Public Policy Partnerships

Policy is perhaps the most potent and cost-effective tool for improving population health and reducing inequities. Departments of health and other arms of state and municipal government are responsible for developing, implementing, and evaluating policies that affect almost every aspect of community health. Especially under current fiscal conditions, they have limited research capacity to ensure that policies are evidence-based. Harvard's most sustainable resources - its faculty and students - are eager to learn and apply policy research skills to decisions that can improve health in the Commonwealth. Working closely with local community-based organizations, the Community Health Innovation and Research Program at Harvard Catalyst (HC-CHIRP) responds to the research needs of state and city public health departments by connecting and supporting faculty and students gaining critical policy research experience.

Recent Projects

Proposed Legislation

When health policy bills come before the legislature, the Massachusetts Department of Public Health (MDPH) is asked to weigh in on their possible health impact, and how they might be strengthened based on the available scientific evidence. Often that means reviewing the evidence base, the experience of other states, and the variety of potential risks, costs, and benefits. The MDPH turned to HC-CHIRP for help with proposals to expand access to raw milk, and to make the medical use of marijuana legal and regulated.

Implementation of New Regulations

Once evidence-based policies are developed, there is sometimes a need for research on best practices for policy implementation. HC-CHIRP created a team of faculty and students at Harvard's School of Public Health to assist with the research on practical aspects of school competitive foods regulations, whose successful implementation in many districts might hinge upon questions such as: Will schools lose money by only selling nutritionally compliant foods?; and, Will students drink less milk if chocolate milk is eliminated? By examining data from other cities and states, the HC-CHIRP team was able to answer these questions, bringing the best possible scientific evidence to bear for the development of strong implementation. In another example, the MDPH approved new regulations to reduce the risk of head injury for middle- and high-school team sports participants, but needed guidance materials for coaches, primary care and pediatrics providers on how best to put the regulations into practice.

Policy Evaluation

It can be difficult and expensive to assess the impact of changes in policy on the health of communities and individuals. Working with quantitative and qualitative researchers from disciplines across the university, HC-CHIRP is seeking improved methods for affordable and practical policy evaluation. Some areas in which policy effects need to be measured include a variety of obesity prevention policies and programs, and requirements for the collection and publication of data on healthcare-associated infections (HAI). Such evaluation projects usually need to balance the researchers' need to control confounders, and the policy and program partners' need to take timely advantage of change opportunities as they occur.

System Building

Massachusetts receives funding under the federal Affordable Care Act to adapt and improve evidence-based home visiting programs in seventeen highest-need communities. Multiple state agencies, led by the MDPH and the Department of Early Education and Care, are collaborating. While home visiting interventions have long focused on enhancing parenting skills, improving maternal and child health, and connecting high-risk families to integrated services, evidence suggests they can be even more effective, addressing domestic violence and substance abuse, and incorporating new findings in child development. HC-CHIRP, working with leading experts in public health approaches to improving pregnancy outcomes and early childhood development, will oversee the design and evaluation of a statewide system of care for pregnant and parenting families. This federally-funded MDPH initiative is a pilot program including a universal one-time home visit. It will include a central intake and referral system capable of connecting all families with children of 0 - 8 years old to a wide array of health and early childhood services. In addition to program-level improvements, the initiative's goals are to improve coordination between multiple state agencies, link currently fragmented databases, and build a system of care that is sustainable in evolving fiscal and health care environments.

For more information on HC-CHIRP's Public Policy Partnerships, please contact Adena Cohen-Bearak, MPH.