Setting Goals And Objectives
Review state and national health goals related to priorities identified in your county
Review goals set for the health issue identified at the state and national levels. New York State goals can be found in "Communities Working Together for a Healthier New York".
Guiding principles and methods used to set targets in Healthy People 2010 included: retention of the year 2000 target, computation of statistical regression using current rates to project a target, knowledge of the programs currently in place and expected change, and expert judgment. It takes generally take three or more years to measure state and national objectives. Your team will have to identify annual objectives that could lead to the attainment of the long-term goals.
Identify target objectives for meeting these goals
Target setting requires knowledge of the current health status of the community; what's achievable and striking a balance between a challenge towards accomplishing the target, and pushing towards achieving the target.
Listed below are target setting options, in order of ease:
- Using an absolute percent decline or improvement to indicate a "reasonable" change over the period. For example, an absolute decline of 1% of the current level adds to 10% over the decade. Be careful to calculate the % for the numbers from the beginning of the decade, or it will be a compounded percentage achieved (as below).
- Use a compounded percentage to both indicate a "reasonable" change over the period but one which becomes less than the absolute. For instance, a decline of 1% each year from the previous year over the period of a decade is actually 9.6% (1-(.99)) and not 10% as above. Reverse this calculation to obtain the annual percentage change if you have a total that you'd like to achieve by the end of the decade.
- Use the current U.S. rate as the challenge point. This works when the state or community rate is worse than the U.S. rate and within a distance achievable. This works when the jurisdiction is deemed "like the U.S." or average in some way.
- Use the median values of one's peers. The Community Health Status Indicators (CHSI) Project has generated 88 peer groupings of counties that share similar characteristics. These characteristics include factors that are though to influence community-level health. This target works when the U.S. rate is too high or too low for the type of jurisdiction. For instance, southern states tend to have more poverty and so to compare health outcomes to the U.S. rates is too much of a challenge.
- Adopt the Healthy People 2010 targets for the indicators. When the jurisdiction cannot decide and when its current levels are similar to the U.S., the Healthy People targets may be very appropriate as well as ready and easy to use.
- Calculate the "Better than the best" (used in Healthy People 2010); setting a target better than the current status of any population sub-group.
- Using pared-mean method or "better than the best" - benchmarking against the top 10% in any area of the US.
- Calculate what's achievable based on clinical or community trials. For instance, breast and colon cancer deaths can be reduced by 30-40% of the peak in breast cancer in the mid 1980's and by the same amount in colon cancer today. Consideration needs to be made in how quickly intervention (in this case, screening) will affect the death rate and how effectively the intervention will be launched in the community.
Criteria for writing objectives
When writing objectives, a helpful acronym to remember is SMART.
Specific
Measurable
Attainable
Resources
Time Specific
Use the goals and objectives worksheet to learn how to write SMART objectives.
-Adapted from Healthy People 2010 Toolkit