Attitudes of State and Community Leaders
Report Publish Date: April 18, 2024
This journal article describes the What Shapes Health and Well-Being survey, which investigates how city, state, nonprofit, and business leaders think about health promotion and their role in it.
The authors found that leaders understand the importance of:
Having self-efficacy and saying they knew others wanted their organization to take action were the two attitudes most associated with leaders intending to promote population health.
Making health a shared value is an important component of building a culture of health. Many surveys have studied how the general public or specific groups of leaders, like mayors, view the social determinants of health and health equity and their role in promoting them. But previous studies had not looked at the attitudes of a broad group of leaders. The authors of this study wanted to fill that gap in the evidence base.
The authors designed the What Shapes Health and Well-Being survey around a conceptual framework related to population health promotion. Within that framework, they investigated five topics, including social determinants of health, equity, community engagement, systems alignment, and allocation of resources. They used the theory of planned behavior to ground their approach. And they conducted a descriptive analysis and two regression analyses.
“Efforts to improve population health through leaders should focus on supporting leaders’ self-efficacy and on increasing leaders’ perceptions regarding behaviors valued by important others.”
—Nyna Williams and Martha Kovac, Mathematica; Emily Newton-Hoe, Harvard University
“Efforts to improve population health through leaders should focus on supporting leaders’ self-efficacy and on increasing leaders’ perceptions regarding behaviors valued by important others,” the authors write. “Governmental entities and funders can use these data to support leaders’ efforts in improving population health, well-being, and equity."
$2,881,775
Awarded on: 04/30/2021
Timeframe: 2021-2024
Grant number: 78477
Location: New Orleans, LA
A critical driver of population health, well-being, and equity is making health a shared value, or the belief that health is a priority for oneself and one’s community. For people in positions of influence, attitudes regarding their organization’s perspective may result in decisions that advance health equity or reinforce inequities. Yet despite the potential role of leaders in influencing health and well-being, little is known about their attitudes regarding their organization’s perspective on what shapes health, or how their attitudes translate into actions that improve population health. The objectives of this study are twofold: (1) to understand leaders’ attitudes with regard to their organization’s perspective on population health and (2) to identify the attitudes associated with leaders’ perspectives regarding their organization’s intention to engage in behaviors that advance population health. We designed a survey instrument grounded in the Theory of Planned Behavior and fielded the survey to 18,367 state and community leaders across all 50 U.S. states, 325 U.S. cities, and nine sectors from fall 2020 until spring 2022. We received surveys from 5,450 leaders, yielding a 32 per- cent response rate. Survey respondents viewed social determinants of health and health equity as important factors influencing population health. Additionally, two attitudes were most associated with leaders’ intentions to promote population health—“self-efficacy” (a leader’s confidence in taking action to promote health for all) and “behaviors valued by important others” (how much certain groups want the organization to take action that pro- motes health for all). Efforts to improve population health through leaders should focus on supporting leaders’ self-efficacy and on increasing leaders’ perceptions regarding behaviors valued by important others. Governmental entities and funders can use these data to support leaders’ efforts in improving population health, well-being, and equity.
PLoS ONE 19(4): e0301450. https://doi.org/10.1371/journal.pone.0301450
Fig 1. Theory of planned behavior (TPB) model. Page 4/15
This study and report was conducted and created by the following people.
