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Phase 4: Questions and Answers


If you have additional questions, contact MAPP staff members at mapp@naccho.org and they will either answer your questions or connect you with a MAPP Mentor.


How can I bring partners, especially non-traditional partners, up-to-speed in regards to data from the four assessments?

Communities have found success in providing a summary of the data from the four assessments. Partners need enough background information to understand this, but not too much. This summary should be kept focused and concise, such as presenting basic morbidity and mortality data rather than everything that was found.

How can the assessments play into the process of identifying strategic issues?
In one community, it was noted that this process should have been more focused and less global. Providing examples and a starting point would have helped move the process forward and streamlined the process of identifying strategic issues, thus getting to the end result sooner.

What criteria were given to participants to help them understand what it means to be "strategic"?
Communities have drawn heavily on suggestions from the MAPP tool when setting forth criteria. Having examples is also useful. Some things for participants to consider include:

  • How big of a public health issue is the item?
  • Can we do it?
  • Is it reasonable, feasible, and financially cost effective?
  • What happens if we do nothing about it?

What is the value of having an external facilitator lead this? What is the value of internal staff?

Outside facilitators may be able to move the process forward because they are able to be "the mean guy" without hurting feelings or making contributors angry. It is fine to have internal staff serve as facilitators, as long as they are aware of the pitfalls involved in being so close to the process. Facilitators need to be brought up-to-speed. It is important that they are fully aware of what the end result should be, so that they may move the process forward in order to accomplish the identification of a limited number of strategic issues to move the overall process forward.

If a strategic issue was not present in all four assessments, should we keep it?
It is useful to let the group decide this. Often, if the group votes to keep the issue, it remains in the final group of the identified strategic issues.

When numbering strategic issues, does this imply prioritization?
In the case of Livingston County, strategic issues were numbered for the sake of organization only. The numbering did not imply that the issues were prioritized in the order they appeared.

In the case of Northern Kentucky, strategic issues were numbered in order of endorsement. Those listed first had the most votes, and tended to be the most comprehensive. However, numbering did not imply the order in which they would be addressed.

What guidance should be given to participants who are unfamiliar with the concept of strategic planning?
It is helpful if participants have a clear sense of what the end result should be. It does take practice and experience to fully understand the concept and value of strategic planning. It may be useful to appeal to participants'' common sense. It is impossible to address 100 issues at once! Helping participants view strategic planning from this perspective should help them realize that picking the most important issues as a group is necessary.

What is the impact of the LPHSA on the selection of strategic issues?
The LPHSA data was very significant for the selection of strategic issues in Livingston County. It helped to solidify the function of the public health system and what it means. The community can equate public health with the local public health department only. Helping them to understand that it is the "health of the public" will allow them to recognize their responsibility, and that of others in the community and within the MAPP process.

How can I obtain funding to pay for external facilitation?
Funding for outside facilitation might be less expensive for this process because there is a relatively small amount of time required from facilitators. Some work on the front end is necessary to educate the facilitators and allow them time to prepare. The actual day of the meeting is another time commitment, and then some work on the back end.

In the Livingston County example, they received money from the New York State Department of Health that was ultimately federal money from a rural health network.

Other sources of funding may come from local industry, businesses, or universities, either in terms of money or in-kind donation. Further, university students with expertise in the area of strategic planning might be a less expensive option.

How can I educate partners on the concept of systems thinking?
This is an area where repetition is key. Repeat the concept as often as you can and bring it up whenever it is relevant. Having the partners continually hear this message will allow them time to process the information and to fully understand the concept. As they become familiar with it and begin to hear it from other agencies, partners will come to accept the message.

How did the Forces of Change Assessment impact the Identification of Strategic Issues? The Community Themes and Strengths? The Community Health Status Assessment?
The Forces of Change Assessment helped Livingston County in retrospect. They realized that the community was taking the data too literally, and this led to the identification of more than 100 strategic issues during their first attempt as leaders and participants became hung up on accepting every issue brought forth.

The Community Themes and Strengths helped in Livingston County in that it put the focus on similarities that the community and focus groups held in common. This allowed the summaries to be more concise because of the overlap. 

The Community Health Status Assessment helped to get the community to understand that the health department in not solely responsible for the health of citizens. That things like behavior and laws (smoking in public places) also have an impact on the public''s health.


What were some lessons learned from going through the Identification of Strategic Issues process?
Both Livingston County and Northern Kentucky representatives feel that holding a one-day meeting to go through this process is beneficial. In the case of Livingston County, they would give a more succinct overview of assessment data and come up with a starting point to begin identification. Further, they would better educate their external facilitators, particularly on what end result they were looking for.

Northern Kentucky noted that it is important to provide background "nuts and bolts" type of information to participants in order for them to understand and have trust in the process. If they understand what result is expected and the MAPP processes that have taken place up until this point, they will feel more comfortable with the process.

Would it be valuable to repeat the MAPP process in the future?

Livingston County agrees that it would be useful to go through the MAPP process again in the future. They feel that MAPP serves as a useful tool and template to work with as it has all of the components that are important for strategic planning at the local level for the local public health system. Every six years, they are required by the State of New York to go through a community health assessment, and plan to use MAPP during this time as well.

The consultant that worked with Northern Kentucky has used many strategic planning tools, and feels that MAPP is among the best as it builds a lot of camaraderie and collaboration among the community. She feels that the process holds great value.

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