New PHSR Grants Announced

Title: Characteristics and Determinants of Intragovernmental Activity Within State Public Health Systems
Grantee Institution: University of Massachusetts at Amherst (School of Public Health)
Principal Investigator: William Bartosch, Ph.D.
Grant Period: 1/1/08–8/31/09
Paragraph Summary: The researchers will examine intragovernmental activities within Connecticut, Massachusetts, New Hampshire, and New York to determine their impact on fragmentation in the public health system. They will study the interactions of state administrative agencies in addressing three public health challenges— substance abuse, HIV/AIDS, and emergency preparedness— to better understand how they facilitate or impede efficient and effective implementation of core public health functions.  In particular, they will: 1) identify the types of intragovernmental activities within state public health systems that are required by law or regulation; 2) describe the types of intragovernmental activities that occur in states that are intended to address core public health functions; 3) identify factors influencing the type of engagement and barriers to such activity; and 4) identify models of successful intergovernmental collaboration. The objective of this project is to generate lessons for states about how they can more efficiently and effectively identify and respond to public health problems with scarce resources.

Title: A Systematic Study of Nebraska’s Regional Public Health Agency Model
Grantee Institution: Board of Regents of the University of Nebraska (University of Nebraska Medical Center)
Principal Investigator: Li-Wu Chen, Ph.D.
Grant Period: 1/1/08–12/31/09
Paragraph Summary: The researchers will evaluate Nebraska’s change from single-county health departments to multi-county or regional public health systems. The researchers posit that a regional approach could have advantages for states like Nebraska due to the state’s relatively small population base and large geographic area. They will examine the regional public health agency model based on variation and/or effectiveness of the following factors: 1) macro context, i.e., political, social, and economic environment; 2) structural capacity, i.e., human, organizational, fiscal, and informational resources; 3) processes, i.e., community partnerships, resource allocation; and 4) outcomes, i.e., practice and performance of public health services. The objective of this project is to inform federal and state policymakers about the lessons learned through Nebraska’s experience with a regional public health agency model, so that performance of public health practice can be improved. 

Title: Understanding the Resource Allocation Decisions of Public Health Officials in the U.S.
Grantee Institution: The Regents of the University of Michigan (University of Michigan Health System)
Principal Investigator: Susan Dorr Goold, M.D., M.S.H.A., M.A.
Grant Period: 1/1/08–12/31/09
Paragraph Summary: The researchers will examine the nature and scope of resource allocation decisions made by public health officials. They will: 1) describe the nature and scope of resource allocation decisions officials confront; 2) identify the processes officials use when they make allocation decisions; 3) assess the degree of discretion officials report in allocating resources and the factors that influence that discretion; and 4) explore whether discretion affects officials’ abilities to assure that their communities’ most important public health needs are met. The objective of this project is to better inform discussions of public health system function by shedding light on how resource allocation decisions are made and the extent to which variation exists in those processes as a result of varying levels of discretion among public health officials.

Title: Local Public Health Capacities to Address the Needs of Culturally and Linguistically Diverse Populations
Grantee Institution: NORC
Principal Investigator: Claudia Schur, Ph.D.
Grant Period: 1/1/08–3/31/09
Paragraph Summary: The researchers will examine the public health needs of culturally and linguistically diverse populations. Specifically, they will develop detailed community multicultural profiles describing the cultural and linguistic diversity of populations served by local health departments (LHDs).  They will then use these profiles to analyze the relationships between population characteristics and existing public health capacity and to identify and survey select communities for more in-depth information about serving these populations. They will seek answers to the following research questions: 1) How do jurisdictions with LHDs compare in terms of the composition of the population served? To what extent do communities include substantial numbers of racial/ethnic minorities, immigrants, and/or persons who speak a language other than English? 2) Does the structure and capacities of LHDs vary with respect to the multicultural profile of the populations they serve? How do LHD resources and activities correspond to local community characteristics? 3) What are the specific strategies that LHDs engage in to meet the needs of diverse populations? What types of strategies appear to be most successful? Are community partnerships used either for training purposes or for the delivery of culturally appropriate services? 4) What obstacles appear to be most difficult to overcome in serving different types of population subgroups? Which types of services are most difficult to deliver? What characteristics or combinations of characteristics of communities and LHDs create the most substantial obstacles? The objective of this project is to develop policy recommendations for implementation of promising strategies to better serve diverse populations.

Title: Developing and Applying a Descriptive Framework for Analyzing Food Safety Resources
Grantee Institution: The George Washington University School of Public Health and Health Services
Principal Investigator: Michael Taylor, J.D.
Grant Period: 1/1/08–6/30/09
Paragraph Summary: The researchers will develop a descriptive framework for public health-oriented analysis of food safety resources. The researchers will use the framework to describe and analyze federal food safety expenditures comprehensively and will apply it on a pilot basis to selected states and localities. Development of the framework will necessitate addressing the following research questions: 1) How should government food safety expenditures be organized into functional categories that enable the evaluation of resource allocation from a public health perspective? 2) Can actual food safety expenditure data be translated into these public health-oriented categories in a way that is feasible and useful for policymakers? 3) How are federal food safety resources allocated across these public health-oriented categories? 4) What are the recent trends in federal food safety expenditures across the system and across these public health-oriented categories, including federal allocations to state and local agencies? 5) How does the current federal resource allocation compare with what data and expert judgment suggest about opportunities to reduce risk across the system? 6) Can the framework be feasibly and usefully applied to state and local expenditures, taking into account budget data availability and the large number of individual agencies? 7) For a pilot set of states and localities, how are current food safety resources allocated across public health-oriented categories? and 8) What budgetary practices of government agencies foster or impede understanding and analysis of food safety expenditures from a public health perspective? The objective of this project is to provide policymakers with a tool for describing and analyzing government food safety expenditures on a system-wide basis and in ways that are relevant to reducing food borne illness.

Title: Informing the Design of Funding Allocation Formulas in Public Health
Grantee Institution: Emory University, Rollins School of Public Health
Principal Investigator: James Buehler, M.D.
Grant Period: 1/1/08–12/31/09
Paragraph Summary: The researchers will examine formula-based allocation strategies in public health practice. In particular, they will assess the impact on funding allocations of various formula design options, including the use of different indicators of target population need, the cost of providing services, state or local resource availability, and various approaches to combining indicators in formula calculations. The will also study the policy implications associated with using different indicators or strategies, including measures of population health disparities and approaches to assuring equity versus equivalency in funding allocations. The objective of this project is to generate practical guidance for public health program managers seeking to make informed choices when developing allocation formulas to best serve program goals.

 
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