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Strategic Planning for Chronic Disease Prevention in Rural America: Looking Through a PRISM Lens

Honeycutt, Amanda A. PhD; Wile, Kristina MS; Dove, Cassandra MPH; Hawkins, Jackie MS; Orenstein, Diane PhD

Journal of Public Health Management and Practice: July/August 2015 - Volume 21 - Issue 4 - p 392–399
doi: 10.1097/PHH.0000000000000062
Original Articles

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 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.

This study aims at sharing 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.

Public Health Economics Program, RTI International, Research Triangle Park, North Carolina (Dr Honeycutt); Systems Thinking Collaborative, Stow, Massachusetts (Ms Wile); Mississippi Delta Health Collaborative, Chronic Disease Bureau of the Office of Preventive Health, Mississippi State Department of Health, Jackson (Mss Dove and Hawkins); and Division of Community Health, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Orenstein).

Correspondence: Amanda A. Honeycutt, PhD, Public Health Economics Program, RTI International, 3040 Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709 (

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

The authors declare no conflicts of interest.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.