A series of new studies will focus on how to reduce health disparities, while strengthening techniques used to compare the delivery of public health services.
The Robert Wood Johnson Foundation’s Public Health Practice-Based Research Networks (PBRNs) are launching the studies, which are part of the Foundation’s Research Acceleration and Capacity Expansion (RACE) Supplemental Awards Series, made available to public health PBRNs across the country.
“Much of the existing research on health disparities focuses on problems and solutions in the medical care system,” said Glen Mays, PhD, director of the Public Health PBRN Program. “These new studies will help us learn about disparities in the delivery of public health and prevention strategies, and about roles that the public health system can play in eliminating health disparities.”
Six of the new studies examine disparities in the delivery of public health services and test strategies within the public health system to close disparities. Two studies focus on new methodological techniques for comparing variation in the delivery of public health services across settings, including direct-observation measurement approaches and comparative effectiveness analytic methods.
The eight new projects include:
Variation in Local Public Health Actions to Address Health Inequities. This project of the Minnesota PBRN seeks to investigate the extent to which local health departments in Minnesota engage in activities to reduce health inequities, and to identify the characteristics of local public health systems that facilitate and impede these activities.
Utilization and Effectiveness of a Health Equity Index in Mobilizing Local Public Health Action. The Connecticut PBRN will refine and expand a methodology developed by the Connecticut Association of Directors of Health (CADH) to construct a health equity index that measures social and economic determinants of health at the neighborhood level. The study will investigate the use of this index by local public health officials to mobilize multi-sector disparity reduction activities.
Effects of Cultural Competency Training on Local Health Departments: A Randomized Trial. This project of the Kentucky PBRN will analyze variation in the cultural and linguistic competence of local health departments within Kentucky, adapt and test a series of training modules designed to strengthen cultural and linguistic competence among staff, and evaluate the effectiveness of these training models.
Local Health Department Workforce Reductions: Implications for Diversity and Health Disparities. The Washington PBRN will use this study to quantify and compare the workforce reductions made by local health departments in Washington state in response to the economic downturn, and to estimate the effects of these reductions on local health department workforce diversity and capacity to address health disparities.
Comparative Effectiveness of State versus Regional Approaches to QI in Public Health. The Georgia PBRN will examine the impact of a quality improvement collaborative model implemented through Georgia’s regional public health districts on the implementation and effectiveness of local public health QI activities.
Regional Public Health Structures and Readiness for Accreditation and QI. The Nebraska PBRN will make use of the state’s recently developed regional public health structures to assess and compare readiness for accreditation among regional health departments and single-county health departments within the state, and to examine the utility of quality improvement (QI) strategies implemented by health departments in preparing agencies for the national voluntary accreditation program for public health agencies.
Incorporating Comparative Effectiveness Research Tools into Public Health PBRN Research. This project of the North Carolina PBRN will use novel comparative effectiveness research (CER) analytics based on propensity score estimation to estimate the effects of a recent reduction of Medicaid reimbursement funding to local health departments for delivery of evidence-based maternity support services. The novel analytics will be used to explore whether there are disparities in the impact of this policy change across different population sub-groups.
Enhanced Direct Observation Methods for Studying Foodborne Outbreak Practices in Ohio. This new project builds on the Ohio PBRN’s ongoing study that uses direct observation methods to assess practice variation in food-borne outbreak (FBO) investigations and response among local health departments in Ohio. The supplement will allow for the incorporation of consumer perceptions of prevention, investigation and management practices along with enhanced analytic methods for studying drivers and correlates of practice variation.
The Public Health PBRN Program is a national program of the Robert Wood Johnson Foundation that supports the development of research networks for studying the comparative effectiveness, efficiency and equity of public health strategies deployed in real-world practice settings. A PBRN brings multiple public health agencies together with research partners to design and implement studies of population-based strategies that prevent disease and injury and promote health. Participating practitioners and researchers collaborate to identify pressing research questions of interest, design rigorous and relevant studies, execute research effectively, and translate findings rapidly into practice. The Public Health PBRN Program is based at the University of Kentucky College of Public Health, under the direction of Mays.