Full text

e-mail story | print story

Note: This report describes the activities and accomplishments of the CSA and the AMA's Group on Science, Quality, and Public Health as of June 2003.

Council on Scientific Affairs
Disaster Preparedness and Emergency Response
Group on Science, Quality and Public Health
Clinical Quality Improvement
Science, Research, and Technology
Medicine and Public Health
Alcohol and Tobacco Policy Advocacy

An organization’s statement of core purpose captures its fundamental reason for being. Since its founding in 1847 by a group of physicians concerned about advancing the quality of medical education, science, and medical practice, the American Medical Association’s (AMA) core purpose has been "To promote the science and art of medicine and the betterment of public health." The Council on Scientific Affairs (CSA) was formed in 1977 to assist in implementing this core purpose. The mission of the CSA is to assure the position of the AMA as the national leader in advancing the science of medicine as the primary mechanism for improving the quality of patient care, promoting medical progress, and enhancing the health of the public. The CSA seeks to be a leader in science and public health advocacy and to enhance the profile and priority of science and public health within the AMA and the Federation.

This informational report summarizes the contributions the CSA has made recently to help fulfill the core purpose of the AMA and in accomplishing the will of the AMA House of Delegates (HOD). Assisting the CSA in its work are the staff and programs comprising the Group on Science, Quality, and Public Health (SQPH). This report also provides brief program descriptions and summarizes some of the key accomplishments and activities of this Group over the past year.

Council on Scientific Affairs

During 1996 to June 2003, the Council on Scientific Affairs submitted more than 145 reports to the AMA’s HOD, with the recommendations adopted as AMA policy or directives; 40 Council reports developed during this time have been published in the peer-reviewed literature. These reports are developed with the assistance of specialty society review. Council reports have addressed a broad range of public health and medical issues affecting physicians and their patients including:

AIDS/HIV issues such as screening pregnant women, home test kits, bloodborne pathogen transmission from and to health care workers, chemoprophylaxis, disability status, and AMA policy consolidation;

Broad public health domains such as medical considerations in air travel, environmental hazards, community syringe disposal, safety of the blood supply, sporting and recreational injuries, use of protective helmets, drivers and vehicle safety, heat-related illness, biohazardous waste disposal, violence, and obesity;

Consumer nutrition and food-related issues such as folate and calcium supplementation, transmissible spongiform encephalopathies, and genetically modified foods;

Cancer screening for prostate, colorectal, or breast malignancies;

Pediatric and adolescent health issues such as infant feeding, bullying, underage drinking, newborn screening, circumcision, lead poisoning, certified athletic trainers in schools, attention deficit hyperactivity disorder, and sexuality education;

Clinical practice issues including geriatric pharmacotherapy, diagnosis and treatment of asthma, pain management in adults, use of opioids in chronic noncancer pain, alternative medicine, folk remedies, and antibiotic resistance;

Consumer products such as home test kits, over-the-counter inhalers for asthma, and antimicrobial-containing topical products;

Hospital and health care worker issues such as discharge criteria, immunization, reprocessing of medical devices, use of radiofrequency devices, prevention of needlestick injuries, bloodborne pathogen transmission, and chemoprophylaxis of exposed individuals;

Mental health topics such as diagnosis and treatment of depression, Alzheimer’s disease, memories of childhood abuse, and guidelines for seclusion and the use of restraints;
Patient education about their prescriptions and the broad topic of health literacy;
Pharmaceutical issues including unlabeled uses, generic drugs, recycling of nursing home drugs, and pharmaceutical expiration dates;

Scientific/public policy issues such as differentiating quality improvement from clinical research, stem cell research, cloning and embryo research, gene patenting, organ donation, tissue transplantation, blood donation and blood banking practices, clinical research, preventive services, medical marijuana, screening nonimmigrant visitors for tuberculosis, vital statistics, xenotransplantation, smallpox, and gender verification of female Olympic athletes;

Special population topics including racial and ethnic disparities, health literacy, use of restraints in nursing homes, on-site physician home health care, and addressing the health care needs of gay men and lesbians in the United States;

Tobacco, alcohol, and other substance abuse topics including screening for alcohol problems, reducing the nicotine content or addictiveness of cigarettes, harm reduction approaches to drug addiction, methadone maintenance, needle exchange, and substance abuse among physicians.

Women’s health issues such as contraception, drug interactions between oral contraceptives and antibiotics, work and pregnancy, mammography screening, breast implants, alcoholism, alternative therapies for symptoms of menopause, osteoporosis, and a global view of sex- and gender-based differences in health and disease.

The CSA Web site provides summaries of all 167 CSA reports produced by the Council from 1994 through December 2002. The full text of 88 of these reports is also posted, as well as complete bibliographic information for the 70 CSA Reports published since 1991. The CSA reports may be accessed by topic here.

The CSA has assumed a leadership role for the AMA in two other areas: clinical research and preparedness for bioterrorism and other disasters. The CSA has actively supported measures to enhance the conduct of clinical research in this country and to translate findings into clinical practice. From convening the major conference, "Clinical Research: Addressing the Future in a Changing Environment," to being engaged in the Clinical Research Summit project, and finally the Clinical Research Roundtable, the CSA continues to monitor the landscape of clinical research. The CSA Web site maintains a "Clinical research" category with links to the most recent information related to current Roundtable activities.

Starting in February 1999, the CSA actively began moving the AMA into a visible position by seeking a role for organized medicine in enhancing disaster preparedness at the local level. AMA policy on disaster preparedness has been articulated through the efforts of the CSA and SQPH staff including six reports, two special sessions at the HOD, a town meeting held in conjunction with the 2000 Weapons of Mass Destruction Conference, testimony provided to the Gilmore Commission, and the Declaration of Washington presented at the World Medical Association. These efforts culminated in the formation of the AMA’s Center for Disaster Preparedness and Emergency Response. Back to Top

Center for Disaster Preparedness and Emergency Response

Established in January 2003 and housed within the Group on Science, Quality, and Public Health (see below), the Center is developing a focused AMA program in the area of disaster preparedness and emergency response. During the initial roll-out of the Center, staff from the Unit on Science, Research, and Technology (SRT) have assisted in several initiatives. Center and SRT Unit staff continue to work with the AMA’s Washington office on public policy issues related to smallpox, bioterrorism, and other disaster preparedness issues. Staff also continue to update and refine the Disaster Preparedness Web site.

Key accomplishments/activities

Crafted the Declaration of Washington for the World Medical Association meeting; this document urges international consensus in condemning the development, production or use of biological weapons;
Based on the AMA Code of Ethics, developed an ethical construct wherein physicians have an obligation to the health, safety and security of the public as a whole;
Formalized a partnership with four universities around the development and fielding of "Basic Disaster Life Support" (BDLS) and "Advanced Disaster Life Support" (ADLS) courses. A two-hour continuing medical education session will be presented at the 2003 Annual meeting of the HOD highlighting the BDLS/ADLS courses and other work of the Center;
Prepared "Chemical and Biological Weapons Agents Reference Charts" for publication in Conn’s Current Therapy;
Initiated development of a dynamic surge model to better measure a community’s ability to respond to a catastrophic event;
Initiated collaborative work on addressing community mental health in terms of improving pre-event resiliency and mitigating post-event, psychosocial morbidity;
Scheduled a follow-up working session under a Nuclear Threat Initiative grant to build on efforts at the World Medical Association meeting to define the role of medicine in ensuring the beneficent use of biogenetic knowledge and technology. Back to Top

The Group on Science, Quality, and Public Health

The Group on Science, Quality, and Public Health (SQPH) comprises four main Units (including the Center described above) and the special programs on Alcohol and Tobacco Policy Advocacy that are funded by grants from the Robert Wood Johnson Foundation. SQPH staff also serve as liaisons/consultants to the program on tobacco policy, the Joint Commission on Accreditation of HealthCare Organizations (JCHAO), the National Patient Safety Foundation, and other patient safety initiatives. Programs in SQPH strive to improve the quality of medical practice, advocate for patient safety, and promote the health of the public.

A cardinal function of this group is to provide scientific support for the CSA, Board of Trustees (BOT), HOD, senior management, and the Washington office. Following the 2002 Annual and Interim Meetings, the Group implemented or assisted with the implementation of 73 resolutions, 14 CSA reports, and 10 BOT reports. Over the past year, staff have assisted on numerous advocacy initiatives, several of which are noted below. Although specific program summaries and key accomplishments are also described under individual Units, several of these represent collaborative efforts involving staff across SQPH Units.

The Internet provides an inexpensive, yet far-reaching, opportunity to inform and educate physicians on important science-related topics. SQPH staff currently maintain 16 dedicated Web sites and another is under development.

Clinical Quality Improvement Unit

The Division of Clinical Quality Improvement supports activities designed to foster the development and implementation of evidence-based physician-level clinical quality improvement efforts. The Physician Consortium for Performance Improvement is a physician-led initiative convened through the AMA to identify and develop performance measurement resources for physicians. Comprised of clinical content experts from more than 50 medical specialty societies, methodological experts, the Agency for Health Research and Quality (AHRQ), and the Center for Medicare & Medicaid Services (CMS). Consortium membership continues to expand through increased participation of state medical associations. A collaborative model in which relevant specialty societies take the lead has been implemented. This initiative is buttressed with several other national collaborative projects involving health care quality.

Key accomplishments and activities

Physician Consortium for Performance Improvement

Performance measures have been developed for seven clinical conditions (diabetes, chronic stable coronary artery disease, prenatal testing, major depressive disorder, heart failure, hypertension, and osteoarthritis of the knee), and for five preventive care screening measures (mammography, colorectal cancer, influenza immunization, tobacco use, and problem drinking);
A new measure for asthma has been completed through the public comment period.
Developmental work continues for measures on community-acquired pneumonia and adolescent depressive disorder;
Completed the feasibility phase of a project to establish automated onsite performance reporting capabilities in a group practice using an existing electronic medical record system;
Submitted CPT Category II code proposals to the CPT Editorial Panel for measures amenable to tracking codes;
New work products, including measures for osteoarthritis of the knee, hypertension, heart failure, chronic stable coronary artery disease, and major depressive disorder, were approved under contract with the CMS Doctor’s Office Quality Project (DOQ);
A component of the DOQ project includes exploration of incentives for clinicians who participate in quality improvement activities. The project encompasses a two-year pilot phase beginning in March 2003, and an evaluation phase extending to August 2005 that, if successful, will result in a national roll-out beginning in August 2005.

Collaborative Quality-linked Activities

Received an AHRQ "Partnership for Quality" grant ("Effecting Change in Chronic Care: The Tipping Point") to pilot test implementation of performance measures developed by the Consortium;
In collaboration with the Alliance of Chicago Community Health Services (Chicago Alliance), submitted a $400,000/year proposal to the National Library of Medicine for a 4-year grant seeking to integrate performance measures developed by the Consortium into an electronic health record system to be installed at the Chicago Alliance’s clinical sites;
Diabetes measures developed by the Alliance, a private-public collaboration including the AMA, were endorsed by the National Quality Forum. The Alliance has initiated an update process for the measures and approved the release of the measures to the public in 2003;
Along with AHRQ and the American Association of Health Plans, the AMA continues to sponsor the National Guidelines Clearinghouse (NGC), an Internet-based source of clinical practice guidelines designed to assist physicians in their clinical decision-making. The NGC currently includes summaries of more than 915 clinical practice guidelines from 117 organizations;
The AMA is collaborating on performance measures development with the Joint Commission on Accreditation of Healthcare Organizations and the National Committee for Quality Assurance. Joint development of a core measurement set for pain management, a two-year project that began in 2001 is scheduled for completion by the end of 2003.

Educational Outreach

Convened the Annual Clinical Quality Improvement Forum, which was devoted to the topic of "Electronic Medical Systems, Performance Improvement, and Quality Enhancement."
Presented a workshop at the International Society for Quality in Health Care Annual Conference, entitled "Deriving Physician Performance Measures from Clinical Guidelines."
Presented a seminar entitled "Putting Performance Measurement into Practice for Quality Improvement" at the 87^th annual meeting of the American Medical Women’s Association.

Other Activities

In response to Substitute Resolution 708 (I-02) and working with the American College of Surgeons, a meeting was convened that included representatives from national medical specialty societies, state medical associations, health care accreditation organizations, the Federation of State Medical Boards, and the National Patient Safety Foundation. It resulted in the drafting of consensus principles for optimal office-based surgery, with a particular emphasis on patient safety;
Staff assisted in preparing testimony for the "Quality and Consumer Information: Physicians’ component" of the Joint Federal Trade Commission/Department of Justice hearing on health care and competition, law and policy. Back to Top

Unit on Science, Research, and Technology

The Unit on Science, Research and Technology (SRT) staff maintains and initiates collaboration and dialogue with national medical specialty societies, state medical societies, numerous external organizations, and legislative/regulatory bodies to discuss and share knowledge in order to provide the scientific basis for AMA responses on legislation, regulations, and private sector proposals that affect the practice of medicine and the health of the public. The focus is on science and drug policy, infectious diseases, molecular medicine, and other pharmaceutical-related issues that affect multiple medical specialties and have a substantial impact on current and future clinical practice.

The SRT Unit provides staff authorship and scientific support for the majority of CSA reports that go to the HOD, the entire administrative support for the CSA, and numerous briefings of BOT members. The Unit currently maintains Web sites on Infectious Disease, Genetics and Molecular Medicine, the USAN Program, and has a Drug Policy and Therapeutics Web site under development.

In 2003, SRT staff established a database of scientific contacts from members of the Specialty and Service Societies (SSS) to directly communicate about CSA reports and other initiatives, programs, and activities of the SQPH Group, and to better coordinate responses to science policy issues of common interest. Science and drug policy issues that have been addressed in the past year are listed below. The SRT Unit also houses the Secretariat for the United States Adopted Names (USAN) Program, which is the federally recognized program for provision of nonproprietary names (ie, generic names) for drugs and biologics in the United States.

Key accomplishments or activities

Drug and vaccine shortages

Drug and vaccine shortages have increased in frequency and severity in recent years. These shortages can have significant public health consequences. An update of the AMA’s activities on drug and vaccine shortages is the subject of Board of Trustees Report 2 (A-03).

With the American Society of Health System Pharmacists (ASHP), the AMA convened a meeting of key stakeholders to address the causes of drug shortages and to develop a list of potential solutions (proceedings of this meeting were published in November 2002);
The AMA and the ASHP met with the Assistant Secretary for Health, Department of Health and Human Services (DHHS), and high-level officials of the Food and Drug Administration (FDA) to seek assistance in implementing potential solutions to prevent or more effectively resolve drug shortages;
In conjunction with the Centers for Disease Control and Prevention (CDC), SRT staff convenes an annual Summit on Influenza Vaccine to improve communications among stakeholders on that year’s influenza vaccine and to develop other short- and long-term strategies on influenza immunization;
Provided significant input on all vaccine shortages to the National Vaccine Advisory Committee’s Work Group on Vaccine Shortages, which prepared a report and recommendations to the Assistant Secretary for Health on ways to solve this problem.

Dietary supplements

Called upon the FDA to remove dietary supplements containing ephedra alkaloids from the United States market because their risks far outweigh their benefits. The AMA also testified on this subject before a Senate subcommittee; BOT Report 25 (A-03) summarizes these activities;
Urged the FDA not to allow so-called "qualified" health claims that are based on equivocal scientific evidence on either dietary supplements or on conventional foods;
Participated in a coalition of stakeholders that is trying to change the regulation of anabolic steroid precursors that are sold as dietary supplements;
Continues to seek changes in the Dietary Supplement Health and Education Act of 1994 to give the FDA more regulatory authority, and provides input to the FDA on a regular basis regarding the FDA’s proposals to regulate dietary supplements.

Reduction in medication errors

SRT staff represents the AMA in various coalitions that are addressing medication error prevention, including the National Coordinating Council on Medication Error Reporting and Prevention and the United States Pharmacopeia’s (USP) Imprint Code Project Team. Additionally, the AMA has commented to the FDA on three issues related to medication errors within the past year:
Advocated for changes in the professional labeling for prescription drugs (ie, the package insert) to make it more useful and user-friendly for physicians;
Provided testimony at the FDA’s public meeting on bar coding and participated in the National Alliance on Health Information Technology's Task Force meeting on "Bar Code Standards" to formulate possible responses to the FDA’s proposed rule;
Commented to the FDA on its new risk management initiatives for prescription drugs that have the potential to manage or restrict physician prescribing of certain drug products.

Sale of prescription drugs over the internet

Continues to work with the FDA and the Federation of State Medical Boards in efforts to prevent the illegal sale of prescription drugs over the Internet;
Provided guidance for physicians on Internet prescribing.

Safe community needle disposal

Formed the Coalition for Safe Community Needle Disposal, which has developed guidelines for home disposal of used sharps. The Environmental Protection Agency has indicated it will incorporate this guidance into its recommendations.

Information and education for physicians on science topics

Revised and launched three multi-media genetics continuing medical education (CME) modules on ovarian, colorectal, and breast cancer;
Provided liaison staff for the National Coalition of Health Professional Education in Genetics on educational initiatives for health professionals in genetics;
Collaborated with the California Medical Association on education of physicians about antimicrobial resistance;
Collaborated with the FDA, CDC, and United States Department of Agriculture to update the successful CME primer on foodborne illness for release later in 2003.

Federal legislation and regulation on science and policy issues.

SRT staff provided scientific expertise for AMA comments on various federal regulatory initiatives or bills. Some of the more prominent issues included antimicrobial resistance; preventive services and coverage for clinical trials; therapeutic vs. reproductive cloning; homeland security; vaccine availability; vaccine compensation; anabolic steroid precursor and ephedra regulation; White House Commission on Complementary and Alternative medicine; DHHS National Action Plan on geriatric drug therapy; CMS drug discount plan; General Accounting Office report on direct-to-consumer advertising; DHHS’ Office of Inspector General report on Pharmaceutical Industry Compliance Programs; FDA and First Amendment issues; and the Drug Enforcement Administration (DEA) and inappropriate use of the DEA number.

USAN program

For approximately 40 years, the AMA, the USP, and the American Pharmacists Association have co-sponsored the United States Adopted Names (USAN) program. Through the USAN Council, this program provides nonproprietary (ie, generic) names for all drugs and biologics in the United States. The Secretariat (ie, the staff support) for the USAN program is located within the SRT Unit at the AMA. Drug and biologic manufacturers pay a user fee (currently, $8,000/submission for a new USAN) to obtain a USAN, and these revenues make the USAN program a self-supporting activity.

The federal government recognizes the USAN program for this purpose and the FDA serves in a liaison capacity to the program. By selecting simple, informative, and unique nonproprietary names for drugs and biologics, the USAN program provides both a logical nomenclature classification system and a template for safer prescribing;
The USAN program works with the World Health Organization’s International Nonproprietary Names Expert Committee for global harmonization of drug nomenclature;
In 2002, 92 applications were submitted to the program for the selection of USANs. Back to Top

Unit on Medicine and Public Health

The Unit on Medicine and Public Health at the AMA promotes the utilization of medicine and public health science in clinical practice through coalition building, awareness raising, and education and training. Primary goals are to enhance the capacity of the AMA to improve clinical and public health practice by building strategic relationships; to enhance physicians’ ability to practice disease prevention/health promotion; and to enhance physicians’ ability to address the health and well-being of special at-risk and vulnerable populations. Additionally, this Unit provides staff support for the AMA’s sponsorship of the International Conference on Physicians’ Health, in conjunction with the Canadian Medical Association. The unit runs five major programs: Roadmaps for Clinical Care, Child and Adolescent Health, Aging and Community Health, Violence Prevention, and Racial/Ethnic Disparities in Health Care. In addition, staff maintains several dedicated Web sites:

Medicine and Public Health

Adolescent Health

Aging and Community Health

Health Disparities

Violence Prevention

Federation of State Physician Health Programs

Organ and Tissue Donation

Key accomplishments/activities

AMA-HHS Memorandum of Understanding (MOU)

Staff represent the AMA at national meetings convened by the DHHS for MOU partners and work with DHHS staff on joint ventures to promote strategies for reaching the goals of Healthy People 2010 and reducing racial/ethnic disparities in health care. This relationship has proven useful to the AMA in securing funding and promoting awareness of AMA positions and programs on disease prevention/health promotion.

Roadmaps for Clinical Practice

This new AMA series serves as the centerpiece for translating disease prevention and health promotion science into practice. Two volumes a year will be published on thematic issues prioritized by the 10 Leading Health Indicators of Healthy People 2010. Key developments to date include:

Developed and published "Intimate Partner Violence: Case Studies in Disease Prevention and Health Promotion";
Secured funding from the Robert Wood Johnson Foundation to support the development of a 10 volume set of guides on the "Assessment and Management of Adult Obesity." This Roadmap publication is being written by a national expert in obesity and will be completed by August, 2003;
Contracted with national experts to write future Roadmap publications on "Immunization in Minority Communities" and "Tobacco Cessation."

Child and Adolescent Health

This program continues to disseminate and provide technical assistance for various products, including:

Monographs on Delivering Culturally Effective Care to Adolescents, Youth Bullying, and Healthy Youth 2010: Supporting the 21 Critical Adolescent Objectives;
AMA Guidelines for Adolescent Preventive Services (GAPS) and related materials;
Parent Package, a set of educational materials for parents of adolescents.

Many current activities in child and adolescent health are supported by a long-standing Public Health Service Grant, including:

Biannual meetings of the AMA National Coalition on Adolescent Health, a gathering of representatives from 20 Federation organizations to promote adolescent health to physician membership organizations;
Biannual meetings of the AMA National Educational Forum, a gathering of representatives from more than 40 organizations; proceedings are published on an annual basis.

Lastly, the Child and Adolescent Health program has received a generous grant from the AMA Foundation to conduct preliminary research on adolescent health literacy.

Aging and Community Health. This program serves to enable physicians to prevent and postpone disease and disability and to maintain the well-being, independence and mobility of an aging population by identifying, developing, and disseminating best practices in health care for the geriatric population.

Received a two-year grant from the AMA Foundation to develop content material for the Foundation’s Health Literacy Program to develop a second edition of the Health Literacy Introductory Kit (completed) and a National Training of Trainers program (to be pilot tested in 2003) to aid physicians in adapting their clinical practices to address the problem of low health literacy;
Received a two-year grant from the National Highway, Traffic and Safety Administration (NHTSA) to develop guidelines and training for physicians on assessing and managing older drivers. The Physician’s Guide to Assessing and Counseling Older Drivers was developed with input from more than 70 researchers in the field of driver safety and representatives from specialty societies, patient advocacy groups, and government agencies. NHTSA will publish 9,000 copies of the Guides and will aid the AMA in dissemination. A National Training of Trainers Program is under development and will be pilot tested in 2003. This program will provide training for physician-led multidisciplinary teams in conducting local implementation training within their own medical settings.

Racial and Ethnic Disparities in Health Care

This program has evolved from recent HOD actions directing the AMA to develop a major national initiative on reducing racial/ethnic disparities in health care. Key accomplishments include:

Developed and submitted multiple grant proposals for a Disparities Speaker’s Kit, a National Physician Training Program, and a national physician survey;
Formed collaborative relationships with the DHHS, CDC, American Heart Association, Kaiser Family Foundation, American Hospital Association, and National Center for Health Statistics to develop initiatives addressing disparities in health care;
Convened a National Advisory Committee comprised of experts in the field of health disparities and representatives of several AMA Councils (CSA, CEJA, CMS, CME) and the Minority Affairs Consortium to provide guidance on program development;
Convened an Internal AMA Working Group that helps coordinate association-wide activities on disparities;
Conducted and published the first national study on racial/ethnic disparities in health care for adolescents.

Violence Prevention

Staff provide support for the AMA National Advisory Council on Violence and Abuse, which provides guidance for the AMA’s violence-related programs. Key accomplishments include:

Produced first cut of the video-based project on children who are victims of violence; this product will be shared with members of the Federation;
Developed a set of core competencies on the educational needs of physicians in violence and abuse issues;
Collaborated with the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and other interested organizations in the National Call to Action: A Movement to End Child Abuse and Neglect;
Completed a training manual on youth violence entitled Connecting the Dots to Prevent Youth Violence: A Training and Outreach Guide for Physicians and other Health Professionals. This training guide was developed to help physicians and others discuss youth violence with both professional and community groups;
Co-chaired the National Conference on Health Care and Domestic Violence. Back to Top

Alcohol and Tobacco Policy Advocacy Units

Office of Alcohol and Other Drug Abuse

The AMA’s Office of Alcohol and Other Drug Abuse is dedicated to raising awareness of alcohol use and abuse issues and policy solutions among physicians and the general public and empowering them to act by serving as an information source for advocacy, public policy change, leadership and education. Staff also serve as liaisons to federal drug abuse prevention activities such as the Office of National Drug Control Policy’s education and communications campaign, and the Center for Substance Abuse and Treatment.

With the support of the Robert Wood Johnson Foundation, the Office of Alcohol and Other Drug Abuse is the national program office for two projects: Reducing Underage Drinking Through Coalitions (RUDC) and A Matter of Degree (AMOD) (The National Effort to Reduce High-Risk Drinking Among College Students). In RUDC, coalitions of physicians, youth, civic organizations, government agencies, the religious community, and other leaders identify factors in the environment that contribute to and promote underage drinking in their communities and work together for positive change. In AMOD, university-community coalitions have identified and are addressing environmental factors that encourage alcohol abuse among college students.

The Office coordinates the activities of 12 RUDC sites and 10 AMOD sites across the country, providing quality technical assistance and using strategies to create solutions through environmental change. Staff also administer a Web site (www.alcoholpolicysolutions.net) launched in December 2002, which provides information about RUDC and AMOD, and about alcohol policy and environmental change strategies.

Key accomplishments and activities

In the past year, staff has convened key meetings, prepared testimony, made presentations, and published key material. Highlights include:

Convened key leaders of the Commonwealth of Puerto Rico and Puerto Rico Coalition to Reduce Underage Drinking, leading to successful passage of a 30 percent alcohol tax increase;
Convened the Alcohol Policy Forum (I-02) in collaboration with the American Association of Public Health Physicians; American Psychiatric Association; American Academy of Child and Adolescent Psychiatry; and American Society for Addiction Medicine;
Prepared and submitted the AMA’s statement on "Alcohol Advertising and Marketing to Children: Underage Drinking and What We Can Do About It," to the New York State Assembly Committee on Alcoholism and Drug Abuse;
Prepared remarks on underage drinking with policy recommendations to the Institute of Medicine’s Committee on Developing a Strategy to Prevent and Reduce Underage Drinking.
Presented the "Partner or Foe" policy briefing paper (plenary presentation) at the Technical Assistance Meeting to the World Health Organization.
Placed a full-page ad in The New York Times, "A Message to Parents from the American Medical Association: Warning: Watching NBC May Be Hazardous to Your Children’s Health," as part of successful effort to persuade NBC to reverse its decision to air hard liquor ads;
Published the policy briefing paper "Partner or Foe? The Alcohol Industry, Youth Alcohol Problems, and Alcohol Policy Strategies"
Published 11 alcohol policy issue briefs over the past year (eg, Restricting Minors’ Access to Bars);
Conducted major media campaigns, including public awareness campaigns in four college towns that resulted in three new city ordinances and a new state law, and a tele-press conference on a new poll conducted for AMOD that found parents outraged by spring break promotions.

Program on Tobacco Policy

The SmokeLess States National Tobacco Policy Initiative is approaching the last full year of a grant worth $52 million, focusing efforts on raising tobacco excise taxes, increasing restrictions/policies on clean indoor air, and seeking reimbursement of tobacco use cessation treatment and counseling. The program strives to achieve long-term sustainable reduction in tobacco use through changes in social norms and public policy. The core purpose is to provide timely, high-quality, strategic technical assistance to state coalitions working on policy campaigns to assure the best strategic use of grantee resources.

Key accomplishments/activities

The SmokeLess States National Program Office (NPO) developed and led a National Tobacco Tax Challenge at the National Press Club in Washington, DC, during the 2002 Annual Meeting of the National Governors’ Association;
Significant tobacco excise tax increases were enacted in 23 of the grantee states and New York City. The final numbers from the campaign were released in May;
Launched the Clean Indoor Air Challenge at the US Conference of Mayor’s annual meeting in Washington, DC, to raise awareness of important health outcomes that could be achieved through restricting exposure to secondhand smoke;
The SmokeLess States NPO is working with community leaders and coalitions in many major metropolitan cities to assist in passing strong clean indoor air measures. Successes to date include New York city and the state of New York, the state of Delaware, Dallas, Boston, Albuquerque, and several smaller municipalities;
Publishes the Smokeless State Policy Focus newsletter; the most recent issue covers the latest news on the clean indoor air front.
Convenes an annual meeting at which approximately 250 advocates from across the country attend workshops, panels, and plenary sessions, discussing the work completed and the lessons learned in planning for the future.

Smokeless States has also developed several documents to serve as resources to the tobacco control field.

In partnership with other national organizations, developed Strategic Thinking on Increasing Tobacco Excise Taxes, a tool for advocates in developing strategic policy campaigns at the state level. The document is available in hard copy.

Updated the guide, Preemption: Taking the Local Out of Tobacco Control, developed and published by the SmokeLess States NPO. It also is available in hard copy.

Some of the AMA’s other recent tobacco policy advocacy work includes providing testimony in the "low tar" case in Illinois, supporting the recommendations of the Subcommittee on Cessation of the Interagency Committee on Smoking Or Health of the DHHS, and supporting legislation that would authorize strong FDA regulation over tobacco products.Back to Top

Conclusion

The AMA has a long history of supporting the scientific basis of medical practice, advocating for high-quality medical care, and dedicating itself to enhancing the health of the public. Along with ethics and a dedication to service, these core programs of the AMA form the cornerstones of Professionalism. With the collaborative assistance of medical specialty societies, the Council on Scientific Affairs and the programs in Science, Quality, and Public Health will continue to offer physicians and the public credible and unbiased information on a variety of medical, quality improvement, and public health issues that affect physicians’ practice and the lives of our patients.

Recommendations

Because this is an informational report it does not contain recommendations.

CSAPH home page
Reports by topic

Last updated: Sep 30, 2008
Content provided by: CSAPH