AN INTEGRATED FRAMEWORK
FOR ASSESSING THE VALUE
OF COMMUNITY-BASED
PREVENTION
Committee on Valuing Community-Based,
Non-Clinical Prevention Policies and Wellness Strategies
Board on Population Health and Public Health Practice
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by contracts between the National Academy of Sciences and the California Endowment (20091915), the de Beaumont Foundation, the Robert Wood Johnson Foundation (68317), and the W.K. Kellogg Foundation (P3016629). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2012. An integrated framework for assessing the value of community-based prevention. Washington, DC: The National Academies Press.
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Willing is not enough; we must do.”
—Goethe
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OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
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COMMITTEE ON VALUING COMMUNITY-BASED, NON-CLINICAL PREVENTION POLICIES AND WELLNESS STRATEGIES
ROBERT S. LAWRENCE (Chair), Center for a Livable Future Professor and Professor of Environmental Health Sciences, Health Policy, and International Health; Director, Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
KIRSTEN BIBBINS-DOMINGO, Associate Professor and Attending Physician, University of California, San Francisco
LAURA K. BRENNAN, President and Chief Executive Officer, Transtria, LLC, St. Louis, MO
NORMAN DANIELS, Mary B. Saltonstall Professor of Population Ethics and Professor of Ethics and Population Health, Harvard University, Cambridge, MA
DARRELL J. GASKIN, Associate Professor, Deputy Director, Center for Health Disparities Solutions, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
LAWRENCE W. GREEN, Professor, Department of Epidemiology and Bisostatistics, University of California, San Francisco
ROBERT HAVEMAN, Professor Emeritus of Public Affairs and Economics and Faculty Affiliate, Institute for Research on Poverty, University of Wisconsin–Madison
JENNIFER JENSON, Managing Senior Fellow, Partnership for Prevention, Washington, DC
F. JAVIER NIETO, Helfaer Professor of Public Health, Professor of Population Health Sciences and Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison
DANIEL POLSKY, Professor of Medicine and Healthcare Management, Perelman School of Medicine and the Wharton School, University of Pennsylvania; Director of Research, Leonard Davis Institute of Health Economics, Philadelphia
LOUISE POTVIN, Professor, Social and Preventive Medicine, Faculty of Medicine, University of Montréal, Institut de Recherche en Santé Publique de l’Université de Montréal, Canada
NICOLAAS P. PRONK, Vice President and Health Science Officer, HealthPartners, Minneapolis, MN
LOUISE B. RUSSELL, Research Professor of Economics, Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, New Brunswick
STEVEN M. TEUTSCH, Chief Science Officer, Los Angeles County Department of Public Health, California
CHAPIN WHITE, Senior Health Researcher, Center for Studying Health System Change, Washington, DC
Consultant
CATHERINE M. JONES, University of Montréal, Canada
Study Staff
LYLA M. HERNANDEZ, Study Director
MELISSA FRENCH, Associate Program Officer
ANDREW LEMERISE, Research Associate
ANGELA MARTIN, Senior Program Assistant
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Reviewers
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Laurie M. Anderson, Washington State Institute for Public Policy
Charles C. Branas, University of Pennsylvania
Norman Fost, University of Wisconsin–Madison
Marthe R. Gold, City University of New York Medical School
Dana Goldman, University of Southern California
Mary Mincer Hansen, Des Moines University
Robert Jeffery, University of Minnesota
Michael Maciosek, HealthPartners Research Foundation
Vickie Mays, University of California, Los Angeles
Barbara A. Ormond, The Urban Institute
Patrick Remington, University of Wisconsin–Madison
Barbara Rimer, University of North Carolina
James F. Sallis, University of California, San Diego
Jane E. Sisk, Institute of Medicine
Pierre Vigilance, George Washington University
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Georges C. Benjamin, American Public Health Association, and Charles E. Phelps, University of Rochester. Appointed by the Institute of Medicine and the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
Acknowledgments
Many people contributed to the development of An Integrated Framework for Assessing the Value of Community-Based Prevention. The committee would like to acknowledge and thank those individuals whose input invigorated committee deliberations and enhanced the quality of this report.
First, we would like to thank the sponsors of this project, the California Endowment, the de Beaumont Foundation, the Robert Wood Johnson Foundation, and the W.K. Kellogg foundation. We are particularly appreciative of the efforts of Angela McGowan, James Sprague, Marion Standish, and Alice M. Warner-Mehlhorn.
The committee greatly appreciated the input of David Paltiel and Charles Poole and the speakers whose presentations informed committee thinking, including Bridget Booske, Rob Grunewald, Veva Islas-Hooker, M. Rebecca Kilburn, Tyler Norris, Deirdre Oakley, Brian Smedley, Harold Sox, Brenda Spencer, Kenneth Thorpe, Steven H. Woolf, and Chen Zhen.
The committee was very fortunate in its staffing for this study. We wish to thank our study director, Lyla M. Hernandez, and our associate program officer, Melissa French, for their efforts in producing a clearly written, well-organized report that reflects the collective thought of the committee. Our appreciation also goes to Andrew Lemerise for his exceptional research support and tireless efforts in tracking down elusive references, and to Angela Martin for her excellent administrative and logistical support. We were also fortunate that Catharine M. Jones at the University of Montréal was available to provide important research assistance.
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Contents
Why Is Community-Based Prevention Important?
How Is Community-Based Prevention Different?
Why Is It So Hard to Assess the Value of Community-Based Prevention?
A Roadmap for the Rest of the Report
Important Features of Community-Based Prevention
Approaches to Community Intervention
Impact of Community-Based Prevention
3 COMMUNITY-BASED PREVENTION: MORE THAN THE SUM OF ITS PARTS
Applying Systems Science to Community-Based Prevention
Valuing Community-Based Prevention: Domains and Elements
Valuing Resources and Costs for Community-Based Prevention
Data Sources and Indicators for Valuing Community-Based Prevention
What Is a Framework for Assessing Value?
Valuing Community-Based Prevention: Is a New Framework Needed?
5 A FRAMEWORK FOR ASSESSING THE VALUE OF COMMUNITY-BASED PREVENTION
A Framework for Assessing Value
Information Needed to Assess Value Using This Framework
How to Use the Framework in the Community Context
Implications for State and National Policy
B EXAMPLES OF SYSTEMS SCIENCE APPROACHES TO VALUING COMMUNITY-BASED PREVENTION
