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Mobilizing for Action through Planning and Partnerships (MAPP) is a strategic approach to community health improvement. This tool helps communities improve health and quality of life through community-wide strategic planning. Using MAPP, communities seek to achieve optimal health by identifying and using their resources wisely, taking into account their unique circumstances and needs, and forming effective partnerships for strategic action.
The MAPP tool was developed by the National Association of County and City Health Officials-(NACCHO), in cooperation with the Public Health Practice Program Office, Centers for Disease Control and Prevention (CDC). A work group comprised of local health officials, CDC representatives, community representatives and academicians developed MAPP between 1997 and 2000.
The following seven principles are integral to the successful implementation of MAPP:
Listed below are just some of the benefits to be derived from the MAPP process
The MAPP tool was designed to include the following key elements.
1) MAPP emphasizes a community-driven and community–owned approach — Because the community's strengths, needs and desires drive the process, MAPP provides the framework for creating a truly community-driven initiative. This creates stronger connections throughout the community and provides access to the collective wisdom necessary for addressing community concerns.
2) MAPP builds on previous experiences and lessons learned — Information from previous planning efforts and established assessment tools was used in developing MAPP. Most notably, MAPP builds on the Assessment Protocol for Excellence in Public Health (APEXPH). Released in 1991, APEXPH has guided hundreds of local health departments through internal organizational capacity assessments and collaborative community health assessment processes. While building on the familiar concepts of APEXPH, MAPP is more progressive in a variety of ways:
APEX PH
3) MAPP uses traditional strategic planning concepts within its model — Strategic planning assists communities in more effectively securing resources, matching needs with assets, responding to external circumstances, anticipating and managing change, and establishing a long-range direction for the community. The MAPP model includes basic strategic planning concepts, such as visioning, an environmental scan, the identification of strategic issues, and the formulation of strategies.
4) MAPP focuses on the creation and strengthening of the local health system — Local health systems are the human, informational, financial and organizational resources, including public, private and voluntary organizations and individuals that contribute to the public's health. This focus is important because the public's health depends on the interaction of many factors; thus, the health of a community is a shared responsibility of many entities and organizations, in the community. The MAPP process brings these diverse interests together to collaboratively determine the most effective way to conduct public health activities.
5) MAPP creates health leadership opportunities — While MAPP focuses on the local health system, it is anticipated that leadership roles in initiating MAPP could come from any interested entity - public or private - in the community. Thus, MAPP will help to create a greater recognition of the importance of the health system and the potential to impact health of the community.
6) MAPP uses the Essential Public Health Services to define public health activities — The Essential Public Health Services and other public health practice concepts have been incorporated into MAPP, providing much-needed links with other public health initiatives. The Essential Public Health Services are a list of ten public health activities that should be undertaken in all jurisdictions.
The use of the Essential Services framework and the focus on the local health system provides a crucial link with the National Public Health Performance Standards Program (NPHPSP), developed by CDC, NACCHO, and other national public health organizations. The local-level instrument of the NPHPSP is an integral part of MAPP's Local Health System Assessment.
Assessment is a significant phase of the MAPP process
MAPP brings four assessments together to drive the development of a community strategic plan — Four unique and comprehensive assessments gather information to drive the identification of strategic issues. The essential services most associated with the core function of assessment are:
The four MAPP Assessments are:
The graphic of the MAPP model illustrates the phases of MAPP process, shown in the center. The four MAPP assessments -the key content areas that drive the process - are shown in the outer circle.
To initiate the MAPP process, lead organizations in the community begin by organizing themselves and preparing to implement MAPP (Organize for Success/Partnership Development). Community-wide strategic planning requires a high level of commitment from partners, stakeholders, and the community residents who are recruited to participate.
The second phase of the MAPP process is Visioning. A shared vision and common values provide a framework for pursuing long-range community goals. During this phase, the community answers questions such as “What would we like our community to look like in 10 years?”
Next, the four MAPP Assessments are conducted, providing critical insights into challenges and opportunities throughout the community:
The Community Themes and Strengths Assessment provides a deep understanding of the issues residents feel are important by answering the questions “What is important to our community?” “How is quality of life perceived in our community?” and “What assets do we have that can be used to improve community health? ”
The Local Health System Assessment is a comprehensive assessment of all of the organizations and entities that contribute to the public’s health. The Local Public Health System answers the questions “What are the activities, competencies, and capacities of our local health system?” and “How are the Essential Services being provided to our community?”
The Community Health Status Assessment identifies priority issues related to community health and quality of life. Questions answered during the phase include “How healthy are our residents?” and “What does the health status of our community look like?”
The Forces of Change Assessment focuses on the identification of forces such as legislation, technology, and other issues that affect the context in which the community and its public health system operates. This answers the questions “What is occurring or might occur that affects the health of our community or the local health system?” and “What specific threats or opportunities are generated by these occurrences
The essential services most associated with the core function of Policy Development are:
Policy Development functions meet the goals and mission of the NPHPSP through the following public health practices:
Once a list of challenges and opportunities has been generated from each of the four assessments, the next step is to Identify Strategic Issues. During this phase, participants identify linkages between the four assessments to determine the most critical issues that must be addressed for the community to achieve its vision. After issues have been identified, participants Formulate Goals and Strategies for addressing each issue.
The final phase of MAPP is the Action Cycle. It is through the steps of the Action Cycle that the core function of Assurance is practiced. During this phase, participants plan, implement, and evaluate. These activities build upon one another in a continuous and interactive manner and ensure continued success.
The essential services most associated with Assurance are:
The Action Cycle links three activities— Planning, Implementation, and Evaluation. Each of these activities builds upon the others in a continuous and interactive manner.
The Action Cycle can be a very satisfying phase, as the efforts of the previous phases begin to produce results through the implementation of the action plan. This is also a challenging phase, as it requires substantial effort to sustain the process and continue implementation over time.
The strategies identified in the previous phase form the foundation for the Action Cycle. Clear strategic goals are another important element. Crisply articulated goals will not only fuel the activities of practical work plans, but will also prompt accountability and evaluation. For the local public health system, such accountability will depend on the specific objectives and components of a work-plan agreed upon by the necessary participants.
The evaluation component of the Action Cycle answers the following fundamental questions: “With the implementation of activity X, what was accomplished?” and “How does that compare what we said we would accomplish?” In essence, these lead to four questions of practical utility: 1. What have you done? 2. How well have you done it? 3. How much have you done? 4. How effective have you been?
There are two focal points to MAPP evaluation activities: evaluation of the overall process and evaluation of each strategy and action plan. Both evaluations should rely on objective parameters (e.g., facts and figures), but should also accommodate subjective value judgments. This interplay between objective and subjective aspects provides the MAPP Committee with an opportunity for a well-balanced evaluation process.
The Action Cycle can be summarized as follows: Planning — Determining what will be done, who will do it, and how it will be done. Implementation — Carrying out the activities identified in the planning stage. Evaluation — Determining what has been accomplished. The cycle repeats itself, offering a sustainable method for the community to build upon accomplishments and position itself for even greater achievements.
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Palm Beach County Health Dept.
Community Health
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