The steps reported by Lewis et al to develop a health promotion success story were tailored to collect, develop, and disseminate the DNPAO stories from the field (6
). The adapted steps are detailed below and in the Box
. Appendix A
has an example of a DNPAO story from the field (also available at www.cdc.gov/obesity/stateprograms/statestories.html
Box. Comparison of Steps Used to Develop Stories
Steps to Develop WISEWOMAN Success Stories (6
1. Identify audience and purpose
2. Develop systematic process
3. Develop standardized form
4. Collect story ideas
5. Conduct interviews
6. Develop appealing format
7. Write and revise stories
8. Organize stories
9. Design and print publication
10. Disseminate publication
Steps to Develop DNPAO Stories From the Field
1. Identify audience and purpose
2. Collect story data
3. Review and select stories
4. Collect additional data
5. Develop and refine stories
6. Design story template
7. Disseminate stories
Abbreviations: WISEWOMAN, Well-Integrated Screening and Evaluation for Women Across the Nation; DNPAO, Division of Nutrition, Physical Activity, and Obesity of the Centers for Disease Control and Prevention.
Identify audience and purpose. The purpose of collecting DNPAO stories from the field was to develop stories that described efforts of state health departments and their role to support communities in planning and implementing PSE strategies related to healthful eating and active living. In comparison to traditional success stories, which only describe exemplary work and highlight achievements, these stories would represent states at various stages of development or maturity, including states that may have achieved full implementation of their PSE initiatives, states that may still be in early planning stages of an initiative, and states that may have had limited success. Overall, some of the goals of the stories would be to feature a diverse set of accomplishments, challenges, and lessons learned of state health departments and their partners; enhance horizontal consultation among state health departments; and increase knowledge of obesity prevention practices.
The primary audience for the DNPAO stories from the field was state health department staff involved in NPAO initiatives and practitioners in local health departments and partnering organizations implementing similar policies and practices. To increase visibility of state health department efforts and inform key stakeholders of the state-based program about practices in the field, secondary audiences of the stories were also identified, which included policy makers, researchers, CDC staff, and the general public.
Collect story data.
In October 2010, twenty-five funded state health departments submitted a story through a web-based data collection form in SPIRS (Appendix B
). Questions and in-depth directions were included in the data collection form to assist state health department staff, usually program managers, in the development of a story. Story data collected included background on the public health problem being addressed; a description of the target population; details on the process of planning or implementing the initiative, including partners involved, where and when the initiative was implemented, and resources associated with the initiative; a description of the key results or products of the initiative; a reflection on the facilitators and barriers to planning and implementation; and considerations for other organizations or communities implementing similar initiatives.
Review and select stories. Because only a limited number of stories could be developed from the data collected through SPIRS, criteria were applied for selecting the stories featured in the series. Two story project team members individually reviewed and ranked the 25 story submissions using the following criteria: focused on PSE approaches; addressed health equity; described collaboration with community-level partners; and demonstrated substantial reach, impact, replicability, and sustainability (). The story rankings were discussed and consideration was given to generating a collective set of stories that represented varied stages of development, DNPAO target areas, and settings. The 2 reviewers achieved consensus on the story rankings and 10 state stories were selected for development.
Criteria Applied to Select DNPAO Stories From the Field
Collect additional data.
Following story review and selection, states were contacted by CDC staff to schedule telephone interviews with state health department staff and relevant community partners to further develop the story. Semistructured discussion guides (Appendix C
) were developed for each state to fill in any missing gaps in the data collection form, provide additional details, and obtain quotes. The telephone interviews typically lasted 60 minutes and were audio recorded. A skilled interviewer facilitated the conversations and a note taker recorded detailed notes, including verbatim quotes. The interview participants were also asked to provide any available background materials, such as previous evaluation reports or web links on the initiative, that would further the development of the story.
Develop and refine stories. Data collected from each story submission and state interview were synthesized into a 1- to 2-page story. Stories were generally written using the following format: 1) a title, communicating the theme or focus of the story; 2) details on the policy or environmental change initiative, describing the key elements of the featured initiative and where appropriate, “how to” information that would be relevant to practitioners engaging in similar efforts; 3) short- and long-term results of the initiative, describing the main outcomes of the featured initiative, both intended and unintended, and where appropriate, information about new partnerships formed, organizational changes, and the potential public health effects; 4) lessons learned, summarizing the knowledge and experiences that facilitated or challenged the state efforts, which may be helpful to practitioners engaging in similar efforts; and 5) contact information.
Once the initial draft of the story was developed, it was shared with CDC staff and state health department representatives involved in the featured story for their review. The purpose of this review was to ensure that the story accurately represented the data collected from the story submission and telephone interview. The stories were revised and edited using any feedback received.
Design story template.
Graphic designers developed a visually appealing template and selected appropriate photographs for each of the stories. Because it was anticipated that the stories would be posted on the CDC website, designers also ensured each story complied with regulations that require federal agencies to make information technology accessible to people with disabilities (16
Disseminate stories. Stories were disseminated to state and local health departments, policy makers, researchers, CDC staff, and the general public through various e-mail listserves and CDC websites. State health departments featured in the series were encouraged to further disseminate the stories to their state- and community-level partners. The series and the methods by which the stories were developed were also shared at national conferences to create awareness of the methods and tools used and at trainings attended by various public health professionals to build capacity in story development.