Council on Linkages Between Academia and Public Health Practice

Bringing Two Worlds Together:
Graduate Research in Health Practice

Carroll S. Nason, Dr.P.A.; Stuart A. Capper, Dr. P.H.

One of the positive outcomes of the changing health care delivery system has been the impetus for health care providers to establish partnerships with various groups to share resources, achieve efficiencies and improve services. Increasingly, public health is adopting this model as it strives to improve population-based health services and community health status.

With this reliance on collaborative approaches to health care delivery comes the obvious need to involve practice-based issues within the educational preparation of public health students. In the column "Academic Perspectives" from the Journal of Public Health Management Practice1, Louis Rowitz makes the case that linkages between public health practice and schools of public health are essential to strengthening the public health system in this country. Rowitz cites ten barriers academics face when establishing these linkages, many of which can be addressed through changes in academic curriculum.

The student project in the course "Introduction to Population Based Health Programs," a core requirement for all MPH and MSPH candidates at the University of Alabama at Birmingham School of Public Health, is designed to facilitate practice/academic interaction and reduce many of the barriers Dr. Rowitz identifies. The project requires that students, in teams, conduct research on specific public health programs and services within a practice setting or a functioning public health program at the state or local level. Students must extensively research their chosen program’s history, population and finances, as well as its scientific and public health rationale and successes, and present their findings in a written report and as an in-class presentation using PowerPoint software. (See sidebar description for specific elements which students are required to include in their reports.)

Because it requires students to interact with practicing public health officials-generally at senior levels of the health department-and because it is co-taught by individuals with practice and academic experience, the course serves as a channel for broadening what is usually a barrier to successful partnerships: the lack of public health practice experience of academic faculty. Additionally, since students are required to attend presentations from each different team (each analyzing a different program) participating in the course, the course affords students a generalized knowledge base from which to understand the scope of public health practice. While specialization is certainly the route to academic success, public health practice usually requires the opposite-a broad range of skills to address a variety of problems and offer a number of possible interventions. By understanding not just one but many different programs of a health department, students and faculty alike can enhance the breadth of their knowledge base.

Successful linkages and collaborations between public health practice and academic public health evolve in environments of shared understanding, mutual respect and common purpose. A primary objective in this detailed research project is to develop the foundation within each individual future public health practitioner for understanding the scope of the public health system and appreciating the importance of collaboration as key to the system’s future success. More importantly, this project provides students with an academic understanding that is strongly grounded in the realities of public health practice. Toward this end, the course prepares the student for one of the most fundamental goals of the MPH degree: the ability to think critically about the delivery of population-based public health programs.

Student guidelines for Introduction to Population-Based Health Programs

Identification of the project

• Description of the service(s) provided by the health department
• Identification and description of the customers for this service, internal, external or both.  What terminology does the program use to describe its customers-client, patient, user, etc.

Program’s public health significance

• Description of the purpose and public health importance of the service(s) provided
• Description of the activities undertaken to produce the service.
• Specific written goals and objectives for the services, and their relationship to the goals of Healthy People 2000 or other national standards.

History

• How the service came about—legal or political mandate, federal initiative, categorical grant or other enterprise such as a community needs assessment
• Documentation of any written information regarding the program’s establishment, including the date service(s) started.
• Description of changes, in any, in purpose, scope or type of services, target population and funding that the service has experienced in its history.  What brought about these changes (funding reduction, changing public policies, new medical or scientific findings, organizational changes, changes in the market share, etc.)?

Scientific Basis for the Service(s)

• Central to the paper is a thorough literature search documenting the science that justifies the provision of the service(s) and describing the scientific basis for the service(s) provided.  If there is no specific scientific basis then the paper should focus on a discussion of why the service is provided.
• Discussion of how the service impacts the health status of the community.
• Discussion of the program in population-based terms.

Utilization of the Service

• For population-based programs, describe the population group, including relevant demographic characteristics.
• Present utilization data for each relevant population, as well as data on utilization trends.

Financing

• How is the service(s) financed (including fee income and all other areas of program support)?
• Present applicable trend data on funding sources.
• Present current budget and budgetary trend data, if available.

Evaluation

• Describe any cost analysis conducted for this service.
• Describe any performance analysis undertaken by the department to determine effectiveness of the service.  What types and sources of data were used as the basis for determining effectiveness?  If surveillance data are collected, describe the surveillance system. Summarize any literature that discusses the effectiveness of the service(s).

Strategic Planning

• Describe any written plans for organizing and financing this service in the future.
• Describe any new partnerships that have developed, or existing ones which have changed as part of future planning.