In 2001, the National Association of County and City Health Officials (NACCHO) and Centers for Disease Control and Prevention (CDC) unveiled the latest public health planning tool, Mobilizing for Action through Planning and Partnerships (MAPP).

From a technical perspective, there is nothing particularly revolutionary about MAPP. The tool reveals no big secret previously withheld from public health practitioners and no great epiphany is likely to follow a first look at the planning model. Rather than revolutionary, as noted by Lenihan in this issue, MAPP is very much evolutionary. MAPP reflects the latest thinking and approach to using planning as a tool in public health practice.

Through MAPP, public health planning has evolved from the more traditional needs assessment and program planning approaches, typically addressing single issues, to a model that is solidly grounded in strategic planning concepts. This connection to strategic planning is critically important, as local public health agencies (LPHAs) are increasingly facing challenges of greater complexity, challenges that create the need for strategic thinking.1 Simply put, old public health planning approaches cannot sufficiently position LPHAs to effectively address new public health challenges.

Through MAPP, strategic planning evolves from a process that usually occurs within a single organization to one that occurs within an entire community. This reflects contemporary public health theory and practice. No single organization-be it a governmental public health agency, hospital, or provider association-can by itself attain the outcomes needed to adequately address the issues facing communities today. Effective responses require collective action and collective action requires both meaningful public health partnerships and an understanding of the resources in the community. By emphasizing participatory planning, MAPP provides both of these.

Closely related to this, and central to MAPP, is the concept of systems thinking. This notion is introduced in the first phase of MAPP, which requires the identification and engagement of all partners-traditional and new-that contribute to the health of the community. This engagement of public health system partners is the cornerstone of MAPP. The systems thinking concept becomes more fully developed in the integration of the four MAPP assessments, which include the application of the Local Public Health System Performance Assessment, developed by the CDC's National Public Health Performance Standards Program (NPHPSP).

Former planning models have worked with fragmented examinations of a community: health status, program needs, or the role of its local health department. MAPP's systems approach encompasses a variety of perspectives to create a more complete picture of how a community can take action not only to resolve specific health issues but also to address the underlying issues affecting the health of the public. Combining these in an inclusive planning process, which includes new and diverse partners, including the business community, leads to innovative strategies for addressing both longstanding and more recent public health challenges.

MAPP's foundation in sound planning principles and its integration of performance standards, the primary tool of accountability that has evolved in public health practice, combine to give the model a level of integration not previously achieved in public health planning.

While MAPP provides step-by-step guidance for public health systems building, as evidenced by the collection of articles in this issue, the model is not overly prescriptive. Success is defined within a general framework for local public health systems building, yet it allows LPHAs and their partners to define their own public health systems and how they should optimally function. Like its planning forerunners (APEX, model standards, etc), the articles in this issue suggest that MAPP too will readily become part of public health practice. But with its emphasis on systems building and performance, MAPP may transform local public health practice in a way not achieved by its predecessors.

This special issue of the Journal of Public Health Management and Practice captures both the history and, through a series of case studies, the early implementation successes of MAPP and the NPHPSP's Local Public Health System Performance Assessment. Perhaps more important, this issue reveals to its readers the promise of MAPP. The articles that follow demonstrate MAPP's intellectual and methodological integrity. They show MAPP's movement from conceptualization and model-building phase to a tool that is firmly taking root in public health practice; a tool that contributes to academic thinking about public health competencies and community-based participatory research; a tool that can be studied.

While the individual successes of MAPP rest with the localities that use the tool, the likelihood of positive outcomes and the successful integration of MAPP into the nation's public health practice landscape will very much depend on the continued commitment and involvement of NACCHO and the CDC. As a flagship program of NACCHO, the membership organization for local public health departments across the country, LPHAs have access not only to this state-of-the-art planning tool but also to the trainings and technical assistance that hundreds of practitioners across the country have already taken advantage of. The continued support from the CDC not only provides resources to support implementation of MAPP but also adds a level of credibility to MAPP that LPHAs can use when promoting the model and engaging other public health systems partners in these planning efforts.

For the past 15 years, since the Institute of Medicine's report on the Future of Public Health, public health agencies have been looking for ways to strengthen their effectiveness. Numerous planning models and conceptual frameworks have been developed, and by themselves, each has made some contribution to the advancement of public health practice. By combining much of this thinking-needs assessment, program planning, community engagement, core functions, performance standards, and systems building-into a single model, MAPP may very well be the first truly comprehensive public health planning tool for local public health practice, and as such a powerful tool for transformation.

REFERENCE