Thursday, August 6, 2009

House & Senate Health Services Subcommittees Report

House & Senate Health Services Committee report. MISRGO presented the "MISRGO Best Practices & Outcomes" report to the House & Senate Health Services Committee of the House and Senate Public Health, Welfare, and Labor Committees on August 4, 2009. (It is available online here and on the right column.)

The report summarizes the best practices and outcomes of the Minority Initiative Sub-Recipient Grant Office's (MISRGO) tobacco prevention efforts. It begins with:

$94 Million Saved in Excess Medical Costs

MISRGO grantees have saved the State of Arkansas $94,944,281.96 in excess medical costs. This is a significant outcome by any standard. It is also an increase from previous years.

The formula for calculating this savings is straightforward. The figures used in the formula come from the Arkansas Department of Health, Campaign for Tobacco-Free Kids, Centers for Disease Control and Prevention, and the U.S. Census Bureau.

The formula is the number of people who stop smoking, times the per person cost of smoking in the State of Arkansas. Then each grantee’s total is added together to produce the final reported figure. The dollars saved are in terms of excess medical costs saved the State.

A table of the formula is presented below:

A complex formula is used to provide precise data by county. However, a simpler approach can be used to calculate the dollars saved. The overall State average can be used to calculate the excess medical costs saved. The formula is based on the following information:

1. $812 million annual health care costs in Arkansas directly caused by smoking

Source: Campaign for Tobacco-Free Kids (The New York Times Magazine called the Campaign the "the country's leading anti-tobacco lobby.")

2. 4900 people who die each year from their own smoking in Arkansas

Source: Campaign for Tobacco-Free Kids

3. $812,000,000 divided by 4900 = $165,714 approximate per person cost

4. $165,714 times 572 (the number of people who have quit smoking as a result of grantee efforts) = $94,788,408 saved in terms of excess medical cost


A state-wide survey was conducted to solicit community views of MISRGO tobacco prevention programs. The most significant survey finding was the overwhelmingly positive value placed on these tobacco prevention programs in communities throughout the State. When asked if:

“Tobacco prevention & education programs are a good use of public money?”

The response from an overwhelming majority of Arkansans sampled was positive (98% answered yes).

In addition, community members believe grantees’ tobacco and prevention efforts have been effective in PREVENTING people from using tobacco and in getting people to STOP using tobacco.


MISRGO grantee programs use CDC recommended tobacco prevention activities. These activities contribute to the outcome data reported earlier, e.g. reduction in the number of smokers in the State and the millions saved in terms of excess medical expenses. A series of bar charts illustrate how MISRGO monitors and supports these efforts across programs and grantees. This tool has also been useful for grantees, placing their activities in comparison with other grantees. It has influenced them to "join in" the collective effort, increasing the "dose" effect with more grantees working on the same tasks and concerns.

The bar charts below provide an insight into the activities held in common across grantees, eg. minority initiatives, coalition building, Quitline promotion, newspaper articles, radio and TV advertisements, and educational materials.

Detailed findings of program activities are presented in the following report: Introducing the Visual Alert System: A Graphical Analysis of the MISRGO Mid-Year Report (Fetterman, Fitch, and Delaney, 2008).


Training is a critical component of MISRGO grantee effectiveness. Grantees and evaluators continually learn more about effective tobacco prevention practices. They also receive evaluation training in order to monitor and assess their effectiveness. (See earlier postings on this site for more information about the evaluation training grantees and evaluators receive to support their efforts.)

The pictures below highlight grantees and evaluators engaged in self-evaluation exercises and Dr. Fetterman providing training in interviewing and observation skills.


Political support for the program is extensive including:

  • University of Arkansas academic officials (Drs. Johnson and Benjamin)
  • Senators (Henry "Hank" Wilkins, IV and Tracey Steele)
  • Representatives (Stephanie Flowers and Earnest Brown)

MISRGO has received a citation from the State of Arkansas for its evaluation training.


One of MISRGO's mandates is to disseminate promising practices, evaluation findings, and program outcomes. MISRGO has made presentations at professional meetings such as the following:

In addition, MISRGO staff and colleagues have published articles and books concerning "lessons learned."

The report summarizes many of MISRGO's tobacco prevention best practices and outcomes. A few of these practices and outcomes include:

  • 94 million saved in excess medical costs between 2005-present
  • 94% engaged in minority initiatives to prevent tobacco consumption
  • 94% using educational materials as part of their tobacco prevention campaigns
  • 88% engaged in coalition building to combat tobacco use
  • 76% promoting the use of Quitline
  • 76% using radio and TV ads to combat tobacco use

MISRGO has provided strong leadership and technical assistance and grantees and evaluators remain vibrant and committed. The prognosis is good. MISRGO and its grantees are well positioned to continue to have a positive impact on the minority community in Arkansas in the foreseeable future.