Federal Policy Academy for Transforming State Mental Health Systems.

Communities Putting Prevention to Work. Cloudburst has been awarded a contract to coordinate and deliver training to U.S. State and Territory recipients of the Centers for Disease Control and Prevention’s (CDC) Communities Putting Prevention to Work (CPPW) funding.  CPPW is an initiative of the American Recovery and Reinvestment Act of 2009, designed to reduce risk factors and prevent/delay chronic disease and promote wellness.  Training and technical assistance coordinated and supported by Cloudburst will enhance the capacity of CPPW State and Territory health departments to increase physical activity and improve nutrition and decrease smoking prevalence through policy change.  Working with the CDC’s Office on Smoking and Health and the Division of Nutrition, Physical Activity and Obesity, Cloudburst will conduct a training needs assessment, develop a master training plan, develop training and evaluation materials and coordinate training events centered on policy, systems and environmental change strategies. 

The primary focus of this work is to assist State and Territory health departments to change policies, systems and community environments through Media, Access, Point of decision, Price, and Social support/services – collectively known as MAPPS strategies.  

MAPPS Strategies are as follows:
• Use Media to promote healthy foods/drinks and increase activity; restrict advertising and employ counter-advertising for tobacco and unhealthy foods/drinks
• Increase Access to healthy food/drink choices and safe locations to be active and improve the built environment; reduce the availability of tobacco and unhealthy food/drinks
• Use of Point of decision labeling/signage/placement to discourage consumption of tobacco, increase consumption of healthy foods/drinks, and prompt physical activity
• Use Price to discourage consumption of tobacco and to benefit consumption of healthy foods/drinks
• Use Social support/services to promote tobacco cessation, breastfeeding, and increased activity

Healthier Food Retail Action Guide . Cloudburst is collaborating with the Centers for Disease Control and Prevention (CDC), Division of Nutrition, Physical Activity, and Obesity (DNPAO) to create an action guide on healthier food retail for state health departments.  DNPAO strives to reduce obesity and obesity-related conditions through state programs and interventions. In doing so, it has developed guidance documents for six target areas, including increasing access to fruits and vegetables and reducing consumption of high energy-dense foods.  Although these documents recommend strategies that can be used by various sectors to address environmental and policy change, they do not provide detailed guidance on how to implement the strategies.

CDC/DNPAO Stories from the Field.  Cloudburst was awarded a contract to work with the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity on the creation of a series of Stories from the Field to highlight the accomplishments of the CDC State-Based Nutrition, Physical Activity and Obesity (NPAO) program.  The State-Based NPAO Program currently funds 25 states to address the problems of obesity and other chronic diseases through statewide efforts coordinated with multiple partners. By leveraging resources and coordinating efforts with their partners, grantees will address the following DNPAO principal target areas:
• Increase physical activity.
• Increase the consumption of fruits and vegetables.
• Decrease the consumption of sugar sweetened beverages.
• Increase breastfeeding initiation, duration and exclusivity.
• Reduce the consumption of high energy dense foods.
• Decrease television viewing.

Mental Health, United States 2010 and 2012.   Cloudburst was awarded a task order to provide support to the Research Triangle Institute (RTI) in its work to develop and produce Mental Health, United States 2010 and 2012 for the Substance Abuse Mental Health Services Administration. Cloudburst is providing developmental and logistical support for the project’s Expert Panel Meeting, which brings together academic, research and field experts to make recommendations regarding the projected content of MHUS.

The Center for Mental Health Services collects, analyzes, and reports national statistical information on mental health services and the people served. Since 1983, the results of these activities have been made available every two years in a widely disseminated publication entitled Mental Health, United States. The 2008 edition saw a major change in the publication's structure and format, and represented an effort to broaden the perspective by including data from a wider range of sources, e.g., other federal agencies and professional organizations. This new format is patterned after Health, United States, a major publication that is issued annually by the Centers for Disease Control (CDC). The 2008 edition of Mental Health, United States is divided into three major areas: People (e.g., the number and characteristics of persons seeking mental health treatment); Providers (e.g., the number the number and types of mental health facilities in the U.S., the volume of services provided, and the number of specialty mental health practitioners and trainees in the U.S.); and Payers (e.g., estimates of public and private expenditures for MH/SA services over the past 10 years, as well as projections of expenditures for the next decade). For each of these areas, the publication includes: 1) an analytic introductory section describing recent overall trends in the field and summarizing research findings; 2) a chartbook section with figures, charts, graphs, and brief bullets highlighting selected topics; and 3) a section of trend tables drawn from a variety of relevant sources.

The 2010 edition of Mental Health, United States, will also include a new section of state-level data, for which the format has not yet been determined. This section may include information such as results from SAMHSA's National Outcome Measurement System (NOMS); rates of psychiatric disorders by state; rates of availability of non-specialty resources by State; descriptions of differences in Medicaid benefits by State; and data on coverage for evidence-based practices by State.

Expert Panelists were convened to provide reactions and recommendations regarding the projected content of MHUS, 2010, not only to ensure its comprehensiveness, but also to provide suggestions regarding particular areas of emphasis, additional topics and data sources that might be included, as well as ideas on alternative ways to present the data in order to maximize its utility and make it accessible to the widest possible audience.

SAMHSA Co-occurring Disorders Initiative (CODI) . Cloudburst (as a subcontractor to Westat) has been selected by HHS SAMHSA to increase the quality of and access to integrated services for people with co-occurring mental health and substance abuse disorders through provision of support to the Center for Substance Abuse Treatment and the Center for Mental Health Services. According to results from SAMHSA’s 2003 National Survey on Drug Use and Health more than seven million people who suffer from at least one mental disorder also have a substance use disorder. Cloudburst serves as the evaluation lead for this project, and will assess the impact of the innovative Learning Community model of knowledge transfer used in the contract, as well as assessing satisfaction with information products and more traditional TA events. Cloudburst is developing the Evaluation Plan (including the creation of instruments to assess impact and participant satisfaction with CODI activities), co-chairing the Evaluation Workgroup, and managing the evaluation of a large number of CODI and learning community activities. This requires coordination across a large number of Westat subcontractors as knowledge transfer activities are implemented. Cloudburst is also the evaluation lead for an innovative pilot of a learning community for federally qualified health centers (FQHCs) involving the participation of both SAMHSA and HRSA.

Analysis, Information Management and Communications – USAID Global Health Evaluation . Cloudburst was recently awarded a contract to evaluate analytical, communications, and knowledge management services provided to USAID's Global Health Bureau by another firm under a support contract. Cloudburst staff interviewed USAID Global Health and Regional Bureau staff and management as well as contractor staff, reviewed the documentary work product and systems developed for USAID under the contract, analyzed the data gathered, wrote a report of findings and recommendations for future directions for the activity, and briefed senior Global Health staff.

Children’s Legacy Study. Cloudburst was awarded a subcontract through CNA to provide support for their 8-1/2 year contract with the Centers for Disease Control and Prevention (CDC) to conduct the Legacy for Children Longitudinal Follow-up Study. CNA will evaluate the cognitive, social, and emotional development of children at ages 8, 10 and 12 from both intervention and comparison families. The study’s findings will inform public policies aimed at improving the success of disadvantaged children in school and in life. The Cloudburst Group will provide logistical support to CNA as it convenes and manages a panel of researchers to provide direction and support to the study.

The study, to be carried out under the leadership of Dr. Sarah Friedman, Associate Director of the CNA Health Research & Policy, will follow the development of children whose mothers participated in a parenting skills intervention effort aimed at improving children's developmental outcomes by fostering their mothers' sense of community, parenting self-efficacy, and parent-child positive interaction.

The Centers for Disease Control and Prevention has initiated Legacy for Children™, a set of longitudinal, randomized, controlled studies examining the potential for improving child developmental outcomes through parenting programs designed to promote self-efficacy and a sense of community. Parental self-efficacy helps parents understand that their behavior can positively influence the development of their children and give them the chance they truly deserve.

The primary research question for Legacy for Children™ is "do children in the parenting intervention groups achieve better developmental outcomes than do the children in the comparison groups?"

Legacy has both a pilot phase and a main study phase. There are 180 intervention and 120 comparison families in the main study phase and 60 of each in the pilot phase at each study site, Miami and Los Angeles. The 720 participating families are those whose children, on average, would be expected to fall below national norms on a range of developmental outcomes. Process, cost, and short- and long-term outcome data are being collected.

Implementation and Monitoring Progress of Division of STD Prevention Strategic Plan . Cloudburst is providing management consultation services to assist CDC’s Division of STD Prevention in developing routine processes and structures to monitor the use of its strategic plan and to facilitate meetings and/or retreats to assist the division in developing activities that will provide ways of measuring progress on strategies and objectives.

Implementation of Best Practices Evaluation for CDC’s Division of Heart Disease and Stroke . Cloudburst (as a subcontractor) is assisting with the implementation of an evaluation plan created by Cloudburst under another contract that was designed to determine the uptake, use and impact of the best practices initiatives undertaken by the Division for Heart Disease and Stroke Prevention (DHDSP). The Best Practices Evaluation Plan uses an innovative framework, combining the Interactive Systems Framework (ISF) with a logic model.

CDC Preventive Health and Health Services Block Grant Health Communications and Marketing Project . Cloudburst was awarded a task order to provide support to the grantees of the Preventive Health and Health Services (PHHS) Block Grant Program in the developing and marketing of programmatic success stories, along with the development of communications projects, technical assistance, and consultation work. Cloudburst staff provide technical assistance to the grantees of the PHHS Block in the development and marketing of programmatic success stories through the use of the PHHS Block Grant Success Story tool. This includes developing a marketing and dissemination plan, providing training on communication for grantees, and developing marketing materials for the PHHS Block Grant Program.

Translating the National Physical Activity Guidelines for Decision-makers and Practitioners in the Workplace Setting . The National Physical Activity Guidelines for Americans are the first-ever comprehensive physical activity guidelines published by the Federal Government. The release of these guidelines provide information for the first time that specifically ties physical activity levels to the prevention, delay, and better management of chronic diseases. Because of this new information, there is an opportunity to impact healthcare costs by working with employers to create worksites that promote physical activity and provide opportunities to employees to be physically active. The purpose of this project is to support CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) Division of Nutrition and Physical Activity to: 1) conduct an environmental scan to identify promising practices and tools for promoting physical activity in the worksite; 2) work with key informants (CEO’s / high-level persons in the business community) to determine what employers need to create worksite cultures that promote physical activity among employees; 3) develop recommendations based on scan and key informant interviews for making the business case for physical activity to employers; and 4) enhance the translation and dissemination of the 2008 Physical Activity Guidelines for Americans and increase the effectiveness of these guidelines through development and evaluation of appropriate materials for employers. Carla Linkous will lead this two-year project as Project Manager, with support from our teaming partner, Strategic Health Concepts.

Statistical Analysis . Cloudburst is under contract with the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services, to provide support to SAMHSA statistical projects (IDIQ Domain 2S). This work will include Sampling Designs and Statistical Methods; Acquisition, Development, and Collection of Data Bases; Analyses of Large Scale Data Bases; Analyses of Complex Quantitative Data; Development, Implementation, and Testing of Quality Tools; and Information Technology (IT) Statistical Projects.

Feasibility and Pilot Studies . In partnership with American Institutes for Research, Cloudburst will develop feasibility and pilot studies and develop tools to assist the Substance Abuse and Mental Health Services Administration (SAMHSA) to increase the fidelity of its successful program models. These studies will help to determine the efficacy of funded activities, and whether study results can be successfully replicated. The work will include sampling design, collecting qualitative and quantitative information, outcome reporting, and managing all logistical requirements.

Evaluation Design for CDC. Cloudburst provides evaluation design services to CDC’s Division of Heart Disease and Stroke Prevention (DHDSP) for the Key Best Practices Initiative. In order to ensure that CDC will be able to analyze the impact of these interventions, and in keeping with DHDSP’s commitment to evidence-based public health policy, Cloudburst is designing a comprehensive evaluation plan, including the identification or development of indicators based on program logic and clear evaluation questions, and preparation of data collection tools.

Evaluation Studies . In partnership with American Institutes for Research, Cloudburst will develop evaluation studies to measure program performance, including project- or program-level analyses; experimental or non-experimental designs; process and outcome assessments; and literature reviews. Products will include data collection instruments, data collection plans and data analysis plans using both qualitative and quantitative methodologies, OMB clearance packages, outcome reporting, and managing all logistical requirements.

HIV/AIDS Evaluation and Research . In partnership with Constella Futures Group International, Cloudburst is working on Project SEARCH (Supporting Evaluation and Research to Combat HIV/AIDS), a USAID-funded project designed to carry out research and evaluation to improve the coverage, quality and effectiveness of HIV/AIDS prevention, care and treatment programs worldwide. In addition, the project focuses on strengthening local capacity in HIV/AIDS research and public health assessments. Additional Project SEARCH team partners include The Elisabeth Glaser Pediatric AIDS Foundation and the University of Washington.

Health Research Outreach Program . For Health Education Enterprises, Cloudburst assisted in the development of an outreach program for researchers developing therapies for tinnitus. Surprisingly little advancement has occurred in the area of tinnitus, given its worldwide prevalence. The National Institute on Deafness and other Communication Disorders (NIDCD) and other organizations have identified tinnitus research as a particularly ripe area for coordination across disciplines (such as audiology, otolaryngology and neuropsychiatry). Cloudburst's work with the Tinnitus Research Initiative, a privately-funded research consortium, identified priority areas for networking, collaboration and research, and created a cohesive international community of researchers.

Subject Recruitment for National Institute on Aging Alzheimer's Study . Cloudburst was assigned to help recruit subjects for a landmark Alzheimer's study conducted jointly by the National Institute of Aging and the University of California at San Diego. The study conducted at 60 research sites around the country was designed to find certain biochemical "markers" in the blood and spinal fluid. It is hoped that these markers will help to diagnose Alzheimer's in an individual before more overt symptoms of memory loss are evident. Cloudburst produced a video that was distributed via satellite to broadcast and cable outlets nationwide to an audience aged 55 and older. The video profiled a woman participating in the study whose mother has Alzheimer's. Cloudburst also helped design a distribution and pitching plan, focusing on the sixty major media markets which are the sites of the study centers. To ensure very broad viewing, the video material will be distributed by satellite and over the Internet, with wire service notification of the feeds to more than one thousand media outlets around the country, and placed on the ABC and CBS network affiliate feeds.

CDC’s Division of Nutrition, Physical Activity and Obesity (DNPAO) State Legislative Database . Cloudburst was awarded a task order to populate and enhance the State Legislative database on nutrition, physical activity and obesity related legislation, regulation and appropriation history. Cloudburst is conducting an assessment of the Nutrition, Physical Activity and Obesity State Legislative Database making recommendations for enhancement, and providing ongoing identification and collection of state legislation, regulation and appropriation, related to nutrition, physical activity, and obesity prevention.

Colorectal Cancer Screening Program Training Materials . The purpose of the Colorectal Cancer Screening Program (CRCP) is to establish and integrate evidence-based colorectal cancer screening programs with existing CRC screening programs and/or other cancer screening or chronic disease programs, in order to increase population-based CRC screening among persons 50 years or older, focusing on asymptomatic persons at average risk for CRC with low incomes and inadequate or no health insurance coverage for CRC screening. Cloudburst is assisting CDC’s Division of Cancer Prevention and Control with the design and testing of training materials relevant to implementation and evaluation of the Colorectal Cancer Screening Program (CRCP).

Consultation and Guidance . For the Georgia Consumer Data Repository/Information Management System, Cloudburst is providing consultation and guidance to the Georgia Department of Mental Health to:

* Provide consultation and guidance to the SRA/Georgia Department of Mental Health project team for the development of the Graphic User Interface (GUI) components of the CDR/IMS system
* Provide Electronic Health Record reference design to ensure the GUI reflects the needs of the system’s end-users
* Provide consultation and guidance to support development of the data storage, ETL (Extract, Transform, Load) and Database/Data Warehouse environment (framework/data strategy)
* Guide and provide input to Business Process Analysis/Reengineering efforts to ensure data entry, retrieval of system data and reporting conforms to the work processes of various Georgia consumers.

This work is being conducted under a subcontract to SRA International. Cloudburst is serving as Subject Matter Expert and liaison between key members of the SRA development team, the Georgia Department of Mental Health and the Georgia Technology Authority to translate technical needs into requirements. We are assisting the SRA team in evaluating the appropriateness of designs, solutions, prototypes, templates, reports and other deliverables.

Programmatic Assistance and Support for the Immunization Activities of CDC’s National Center for Immunization and Respiratory Diseases . CDC has awarded Cloudburst Consulting Group a task order to provide programmatic assistance and support to CDC in its partnership with the Indian Health Service (IHS) and assist IHS in preventing disease, implementing an effective immunization system, and raising and sustaining vaccine coverage for the American Indian/Alaska Native population. Cloudburst will provide IHS with advice and assistance in the collection and monitoring of quarterly and annual immunization data, compiling quarterly childhood and adolescent immunization reports and annual immunization reports from each IHS Area, distributing quarterly and annual reports on immunization coverage for the IHS, and providing advice and assistance with the analysis of immunization program data to identify problems and trends in immunization coverage. Cloudburst will also coordinate periodic meetings of a user group to identify needed upgrades and enhancements to the system, coordinate trainings on the system for all IHS and tribal users, and coordinate the provision of technical assistance to users of the system. Cloudburst will coordinate with an on-site Division and with area offices bringing together the Cloudburst Group’s depth in providing technical consulting support, particularly around using existing and emerging technology to guide users on data collection and utilization, and experience in providing the CDC with on-site program assistance and consultation.

Medical Cancer Atlas (CDC/NCCDPHP). Cloudburst provides technical support to the CDC’s Division of Cancer to develop a protocol for a Medicare Cancer Atlas in order to provide practical information for state comprehensive cancer control (CCC) programs on the use of Medicare data as part of CCC planning projects. Included in this protocol will be the steps necessary to comply with CDC IRB protocol, the ResDAC data request packet, and the CMS data use agreement. As part of the protocol development process, Cloudburst is convening an expert panel of external scientists who have expertise in Medicare data analysis, cancer registry data, atlas design and spatial statistics, and collaborative data analysis research to review the draft protocol.

Strategic and Analytical Review of Monitoring and Coordination Plan . Cloudburst conducted a pre-publication review and provided critical comments to a grantee oversight and coordination plan developed for grantees of the Health and Human Services, Administration for Children and Families, Compassion Capital Fund (CCF) Program Office. Part of the Administration's Faith-based and Community Initiative, this plan was developed to monitor activities and provide guidance to these Faith-Based and Community-based Organizations. Under contract to Dare Mighty Things, Inc. Cloudburst assisted with overall design issues related to grantee management policies and procedures, as well as systems requirements, to run and manage an effective oversight function for these nonprofit entities. Cloudburst provided expertise in grantee performance management for federal government grantees.

Strategic Communications Support and Media Training. For the Girl Scouts of the USA, Cloudburst provided strategic communications support and media training workshops for senior Washington-based staff. The strategic support and training was provided just prior to the annual Girl Scout Day on Capitol Hill, where individual troop leaders and other Girl Scout officials visit with members of Congress to advocate for legislation that will be beneficial to teenage girls. In 2007, the Girl Scouts conducted a nationwide poll of teenage girls which found that this age group wants policy makers to adopt a holistic approach to supporting their health, rather than focus on one issue such as weight control, prevention of sexually transmitted diseases, or prevention of early pregnancies. Cloudburst helped the Girl Scouts formulate and deliver key messages to deliver these findings to influential members of Congress. Cloudburst also provided Girl Scout staff members with presentation training and speaker training, and provided videotaped role play to help them succinctly and effectively deliver their key messages. Training was provided adhering to the Cloudburst Continuum, which includes both didactic instructions and presentation practice to ensure that trainees internalize the skills they are taught.

Strategic Communications Planning. As part of an ongoing technical assistance and communications contract, Cloudburst provided tactical and strategic communications support to the American Society of Health System Pharmacists (ASHP), the 30,000 member national professional association that represents pharmacists who practice in hospitals, health maintenance organizations, long-term care facilities, home care, and other components of health care systems. Cloudburst worked with ASHP to help formulate a strategy to reach current pharmacy students, and encourage them both to choose a career in health system pharmacy (as opposed to retail pharmacy) and to pursue a residency in pharmacy in a health system setting. Cloudburst formulated key messages to reach this group, and produced two videos incorporating the target messages. Cloudburst staff conducted extensive videotaped interviews with pharmacist residents and preceptors at hospitals in Charleston, South Carolina; Tampa, Florida; and Kansas City, Missouri. Based on these interviews, Cloudburst scripted two video products, oversaw the production and consulted with ASHP regarding distribution plans for these products. Cloudburst also conducted media training for the incoming President of ASHP. This effort included generation of key messages targeted to ASHP members and the general public, as well as a didactic session and on-camera role play and critique. This effort was designed to prepare for media outreach interviews with both the pharmacy trade media and broader consumer media outlets.

Federal Policy Academy for Transforming State Mental Health Systems.   Cloudburst provided facilitation services on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Governor's Association Center for Best Practices, to a national group in an effort to create a state-level agenda for mental health policy transformation. Cloudburst assisted states to develop a strategic action plan, consistent with the New Freedom Initiative, which were driven by a set of local priorities with programs and services that provided beneficiaries with the promise of recovery.