Academic and Practice Partnerships: Building an Effective Public Health System Focusing on Public Health Preparedness and Response

Schools and programs of public health accredited by the Council on Education for Public Health (CEPH) are vitally concerned with supporting effective public health initiatives, which they do through the generation and application of evidence-based public health science and knowledge. The ability of the public health workforce to deliver high-quality public health services is likely to be strengthened by bringing the resources of these schools and programs of public health to public health practitioners and by having these schools and programs partner with public health organizations, including federal, state, tribal, local, and territorial public health departments.

The transition to a more effective public health academic–practice partnership can be traced back to at least 1988, when the Institute of Medicine (IOM) published The Future of Public Health.¹ In this report, the IOM identified the three core functions of public health practice as

1. Assessment—the ability to appropriately use data to direct actions;

2. Policy development—the appropriate use of scientific knowledge in developing public health policies and programs; and

3. Assurance—the development of policies that are backed up by services necessary to ensure their success.

In 1999, building on the IOM report, the Council of Public Health Practice Coordinators of the Association of Schools of Public Health formally recognized academic public health practice as a new domain of scholarship. In its document Demonstrating Excellence in Academic Public Health Practice, the Council defined academic public health practice as “the applied, interdisciplinary pursuit of scholarship in the field of public health,”^(p9) and it noted that the discipline should be grounded in practice-based research, teaching, and service.²

Today, CEPH-accredited schools and programs remain committed to the principles of the IOM and Council reports and to fulfilling their roles as providers of quality public health research and training. This AJPH supplement provides a window into how that work continues and how partnerships between those in academia and those in practice have been used to enhance the effectiveness of the public health system, in this case focusing on public health emergency preparedness and response.

RESEARCH CENTERS

In December 2006, the US Congress passed the Pandemic and All-Hazards Preparedness Act (PAHPA), the mission of which was “to improve the nation’s public health and medical preparedness and response capabilities for emergencies, whether deliberate, accidental, or natural.”³ In January 2008, in its letter report Research Priorities in Emergency Preparedness and Response for Public Health Systems, the IOM recommended four specific research priorities that would be particularly relevant to areas of expertise represented in schools of public health.⁴ In turn, that same year the Centers for Disease Control and Prevention (CDC) Coordinating Office for Terrorism and Emergency Preparedness and Response used these priority recommendations to develop the announcement for the Preparedness Emergency Response Research Centers (PERRC) program (bit.ly/2KYr9Po). The stated intent of this CDC-funded program was to provide financial support to schools of public health for applied public health systems research aimed at strengthening and improving national public health preparedness and emergency response capabilities (PERRCs).

LEARNING CENTERS

In 2010, another major CDC-funded initiative, the Preparedness and Emergency Response Learning Centers (PERLC) program, took shape.⁵ The intent of this program, which also stemmed from the PAHPA legislation, was to provide financial support to academic public health centers (PERLCs) for the development of competency-based emergency preparedness training to enhance the readiness of the public health workforce. PERLCs facilitated the development of practical and useful products, resources, and training for public health practitioners by working in collaboration with practice partners from state, tribal, local, and territorial public health agencies, health care organizations, and nonprofit organizations.

RESEARCH CENTER AND LEARNING CENTER OUTPUT

The PERRC and PERLC programs involved faculty and staff at CEPH-accredited schools of public health and resulted in a vast array of research projects and training products, many of which advanced the state of emergency preparedness of the public health workforce at various government public health agency levels. The PERRC program produced more than 130 peer-reviewed articles and approximately 80 training tools and resources for public health practitioners.⁶ The PERLC program was responsible for close to 700 training tools and resources.⁵ In addition, the CDC engaged PERRCs in the development of the inaugural National Health Security Preparedness Index, which was designed to “provide an accurate portrayal of our nation's health security using relevant, actionable information to help guide efforts to achieve a higher level of health security preparedness.”^7(p6)

Translation and Dissemination

Despite the contributions of the PERRC program to the national research agenda and the outreach of the PERLC program to the public health workforce, as these programs came to an end, unfinished business remained: the knowledge gleaned from public health research needed to be more fully translated into public health practice and new information, and training tools needed to be disseminated more broadly into all public health practice settings.

To address these issues, in 2015 the CDC selected the Association of Schools and Programs of Public Health (ASPPH) to serve as the coordinating center for a next phase of work involving PERRCs and PERLCs. This two-year cooperative agreement (fall 2015–fall 2017) provided funding for an initiative focused on the translation of research outcomes and the dissemination of promising practices in the field. The goal was to strengthen the competence of the nation’s public health workforce, ultimately leading to an upgraded national public health preparedness and response infrastructure and improved health security for the US population.

ASPPH recently commissioned an evaluation of this Translation, Dissemination, and Implementation of Public Health Preparedness and Response Research and Training project. The evaluation validated the beneficial role of formalized public health academic–practice partnerships in building the capacity of state, local, tribal, and territorial health departments to prevent, detect, and respond to public health emergencies. Having identified particular barriers to translating public health preparedness research into public health practice, the evaluation also provided recommendations for bolstering the translation process. Proposed activities for this included creating more opportunities for interaction between the research and practice communities, engaging in capacity-building with public health practitioners by focusing on how to adapt evidence-based practices to local contexts, and ensuring training tools and resources available are stable and sustainable, preferably through a central online location.

Partnerships for Research and Training

In this supplemental issue of AJPH, investigators from PERRCs and PERLCs who received grants as part of the Translation, Dissemination, and Implementation of Public Health Preparedness and Response Research and Training project report on their activities. These activities were designed to address one of three possible objectives:

1. Synthesize and disseminate research findings from PERRCs;

2. Synthesize and disseminate training products from PERLCs; or

3. Move new knowledge resulting from public health preparedness response research and training into practice and policy.

The supplement contains noteworthy examples of how PERRCs and PERLCs have contributed to the accelerated synthesis, dissemination, and promotion of public health emergency preparedness and response research findings and training resources into broader public health practice and policy. Furthermore, the articles herein provide evidence of how public health academic–practice partnerships can be used, not only to enhance the effectiveness of both sectors but also to promote the application of new knowledge to improve population health. The next steps will be to extend the use of these types of collaborations between schools and programs of public health and public health practice partners and to use the resulting knowledge and resources to build an even more effective public health system.