Council on Linkages Between Academia and Public Health Practice

Meeting Minutes

Monday, June 8, 1998
Alexandria, Virginia

Members Present: Bill Barker, Ron Brown, Diane Downing, Bill Keck, Joshua Lipsman (chair), Charles Mahan, Hugh Tilson, Marty Wasserman

Other Participants Present: Elaine Auld, Carol Brown, Annette Ferebee, Mike Gemmell, Paul Kim, Patricia Clem Kober, Rika Maeshiro, Ron Merrill, Darcy Steinberg, Liz Weist

Staff Present: Lois Banks, Michon Béchamps, Ron Bialek, and Marie Flake


I. Opening Business
Dr. Joshua Lipsman, chair, opened the meeting and welcomed all participants. The minutes from the last Council meeting on March 6, 1998 were unanimously approved with the addition of Marty Wasserman on the attendance list.

II. Public Health Prevention Research and Applications Agenda
Since the presentation made by Mr. Mike Gemmell, Executive Director of the Association of Schools of Public Health (ASPH), and the ensuing discussion during the March 6, 1998 Council meeting, Mr. Ron Bialek has been coordinating a subcommittee to begin work on developing a public health prevention research and application agenda. The subcommittee is composed of interested individuals representing both government and private entities. After a subcommittee conference call, Mr. Bialek made an initial presentation explaining the concept to the Public Health Functions Working Group. As a result, Dr. Lipsman was invited to present the topic and recommendations, representing the Council, at the May 27 Public Health Functions Steering Committee meeting.

After initial discussion, the Council agreed to continue to facilitate the subcommittee and to develop a scope of work, workplan, timetable, and possibly a budget. The initiative fits well with the Council’s purpose and objective.

It was estimated that development of the final agenda will take up to five years. The Council identified several steps to take within the next six months to facilitate development of the draft workplan:

  1. Identify current research agendas and research-building activities. For example, the American Association of Medical Colleges (AAMC) is advocating for more than doubling of the NIH research agenda budget and the Lasker Foundation is including public health in their agenda.
  2. Develop criteria for including items on the research agenda such as using Foege-McGinnis actual causes of death, the Essential Public Health Services, and Healthy People 2010 objectives as the framework.
  3. Identify the necessary audiences and the focus of information presented. For example, Congress would require a more general approach for appropriations of funds whereas other supporters such as the Lasker Foundation and AAMC would require a more targeted presentation to leverage funding. Suggested "take home" messages included identifying the top 100 areas or top 100 questions of research.
  4. Develop more fully the concept paper presented to the Public Health Functions Steering Committee so that the idea can be more effectively advocated.

It was noted that in the upcoming issue of the Journal of Preventive Medicine, several articles related to developing a research agenda are scheduled to appear and the Council may wish to respond to some of the articles. In moving forward with this initiative, several Council members noted that it will be important to include all relevant organizations, particularly members of the Research!America coalition and Partnership for Prevention. A motion to find a source for funding the development of a workplan was raised and unanimously passed.

III. OPHS Update
Dr. Rika Maeshiro, of the Office of Disease Prevention and Health Promotion, presented an update of new OPHS activities, the Public Health Functions Project, and progress made in the Healthy People 2010 initiative.

Dr. Maeshiro announced that Dr. Linda Myers has been named Acting Director of the Office of Disease Prevention and Health Promotion. Within 60 days a permanent director should be named.

A recent executive order has been issued that focuses on children’s health and the environment. Plans are in place to create an inventory of environmental health research as it relates to children. The group involved is looking to involve more stakeholders. The inventory will be made available for public comment once completed. Dalton Paxman (202-205-5829) is the lead contact for the project.

As stated earlier, the Public Health Functions Steering Committee met in late May. The meeting mainly focused on public health expenditures projects. The committee members also explored betters ways to work with data. In addition, Dr. Lipsman, representing the Council, presented the concept of developing a national prevention research and applications agenda.

Much progress has been made in moving forward the Healthy People 2010 initiative. Throughout the summer, a series of audioconferences, developed by the Public Health Foundation, will be held to assist states and localities in developing and achieving measurable health objectives. A new logo has been designed and the final draft will be open for public comment beginning mid-September. Beginning in early October, there will be five regional meetings for public discussion of the draft objectives. Council members agreed to keep abreast of new developments and to review the final draft objectives when released.

IV. Initiatives in Public Health Education

Prevention Point Person in Medical Schools
Dr. William Barker presented information regarding the Association for Teachers of Preventive Medicine (ATPM) initiative to establish a point person for prevention in medical schools. As presented by Dr. Barker, this idea represents an important step in addressing the need to effectively incorporate preventive and population-based aspects of health and health care delivery into medical education across the pre-clinical and clinical curriculum. The program would potentially be modeled after the Council of Public Health Practice Coordinators established by ASPH. Since medical schools are not teaching a significant amount of preventive medicine, there is a need to advocate accountability. Appointing a contact person for the community would promote partnership and help raise overall awareness of the importance of teaching preventive medicine. In addition, there has been a recent decrease of preventive medicine questions on the licensing exam boards. The Council members strongly supported this effort and through a motion and unanimous vote, agreed to draft a letter of support for the initiative.

CEPH Accreditation of Graduate Programs
Dr. William Keck presented ideas and strategies for developing the relationship between the Council and the Council on Education for Public Health (CEPH). Dr. Keck advocated that the Council should embrace CEPH accreditation because CEPH accreditation is an institutional means by which certain objectives that the Council believes will contribute to a well-trained, competent public health work force can be achieved and sustained. Every five years, the CEPH accreditation criteria are reviewed. After the most recent review, the CEPHS Council renewed its commitment to work toward increasing the value of accredited public health degrees.

In a concept paper provided to Council members in the pre-meeting packet, several relevant CEPH criteria were identified. In addition, ways for the Council and its member organizations to use accreditation for promoting mutually desirable goals were identified in the concept paper. A motion to further explore the suggested actions, identify strategies for implementation, and incorporate the concept into Council objectives, was unanimously passed with one abstention.

The Academic Health Department
Dr. Keck also presented to the Council a proposal to examine the question of what should be done to facilitate the development of academic health departments. As stated by Dr. Keck, an important mechanism to improve the linkage between public health practice and its broad academic base is the inception of academic health departments. There are three key issues that an academic health department helps address if successfully implemented:

  1. Health professional students are not as well prepared as they could or should be to meet the needs of communities;
  2. Community agencies have limited access to expertise needed to assess community needs and responds to changing demands for services; and
  3. Community-based research is currently too limited in quantity and quality.

The academic health department, like academic institutions, rests on the tenets of service, teaching, and research. Dr. Keck’s presentation also highlighted the benefits of forming a formal affiliation between a health professions school and a local health department. The proposal highlighted seven mutual benefits, which focused on the results of building partnerships and raising the awareness of public health among health professions students and community leaders.

Dr. Keck’s proposal identified three suggested action steps for the Council to help promote academic health departments:

  1. Arrange for a full discussion of relevant issues at a national forum;
  2. Ask the National Association of County and City Health Officials to include questions on their next local health department survey intended to identify health departments with academic linkages; and
  3. Propose a mechanism to bring academically oriented health departments together to review the potential for building stronger academic ties involving more local health departments

Through a motion and unanimous vote, the Council agreed to work with APHA to set up a session during the 1998 APHA Annual Meeting and to continue discussions regarding the second and third suggested activities.

V. Competencies Issues Update
Mr. Bialek provided an update on the current status of the Council’s work with competencies. The subcommittee has not met since January, but Council staff has continued to explore potential funders for more substantive project work. It is possible that some future work on refining public health competencies will be funded by HRSA or by the Robert Wood Johnson Foundation (RWJ). Using some of the sites selected for the RWJ Turning Point project, to conduct a competencies assessment of work force, has also been presented as a possibility once work begins. In the next few months, Council staff will continue to work on identifying sources for funding and refining the scope of proposed work as necessary.

VI. Linkages Activities

The Link
Ms. Michon Béchamps reported to the Council that the Summer issue of The Link is on schedule. Through a continuous process, Council staff is striving to make the bulletin a better resource for its readers with up-to-date information. Council staff is also working to update the mailing list, which currently contains more 2,500 names of public health professionals. The Fall issue will focus on topics related to developing a research agenda.
 
Council Web Site
The Council web site is now active and can be found at <www.phf.org/Link.htm>. The web site lists the Council’s mission, goals and objectives, past and current projects, scheduled meetings, The Link articles, and members with hotlinks to the represented organizations. Council staff will continue to update the site as necessary, particularly information about future meetings and articles from The Link. A promotional brochure, based on the web site, is being designed to help promote the purpose and activities of the Council.
 
Linkages Award
This year, 15 public health agencies submitted abstracts for the annual Linkages Award. The review committee was composed of two public health practitioners and two public health academicians. The top three scorers will be selected as winners of the cash awards and will be formally announced during the ASTHO and NACCHO Awards Luncheons during the joint annual meeting in September.

VII. Council Direction

Review of Council Goals and Objectives
As agreed upon during the March 6, 1998, Council meeting, a current listing of Council objectives and action steps were provided in the pre-meeting packets to Council members and will be reviewed on a regular basis. In light of discussion during this meeting, the following revisions were proposed:
  1. Provide leadership and coordination to the process of establishing a comprehensive and coordinated public health research and applications agenda.
  2. Periodically assess the research and applications agenda setting process to ensure that information gaps continue being identified and research activities continue being coordinated.

Strategies:

  1. Reexamine competencies to determine their continued appropriateness and make revisions, if appropriate.
  2. Work with the competencies subcommittee of the Public Health Functions Working Group.
  3. Work with the Council for Education in Public Health to promote and encourage accreditation of all schools and programs that offer public health degrees
  4. Promote the use of the competencies and the importance of accreditation through The Link, other publications, and meetings of practice and academic organizations.

2) (Revised) Work with the managed care sector to identify population-based health training needs and research opportunities and the potential for academic/practitioner teams to be assembled to begin to address these needs.

4) (New) Support ATPM initiatives to revise and update its inventory of skills and knowledge and to implement its proposal to establish a faculty Point Person for Prevention in every accredited medical school.

Report Card
Ms. Marie Flake provided an overview of the Council’s 1994 report card process and led the discussion of how to best accomplish the 1998 report card.

The purpose of developing a report card is to provide accountability for the Council to its funders and member organizations. It also serves to identify best practices, areas that need further work, and the impact and outcomes of developing linkages.

After discussion, Council members decided that the first step should be to review and summarize what is known about changes in linkages between public health academia and practice since the last report card. The Council objectives should be used as a framework for collecting information and developing case studies of "best practices." The draft report will be disseminated to Council members and eventually submitted for publication in public health journals or newsletters. The potential audience includes funders, member organizations, public health practice coordinators, prevention point persons at schools of medicine, public health practitioners, graduate students and other interested public health professionals. It was agreed to use the Council objectives as a framework.

Participation Agreement
The draft Participation Agreement, which was initially shared with the Council during its last meeting, was approved without comment. Council staff will distribute the final version to all Council members and the organizations that they represent to sign and return; the signed agreement will be kept on file.

VIII. Administrative Business
Dr. Lipsman announced the dates for the remaining meetings in 1998:

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