Advancing the Science to Improve Population Health Proceedings of a Workshop (2017) / Chapter Skim
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3 Research in Practice: Opportunities and Challenges
3 Research in Practice: Opportunities and Challenges
Pages 11-24
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From page 11... ...
David Holtgrave, professor and chair of the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, examined the role of population health research in the development of policies that contributed to the decline in AIDS-related deaths in the United States. Brendan Nyhan, assistant professor in the Department of Government at Dartmouth College, highlighted the importance of effective communication in informing health policy action on controversial issues.
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From page 12... ...
Housing affordability affects stress, stability (e.g., eviction, relocation) , and quality of the home (e.g., 2 How Housing Matters is operated by the Urban Land Institute Terwilliger Center for Housing, with funding from the MacArthur Foundation.
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From page 13... ...
demonstration project in the 1990s provided a cohort of public housing residents in five different cities with vouchers to relocate to more affluent neighborhoods. Brennan noted that MTO followed a similar effort that was the result of a racial discrimination suit against the City of Chicago.
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Rental Assistance Demonstration, a pilot program to convert public housing to privately owned, affordable housing. There is a $25.6 million backlog of repairs needed for public housing.
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. In the mid- to late 1980s and early 1990s, a variety of prevention tools were available: • ew information about modes of transmission n • social activism as a direct result of the tremendous health disparities • information campaigns • behavioral interventions, such as promoting condom use • HIV testing coupled with risk-reduction counseling • syringe exchange • housing • food security and social support • behavioral factors in care Holtgrave highlighted some of the population health research that might have led to this decline in deaths from AIDS.
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From page 16... ...
The federal government stopped funding needle exchange programs in the late 1990s, despite their proven effectiveness in preventing HIV transmission and no evidence they led to increased drug use.6 However, there are ongoing state, local, and privately funded needle exchange programs (CDC, 2010)
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As examples, Nyhan mentioned the Patient Protection and Affordable Care Act (ACA) myth of "death panels" and false claims that vaccines are poisoning children.
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. Although the corrective information resulted in fewer parents expressing agreement with the myth that vaccines cause autism, parents who received it were also less likely to say they would vaccinate a future child relative to a control group.
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TRANSLATING POPULATION HEALTH RESEARCH INTO POLICY AND PRACTICE11 In population health research, as with many other fields, researchers are trained to produce peer-reviewed publications, secure research grants, make conference presentations, and teach, and there are clear incentives -- financial and professional -- that drive researchers to pursue those activities, Simpson began. Although behavioral economics is often discussed as an approach to get patients or providers to change behaviors and advance health, Simpson suggested that it could also be applied to modifying the behaviors of researchers.
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From page 20... ...
The Research Excellence Framework is a new peer-assessment system for evaluating the quality of research in UK higher education institutions.12 The Research Excellence Framework defines impact as "any effect on, change, or benefit to the economy, society, culture, public policy or services, health, the environment, or quality of life, beyond academia," Simpson said. The outcome of this assessment is used for funding allocation, accountability, and benchmarking.
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From page 21... ...
In general, while Australia, Canada, and the United Kingdom have made significant strides in evaluating research impact and using the results as part of future research funding allocations, the United States lags behind, Simpson said. To date, demonstration of measurable population or community impact from prior research is not a criterion for future research funding at the National Institutes of Health or other U.S.
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From page 22... ...
Incentives are needed to ensure that there is a research base as part of the change process. It was pointed out that one of the recommendations in the Institute of Medicine report The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research was to engage the community across the research spectrum (IOM, 2013)
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From page 23... ...
There have also been cycles of thinking that social media could be used to more efficiently deliver information to people to change their minds, followed by pessimistic views that there is so much misinformation to try to counter. Nyhan said that social media needs to be considered within the larger context of what is known about how people process information.
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From page 24... ...
Holtgrave agreed that the issue of health equity is key, as is the need to consider and balance both short-term and longer-term effects of research. The updated National HIV/AIDS Strategy calls for a reduction in new diagnoses, but he said that the epidemic of undiagnosed young, black, gay men is so severe in Baltimore that there is a need for increased diagnosis over the next 6 months so there can be a reduction in the longer term.
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