The HCFO program is pleased to announce nine new grants under the Robert Wood Johnson Foundation Special Solicitation in Public Health Systems Research. The proposals cover the use of data to inform policy, the organization of rural health systems, the training of financial managers, the intersections of public health partnerships, surge capacity, enhancements of CTS to analyze workforce needs, and the connection between local public health expenditures and health disparities. Taken together, these proposals offer a portrait of some of the most complex, vexing, and important issues in Public Health Services and Public Health Systems Research.
Title: Assessment of Training Needs for Public Health Financial Managers
Institution: University of Kentucky
Principal Investigator: Julia F. Costich, Ph.D., J.D.
Grant Duration: January 1, 2007 – June 30, 2008
The researchers will examine competencies of financial managers in state and local public health departments. A national sample of public health finance officers, and the senior public health officials to whom they report, will be surveyed. The survey will gather information on their self-assessment of current knowledge and performance in relation to public health finance competencies, as well as their preference for educational formats. Using newly issued competencies in public health financial management as benchmarks, the researchers will identify areas of need, mechanisms for delivering training, and potential funding sources. The objective of this project is to identify professional development needs for financial officers in state and local public health agencies.
Title: Public Health System Organization and Performance in Rural Communities
Institution: University of Minnesota
Principal Investigator: Douglas R. Wholey, Ph.D.
Grant Duration: January 1, 2007 – June 30, 2008
The researchers will examine public health system organization and public health performance in eight rural communities through a comparative case study. Their particular focus is on rural communities, since the scarcity of resources there increases the importance of integrating public and private resources optimally. In particular, they will: 1) describe the organization of key essential services networks within each rural community; 2) describe the structures and processes that integrate activities across the essential services networks; and 3) compare public health system performance. The objective of this project is to illuminate the relationship between local public health systems and public health outcomes.
Title: Incorporating Disparities into State Strategies to Monitor and Improve Health Status
Principal Investigator: Marcia Gold, Sc.D.
Institution: Mathematica Policy Research, Inc.
Grant Duration: January 1, 2007 – March 31, 2008
The researchers will examine state capacity to develop the 10 leading indicators defined in Healthy People 2010, both overall and by geographic group. In particular, they will study: 1) the strengths and weaknesses of data available within states to adequately assess the health of a population that includes diverse groups; and 2) the organizational, political, and other forces that promote or impede use of such data to intervene in ways that improve the health of the state’s population. The three part study includes: 1) an inventory of state practices with respect to available data on leading indicators; 2) case studies of four states to learn about how the indicators and disparities in the indicators across subgroups are viewed in developing initiatives to improve public health; and 3) a dissemination plan for translating information in ways that would be useful to diverse audiences. The objective of this project is to further the vision articulated in Healthy People 2010, setting health goals that explicitly link overall improvements in public health to reduced disparities in health status across diverse subgroups of the population.
Title: Local Community Strategies to Develop their Public Health Surge Capacity to Handle Emergencies Affecting Many People
Principal Investigator: Laurie Felland
Institution: Center for Studying Health System Change
Grant Duration: January 1, 2007 – July 31, 2007
The researchers will examine local community strategies to develop their public health surge capacity. They note that following Hurricane Katrina, public health agencies recognize an urgent need to ensure that they can meet increased volume in times of high demand. The researchers plan to build on the Community Tracking Study site visits, conducting more focused, in-depth case studies on the surge capacity in six selected communities. The objective of the study is to identify key strategies that selected communities have used to develop surge capacity, pinpointing lessons that can be drawn from each community’s experience.
Title: Public Health Funding and Population Health
Principal Investigator: David E. Grembowski, Ph.D.
Institution: University of Washington
Grant Duration: January 1, 2007 – December 31, 2007
The researchers will examine the relationship between local health department expenditures and county-level disparities in mortality and infant mortality rates for African American and Caucasian racial/ethnic groups. They will also estimate whether changes in expenditures are associated with changes in those rates over time. The objective of this project is to inform the debate about the level of resources that should be allocated to public health systems rather than to medical care or other determinants of population health.
Title: Effective Strategies that Local Communities Have Used to Meet Expanded Public Health Workforce Needs
Principal Investigator: Robert Hurley, Ph.D./Debra Draper, Ph.D.
Institution: Center for Studying Health System Change
Grant Duration: January 1, 2007 – July 31, 2007
The researchers will examine local communities’ effective strategies for meeting expanding public health workforce needs. They plan to study six of the twelve Community Tracking Study (CTS) communities that have faced particularly unique and/or challenging situations. They will also conduct interviews with key public health stakeholders, covering topics such as local factors that have an impact on the public health workforce, current public health workforce needs and areas of severe shortages, current recruitment and retention challenges and strategies to overcome them, and resource and other needs that might facilitate recruitment and retention. The objective of this project is to better understand how local agencies are dealing with the public health workforce shortages identified in the 2005 CTS site visits.
Title: Comparison of Public Health Organizational Structures Using Dynamic Network Analysis
Principal Investigator: Jacqueline Merrill, D.N.Sc.
Institution: Columbia University
Grant Duration: January 1, 2007 – December 31, 2008
The researchers will examine how intra-organizational public health networks are linked to process and outcomes. Using dynamic organizational analysis, they will study several agency networks. They will determine baselines for public health organizational networks, identify common elements, and relate common elements identified to performance. The researchers will also compare the public health networks to similar networks in the private sector, allowing their findings to be interpreted in that context and theory. The objective of this project is to provide public health managers with a better understanding of the dynamics and impact of intra-organization networks, so that they can better plan for and justify allocating limited resources.
Title: An Academic Health Center and Public Health Practice Collaboration: Disseminating Continuous Quality Improvement Capability to Local and State Public Health Agencies
Principal Investigator: William J. Riley, Ph.D.
Institution: University of Minnesota
Grant Duration: January 1, 2007 – December 31, 2008
The researchers will develop a pilot program to expand the use of continuous quality improvement (CQI) principles to public health agencies, with a focus on reducing health disparities. They intend to implement CQI through collaboration among the School of Public Health at the University of Minnesota and local and state public health agencies. They will create a coordinated academic curriculum in CQI, preparing personnel to lead CQI efforts, and they would implement CQI capabilities into eight separate public health agency projects. The objective of this project is to demonstrate that CQI can be used in public health organizations to improve performance of core processes.
Title: Understanding and Assessing Partnership Connections in Public Health Departments
Principal Investigator: Danielle M. Vogenbeck, Ph.D.
Institution: RAND Corporation
Grant Duration: January 1, 2007- December 31, 2007
The researchers will examine partnerships, designed to leverage limited resources and fulfill common missions, among state and local public health agencies and other organizations, agencies, and groups. In particular, they intend to: 1) define what good connectivity means in a public health partnership; 2) quantify good connectivity as percentile score measured against a standard; and 3) develop a tool to measure connectivity and document the analytic process through which the tool produces a connectivity score. The objective of this project is to develop a tool to allow public health partners to measure their multi-agency collaborations in order to strengthen them.
