Jonathan Purtle
Jonathan Purtle
Associate Professor of Public Health Policy & Management
Director of Policy Research at NYU’s Global Center for Implementation Science
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Professional overview
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Jonathan Purtle is Associate Professor of Public Health Policy & Management and Director of Policy Research at NYU’s Global Center for Implementation Science.
Dr. Purtle is an implementation scientist whose research focuses on mental health policy. His work examines questions such as how research evidence can be most effectively communicated to policymakers and is used in policymaking processes, how social and political contexts affect policymaking and policy implementation, and how the implementation of policies “on the books” can be improved in practice. He is also interested in population-based approaches to mental health and how mental health can be integrated in to mainstream public health practice.
Dr. Purtle’s work has been consistently funded by the National Institute of Mental Health (NIMH) and Robert Wood Johnson Foundation (RWJF). He is currently leading NIMH-funded projects focused on the implementation of policies that earmark taxes for mental health services and understanding the dynamics of research evidence in mental health policymaking and a RWJF-funded project that experimentally tests different ways of communicating evidence about child maltreatment to the public and policymakers. His research is regularly published in journals such as Implementation Science, Psychiatric Services, The Milbank Quarterly, and Annual Review of Public Health. He has been the Chair of the Policy Section of the AcademyHeath/NIH Dissemination and Implementation in Heath Conference since 2017 and was awarded the 2018 Champion of Evidence-Based Interventions Award from the Association for Behavioral and Cognitive Therapies for his work on evidence use in mental health policymaking.
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Education
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BA, Psychology, Roger Williams UniversityMSc, Sociology, Universiteit van AmsterdamMPH, Drexel UniversityDrPH, Drexel University
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Publications
Publications
An Examination of Factors Affecting State Legislators’ Support for Parity Laws for Different Mental Illnesses
National Suicide Prevention Lifeline 2020 In-State Answer Rates, Stratified by Call Volume Rates and Geographic Region
Purtle, J., Lindsey, M. A., Raghavan, R., & Stuart, E. A. (n.d.).Publication year
2023Journal title
Hospital and Community PsychiatryVolume
74Issue
2Page(s)
204-205Newspaper Coverage of Adverse Childhood Experiences and Toxic Stress in the United States, 2014–2020: Consequences, Causes, and Solutions
Growing inequities in mental health crisis services offered to indigent patients in Puerto Rico versus the US states before and after Hurricanes Maria and Irma
AbstractPurtle, J., Mercado, D. L., Barajas, C. B., Rivera-González, A. C., Chavez, L., Canino, G., & Ortega, A. N. (n.d.).Publication year
2022Journal title
Health Services ResearchVolume
58Issue
2Page(s)
325-331AbstractObjective: To assess changes in the availability of mental health crisis services in Puerto Rico relative to US states before and after Hurricanes Maria and Irma. Data Sources/Study Setting: National Mental Health Services Surveys conducted in 2016 and 2020. Study design: Repeated cross-sectional design. The independent variable was mental health facility location in Puerto Rico or a US state. Dependent variables were the availability of three mental health crisis services (psychiatric emergency walk-in services, suicide prevention services, and crisis intervention team services). Data Collection/Extraction Methods: The proportion and per 100,000 population rate of facilities offering crisis services were calculated. Principal Findings: The availability of crisis services at mental health facilities in Puerto Rico remained stable between 2016 and 2020. These services were offered less at indigent care facilities in Puerto Rico than US states (e.g., 38.2% vs. 49.5% for suicide prevention, p = 0.06) and the magnitude of difference increased following Hurricane Maria. Conclusions: There are disparities between Puerto Rico and US states in the availability of mental health crisis services for indigent patients.Heterogeneity in Disparities in Life Expectancy Across US Metropolitan Areas
Impacts of COVID-19 on Mental Health Safety Net Services for Youths: A National Survey of Agency Officials
Inter-agency collaboration is associated with increased frequency of research use in children's mental health policy making
Partisan Differences in Legislators' Discussion of Vaccination on Twitter During the COVID-19 Era: Natural Language Processing Analysis
Partisan differences in the effects of economic evidence and local data on legislator engagement with dissemination materials about behavioral health: a dissemination trial
AbstractPurtle, J., Nelson, K. L., Gebrekristos, L., Lê-Scherban, F., & Gollust, S. E. (n.d.).Publication year
2022Journal title
Implementation ScienceVolume
17Issue
1AbstractBackground: State legislators make policy decisions that influence children’s exposure to adverse childhood experiences (ACEs), such as child maltreatment, and their effects on behavioral health. Effective dissemination of scientific research can increase the likelihood that legislators’ decisions are aligned with evidence to prevent ACEs and their consequences, and effective dissemination requires legislators to engage with dissemination materials. Informed by the elaboration likelihood model of persuasive communication and Brownson’s Model of Dissemination Research, we tested the hypothesis that inclusion of economic evidence and local data would increase legislator engagement with dissemination materials about evidence-supported policies related to ACEs and behavioral health. Methods: A three-arm randomized dissemination trial was conducted. A university researcher e-mailed dissemination materials which contained evidence about ACEs and behavioral health problems to state legislators (two e-mails sent 2 weeks apart, 12,662 e-mails delivered to 6509 legislators). The e-mail subject lines, text, and policy brief content were manipulated across the study arms. The intervention condition received state-tailored data about rates of ACEs and state-tailored economic evidence about the costs of ACEs for public systems, the enhanced control condition received state-tailored data and not economic evidence, and the control condition received national data and not economic evidence. Outcomes were rates of e-mail views, policy brief link clicks, requests for researcher consultation, and mentions of child maltreatment terms in legislators’ social media posts. Results: For the first e-mail, the e-mail view rate was 42.6% higher in the intervention than in the enhanced control condition (22.8% vs. 14.8%) and 20.8% higher than in the control condition (22.8% vs. 18.5%) (both p <.0001). Similar results were observed for the second e-mail. These differences remained significant after adjustment for demographic differences across study conditions in individual-level models, but not multilevel models. There was a significant interaction between the experimental condition and political party (p <.0001) in which the intervention increased e-mail view rates among Democrats but not Republicans. The intervention had no effect on policy brief link clicks or requests for consultation and a mixed effect on social media posts. Conclusions: Inclusion of state-tailored economic evidence in dissemination materials can increase engagement with research evidence among Democrat, but not Republican, legislators. Dissemination strategies tailored for legislators’ political party affiliation may be needed.Policy Makers' Priorities for Addressing Youth Substance Use and Factors That Influence Priorities
Promises and pitfalls in implementation science from the perspective of US-based researchers: learning from a pre-mortem
Public Opinion About Adverse Childhood Experiences: Social Stigma, Attribution of Blame, and Government Intervention
AbstractPurtle, J., Nelson, K. L., & Gollust, S. E. (n.d.).Publication year
2022Journal title
Child MaltreatmentVolume
27Issue
3Page(s)
344-355AbstractAdverse childhood experiences (ACEs) are receiving increasing attention in academic, policy, and media discourses. However, no public opinion research has focused on ACEs. We conducted a nationally representative survey of U.S. adults to address this knowledge gap. A web-based survey was conducted using the Ipsos KnowledgePanel (N = 503, completion rate = 60.5%) in fall 2019. We found that inter-personal stigma and parental blame related to ACEs were prevalent, with 25.0% of respondents unwilling to have a person with “a lot of ACEs” as a close co-worker and 65.2% believing that parents were very much to blame for the consequences of ACEs. Fifty percent of respondents believed that government intervention to prevent ACEs was very important. After adjustment for demographic characteristics, inter-personal stigma toward people with ACEs and conservative ideology were significantly associated with lower perceived importance of government intervention to prevent ACEs. Black race, Hispanic ethnicity, and female gender were significantly associated with higher perceived importance of government intervention. These findings provide an empirical foundation to inform strategies to communicate ACE science to public and policymaker audiences.Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science
AbstractMcGinty, E. E., Seewald, N. J., Bandara, S., Cerdá, M., Daumit, G. L., Eisenberg, M. D., Griffin, B. A., Igusa, T., Jackson, J. W., Kennedy-Hendricks, A., Marsteller, J., Miech, E. J., Purtle, J., Schmid, I., Schuler, M. S., Yuan, C. T., & Stuart, E. A. (n.d.).Publication year
2022Journal title
Prevention ScienceAbstractPolicy implementation is a key component of scaling effective chronic disease prevention and management interventions. Policy can support scale-up by mandating or incentivizing intervention adoption, but enacting a policy is only the first step. Fully implementing a policy designed to facilitate implementation of health interventions often requires a range of accompanying implementation structures, like health IT systems, and implementation strategies, like training. Decision makers need to know what policies can support intervention adoption and how to implement those policies, but to date research on policy implementation is limited and innovative methodological approaches are needed. In December 2021, the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness and the Johns Hopkins Center for Mental Health and Addiction Policy convened a forum of research experts to discuss approaches for studying policy implementation. In this report, we summarize the ideas that came out of the forum. First, we describe a motivating example focused on an Affordable Care Act Medicaid health home waiver policy used by some US states to support scale-up of an evidence-based integrated care model shown in clinical trials to improve cardiovascular care for people with serious mental illness. Second, we define key policy implementation components including structures, strategies, and outcomes. Third, we provide an overview of descriptive, predictive and associational, and causal approaches that can be used to study policy implementation. We conclude with discussion of priorities for methodological innovations in policy implementation research, with three key areas identified by forum experts: effect modification methods for making causal inferences about how policies’ effects on outcomes vary based on implementation structures/strategies; causal mediation approaches for studying policy implementation mechanisms; and characterizing uncertainty in systems science models. We conclude with discussion of overarching methods considerations for studying policy implementation, including measurement of policy implementation, strategies for studying the role of context in policy implementation, and the importance of considering when establishing causality is the goal of policy implementation research.Selecting evidence to frame the consequences of adverse childhood experiences: testing effects on public support for policy action, multi-sector responsibility, and stigma
Simulating the role of knowledge brokers in policy making in state agencies: An agent-based model
AbstractCombs, T., Nelson, K. L., Luke, D., McGuire, F. H., Cruden, G., Henson, R. M., Adams, D. R., Hoagwood, K. E., & Purtle, J. (n.d.).Publication year
2022Journal title
Health Services ResearchVolume
57Page(s)
122-136AbstractObjective: To model children's mental health policy making dynamics and simulate the impacts of knowledge broker interventions. Data sources: Primary data from surveys (n = 221) and interviews (n = 64) conducted in 2019–2021 with mental health agency (MHA) officials in state agencies. Study design: A prototype agent-based model (ABM) was developed using the PARTE (Properties, Actions, Rules, Time, Environment) framework and informed through primary data collection. In each simulation, a policy is randomly generated (salience weights: cost, contextual alignment, and strength of evidence) and discussed among agents. Agents are MHA officials and heterogenous in their properties (policy making power and network influence) and policy preferences (based on salience weights). Knowledge broker interventions add agents to the MHA social network who primarily focus on the policy's research evidence. Data collection/extraction methods: A sequential explanatory mixed method approach was used. Descriptive and regression analyses were used for the survey data and directed content analysis was used to code interview data. Triangulated results informed ABM development. In the ABM, policy makers with various degrees of decision influence interact in a scale-free network before and after knowledge broker interventions. Over time, each decides to support or oppose a policy proposal based on policy salience weights and their own properties and interactions. The main outcome is an agency-level decision based on policy maker support. Each intervention and baseline simulation runs 250 times across 50 timesteps. Principal findings: Surveys and interviews revealed that barriers to research use could be addressed by knowledge brokers. Simulations indicated that policy decision outcomes varied by policy making context within agencies. Conclusions: This is the first application of ABM to evidence-informed mental health policy making. Results suggest that the presence of knowledge brokers can: (1) influence consensus formation in MHAs, (2) accelerate policy decisions, and (3) increase the likelihood of evidence-informed policy adoption.State Policies that Impact the Design of Children’s Mental Health Services: A Modified Delphi Study
State-Level Social and Economic Policies and Their Association With Perinatal and Infant Outcomes
AbstractWebster, J. L., Paul, D., Purtle, J., Locke, R., & Goldstein, N. D. (n.d.).Publication year
2022Journal title
Milbank QuarterlyVolume
100Issue
1Page(s)
218-260AbstractPolicy Points State-level social and economic policies that expand tax credits, increase paid parental leave, raise the minimum wage, and increase tobacco taxes have been demonstrated to reduce adverse perinatal and infant health outcomes. These findings can help prioritize evidence-based legislated policies to improve perinatal and infant outcomes in the United States. Context: Rates of preterm birth and infant mortality are alarmingly high in the United States. Legislated efforts may directly or indirectly reduce adverse perinatal and infant outcomes through the enactment of certain economic and social policies. Methods: We conducted a narrative review to summarize the associations between perinatal and infant outcomes and four state-level US policies. We then used a latent profile analysis to create a social and economic policy profile for each state based on the observed policy indicators. Findings: Of 27 articles identified, nine focused on tax credits, eight on paid parental leave, four on minimum wages, and six on tobacco taxes. In all but three studies, these policies were associated with improved perinatal or infant outcomes. Thirty-three states had tax credit laws, most commonly the earned income tax credit (n = 28, 56%). Eighteen states had parental leave laws. Two states had minimum wage laws lower than the federal minimum; 14 were equal to the federal minimum; 29 were above the federal minimum; and 5 did not have a state law. The average state tobacco tax was $1.76 (standard deviation = $1.08). The latent profile analysis revealed three policy profiles, with the most expansive policies in Western and Northeastern US states, and the least expansive policies in the US South. Conclusions: State-level social and economic policies have the potential to reduce adverse perinatal and infant health outcomes in the United States. Those states with the least expansive policies should therefore consider enacting these evidence-based policies, as they have shown a demonstratable benefit in other states.The impact of Medicaid funding structures on inequities in health care access for Latinos in New York, Florida, and Puerto Rico
What social norms are associated with parenting programs?
“If I was to post something, it would be too vulnerable:” University students and mental health disclosures on instagram
AbstractBudenz, A., Klassen, A., Purtle, J., Yom-Tov, E., Yudell, M., & Massey, P. (n.d.).Publication year
2022Journal title
Journal of American College HealthVolume
70Issue
2Page(s)
615-624AbstractObjective: Assess Instagram use for mental health disclosure in university students to assess the potential for Instagram use as mental health support-seeking. Participants: Twenty-one students using mental health services while attending a private, Mid-Atlantic university between 6/2017-12/2017. Methods: Collected qualitative interview and Instagram data and analyzed them in parallel. Instagram data supplemented interview themes and were coded and analyzed quantitatively to define features of participants’ Instagram use. Results: Participants displayed aversions to posting mental health disclosures on Instagram, citing public and self-stigma as barriers to disclosure. Despite this, participants reported instances in which their Instagram posts directly or indirectly reflected their lived experiences. Some also maintained second anonymous accounts for fuller disclosure. Conclusions: Given the benefits of mental health disclosures to well-being and the predilection for social media use in university students, student and university-led initiatives to promote social media environments conducive to disclosures could have widespread mental health benefits.Academic-Policy Partnerships in Evidence-Based Practice Implementation and Policy Maker Use of Child Mental Health Research
Association between local public housing authority policies related to criminal justice system involvement and sexually transmitted infection rates
Changes in legislator vaccine-engagement on Twitter before and after the arrival of the COVID-19 pandemic
Determinants of using children’s mental health research in policymaking: variation by type of research use and phase of policy process
AbstractPurtle, J., Nelson, K. L., Horwitz, S. M. C., McKay, M. M., & Hoagwood, K. E. (n.d.).Publication year
2021Journal title
Implementation ScienceVolume
16Issue
1AbstractBackground: Research use in policymaking is multi-faceted and has been the focus of extensive study. However, virtually no quantitative studies have examined whether the determinants of research use vary according to the type of research use or phase of policy process. Understanding such variation is important for selecting the targets of implementation strategies that aim to increase the frequency of research use in policymaking. Methods: A web-based survey of US state agency officials involved with children’s mental health policymaking was conducted between December 2019 and February 2020 (n = 224, response rate = 33.7%, 49 states responding (98%), median respondents per state = 4). The dependent variables were composite scores of the frequency of using children’s mental health research in general, specific types of research use (i.e., conceptual, instrumental, tactical, imposed), and during different phases of the policy process (i.e., agenda setting, policy development, policy implementation). The independent variables were four composite scores of determinants of research use: agency leadership for research use, agency barriers to research use, research use skills, and dissemination barriers (e.g., lack of actionable messages/recommendations in research summaries, lack of interaction/collaboration with researchers). Separate multiple linear regression models estimated associations between determinant and frequency of research use scores. Results: Determinants of research use varied significantly by type of research use and phase of policy process. For example, agency leadership for research use was the only determinant significantly associated with imposed research use (β = 0.31, p < 0.001). Skills for research use were the only determinant associated with tactical research use (β = 0.17, p = 0.03) and were only associated with research use in the agenda-setting phase (β = 0.16, p = 0.04). Dissemination barriers were the most universal determinants of research use, as they were significantly and inversely associated with frequency of conceptual (β = −0.21, p = 0.01) and instrumental (β = −0.22, p = 0.01) research use and during all three phases of policy process. Conclusions: Decisions about the determinants to target with policy-focused implementation strategies—and the strategies that are selected to affect these targets—should reflect the specific types of research use that these strategies aim to influence.Does rental assistance improve mental health? Insights from a longitudinal cohort study
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