The Interim Director has requested a plan for enhancing prevention activities to assist in the elimination of the health disparities affecting American Indians and Alaska Natives (AI/AN). The Indian Health Service faces difficult challenges in eliminating the significant disparities in health in Indian Country. The enhancement of the agency and tribal efforts to prevent the diseases associated with these disparities both primarily and secondarily is a productive strategic approach to facing this challenge. Accordingly, the Interim Director has requested that actions be initiated to strengthen the use of scientifically proven interventions targeting these health issues.

The Headquarters (HQ) staff charged with initiating these actions has provided a strategic approach that involves focusing on the personal health behaviors and the public health system components that are associated with the disparities. The staff also proposed that engagement of stakeholders in further development of the actions is critical to assuring that the strategy has the full support of the field. Further, the stakeholders may be in the best position to articulate the benchmarks for progress, those interventions that have merit, the training needed to implement, and the resources available and needed. One mechanism for engaging the stakeholders is by forming a task force to address these issues composed of the stakeholders themselves.

1.	The Task Force shall recommend the strategic approach most useful to the Indian Health system to enhance and improve disease prevention and health promotion. The Task Force shall identify the disease areas with the greatest disparities and consider a framework that addresses these diseases without necessarily limiting the strategy to individual diseases. In making its recommendation, the Task Force shall account for personal health behaviors, community programs of public health, wellness and disease prevention, and clinical preventive services of highest utility in addressing targeted disparities. The strategy should be one that can be most useful for implementation in communities and yet is consistent with Departmental initiatives and allows for national advocacy and accountability.
2.	The Task Force shall establish a plan for identifying, prioritizing, and disseminating the scientific knowledge of "best practices" known to have efficacy in preventing disease and promoting health. This approach should be one that can be institutionalized during the first twelve months of the effort for continuing "best practices" identification and dissemination to providers and communities.
3.	The Task Force shall identify benchmarks for monitoring the progress of the enhancement effort that may include process, impact, and outcome measures. The Task Force shall also propose a process for continuing review of these measures that assure stakeholder participation. Wherever possible, these benchmarks should be readily available data to the Indian Health system (e.g., existing GPRA or ORYX benchmarks, diabetes audits, or other RPMS data, etc.). Attention to the timeframes for benchmarks and the linkage between short term measures (usually process measures such as height and weight measurements) to longer term measures (e.g. usually outcome measures such as declines in childhood obesity) should be addressed. Measurement of progress in the first twelve months shall be a priority for action, but should be implemented in a manner that will allow long term outcomes to be assessed.
4.	The Task Force shall identify the categories of training needed, the audiences for these training efforts, and the timeframe for initiation of these efforts. Attention shall be given to the needs of communities and providers. Attention to the detail of short term actions that can be taken should be priority, but longer term training activities may be addressed. Attention should be given to already existing training opportunities that could be exploited through action in the short term.
5.	The Task Force shall identify potential resource donors (both Federal and non-Federal) for the activity to be undertaken in the first 12 months of the effort and a plan to outreach to these donors. Longer term resource requirements should be addressed, but in more general terms. Priority consideration shall be given to those actions and resource options that do not require new Indian Health Service appropriations in FY2003.
6.	The Task Force shall provide the record of its deliberations and its specific recommendations by February 2003.