Skip to main content
SpringerLink
Log in

Priority setting for evidence-based health outreach in community-based organizations: a mixed-methods study in three Massachusetts communities

  • Original research
  • Published:
Translational Behavioral Medicine

Abstract

Priority setting, or determining how to best allocate limited resources, is an important first step for evidence-based public health approaches in community-based organizations (CBOs), but guidance for such work is limited. This study aims to study drivers of priority setting and the way CBOs use data for this work. Data come from PLANET MassCONECT, a Community-Based Participatory Research project focused on knowledge translation among CBOs targeting the underserved in Boston, Lawrence, and Worcester, MA. We conducted four focus group discussions with CBO staff members (31 participants) in 2008 and a survey of 214 CBO staff members in 2009. Multiple, often competing factors appear to drive priority setting, including data, funding, partnerships, and community preferences. The process may be hindered by challenges related to finding, evaluating, and utilizing data for priority setting. Supporting CBOs in efforts to use data effectively and incorporate context into systematic priority-setting processes is vital.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Institute of Medicine Committee for the Study of the Future of Public Health. The Future of Public Health. Washington, DC: National Academies; 1988.

    Google Scholar 

  2. Kohatsu ND, Robinson JG, Torner JC. Evidence-based public health: an evolving concept. Am J Prev Med. 2004;27(5):417-421.

    PubMed  Google Scholar 

  3. Green LW, Kreuter MW. Health Program Planning: An Educational and Ecological Approach. 4th ed. New York: McGraw-Hill; 2005.

    Google Scholar 

  4. Brownson RC, et al. Evidence-Based Public Health. New York: Oxford University Press; 2011.

    Google Scholar 

  5. Brownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health. 2009;30:175-201.

    Article  PubMed  Google Scholar 

  6. Brownson RC, Gurney JG, Land G. Evidence-based decision making in public health. J Public Health Manag Pract. 1999;5(5):86-97.

    PubMed  CAS  Google Scholar 

  7. Rychetnik L, et al. A glossary for evidence based public health. J Epidemiol Community Health. 2004;58:538-545.

    Article  PubMed  Google Scholar 

  8. Maibach EW, Van Duyn MAS, Bloodgood B. A marketing perspective on disseminating evidence-based approaches to disease prevention and health promotion. Prev Chronic Dis. 2006; 3(3).

  9. Kerner J, et al. Translating research into improved outcomes in comprehensive cancer control. Cancer Causes Control. 2005;16(Suppl 1):27-40.

    Article  PubMed  Google Scholar 

  10. World Health Organization. Health 21: Health for All in the 21st Century. Copenhagen: World Health Organization Regional Office for Europe; 1999.

    Google Scholar 

  11. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies; 2001.

    Google Scholar 

  12. Institute of Medicine, Challenges and Successes in Reducing Health Disparities: Workshop Summary. Institute of Medicine: Washington, DC. 2008.

  13. Viswanath K. Public communication and its role in reducing and eliminating health disparities., in Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Thomson GE, Mitchell F and Williams MB, eds. Institute of Medicine: Washington, DC. 2006: p. 215–253.

  14. Flaman LM, et al. Exploring facilitators and barriers to individual and organizational level capacity building: outcomes of participation in a community priority setting workshop. Glob Heal Promot. 2010;17(2):34-43.

    Article  Google Scholar 

  15. Mooney G. Communitarian claims and community capabilities: furthering priority setting? Soc Sci Med. 2005;60:247-255.

    Article  PubMed  Google Scholar 

  16. Laverack G, Labonte R. A planning framework for community empowerment goals within health promotion. Health Policy Plan. 2000;15(3):255-262.

    Article  PubMed  CAS  Google Scholar 

  17. Green A, Barker C. Priority setting and economic appraisal: whose priorities—the community or the economist? Soc Sci Med. 1988;26(9):919-929.

    Article  PubMed  CAS  Google Scholar 

  18. Peacock S, et al. Overcoming barriers to priority setting using interdisciplinary methods. Health Policy. 2009;92(2–3):124-132.

    Article  PubMed  Google Scholar 

  19. Hauck K, Smith PC, Goddard M. The Economics of Priority Setting for Health Care: A Literature Review, in Health, Nutrition, and Population Family Discussion Papers. Washington, DC: World Bank; Human Development Network; 2004.

    Google Scholar 

  20. Gibson JL, Martin DK, Singer PA. Setting priorities in health care organizations: criteria, processes, and parameters of success. BMC Health Serv Res. 2004; 4(1):25.

    Google Scholar 

  21. Sibbald SL et al. Priority setting: what constitutes success? A conceptual framework for successful priority setting. BMC Health Services Research. 2009; 9(1):43.

    Google Scholar 

  22. Institute of Medicine, Priority Areas for National Action: Transforming Health Care Quality, Adams K and Corrigan JM, eds. Institute of Medicine; Committee on Identifying Priority Areas for Quality Improvement: Washington, DC. 2003.

  23. Jacobs LM, Elligers JJ. The MAPP approach: using community health status assessment for performance improvement. J Public Health Manag Pract. 2009;15(1):79-81.

    PubMed  Google Scholar 

  24. KU Work Group for Community Health and Development. The Community Tool Box. [cited 2012 September 13] 2010.

  25. Fixsen DL et al. Implementation Research: A Synthesis of the Literature, University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.: Tampa, FL. 2005.

  26. Brownson RC, Colditz GA, Proctor EK, eds. Dissemination and implementation research in health: Translating science to practice. New York: Oxford University Press; 2012.

    Google Scholar 

  27. Lavis JN, et al. Assessing country-level efforts to link research to action. Bull World Health Organ. 2006;84(8):620-628.

    Article  PubMed  Google Scholar 

  28. Martinez LS, et al. Community conceptualizations of health: implications for transdisciplinary team science. Clin Transl Sci. 2011;4(3):163-167.

    Article  PubMed  Google Scholar 

  29. Wilson MG et al. Community-based knowledge transfer and exchange: Helping community-based organizations link research to action. Implement Sci. 2010; 5(33).

  30. Kapiriri L, Norheim OF, Martin DK. Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making? Soc Sci Med. 2009; 68: p. 766–773.

    Google Scholar 

  31. Chambers DA and Kerner J. Closing the Gap between Discovery and Delivery. Dissemination and Implementation Research Workshop: Harnessing Science to Maximize Health. Rockville, MD 2007.

  32. Swinburn B, Gil T, Kumanyika S. Obesity prevention: a proposed framework for translating evidence into action. Obes Rev. 2005;6(1):23-33.

    Article  PubMed  CAS  Google Scholar 

  33. Ramanadhan S, et al. Perceptions of evidence-based programs by staff of community-based organizations tackling health disparities: a qualitative study of consumer perspectives. Heal Educ Res. 2012;27(4):717-728.

    Article  Google Scholar 

  34. Mitton CR, Donaldson C. Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA). Health Policy. 2003;64(3):335-348.

    Article  PubMed  Google Scholar 

  35. Kapiriri L, Norheim OF, Heggenhougen K. Using burden of disease information for health planning in developing countries: the experience from Uganda. Soc Sci Med. 2003;56:2433-2441.

    Article  PubMed  Google Scholar 

  36. Menon D, Stafinski T, Martin DK. Priority-setting for healthcare: who, how, and is it fair? Health Policy. 2007;84(2–3):220-233.

    Article  PubMed  Google Scholar 

  37. Israel BA, et al. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173-201.

    Article  PubMed  CAS  Google Scholar 

  38. Minkler M, Wallerstein N. In: Minkler M, Wallerstein N, eds. Introduction to Community-Based Participatory Research, in Community-based Participatory Research for Health: From Process to Outcomes. San Francisco: Jossey-Bass; 2008:5-24.

    Google Scholar 

  39. Sale JE, Lohfeld LH, Brazil K. Revisiting the quantitative-qualitative debate: implications for mixed-methods research. Qual Quant. 2002;36:43-53.

    Article  Google Scholar 

  40. Palinkas LA, et al. Mixed-methods designs in mental health services research: a review. Psychiatr Serv. 2011;62(3):255-263.

    Article  PubMed  Google Scholar 

  41. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. Thousand Oaks: Sage Publications; 2007.

    Google Scholar 

  42. Gilchrist VJ. In: Williams RL, Crabtree B, Miller B, eds. Key Informant Interviews, in Doing Qualitative Research. Thousand Oaks: SAGE Publications; 1999.

    Google Scholar 

  43. Brown JB. In: Crabtree B, Miller B, eds. The Use of Focus Groups in Clinical Research, in Doing Qualitative Research. Thousand Oaks: SAGE Publications; 1999.

    Google Scholar 

  44. Borkan J. Immersion/Crystallization. In: Crabtree BF, Miller WL, eds. Doing Qualitative Research. Thousand Oaks: Sage Publishing; 1999:179-194.

    Google Scholar 

  45. QSR International Pty Ltd., NVivo qualitative data analysis software; Version 8. Melbourne, Australia 2008.

  46. Lincoln YS, Guba EG. Naturalistic Inquiry. Beverly Hills: Sage; 1985.

    Google Scholar 

  47. Tourangeau R, Rips LJ, Rasinski K. The Psychology of Survey Response. Cambridge: Cambridge University Press; 2000.

    Book  Google Scholar 

  48. Lavrakas PJ. Telephone Survey Methods: Sampling, Selection and Supervision. Newbury Park: Sage Publications; 1993.

    Google Scholar 

  49. SAS Institute, SAS. Cary, NC 2008.

  50. Kothari A and Armstrong R. Community-based knowledge translation: unexplored opportunities. Implement Sci. 2011; 5(59).

  51. Paalman M, et al. A critical review of priority setting in the health sector: the methodology of the 1993 World Development Report. Health Policy Plan. 1993;13(1):13-31.

    Article  Google Scholar 

  52. Kothari A et al. The use of tacit and explicit knowledge in public health: a qualitative study. Implement Sci. 2012; 7(20).

  53. Minkler M, Wallerstein N, eds. Community Based Participatory Research in Health. 2nd ed. San Francisco: Jossey-Bass; 2008.

    Google Scholar 

  54. Carman J. Evaluation practice among community-based organizations: research into the reality. Am J Eval. 2007;28:60-75.

    Article  Google Scholar 

  55. Carman J, Fredericks KA. Nonprofits and evaluation: empirical evidence from the field. New Dir Eval. 2008;119:51-71.

    Article  Google Scholar 

  56. Hawe P, et al. Multiplying health gains: the critical role of capacity-building within health promotion programs. Health Policy. 1997;39(1):29-42.

    Article  PubMed  CAS  Google Scholar 

  57. Vilnius D, Dandoy S. A priority rating system for public health programs. Public Health Rep. 1990;405(5):463-470.

    Google Scholar 

  58. National Cancer Institute. Cancer Control P.L.A.N.E.T.—About This Site. 2011 [cited 2011 August 15]; Available from: http://cancercontrolplanet.cancer.gov/about.html.

  59. Orleans CT. Increasing the demand for and use of effective smoking-cessation treatments reaping the full health benefits of tobacco-control science and policy gains-in our lifetime. Am J Prev Med. 2007;33(6 Suppl):S340-S348.

    Article  PubMed  Google Scholar 

  60. Maciosek MV, et al. Prioritizing clinical preventive services: a review and framework with implications for community preventive services. Annu Rev Public Health. 2009;30:341-355.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was funded by the National Cancer Institute: grant no. 1R01 CA132651 (PI, Viswanath). The study was conducted in collaboration with the PLANET MassCONECT C-PAC, which includes the following members: community partners: Chyke Doubeni, MD, PhD (University of Massachusetts Medical School); Clara Savage, EdD (Common Pathways); David Aaronstein (Boston Alliance for Community Health/Health Resources in Action); Ediss Gandelman, MBA, MEd (Beth Israel Deaconness Medical Center); Erline Achille (Boston Public Health Commission); Nashira Baril, MPH (Boston Public Health Commission); Vilma Lora (YWCA of Greater Lawrence/City of Lawrence Mayor’s Health Task Force); investigators: K. “Vish” Viswanath, PhD (Harvard School of Public Health/Dana-Farber Cancer Institute); Karen Emmons, PhD, (Harvard School of Public Health/Dana-Farber Cancer Institute); Elaine Puleo, PhD (University of Massachusetts); Glorian Sorensen, PhD, MPH (Harvard School of Public Health/Dana-Farber Cancer Institute); and PLANET MassCONECT Study Team: Jaclyn Alexander-Molloy, MS; Cassandra Andersen; Carmenza Bruff; Josephine Crisostomo, MPH; Lisa Lowery, Sara Minsky, MPH; Yudy Muneton, LCSW; and Shoba Ramanadhan, ScD, MPH. (All from Dana-Farber Cancer Institute).

Author information

Authors and Affiliations

  1. Center for Community-Based Research, Dana-Farber Cancer Institute, 450 Brookline Ave., LW 703, Boston, MA, 02215, USA

    Shoba Ramanadhan ScD, MPH & Kasisomayajula Viswanath PhD

  2. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA

    Kasisomayajula Viswanath PhD

Authors
  1. Shoba Ramanadhan ScD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kasisomayajula Viswanath PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shoba Ramanadhan ScD, MPH.

Additional information

Implications

Practice: Enhancing the capacity of CBOs to gather, evaluate, and utilize data is vital to support the use of systematic priority-setting processes.

Policy: Public health systems should improve the delivery and packaging of data to facilitate use without requiring extensive technical knowledge.

Research: Future research should describe the mechanisms by which key drivers of priority setting influence decision-making processes in CBOs.

About this article

Cite this article

Ramanadhan, S., Viswanath, K. Priority setting for evidence-based health outreach in community-based organizations: a mixed-methods study in three Massachusetts communities. Behav. Med. Pract. Policy Res. 3, 180–188 (2013). https://doi.org/10.1007/s13142-012-0191-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13142-012-0191-y

Keywords

Search

Navigation