An Integrated Framework for Assessing the Value of Community-Based Prevention (2012) / Chapter Skim
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1 Introduction
1 Introduction
Pages 13-22
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From page 13... ...
COMMITTEE CHARGE Four foundations -- the California Endowment, the de Beaumont Foundation, the Robert Wood Johnson Foundation, and the W.K. Kellogg Foundation -- asked the Institute of Medicine to convene an expert committee to develop a framework for assessing the value of community-based, non-clinical prevention policies and wellness strategies, especially those targeting the prevention of long-term, chronic diseases.
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From page 14... ...
The committee assembled to respond to the charge from the sponsors was composed of experts spanning different disciplines ranging from economics and program evaluation to community-based providers. Over the course of this 20-month study the committee met six times in person, participated in many conference calls, and held three information-gathering workshops.
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From page 15... ...
A community-based prevention program is a coordinated activity or set of activities, such as an educational campaign against smoking, improvements to the built environment to encourage physical activity, a chronic disease education and awareness campaign to improve self-management, or a combination of such interventions, that is intended to accomplish a health objective or outcome. A policy is a rule or set of guidelines, such as nutritional standards for school lunches.
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From page 16... ...
Researchers have developed and fine-tuned frameworks such as randomized controlled trials and cost- effectiveness analysis for assessing the value of these clinical activities. Decent housing, clean air and water, effective sanitation, and food safety have become such a part of our culture and public infrastructure that they are no longer thought of as health endeavors.
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From page 17... ...
As discussed earlier, improving health and preventing disease does not occur solely in the patient's examination room; it also takes place in the community of patients and their families, friends and neighbors, employers, teachers, and storekeepers. People's socioeconomic status, social context, and physical and cultural environment influence their health both directly and, through behavioral changes and lifestyle development and reinforcement, indirectly (Box 1-1)
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From page 18... ...
The researchers discovered that about 20 percent of the variance in health status and life expectancy between grades could not be explained by the usual risk factors for poor health. This relationship between social status and health is referred to as the social gradient in health.
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From page 19... ...
One potential benefit, for example, is that cyclists receive enjoyment and ex ercise riding their bikes to work and other destinations. This may improve cyclists' general and mental health and lower their risks of long-term chronic diseases.
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From page 20... ...
A ROADMAP FOR THE REST OF THE REPORT In this chapter, the committee has discussed the committee charge, defined important terms, examined why community-based prevention is important and how it differs from other prevention approaches, and explored the concept and issues involved in valuing such programs and policies. Chapter 2 expands on the discussion of community, provides a brief historical perspective of community interventions, discusses four approaches to community-based prevention, reviews the models for implementation that represent the current state of the field, identifies key features
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From page 21... ...
Chapter 4 provides a list of elements that a framework for assessing value should possess, examines how a framework for valuing resides within a decision-making context, reviews eight frameworks currently used to assess community-based prevention, and discusses the strengths and limitations of each for addressing the special characteristics of communitybased prevention. In Chapter 5 the committee lays out its vision for the future of valuing community-based prevention.
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From page 22... ...
2006. An ecological approach to creating active living communities.
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Key Terms
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