Disrupting the Status Quo: Seeking Innovations from Low-Resource Communities

Nov 4, 2015, 3:03 PM, Posted by Catherine Arnst

A call for proposals seeks to support evaluation of disruptive innovations that improve the health of low-resource communities—without increasing costs.

Many of the resources that influence whether or not people are healthy vary widely from one community to the next. Income, education and employment levels, access to quality, affordable health care, the availability of social services, and the cultural and physical environment—all have a significant impact on health outcomes. Poorer communities, lacking in resources may struggle to offer all the components that create a healthy environment to live, learn, work and play.

By necessity, however, these low-resource communities often find new and creative ways to do more with less to promote health.  In an effort to uncover such fresh and disruptive approaches to improving health in these communities, the Robert Wood Johnson Foundation (RWJF) has issued a call for proposals.

We plan to award up to $2.5 million in total for innovations that improve health and health care quality among geographic communities where at least 20 percent of the residents live below the federal poverty level or for well-specified target populations that may not live within a single geographic region (such as high-need children and adults) without increasing costs. We are particularly interested in innovations that help ensure that consumers have the influence, tools, and ability to play an integral role in staying healthy. Once identified and vetted, we’ll disseminate successful innovations as examples for other communities to implement.

To learn more, RWJF media director Catherine Arnst sat down with Claire Gibbons, an RWJF senior program officer who is working on efforts to achieve the best possible outcomes and highest value from national investments in health care, public health and population health. Claire shared key insights around this new effort.

ARNST: What specifically is the purpose of this Call for Proposals (CFP)?

Gibbons: We are really interested in promoting high value innovations and health care practices that promote health, while not increasing costs. Public funding of health care and social services keeps decreasing, and a lot of communities are feeling the squeeze. But some poorer communities are rising to the occasion and working within that tighter budget to develop unique, cost- effective innovations. Those are the ones we’re looking for.

What kinds of innovations do you have in mind?

We want ideas that are very different from the status quo—not just a minor tweak to ongoing programs. We are looking for truly disruptive innovations rather than modest changes to existing programs or spreading existing programs to new areas or sites

We are particularly interested in innovations that integrate health care, public health, and the many social determinants of health. We know there are great activities going on across the country, and that is why we are issuing the CFP: to find out what those activities are and test their impact. Some of our Culture of Health Prize winners offer examples of low-resource communities that are improving health.

Finally, it’s important to note that we are especially interested in outcomes that improve value—that is evaluations that measure outcomes with a cost component in addition to a health component.

Who can apply?

We are interested in proposals from community based organizations in partnership with evaluators. A community may be a geographic area or a well-specified target population, such as low-income children with special health care needs in a less strictly defined geographic setting. We are particularly interested in hearing from rural areas, which are too often overlooked. However, the innovation should have expansion potential. Eligible innovations will be set in a town, city, county, or region with a population of at least 25,000 people.

Eligible applicants must be based in the United States. Preference will be given to 501c3 organizations, but anyone can apply.  Proposals will preferably consist of an applicant working in partnership with an evaluator who can determine whether the program meets its goals.

Why the emphasis on evaluation?

We want to find programs with a rigorous design that can produce strong evidence that they actually achieve what they were designed to do. We aren’t looking for after-the-fact analysis—the proposal must have its goals and anticipated results clearly defined going in as well as the method for measuring those goals. We want to find answers to questions that will bring greater knowledge to the field, and that can only be done with rigorous evaluation of the program.

We recognize that it is hard for most low-resource communities to come up with that kind of evaluation without an evaluator trained to analyze outcomes. Partnering with a local evaluator or  university is often a good first step to ensuring rigorous evaluation, as most schools will have evaluators on staff. There are also professional organizations that provide evaluation services.

What do you hope to do with the results?

Ultimately we will want to communicate and spread the word about disruptive innovations –those that are very different from the status quo--that affect value so that more communities can learn about them and implement them in their own settings. To that end we are looking for scalable innovations that can be relevant to communities of all sizes.

Claire Gibbons is a senior program officer dedicated to understanding and measuring key health and health care issues and analyzing programs that seek to improve the value of the nation’s health care and public health systems. Read her full bio.