Assessing the status of partnerships between academic institutions and public health agencies

H.O.P.E. grows: An academic-public health partnership to reimagine public health services and increase mental health access among socially vulnerable populations

OBJECTIVE

To illustrate the process of developing and sustaining an academic-public health partnership for behavioral health integration through an expansion of the Aligning Systems for Health (ASfH) framework.

STUDY SETTING

Practice-informed primary data (2017-2023) from the Holistic Opportunity Program for Everyone (HOPE) Initiative based in Charlotte, NC.

STUDY DESIGN

The unit of analysis in this descriptive case study is inter-organizational, specifically focusing on an academic-public health relationship. We illustrate the partnership process across the ASfH four core areas, including key challenges and insights.

DATA COLLECTION

Utilized a Critical Moments Reflection methodology and review of HOPE program data.

PRINCIPAL FINDINGS

(1) Formal partnership structures and processes are essential to monitoring the four ASfH core components for on-going system alignment. (2) Aligning systems for health principally involves two ecologies: (i) the health program and (ii) the partnership. The vitality and sustainability of both ecologies require continuous attention and resource investment. (3) Relationships rest at the heart of aligning systems. (4) With comparative advantages in research methods, the academic sector is especially poised to collaborate with healthcare systems and human service organizations to study, develop, implement, and scale evidence-based health interventions.

CONCLUSIONS

The academic sector shares overlapping purposes with the public health, healthcare, and social services sectors while providing complementary value. It is a critical sectoral partner in advancing population health and health equity.

A case study of an academic-stakeholder partnership: Evaluation of the '10 000 Lives' smoking cessation health promotion program

ISSUE ADDRESSED

In Australia, smoking prevalence is higher in regional areas than in metropolitan cities; Central Queensland, a central-east district of Queensland, has substantially higher smoking rates than the state average. In November 2017, Central Queensland Public Health Unit (CQPHU) launched the '10 000 Lives' initiative to reduce the smoking prevalence in the region. The initiative partnered with local hospitals and community organisations to increase the uptake of interventions like Quitline in the region. Evaluating a program like '10 000 Lives' is critical for evidence-based health promotion practice. CQPHU partnered with a large metropolitan Australian university to evaluate the '10 000 Lives' through a scheme that provided a stipend for a Doctor of Philosophy (PhD) student.

METHODS

This narrative report describes the experience of evaluating '10 000 Lives' in a collaborative partnership between CQPHU and the public health academia.

RESULTS

A PhD student was recruited to join this collaboration, and both developed a program logic model and completed a process and impact evaluation. This evaluation provided an ideal 'living' case study to embed in the Master of Public Health curriculum and provided the PhD student with teaching experience delivering a demonstration of public health in practice.

CONCLUSION

The collaboration project was highly successful, exemplifying research, learning and practical integration for all partners. SO WHAT?: The partnership demonstrated how universities can work with government health agencies to build practice-based evidence, and importantly give public health students authentic learning opportunities.

Design and Implementation of a COVID-19 Case Investigation Program: An Academic-Public Health Partnership, Arizona, 2020

From May through July 2020, Arizona was a global hotspot for new COVID-19 cases. In response to the surge of cases, local public health departments looked for innovative ways to form external partnerships to address their staffing needs. In collaboration with the Maricopa County Department of Public Health, the Arizona State University Student Outbreak Response Team (SORT) created and implemented a virtual call center to conduct public health case investigations for COVID-19. SORT officially launched a dedicated COVID-19 case investigation program after 3 weeks of program design and training. From June 29 through November 8, 2020, SORT recruited and trained 218 case investigators, completed 5000 case patient interviews, and closed 10 000 cases. Our team also developed process improvements to address disparities in case investigation timeliness. A strong infrastructure designed to accommodate remote case investigations, paired with a large workforce, enabled SORT to provide additional surge capacity for the county's high volume of cases. University-driven multidisciplinary case investigator teams working in partnership with state, tribal, and local public health staff members can be an effective tool for supporting a diverse and growing public health workforce. We discuss the essential design factors involved in building a university program to complement local COVID-19 response efforts, including workflows for case management, volunteer case investigator recruitment and training, secure technology platforms for conducting case investigations remotely, and robust data-tracking procedures for maintaining quality control and timely case reporting.

Exploring the evolution of engagement between academic public health researchers and decision-makers: from initiation to dissolution

CONTEXT

Relationships between researchers and decision-makers have demonstrated positive potential to influence research, policy and practice. Over time, interest in better understanding the relationships between the two parties has grown as demonstrated by a plethora of studies globally. However, what remains elusive is the evolution of these vital relationships and what can be learned from them with respect to advancing evidence-informed decision-making. We therefore explored the nuances around the initiation, maintenance and dissolution of academic-government relationships.

METHODS

We conducted in-depth interviews with 52 faculty at one school of public health and 24 government decision-makers at city, state, federal and global levels. Interviews were transcribed and coded deductively and inductively using Atlas.Ti. Responses across codes and respondents were extracted into an Excel matrix and compared in order to identify key themes.

FINDINGS

Eight key drivers to engagement were identified, namely (1) decision-maker research needs, (2) learning, (3) access to resources, (4) student opportunities, (5) capacity strengthening, (6) strategic positioning, (7) institutional conditionalities, and (8) funder conditionalities. There were several elements that enabled initiation of relationships, including the role of faculty members in the decision-making process, individual attributes and reputation, institutional reputation, social capital, and the role of funders. Maintenance of partnerships was dependent on factors such as synergistic collaboration (i.e. both benefit), mutual trust, contractual issues and funding. Dissolution of relationships resulted from champions changing/leaving positions, engagement in transactional relationships, or limited mutual trust and respect.

CONCLUSIONS

As universities and government agencies establish relationships and utilise opportunities to share ideas, envision change together, and leverage their collaborations to use evidence to inform decision-making, a new modus operandi becomes possible. Embracing the individual, institutional, networked and systems dynamics of relationships can lead to new practices, alternate approaches and transformative change. Government agencies, schools of public health and higher education institutions more broadly, should pay deliberate attention to identifying and managing the various drivers, enablers and disablers for relationship initiation and resilience in order to promote more evidence-informed decision-making.

Optimizing the Impact of Public-Academic Partnerships in Fostering Policymakers' Use of Research Evidence: Proposal to Test a Conceptual Framework

Background

Previous research has reported that public-academic partnerships (PAPs) can effectively promote PAP leaders’ use of research evidence in improving youth outcomes. However, the existing literature has not yet clarified whether and how PAP leaders’ use of research evidence evolves along the PAP life cycle and whether PAP partners’ concordant perceptions of usefulness of their PAP has an impact on PAP leaders’ use of research evidence. Developing a conceptual framework that recognizes the PAP life cycle and empirically identifying contexts and mechanisms of PAPs that promote PAP leaders’ use of research evidence from the PAP life cycle perspective are imperative to guide researchers and policymakers to successfully lead PAPs and foster policymakers’ use of research evidence for improving youth outcomes.

Objective

Utilizing an integrated framework of organizational life cycle perspective, a social partnership perspective, and a realist evaluation, this study examines the extent to which PAP development and PAP leaders’ use of research evidence can be characterized into life cycle stages and identifies PAP contexts and mechanisms that explain the progress of PAPs and PAP leaders’ use of research evidence through life cycle stages.

Methods

Recruiting PAPs across the United States that aim to improve mental health and promote well-being of youth aged 12-25 years, the study conducts a document analysis and an online survey of PAPs to inform policymakers and academic researchers on the contexts and mechanisms to increase PAP sustainability and promote policymakers’ use of research evidence in improving youth outcomes.

Results

Fifty-three PAPs that meet the recruitment criteria have been identified, and document review of PAPs and participant recruitment for the online survey of PAP experience have been conducted.

Conclusions

This paper will help policymakers and researchers gain a deeper knowledge of the contexts and mechanisms for each PAP life cycle stage in order to optimize PAP leaders’ use of research evidence in achieving positive youth outcomes.

International Registered Report Identifier (IRRID)

DERR1-10.2196/14382

Factors affecting engagement between academic faculty and decision-makers: learnings and priorities for a school of public health

Background

Schools of public health (SPHs) are increasingly being recognised as important contributors of human, social and intellectual capital relevant to health policy and decision-making. Few studies within the implementation science literature have systematically examined knowledge exchange experiences within this specific organisational context. The purpose of this study was therefore to elicit whether documented facilitators and barriers to engaging with government decision-makers resonates within an academic SPH context. We sought to understand the variations in such experiences at four different levels of government decision-making. Furthermore, we sought to elicit intervention priorities as identified by faculty.

Methods

Between May and December 2016, 211 (34%) of 627 eligible full-time faculty across one SPH in the United States of America participated in a survey on engagement with decision-makers at the city, state, federal and global government levels. Surveys were administered face-to-face or via Skype. Descriptive data as well as tests of association and logistic regression analyses were conducted using STATA.

Results

Over three-quarters of respondents identified colleagues with ties to decision-makers, institutional affiliation and conducting policy-relevant research as the highest facilitators. Several identified time constraints, academic incentives and financial support as important contributors to engagement. Faculty characteristics, such as research areas of expertise, career track and faculty rank, were found to be statistically significantly associated with facilitators. The top three intervention priorities that emerged were (1) creating incentives for engagement, (2) providing funding for engagement and (3) inculcating an institutional culture around engagement.

Conclusions

The data suggest that five principal categories of factors – individual characteristics, institutional environment, relational dynamics, research focus and funder policies – affect the willingness and ability of academic faculty to engage with government decision-makers. This study suggests that SPHs could enhance the relevance of their role in health policy decision-making by (1) periodically measuring engagement with decision-makers; (2) enhancing individual capacity in knowledge translation and communication, taking faculty characteristics into account; (3) institutionalising a culture that supports policies and practices for engagement in decision-making processes; and (4) creating a strategy to expand and nurture trusted, relevant networks and relationships with decision-makers.

Academic and Government Partnerships to Address Diabetes in the USA: a Narrative Review

PURPOSE OF REVIEW

Multi-sector partnerships are broadly considered to be of value for diabetes prevention and management. The purpose of this article is to summarize academic and government collaborations focused on diabetes prevention and management.

RECENT FINDINGS

Using a narrative review approach, we identified 17 articles describing 10 academic and government partnerships for diabetes management and surveillance. Challenges and gaps in the literature include complexity of diabetes management vis a vis current healthcare infrastructure; a paucity of racial/ethnic diversity in translational efforts; and the time/effort needed to maintain strong relationships across partner institutions. Academic and government partnerships are of value for diabetes prevention and management activities. Acknowledgment that the key priorities of government programming are often costs and feasibility is critical for collaborations to be successful. Future translational efforts of diabetes prevention and management programs should focus on the following: (1) expansion of partnerships between academia and local health departments; (2) increased utilization of implementation science for enhanced and efficient implementation and dissemination; and (3) harnessing of technological advances for data analysis, patient communication, and report generation.

Development of a Research Agenda Focused on Academic Health Departments

An academic health department (AHD) is a formal partnership between an academic institution and a governmental public health agency. Case studies have described the value of individual AHDs in the areas of student engagement, practice-based research, workforce development, and service. With growing interest in AHDs and the increasing importance of academic-practice linkages in both academic programs' and public health agencies' accreditation processes, articulating a research agenda focused on the AHD model can be useful for stimulating the research and practice fields to further develop the evidence base for AHDs. We provide a research agenda, developed through an iterative process involving academicians, practitioners, and others interested in academic-practice linkages.

The role of researchers in disseminating evidence to public health practice settings: a cross-sectional study

BACKGROUND

Evidence-based public health interventions, which research has demonstrated offer the most promise for improving the population's health, are not always utilized in practice settings. The extent to which dissemination from researchers to public health practice settings occurs is not widely understood. This study examines the extent to which public health researchers in the United States are disseminating their research findings to local and state public health departments.

METHODS

In a 2012, nationwide study, an online questionnaire was administered to 266 researchers from the National Institutes of Health, the Centers for Disease Control and Prevention, and universities to determine dissemination practices. Logistic regression analyses were used to examine the association between dissemination to state and/or local health departments and respondent characteristics, facilitators, and barriers to dissemination.

RESULTS

Slightly over half of the respondents (58%) disseminated their findings to local and/or state health departments. After adjusting for other respondent characteristics, respondents were more likely to disseminate their findings to health departments if they worked for a university Prevention Research Center or the Centers for Disease Control and Prevention, or received their degree more than 20 years ago. Those who had ever worked in a practice or policy setting, those who thought dissemination was important to their own research and/or to the work of their unit/department, and those who had expectations set by their employers and/or funding agencies were more likely to disseminate after adjusting for work place, graduate degree and/or fellowship in public health, and the year the highest academic degree was received.

CONCLUSIONS

There is still room for improvement in strengthening dissemination ties between researchers and public health practice settings, and decreasing the barriers researchers face during the dissemination process. Researchers could better utilize national programs or workshops, knowledge brokers, or opportunities provided through academic institutions to become more proficient in dissemination practices.

Successful Academic-Public Health Practice Collaboration: What Works From the Public Health Workforce's Perspective

CONTEXT

Public health departments and academic institutions engage in a range of cooperative activities that can greatly benefit a public health department and can often be mutually beneficial. Yet, little is known regarding practitioners' views of successful academic collaborations.

OBJECTIVE

The purpose of this study was to explore predictors and correlates of beneficial academic collaboration from the perspective of those on the front lines--the practitioners constituting the public health workforce.

DESIGN

Analysis of the Public Health Workforce Interests and Needs Survey (PH WINS), a cross-sectional survey of state health department practitioners, conducted in 2014.

PARTICIPANTS

PH WINS is a nationally representative survey of state health department practitioners. Data were available for a total of 8718 respondents in 37 states.

MAIN OUTCOME MEASURES

Two main outcome measures were used--(a) whether a respondent reported collaborating with an academic entity (including faculty/staff/students) in the past year, and (b) when collaboration did occur, the success of the collaboration insofar as the respondent perceived the engagement as very helpful.

RESULTS

Health department practitioners (27.2%) reported participating in an academic-practice collaboration. Factors associated with partnering included respondents' supervisory status, positional duties, and public health background. Of these respondents, 46.6% reported a successful collaboration. Factors associated with a successful collaboration included respondents' self-reported job skills and public health background.

CONCLUSION

While characteristics related to a public health practitioner's position are most significant in predicting whether a collaboration will occur, characteristics of the individual him- or herself are more relevant in predicting whether a collaboration will be successful. Public health managers interested in fostering an environment that promotes a successful academic-practice collaboration may benefit from ensuring that the public health practitioners involved in such collaborations are themselves trained in public health.

The Academic Health Department: the process of maturation

The Academic Health Department (AHD) involves an arrangement between a governmental health agency and an academic institution, which provides mutual benefits in teaching, service, research, and practice. From its initial development in the mid-1980s as the public health equivalent of the relationship between a teaching hospital and a medical school, the AHD concept has evolved to include multiple levels of governmental public health agencies (local, state, and federal) as well as multiple academic institutions (public health, medicine, and primary care medical residencies). Throughout the decade of the 2000s, multiple influences have impacted both the quality and quantity of AHDs, leading to an expansion of AHDs through the Council on Linkages' AHD Learning Community. The value of the AHD--as described from prior studies as well as the AHD case examples in this current special issue--is evident in its impact on the quality of educational experiences and workforce development, agency and academic accreditation, practice-based research, and the potential to influence health reform.

Academic-health department collaborative relationships are reciprocal and strengthen public health practice: results from a study of academic research centers

BACKGROUND

Collaborations between academic institutions and state and local health departments have been shown to enhance the public health core functions of Assurance by improving the public health workforce's knowledge and skills. Few studies have analyzed how academic-health department collaborations enhance Assessment and Policy Development core functions. This qualitative study explores types of collaborations between health departments and Prevention Research Centers (PRCs) and how they align with the core functions. Prevention Research Centers are academic institutions funded by the Centers for Disease Control and Prevention to conduct public health research and translate research results for policies and practices.

METHODS

We reviewed each PRC's annual report from fiscal year 2011 and abstracted descriptions of PRC-health department collaborations. We identified 14 themes of PRC-health department collaborations and conducted a qualitative analysis to describe the dimensions and distribution of themes.

RESULTS

Of the 37 PRCs, 36 reported 215 collaborations with 19 city, 97 county, 31 state, and 46 tribal health departments. Themes of research, survey, and surveillance aligned with the Assessment core function and evaluation, strategic planning, technical assistance, and program implementation supported the Policy Development and Assurance core functions. Overall, health departments provided on-the-ground expertise to inform PRC research, ensuring its applicability to public health practice. Reciprocally, PRCs improved data quality, increased the scientific rigor of health department processes and programs, and filled knowledge gaps within health departments. Both PRCs and health departments enhanced the relevance of public health programs and practices by grounding implementation and evaluation in community needs and views.

CONCLUSION

Findings from this study demonstrate that PRC-health department collaborations often enhanced multiple core functions that could lead to implementation of evidence-based interventions and continuous quality improvement of public health administration at the local, state, and tribal levels. This study highlights the value and importance of reciprocal academic-health department partnerships.

Factors influencing partnerships between higher education and healthcare

OBJECTIVE

The aim of this study was to describe the factors influencing partnerships between higher education and healthcare.

BACKGROUND

Partnerships have often been studied as organisations' internal processes or multi-professional team activities. However, there has been less research on the partnership as a phenomenon between organisations and, until now, the research has mainly focused on experiences in the US and the UK.

SETTING, PARTICIPANTS AND METHODS

The study was carried out in Finland. Staff from a university of applied sciences and a service unit for the elderly took part in nine focus group interviews (n=39) and produced self-evaluations based on diaries (n=13) and essays (n=24). The data were analysed by qualitative content analysis.

RESULTS

The factors influencing partnerships were: a joint development target, agreeing on collaboration, providing resources for partnership, enhancing mutual understanding, sharing operational culture, commitment and participatory change management and communication.

CONCLUSIONS

This study updates, and complements, previous reviews on factors influencing partnerships, by providing some new concepts and a new cultural perspective from Finland on a partnership between higher education and healthcare. The results provide information on factors that influence partnerships and develop and manage their sustainability.

Public health system partnerships: role for local boards of health in preparing the future public health workforce

The Institute of Medicine's report, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, recommended that public health education be accessible to undergraduate students. Promoting access to public health education will ideally contribute to a well-educated public health workforce, thus assuring the fulfillment of the public health mission. In response to this call to action, the authors examined the current practice, feasibility, and value in developing a functional partnership between academic institutions and local boards of health in preparing future public health professionals. Local boards of health in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of their collaborations with academic partners; and (3) assess how they jointly advance public health workforce development. Despite the main barriers of a lack of time, staff, and funding that are often cited for the absence of collaborations between institutions, one New England state, in particular, reported that their academic institution and local board of health partnerships were important and effective. The authors discuss how academic-practice collaborations hold the potential to combine basic public health principles with leadership and governance experience offered by local boards of health. Such partnerships are underutilized and have the potential to integrate core public health concepts while facilitating applied experiential learning opportunities in a professional public health setting, thus contributing to the development of the future public health workforce.

Using core competencies to build an evaluative framework: outcome assessment of the University of Guelph Master of Public Health program

BACKGROUND

Master of Public Health programs have been developed across Canada in response to the need for graduate-level trained professionals to work in the public health sector. The University of Guelph recently conducted a five-year outcome assessment using the Core Competencies for Public Health in Canada as an evaluative framework to determine whether graduates are receiving adequate training, and identify areas for improvement.

METHODS

A curriculum map of core courses and an online survey of University of Guelph Master of Public Health graduates comprised the outcome assessment. The curriculum map was constructed by evaluating course outlines, assignments, and content to determine the extent to which the Core Competencies were covered in each course. Quantitative survey results were characterized using descriptive statistics. Qualitative survey results were analyzed to identify common themes and patterns in open-ended responses.

RESULTS

The University of Guelph Master of Public Health program provided a positive learning environment in which graduates gained proficiency across the Core Competencies through core and elective courses, meaningful practicums, and competent faculty. Practice-based learning environments, particularly in collaboration with public health organizations, were deemed to be beneficial to students' learning experiences.

CONCLUSIONS

The Core Competencies and graduate surveys can be used to conduct a meaningful and informative outcome assessment. We encourage other Master of Public Health programs to conduct their own outcome assessments using a similar framework, and disseminate these results in order to identify best practices and strengthen the Canadian graduate public health education system.

Interest in public health careers among undergraduate student nurses

CONTEXT

Public health workforce trends demonstrate threats to a vital national resource. The current shortage of public health nurses is due to a variety of factors. One route to addressing the public health nursing shortage is to increase the level of interest in public health as a career option for nurses.

OBJECTIVE

The main objective of this study was to examine the relationship of nursing education program and field experience characteristics on the level of interest in a public health career among student nurses.

DESIGN

Cross-sectional, online surveys of undergraduate student nurses were conducted over 6 semesters to assess the relationship of field practicum characteristics and level of interest in a public health career.

SETTING

Undergraduate student nurses (N = 882) enrolled in traditional baccalaureate nursing programs (n = 18) and online associate to baccalaureate degree completion programs (n = 2) in one US state participated in the survey after completing the required community or public health coursework and field experiences.

MAIN OUTCOME MEASURE

Level of interest in a career in public health was measured using a 4-point Likert-type scale anchored by "no interest" and "very strong interest."

RESULTS

Overall, 46% of respondents expressed either moderate or strong interest in a future career in public health. Having had a field experience in a local health department was the only type of experience associated with stronger interest in a public health career. Enrollment in baccalaureate completion programs was associated with higher interest, and enrollment in programs located in a region of the state where students were significantly less likely to have field experiences in local health departments was associated with lower interest.

CONCLUSION

Career interests for nurses are developed in part through field experiences while in nursing school. Interest in public health careers may be nurtured through field experiences in local health departments.

The relationship between local public health agency characteristics and performance of partnership-related essential public health services

OBJECTIVE

The relationships between characteristics of local public health agencies and their self-reported scores on partnership-related indicators of the Ten Essential Public Health Services were examined.

DESIGN

A retrospective cross-sectional study using secondary data from the National Public Health Performance Standards Program (NPHPSP) and the 2005 Profile of Local Public Health Agencies from the National Association of City and County Health Organizations (NACCHO) was completed. Participants. Local public health systems that participated in both the NPHPSP and the NACCHO surveys.

MAIN OUTCOME MEASURES

Partnership-related elements from the NPHPSP data set were used as dependent variables, whereas combined focused elements from the NPHPSP and the NACCHO surveys served as independent variables.

RESULTS

Local public health agencies' increase in partnerships over the preceding 3 years and involvement in a community health improvement process were significantly related to numerous partnership performance scores--more so than other agency characteristics. Involvement in the Mobilizing Action through Planning and Partnerships process was inversely related to some partnership performance scores.

CONCLUSIONS

Future research must continue to identify and explore additional community- and agency-level predictors of partnership performance.

An Interinstitutional Academic Collaborative Partnership to End Health Disparities

Much has been published in the health care literature describing partnerships between academic institutions and community or health care agencies that are designed to improve health outcomes in medically underserved populations. However, little has been published regarding partnerships between minority- and majority-serving academic institutions with this same aim. Key principles of collaborative partnerships are used in a descriptive analysis of the development, functions, and benefits of such an interinstitutional academic partnership that was formed to reduce and ultimately eliminate health disparities in rural South Carolina. Lessons learned from the partnership parallel other human relationships where mutual respect and trust, open and clear communication, and shared decision and problem solving are important for building and sustaining partnerships.