Figure 1. Washington State Specific Logic Model Framework for Heart Disease and Stroke Prevention Program. (HDSPP indicates Heart Disease and Stroke Prevention Program; CDC, Centers for Disease Control and Prevention; and HD&S, heart disease and stroke.)

The figure begins with a series of boxes organized into three columns. The three boxes arranged on top of each of the columns read 1) Inputs, 2) Activities, and 3) Goals From State Plan (5 year MIS objectives). In the first column, entitled “Inputs,” are three boxes arranged from top to bottom. Inside the first box, entitled “HDSPP,” are the following bullet points: state program funding; expertise of professional staff and infrastructure; time commitment; internal partners and stakeholders; communication; and internal epidemiology support for surveillance and evaluation. Inside the second box, entitled “CDC,” are the following bullet points: funding; programmatic guidance; training; CDC project officer; conference calls, listserv; and technical assistance. Inside the third box, entitled, “Advisory Council Members and Organizations,” is the following information: investment of staff time for strategic planning and implementation of defined strategies. All three boxes in the first column are connected with a right-pointing bracket to the boxes in the second column.

The second column, entitled “Activities,” contains one large box beneath the title box. The large box contains four major sections, each with information listed beneath. The four major sections are: 1) Communication, 2) Systems Change, 3) Implement State Plan, and 4) Assessment and Evaluation. Underneath the “Communication” section is the following information: Go Red for Women campaign; and Signs of Stroke campaign. Underneath the “Systems Change” section are the following bullet points: employer-based health and productivity; Washington State Collaborative; Get with the Guidelines (AHA); NCQA recognition program (Puget Sound health alliance); and HD&S Systems of Care Improvement Project. Underneath the “Implement State Plan” section is the following information: Heart Disease and Stroke Prevention steering council meetings. Underneath the “Assessment and Evaluation” section is the following information: produce a) expanded county profiles, b) the surveillance notebook, c) other analyses; and inventory CVD data sources.

The third column, entitled “Goals From State Plan (5 year MIS objectives),” contains one large box beneath the title box. The large box contains a listing of eight goals, which are organized in the following order: 1) Goal 3: Washington residents know risk factors and warning signs of HD&S; 2) Goal 5: action plan and policies empower consumers, result in improved health status and quality; 3) Goal 2: surveillance used to transform operations (adopt evidence–based practices); 4) Goal 7: Washington maintains and coordinates HD&S systems of prevention, screening, diagnosis, treatment and rehabilitation; 5) Goal 8: education for HD&S prevention and management for licensed, registered, or certified health care providers; 6)Goal 4: steering council is convened; 7) Goal 9: evaluation of effectiveness of HD&S prevention system; and 8) Goal 1: comprehensive HD&S data.

All of the information in the large box in the second column is connected to the goals listed in the large box in the third column, using right-pointing arrows. “Go Red for Women Campaign” and “Signs of Stroke Campaign” under the “Communication” section of column two is connected to “Goal 3: Washington residents know risk factors and warning signs of HD&S” in column three. “Employer-based health and productivity” under the “Systems Change” section of column two is connected to “Goal 5: action plan and policies empower consumers, result in improved health status and quality” in column three. “Washington State Collaborative,” “Get with the Guidelines (AHA),” and “NCQA recognition program (Puget Sound health alliance)” under the “Systems Change” section of column two are connected to “Goal 2: Surveillance used to transform operations (adopt evidence–based practices)” in column three. “HD&S Systems of Care Improvement Project” under the “Systems Change” section of column two is connected to “Goal 7: Washington maintains and coordinates HD&S systems of prevention, screening, diagnosis, treatment and rehabilitation” and to “Goal 8: education for HD&S prevention and management for licensed, registered, or certified health care providers” in column three. “Heart Disease and Stroke Prevention steering council meetings” under the “Implement State Plan” section of column two is connected to “Goal 4: steering council is convened” in column three. “Produce a) expanded county profiles, b) the surveillance notebook, c) other analyses” under the “Assessment and Evaluation” section of column two is connected to “Goal 9: evaluation of effectiveness of HD&S prevention system” in column three. “Inventory CVD data sources” under the “Assessment and Evaluation” section of column two is connected to “Goal 1: comprehensive HD&S data” in column three.

To the right of column three are another series of three columns, each with a heading box above them. The first three columns already described are connected to the second series of three columns with a right-pointing bracket. The heading boxes above the second set of three columns read, “Short-term Outcomes,” “Medium-term Outcomes,” and “Long-term Outcomes.” Inside the first box of the second set of columns is the following information: partnerships and collaborations are established and Working; increased public awareness of the signs and symptoms of heart disease and stroke, knowledge to call 9-1-1 [noted as a CDC priority area]. Box one is connected with a right-pointing arrow to box two of the second set of columns. Inside the second box there are three sections. The first section reads, “Enhanced public health system infrastructure.” The second section, entitled “Improved quality of care,” contains the following two bullet points: a) improved emergency response to acute events across the state, and b) better management of chronic conditions. (The entire section of “Improved quality of care” is noted as a CDC priority area.) The third and last section of the second box, entitled “Individual Behavior Change,” contains the following three bullet points: a) better self-management of chronic disease; b) control of risk factors, especially blood pressure and cholesterol [noted as a CDC priority area]; and c) improved lifestyle. Box two is connected with a right-pointing arrow to two separate boxes in column three. These two smaller boxes are arranged vertically to form the final column. Inside the top box of column three is the following information: Reduce health disparities between general and priority populations. (The words “reduce health disparities” are noted as a CDC priority area.) Inside the bottom box of column three is the following information: Reduce deaths and disability due to heart disease and stroke.

Underneath the six columns is the following text: Washington State’s Contextual Influences: unique patterns of ethnic diversity and income inequities, high unemployment. This text has a series of seven arrows that point upwards toward a large bolded line that lies beneath the six columns.

Volume 5: No. 2, April 2008