The Program Being Evaluated
Turning Point: Collaborating for a New Century in Public Health was a national initiative to strengthen the public health infrastructure in the United States through collaborative partnerships between public health departments, other state and local health agencies, schools of public health, the business community, health maintenance organizations, hospitals, environmental organizations, and faith-based groups. During the planning phase of the initiative, the Robert Wood Johnson Foundation (RWJF) provided states with funding to develop plans for modernizing and improving their public health systems.
In October 1999, RWJF provided funding to states to implement priority projects from their state plan. The Turning Point initiative also created five National Excellence Collaboratives that worked to modernize public health statutes, create accountable performance management systems, utilize information technology, invest in social marketing, and develop public health leadership.
Major Evaluative Topics and Questions
Led by Todd Rogers, Ph.D., and Dianne Barker, M.H.S., of the Public Health Institute, the goal of the evaluation was to describe the outcomes of Turning Point activities at both the state and national collaborative levels. The evaluation was designed to answer three key questions:
How has the public health system changed in the Turning Point states since the inception of the initiative?
What is the likelihood that these changes may be sustained over time?
In what ways have these changes been replicated in other states?
Summary of Methods
Data collection activities were conducted through interviews and review of documentation. Outcomes achieved by Turning Point were captured through qualitative case reports that reflect the insights of the initiative participants.
Knowledge and Impact
Based on the findings, the Public Health Institute staff wrote a case study describing the impact of infrastructure change on local public health; developed a chart on the sustainability of public health system change in the Turning Point grantee states; and developed a presentation on principles and practices of emerging and established public health institutes.
Evaluators from the Public Health Institute reported the following key findings based on comparing changes in three Turning Point states (Oklahoma, Nebraska and New Hampshire) from 2000 to 2004 to changes in three similar states that did not participate in the program (Idaho, Tennessee and Vermont).
- The three Turning Point states changed their public health infrastructures more than the three comparison states. Changes included: new or reorganized public health advisory councils; new issue-specific public health workgroups and new or reorganized task forces; and new or reorganized public health coalitions.
- The only infrastructure change that was not significantly different between Turning Point and comparison states was the presence of a new or reorganized office of emergency preparedness. The federal government has made emergency preparedness funding available to all states since 2001, which may help to explain this.