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Strategic Planning for Chronic Disease Prevention
in Rural America: Looking Through a PRISM Lens
Amanda A. Honeycutt, PhD; Kristina Wile, MS; Cassandra Dove, MPH; Jackie Hawkins, MS;
Diane Orenstein, PhD
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Context: Community-level strategic planning for chronic disease
prevention. Objective: To share the outcomes of the strategic
planning process used by Mississippi Delta stakeholders to
prevent and reduce the negative impacts of chronic disease in
their communities. A key component of strategic planning was
participants’ use of the Prevention Impacts Simulation Model
(PRISM) to project the reduction, compared with the status quo,
in deaths and costs from implementing interventions in
Mississippi Delta communities. Design: Participants in
Mississippi Delta strategic planning meetings used PRISM, a
user-friendly, evidence-based simulation tool that includes 22
categories of policy, systems, and environmental change
interventions, to pose what-if questions that explore the likely
short- and long-term effects of an intervention or any desired
combination of the 22 categories of chronic disease intervention
programs and policies captured in PRISM. These categories
address smoking, air pollution, poor nutrition, and lack of
physical activity. Strategic planning participants used PRISM
outputs to inform their decisions and actions to implement
interventions. Setting: Rural communities in the Mississippi
Delta. Participants: A diverse group of 29 to 34 local chronic
disease prevention stakeholders, known as the Mississippi Delta
Strategic Alliance. Main Outcome Measure(s): Community
plans and actions that were developed and implemented as a
result of local strategic planning. Results: Existing strategic
planning efforts were complemented by the use of PRISM. The
Mississippi Delta Strategic Alliance decided to implement new
interventions to improve air quality and transportation and to
expand existing interventions to reduce tobacco use and
increase access to healthy foods. They also collaborated with the
J Public Health Management Practice, 2015, 21(4), 392–399
Copyright C 2015 Wolters Kluwer Health, Inc. All rights reserved.
Department of Transportation to raise awareness and use of the
current transportation network. Conclusions: The Mississippi
Delta Strategic Alliance strategic planning process was
complemented by the use of PRISM as a tool for strategic
planning, which led to the implementation of new and
strengthened chronic disease prevention interventions and
policies in the Mississippi Delta.
KEY WORDS: chronic disease, prevention, strategic planning,
systems modeling
Mississippi has the highest heart disease death rate
of any state in the nation.1 In 2007, 28.4% of all deaths
in Mississippi w
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