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Army Health Promotion and Prevention Initiatives
(HPPI)
Presented by MAJ Mark Piotrowski DSN 584-7390/
410-436-7390 U.S. Army Center for Health
Promotion and Preventive Medicine
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Briefing Topics

• History
• Process Evolution
• Current Process
• Oral Health HPPI Projects
• Future

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Description

• OCT 7 1996, Memorandum for Lead Agents
• Through Surgeons General
• SUBJECT Health Promotion and Prevention
  Initiative
• Submission of Concept Descriptions for
  Progressive Prevention Programs at the Healthcare
  Facility Level

FOR MORE INFO...

• http//www.tricare.osd.mil/readiness/hppiwnrs.html

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Process Evolution
OASD(HA) MEDCOM CHPPM
FOR MORE INFO...
http//www.armymedicine.army.mil http//chppm-www.
apgea.army.mil/dhpw/HPPI
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HPPI Goals

• Development of Metrics
• Identification of Best Practices
• Proliferation

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Initiative Selection Criteria

• Overall Population Impact
• System-wide Replication Opportunity
• Cost
• Scientific Basis
• Compatibility with Put Prevention Into Practice
  and Healthy People 2000 objectives (DoD selected)

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OverviewArmy Process
TSG Top 20 - Issue No. 11

• 27 Army Initiative Winners
• 1.446 M Received Each Year (FY 97 - FY 00)
• Purpose of the Initiative
• Identify specific evaluation metrics.
• Identify best practices for proliferation
  throughout the AMEDD.
• Recommend funding distribution.

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FY 1998 Funding1.446 M

• CHPPM Temporary Repository of Funds
• Recommendations for FY 98 Distribution
• Reinvestment of Developmental and One-time Costs
• Continuation of Selected Existing Initiatives

HPPI
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FY 1999 Funding1.446 M

• CHPPM Temporary Repository of Funds
• Data Call
• 64 Proposals Received 4.431 in funding
• 27 Proposals Funded
• 11 Continuations

HPPI
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FY 2000 Funding1.446 M

• CHPPM Temporary Repository of FundsFocused Data
  Call66 Proposals Received 6.431 in
  fundingProposals FundedContinuationsNewProject
  Impact Matrices
• Evidence Matrices

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Health Promotion and Prevention Initiatives
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Current ProcessProgram Plan

• Title and Duration of Program
• Background Information
• Description of Need
• Bibliography of Literature Review
• How Program Achieves DoD/Army Goals
• Resource Requirements - Incremental
• Developmental Costs
• Continuation Costs

HPPI
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Current ProcessProgram Plan (Continued)

• Program Implementation Plan
• Description
• Goals/Objectives
• Evaluation
• Target Population
• Timelines and Milestones

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Criteria to Identify Best Practices
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Future
Where we are headed.
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Desired HPPI Outcomes

• Creation of a HPPI portfolio
• Uniform Benefit
• Development of templates/tools
• Design and evaluation of local programs.
• Appropriate resourcing of health and fitness
  programs
• Identification of best practices
• Listing of validated metrics

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Proposed Uniform Benefit Package for Health
Promotion
Tool Box -- Web - Based

• Tobacco Cessation
• Physical Fitness
• Nutrition and Weight Control
• Stress Management and Suicide Prevention
• Hypertension Education

• STDs and HIV Prevention
• Oral Health Fitness
• Spiritual Fitness
• Injury Prevention
• Self-Care

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Tool Box -- Web - Based Illustration

• Injury Prevention
• Current Information
• Atlas of Injuries in the U.S. Armed Forces
• Best Practices and Benchmarks
• CDC
• Hot Links
• Prevention, Safety, and Health Promotion Council

http//www.denix.osd.mil/denix/Public/Library/Atla
s/atlas.html
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Tool Box -- Web - Based Illustration

• Program Design Hot Links
• Lessons Plans/Training Manual
• Fact Sheets
• Bibliography
• Public Service Announcements (sample articles for
  publication
• National and Community Resource Directory
• Multimedia Activities (video/audio)
• Evaluation Mechanism and Metrics
• Marketing Materials
• Training Briefing Slides
• Command Briefing Package
• Identify of the Necessary Credentials for Health
  Promotion Professionals.
• Job Descriptions

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Sounds Great -- Right?????BUT..
We MUST receive the data from the field!!!
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Focused Data CallTentative Topics

• Injury Prevention
• Mental Health
• Spiritual Fitness
• Oral Health

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Project Impact Matrices
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Outcome MatricesMatrix
Does your proposed HPPI Project ID 1
Identify the target group to receive the
HPPI intervention? 2 Document
participant demographics (gender, age, race,
rank, health status, health
risk, etc.)? 3 Increase health
knowledge? 4 Positively affect
health attitude? 5 Teach health
skills or health behaviors? 6
Decrease behavioral health threat? 7
Decrease environmental health threat? 8
Measure pre-intervention health
knowledge? 9 Measure
pre-intervention health attitude? 10
Measure pre-intervention health behavior? 11
Measure pre-intervention health status?
12 Measure pre-intervention health
threat? 13 Measure pre-intervention
organizational health awareness and/or health
threat status? 14
Measure post-intervention health knowledge? 15
Measure post-intervention health
attitude?
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Outcome Matrices, continued16
Measure post-intervention health behavior?17
Measure post-intervention health status?18
Measure post-intervention health
threat?19 Measure post-intervention
organizational health awareness and/or health
threat status?20
Evaluate your HPPI Project effectiveness by the
project team (such as AAR)?21 Evaluate
your HPPI Project effectiveness by project
participants (such as AAR)?22 Evaluate
your HPPI Project effectiveness by project
sponsors/proponents (such as
AAR)?23 Evaluate your HPPI Project
effectiveness by project collaborators (such as
AAR)?24 Use objective health
status/health threat indicators (blood pressure,
injury, APFT score, etc.)?25
Use self-reported health status/health
threat indicators (alcohol, mental health,
family, etc)?26 Use
participant HRA or HEAR data? 27 Use
target group surveillance data?28 Use
target group survey data?
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Oral Health Fitness Mouthguards

• Goals/Objectives
• Initiate the awareness of mouth protection to
  incoming troops.
• Develop a program that designates a subject
  matter expert
• Gather data that will support the instrumentation
  of a mouth protection program.
• Ultimate goal is develop a viable safety program
  for mouth protection that can be incorporated
  throughout the Army and mandated by TRADOC

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Oral Health Fitness Mouthguards

• Needs Analysis
• Mouth guards prevent injury and severity to
  teeth and the facial complex.
• Several sports mandate it use, sports dentistry
  recommends its use in over 50 sports,
• Numerous hours of training are lost due to
  injuries to the teeth and mouth.
• Mouth protection cost pennies while one accident
  monetarily cost in the thousands of dollars to
  repair.
• Troops have reported to emergency dental sick
  call with mouth trauma from sports accidents and
  the following training accidents, pugal stick,
  repelling, obstacle courses, firing range and
  land navigation

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Oral Health Fitness Mouthguards
Time TASK Implementation
Have literature, supplies, lectures and trained
personnel start program   Two month
Evaluate initial recruit cycle for
compliance to mouth guard
integration   Fourth month Reevaluate
implementation plan   Sixth Month
Brief Commanding General and Training Brigades
on progress and initiate a
SOP that require recruits to
maintain 100 accountability of mouth
guard and
Require participants in intramural sports to wear
mouth protection.   Tenth Month
Reeval progress  Twelfth Month Gather data
for AAR  
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Oral Health Fitness
BITE

• Project Work plan  
•  Continue to fine tune program develop new
  materials.
•  Order distribute educational materials.
•  Continue sustainment of the program through
  Health Promotion briefings at all officer
  enlisted dental courses at AMEDD Center School,
  Command Assistance Visit Staff Assistance Visit
  emphasis of all HP initiatives
•  Schedule trainings with Reserve units.
•  Develop distribute CD ROM dental readiness /
  health promotion education CD ROM
• Develop Health Promotion Website (currently at
  http//www.armymedicine.army.mil/dencom/dcbranch/a
  dcs/chief/main.html) with links to other HP sites

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Oral Health FitnessFluoride

• Goals/Objectives
• Educate sponsors and family members
• Provide a convenient and cost-free means for
  water testing
• Prescribe appropriate fluoride supplementation
• Permit beneficiaries to realize the benefits of
  fluoride
• Monitor compliance with fluoride supplementation.

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Oral Health FitnessErgonomics

• Goals/Objectives
• Demonstrate the effectiveness of an integrated
  ergonomics program
• Education/Investigation
• Task, tool, and equipment redesign and workload
  scheduling)
• Readiness, health care utilization,
  musculoskeletal symptom and stress reduction

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HPPI POCs

• Tina Allen
• DSN 584-7208 Commercial 410-436-7208
• MAJ Mark Piotrowski
• DSN 584-7390 Commercial 410-436-7390
• Brad Taft
• DSN 584-7972 Commercial 410-436-7972
• Carlla Jones
• DSN 584-1329 Commercial 410-436-1329
• http//chppm-www.apgea.army.mil/dhpw, under
  "What's New?" in the upper right-hand corner.