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Kelly MA, Puddy RW, Siddiqi SM, Nelson C, Ntazinda AH, Kucik JE, Hall D, Murray CT, Tomoaia-Cotisel A. Distilling the Fundamentals of Evidence-Based Public Health Policy. Public Health Rep 2024:333549241256751. [PMID: 38910545 DOI: 10.1177/00333549241256751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
Public health policy interventions are associated with many important public health achievements. To provide public health practitioners and decision makers with practical approaches for examining and employing evidence-based public health (EBPH) policy interventions, we describe the characteristics and benefits that distinguish EBPH policy interventions from programmatic interventions. These characteristics include focusing on health at a population level, focusing on upstream drivers of health, and involving less individual action than programmatic interventions. The benefits of EBPH policy interventions include more sustained effects on health than many programs and an enhanced ability to address health inequities. Early childhood education and universal preschool provide a case example that illustrates the distinction between EBPH policy and programmatic interventions. This review serves as the foundation for 3 concepts that support the effective use of public health policy interventions: applying core component thinking to understand the population health effects of EBPH policy interventions; understanding the influence of existing policies, policy supports, and the context in which a particular policy is implemented on the effectiveness of that policy; and employing a systems thinking approach to identify leverage points where policy implementation can have a meaningful effect.
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Affiliation(s)
- Megan A Kelly
- Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard W Puddy
- Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sameer M Siddiqi
- RAND Corporation, Arlington, VA, USA
- Amazon Web Services, Amazon.com, Inc, Seattle, WA, USA
| | - Christopher Nelson
- RAND Corporation, Santa Monica, CA, USA
- Pardee RAND Graduate School, Santa Monica, CA, USA
| | - Alexandra H Ntazinda
- RAND Corporation, Santa Monica, CA, USA
- Pardee RAND Graduate School, Santa Monica, CA, USA
| | - James E Kucik
- Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Office of the Director, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Diane Hall
- Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Office of Rural Health, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christian T Murray
- Office of Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Pellegrin KL, Hales S, O'Neil P, Wongwiwatthananukit S, Jongrungruangchok S, Songsak T, Lozano AJ, Miller K, Mnatzaganian CL, Fricovsky E, Nigg CR, Tagorda-Kama M, Hanlon AL. Community Culture Survey - Revised: Measuring neighborhood culture and exploring geographic, socioeconomic, and cultural determinants of health in samples across the United States and in Thailand. PUBLIC HEALTH IN PRACTICE 2024; 7:100512. [PMID: 38846106 PMCID: PMC11153899 DOI: 10.1016/j.puhip.2024.100512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 06/09/2024] Open
Abstract
Objectives Research on links between social, geographic, and cultural determinants of health has been thwarted by inadequate measures of culture. The purpose of this study was to improve the measurement of community culture, defined as shared patterns of attitudes and behaviors among people within a neighborhood that distinguish it from others, and to examine dimensions of culture, independent of socioeconomic and demographic factors, and their relationships with health. Study design A survey research design with correlational analyses was used. Methods A survey packet including the Community Culture Survey - Revised (CCS-R), demographic, health, and other individual-level measures was administered through convenience sampling across the United States (US) and to a sample in Thailand from 2016 to 2018. US county-level variables were obtained from zip codes. Results 1930 participants from 49 US states (n = 1592) and Thailand (n = 338) completed all CCS-R items, from which 12 subscales were derived: Social Support & Connectedness, Responsibility for Self & Others, Family Ties & Duties, Social Distress, Urban Diversity, Discontinuity, Church-Engaged, External Resource-Seeking, Locally Owned Business-Active, Power Deference, Next Generation Focus, and Self-Reliance. Neighborhood culture subscale scores varied more by geography than by participant's demographics. All subscales predicted one or more health indicator, and some of these relationships were significant after adjusting for participant age and county-level socioeconomic variables. Most of the significant differences on subscales by race/ethnicity were no longer significant after adjusting for participant's age and county-level socioeconomic variables. Most rural/urban and regional differences in culture within the US persisted after these adjustments. Based on correlational analyses, Social Support & Connectedness and Responsibility for Self & Others were the best predictors of participants' overall health and quality of life, and Responsibility for Self & Others was the best predictor (inversely) of the CDC's measures of social vulnerability. Conclusions Neighborhood culture is measurable, multi-dimensional, distinct from race/ethnicity, and related to health even after controlling for age and socioeconomic factors. The CCS-R is useful for advancing research and practice addressing the complex interactions between individuals, their neighborhood communities, and health outcomes.
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Affiliation(s)
- Karen L. Pellegrin
- Center for Rural Health Science, Daniel K. Inouye College of Pharmacy, University of Hawaiʻi at Hilo, USA
| | - Sarah Hales
- Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Patrick O'Neil
- Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | | | | | - Alicia J. Lozano
- Center for Biostatistics and Health Data Science (CBHDS), Department of Statistics, Virginia Tech, USA
| | - Katharine Miller
- Statistical Applications and Innovations Group (SAIG), Department of Statistics, Virginia Tech, USA
| | | | - Eduardo Fricovsky
- University of California San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA
| | - Claudio R. Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Switzerland
| | | | - Alexandra L. Hanlon
- Center for Biostatistics and Health Data Science (CBHDS), Department of Statistics, Virginia Tech, USA
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Williams N, Newton-Hoe E, Kovac M. How attitudes of state and community leaders regarding health equity and social determinants of health are associated with behavioral intentions to improve population health. PLoS One 2024; 19:e0301450. [PMID: 38635677 PMCID: PMC11025853 DOI: 10.1371/journal.pone.0301450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/12/2024] [Indexed: 04/20/2024] Open
Abstract
A critical driver of population health, well-being, and equity is making health a shared value, or the belief that health is a priority for oneself and one's community. For people in positions of influence, attitudes regarding their organization's perspective may result in decisions that advance health equity or reinforce inequities. Yet despite the potential role of leaders in influencing health and well-being, little is known about their attitudes regarding their organization's perspective on what shapes health, or how their attitudes translate into actions that improve population health. The objectives of this study are twofold: (1) to understand leaders' attitudes with regard to their organization's perspective on population health and (2) to identify the attitudes associated with leaders' perspectives regarding their organization's intention to engage in behaviors that advance population health. We designed a survey instrument grounded in the Theory of Planned Behavior and fielded the survey to 18,367 state and community leaders across all 50 U.S. states, 325 U.S. cities, and nine sectors from fall 2020 until spring 2022. We received surveys from 5,450 leaders, yielding a 32 percent response rate. Survey respondents viewed social determinants of health and health equity as important factors influencing population health. Additionally, two attitudes were most associated with leaders' intentions to promote population health-"self-efficacy" (a leader's confidence in taking action to promote health for all) and "behaviors valued by important others" (how much certain groups want the organization to take action that promotes health for all). Efforts to improve population health through leaders should focus on supporting leaders' self-efficacy and on increasing leaders' perceptions regarding behaviors valued by important others. Governmental entities and funders can use these data to support leaders' efforts in improving population health, well-being, and equity.
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Affiliation(s)
- Nyna Williams
- Division of Health Research, Mathematica, Princeton, NJ, United States of America
| | - Emily Newton-Hoe
- Department of Social and Behavioral Sciences, Harvard University, Cambridge, MA, United States of America
| | - Martha Kovac
- Division of Health Research, Mathematica, Princeton, NJ, United States of America
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FISCELLA KEVIN, EPSTEIN RONALDM. The Profound Implications of the Meaning of Health for Health Care and Health Equity. Milbank Q 2023; 101:675-699. [PMID: 37343061 PMCID: PMC10509522 DOI: 10.1111/1468-0009.12660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
Policy Points The meaning of health in health care remains poorly defined, defaulting to a narrow, biomedical disease model. A national dialogue could create a consensus regarding a holistic and humanized definition of health that promotes health care transformation and health equity. Key steps for operationalizing a holistic meaning of health in health care include national leadership by federal agencies, intersectoral collaborations that include diverse communities, organizational and cultural change in medical education, and implementation of high-quality primary care. The 2023 report by the National Academies of Sciences, Engineering, and Medicine on achieving whole health offers recommendations for action.
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Farris P, Crist R, Miller S, Shannon J. Rural research capacity: a co-created model for research success. Health Res Policy Syst 2023; 21:76. [PMID: 37488533 PMCID: PMC10364434 DOI: 10.1186/s12961-023-01030-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE The United States' National Institutes of Health (NIH) have long challenged academia to improve clinical trial enrollment, especially in underrepresented populations; inclusive of geography, age, disability status, racial and ethnic minorities. It has been shown that rural and urban residents enrolled in clinical trials have similar outcomes, yet, rural healthcare systems struggle to provide opportunities to rural residents to participate in clinical trials when infrastructure is limited or unsupportive of research programs and/or research staffing levels are insufficient. To fully address the barriers to clinical trial access in rural areas, it is not adequate to simply open more trials. Community receptivity of research as well as organizational and community capacity must be considered. This project was determined by the Oregon Health and Science University's Institutional Review Board to be generalizable research across the chosen counties and was approved to operate under a waiver of written consent. Participants received a cash incentive in appreciation for their time and verbally agreed to participate after reviewing a project information sheet. METHODS The research team co-created a community-responsive approach to the receipt, review, and acceptance of clinical trials in a rural community setting. An adapted 5 step Implementation Mapping approach was used to develop a systematic strategy intended to increase the success, and therefore, the number of clinical trials offered in a rural community. RESULTS The research team and participating rural community members pilot-tested the implementation of a co-designed research review strategy, inclusive of a Regional Cultural Landscape and three co-created project submission and feasibility review forms, with a cancer early detection clinical trial. The proposed clinical trial required engagement from primary care and oncology. Utilizing the research review strategy demonstrated strong researcher-community stakeholder communication and negotiation, which resulted in early identification and resolution of potential barriers, hiring a local clinical research coordinator, and timely trial opening. CONCLUSION To the knowledge of the research team, the work described is the first to use a community-engaged approach for creating a clinical trial implementation strategy directly supportive of rural-sitting community stakeholders in receiving, reviewing, and approving cancer-related clinical trials in their community. Participating community members and leaders had the chance to negotiate research protocol changes or considerations directly with researchers interested in conducting a cancer clinical trial in their rural setting.
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Affiliation(s)
- Paige Farris
- Community Outreach and Engagement Program, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97239, United States of America
| | - Rachel Crist
- Community Outreach and Engagement Program, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, 97239, United States of America
| | - Sylvia Miller
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, OR, 97239, United States of America
| | - Jackilen Shannon
- Division of Oncologic Sciences, Knight Cancer Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, United States of America.
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Taylor LA, Aveling EL, Roberts J, Bhuiya N, Edmondson A, Singer S. Building resilient partnerships: How businesses and nonprofits create the capacity for responsiveness. FRONTIERS IN HEALTH SERVICES 2023; 3:1155941. [PMID: 37256212 PMCID: PMC10225548 DOI: 10.3389/frhs.2023.1155941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/03/2023] [Indexed: 06/01/2023]
Abstract
Increasingly, businesses are eager to partner with nonprofit organizations to benefit their communities. In spite of good intentions, differences between nonprofit and business organizations can limit the ability of potential partnerships to respond to a changing economic and public health landscape. Using a retrospective, multiple-case study, we sought to investigate the managerial behaviors that enabled businesses and nonprofits to be themselves together in sustainable partnerships. We recruited four nonprofit-business partnerships in the Boston area to serve as cases for our study. Each was designed to address social determinants of health. We thematically analyzed qualitative data from 113 semi-structured interviews, 9 focus groups and 29.5 h of direct observations to identify organizational capacities that build resilient partnerships. Although it is common to emphasize the similarities between partners, we found that it was the acknowledgement of difference that set partnerships up for success. This acknowledgement introduced substantial uncertainty that made managers uncomfortable. Organizations that built the internal capacity to be responsive to, but not control, one another were able to derive value from their unique assets.
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Affiliation(s)
- Lauren A. Taylor
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Emma-Louise Aveling
- Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Jane Roberts
- Survey and Qualitative Methods Core, Division of Population Sciences, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Nazmim Bhuiya
- MassHealth, Executive Office of Health & Human Services, Boston, MA, United States
| | | | - Sara Singer
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
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Martin LT, Carman K, Yeung D. What drives health mindset and expectations in the United States? J Public Health Policy 2023; 44:34-46. [PMID: 36526740 PMCID: PMC9756721 DOI: 10.1057/s41271-022-00382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Abstract
Health mindset is a group of beliefs or assumptions that individuals hold about the causes of health and well-being. Strengthening our understanding of factors that shape mindset and how mindset shapes expectations for who can and should be responsible for health can inform the success and sustainability of solutions to current health crises including the COVID-19 pandemic, ongoing disparities in health outcomes, and gun violence. We first examined associations between personal characteristics and experiences with health mindset. Next, we examined the association between mindset and the belief that government involvement can help address pressing health questions, using obesity as an example of a health outcome that is shaped both by personal choices and factors outside one's control. Going forward, it will be important to consider health mindset in broader transformations of the health system and population approaches to improving health.
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Affiliation(s)
- Laurie T Martin
- RAND Corporation, 1200 South Hayes Street, Arlington, VA, 22202, USA.
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Examining the mediating role of team growth mindset on the relationship of individual mindsets and shared leadership. EUROPEAN JOURNAL OF TRAINING AND DEVELOPMENT 2022. [DOI: 10.1108/ejtd-08-2022-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Purpose
As a cornerstone of team performance, learning depends on each member’s mindset. Drawing on implicit theories of intelligence, the purpose of this study is to investigate the relationships among individual members’ mindsets and shared leadership (SL) behaviors in design teams and the mediation role of team growth mindset (TGM) on that relationship.
Design/methodology/approach
The authors analyzed survey results based on individuals who participated in an international design competition. To test the hypothesized model, the data was analyzed by using SEM using Mplus 7.
Findings
The results indicated that an individual growth mindset (IGM; but not an individual-fixed mindset) has significant and positive direct effects on a team growth mindset and SL behaviors. In addition, a TGM mediates the relationship between an IGM and SL.
Originality/value
The research discusses several theoretical and practical implications for human resource development professionals and scholars to improve understanding of a TGM and its influence on individual mindsets and SL behaviors.
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Gollust SE, Call KT, Moon JR, Cluxton B, Bailey Z. Designing and Implementing a Curriculum to Support Health Equity Research Leaders: The Interdisciplinary Research Leaders Experience. Front Public Health 2022; 10:876847. [PMID: 35646764 PMCID: PMC9136100 DOI: 10.3389/fpubh.2022.876847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/13/2022] [Indexed: 12/05/2022] Open
Abstract
Health inequities in the United States are well-documented. However, research that is focused on solutions, rather than just describing the problem, and research that is designed explicitly to inform needed policy and practice change, is still too rare. The Robert Wood Johnson Foundation Interdisciplinary Research Leaders (IRL) program launched in 2016 with the goal of filling this gap: to generate community-engaged research to catalyze policy action in communities, while promoting leadership among researchers and community partners. In this paper, we describe the creation and implementation of a curriculum for IRL program participants over the first 5 years of the program. The curriculum—spanning domains of leadership, policy, communication, community engagement, and research methodologies—was designed to cultivate leaders who use research evidence in their efforts to promote change to advance health equity in their communities. The curriculum components implemented by IRL might be applied to other educational programs or fellowships to amplify and accelerate the growth of leaders nationwide who can use research and action to respond to grave and ongoing threats to community health.
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Affiliation(s)
- Sarah E. Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
- *Correspondence: Sarah E. Gollust
| | - Kathleen T. Call
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - J. Robin Moon
- Department of Health Policy and Management, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | | | - Zinzi Bailey
- Divisions of Medical Oncology and Epidemiology, Department of Medicine, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
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Nelson C, Martin LT, Yeung D, Bugliari D. Has COVID-19 changed how people think about the drivers of health? If so, does it matter? FRONTIERS IN HEALTH SERVICES 2022; 2:987226. [PMID: 36925888 PMCID: PMC10012659 DOI: 10.3389/frhs.2022.987226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/02/2022] [Indexed: 11/24/2022]
Abstract
Background Could the COVID-19 pandemic prompt shifts in Americans' basic views on health mindset and policy solutions to health crises? Methods A sample of 1,637 individuals rated the extent to which items (e.g., the role of environmental vs. individual factors) "may affect people's health and wellbeing," both before (2018) and during the pandemic. In summer 2020 and fall 2021 they responded to questions about vaccination status and perceptions of COVID-19 related policies. We assessed changes in health mindset using repeated measures logistic regression, and used cross-sectional logistic regressions to assess whether variations in mindset explain COVID-19 related attitudes and behavior. Results Between 2018 and 2021 respondents gave increasing weight to where people live and genetic factors and less weight to the role of individual health choices. Views on the importance of access to healthcare did not change appreciably. Those who reported that health care and place have a strong effect on health and wellbeing were significantly more likely to get vaccinated. Moreover, those who strongly believed that place is important were significantly less likely to agree that their local government went too far in restricting their freedom and that the local economy should have been left alone. Conclusion Respondents were more likely in 2021 than in 2018 to recognize social determinants of health, and this is associated with a greater openness to pandemic-control measures. It remains to be seen, however, whether the changes in health mindset will persist over time and contribute to changes in policy and practice.
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Shim RS, Starks SM. COVID-19, Structural Racism, and Mental Health Inequities: Policy Implications for an Emerging Syndemic. Psychiatr Serv 2021; 72:1193-1198. [PMID: 33622042 DOI: 10.1176/appi.ps.202000725] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The complex interactions between the 2019 coronavirus disease (COVID-19) pandemic, structural racism, and mental health inequities have led to devastating health, economic, and social consequences. The intersection of these three conditions, which meets criteria for a syndemic (synergistic epidemics), presents numerous policy challenges-and opportunities. Addressing these issues in a unified manner, using a syndemic theory approach, can lead to significant progress and effective solutions for otherwise intransigent problems in society. This article proposes steps that can be taken to protect "essential workers" and other "vulnerable" populations; engage and empower communities; optimize community-led crisis response interventions; improve data collection about the intersection of COVID-19, structural racism, and mental health inequities; support school-based interventions; expand financial supports for mental health service delivery; expand health care insurance coverage to increase access and lower out-of-pocket costs; and promote workforce diversity. Emphasis on local, state, and federal policy interventions that prioritize equity and justice and focus on collective health and well-being will ultimately lead us on a more sustainable and equitable path.
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Affiliation(s)
- Ruth S Shim
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Shim); Department of Clinical Sciences, University of Houston College of Medicine, Houston (Starks)
| | - Steven M Starks
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Shim); Department of Clinical Sciences, University of Houston College of Medicine, Houston (Starks)
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Kelly G, Pennington J, Segev Y, Brokamp C, Jones MN, Camara S, Henize AW, Kahn RS, Beck AF. Voter Participation is Associated with Child Health Outcomes at the Population Level. J Pediatr 2021; 235:277-280. [PMID: 33894260 DOI: 10.1016/j.jpeds.2021.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Civic engagement, including voting, has been linked to health outcomes for adults. Here, we found that census tract-level voter participation rates are significantly associated with pediatric inpatient bed-day rates even after adjustment for socioeconomic deprivation. Such links suggest that promotion of voting participation could be warranted in healthcare settings.
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Affiliation(s)
- Grace Kelly
- University of Cincinnati College of Medicine, Cincinnati, OH
| | | | - Yonatan Segev
- University of Cincinnati College of Medicine, Cincinnati, OH
| | - Cole Brokamp
- University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Saige Camara
- University of Cincinnati College of Medicine, Cincinnati, OH
| | | | - Robert S Kahn
- University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Andrew F Beck
- University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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Graif C, Meurer J, Fontana M. An Ecological Model to Frame the Delivery of Pediatric Preventive Care. Pediatrics 2021; 148:s13-s20. [PMID: 34210842 PMCID: PMC8312252 DOI: 10.1542/peds.2021-050693d] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/24/2022] Open
Abstract
Screening and surveillance are integral aspects of child health promotion and disease prevention. The American Academy of Pediatrics recommends that primary care clinicians screen children and adolescents for a broad array of conditions, conduct surveillance of growth and development, identify social determinants of health, and identify protective and risk factors that might impact health over time. However, access to and outcomes of preventive services vary based on features of children’s social ecology, including family and community contexts. The proposed five-stage socio-ecological model considers multiple contextual dimensions of pediatric screening: (1) individual, (2) interpersonal, (3) organizational, (4) community/population, and (5) public policy. Incorporating this model into routine care might improve outcomes at the individual and population level. Future endeavors should focus on integration of this model with validated risk screening tools as part of a supportive electronic health record, culture, and incentive structure. Further research assessing the contributors and outcomes of differences in beliefs, resources, practices, and opportunities among individuals, families, providers, primary care organizations, communities, health systems, and policy partners will be essential in advancing knowledge and policies to improve preventive services delivery.
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Affiliation(s)
- Corina Graif
- Department of Sociology and Criminology, College of the Liberal Arts and Population Research Institute, Pennsylvania State University, University Park, Pennsylvania
| | - John Meurer
- Division of Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
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Weiss-Laxer NS, Crandall A, Hughes ME, Riley AW. Families as a Cornerstone in 21st Century Public Health: Recommendations for Research, Education, Policy, and Practice. Front Public Health 2020; 8:503. [PMID: 33072687 PMCID: PMC7530559 DOI: 10.3389/fpubh.2020.00503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022] Open
Abstract
Families are vastly overlooked in US initiatives to promote population health and health equity despite being the most proximal context for health across the life course. We urge the public health sector to take the lead in recognizing families as essential for promoting 21st century population health. We highlight ways families influence health by providing context, care, continuity, and connections. The dual private and public aspect of families has contributed to how they have been overlooked in the public health sector. We provide recommendations for better integrating families into population health initiatives through national health goals, research, education, policy, and practice.
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Affiliation(s)
- Nomi S Weiss-Laxer
- Department of Family Medicine, Primary Care Research Institute, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - AliceAnn Crandall
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Mary Elizabeth Hughes
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Anne W Riley
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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McCullough JM, Singh SR, Leider JP. The Importance of Governmental and Nongovernmental Investments in Public Health and Social Services for Improving Community Health Outcomes. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:348-356. [PMID: 31136508 DOI: 10.1097/phh.0000000000000856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore whether health outcomes are influenced by both governmental social services spending and hospital provision of community health services. DESIGN We combined hospital provision of community health services data from the American Hospital Association with local governmental spending data from the US Census Bureau. Longitudinal models regressed community health outcomes for 2012-2016 on local government spending on health, social services, and education from 5 years previously, controlling for sociodemographic and hospital marketplace characteristics, spatial autocorrelation, and state-level random effects. For counties with hospitals, models also included county-level data on hospitals' provision of community health services. SETTING All analyses were performed at the county level for US counties between 2012 and 2016. PARTICIPANTS Complete spending, hospital, and health outcomes data were available for a total of 2379 counties. MAIN OUTCOME MEASURES We examined relationships between governmental spending, hospital service provision, and 5 population health outcome measures: years of potential life lost prior to age 75 years per 100 000 population, percentage of population in fair or poor health, percentage of adults who are physically inactive, deaths due to injury per 100 000 population, and percentage of births that are of low birth weight. RESULTS Governmental investments in health, social services, and education positively impacted key health outcomes but mainly in counties with 1 or more hospitals present. Hospitals' provision of community health services also had a significant positive impact on health outcomes. CONCLUSIONS Hospital provision of community health services and increases in local governmental health and social services spending were both associated with improved health. Collaboration between local governments and hospitals may help ensure that public and private community health resources synergistically contribute to the public's health. Local policy makers should consider service provision by the private sector to leverage the public investments in health and social services.
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Affiliation(s)
- J Mac McCullough
- School for the Science of Health Care Delivery, Arizona State University, Phoenix, Arizona (Dr McCullough); Department of Health Policy & Management, University of Michigan School of Public Health, Ann Arbor, Michigan (Dr Singh); and Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Leider)
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Learning to See Racism: Perspective Transformation Among Stakeholders in a Regional Health and Equity Initiative. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 28:S82-S90. [PMID: 32487923 DOI: 10.1097/phh.0000000000001171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Achieving a meaningful reduction in health inequities will require not only policy and programmatic changes but also an increased understanding of structural racism and its deleterious impact on health and well-being. One way to enhance understanding is to actively promote "perspective transformation" (PT) around race among health equity stakeholders. Experiences of PT are defined as moments or events that bring about a deepened understanding of racism and that may result in new ways of thinking and acting. OBJECTIVE To identify catalysts and effects of PT among health equity stakeholders. DESIGN Semistructured, in-person interviews were conducted with stakeholders (n = 50) as part of a 2-phase, mixed-methods study (n = 170). Interviews were audio-recorded, transcribed, and coded using a mixed-methods software platform. SETTING Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), a regional health and equity initiative in Greater Cleveland, Ohio. PARTICIPANTS A purposive sample of participants in HIP-Cuyahoga spanning 5 groups: metro-wide decision makers, public health professionals, clinicians, community leaders, and community members. RESULTS More than two-thirds of interviewees reported at least one discrete experience that catalyzed PT, as defined earlier. Three catalysts were especially common: witnessing, learning, and personally experiencing racism. A fourth, less common catalyst involved getting uncomfortable during discussions of race and racism. Experiences of PT resulted in common effects including acquiring new terms, concepts, and frameworks; carrying the conversation forward; finding fellow travelers; and feeling energized and motivated to confront structural racism and its consequences. People of color tended to experience PT, and its catalysts and effects, differently than White interviewees. CONCLUSIONS Many health equity stakeholders have experienced PT around racism and its impact. Experiencing PT is associated with new skills, capacities, and motivations to confront racism and its impact on health and well-being. Understanding how different groups experience PT can help advance efforts to promote health equity.
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Dubowitz T, Nelson C, Weilant S, Sloan J, Bogart A, Miller C, Chandra A. Factors related to health civic engagement: results from the 2018 National Survey of Health Attitudes to understand progress towards a Culture of Health. BMC Public Health 2020; 20:635. [PMID: 32380964 PMCID: PMC7203885 DOI: 10.1186/s12889-020-08507-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/11/2020] [Indexed: 11/26/2022] Open
Abstract
Background Civic engagement, including voting, volunteering, and participating in civic organizations, is associated with better psychological, physical and behavioral health and well-being. In addition, civic engagement is increasingly viewed (e.g., in Robert Wood Johnson Foundation’s Culture of Health action framework) as a potentially important driver for raising awareness of and addressing unhealthy conditions in communities. As such, it is important to understand the factors that may promote civic engagement, with a particular focus on the less-understood, health civic engagement, or civic engagement in health-related and health-specific activities. Using data from a nationally representative sample of adults in the United States (U.S.), we examined whether the extent to which individuals feel they belong in their community (i.e., perceived sense of community) and the value they placed on investing in community health were associated with individuals’ health civic engagement. Methods Using data collected on 7187 nationally representative respondents from the 2018 National Survey of Health Attitudes, we examined associations between sense of community, valued investment in community health, and perceived barriers to taking action to invest in community health, with health civic engagement. We constructed continuous scales for each of these constructs and employed multiple linear regressions adjusting for multiple covariates including U.S. region and city size of residence, educational attainment, family income, race/ethnicity, household size, employment status, and years living in the community. Results Participants who endorsed (i.e., responded with mostly or completely) all 16 sense of community scale items endorsed an average of 22.8% (95%CI: 19.8–25.7%) more of the health civic engagement scale items compared with respondents who did not endorse any of the sense of community items. Those who endorsed (responded that it was an important or top priority) all items capturing valued investment in community health endorsed 14.0% (95%CI: 11.2–16.8%) more of the health civic engagement items than those who did not endorse any valued investment in community health items. Conclusions Health civic engagement, including voting and volunteering to ultimately guide government decisions about health issues, may help improve conditions that influence health and well-being for all. Focusing on individuals’ sense of community and highlighting investments in community health may concurrently be associated with increased health civic engagement and improved community and population health.
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Affiliation(s)
- Tamara Dubowitz
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA.
| | - Christopher Nelson
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Sarah Weilant
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Jennifer Sloan
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Andy Bogart
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | | | - Anita Chandra
- RAND Corporation, Social & Economic Wellbeing, Santa Monica, USA
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FOWLER ERIKAFRANKLIN, BAUM LAURAM, JESCH EMMA, HADDAD DOLLY, REYES CAROLYN, GOLLUST SARAHE, NIEDERDEPPE JEFF. Issues Relevant to Population Health in Political Advertising in the United States, 2011-2012 and 2015-2016. Milbank Q 2019; 97:1062-1107. [PMID: 31650628 PMCID: PMC6904264 DOI: 10.1111/1468-0009.12427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Policy Points Political advertising can influence which issues are public policy priorities. Population health-relevant issues were frequently referenced in televised political advertising in the 2011-2012 and 2015-2016 US election cycles, with about one-fourth of all ads aired mentioning traditional public health and health policy topics and more than half referencing broader determinants of population health. The volume of population health-relevant issues referenced in political ads varied by geography, political office, political party, and election cycle. Ads referencing broader determinants of population health (such as employment, education, or gender equality) rarely tied these determinants directly to health outcomes. CONTEXT Political discourse is one way that policymakers and candidates for public office discuss societal problems, propose solutions, and articulate actionable policies that might improve population health. Yet we know little about how politicians define and discuss issues relevant to population health in their major source of electoral communication, campaign advertisements. This study examined the prevalence of references to population health-relevant issues conveyed in campaign advertising for political office at all levels of government in the United States in 2011-2012 and 2015-2016. Understanding advertising as part of the political discourse on topics of relevance to population health yields insights about political agenda-setting and can inform efforts to shape opinion. METHODS We conducted a content analysis of all English-language, candidate-related campaign advertisements aired on local broadcast, national network, and national cable television in the 2011-2012 and 2015-2016 election cycles (3,980,457 and 3,767,477 airings, respectively). We analyzed the volume of coverage in these ads about issues relevant to population health, including narrowly defined public health issues as well as a broad range of other social, economic, and environmental factors that affect population health. FINDINGS Across both election cycles and all electoral races, 26% of campaign advertising discussed issues relevant for the narrowly defined conceptualization of public health and 57% discussed issues pertinent to topics within the more expansive population health conceptualization. There was substantial variation in population health-related content in ads across election cycles, by level of political office, political party, and geographic area. Geographic variation indicates that where a person lives affects their potential exposure to political communication about various health-related topics. CONCLUSIONS Political campaign ads in the United States frequently referenced population health-relevant content at all levels of government, although the ads rarely connected population health-relevant issues to health. Variation in volume and content of these references likely shaped public opinion and the public will to address population health-related policy.
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Affiliation(s)
| | | | - EMMA JESCH
- Cornell University
- Annenberg School for CommunicationUniversity of Pennsylvania
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KYLE MICHAELANNE, SEEGARS LUMUMBA, BENSON JOHNM, BLENDON ROBERTJ, HUCKMAN ROBERTS, SINGER SARAJ. Toward a Corporate Culture of Health: Results of a National Survey. Milbank Q 2019; 97:954-977. [PMID: 31502327 PMCID: PMC6904256 DOI: 10.1111/1468-0009.12418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Policy Points The private sector has large potential influence over social determinants of health, but we have limited information about how businesses perceive or engage in actions to promote health and well-being. We conducted a national survey of more than 1,000 businesses of varying sizes and industries to benchmark private sector engagement in employee, environmental, consumer, and community health, which we collectively refer to as a corporate culture of health. Overall, the private sector is taking steps to foster health and well-being but still has substantial opportunity for growth. CONTEXT The private sector has a large potential role in advancing health and well-being, but attention to corporate practices around health tends to focus on a narrow range of issues and on large businesses. Systematically describing private sector engagement in health and well-being is a necessary step toward understanding the current state of the field and developing an agenda for businesses going forward. METHODS We conducted a national survey of 1,017 private sector organizations to assess current levels of engagement in what we term a culture of health (CoH). We measured corporate CoH along four dimensions, which assess the extent to which businesses promote employee, environmental, consumer, and community health and well-being. We also explored potential explanations for the number of health-related actions taken in each dimension. FINDINGS On average, businesses took 38% of health-related actions included in our survey. For each dimension, we found variation among businesses in the number of actions taken (on average, there were almost fourfold differences between the bottom and top quartiles of businesses in terms of actions taken). Mentioning health and well-being in the corporate mission, having a strategic plan for CoH, and perceiving a positive return on CoH investments were all associated with businesses' actions taken. Fewer than half of businesses, however, perceived a positive return on their CoH investments. CONCLUSIONS Overall, the private sector is taking steps to foster health and well-being. However, there remains substantial variation among businesses and opportunity for growth, even among those currently taking the most action. Strengthening the business case for a corporate CoH may increase private sector investments in health and well-being. Actions taken by individual businesses, business groups, industries, and regulators have the potential to improve corporate engagement and impact.
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Affiliation(s)
| | | | | | | | | | - SARA J. SINGER
- Stanford School of Medicine and Stanford Graduate School of Business
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Reid A, Abraczinskas M, Scott V, Stanzler M, Parry G, Scaccia J, Wandersman A, Ramaswamy R. Using Collaborative Coalition Processes to Advance Community Health, Well-Being, and Equity: A Multiple-Case Study Analysis From a National Community Transformation Initiative. HEALTH EDUCATION & BEHAVIOR 2019; 46:100S-109S. [PMID: 30982339 PMCID: PMC6759367 DOI: 10.1177/1090198119838833] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spreading Community Accelerators Through Learning and Evaluation (SCALE) was a Robert Wood Johnson Foundation-funded initiative from 2015 to 2017 to build capability of 24 community coalitions to advance health, well-being, and equity. The SCALE theory of change had three components: develop leadership capability, build relationships within and between communities, and create an intercommunity system to spread promising ideas. The theory was operationalized through training academies, coaching, and peer-to-peer learning that explicitly addressed equity and systems change. In this article, we describe how SCALE facilitated community transformation related to Collaborating for Equity and Justice Principles 1, 3, 4, and 6. We conducted a multiple-case study approach with two community coalitions including site visits, interviews, and observation to illuminate underlying mechanisms of change by exploring how and why change occurs. Skid Row Women worked with women experiencing homelessness in Los Angeles to address diabetes and food systems. Healthy Livable Communities of Cattaraugus County used a portfolio of projects in order to create system changes to improve population health and increase access to services for people with disabilities in rural New York State. Through our analysis, we describe how two coalitions used SCALE tools for collaborative coalition processes such as aim setting, relationship building, and shared decision making with community residents. Our findings suggest that advancing Collaborating for Equity and Justice principles requires self-reflection and courage; new ways of being in relationship; learning from failure; productive conflict to explicitly address power, racism, and other forms of oppression; and methods to test systems improvement ideas.
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Affiliation(s)
- Amy Reid
- Institute for Healthcare Improvement, Boston, MA, USA
| | | | - Victoria Scott
- University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Gareth Parry
- Institute for Healthcare Improvement, Boston, MA, USA
| | | | | | - Rohit Ramaswamy
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Building the evidence on Making Health a Shared Value: Insights and considerations for research. SSM Popul Health 2019; 9:100474. [PMID: 31485479 PMCID: PMC6715953 DOI: 10.1016/j.ssmph.2019.100474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 12/02/2022] Open
Abstract
The Robert Wood Johnson Foundation (RWJF)'s Culture of Health Action Framework guides a movement to improve health and advance health equity across the nation. Action Area One of the Framework, Making Health a Shared Value, highlights the role of individual and community factors in achieving a societal commitment to health and health equity, centered around three drivers: Mindset and Expectations, Sense of Community, and Civic Engagement. To stimulate research about how Action Area One and its drivers may impact health, Evidence for Action (E4A), a signature research funding program of RWJF, developed and released a national Call for Proposals (CFP). The process of formulating the CFP and reviewing proposals surfaced important challenges for research on creating and sustaining shared values to foster and maintain a Culture of Health. In this essay, we describe these considerations and provide examples from funded projects regarding how challenges can be addressed.
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Beck AF, Anderson KL, Rich K, Taylor SC, Iyer SB, Kotagal UR, Kahn RS. Cooling The Hot Spots Where Child Hospitalization Rates Are High: A Neighborhood Approach To Population Health. Health Aff (Millwood) 2019; 38:1433-1441. [DOI: 10.1377/hlthaff.2018.05496] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Andrew F. Beck
- Andrew F. Beck is an associate professor of pediatrics at the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center, in Ohio
| | - Kristy L. Anderson
- Kristy L. Anderson is a clinical manager for social services at Cincinnati Children’s Hospital Medical Center
| | - Kate Rich
- Kate Rich is a data analyst at the James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center
| | - Stuart C. Taylor
- Stuart C. Taylor is a data analyst at the James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center
| | - Srikant B. Iyer
- Srikant B. Iyer is director of pediatric emergency medicine at Emory University School of Medicine and Children’s Healthcare of Atlanta, in Georgia. At the time this work was conducted, he was an associate professor of pediatrics at the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center
| | - Uma R. Kotagal
- Uma R. Kotagal is executive leader of population and community health and a professor of pediatrics at the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center
| | - Robert S. Kahn
- Robert S. Kahn is the associate chair of community health and a professor of pediatrics at the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center
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Mason DJ, Martsolf GR, Sloan J, Villarruel A, Sullivan C. Making health a shared value: Lessons from nurse-designed models of care. Nurs Outlook 2019; 67:213-222. [DOI: 10.1016/j.outlook.2018.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/13/2018] [Accepted: 12/21/2018] [Indexed: 11/28/2022]
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Chapman AR. When Going Beyond Gentle Nudges Is Legitimate. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2019; 19:68-69. [PMID: 31090527 DOI: 10.1080/15265161.2019.1588416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Engaging Stakeholders to Co-design an Academic Practice Strategic Plan in an Integrated Health System: The Key Roles of the Nurse Executive and Planning Team. Nurs Adm Q 2019; 43:186-192. [PMID: 30839455 DOI: 10.1097/naq.0000000000000340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
As key members of the executive team, nurse executives play an integral role in the planning process and operationalization of strategic imperatives to ensure the overall success of the organization. Nurse executives are leading organizations through transition periods that require transformational leadership. Leaders must design a shared vision and set strategic priorities; empower others to lead; ensure access to resources needed for safe care delivery; and inspire people to meet the demands of the future. Paramount to effective strategic planning and achievement of positive outcomes is a leadership team that engages key stakeholders in the strategic planning process. This article provides an overview of a recently integrated health system's strategic planning process that included the engagement of patients and caregivers. This can serve as a blueprint for others in their efforts to implement a systematic approach for enhancing collaborative academic practice in their organizations.
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Tziraki-Segal C, De Luca V, Santana S, Romano R, Tramontano G, Scattola P, Celata C, Gelmi G, Ponce Márquez S, Lopez-Samaniego L, Zavagli V, Halkoaho A, Grimes C, Tomás MT, Fernandes B, Calzà L, Speranza P, Coppola L, Jager-Wittenaar H, O'Caoimh R, Pietilä AM, Carriazo AM, Apostolo J, Iaccarino G, Liotta G, Tramontano D, Molloy W, Triassi M, Viggiani V, Illario M. Creating a Culture of Health in Planning and Implementing Innovative Strategies Addressing Non-communicable Chronic Diseases. FRONTIERS IN SOCIOLOGY 2019; 4:9. [PMID: 33869336 PMCID: PMC8022497 DOI: 10.3389/fsoc.2019.00009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/01/2019] [Indexed: 06/12/2023]
Abstract
Ongoing demographic changes are challenging health systems worldwide especially in relation to increasing longevity and the resultant rise of non-communicable diseases (NCDs). To meet these challenges, a paradigm shift to a more proactive approach to health promotion, and maintenance is needed. This new paradigm focuses on creating and implementing an ecological model of Culture of Health. The conceptualization of the Culture of Health is defined as one where good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities where citizens have the opportunity to make choices and be co-producers of healthy lifestyles. Based on Antonovsky's Salutogenesis model which asserts that the experience of health moves along a continuum across the lifespan, we will identify the key drivers for achieving a Culture of Health. These include mindset/expectations, sense of community, and civic engagement. The present article discusses these drivers and identifies areas where policy and research actions are needed to advance positive change on population health and well-being. We highlight empirical evidence of drivers within the EU guided by the activities within the thematic Action Groups of the European Innovation Partnership on Active and Healthy Aging (EIP on AHA), focusing on Lifespan Health Promotion and Prevention of Age-Related Frailty and Disease (A3 Action Group). We will specifically focus on the effect of Culture on Health, highlighting cross-cutting drivers across domains such as innovations at the individual and community level, and in synergies with business, policy, and research entities. We will present examples of drivers for creating a Culture of Health, the barriers, the remaining gaps, and areas of future research to achieve an inclusive and sustainable asset-based community.
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Affiliation(s)
- Chariklia Tziraki-Segal
- Israel Gerontological Data Center, Hebrew University of Jerusalem, Jerusalem, Israel
- MELABEV- Community Clubs for Elders, Jerusalem, Israel
| | - Vincenzo De Luca
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - Silvina Santana
- Department of Economics, Management, Industrial Engineering and Tourism, Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
| | - Rosa Romano
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - Giovanni Tramontano
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - Paola Scattola
- Health Protection Agency of the Metropolitan City of Milan, Milan, Italy
| | - Corrado Celata
- Health Promotion, Screening and Prevention Unit, Milan, Italy
| | - Giusi Gelmi
- Health Protection Agency of the Metropolitan City of Milan, Milan, Italy
| | - Sara Ponce Márquez
- International Research Projects Office (IRPO), Universidad de Deusto, Bilbao, Spain
| | - Luz Lopez-Samaniego
- Progress and Health Foundation, Regional Ministry of Health of Andalucía, Seville, Spain
| | | | - Arja Halkoaho
- School of Health Care and Social Services Education and R&D, Tampere University of Applied Sciences, Tampere, Finland
| | - Corrina Grimes
- Public Health Agency of Northern Ireland, Belfast, United Kingdom
| | - Maria Teresa Tomás
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Beatriz Fernandes
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Laura Calzà
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Patrizia Speranza
- General Affairs Unit, Federico II University Hospital, Naples, Italy
| | - Liliana Coppola
- Health Promotion, Screening and Prevention Unit, Milan, Italy
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Rónán O'Caoimh
- Department of Medicine, Clinical Sciences Institute, National University of Ireland, Galway, Ireland
| | - Anna-Maija Pietilä
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | | | - Joao Apostolo
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Guido Iaccarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Donatella Tramontano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | - William Molloy
- Clinical Gerontology and Rehabilitation Centre, Gerontology and Rehabilitation School of Medicine, University College of Cork, Cork, Ireland
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | | | - Maddalena Illario
- Health Innovation Division, General Directorate for Health, Naples, Italy
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Hsu P, Bryant MC, Hayes-Bautista TM, Partlow KR, Hayes-Bautista DE. California And The Changing American Narrative On Diversity, Race, And Health. Health Aff (Millwood) 2018; 37:1394-1399. [PMID: 30179544 DOI: 10.1377/hlthaff.2018.0427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The historical narrative on diversity, race, and health would predict that California's population change from 22 percent racial/ethnic minority in 1970 to 62 percent in 2016 would lead to a massive health crisis with high mortality rates, low life expectancy, and high infant mortality rates-particularly given the state's high rates of negative social determinants of health: poverty, high school incompletion, and uninsurance. We present data that suggest an alternative narrative: In spite of these negative factors, California has very low rates of mortality and infant mortality and long life expectancy. This alternative implies that racial diversity may offer opportunities for good health outcomes and that community agency may be a positive determinant. Using national-level mortality data on racial/ethnic groups, we suggest that new theoretical models and methods be developed to assist the US in achieving high-level wellness as it too becomes "majority minority."
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Affiliation(s)
- Paul Hsu
- Paul Hsu ( ) is an adjunct assistant professor in the Department of Medicine, University of California Los Angeles (UCLA) David Geffen School of Medicine
| | - Mara C Bryant
- Mara C. Bryant is operations executive at Adventist Health White Memorial, in Los Angeles
| | - Teodocia M Hayes-Bautista
- Teodocia M. Hayes-Bautista is a Graduate Medical Education mentor/consultant at Adventist Health White Memorial
| | - Keosha R Partlow
- Keosha R. Partlow is director of the Urban Health Institute, Charles R. Drew University of Medicine and Science, in Los Angeles
| | - David E Hayes-Bautista
- David E. Hayes-Bautista is a distinguished professor in the Department of Medicine, UCLA David Geffen School of Medicine
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Jeffs L, Muntlin Athlin A, Needleman J, Jackson D, Kitson A. Building the foundation to generate a fundamental care standardised data set. J Clin Nurs 2018; 27:2481-2488. [PMID: 29446500 DOI: 10.1111/jocn.14308] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2018] [Indexed: 12/15/2022]
Abstract
AIM AND OBJECTIVES This paper provides an overview of the current state of performance measurement, key trends and a methodological approach to leverage in efforts to generate a standardised data set for fundamental care. BACKGROUND Considerable transformation is occurring in health care globally with organisations focusing on achieving the quadruple aim of improving the experience of care, the health of populations, and the experience of providing care while reducing per capita costs of health care. In response, healthcare organisations are employing performance measurement and quality improvement methods to achieve the quadruple aim. Despite the plethora of measures available to health managers, there is no standardised data set and virtually no indicators reflecting how patients actually experience the delivery of fundamental care, such as nutrition, hydration, mobility, respect, education and psychosocial support. CONCLUSIONS Given the linkages of fundamental care to safety and quality metrics, efforts to build the evidence base and knowledge that captures the impact of enacting fundamental care across the healthcare continuum and lifespan should include generating a routinely collected data set of relevant measures. RELEVANCE TO CLINICAL PRACTICE This paper provides an overview of the current state of performance measurement, key trends and a methodological approach to leverage in efforts to generate a standardised data set for fundamental care. Standardised data sets enable comparability of data across clinical populations, healthcare sectors, geographic locations and time and provide data about care to support clinical, administrative and health policy decision-making.
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Affiliation(s)
- Lianne Jeffs
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, Institute of Health, Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Asa Muntlin Athlin
- Department of Emergency Care and Internal Medicine, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Public Health and Caring Sciences/Health Services Research, Uppsala University, Uppsala, Sweden.,Adelaide Nursing School, University of Adelaide, Adelaide, SA, Australia
| | - Jack Needleman
- Department of Health Policy and Management, University of California, Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
| | - Debra Jackson
- Oxford Institute of Nursing, Midwifery & Allied Health Research, Oxford University, Oxford, UK
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University
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Yeung D. Social Media as a Catalyst for Policy Action and Social Change for Health and Well-Being: Viewpoint. J Med Internet Res 2018; 20:e94. [PMID: 29555624 PMCID: PMC5881041 DOI: 10.2196/jmir.8508] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 12/26/2022] Open
Abstract
This viewpoint paper argues that policy interventions can benefit from the continued use of social media analytics, which can serve as an important complement to traditional social science data collection and analysis. Efforts to improve well-being should provide an opportunity to explore these areas more deeply, and encourage the efforts of those conducting national and local data collection on health to incorporate more of these emerging data sources. Social media remains a relatively untapped source of information to catalyze policy action and social change. However, the diversity of social media platforms and available analysis techniques provides multiple ways to offer insight for policy making and decision making. For instance, social media content can provide timely information about the impact of policy interventions. Social media location information can inform where to deploy resources or disseminate public messaging. Network analysis of social media connections can reveal underserved populations who may be disconnected from public services. Machine learning can help recognize important patterns for disease surveillance or to model population sentiment. To fully realize these potential policy uses, limitations to social media data will need to be overcome, including data reliability and validity, and potential privacy risks. Traditional data collection may not fully capture the upstream factors and systemic relationships that influence health and well-being. Policy actions and social change efforts, such as the Robert Wood Johnson Foundation’s effort to advance a culture of health, which are intended to drive change in a network of upstream health drivers, will need to incorporate a broad range of behavioral information, such as health attitudes or physical activity levels. Applying innovative techniques to emerging data has the potential to extract insight from unstructured data or fuse disparate sources of data, such as linking health attitudes that are expressed to health behaviors or broader health and well-being outcomes.
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