam to propose a name 4. Consultation (buy-in) process – in-country visits by PPHSN partners to discuss with leader (see DDM flowchart
above for the detail) – standardize the process – feedback to leaders between modules, etc. Alden can send what information CDC FETP has on this process. Also, implications of career path etc. Mark and Damian have done some work on this – include in facilitator guide. Develop MOU (ACTION: Alden can send their example). Desirable for consultation at time of recruitment of Masters-level candidates to include discussion and agreements re. career path and clear setting out of new role post training. Also consider engaging US Dept of Interior with setting expectation and supporting this role in Compact agreements/ budgets. ACTION: Damian and Mark to standardize consultation process and finalize sample MOU for use to capture roles/responsibilities from consultation with Secretaries/Directors.
5. Facilitator guide – ACTION: Damian will keep working on and circulate asap for comment. ACTION: once it has been drafted, Alden will look for curriculum development fellows to help with tightening up curriculum.
6. Registration: on PPHSN website with a very clear flow through process as part of this that tracks enrolment etc –ACTION: Adam and Damian will try to incorporate this into the work of the consultant who will be updating
the PPHSN website. Also look at Regie’s freeware that he has been using. ACTION: Alden with share the ‘epi-track’ process used at CDC.
7. All agreed on the value and importance of a regular retreat – at least every year to monitor/evaluate/adapt the Program.
8. The SHIP has already commenced: Upcoming OR courses will be offered in August, Nov, and May with a strong preference for DDM fellows
9. Accreditation with FNU – look to see if we can have an MOU as opposed to an MOA between FNU and PPHSN – ACTION: Damian/Adam to see if this is possible. ACTION: Alden can send the MOU they use.
10. Funding – consider Gates and Bloomberg – emphasize features of development effectiveness. Need to have budget within proposal to cover program coordinator and program administrator. Also for graduation celebration/presentations of each level. Also need to include mention of all the in-kind contributions from partners. ACTION: Adam to continue to develop list of funding sources and proposal to present at the PPHSN-CB meeting.
11. Regional mentors: Group selection committee (eg SPC, PIHOA and one of the HoHs). Alden can help advertise through his networks. Mentor training: ACTION: Alden has in-country 3 day mentor training module that he can share.
12. Monitoring and evaluation of SHIP – ACTION: Damian to develop draft M&E plan as part of the Facilitator Guide (Mark and Bev also happy to help out):
a. To come up with a relatively simple M&E framework – mixed-methods b. Revisit some of their maps to see if gaps still exist c. Set goal and impact indicator(s) according to what has been recommended by HoHs and Health
Ministers d. Tie it to the consultation process. e. Adapt CDC FETP indicators to Pacific (for the outcome/process indicators) f. Number of SitReps posted on PacNet; weekly CD reports; complete NCD M&S Plan, etc.; Proportion of
Outbreaks posted on PacNet? g. Consider inclusion of number of lives saved, but also something that captures non-fatal outcomes h. Have a qualitative component to the assessment:
i. Most significant change method as a way of evaluation – stories from different levels (leaders, participants, facilitators). Published in Inform’Action.
ii. Also looking at their interventions and recommendations – how many of these were actually carried out or what were the enables/barriers to these being carried out (this would also be partly quantitative).
i. CDC have a paper writing workshop in Laos in late August – if there are any participants who would benefit from this – CDC could support one participant potentially.
j. CDC could host internships in Asia – e.g. six-month attachments within FETP to other countries – should come with their own funding if possible, but depends on the timing.
k. CDC do joint surveillance assessments (bilateral) – FETPs of both countries undertake the surveillance assessments – focus on the process of working together – having been doing together for 10 years and has been very successful. Some students could join this group too – it’s a two week evaluation plus prep/write up so 6 week placement would be perfect.
Points specific to the DDM component of SHIP
13. Order of DDM courses: there are trade-offs, but consensus is that order should be: Public Health Surveillance (previously DDM4) Responding to public health alerts (previously DDM1) Basic epidemiology and data analysis (previously DDM2) Intermediate epidemiology and data analysis (previously DDM3). The DDM5 Project would start at the end of Public Health Surveillance (the new DDM1) and then continuing throughout the curriculum and for 3 months after DDM-3 to completion. The PowerPoint presentation sent around is the culmination of that discussion – additional notes from the retreat are below.
14. Name of courses in DDM: a. DDM1: Public Health Surveillance (previously DDM4)
b. DDM2: Responding to public health alerts (previously DDM1) – this name change is to ensure it’s clear that it includes both CDs and NCDs. DDM3: Basic epidemiology and data analysis (previously DDM2)
c. DDM4: Intermediate epidemiology and data analysis (previously DDM3) d. DDM5: Surveillance or research project.
15. Module objectives: Objectives to be re-considered over next few weeks to inform FNU PCAR2 form in the accreditation process. ACTION: Damian to commence this process and circulate for comment.
16. Changes to each module: a. DDM1: Public Health Surveillance (previously DDM4)
i. More on ethics. ii. Routine (incl Syndromic surveillance) mapping process belongs in Public Health Surveillance
module (as does NCD surveillance mapping and S&P plan development). iii. This module also needs to include mass gatherings, and event-based surveillance. ACTION: Mark
and Damian to contact Jennie Musto and Christelle to see if they’d like to work together on the event-based surveillance curricula.
iv. Inclusion of leaders, and other key surveillance system stakeholders (such as community health centre nurses – those who report in the system) in Monday morning session (targeted to them). See if they can use for their continuing education requirements.
v. Need to have an objective to teach students on how to write good recommendations. ACTION: Alden will send Lecture on this.
vi. Design hands-on course so that it is tighter around developing specific exemplary outputs (SOPs, NCD Mon Plans, routine weekly CD surveillance reports, NCD dashboards/annual reports). ACTION: Mark and Damian to start work on this and circulate. Introduce these info products in this module and develop initial prototypes then address what changes to these core products come at each course.
b. DDM2: Responding to public health alerts (previously DDM1): i. Remove syndromic surveillance mapping process to Public Health Surveillance module
ii. Relate each presentation to NCDs as well (one slide) iii. Inclusion of all EpiNet team members in the “Responding to public health alerts”, even those
who do not aspire to become Epi Technicians. iv. Hands-on work should be focused on dealing with alerts that come out of the surveillance
process. “Reporters” and leaders within the surveillance system need an orientation directed to
them.
v. Inclusion of leaders, and other key surveillance system stakeholders (such as community health centre nurses – those who report in the system) in Monday morning session (targeted to them). See if they can use for their continuing education requirements.
vi. Pre-work- require POLHN excel course before DDM-2 so that participants don’t show up
completely “excel illiterate”
c. DDM3: Basic epidemiology and data analysis (previously DDM2): i. Remove NCD surveillance mapping and S&P plan development process to Public Health
Surveillance module. ii. Have group separated for presentations so they can get more focused feedback/mentoring –
could use “American Idol” type exercises. d. DDM4: Intermediate epidemiology and data analysis (previously DDM3):
i. Simplify ii. Have group separated for presentations so they can get more focused feedback/mentoring –
could use “American Idol” type exercises. e. DDM5: Surveillance or research project.
i. A prize for the best DDM5 projects could include a trip to present at the HoH meeting with presenting to HoHs, donors, reporters and other partners.
ii. Need to find funds for a graduation process for DDM closure. 17. Products (see DDM flowchart above):
o DDM-1: SOPs/NCD Mon & Surv Plans and standardized routine CD weekly surveillance reports and annual NCD reports/dashboard
o DDM-2: Outbreak SitRep o DDM-3: cleaned data set, data dictionary (to feed into DDM-3) and data communication brief or
infographic (Show the principle table/graph, and bullet points re. methods, strengths & weaknesses of data, interpretation and conclusions)
o DDM-4: Poster from dataset analysis o DDM-5: Refine NCD Annual Mon & Surv Reports and Annual report
18. Manual and pre-ddm online learning: a. Look to hire Dawn to go through DDM module curricula to check for consistencies, etc etc – any changes
should be discussed with the presentation/group work developer. As part of the consultancy, develop curricula into a manual/textbook. ACTION: Adam will look for budget for this
b. “Pre-ddm online learning” – discussed with Kunhee to utilise POLHN as a platform to undertake. He reported that it would be fairly simple to do and that the maintenance/editing to the curriculum would be managed by the SHIP PPHSN partners. Once Dawn’s done, Franklin (CDC consultant) to see if he can help with the online development (e.g., beyond just ppt presentations). ACTION: Mark check with Kunhee re. whether POLHN self-study courses are easily editable. ( yes, they are)
19. ACTION: Adam and Damian to draft DDM experience-so-far manuscript and circulate for comment.
Notes for Dawn in addition to the above:
Have consistent slide templates, slides,
Common format for presentation of tables, exercises,
Instructor notes at the bottom of each slide for people who have never presented before,
Go thru notes of evaluations to ensure plenaries are aligned with participants needs,
Have an online practice test for each pre-ddm online content, plus an exam for the hands on week
Ensure exams are able to assess the new set of objectives (once they are developed)
Naming and order of the modules based on the facilitator’s retreat recommendations
More on ethics in public health surveillance module
Simplify Intermediate Epi module according to what the new set of objectives will be
Align content with new set of objectives (to be developed over next couple of weeks)
Re-design initial course session of new DDM 1 and 2 to deliver overview to health leaders/nurses (in addition to
course participants)
Relate each presentation in DDM 2 to NCDs as well (one slide)
Design DDM-3 product template (infographic or Data Communication Brief)
Need to have an objective to teach students on how to write good recommendations. ACTION: Alden will send Lecture on this
Remove NCD surveillance mapping and S&P plan development process to Public Health Surveillance module.
Have group separated for presentations so they can get more focused feedback/mentoring – could use “American Idol” type exercises.
Simplify DDM-4
Refine all products