As public health departments across the country continue to be stretched to the limits to address community health threats such as H1N1 and seasonal flu, it’s more important than ever that policy-makers, practitioners and other stakeholders have the evidence to make a strong fiscal and political case for public health as a national priority.
Today, the Robert Wood Johnson Foundation (RWJF) announced the second round of grantees for the Public Health Practice-Based Research Network (PBRN) program, which is developing evidence about the most effective ways of organizing, financing and delivering public health services. Starting in December 2009, the seven statewide PBRNs will begin a two-year effort to identify ways to overcome obstacles to research that commonly emerge in public-health practice settings, and to develop strategies to accelerate the production and translation of research.
A PBRN brings together state and local public health agencies along with local research partners to design and implement studies in real-world practice settings. Borrowing concepts from clinical PBRNs formed among primary care practices, public health PBRNs seek to expand the volume and quality of “practice-based evidence” in public health by involving practitioners in all phases of the research process, from conceptualization through translation to practice. (Play the audio podcast to hear Glen Mays of the University of Arkansas for Medical Sciences discuss recent PBRN research findings from the local health department response to H1N1.)
While these networks remain a new concept in public health, they have already examined a range of critical issues including communication practices, public outreach, investigation processes, mass vaccination, and mitigation strategies. When the novel influenza virus arrived in the U.S. in April, for instance, PBRNs in North Carolina, Kentucky, and Washington were well-positioned to conduct comparative analyses of how local public health systems responded to the threat.
The seven new Public Health PBRNs will receive up to $90,000 each in financial support plus up to 20 days of expert consultation. Each PBRN will develop its research network and conduct a small-scale research project, producing relationships and processes that will make it possible to design and conduct practice-based studies on an ongoing basis, and apply findings quickly to public health practice. During the second and subsequent years, PBRNs will have opportunities to collaborate on large-scale and multi-site research projects through the Public Health PBRN National Coordinating Center under the leadership of Glen Mays, chair of the Department of Health Policy and Management in the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences.
These PBRN will join the existing cohort of five Public Health PBRNs, formed in December 2008, in Massachusetts, North Carolina, Kentucky, Colorado, and Washington. Additional networks can participate by joining the program as an affiliate PBRN. The new PBRNs are:
- Wisconsin PBRN. Led by the Wisconsin Division of Public Health (WDPH), this network brings together the state’s independent public health institute, the Wisconsin Association of Local Health Departments and Boards, the Wisconsin Public Health Association, and an initial group of 12 local health departments that vary in size, service mix, and geographic location. Academic partners include the University of Wisconsin-Madison School of Nursing and School of Medicine and Public Health. The network will focus initially on research examining how public health budgets and revenues have changed in response to the economic downturn, and the effects of these changes on service delivery. Patricia Guhlerman of the Wisconsin Department of Health and Susan Zahner of the University of Wisconsin will serve as co-principal investigators.
- Ohio PBRN. Ohio’s network includes a diverse group of local health departments in nine counties that are affiliated with the state’s academic public health programs, along with the Ohio Department of Health and Case Western Reserve University’s public health program and Prevention Research Center. The network’s initial research will evaluate the use of public health informatics methodologies within local health departments and evaluate the effects of these methodologies on community health assessment, surveillance, and service delivery activities conducted by local health departments. Matthew Stefanak of Mahoning County Department of Health and Scott Frank of Case Western Reserve University will serve as co-principal investigators.
- Florida PBRN. Led by Duval County Health Department, this network includes the Florida Association of County Health Officers, two urban and four rural local health departments, the Florida Department of Health, the Florida Public Health Institute, and a consortium of university partners at Florida State University, University of Florida, and the University of South Florida. The network’s first research project will examine the effects of public health funding streams within the state on local health department capacities and services. Bill Livingood and Nancy Winterbauer of the Duval County Health Department will serve as co-principal investigators.
- Minnesota PBRN. Organized by the Minnesota Department of Health, this network includes partners at the Local Public Health Association of Minnesota, the State Community Health Services Advisory Committee, the University of Minnesota School of Public Health, and local health departments across the state. An initial research project will examine variation in the organizational structures and operational environments of local public health agencies, and the effects of this variation on the quality of public health services. Debra Burns and Kimberly Gearin of the Minnesota Department of Health will serve as co-principal investigators.
- Nebraska PBRN. The Nebraska Division of Public Health will organize a research network that encompasses Nebraska’s recently-regionalized public health agencies along with four urban and rural single-county health departments, the University of Nebraska, Creighton University, and several other public health organizations. The network’s initial studies will examine the implementation and impact of Nebraska’s newly established regional public health service model, with an early focus on organizational design and workforce issues. David Palm of the Nebraska Division of Public Health and Li Wu Chen of the University of Nebraska Medical Center will serve as co-principal investigators.
- Connecticut PBRN. Led by the Connecticut Association of Directors of Health, this network includes the Connecticut Department of Health, local health departments across the state, the Hispanic Health Council, and the academic public health programs of the University of Connecticut, Southern Connecticut State University, and Yale University. Initial research projects will focus on organizational and governance issues within local public health systems and their effects on the scope and cost of state-mandated public health services. Jennifer Kertanis of the Connecticut Association of Directors of Health and Elaine O’Keefe of Yale University will serve as co-principal investigators.
- New York PBRN. The New York State Department of Health will lead a network that includes the local health department members of the New York State Association of County Health Officials along with the University at Albany School of Public Health, the Northeast Public Health Leadership Institute, the New York Academy of Medicine, and the New York-New Jersey Public Health Training Center. An initial research project will use both quantitative and qualitative approaches to characterize impediments to evidence-based decision making in local health departments and to identify factors that promote and support its use. Sylvia Pirani of the New York Department of Health and Sandra McGinnis of the University of Albany will serve as co-principal investigators.
Glen Mays on Public Health Departments' Responses to H1N1
Glen P. Mays, MPH, PhD, discusses public health departments' responses to H1N1.