Population health Interventions need to influence prevalence of a disease or health issue, including prevalence within populations. This calls for a balanced portfolio that addresses the multiple determinants of health: health care, genetics, environment health behaviors, and social determinants. A balanced portfolio includes:
• Strategies at the clinical, community-linkage, and total population level
• Science-based strategies from literature review and proven practice (look for information on effectiveness, and any economic evaluations)
• Innovative strategies, especially when research doesn’t include populations of focus
Some important considerations when developing interventions:
• Incorporate social determinants of health, the socio-ecological model, place matters, and life course approach (see Resources Index for more information on these models and frameworks.)
• Identify options, including policy, systems and environmental change, programmatic interventions, and health promotion. Include interventions in each of these categories to strengthen your overall approach.
• Engage community partners in prioritizing interventions and developing action plan
• Allocate and align resources necessary for implementation
While planning the interventions, also plan for sustainability. How will the desired outcomes be sustained over time? Funding is often the first consideration when thinking about sustainability, yet infrastructure, policy, and community buy-in are equally important. Tools to help with sustainability planning can be found in the Resources below.
Challenge: Some funding sources require proven interventions; partners and stakeholders may want to pursue innovative interventions.
- Try: When adding interventions that are not recognized as best practices, include a rationale (i.e. strategy is necessary for cultural sensitivity to target community) and cite any research you may have to support using the innovative intervention. Put evaluation strategies in place from the start to assess the success of any intervention not classified as evidence-based. You may be able to develop a new best practice that will benefit not only your community but others as well.
Challenge: Sustainability planning may begin too late in the process.
- Try: Include sustainability planning at the beginning of a project or program. Revisit along the way as needs, resources, and opportunities evolve.
Challenge: Partners may perceive sustainability as strictly a matter of funding.
- Try: Identify the infrastructure, policy and procedures needed to sustain outcomes. Then break them down into those that require funding. Form a work group to identify potential funding sources as well as opportunities to leverage existing funds.
Challenge: Health care systems are struggling to keep up with the demands of health transformation, limiting capacity for sustainability planning.
- Try: Engage partners that want the same outcome even though they may have different reasons. For example, rental property owners may support smoke-free housing because it reduces fire hazard and cleaning costs. Smoke-free housing also benefits community health by reducing indoor secondhand smoke.
Challenge: The public may not realize the value of a population health achievement.
- Try: Tell the story of good results in many ways and at different points in time. Help communities connect the dots between successful interventions and health outcomes. For more tools, see the Communications section.
- The Guide to Community Preventive Services, USA.gov
- The 6/18 Initiative: Accelerating Evidence into Action, Centers for Disease Control
- The Socio-Ecological Model: a Framework for Prevention, Centers for Disease Control and Prevention
- A Life Course Approach to Health, World Health Organization
- Social Determinants of Health, Healthy People 2020
- Aligning with Foundational Public Health Services, Department of Health
- Aligning Clinical-Community Linkages, Agency for Healthcare Research and Quality
- Aligning with Hospital Benefit Nonprofit Hospitals' Community Benefit Requirements (PDF), HealthAffairs.org
- Aligning with Value-Based Payment Road Map, Washington Health Care Authority
- Social Impact Bonds, Centers for Disease Control and Prevention
- "Financing Population Health Improvement," Institute of Medicine