IHS Tribal Epidemiology Centers (TEC) Assessment

The first TEC was established in 1997, with other TECs established over the following decade to provide regional capacity throughout all of Indian Country. As the program is now fully established, IHS was interested in assessing the performance and limitations of the TECs relative to the IHS Division of Epidemiology and Disease Prevention (DEDP) and individual TEC goals and objectives, identifying the needs of the TECS that would assist them to strengthen their performance, and developing recommendations for the future development of the TECs.

Sundance Research Institute, in partnership with Econometrica, developed an approach to the assessment of IHS TECs that had three major components:

• Development of a historical and current profile of each TEC. Because the 12 TECs have original start-up dates that range from 1997 to 2008, some are considered “mature,” while others are in early development stages with less history and evolution. The profiles provided a description of each TEC and permitted it to be compared with TECs of the same stage of development. Individual TEC profiles were constructed to describe the history and development of each TEC. In addition, a summary report was prepared that permitted a comparison across TECs that will document evolution over time in organizational characteristics and development. This will be used to determine the extent to which TECs of the same cohort are developing similarly or differently and whether there are patterns of development that emerge from this examination.
• Assessment of TEC success in achieving IHS DEDP requirements as stated in the Cooperative Agreement Funding Announcement and assessment of TEC success in achieving specific goals and objectives in each TEC’s submitted work plan.

An assessment tool was developed with four components:

• An initial general section that focuses on IHS requirements of TECs, based on the most recent funding announcement under which the TEC is operating.
• A TEC-specific section that focuses on the specific work plan goals and objectives of each TEC.
• A section on challenges, limitations, and recommendations for future development and changes in the TEC program.
• Assessment of the progress and status of each TEC in developing as a public health entity was conducted, using the Local Public Health System Performance Assessment Instrument developed by the National Public Health Performance Standards Program, a collaborative program of CDC, American Public Health Association, Association of State and Territorial Health Officials, National Association of County and City Health Officials, National Association of Local Boards of Health, National Network of Public Health Institutes, and the Public Health Foundation. The Assessment Tool is based on the 10 Essential Public Health Services.

This approach to the assessment of the TECs was designed to provide a comprehensive and detailed understanding of the current accomplishments and successes of the TEC program and of the individual TECs. In addition, the approach offered the opportunity to identify limitations and challenges faced by the TECs in meeting the goals and objectives of the TEC program and potential changes and directions that would strengthen the program as it moves forward.