SPREAD, SCALE, and
SUSTAINABILITY in
POPULATION HEALTH
WORKSHOP SUMMARY
Theresa Wizemann and Darla Thompson, Rapporteurs
Roundtable on Population Health Improvement
Board on Population Health and Public Health Practice
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and Aetna Foundation (#10001504), The California Endowment (20112338), Kaiser East Bay Community Foundation (20131471), The Kresge Foundation (101288), Missouri Foundation for Health (12-0879-SOF-12), New York State Health Foundation (12-01708), and the Robert Wood Johnson Foundation (70555). The views presented in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-37117-9
International Standard Book Number-10: 0-309-37117-1
DOI: 10.17226/21708
Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
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Copyright 2015 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
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Suggested citation: IOM (Institute of Medicine). 2015. Spread, scale, and sustainability in population health: Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE FOR SPREAD, SCALE, AND
SUSTAINABILITY IN POPULATION HEALTH1
DEBBIE CHANG (Co-Chair), Vice President, Policy and Prevention, Nemours
JACQUELINE MARTINEZ GARCEL (Co-Chair), Vice President, New York State Health Foundation
J. DAVID HAWKINS, Endowed Professor of Prevention and Founding Director of the Social Development Research Group, University of Washington, Seattle
KERRY ANNE McGEARY, Senior Program Officer, Robert Wood Johnson Foundation
KEVIN NOLAN, Statistician and Consultant, Associates in Process Improvement
WYNNE E. NORTON, Assistant Professor, School of Public Health, Department of Health Behavior, University of Alabama at Birmingham
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
___________________
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners, Inc., and Senior Fellow, HealthPartners Institute for Education and Research
DAVID A. KINDIG (Co-Chair), Professor Emeritus and Emeritus Vice Chancellor, University of Wisconsin School of Medicine and Public Health
TERRY ALLAN, President, National Association of County and City Health Officials, and Health Commissioner, Cuyahoga County Board of Health
CATHERINE BAASE, Global Director of Health Services, The Dow Chemical Company
GILLIAN BARCLAY, Vice President, Aetna Foundation
RAYMOND J. BAXTER, Senior Vice President, Community Benefit, Research and Health Policy, Kaiser Permanente, and President, Kaiser Permanente International
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
GEORGE R. FLORES, Program Manager, The California Endowment
JACQUELINE MARTINEZ GARCEL, Vice President, New York State Health Foundation
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
MARTHE R. GOLD, Arthur C. Logan Professor and Chair, Department of Community Health and Social Medicine at the Sophie Davis School of Biomedical Education, City College of New York
GARTH GRAHAM, President, Aetna Foundation
PEGGY A. HONORÉ, Director, Public Health System, Finance and Quality Program, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services
ROBERT HUGHES, President and Chief Executive Officer, Missouri Foundation for Health
ROBERT M. KAPLAN, Chief Science Officer, Agency for Healthcare Research and Quality
JAMES KNICKMAN, President and Chief Executive Officer, New York State Health Foundation
PAULA LANTZ, Professor and Chair, Department of Health Policy, Milken Institute School of Public Health, The George Washington University
MICHELLE LARKIN, Assistant Vice President, Health Group, Robert Wood Johnson Foundation
___________________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
THOMAS A. LaVEIST, William C. and Nancy F. Richardson Professor in Health Policy, and Director, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
JEFFREY LEVI, Executive Director, Trust for America’s Health
SARAH R. LINDE, Rear Admiral, U.S. Public Health Service, Chief Public Health Officer, Health Resources and Services Administration
SANNE MAGNAN, President and Chief Executive Officer, Institute for Clinical Systems Improvement
PHYLLIS D. MEADOWS, Associate Dean for Practice, Office of Public Health Practice, School of Public Health, University of Michigan, and Senior Fellow, Health Program, The Kresge Foundation
JUDITH A. MONROE, Director, Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention
JOSÉ MONTERO, President, Association of State and Territorial Health Officials, and Director, New Hampshire Division of Public Health Services
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
LILA J. FINNEY RUTTEN, Associate Scientific Director, Population Health Science Program, Department of Health Sciences Research, Mayo Clinic
BRIAN SAKURADA, Senior Director, Managed Markets and Integrated Health Systems
MARTÍN JOSE SEPÚLVEDA, Fellow and Vice President, Health Industries Research, IBM Corporation
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
IOM Staff
ALINA B. BACIU, Study Director
COLIN F. FINK, Senior Program Assistant
AMY GELLER, Senior Program Officer
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
DARLA THOMPSON, Associate Program Officer
ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice
Consultant
THERESA WIZEMANN, Rapporteur
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Pierre Barker, Institute for Healthcare Improvement
Angela Diaz, Icahn School of Medicine at Mount Sinai
David J. Erickson, Federal Reserve Bank of San Francisco
Paul Jellinek, Isaacs/Jellinek
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Bruce N. Calonge, The Colorado Trust. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
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Contents
Organization of the Workshop and Summary
Spread, Scale, and Sustainability in Population Health
Interactive Activity: Making Sense of Spread, Scale, and Sustainability
3 APPROACHES TO SPREAD, SCALE, AND EVALUATION OF IMPACT
USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project
Coordinated Approach to Child Health (CATCH)
CMMI Population and Preventive Health Models
5 LEARNING FROM THE SPREAD AND SCALE OF TOBACCO CONTROL: FROM CONCEPT TO MOVEMENT
Smoking Prevention in Youth: The truth® Campaign
Federal Perspective on Scaling Tobacco Control
Spread and Scale to Reach Diverse Communities
Changing Social Norms and Policy
6 ACCELERATING SPREAD AND SCALE IN POPULATION HEALTH
From Contemplation to Action: Keys to Getting Started and Scaling Efficiently
| ACO | accountable care organization |
| ASSIST | American Stop Smoking Intervention Study (NCI) |
| ASSIST | Applying Science to Strengthen and Improve Systems (USAID) |
| CACTI | Center for the Advancement of Critical Time Intervention |
| CATCH | Coordinated Approach to Child Health |
| CDC | U.S. Centers for Disease Control and Prevention |
| CMMI | Center for Medicare & Medicaid Innovation |
| CMS | Centers for Medicare & Medicaid Services |
| CTI | Critical Time Intervention |
| IHI | Institute for Healthcare Improvement |
| IOM | Institute of Medicine |
| NCI | National Cancer Institute |
| NIMH | National Institute of Mental Health |
| TPCB | Tobacco Prevention and Control Branch (North Carolina) |
| USAID | U.S. Agency for International Development |
