In partnership with the CDC’s Office on Smoking and Health, The Center for Public Health Systems Science (CPHSS) worked with North Dakota in 2018 to complete a sustainability assessment and planning process for the state’s commercial tobacco prevention and cessation efforts. Neil Charvat, Director of the North Dakota Tobacco Prevention and Control Program (TPCP), explained that before their work with CPHSS, sustainability had been a vague concept for North Dakota tobacco control efforts.
The Sustainability Framework and Action Planning Process provided an actionable approach to building sustainability capacity that leverages existing resources and strengths in key program areas. One takeaway for North Dakota was the importance of messaging for demonstrating their program’s value to decision-makers. Proving the program’s impact was especially critical because state leadership had less confidence in North Dakota’s tobacco prevention efforts following a recent restructuring of those efforts. In the 2017 North Dakota Legislature, the state eliminated the foundation primarily responsible for comprehensive tobacco prevention activities, leaving the Department of Health program to lead those efforts.
By focusing on communicating value to decision-makers, North Dakota has increased funding for their program over the last two biennia. The program attributes this to their work with an external evaluator, Professional Data Analysts (PDA), to develop synthesis reports that tell the story of their program, including its impact and needs. The reports feature both quantitative and qualitative data to show the program’s progress in addressing key issues for North Dakota. In evaluating their statewide efforts, the program decided to focus on outcomes representing leadership and funder priorities, directly connecting funding to community benefits. It was also important to balance highlighting program successes with identifying areas in need of more resources. North Dakota develops new reports based on a biennial cycle that aligns with the state legislature so they can continue sharing the most relevant information based on a changing program and state.
Director Neil Charvat and the TPCP staff first shares the reports with leadership for their approval, which provides the opportunity to educate them on the program’s activities and impact. Once approved by leadership, Neil presents the reports to appropriation committees in the House and Senate to show their program’s success using previous funding and to support additional funding requests. For example, during the 2023 legislative session, the TPCP received an additional appropriation of $300,000 for youth action summits and youth nicotine dependence treatment. Following the integration of the Department of Health and the Department of Human Services, Director Neil Charvat says,
Other programs were worried about what could happen with their program and staffing levels. I was not because we have demonstrated that our staff is effective.”
The reports are also available to the public and for use by partners to promote their efforts. As North Dakota continues its sustainability efforts, they would also like to show the effectiveness of local efforts. The state program has started requesting that local grantees provide more detailed documentation of how funds support activities to adapt best practices in their communities. Neil says, “That’s the level we’re taking our sustainability to. It’s one thing to prove our effectiveness as a state program. […] What we want to do now is make sure we can demonstrate that with our other grantees and partners.”
North Dakota’s Comprehensive Commercial Tobacco Prevention and Control Team