A Review of the Current Status of the Best Practices Project Website and a Proposal for Website Expansion

Submitted by ASTDD Best Practices Project

October 9, 2009

I. Current Web Status

A. Front End of the “Best Practices Project Website” Since FY 2003-2004, the ASTDD Best Practices (BP) Project has developed, maintained and displayed information on the live ASTDD Website. There are two front end Web sections that end-users visit and search for information from the BP Project: 1. The Best Practices Section < http://www.astdd.org/index.php?template=bestpractices.html >

This section is titled: Proven and Promising Best Practices for State and Community Oral Health Programs. The ASTDD Best Practices Project uses this Web platform to promote best practices for state, territorial and community oral health programs by offering resource information as building blocks. Currently, this section posts 9 Best Practice Approach Reports and more than 100 descriptive reports of successful State and Community Practice Examples (“full practice submissions”). Other information are also posted including background on the BP Project and BP Committee, how BP Approaches relate to public health initiatives, a list of emergent issues, journal articles on state of the science, and resource links on standards, guidelines and evidence-based dentistry. [See Attachment 1.]

2. The State Activities Section < http://www.astdd.org/index.php?template=sactnav_temp.php >

This section is titled: State and Territorial Dental Public Health Activities – A Collection of Descriptive Summaries. ASTDD Best Practices Project uses this Web platform to provide more than 200 summaries of dental public health activities. Summaries of all the State and Community Practice Examples in the BP Section (described above) are in this collection as well as additional practices. This section reports field efforts in each state on a range of public health functions. This section also provides contact information for inquires to build a technical support network of field experts. The summaries (“summary practice submissions”) can be searched by topic or by state. [See Attachment 2.]

For the past seven years, the front end “BP Project Website” has been incrementally developed and expanded. With limited funding for Web development, basic design options were selected with hope of further expansion at a later time. A total of four Web contractors (with eight different Web developers) have contributed to designing and setting up the “BP Project Website” over the years. Each Web developer has built upon previous work and added new components and features to address the growing BP information database and other resource information.

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B. Administrative Backend of the “Best Practices Project Website” The Administrative Backend has also been incrementally developed over the years and is still in development [see Attachment 3]. The online systems and administrative controls of the Administrative Backend manage the “BP Project Website” and include the following:

1. BP Online Database: Houses information displayed on the live Website (e.g., submissions).

2. Online System for Review of New Submissions: The system supports the BP Committee (organized into 3 teams) to review new practice submissions, communicate with BP Project Director to obtain additional information/clarification from submitters, complete final editing, and give approval for Web posting.

3. Online System to Post New Submissions: Screens with data fields allow the BP Project Director to enter new submission information into the BP Online Database, tag each submission to add to index listings, and display submissions on the live Website.

4. Online System to Update Submissions: The system creates Web Boards to organize submission files allowing states (submitters) to download files, update submissions, and upload revised files; the BP Project Director posts the updated submission on the Website.

5. File Uploader: The Administrative Control allows documents to be uploaded and store in selected folders; these documents are then accessible online through links on the Website (e.g., downloading a BP Approach Report in PDF format).

6. Content Management Tool: The tool allows the BP Project Director to directly manage, edit and add information to selected BP Webpages without a Web developer’s support.

7. Web Usage Statistic Reporting System: The system tracks Web usage and provide two standard reports giving the ranking of “most visited” pages, number of hits, number of downloads, etc.

The Administrative Backend will next develop a Database Query for the BP Online Database. This will allow queries for information on submissions. For example, identifying submissions 3 years or older. It should be noted that multiple Web developers have built different parts of the BP Administrative Backend controls. As a result, the online BP systems and BP database are not fully integrated into one administrative environment (e.g., systems are isolated and functions are not connected across systems).

II. Need for BP Project Web Expansion The reasons for proposing expansion of the Best Practices Project Website include the following:

1. In 2007, two analyses were conducted by a CDC Web consultant on the ASTDD Website: a Heuristic Evaluation (assess the people/computer/web interface) and a Usability Testing (determine how well end-users perform tasks to access information on the Website and the ease of navigation through the Webpages). Recommendations based on these analyses that relate to the “BP Project Website” have not been addressed.

2. The ASTDD Best Practice Committee recommended that the BP Website improve the organization of resource information for end-users and allow posting of more resource information (such as creating topic-specific Webpages for target audiences).

3. Requests for BP information from agencies, organizations, state programs, grantees, etc. have been challenging at times because requested information does not always align with how the BP resource information is currently organized on the Website. Having the ability to create topic-specific Webpages that post BP links or provide an URL that display an index listing of submissions from a database query will allow an efficient way to respond to these requests.

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4. The BP Committee asked for more Web usage information (e.g., additional details on Website visitors and the type of information viewed). Currently, Web usage statistics included in the two standard reports lack higher level of details for the “BP Project Website” which limits the interpretation of what information is most useful for end-users. Also, with better Web usage information, the BP Project could report additional outputs and outcomes for the CDC and HRSA cooperative agreements

5. The BP Project Director and the current ASTDD Web contractor noted that the Best Practice online systems in the Backend Administration can be improve through more automation and streamlining of processes. Since parts of the Backend Administration have been built in pieces by different Web developers, integrating the systems into one set-up can improve the efficiency to manage and process BP data for posting on the live Website.

6. The BP Project has not yet used the Content Management Tool to its full potential in creating new Webpages. With help from the Web contractor, a system can be set up with a set of blank template pages that will allow a quick way for the BP Project Director to create new Webpages.

III. Proposed Web Expansion Activities

The BP Project is requesting the following to expand the front end “BP Project Website” and improve the Administrative Backend. It is understood that funding is limited to support the Web expansion activities. Perhaps a few of these activities can be planned each fiscal year. At this time, the BP Project places priority for activities related to the live “BP Project Website” listed below. A. Live “BP Project Website”

1. Establish a new “Best Practices” Tab that will define the BP Project Section and allow additional organization of BP information within the Tab Section. [See Attachment 4.]

2. Develop a new BP Homepage (Index Page) that will provide portals and help end-users better navigate through Webpages to access BP information. [See Attachment 4.]

3. Review, assess, decide how to respond and revise Webpages to address the Usability Testing Report provided by the CDC Web consultant in 2007. [See Attachment 5 and 6.]

4. Review, assess, decide how to respond and revise Webpages to address the Heuristic Evaluation Report provided by the CDC Web consultant in 2007. [See Attachment 7.]

5. Respond to the BP Committee request to organize BP information for end-users through creating additional Webpages such as topic-specific resource pages.

6. Conduct usability testing on new Website changes related to creating the BP Tab, developing a new BP homepage (index page), and revising BP Webpages in response to the recommendations of the 2007 Usability Testing and Heuristic Evaluation.

B. Administrative Backend

1. Increase the details and accuracy of ASTDD Web usage statistics reports to provide a better picture of how end-users are viewing and downloading the BP Web-based resource information (this may be part of overall Web usage reporting for the ASTDD Website). For example, more details on geographic analysis of where the end0users are based and having a pop up screen to asking 1-2 questions for feedback on BP such as implementation.

2. Develop a system that allows using the Content Management Tool to create new Webpages by using a few templates.

3. Improve the administrative efficiency in using the BP online systems (further automation and streamlining of the data entry and Web posting processes). This should also address the need to archive and delete data over time and create administrative controls to add new items to existing dropdown menus (e.g., data entry of a submission requires selecting a BP

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Approach Report and a topic for linkage to index listings; new reports and topics need to be added to the dropdown menus).

4. Add a feature to save “index listings of submissions links” from the existing “search” feature on the live Website or from the future “database query” for the BP Online Database (e.g., capture the URL that will display a listing of submission links from a search/query). The URLs of the saved index listings can be added to the ASTDD Guidelines document, posted on new topic-specific resource pages, forwarded to states requesting specific dental public health practice information, and provided to organizations as “links of interest” for their websites.

IV. Estimate of Time and Cost

The BP Project Director will need to work with the ASTDD Web contractor to determine the following:

• Estimated time and cost to complete these proposed activities;

• Appropriate sequence of activities; and

• Grouping of activities into stages for incremental completion over time.

This information will be presented to the ASTDD Management, Web Committee and BP Committee to help decide on priorities and set timelines.

V. Attachments

1. Display of the Current “Best Practices” Homepage (August 2009) 2. Display of the Current “State Activities” Homepage (August 2009) 3. Display of the Current Administrative Backend Index Page (August 2009) 4. An Illustration of a New BP Homepage (Not a Final Design) 5. Illustrations of the Web Changes Based on Recommendations from 2007 Usability Testing for BP

Webpages 6. Recommendations from 2007 Usability Testing for BP Webpages 7. Recommendations from 2007 Heuristic Evaluation for BP Webpages

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Attachment 1 Display of the Current “Best Practices” Homepage

(August 2009)

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Attachment 2 Display of the Current “State Activities” Homepage

(August 2009)

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Attachment 3 Display of the Current Administrative Backend Index Page

(August 2009) ASTDD Administrative Backend

A. Best Practices

Online REVIEW of Submissions

1. Online Submission <Inactivated and merged with A3.>

Upload submission files

2. Tracking Requests for Submissions <Not yet developed.>

3. New Submission Management

Assign to review teams page

4. Online Review Notification

5. Team Member Management

6. Team Member Review of Submissions

Team member login

7. Team Log Assignment Approval

8. Submission Approval & Posting Status

Tracking team approval

Prepare files for Web posting

9. Log of Submission Processing

Posting to Live Website

10. State Activities - Practice Summaries

11. Best Practices - Practice Descriptive Reports

12. File Uploader

Online UPDATE of Submission

13. Submission Update System

Online BP Database Management 14. Database Query <To be developed.>

B. ASTDD State Programs(Members) & Associate Members Administrative Tool o Administrative Control

C. Calendar Administrator o Calendar Administrator

These are links to the old calendar. I left them in case you needed to double check an event in the old database. Let me know if everything looks good, and I'll remove these links. Thx, Bradley - Calendar Administrator - Old Calendar Back End - Calendar - Old Calendar Front End

D. Statistics o View General Statistics o Custom Statistics Reports

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Attachment 4 An Illustration of a New BP Homepage (Not a Final Design)

The ASTDD Best Practices Project prepared the following resource information to support state, territorial and community oral health programs in developing their best practices. Best Practices Definitions & CriteriaOffers definitions of “best practice” and “best practice approach” and the best practice criteria used by the ASTDD Best Practices Project.

Best Practices

DRAFTProven and Promising Best Practices for State and Community Oral Health Programs

Announcements / News New Best Practice Approach Report on early childhood oral health… (read more) New practice submissions: 1. BEST Oral Health Program 2. AAP Oral Health Initiative (read more)

Optimal oral health across the lifespan...

Best Practice ApproachesASTDD

Best Practices Project Best Practices Project

Introduction to the Project

Input from States (Surveys)

Best Practices Committee

Committee Members Messages from the Best Practices Committee

To Visitors of the Web Site

To Policy & Government Agencies

To Professional Groups & Organizations

To Funders & Insurers

Offers a series of Best Practice Approach Reports to guide the development of best practices using effective dental public health strategies, available evidence, and lessons from successful practices. Successful/Promising Practices Reported by States & CommunitiesOffers detailed descriptions and short summaries of successful practices reported by states and communities. Contact information provides a support network. State of the ScienceOffers information on scientific research studies and analyses that provide evidence on the effectiveness and/or efficiency of dental public health strategies and methods. Emergent Issues Offers a list of emergent issues for dental public health and oral health programs. Addressing emergent issues can lead to effective applications of strategies and future best practices. Topic-Specific Resources: <New Webpages to be developed using the Content Management Tool>

Guidelines, Recommendations and Evidence Based Dentistry Resource Links

Program Evaluation

Early Childhood Oral Health

Public – Private Partnership

Oral Health Resources for Health Professionals

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Attachment 5

Illustrations of Web Changes Based on Recommendations from 2007 Usability Testing for BP Webpages

(a) The illustration shows a new organizational format to access Best Practice Approach Reports and State & Community Practice Examples

(as recommended by CDC Web consultant).

* Explore having a new side panel “Additional Links” for each BP Webpage to allow

posting of additional resource links relevant to the topic of each Webpage.

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Attachment 5 Illustrations of Web Changes Based on

Recommendations from 2007 Usability Testing for BP Webpages (Continued)

(b) The illustration shows a new organization format for the right side panels (as recommended by CDC Web consultant).

* Adjust the “Contact Info” panel to provide contact information specific for the ASTDD BP Project and requesting comments/suggestions for the BP Project.

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Attachment 5 Illustrations of Web Changes Based on

Recommendations from 2007 Usability Testing for BP Webpages (Continued)

(c) The illustration shows that “Table of Content” links are added to improve the navigation in viewing a Best Practice Approach Report

(as recommended by CDC Web consultant).

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Attachment 6 Recommendations from 2007 Usability Testing for BP Webpages

2007 Usability Testing Results for Best Practices Webpages

Issue Description Impact Issues Recommendation

a. Presentation of information and reports under State Dental Public Health Activities – Summaries and Best Practices - State & Community Practice Examples: Most of the participants didn’t understand the difference between the reports presented under the “State Activities Summaries” page and “Best Practices – State Examples” page. They felt it was essentially the same kind of information displayed under both the sections.

High Integrate State Dental Public Health Activities – Summaries and Best Practices - State & Community Practice Examples sections and clearly differentiate the two kinds of reports using a brief descriptive text.

b. Presentation of information under “State Programs” section: For tasks involving finding information from State Activities Summaries and Best Practices - State Examples, users first went into the “State Programs” section and navigated inside a specific state’s page to look for that information. They assumed “State Programs” section would be a one stop and shop area for all the state specific information.

High Provide gate way links to state specific best practices examples and activities summaries page from the individual state information page under “State Programs” section.

c. Presentation of information under “Best Practices” section: Most of the users had difficulty finding information under the Best Practices section. The difference between the “Best Practice Approach” Reports and “State & Community Practice Examples” Reports were not too intuitive. They also had difficulty navigation within the section. They had expressed concerns regarding the volume of text being presented on the page and it hindering with their ability to get to the appropriate content.

High List the topics (Surveillance System, State Coalition, etc) on the index page and present available report types (Approach Reports, State Examples) in two different columns adjacent to it. Provide a brief description on how the various reports differ from each other. Provide breadcrumb navigation for users to get a good understanding of the orientation of the section as well as to easily navigate within the section. Provide only the brief descriptive text on the page and present other detailed text under page/context specific help sections. Reduce the number of links being presented in the right navigational area as it competes with the main content for drawing users’ attention. (Refer to the three illustrations in Attachment 5 above.)

d. Presentation of content application wide (applies to all ASTDD Webpages):

Many users felt that most of the application pages were really busy with text and cluttered links and was really difficult to get to the actual content. They understood that part of it was due to the fact that the web site was filled with useful information in oral health area but they wanted to be gradually exposed to the content and not be dumped with all the information on the index pages. They also felt the link labels were long and contained redundant explanatory text.

High Just present the most important text on the index pages. Try to keep the descriptive text on index pages really brief. Present any additional explanatory text in context and page specific Help sections. Keep the link labels short. For e.g.: “Best Practices for State Oral Health Programs” link title could be shortened to “Best Practices” on the home page. Only present key links on the page under “Additional Links” or “Related Links” sub section. (Refer to Attachment 5 above.)

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Attachment 7 Recommendations from 2007 Heuristic Evaluation for BP Webpages

Please note: (1) Some of the recommendations from the Heuristic Evaluation that relate to the Best Practices

Webpages have already been addressed as part of the changes for the entire ASTDD Website (e.g., adding breadcrumbs).

(2) A detailed review of the Heuristic Evaluation Report should be made with the ASTDD Web contractor

to assess the type of Web changes needed and the resources required to address the recommendations for the Best Practices Webpages.

(3) The following table captures recommendations from the Heuristic Evaluation results specific for the

Best Practices Webpages that have not yet been addressed.

2007 Heuristic Evaluation Results for Best Practices Webpages The Heuristics Standard Used to Evaluate the System

1. Visibility of system status The system should always keep users informed about what is going on, through appropriate feedback within reasonable time.

2. Match between system and the real world The system should speak the users' language, with words, phrases and concepts familiar to the user, rather than system-oriented terms. Follow real-world conventions, making information appear in a natural and logical order.

3. User control and freedom Users often choose system functions by mistake and will need a clearly marked "emergency exit" to leave the unwanted state without having to go through an extended dialogue. Supports undo and redo.

4. Consistency and standards Users should not have to wonder whether different words, situations, or actions mean the same thing. Follow platform conventions.

5. Error prevention Even better than good error messages is a careful design, which prevents a problem from occurring in the first place.

6. Recognition rather than recall Make objects, actions, and options visible. The user should not have to remember information from one part of the dialogue to another. Instructions for use of the system should be visible or easily retrievable whenever appropriate.

7. Flexibility and efficiency of use Accelerators -- unseen by the novice user -- may often speed up the interaction for the expert user such that the system can cater to both inexperienced and experienced users. Allow users to tailor frequent actions.

8. Aesthetic and minimalist design Dialogues should not contain information, which is irrelevant or rarely needed. Every extra unit of information in a dialogue competes with the relevant units of information and diminishes their relative visibility.

9. Help users recognize, diagnose, and recover from errors Error messages should be expressed in plain language (no codes), precisely indicate the problem, and constructively suggest a solution.

10. Help and documentation Even though it is better if the system can be used without documentation, it may be necessary to provide help and documentation. Any such information should be easy to search, focused on the user's task, list concrete steps to be carried out, and not be too large.

Problem Description Heuristic Violated

(1-10)

Problem Severity

(High, Medium, Low)

Recommendation

a. It is frustrating to scroll up and down on exceptionally long pages (i.e. Member List, Best Practices Reports, etc).

4,7 Low Provide “Top of Page” links after specific sections and/or at the bottom of the page.

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b. Avoid spawning HTML pages/web sites in a new browser window, even if it is an external web site. The exception to this rule would be print friendly and help pages.

1,4 High • The usability best practices recommend opening all the HTML pages and web sites in the current browser window. This will avoid any potential user frustration of having to manage multiple browser windows.

• Use “ ” icon next to the links to indicate external links and provide a generic note (“ Link to external web sites”) on those pages.

c. Routing questions from the users to the content specialists is currently done manually. Also some content areas like State of Sciences, Emergent Issues, etc have 2 different Contact Us mechanisms (left nav & body of the page).

4,7 Medium • Uniformly present the Contact Us information in the right side below the Featured Links on all the pages. Do not present it in the body of the page.

• Include a “Section” dropdown on the “Contact Us” page which should include areas like About ASTDD, Best Practices, etc. Automate the routing process to the appropriate contact person based on the section selected by the users.

d. The users would have to click on the attachments on the Best Practices Reports to know the content of the attachment. Currently the attachments are named A,B,C,D,etc.

6 High Give meaningful names to attachments which would help the users to get a sense of the content without having to click/open the attachment.

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