PHSSR Finds Permanent Home Within Clinical Services Community
By Debra Perez, Senior Program Officer at the Robert Wood Johnson Foundation
This year’s Annual Research Meeting has exceeded expectations both in quality of sessions and the level of participation in public health services and systems research. I still remember my first PHSSR interest group meeting back in 2005.
There were 65 total participants and the IG was the only venue for healthy debate and exploration in PHSSR. What’s new about this year’s meeting is the very visible presence of public health throughout the general meeting -not just as part of the IG. Sessions in the general meeting covered burgeoning fields such as accreditation, health impact assessments and public health law.
Though it is undeniable that much more work needs to be done in terms of methodology, assessing the effectiveness of QI interventions, and research on the structure of basic public health services, it is equally undeniable that we’ve come a long way. Hundreds of participants have now been exposed to PHSSR and thanks to AcademyHealth, this critical research field has found a permanent home within the clinical services community.
Talking about Public Health Measurement and Improvement at AcademyHealth
By: Bridget Booske, Project Director, County Health Rankings, and Senior Scientist, University of Wisconsin Population Health Institute
I just finished participating in a panel at AcademyHealth where I was one of four speakers talking about the latest research on measurement and quality improvement in public health. Being a part of this panel at the annual AcademyHealth Annual Research Conference in Boston was exciting for a number of reasons:
1) The four presentations were selected through a very competitive peer-review process,
2) Three of the four projects were based on work funded by the Robert Wood Johnson Foundation (with Brenda Henry, PhD as the program officer),
3) The moderator of the session, Michael Stoto, asked each of us the same challenging question, and
4) Boston is a great city to visit!
Points 1, 2 and 4 are probably self-explanatory so I’ll just elaborate on point 3. I kicked off the session talking about the County Health Rankings and was followed by Sheryl Davies of Stanford University talking about measuring hospital preparedness for pandemic and mass casualty funds. The other two presentations, by Alycia Infante (National Opinion Research Center) and Brenda Joly (Muskie School of Public Health, University of Southern Maine), both addressed the implementation of process and quality improvement in governmental public health.
The question that Mike asked each of us was to go beyond talking about what we were measuring and trying to improve and to think about how we will know if what we are working on is actually improving health outcomes? This is a great question –we all have logic models that guide our work, often with different short-term and intermediate-term outcomes (many of which may be process-based), but the long-term outcomes for all of us should be improved health in our populations.
For the County Health Rankings, while it is too soon to be able to answer Mike’s question, we are measuring and tracking some short-term outcomes (media attention and community engagement in health improvement) and whether media coverage reflects key messages about the Rankings.
And, we’ll be trying to find out if this leads to the intermediate outcomes of data-driven decisions and the implementation of evidence-based programs and policies. Eventually we hope to be able to use our Rankings health outcome measures to monitor improvement in population health.
In the meantime, I’m off to more sessions to learn more about the latest in public health systems research: one on measurement methods and another on accreditation.
Post Keeneland Conference Wrap Up
Filed under: AcademyHealth, CDC, Centers for Disease Control and Prevention, Keeneland Conference, Multimedia PHSSR Resources, National Library of Medicine, OSTLTS, Office for State Tribal Local and Territorial Support, PHLR, Robert Wood Johnson Foundation (RWJF)
Dear Friends & Colleagues,
Well, another Keeneland Conference has come and gone. I hope all who attended enjoyed the presentations of cutting edge research, the networking, and the hospitality. In Kentucky, we take great pride in our hospitality. I hope that I and the CPHSSR staff made it a memorable experience for you. We are already at work on next year’s conference and hope to make it even better.
In the coming weeks, we will post presentations, posters, photos, videos and audio from the conference online. I hope those of you, who couldn’t make it to Lexington, will take advantage of these online resources. They are chock full of useful information for the public health practitioner and researcher.
Dr. Donald Lindberg
One highlight of this year’s conference was the keynote speech by Dr. Don Lindberg, Director of the National Library of Medicine. We have been collaborating with NLM for some time, and have played an active role, in partnership with NLM, RWJF, and AcademyHealth to make information resources available to researchers and practitioners. If you have suggestions for new resources we can include, please let us know. Dr. Lindberg is a pioneer in medical informatics and his presence brought out librarians from across the medical community. If you are not familiar with the librarian at your institution, please take this as a prompt to seek them out. They are worth their weight in gold.
Dr. Judith Monroe
Dr. Judith Monroe, the new Director of the CDC Office for State, Tribal, Local, and Territorial Support and CDC Deputy Director gave her “inaugural address” as the new leader of CDC’s efforts to strengthenand create liaisons with practice. Dr. Monroe is a dear friend, who has a vision for her new office to make it both practice friendly and also move the needle on the type of collaborations needed in the future. She and I are both graduates of Eastern Kentucky University (EKU), so it was a special pleasure to have Dr. Doug Whitlock, the President of EKU, honor Dr. Monroe’s achievements.
Dr. Kyu Rhee
I always appreciate plugs for the Scutchfield and Keck public health practice text and Dr. Kyu Rhee did it this year. He began into his keynote address by using a quote from the book’s dedication and then shared a bit about his daughter which was a nice, personal touch. His leadership in public health at Health Resources and Services Administration (HSRA) is beginning to be bear fruit. We will undoubtedly see more of his leadership there translated into action on the part of HRSA.
Dr. David Lawrence
Dr. David Lawrence, the CEO Emeritus of Kaiser Foundation Health Plans, did a spectacular job closing the conference. He shared stories about his past experiences in public health, as a health officer and physician and his current work with corporate boards. He emphasized the fact that the public health community should strive to find new ways to solve problems. The new disruptive technologies will be a major force in health care beyond the immediate horizon and we need to set our sights for change.
The pre-conference ancillary meetings were also productive. I think that one of the best sessions that we had was with public health law researchers, leaders from RWJF, and representatives of the practice community. These groups met to create new ideas about the interface between law and public health, and how law can be used to promote the public’s health. After the session, I came away with even more respect for Dr. Scott Burris, his staff from Temple University and the strong RWJF leaders, Drs. Michelle Larkin, Angie McGowan and Pam Russo.
Once again, the Keeneland Conference was a success. This year we had over 300 attendees, quite a leap from last year. We will soon post pictures on the website from the sessions and networking events.
We hope those who joined us had a great time and will not only save-the-date for the 2011 PHSSR Keeneland Conference, but will encourage other colleagues to attend. In addition, I encourage you to start thinking now of any research you may have ready to present at the conference. As it stands now, the dates for next year are April 12-14, 2011 and since the conference is growing we may relocate to assure we have sufficient capacity.
Click the image below to visit the conference website and download a copy of the final program.
Scutch
A Big Challenge in Public Health Finance
Filed under: Keeneland Conference, Robert Wood Johnson Foundation (RWJF)
By: Brenda Henry, Program Officer, Robert Wood Johnson Foundation, Public Health
Unfortunately, there appears to be a growing body of evidence that overwhelming majority of health department leadership is not optimally equipped to handle their departments’ finance-related responsibilities. The top masters in public health (MPH) programs do not require students to take a finance course. When a course is available, the focus is typically on “health care” finance – not on issues related to governmental public health.
So what? What this often means is that leaders do not have the tools to not only monitor the financial performance of their departments, but to also plan when issues arise – such as the budget cuts that have taken hold in departments across the country during the current economic climate.
Learn more about public health by visiting the Robert Wood Johnson Foundation’s Public Health page.
Informing Solutions to Reduce Health Disparities
Filed under: Keeneland Conference, PHSSR Grants, Robert Wood Johnson Foundation (RWJF)
By: Brenda Henry, Program Officer, Robert Wood Johnson Foundation, Public Health
Yesterday I moderated a session that highlighted the work of two researchers on health disparities. One looked at the relationship between the maternal/child health services provided by health departments and mortality rates in the community. The other researcher reached out to community members to hear their views on what contributes to poor birth outcomes among African American women in their community.
Given that disparities have improved very little – and in some cases have worsened – since the Healthy People 2010 goal to eliminate disparities, it is very important to understand what we can do as a public health community to reduce the gaps.
The promising role for PHSSR is that it can generate the science that examines and identifies the parts of the public health system – or more specifically, the services and programs–that reduce disparities. We can then replicate this information in other places to further reduce the gaps.
PHSSR needs to do more to help the public health community understand the solutions that exist within the system that can help us finally realize our goal of eliminating health disparities.
We Need More Evidence
Filed under: Keeneland Conference, PHSSR Grants, Robert Wood Johnson Foundation (RWJF)
By: Michelle Larkin, J.D., R.N., M.S., leader, Public Health Team at the Robert Wood Johnson Foundation
Pat Sweeney, University of Pittsburgh, shared early findings from her legal network analysis on state public health system emergency preparedness and response. Relevant statutes from Pennsylvania, California, Georgia, Florida and Texas were coded and analyzed, looking at the connections in emergency preparedness, emergency response, and emergency recovery.
There was remarkable variability in these states, including in how agencies are mandated to work together in emergency situations. One striking gap was the failure to connect mental health services to emergency response and recovery. Additional analysis will tell us more about how these connections play out during real-world emergencies, and how the networks function.
Ellen Jones then presented findings from her project, which examines the qualitative factors that influence passage of childhood obesity legislation in states with low versus high rates of obesity and low versus high numbers of childhood obesity laws. When legislators and their staff express support for prevention of childhood obesity, it does not necessarily result in legislative action.
What drives policymakers to act needs further study, but there was a sense from the audience that we need more evidence – communicated to policymakers in a meaningful and understandable way – to win the day. Our field needs to encourage champions from multiple sectors to come forward and advocate for policy changes to improve the public’s health.
Learn more about public health by visiting the Robert Wood Johnson Foundation’s Public Health page.
Dr. Judith Monroe in Keeneland
Filed under: CDC, Centers for Disease Control and Prevention, Keeneland Conference, Robert Wood Johnson Foundation (RWJF), Uncategorized
By: Michelle Larkin, J.D., R.N., M.S., leader, Public Health Team at the Robert Wood Johnson Foundation
Dr. Judith Monroe, former State Health Officer for Indiana, made her debut appearance as the newest deputy director of the Centers for Disease Control and Prevention and and director of the CDC’s Office for State, Tribal, Local and Territorial Support (OSTLTS). She said she has carried three lessons with her throughout her career and into her new position.
The first is the importance of listening. In her new role, she pledges to listen to public health practitioners and researchers and continue to challenge assumption. The second is to use system resources wisely to better meet population health needs. And lastly, relationships matter and must be dynamic and flexible to get the best results for the public.
Dr. Monroe then connected these lessons to six winnable battles – tobacco, nutrition, healthcare associated infections, motor vehicle injury prevention, teen pregnancy prevention, and HIV prevention. Her vision for public health and OSTLTS is clear, and our field is lucky to have her leadership and that of Dr. Thomas Frieden, the CDC’s director, to transform the public health system.
Listen to Fran Kritz, editor of the RWJF Public Health website, interview Dr. Judith Monroe from Keeneland.
From Keeneland: PHSSR and PHLR
Filed under: Keeneland Conference, PHLR, PHSSR Grants, Public Health Workforce, Robert Wood Johnson Foundation (RWJF)
By: Scott Burris, Professor of Law at Temple University and Director of the Robert Wood Johnson Public Health Law Research Center
Public health law research is the scientific study of the relation of law and legal practices to population health. PHSSR investigates system-level properties and outcomes that result from the dynamic interactions among various components of the public health system and how those interactions affect organizations, communities, environments, and population health status.
The overlap between the two concerns at least two important issues: 1) how law influences the system-level properties of (and outcomes produced) by health agencies, and 2) how health agencies use (or fail to use) their legal powers effectively.
Two RWJF-supported entities – the University of Kentucky’s Center for Public Health Systems and Services Research and the National Program Office of the Public Health Law Research Program at Temple University – worked together to organized a “thought leaders” discussion of the state of research at the intersection of PHLR and PHSSR.
We started with the fact that there are barely a dozen published studies on this topic, but the group agreed that this had nothing to do with a shortage of important questions. From whether health agency leaders understand their legal powers, to the quality of the legal advice they receive, to how readily they use their regulatory authority, there are research questions whose answers could help public health practitioners do a better job.
The challenges to encourage this research include fostering multi-disciplinary teams including researchers, lawyers and practitioners; developing and disseminating legal data sets in key areas of law; and finding funding for the long-term pursuit of significant lines of research.
Listen to a podcast with Scott Burris on how law is a crucial factor in PHSSR.
Practice-based Research to Study the Effects of Public Health System Reform and Other Rapidly Evolving Issues
Filed under: Keeneland Conference, NACCHO, Robert Wood Johnson Foundation (RWJF)
By: Glen P. Mays, M.P.H., Ph.D., associate professor and chair of the Department of Health Policy and Management at the University of Arkansas
The nation’s public health system faces a wave of new developments that are transforming the nature of its work and its impact on health, including the devastating effects of the economic downturn on state and local public health capacity, the movement toward a national accreditation system for public health agencies, and increased federal investments in prevention and public health strategies within a national health system reform package.
The many, many uncertainties surrounding these issues create an urgent demand for new research to inform policy and practice. But how is it possible to conduct well-designed research studies on such rapidly-emerging issues? How can practitioners engage meaningfully in such studies while they are in the midst of a full-court press to address crises and opportunities? How can findings be produced and disseminated in time to be most helpful to decision-makers?
Two sessions at the Keeneland Conference on Wednesday will showcase the work of RWJF’s Public Health Practice-Based Research Networks (PBRNs) in fielding real-time and relevant studies on rapidly advancing issues in public health practice.
Wednesday morning we will present findings from a study of local public health responses to the H1N1 outbreak this past year, sharing findings and lessons learned from this real-world, nation-wide stress test of public health preparedness. When the novel influenza virus arrived in the U.S. in April, our PBRNs in North Carolina and Kentucky were already established and well-positioned to conduct comparative analyses of how local public health systems responded to the threat. These networks, which are comprised of state and local public health agencies along with local research partners, have examined a range of issues including communication practices, public outreach, investigation processes, mass vaccination, and mitigation strategies.
Of particular interest, our research in North Carolina examined whether that state’s public health accreditation program left agencies more prepared to respond to the novel H1N1 threat. Findings indicated that accredited public health agencies performed a broader range of investigation and mitigation activities and implemented these activities more rapidly than their non-accredited counterparts, potentially helping to contain the outbreak more effectively.
Later in the day on Wednesday, all twelve of the RWJF Public Health PBRNs will share experiences and lessons learned from their first year of bringing researchers and practitioners together to study emerging issues in public health practice. Highlights include the work of the Massachusetts PBRN in examining how best to regionalize the delivery of public health services, offering valuable lessons for how to organize public health within the context of a reforming national health system. Equally relevant to the national reform discussions, the Colorado PBRN will describe progress in assessing the implementation of recently passed state legislation that modernizes state public health laws and redistributes local public health agency responsibilities and powers.
These speakers will be joined by leaders from the PBRNs in Kentucky, North Carolina, Washington, Nebraska, New York, Connecticut, Wisconsin, Minnesota, and Ohio to share what is being learned from the study of practice variation and innovation in public health across the country.
A Growing Interest in PHSSR
Filed under: NACCHO, PHSSR Grants, Robert Wood Johnson Foundation (RWJF), Uncategorized
By: Michelle Larkin, J.D., R.N., M.S., leader, Public Health Team at the Robert Wood Johnson Foundation
Veterans of this now three-year-old meeting say the growing interest in PHSSR is obvious from the large numbers of graduate students and researchers who are attending for the first time, many engaged in PHSSR research. So last night’s kick-off dinner was certainly useful for them–a look back by Dr. Scutchfield and ASTHO president Paul Halverson at the early meetings on PHSSR.
Scutchfield acknowledged that the emerging field of health services research prompted him to want the same data sets for public health “on behalf of the people we serve.” Halverson, who is also president of the Arkansas Department of Health, said PHSSR work has been going on for a long time – but in small pockets and that early work was in performance standards. ”We started by creating measurements. We felt we had to have evidence about what we do.” He pointed out the need to fund relevant research and to continually engage new partners and improve the public health system.
Donald Lindberg, director of the National Library of Medicine, and the dinner speaker, underscored the value of reliable information to key areas such as disaster preparedness. He pointed out the emergency access initiative, which opens up resources in the field — such as information on what drugs are needed in specific situations — for use in a disaster.