| January 2, 2006
As a new member, I'm testing this site for its utility as a place to record random observations and thoughts that I dare share with the world. There might not be many worth sharing, but this can at least serve temporarily as an alternative portal to my website (www.lgreen.net) where I record things related to public health that I think worth sharing and worth maintaining in some greater degree of organization. Here I will record thoughts as they arise, in the spirit of a blog, but also as a place to draft ideas for a forthcoming speech or paper and to invite comments from friends and colleagues. The following are thoughts for a speech I will make in Scottsdale this week as a member of the National Advisory Committee for the Robert Wood Johnson Foundation's Prescription for Health grant program, and for a commentary I'm preparing for the American Journal of Preventive Medicine for a special issue of that journal on the CDC-funded Prevention Research Centers.
My Abiding Issue: Getting Science into Public Health Practice
An existential focus in this quasi-retirement phase of my public health career is to build a better link between science and practice, having observed and contributed to the accumulation of a gigantic database and scientific grounding for the social and behavioral sciences in public health over the past 45 years, but also observing that much of it is not of great interest to policy makers, program planners, and practitioners in the field. I've devoted a good deal of my academic, international and federal government career, and three years as Vice President of the Kaiser Family Foundation, trying to push more of the scientific evidence into the pipeline from research to practice by professionals and the public.
In recent years, I've concluded that the problem is not so much the lack of information, if it ever was. People have a glut of information available to them, and the glut is evermore accessible by search engines, PDAs, and even intrusively imposed by pop-ups, podcasts, spamcasts and other electronic technologies. As John Nesbitt said in Megatrends, [something like:] "We are drowning in information, but starved for knowledge." The missing link for making our research more knowledge-based, accessible and usable for those who might need it is to devote more effort to engaging the intended or potential end-users more actively in the process of generating the knowledge--at least in posing the research questions--so that it will be assured of being more relevant to their needs.
The report of an Institute of Medicine (National Academies) committee I chaired in 1996 (Stoto MA, Green LW, & Bailey LA, Linking Research and Public Health Practice: A Review of CDC's Program of Centers for Research and Demonstration of Health Promotion and Disease Prevention, Washington, DC: National Academy Press, 1997; http://books.nap.edu/catalog/5564.html) to review the CDC-funded Prevention Research Centers (PRCs) recommended, inter alia, that:
- PRCs should document the impact of their activities on public health research, practice, and policy, both locally and nationally.
- The PRCs should adopt a community-based approach to their research and demonstration efforts.
- The PRC program, as a whole, should increase its focus on dissemination efforts.
- PRCs should seek to be part of regional and national networkds for prevention that include CDC, the public health practice community, and other relevant parties.
- The PRCs should increase their dissemination research efforts.
- CDC should modify its definition of prevention research as articulated in the application guidelines for the PRC program to encompass the broader scope of health promotion research that is needed to address the underlying determinants of health (risk conditions) and to build the capacity of individuals and communities to "cultivate health," rather than to focus soley on those determinants with immediate application to disease prevention (risk factors).
- CDC should develop strategies for improving community input into the PRCs.
Participatory Research
This followed closely on the heels of a report issues by the Royal Society of Canada on Study of Participatory Research in Health Promotion: Review and Recommendations for the Development of Participatory Research in Health Promotion in Canada (Green LW, George MA, Daniel M, Frankish CJ, Herbert CJ, Bowie WR, O'Neill M, Institute of Health Promotion Research & the BC Consortium for Health Promotion Research, Vancouver. Ottawa: The Royal Society of Canada, 1995). Participatory research was catching on as an alternative to the academically driven research agenda that had seemed to miss the point of many community and professional needs for public health research.
Today, community-based participatory research (CBPR) has taken root in the calls for grant applications from many federal agencies and foundations. Two prominent books out of prominent schools of public (Minkler M, Wallerstein N at UC Berkeley, Participatory Research for Health, and Israel B et al. at the University of Michigan, both published by Jossey-Bass of San Francisco) have heralded the arrival of this approach to research efforts in community health. A growing peer-reviewed literature and a new journal from Johns Hopkins Univeristy devoted to community partnerships and participatory research further attest to the demand for and the growing supply of participatory research. |
