Every 10 years, the U.S. Department of Health and Human Services (HHS) leverages scientific research and training educated from the precedent decade, together with new knowledge of present data, developments, and innovations. Healthy People provides science-centered, 10-year national objectives for endorsing health and averting disease. At present, Healthy People 2010 is foremost in the way to achieving increased quality and years of healthy existence and get rid of health discrepancies. Healthy People 2020 will mirror appraisals of main risks to health and wellness, altering public health precedence's, and up-and-coming issues associated with our nation's health awareness and prevention (Rahimian et al. 2003).

The Healthy People method is comprehensive and shared. The development course struggles to make the most of transparency, public contribution, and stakeholder conversation to make sure that Healthy People 2020 is pertinent to varied public health requirements and takes benefit of chances to attain its goals. Since its beginning. Healthy People has turned out to be a sophisticated, public appointment initiative with thousands of people serving to form it every stride of the way.

Public contribution will form Healthy People 2020-its reason, goals, association, and deed tactics. HHS will seek contribution from communities and stakeholders during public meetings transversely and the country and public comment eras. As a nationwide plan, Healthy People's triumph depends on a synchronized promise to develop the physical condition of the country (Santoyo, 2003).

Summary of Impact

Efforts by the Centers for Disease Control and Prevention ( CDC), implemented through the State of California, to institutionalize local knowledge and community participation in the development and implementation of HIV / AIDS prevention accomplished multiple goals in Orange County, California (Santoyo, 2009). First, there were substantive data collection results. Local epidemiological data were collected and analyzed to form the basis for developing a prioritization of target groups for education and prevention services, and a catalogue of community-based organizations and their services. Second, there were representational and participatory results (Mishra, 2010). Most importantly, affected groups (e.g. persons living with HIV / AIDS and groups identified as being at high risk of HIV transmission), who had had minimal presence in previous decision-making processes concerning the development, funding, and implementation of education and prevention policies, were directly involved in the formulation of the Prevention Plan which the County now uses to distribute funds (Orange County HIV Planning Advisory Council, 2006).

Third, institutional structures were created at the local and state levels. At the local level in Orange County, the HIV Prevention Planning Committee (following the guidance of the Advisory Council acting as the local planning group) continues to develop and adapt its planning process (in response to changing CDC and state guidelines) to encourage greater community participation and appropriate representation, to develop stronger linkages with state committees and agencies, and to ensure that adequate data and widely accepted methods are used to prioritize needs and evaluate results (Newton, 2007). At the state level, fifty-four local planning groups (LPGs) were established, creating a network of local groups linked with state organizations to develop prioritized needs and to disseminate state funds. The State Office of AIDS continues to provide external reviews of community planning processes, and to provide technical assistance and information for LPGs to facilitate community planning into the fiscal year 1996-7 and beyond (Orange County HIV Planning Advisory Council, 2006).

There were several elements which facilitated this community planning process in Orange County with relatively minimal conflict (Santoyo, 2009; Weston, 2001). First, the short time frame allowed for the development of Orange County's HIV Prevention Plan necessitated the putting aside of many significant potential and existing suspicions and conflicts because of the pragmatic and collective need to accommodate the state's and CDC's guidelines for data collection, analysis, and evaluation (Orange County HIV Planning Advisory Council, 2006). Because funding for all organizations and individuals was tied to the completion of this plan, members of the HIV Prevention Planning Committee for the most part engaged in minimal partisanship in favor of completing the plan on schedule (Newton, 2007).

The spring to December time frame also functioned to minimize debate over membership on the HIV Prevention Planning Committee (Ropers, 1988). The process of selecting members may also have served to minimize conflict during the development of the plan, since organizations and individuals not already involved in local education and prevention, or those deemed to be controversial, confrontational, or non-cooperative, did not gain entry to the decision-making process. The issue of membership was revisited by the Orange County HIV Prevention Planning Committee during the spring of 1997 as renewed discussion and debate occurred over the composition and privileges of members (Mishra, 2010).

The community planning process outlined by the CDC, the State of California, and the Orange County Health Care Agency itself, has made possible internal and external critiques and adaptation of the process (Rahimian et al. 2003). Thus, although there remain concerns about the nature of participation and representation, the institutionalization of community participation in HIV / AIDS education and prevention holds much potential in not only improving the cost effectiveness of education and prevention programs, but also allowing local knowledge and representation eventually to influence the ways in which the state and the CDC design, fund, and implement HIV / AIDS policies. Such efforts are a central element not only in shifting public policies towards local needs, but also in developing a localized representation of HIV / AIDS.


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