Spread, Scale, and Sustainability in Population Health Workshop Summary (2015) / Chapter Skim
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3 Approaches to Spread, Scale, and Evaluation of Impact
3 Approaches to Spread, Scale, and Evaluation of Impact
Pages 17-28
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From page 17... ...
and professor of epidemiology at the Michael & Susan Dell Center for Healthy Living of the University of Texas School of Public Health discussed CATCH, which is focused on preventing obesity and promoting healthier lifestyles. Darshak Sanghavi, the director of the population and preventive health models group at the Center for Medicare & Medicaid Innovation (CMMI)
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The USAID ASSIST Project is working with multiple partners, including more than 230 governments and implementing partners, more than 4,400 facilities, more than 900 communities, and more than 2,500 quality improvement teams reaching more than 96 million people in the areas served. The project is working to address global health priorities, focusing on technical areas such as HIV; tuberculosis; maternal, newborn, and child health; community health; health workforce development; noncommunicable diseases; and others, depending on the geographic area.
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The key elements of the CATCH School Health Model include physical education (including professional development for teachers) , nutrition services, classroom education, family education, preschool and afterschool programs, and physical activity breaks.
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The foundation links underserved schools and communities to the resources necessary to create and sustain healthy change for future generations. In closing, Kelder noted the value of social media for outreach and dissemination in the face of limited resources.3 3 In Appendix C, Kelder elaborates that the CATCH program of promoting healthy eating and physical activity is spread and adapted for use in afterschool programs, YMCA, and
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Sanghavi described two broad population and preventive health models that his group at CMMI is exploring. Despite the evidence, it is difficult to make the case for prevention to payers, Sanghavi said.
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Kelder said that CATCH started by developing local partnerships with the larger school districts through the diffusion-of-innovation model, finding those people who were interested in and passionate about the topical area for which CATCH had solutions. Later, CATCH partnered with the Texas State Department of Education to align the program with the state educational objectives and garner approval from the State Board of Education to allow any school in Texas to implement the program.
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Sanghavi said that it is often the communities that already have durable, highly invested institutions that are the ones applying for CMS funding for innovative health care programs. There are very large areas of the country without innovative care solutions or a focus on community health.
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Staff at the school district level can usually provide information about the evaluation methods that they use to meet state standards. Kelder added that Texas -- like many other states -- requires schools to fill out a campus improvement plan annually.
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Kelder agreed and added that in his area, for example, there are programs that are known to work with middle school children that do not work with preschoolers. The problems are different, the solutions are different, and the personnel are different, he said.
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From page 26... ...
One path forward might be what Sanghavi referred to as "virtual braided funding." If different organizations (e.g., health, social services, corrections, housing, and welfare) consider the trends for where they spend money, they can collectively fund shared interventions (e.g., investing in substance abuse treatment)
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This can be a challenge for hospitals from a workforce perspective, but is important for prevention and screening to reach the populations who are at a disparate health risk. Sanghavi suggested that for large health systems and public health agencies, it may be more effective to find ways to improve care for the entire population, which 5Social impact bonds are a "pay for success" funding model in which private investors fund public projects, receiving a return on investment only if the project successfully demonstrates improvement in social outcomes.
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From page 28... ...
It is better to prevent the child from becoming morbidly obese in the first place, he said. Priorities for the Roundtable Sanne Magnan of the Institute for Clinical Systems Improvement in Minnesota asked panelists to advise the roundtable on priorities, given the roundtable's three basic goals: increasing life expectancy and other health outcomes, decreasing disparities in those outcomes, and decreasing health care expenditures and using the savings upstream.
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