A highlight of last week's Public Health Systems Research Interest Group meeting, which followed the AcademyHealth Annual Research Meeting, was a “Critical Opportunities” reception during which several presenters pitched their ideas for a law that could be used to improve or solve critical public health issues. The presenters were timed, given only five minutes to share the background of the issue to be addressed, their idea for the law, evidence that it could work and the feasibility of implementing the change. Attendees were encouraged to vote on their favorite to see which Critical Opportunity ranked highest--see below for the results!

This was the second such event since this year’s debut of Critical Opportunities for Public Health Law, an initiative of the Public Health Law Research Program (PHLR), a Robert Wood Johnson Foundation program at Temple University. The goal is to make the case for laws that can improve current critical public health needs by:

• Identifying important ways to use law to improve the public’s health
• Enhancing public and professional recognition of law as a vital force for better public health
• Guiding public health law research

NewPublicHealth caught up with two of the invited presenters, who also accrued the most votes on their topics--Tamar Klaiman, assistant professor at the Jefferson School of Population Health in Philadelphia, and Georgia Heise, DrPh, director of the Three Rivers District Health Department in Kentucky, and recently elected vice president of the National Association of County and City Health Officials.

NewPublicHealth: What did you both present on?

Tamar Klaiman: The policy that I addressed is about requiring physicians to offer new parents TDAP (pertussis) vaccines because infants who are [less than] six months of age are at the highest risk of mortality from pertussis, and so parents can protect their children by being vaccinated. Around 80 percent of pertussis cases in infants, when they can track where the pertussis came from, come from parents. The policy that I talked about is having providers offer pertussis vaccine to new parents prior to leaving the hospital or birth center with the newborn.

NPH: Why would that be valuable?

Tamar Klaiman: Newborns are not fully protected against pertussis until after their 6-month booster so vaccinating parents offers the best protection. So it’s a very low risk, high reward policy.

NPH: Are there states that are already implementing this law?

Tamar Klaiman: None as far as I know.

NPH: Georgia, what’s your critical opportunity?

Georgia Heise: I talked about voluntary public health department accreditation for local health departments. Accreditation encompasses a myriad of standards that cover the mission of public health and what health departments should be doing. This would standardize public health across the nation and force into place a lot of preventive measures and assessments and best practices that the health department would be doing things that would actually make a difference in population health.

NPH: Why is this a critical opportunity?

Georgia Heise: I think that across the United States we operate on a medical model, which means we don’t really put enough funding into anything that would teach people how to be healthy or keep them healthy. We put a lot of money into taking care of somebody once they’re sick or dying. We need to push in the opposite direction and focus on keeping people healthy, and these accreditation standards are a framework for health departments to start that. There’s now an opportunity for health departments to become accredited at the national level. It’s in place and ready to go, however, not all the health departments have opted in yet.

Results of the Critical Opportunities Vote at AcademyHealth

About 100 people texted their votes for the presentations at the Interest Group meeting. The results were as follows:

• Requiring physicans to vaccinate parents of newborns against pertussis (whooping cough) to better protect young babies: 50 percent of votes
• A law requiring that states health departments be accredited and that funding be provided to go through the accreditation process: 24 percent of votes
• Establishing comprehensive laws to deal with designer drugs such as synthetic marijuana that would be broad enough to encompass new drugs as they are introduced: 18 percent of votes
• Creating standards for public health department contracts with private entities: 9 percent of votes

>>Watch YouTube videos of Critical Opportunities presentations at the Public Health Law Research Program meeting earlier this year.

Social media has been hyped for everything from communicating during emergencies to tracking the spread of the flu. So how are state health departments using such tools as blogs, Facebook, and Twitter? That was the subject of a presentation at the recent Public Health Systems Research Interest Group meeting that followed the AcademyHealth Annual Research Meeting last week.

In an unfunded study, Jenine Harris and Doneisha Snider of Washington University in St. Louis looked at how widely Facebook and Twitter are used by state health departments. Harris pointed out that social media can augment the resources health departments have to communicate with the public and “have the potential to diffuse information quickly.” Harris added that health departments can use social media to communicate with each other about new information, best practices and lessons learned in addition to communicating with the public.

Researchers shared stats on state health department social media presence so far:

• 28 have a Facebook page
• 41 have a Twitter feed
• 37 state health departments were following each other on Twitter
• 24 state health departments had friended each other on Facebook
• On average, state health department Facebook pages have 993 friends
• The average number of Twitter followers for a state health department is 1,340
• State health departments are actively using their Facebook and Twitter accounts; thirty-six health departments had tweeted within the last week and 24 had posted on Facebook

Harris says content for the tweets and Facebook posts primarily includes prevention (such as immunization, nutrition and smoking cessation information) and operations (hours of operations, job openings). Tweets were mostly aimed at the general public.

Harris offered some recommendations on how state health departments could potentially use Facebook and Twitter to communicate with each other to share best practices. However, she says there is much left to learn about the potential of social media for public health practice and how to use this new tool most effectively.

For more detailed analyses, look for Harris’s article, “The network of Web 2.0 connections among state health departments: New pathways for dissemination,” which is forthcoming in the Journal of Public Health Management and Practice. Harris and her colleagues also plan to examine social media use in local health departments.

>>Catch up on what you may have missed at the AcademyHealth Annual Research Meeting.

Even Modest Walking Linked to Lower Risk of Diabetes

A new study, published in the journal Diabetes Care, examined number of steps walked on average and diabetes risk, and found that people who walked the most were 29 percent less likely to develop diabetes than those who walked the least. This study builds on research linking even limited physical activity to lower diabetes risk, and helps to quantify the effect with number of steps taken on average. The association held when accounting for age, smoking status and other diabetes risk factors, but not BMI. Read more on diabetes.

Fewer Women Got Mammograms After New Guidelines Released

Preventive mammography rates in women in their 40s have dropped nearly 6 percent nationwide since the U.S. Preventive Services Task Force recommended against routine mammograms for women in this age group, according a Mayo Clinic analysis. The study was presented at the AcademyHealth Annual Research Meeting this week. Read more NewPublicHealth coverage from the AcademyHealth meeting.

Sixteen Percent of U.S. Population Addicted to Cigarettes, Alcohol or Drugs

Forty million Americans ages 12 and older have an addiction involving nicotine, alcohol or other drugs, according to a five-year national study released this week by The National Center on Addiction and Substance Abuse at Columbia University. The study authors say only about 1 in 10 people who need treatment for addiction involving alcohol or other drugs receive it. Read more on substance abuse.

Three entities in Minnesota shared their experience with workplace wellness programs at this week’s AcademyHealth Annual Research Meeting. Employers can play critical roles in improving the health and lifestyles for their employees and their community, but many are still on the learning curve of why it’s important, according to presenters at the session.

Marc Manley, MD, MPH, chief prevention officer of Blue Cross Blue Shield (BCBS) of Minnesota says “workplace wellness needs a business plan, not just a culture.” Manley says to be successful, workplace wellness plans need goals and a decision on who will pay for it. It also needs a long-term commitment—at least three years, says Manley, since most firms can’t afford to introduce every wellness incentive—such as healthier foods, incentives for healthier lifestyles, and company-based programs such as smoking cessation and weight loss—all at once.

Manley adds: "You also need infrastructure, communication with employees, feedback, incentives, goals, a measurement strategy; and a lot of employers just don’t have this in place for wellness."

Examples of things to focus on include the types of food offered throughout the workplace, and what you will do to make the healthy choice the easy choice, such as pricing healthier foods differently than less healthy ones.

Manley, who is also the chief medical officer for Invitation Health & Wellness, a consulting arm of BCBS Minnesota aimed at widely sharing evidence-based practices, says small firms often want to know what they can introduce that’s fully free of financial costs that will help improve the health of their employees. Manley says he does have one suggestion: have CEOs model healthy behaviors, and serve as role models.

Wellness initiatives at BCBS Minnesota, which has 3,500 employees and 2.5 million members, include online and telephone behavior coaching, unlimited office visits to physicians and dieticians, discounts to lifestyle programs such as weight loss classes, provider incentives, paid media campaigns, lobby for strong health policies such as active transportation and funding of local community efforts to promote physical activity and healthy eating. Also needed, said Manley, are data to establish priorities, evidence-based strategies that support goals, measureable goals, and measurement and reporting of progress.

“Firms that have a business plan for a healthier workplaces connected to a culture of health, are more likely to succeed in helping employees get and stay healthy,” says Manley.

Manley cited a 2012 study in the American Journal of Health Promotion that found that workplace wellness programs can produce, on average, reductions in sick leave, health plan costs, and workers’ compensation and disability insurance costs by around 25 percent.

Target’s corporate headquarters are based in Minneapolis, and recently the company started a “wellbeing” initiative as its inaugural project for workplace wellness. While they’ve started some wellness projects, such as reducing the cost of fruit in the cafeteria, well being is what the company is after, to start—including camaraderie and teambuilding efforts. "When they go home we want them feeling good about where they work," says Kara McNulty, senior group manager of medical affairs at Target, who added that the biggest influence from well being on health is on stress-related disease such as coronary artery disease and depression.

McNulty says team members with a higher rate of well being are more likely to stay with the company, volunteer in the community and participate in health surveys. Target’s next steps will be to grow participation in the well being program, study the role of well being “captains” and establish more actionable measurement systems.

At a panel convened by the Alliance for a Healthier Minnesota, a collaborative private and public stakeholders, Target was one of the firms discussing an accreditation program for wellbeing. The program sets standards for workplace wellness programs in three areas: organizational engagement and alignment; population health management and well-being; and outcomes reporting.

Tom Mason, head of the Alliance for a Healthier Minnesota and the final speaker on the session on workplace wellness, said that although business is not often seen as a change agent, real health care reform requires both business and public health. “There has to be coalition building, we have to stick with it for the long haul, and we have to do have forward looking companies."

The Alliance has completed focus groups with small companies on their thinking with regard to workplace wellness, with results to be released in the fall. “The big challenge is small business,” says Mason; "in Minnesota 65 percent of those employed, work for small companies."

Dr. Manley added a twist to his presentation that showed the relative ease of introduction of small changes, especially for a willing audience. He bemoaned the need for conference attendees to spend so much of the meeting sitting, and challenged the sessions attendees to get out of their chairs and stand, and even move their arms and legs a bit, after each speaker—and just about everyone did as he asked, after a careful look around to be sure they wouldn’t be the only ones. “Changing a norm is not so easy,” said Manley. “But it’s possible if you start thinking about what you need to do.”

>>Weigh in: What’s a small change your community has made that has increased, even slightly, physical activity among a group?

>>Bonus Interview: Read a NewPublicHealth Q&A with Tom Mason of the Alliance for a Healthier Minnesota

We’ll never know if it was the spirited discussions or Tropical Storm Debby, which is pummeling northern and central Florida, that kept most of the 2,000-plus attendees at this year’s AcademyHealth Annual Research Meeting—this year in Orlando—indoors and packed into the sessions and the exhibit hall at just about every minute of the meeting this year. Public Health was a featured topic, according to AcademyHealth president and CEO Lisa Simpson, and a session on the IOM report on the integration of public health and primary care, led by the committee chair, Paul Wallace, MD, was a featured, and well-attended, session as well.

Not surprisingly, many public health officials made their way into a ballroom very early Tuesday morning to hear three health law scholars, Sara Rosenbaum of the George Washington University, Timothy Jost of Washington and Lee and Mark Hall of Wake Forest, talk about the issues likely contemplated by the Supreme Court Justices as they considered the cases brought against the Affordable Care Act. Critical for public health were the discussion points aired just before the session ended, concerned with continued state and federal budget cuts including cuts to the Centers for Disease Control and Prevention and other divisions of the Department of Health and Human Services, which could impact public health service delivery now underway, as well as implementation of the Affordable Care Act, if it is upheld.

Health disparities were also a focus of several sessions, as well as the topic that won the student poster award of the conference. Stephen Vance, a fourth-year medical student at the University of North Carolina at Chapel Hill School of Medicine, won the best student poster award for his work with Aida Lugo-Somolinos, MD, of the medical school, on clinical trial enrollment barriers faced by the Hispanic population in North Carolina. Vance’s research found that the barriers identified by the Hispanic participants in the study differ from those expected by clinical investigators.

The study provided a questionnaire for physicians on their perceptions of why more members of the Hispanic community don’t enroll in clinical trials, and also collected patient questionnaires on trial participation from close to 400 members of the Hispanic community.

The physician responses showed that they viewed language and transportation as the key barriers. But the patient responses showed other concerns including worries about what participating might cost them, concern about missed work time and a lack of understanding about the potential benefits of trial participation, including access to health care. The researchers say the following should be considered as a means to enroll more members of Hispanic communities in trials:

• Provide information about studies to health care providers in areas with large Hispanic populations
• In large cities, create partnerships with Hispanic advocacy groups
• Communicate that trial participation is not necessarily costly and may take no more time than a regular doctor’s appointment
• Include a person fluent in Spanish on the research team

“Before this study, I would have thought that transportation and language were the key barriers,” says Vance. “It’s really a lack of understanding of what a clinical research project entails.”

“Perhaps as clinicians, we’re asking the wrong questions,” says Vance, who is on track to get an MBA as well as his MD degree, and plans to go into health management. “This study focuses on the Hispanic community, but should push us to look at the reasons why other groups are underrepresented in trials.”

Primary care and public health share a common goal but historically have functioned independently of each other. However, health experts say that better integration of the two disciplines could result in critical improvements in the health of individuals and communities. The Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the Institute of Medicine (IOM) to look at issues related to the integration of primary care and public health, and the resulting report was released earlier this year.

The recent report on integrating was so groundbreaking, that it has launched a number of discussions and publications on the issue, including a keynote panel at the recent 2012 Keeneland Conference, a first ever joint issue of the American Journal of Preventive Medicine and the American Journal of Public Health and a session on the report at next week’s AcademyHealth Annual Research Meeting by the IOM report’s committee chair, Paul Wallace, MD. NewPublicHealth spoke with Dr. Wallace, Director of the Center for Comparative Effectiveness Research at the Lewin Group, about the committee’s critical finding and recommendations.

The IOM identifies a set of core principles common to successful integration efforts, such as involving the community in defining and addressing its needs. The principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system.

NewPublicHealth: What were the key findings were in the report?

Dr. Wallace: There are many instances in which communities have figured out aspects of integration but, as we learn over and over again in health care, solutions often need to be locally adaptive, and that holds true in thinking about how integration takes place as well.

I think what was very helpful for us was recognizing that integration is really a continuum, sort of extending from either being disintegrated or, if you will, parallel play on one end up through quite formal partnerships or mergers on the other end. There are opportunities for creating better care and efficiencies along that continuum. For public health to be aware of what primary care is doing and for primary care to be deeply aware of what public health is doing would be a substantial element of progress.

NPH: Why is integration coming about now?

Dr. Wallace: It isn’t quite yet. Until about a hundred years ago health care was the province, almost exclusively, of the clinician-patient relationship. Previously, though, if you go back 150 years, in medical schools, there was really a sort of blending of what we now would think of as public health and what we think of as health care. But the Flexner Report back in the early 20^th century re-configured how medical education took place, which changed the structure of medical schools, and public health wasn’t really part of that.

The other thing that happened was that public health was figuring out what it needed as an academic base, and that was about the time that the Rockefeller Foundation stepped up and started funding separate schools of public health. So really what happened is that the education and the academic foundation sort of diverged and they followed separate paths for most of the last century.

NPH: With stronger collaboration between public health and health care, what could be achieved?

Dr. Wallace: I think if you look at it from a patient-centered perspective, there would be rational and consistent availability and access to a whole range of services like healthy food and the ability to exercise, and it would be reinforced by our public policy. There would be a shared awareness of who are the people at greatest risk, perhaps related to data and information systems. There would be an alignment between messaging from public health agencies and what you would hear in your clinician’s office. And in the clinician’s office there would be recognition that it isn’t just about doing physical exams and prescribing pills, it’s also thinking about aspects of healthy living such as active living and healthy eating.

But I think that there really would just be a blending of the whole continuum, and I think that the other really important thing is that a lot of the emphasis would shift from fixing things through health care to more of a proactive context of prevention, and really primary prevention. It’s about not waiting until people have high cholesterol and heart attacks and then trying to treat them with lipid-lowering drugs, but thinking how you get ahead of this in public schools, in the workplace and in our communities.

NPH: Would money be saved with the appropriate integration?

Dr. Wallace: Another way to think about it would be—can we get more health for the dollars we’re spending? We certainly could make the system more efficient. There are a lot of issues of maldistribution, for instance, where we tend to over-treat certain people in certain ways, and as a consequence there are other folks who are poorly treated. The disparities discussion I think is a very rich one that’s right in the middle of this.

Over time, we might start to see spending migrate from very high-risk dollars on things that are very unlikely to work with expensive interventions, to more fundamental upstream interventions that will have dividends over many years.

NPH: Is it sufficient to just have primary care and public health at the table together to solve the massive problems that have been created?

Dr. Wallace: If you really want to create health on a community basis, you need public health and you need the health care delivery system, primary care, but almost all of the successful programs also have some third party. And that third party may be government, it may be schools, it may be a faith-based organizations. It gives you sort of a place to convene. Rather than having public health and primary in a tug of war over who is bigger and brighter and smarter, you realign that effort to think about how we can collectively engage to support this third party. That sort of triangulation I think is a really critical thing about trying to bring these mindsets and forces back together.

NPH: What are the next steps to the report’s findings?

Dr. Wallace: What was different about this report we feel is that it involved people who have a direct interest in this, who are motivated to actually do some things to try and support this. CDC and HRSA, who together commissioned the report, between them have a footprint that really extends into every community. They’re actively thinking together about a lot of things that we’ve suggested, but a lot of our suggestions reflected openness from them to where they want to go. CDC and HRSA are increasingly aware of what each other are doing, they actively cooperated in funding the study and they’re collaborating now in thinking about some funding models.

There are also workforce issues. There probably is a set of workers who are critical to this and they aren’t necessarily traditional health care roles, but they’re more like the community health worker who can help people with education. They’re in the community, they understand the culture, they understand the nuance and may be more effective at translating some of these messages.

NPH: What made it feasible to have a receptive audience for this report now?

Dr. Wallace: There is a growing understanding of what population health is, and in a sense that population health is bigger than either primary care or public health and it’s only going to get addressed if they do it collaboratively. The other really critical factor that makes things different now is the availability of data. That is just fundamentally changing people’s thinking. An example of that would be creating community-wide registries that can be used to recognize where there’s opportunity such as pockets of a city that have a very high incidence of asthma, and then being able to think about what are the community or public health-based interventions.

Data democratization is also creating new levels of transparency and accountability. There’s this growing recognition that you can now know what is going on, where before people always wondered or hypothesized.

AcademyHealth will hold its Annual Research Meeting in Orlando, Fla., next week. NewPublicHealth spoke with AcademyHealth president and CEO Lisa Simpson, MD, MPH, about the focus of the meeting, including a renewed focus on public health.

NewPublicHealth: What’s new this year?

Lisa Simpson: There is a lot new at the AcademyHealth Annual Research Meeting. Working with our board over the last year we updated our strategic plan and public and population health is one of our topic areas of priority to which we apply our core purpose, which is to develop new knowledge and move research into action.

This priority is seen throughout the upcoming meeting. One of the themes this year selected by our planning committee is Prevention, Public Health and Population Health Improvement. The theme had the second highest number of abstracts submitted. As a result we have two to three sessions in every time slot related to public health and prevention. In addition we have policy round tables and methods sessions on the topic, as well as the Public Health Systems Research Interest Group meeting, which will be the best attended of the interest group sessions.

Another new thing we’ve done this year is to have a public health day and offer free registration to local public health leaders and practitioners. We will have 19 local public health practitioners joining us.

NPH: What will they get from attending, and how do you think attendees might benefit from having the practitioners at the meeting?

Lisa Simpson: They will give a lot of the real world perspective of the struggles they are facing in promoting the health of the public and delivering public health services in the state of Florida. The Florida budget is much stressed and there have been many challenges, so this is an opportunity to bring that reality to the research community. What the invited practitioners get is an updated understanding of what we’re learning about what works in public health, and about return on investment, and cost and benefit of public health services. In addition, they will learn about the focus on prevention and population health in sectors outside traditional governmental public health, such as the role of employers, many of whom are now working with government health agencies.

NPH: What do you think prompted the recent increased interest in prevention and public health?

Lisa Simpson: I think it’s a combination of several factors coming together, most prominently cuts in state budgets. And not just in public health, but all actors in the health system have to take very critical looks at the effectiveness of what they’re doing in order to improve efficiency and get the biggest bang for the public health dollar. That really focuses a laser beam on what services work for which communities in order to achieve particular aims. And we’re learning from research by leaders such as Glen Mays and others that investment in public health reaps a return on investment.

NPH: It’s a long list to choose from, but what’s another meeting highlight you’d point out?

Lisa Simpson: Just as we did last year, we’ll have an innovation station where people can see new data sets, applications and tools relevant to the field. And attendees will be able to use their smart phones to text their votes for best poster—poster authors will wear their numbers.

We want to make it substantive, diverse, enjoyable and dynamic for participants.

NPH: How will you address a decision by the Supreme Court on the Affordable Care Act during the conference?

Lisa Simpson: We’ve all been talking and thinking and prognosticating about what might happen. Fortuitously, we have a session scheduled for Tuesday morning, the third day of the meeting, with three experts, Sara Rosenbaum of George Washington University, Mark Hall of Wake Forest University Medical School and Tim Jost of Washington and Lee.

The session on Tuesday will go forward regardless of the decision. The reality is that health services research and health services and systems research are going to be critical to continue to provide the evidence base for the next steps, whether those next steps are implementing the Affordable Care Act or fashioning some other solution.

This week’s final plenary at the AcademyHealth annual National Health Policy Conference focused on the media’s role in health policy and featured Austin Frakt of The Incidental Economist (which is supported in part by the Robert Wood Johnson Foundation), Ezra Klein of the Washington Post and Merrill Goozner of The Fiscal Times. Frakt, a health economist, touched on virtually all of the points the speakers made during the one hour session, in a post on his blog the day of the plenary. Most important perhaps was that researchers need to do more than just issue a press release in order to disseminate their results. “I encourage researchers to get involved on Twitter and blogs. Promote the work of the community when it is timely and relevant,” wrote (and said) Frakt. Ezra Klein, who has an extensive following, invited researchers to email him and not shy away because they think he might be inundated. “Let me manage my inbox,” Klein said.

NewPublicHelath spoke with Frakt about the role of social media in reporting critical health information.

NewPublicHealth: Your training was not in health. What did you do before and did you get into the health field?

Austin Frakt: My training is in physics and engineering. I went through a PhD program in electrical engineering at MIT, and although what I was really doing was kind of applied math, I recognized during my studies that I really was interested in questions pertaining to policy. So I did finish my PhD, and the math and the rigor of it was valuable. I was intrigued by [health policy work at Abt Associates] and that’s where I ended up. It wasn’t that I was, at the time, particularly drawn to health, I just wanted to do something in the policy direction and I was particularly drawn to a rigorous, mathematical kind of evidence-based study.

NPH: And what made you focus on health policy?

NewPublicHealth spoke with Eduardo Sanchez, MD, the chief medical officer for Blue Cross Blue Shield of Texas and Chair of the Partnership for Prevention, at the AcademyHealth annual National Health Policy Conference in Washington, D.C. Dr. Sanchez shared his perspective on the intersection and potential opportunities for collaboration between public health and health care.

NewPublicHealth: How do you think public health is being redefined now?

Dr. Sanchez: I think the health system needs to be thought of as being made up of two interdependent components—public health and medical care—that traditionally have been thought of as two different systems. The reason is that a high quality, cost-effective health system that is going to achieve optimal health for all Americans, depends on appreciating that “public health” is important for a truly successful effort to optimize health.

NPH: Where does the responsibility lie for making the critical changes needed for public health?

Glen Mays, M.P.H., Ph.D, Professor and Chair and director of research for the Department of Health Policy and Management at the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences, is a key researcher in the field of Public Health Services and Systems Research. Dr. Mays presented new findings both during the Annual Research Meeting and at the Public Health Services Research Interest Group meeting that followed the larger meeting. NewPublicHealth spoke with Dr. Mays about the presentations.

NPH: What were your key presentations at the Annual Research Meeting?

Glen Mays: Two presentations I’ve made here at the meeting I think get at some critical issues in terms of better understanding the contribution of Public Health Services and Systems Research (PHSSR) to overall health. One is a follow-up to some work we’ve been doing looking at public health spending patterns. Our most recent analysis looked at the effects of investments in public health on medical care spending to find out whether enhanced investments in public health can help to bend the medical care cost curve and help to alleviate some of the challenges that we have with affordability of medical care.

NPH: Talk a little bit about the tenth anniversary. You’ve seen the field grow--what practical applications are you seeing from the decade of research into PHSSR?

Mays: Well, I think we are really seeing a convergence now between the resources being produced in the research community and the demand and information needs of practitioners and policy makers to actually use that research. We are now seeing opportunities for using research and evidence to help inform practice and policy decisions. A good example is the current economic climate which is forcing some difficult choices--both in the policy level and the practice level --about what kinds of services to deliver and how to operate more efficiently.

NPH: What was your focus at the Interest Group meeting?

Mays: I spoke about our practice-based research networks--and looking at those networks as a mechanism for taking research findings and moving them into practice. So we’re studying the research process and our findings suggest that these networks, that bring together researchers, scientists, and practitioners, are actually helping to speed up that flow of information from research into decision-making in public health. We did a study with our initial cohort of five networks and looked at the membership of those networks. We surveyed over two hundred organizations that are part of those networks and looked at their engagement in the research process and their utilization of information that flows out of the research projects.

NPH: What is the best PHSSR question that anyone has asked you at this meeting?

Mays: I think one of the best questions that I’ve heard relates to how we define the public health delivery system and what are the attributes that make a system function as a coordinated system that address population health issues? That’s a question that we’ve danced around conceptually for a long time and we’re starting to think about how to better define and act on--and ultimately, improve the system aspects of public health.

For more, read a guest post by Glen Mays on Economic Shocks and Public Health Decision-making: How Can Research Help?

Read previous NewPublicHealth.org Q&As with newsmakers and difference makers in public health.