Division of Cancer Prevention and Control
Demonstrating the Capacity of Comprehensive Cancer Control
Programs to Implement Policy and Environmental Cancer Control
Interventions
Comprehensive Cancer Control
Policy Agenda Worksheet
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CDC INTRODUCTION
The purpose of this worksheet is to help DP10-1017 grantees develop a policy agenda as part of
recipient activity three (RA 3), “Develop a Policy !genda”, under funding opportunity
announcement (FOA) DP 10-1017. The policy agenda worksheet was developed to meet the
guidance provided in FOA DP 10-1017 and underscores required components of a policy agenda
as outlined in DP 10-1017.This worksheet provides an outline for a policy agenda that can serve
as the foundation for your policy agenda in your state or tribe.
Completion of a policy agenda is required for grantees under DP 10-1017 and may also serve as
a promotion tool for all funded programs and their partners. Use of this worksheet is not
required, but encouraged.
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POLICY AGENDA WORKSHEET*
A. Introduction
Framing the Issue
The Consensus Process
B. Policy Agenda for Comprehensive Cancer Control
C. Conclusion and Call to Action
D. Works Cited and Appendices (optional)
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A. INTRODUCTION
Framing the Issue (cancer burden, cancer related health disparities, analyze
potential for broad reach)
INSTRUCTIONS: For this section, describe the specific environmental and contextual factors in your
state/tribe/tribal organization/territory/Pacific Island Jurisdiction that contribute to cancer burden and
cancer-related health disparities. Describe the policy and environmental barriers and the potential
impact of addressing those factors through policy and environmental change. What are currently the
top cancer sites with modifiable risk factors in your jurisdictional area? Does your jurisdictional area
have cancer-related disparities in incidence and mortality among different underserved and
underrepresented populations? Do you have specific geographic areas that experience a greater cancer
burden than others? Among cancer related behavioral risk factors (smoking, obesity, physical activity,
UV exposure, HPV or hepatitis B vaccine use), what do your data currently show? Are there disparities
among underserved and underrepresented populations or geographic differences in these risk factors in
your state or tribe?
Example: In our state, lung cancer is the second highest cancer in both incidence and mortality among
men and women. In 2007, the lung cancer incidence and mortality rates among both sexes were 77.2
per 100,000, and 60.3 per 100,000, respectively. African American men have the highest lung cancer
incidence (113.9 per 100,000) and mortality (91.2 per 100,000) raters compared to men from other
racial/ethnic groups. African American women also have the highest lung cancer incidence (62.9 per
100,000) and mortality (48.8 per 100,000) rates compared to women from other racial/ethnic groups.
Incidence and mortality rates from lung cancer are highest in the southeastern part of our state.
Although lung cancer incidence and mortality rates have declined in men, women have experienced a
lower percentage change in rates over time. In addition, the annual percentage change in rates have
been lower in the southeastern section of our state, which means this part of the state is not seeing lung
cancer incidence and mortality rates decline as fast as other geographic areas.
Our state is currently ranked sixth in the United States in the current smoking prevalence. African
Americans have higher current smoking prevalence (27.1%) compared to non Hispanic whites (22.2%).
Among adolescents, the prevalence of current smokers is 20.3%.
Since tobacco use causes the vast majority of lung cancers, efforts are needed to address our high lung
cancer burden and reduce youth initiation and adult smoking rates. Passing a comprehensive 100%
smoke free law is one strategy in our state cancer plan to meet our 2015 target of reducing adult
smoking prevalence to 20%. Other states with statewide comprehensive smoke free laws have seen
greater reductions in adult smoking prevalence compared to states without these laws. Our state
currently has no comprehensive 100% smoke free law in workplaces, bars, and restaurants. Four
localities have recently passed comprehensive smoke free ordinances. Although there was coordinated
opposition to these policies, public polls indicated strong community support for these smoke free
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ordinances. Local grass roots coalitions were instrumental in garnering support and influencing the city
councils to pass these ordinances.
THE CONSENSUS PROCESS
Overview of Policy Task Force
INSTRUCTIONS: Describe the skills and abilities of partners making up the task force and how they may
be able to effectively advance the policy agenda. Briefly describe the development and purpose of the
task force. How is this task force linked to the broader comprehensive cancer control
partnership/coalition and to other chronic disease programs (e.g. Communities Putting Prevention to
Work)?
Example: Since 2007, our CCC coalition has had a policy taskforce. Recognizing that policy,
environmental, and systems level changes were needed to address our high cancer burden, particularly
for cancers with known modifiable risk factors, we further strengthened the policy taskforce by recruiting
members involved with CPPW, tobacco advocacy organizations, the state educational agency, school
health coordinators, a former news reporter, and several local community groups. We recruited partners
based on their expertise around issue framing, advocacy, gaining earned media, and their links to other
organizations working on chronic disease policy, systems, and environmental change.
Engaging Stakeholders
INSTRUCTIONS: Provide an overview of your community engagement plan, what has been done so far,
what worked and did not work, and how you plan to get communities to assist in the process and gain
buy in.
Example: During the development of our policy agenda, we engaged a local community group that
formed to address childhood obesity in their county. We presented our proposed policy intervention
around childhood obesity which was to require schools to have daily quality physical education for
children in kindergarten – 8th grade. This community group led a town hall meeting where members of
the community provided input into this proposed policy. Several community members are planning to
attend the upcoming school board meeting and speak in support of the proposed policy.
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B. POLICY AGENDA FOR COMPREHENSIVE CANCER CONTROL
INSTRUCTIONS: In this section, identify and describe your proposed goals and objectives as they link to
your Comprehensive Cancer Control plan. Describe your 3-5 planned interventions [policy, system,
environmental change strategies] addressing primary, secondary, or tertiary cancer prevention that you
hope to accomplish during this project period. These should include measurable objectives and
outcomes. Cite the research and epidemiological evidence for why the policy is needed.
I. Cancer Goal:
Instructions: State your cancer goal here.
Example: Reduce the impact of tobacco use and exposure on cancer incidence and mortality.
II. Cancer Objective:
Instructions: State your cancer objective here.
Example: By 2015, reduce adult smoking prevalence from 23.3% to 20%. By 2015, reduce youth smoking prevalence from 20.3% to 17%. III. Cancer Policy Strategies:
Instructions: Describe your policy, systems, or environmental change interventions here and specifically
state the recommended policy change.
Example: Implement a statewide comprehensive 100% smoke free law addressing workplaces,
bars, and restaurants.
Implement a comprehensive tobacco-free school policy in local district 7.
IV. Rationale:
Instructions: Make the case for why the policy, systems, and environmental change is needed.
Concisely cite relevant research and epidemiological evidence supporting the policy, systems, or
environmental change. What evidence supports that this policy will reduce cancer burden?
Why is this policy, systems, or environmental change needed in your state/tribe? Does broad
support already exist for this proposed policy?
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Example:
 Tobacco use causes the vast majority of lung cancers and is linked to a number of other
cancer sites, chronic diseases, and adverse health conditions. 30% of all cancer deaths
are attributable to tobacco use alone.
 Second hand smoke also contributes to a number of adverse health conditions.
 Our state is currently ranked sixth in the United States in the current smoking
prevalence.
 Disparities in lung cancer incidence and mortality exist in our state. African Americans
are disproportionately affected compared to other racial/ethnic groups, and tobacco use
is highest in African American men.
 Other states with statewide comprehensive smoke free laws have seen greater
reductions in adult smoking prevalence compared to states without these laws.
 65% of residents support a statewide comprehensive smoke free law.
 Many business groups support a statewide comprehensive smoke free law because
reducing smoking rates will reduce employee absenteeism and increase employee
productivity.
V. Impact Statement:
Instructions: Describe what you hope will be accomplished by implementing the policy,
systems, or environmental change (i.e. long term outcome and impact). How will it significantly
affect future cancer burden? How does it link to cancer plan goals and objectives?
Example: Passing a comprehensive 100% smoke free law is one strategy in our state cancer plan
to meet our goal of reducing tobacco use in adolescents and adults. This will ultimately further
reduce incidence and mortality rates of lung and other tobacco-related cancers and reduce the
racial/ethnic and geographic disparities in lung cancer incidence and mortality in our state. Our
objectives from our cancer plan include the following:
VI. Current Policy Status in [insert your state, tribe, pacific island
jurisdiction]:
Instructions: Using results from your environmental policy scan, describe what has already been
accomplished in your state/tribe around this proposed policy intervention.
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Example: Four localities have recently passed comprehensive smoke free ordinances. Although
there was coordinated opposition to these policies, public polls indicated strong community
support for these smoke free ordinances. Local grass roots coalitions were instrumental in
garnering support and influencing the city councils to pass these ordinances. A statewide
smokefree workplace bill was introduced in the legislature in 2006 but was never passed
VII. Notable Policies in Other States/Tribes/Pacific Island Jurisdiction:
Instructions: Describe states or tribes that have already passed policies, systems, or
environmental change initiatives similar to those that you propose. Give specific examples from
2-3 states or tribes, if applicable.
Example: 26 states currently have comprehensive smoke free laws. In 2006, comprehensive
smoke-free laws went into effect in Colorado, Hawaii, New Jersey, and Ohio. Arizona, DC,
Minnesota, and New Mexico enacted laws in 2007, followed by Illinois, Iowa, and Maryland in
2008; Maine, Montana, Nebraska, Oregon, Utah, and Vermont in 2009; and Kansas, Michigan,
South Dakota, and Wisconsin in 2010.
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B. POLICY AGENDA FOR COMPREHENSIVE CANCER CONTROL (CON’T)
I. Cancer Goal:
II. Cancer Objective:
III. Cancer Policy Strategies:
IV. Rationale:
V. Impact Statement:
VI. Current Policy Status in [insert your state, tribe, pacific island
jurisdiction]:
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VII. Notable Policies in Other States/Tribes/Pacific Island Jurisdiction:
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B. POLICY AGENDA FOR COMPREHENSIVE CANCER CONTROL (CON’T)
I. Cancer Goal:
II. Cancer Objective:
III. Cancer Policy Strategies:
IV. Rationale:
V. Impact Statement:
VI. Current Policy Status in [insert your state, tribe, pacific island
jurisdiction]:
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VII. Notable Policies in Other States/Tribes/Pacific Island Jurisdiction:
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C. CONCLUSION AND CALL TO ACTION
INSTRUCTIONS:
Briefly summarize your agenda and why it is important for these proposed policies to be
enacted.
Example: Smoking prevalence and childhood obesity rates are high in our state. Implementing a
comprehensive smoke free law and requiring schools to provide daily quality physical education
will allow us to meet our cancer plan objectives around reducing tobacco use and childhood
obesity
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WORKS CITED
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APPENDICES
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