Sep 26 2012
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What Works For Health: A New Resource for Community Leaders

Bridget Booske Catlin, Director, County Health Rankings & Roadmaps Bridget Booske Catlin, Director, County Health Rankings & Roadmaps

When it comes to solving problems that affect the health of our communities, knowing what works matters. Using programs, policies and innovations that are based on solid evidence offers a better chance to improve public health.

What Works for Health, the latest release from County Health Rankings & Roadmaps, is an online, searchable menu of policies and programs—each with a rating based on strength of evidence for factors that can help make communities healthier places to live, learn, work and play. Policies, such as sobriety checkpoints, and programs, such as early childhood interventions, included in What Works for Health are rated on their level of evidence to help guide users toward choosing proven strategies. The County Health Rankings & Roadmaps team also hopes this tool will help spur a dialogue, and encourage those in the field to weigh in on other possible evidence-based programs.

NewPublicHealth spoke with Bridget Catlin, PhD, MHSA, director of the County Health Rankings & Roadmaps about the new tool and how she expects it to be used.

NewPublicHealth: Who is the primary audience for What Works for Health?

Bridget Catlin: There are a number of audiences for What Works for Health. Key audiences are people who are leading community health improvement planning processes such as public health officials. Hospitals are also getting involved in this area due to requirements from the ACA and from the IRS. They’re doing community health needs assessments to identify needs in communities and then what they can do to address those needs. Other audiences include employers who want to make their communities healthier for their employees and dependents, as well as grant-makers and policy-makers who are interested in spending their resources in areas that they know will work.

NPH: What’s new about this resource? How is it different from some of the other evidence guides that are out there like The Community Guide?

Bridget Catlin: What Works for Health covers the entire County Health Rankings model. So it addresses policies and programs that will improve health behaviors, which is a lot of what the Community Guide touches on, but it goes beyond that. It also addresses interventions in clinical care, particularly to do with health care access. It also contains a lot of information on policies and programs to address the social and economic factors—people who are familiar with the County Health Rankings model will know that those factors contribute the most towards health outcomes. And then finally, we have policies and programs to address the physical and built environment. Other evidence rating guides will touch on one piece of this, whereas our tool addresses everything. We don’t replicate other people’s work. We point to things like the Community Guide where it has done a thorough assessment, but we also point to a lot of other tools too. So it’s one stop shopping.

NPH: The tool is based on one that you and other folks at the University of Wisconsin Population Health Institute developed. What feedback have you gotten over the years and what people were able to learn from it?

Bridget Catlin: We first introduced an online tool like this back in January of 2009 as part of a project we were doing here in Wisconsin. The project is called Making Wisconsin the Healthiest State, a very grandiose title. We spent time both measuring Wisconsin’s health, and then really wanting to help the entire state move forward, and so we’ve put this tool together following a very similar model to the County Health Rankings model. The reactions to the tool were really positive. There were a lot of people out there really interested in implementing evidence-based strategies, but it’s very time consuming to go searching for that evidence. We got a lot of feedback that this really helped people. We summarized the evidence, so if you just want to see the high level you can just look at the high level. If you actually also want to go to the underlying references, we link to each one of those. So it was appealing to both people who just wanted the answer and those who wanted the supporting information behind the answer.

The people who funded that work, the Wisconsin Partnership Program, are a grant-maker, and they found the tool particularly helpful for them when they were reviewing applications for funds to be spent in the community. The tool was helpful to them to be able to understand which of the applications were actually for implementing proven practices versus those where there was more uncertainty and where they wanted to be sure that there were more money devoted to evaluation to be sure that we could build the evidence around what works.

NPH: Why is evidence so critical when we’re thinking about developing solutions for community health?

Bridget Catlin: In this era when we’ve got limited resources, everybody wants to spend their money wisely. They want to spend it doing things that we know work. That doesn’t mean we want to stifle creativity. Obviously, some of the best ideas have to start somewhere. But when you’re in a community and you’re trying to figure out how you might proceed, you probably want to go with a balance of implementing things that you know work, and then maybe just one or two things where there’s less evidence that are more innovative. It’s like building a portfolio. When you’re investing money, you want some sure wins and then you want some things where there might be great returns but you don’t know. Having a summary of the evidence allows you to take a look and select an appropriate portfolio of strategies.

NPH: What do you suggest that person do if they’re trying to get more support on replicating evidence-based programs or policies?

Bridget Catlin: One of the things the tool includes, as well as actually having these summaries of evidence and the evidence ratings, is links to resources that help guide implementation. Wherever we can find them, we add these links to toolkits or action guides—any material that we can find that’s been put together by people who have already had experience with a particular policy or program. Those are really helpful. Several of those will include names of organizations or people that have worked with a particular policy or program. Talking to people who have done this before is also really helpful.

What Works for Health is a starting point for that. We’re hoping that over time, as people start using the tool that they will weigh in with comments—they can send us messages via the web site’s "Contact Us" link.

We also have a very active audience on our Facebook page on the County Health Rankings & Roadmaps. One really practical thing that someone could do is if they find a strategy on What Works for Health, they could post on Facebook and ask, “Has anybody tried this? What can you tell me about it? What works? What will help us implement it? What barriers might we face?” They could tweet about it too. There are different ways to gather input from other people, and that’s what we think will be the next step.

NPH: Is there anything else that you want to mention?

Bridget Catlin: Following on in this vein about us all working together, we’re going to be working on this tool continuously. We’re going to be updating evidence. We’re going to be adding new policies and programs as we find them, and we want suggestions from people. If they go looking in What Works for Health and they can’t find a policy or program, send us an email; let us know. We’ll put one of our analysts to work looking for evidence in that area.

We summarize a lot of evidence and we have rules as to how we do this. But if a user sees that we’ve given something a rating of only some evidence rather than saying that it’s scientifically supported—if they don’t agree with us, email us and tell us and we can get back to them and have a discussion about why we rated it the way we did. We want to hear from everyone as we continue to refine the tool going forward.

Tags: County Health Rankings, Healthy communities, Public Health , Public health, Q&A, Social determinants of health, Technology