Jonathan Purtle

Associate Professor of Public Health Policy & Management

Director of Policy Research at NYU’s Global Center for Implementation Science

Professional overview

Jonathan Purtle is Associate Professor of Public Health Policy & Management at the New York University School of Global Public Health and also Director of Policy Research at NYU’s Global Center for Implementation Science.

Dr. Purtle is a mental health policy researcher and implementation scientist. His work examines questions such as how the implementation of policies “on the books” can be improved in practice, how research evidence can be most effectively communicated to policymakers and is used in policymaking processes, and how social and political contexts affect mental health policymaking and policy implementation. He is also studies population-based approaches to mental health, suicide prevention, and novel financing models for mental health services—such as earmarked taxes and fees.

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 a NIMH-funded project focused on financing policies related to the 988 Suicide & Crisis Lifeline (R01MH131649), a NIDA-funded study (through the CHERISH Center, P30DA040500) that is analyzing social media data to identify audience segments of state legislators who conceptualize substance use issues in different ways and experimentally testing different ways of communicating evidence these legislators, and co-leading a NCI-funded study focused on cancer policy implementation strategies (R21ACA293319). He is also a co-investigator on projects focused on mental health and health care system resilience following disasters is Puerto Rico (R01MD016426) and Hawaiʻi (R61MD019939).

He has published over 170 peer-reviewed journal articles, is an Associate Editor at Implementation Science, Co-Chairs the Policy Advisory Board at Psychiatric Services, is on the Scientific Advisory Committee of the American Foundation for Suicide Prevention, and is Core Faculty of the NIMH-funded Implementation Research Institute. 

Education

BA, Psychology, Roger Williams University

MSc, Sociology, Universiteit van Amsterdam

MPH, Drexel University

DrPH, Drexel University

Publications

Publications

Mental illness and bipolar disorder on Twitter : implications for stigma and social support

Budenz, A., Klassen, A., Purtle, J., Yom Tov, E., Yudell, M., & Massey, P. (n.d.).

Publication year

2020

Journal title

Journal of Mental Health

Volume

29

Issue

2

Page(s)

191-199

10.1080/09638237.2019.1677878

Abstract

Abstract

Background: Mental illness (MI), and particularly, bipolar disorder (BD), are highly stigmatized. However, it is unknown if this stigma is also represented on social media. Aims: Characterize Twitter-based stigma and social support messaging (“tweets”) about mental health/illness (MH)/MI and BD and determine which tweets garnered retweets. Methods: We collected tweets about MH/MI and BD during a three-month period and analyzed tweets from dates with the most tweets (“spikes”), an indicator of topic interest. A sample was manually content analyzed, and the remainder were classified using machine learning (logistic regression) by topic, stigma, and social support messaging. We compared stigma and support toward MH/MI versus BD and used logistic regression to quantify tweet features associated with retweets, to assess tweet reach. Results: Of the 1,270,902 tweets analyzed, 94.7% discussed MH/MI and 5.3% discussed BD. Spikes coincided with a celebrity’s death and a MH awareness campaign. Although the sample contained more support than stigma messaging, BD tweets contained more stigma and less support than MH/MI tweets. However, stigma messaging was infrequently retweeted, and users often retweeted personal MH experiences. Conclusions: These findings demonstrate opportunities for social media advocacy to reduce stigma and increase displays of social support towards people living with BD.

Methods and measures to evaluate the impact of participatory model building on public policymakers : a scoping review protocol

Henson, R. M., Purtle, J., Headen, I., Stankov, I., & Langellier, B. A. (n.d.).

Publication year

2024

Journal title

BMJ open

Volume

14

Issue

1

10.1136/bmjopen-2023-074891

Abstract

Abstract

Introduction Public policymakers are increasingly engaged in participatory model building processes, such as group model building. Understanding the impacts of policymaker participation in these processes on policymakers is important given that their decisions often have significant influence on the dynamics of complex systems that affect health. Little is known about the extent to which the impacts of participatory model building on public policymakers have been evaluated or the methods and measures used to evaluate these impacts. Methods and analysis A scoping review protocol was developed with the objectives of: (1) scoping studies that have evaluated the impacts of facilitated participatory model building processes on public policymakers who participated in these processes; and (2) describing methods and measures used to evaluate impacts and the main findings of these evaluations. The Joanna Briggs Institute's Population, Concept, Context framework was used to formulate the article identification process. Seven electronic databases - MEDLINE (Ovid), ProQuest Health and Medical, Scopus, Web of Science, Embase (Ovid), CINAHL Complete and PsycInfo - will be searched. Identified articles will be screened according to inclusion and exclusion criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist for scoping reviews will be used and reported. A data extraction tool will collect information across three domains: study characteristics, methods and measures, and findings. The review will be conducted using Covidence, a systematic review data management platform. Ethics and dissemination The scoping review produced will generate an overview of how public policymaker engagement in participatory model building processes has been evaluated. Findings will be disseminated through peer-reviewed publications and to communities of practice that convene policymakers in participatory model building processes. This review will not require ethics approval because it is not human subject research.

Modeling HPV vaccination scale-up among urban young men who have sex with men in the context of HIV

Goldstein, N. D., LeVasseur, M. T., Tran, N. K., Purtle, J., Welles, S. L., & Eppes, S. C. (n.d.).

Publication year

2019

Journal title

Vaccine

Volume

37

Issue

29

Page(s)

3883-3891

10.1016/j.vaccine.2019.05.047

Abstract

Abstract

Introduction: Young men who have sex with men (YMSM) are at high risk to contract human papillomavirus (HPV). While an effective vaccination exists, its use among YMSM is markedly lower compared to non-MSM and women. This study compares scaling up HPV vaccination in conjunction with other prevention strategies. Methods: An agent-based model of urban YMSM (≤26 years of age) reflective of the demography of Philadelphia, PA, simulated for up to ten years of follow-up to examine anal and oral transmission of the HPV genotypes covered in the nonavalent (9v) vaccine: 6, 11, 16, 18, 31, 33, 45, 52, 58. Starting HPV prevalences ranged from a high of 18% (type 6) to a low of 6% (type 31); overall 65% of individuals carried any HPV genotype. Simulated levels of vaccination were ranged from 0% to 13% (present-day level), 25%, 50%, 80% (Healthy People 2020 target), and 100% in conjunction with condom use and HIV seroadaptive practices. The primary outcome was the relative reduction in HPV infection. Results: Compared to present-day vaccination levels (13%), scaling-up vaccination led to expected declines in 10-year post-simulation HPV prevalence. Anal HPV (any 9v types) declined by 9%, 27%, 46%, and 58% at vaccination levels of 25%, 50%, 80%, and 100%, respectively. Similarly, oral HPV (any 9v types) declined by 11%, 33%, 57%, and 71% across the same levels of vaccine uptake. Comparing the prevention strategies, condoms blocked the greatest number of anal transmissions when vaccination was at or below present-day levels. For oral transmission, vaccination was superior to condom use at all levels of coverage. Conclusions: Public health HPV preventions strategies should continue to emphasize the complementary roles of condoms and vaccination, especially for preventing oral infection. Improving vaccination coverage will ultimately have the greatest impact on reducing HPV infection among YMSM.

Multi-level alignment processes in the sustainment of a youth substance use treatment model following a federal implementation initiative : A mixed method study

Wright, B., González, I., Chen, M., Aarons, G. A., Hunter, S. B., Godley, M. D., Purtle, J., & Dopp, A. R. (n.d.).

Publication year

2024

Journal title

Journal of Substance Use and Addiction Treatment

Volume

166

10.1016/j.josat.2024.209445

Abstract

Abstract

Introduction: Government agencies have identified evidence-based practice (EBP) dissemination as a pathway to high-quality behavioral health care for youth. However, gaps remain about how to best sustain EBPs in treatment organizations in the U.S., especially in resource-constrained settings like publicly-funded youth substance use services. One important, but understudied, determinant of EBP sustainment is alignment: the extent to which multi-level factors that influence sustainment processes and outcomes are congruent, consistent, and/or coordinated. This study examined the role of alignment in U.S. states' efforts to sustain the Adolescent Community Reinforcement Approach (A-CRA), an EBP for youth substance use disorders, during the COVID-19 pandemic. Methods: In this mixed methods study, the qualitative investigation preceded and informed the quantitative investigation. We interviewed state administrators and providers (i.e., supervisors and clinicians) from 15 states that had completed a federal A-CRA implementation grant; providers also completed surveys. The sample included 50 providers from 35 treatment organizations that reported sustaining A-CRA when the COVID-19 pandemic began, and 20 state administrators. In qualitative thematic analyses, we applied the EPIS (Exploration, Preparation, Implementation, Sustainment) framework to characterize alignment processes that interviewees described as influential on sustainment. We then used survey items to quantitatively explore the associations described in qualitative themes, using bivariate linear regressions. Results: At the time of interview, staff from 80 % of the treatment organizations (n = 28), reported sustaining A-CRA. Providers from both sustainer and non-sustainer organizations, as well as state administrators, described major sources of misalignment when state agencies ceased technical assistance post-grant, and because limited staff capacity conflicted with A-CRA's training model, which was perceived as time-intensive. Participants described the pandemic as exacerbating preexisting challenges, including capacity issues. Sustainer organizations reported seeking new funding to help sustain A-CRA. Quantitative associations between self-rated extent of sustainment and other survey items mostly followed the pattern predicted from the qualitative findings. Conclusions: The COVID-19 pandemic amplified longstanding A-CRA sustainment challenges, but treatment organizations already successfully sustaining A-CRA pre-pandemic largely continued. There are missed opportunities for state-level actors to coordinate with providers on the shared goal of EBP sustainment. A greater focus on alignment processes in research and practice could help states and providers strengthen sustainability planning.

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

2023

Journal title

Hospital and Community Psychiatry

Volume

74

Issue

2

Page(s)

204-205

10.1176/appi.ps.202200020

Abstract

Abstract

~

Newspaper Coverage of Adverse Childhood Experiences and Toxic Stress in the United States, 2014–2020 : Consequences, Causes, and Solutions

Purtle, J., Bowler, S., Boughter-Dornfeld, M., Nelson, K. L., & Gollust, S. E. (n.d.).

Publication year

2021

Journal title

Trauma, Violence, and Abuse

10.1177/15248380211029407

Abstract

Abstract

News media can shape public opinion about child adversity and influence the translation of research into public policy. Research about adverse childhood experiences (ACEs) and toxic stress has increased dramatically in recent years, but little is known about how these concepts are covered in news media. We reviewed how newspapers in the United States have portrayed the consequences of, causes of, and solutions to address ACEs and toxic stress, examined trends in newspaper coverage, and assessed differences in coverage of ACEs versus toxic stress. Quantitative content analysis was conducted of 746 newspaper articles mentioning “adverse childhood experience(s)” and/or “toxic stress” published in 25 U.S. newspapers between January 1, 2014, and May 30, 2020. κ statistics of interrater reliability were calculated, and variables with κ ≥.60 were retained for quantitative analysis. We found that newspaper coverage of ACEs and toxic stress increased dramatically between 2014 and 2018 and then sharply declined. Only 13.3% of articles mentioned both ACEs and toxic stress. There were many statistically significant (p

Operational and organizational variation in determinants of policy implementation success : the case of policies that earmark taxes for behavioral health services

Purtle, J., Stadnick, N. A., Mauri, A. I., Walker, S. C., Bruns, E. J., & Aarons, G. A. (n.d.).

Publication year

2024

Journal title

Implementation Science

Volume

19

Issue

1

10.1186/s13012-024-01401-8

Abstract

Abstract

Background: Research on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a person’s organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services. Methods: Web-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N = 272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success. Results: Perceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (β = 0.37 vs. β = 0.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (β = 0.23 vs. β = 0.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (β = 0.48 vs. β=-0.06). Conclusion: Determinants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a person’s organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies.

Partisan Differences in Legislators' Discussion of Vaccination on Twitter During the COVID-19 Era : Natural Language Processing Analysis

Engel-Rebitzer, E., Stokes, D. C., Meisel, Z. F., Purtle, J., Doyle, R., & Buttenheim, A. M. (n.d.).

Publication year

2022

Journal title

JMIR Infodemiology

Volume

2

Issue

1

10.2196/32372

Abstract

Abstract

Background: The COVID-19 era has been characterized by the politicization of health-related topics. This is especially concerning given evidence that politicized discussion of vaccination may contribute to vaccine hesitancy. No research, however, has examined the content and politicization of legislator communication with the public about vaccination during the COVID-19 era. Objective: The aim of this study was to examine vaccine-related tweets produced by state and federal legislators during the COVID-19 era to (1) describe the content of vaccine-related tweets; (2) examine the differences in vaccine-related tweet content between Democrats and Republicans; and (3) quantify (and describe trends over time in) partisan differences in vaccine-related communication. Methods: We abstracted all vaccine-related tweets produced by state and federal legislators between February 01, 2020, and December 11, 2020. We used latent Dirichlet allocation to define the tweet topics and used descriptive statistics to describe differences by party in the use of topics and changes in political polarization over time. Results: We included 14,519 tweets generated by 1463 state legislators and 521 federal legislators. Republicans were more likely to use words (eg, "record time,""launched,"and "innovation") and topics (eg, Operation Warp Speed success) that were focused on the successful development of a SARS-CoV-2 vaccine. Democrats used a broader range of words (eg, "anti-vaxxers,""flu,"and "free") and topics (eg, vaccine prioritization, influenza, and antivaxxers) that were more aligned with public health messaging related to the vaccine. Polarization increased over most of the study period. Conclusions: Republican and Democratic legislators used different language in their Twitter conversations about vaccination during the COVID-19 era, leading to increased political polarization of vaccine-related tweets. These communication patterns have the potential to contribute to vaccine hesitancy.

Partisan differences in the effects of economic evidence and local data on legislator engagement with dissemination materials about behavioral health : a dissemination trial

Purtle, J., Nelson, K. L., Gebrekristos, L., Lê-Scherban, F., & Gollust, S. E. (n.d.).

Publication year

2022

Journal title

Implementation Science

Volume

17

Issue

1

10.1186/s13012-022-01214-7

Abstract

Abstract

Background: 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

Partisan differences in twitter language among US legislators during the COVID-19 pandemic : Cross-sectional study

Guntuku, S. C., Purtle, J., Meisel, Z. F., Merchant, R. M., & Agarwal, A. (n.d.).

Publication year

2021

Journal title

Journal of medical Internet research

Volume

23

Issue

6

10.2196/27300

Abstract

Abstract

Background: As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems. Objective: We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared. Methods: We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation. Results: We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; P

Perceived Persuasiveness of Evidence About Adverse Childhood Experiences : Results From a National Survey

Purtle, J., Nelson, K. L., Srivastav, A., & Gollust, S. E. (n.d.).

Publication year

2021

Journal title

Academic Pediatrics

Volume

21

Issue

3

Page(s)

529-533

10.1016/j.acap.2020.05.031

Abstract

Abstract

Objective: Advocates must make decisions about the types of evidence they emphasize when communicating to cultivate support for adverse childhood experience (ACE) prevention policies. This study sought to characterize public perceptions of the persuasiveness of 12 ACE evidence statements and assess differences by ideology in the strength of these evidence messages as rationales for ACE prevention policies. Methods: A web-based survey of a nationally representative sample of US adults was conducted using the KnowledgePanel (N = 503, completion rate = 60.5%). Respondents read ACE evidence statements and answered questions about the extent to which each was perceived as persuasive. Data were collected and analyzed in 2019. Results: The evidence statements perceived as most persuasive (scoring range 3–17) were those about ACEs as risk factors for mental health and substance use conditions (mean = 12.39) and suicide (mean = 12.14); ACEs generating financial costs for society (mean = 12.03); and the consequences of ACEs being preventable by a supportive adult (mean = 11.97). The evidence statements perceived as least persuasive were about ACEs generating health care costs for individuals (mean = 9.42) and ACEs as risk factors for physical health conditions (mean = 9.47). A larger proportion of liberals than conservatives rated every statement as providing a “strong reason” for ACE prevention policies. These differences were largest for evidence about ACEs generating financial costs for society (84.6% vs 42.8%, P

Perceptions of patient-provider communication and receipt of mental health treatment among older adults with depressive symptoms

Nelson, K. L., & Purtle, J. (n.d.).

Publication year

2019

Journal title

Aging and Mental Health

Volume

23

Issue

4

Page(s)

485-490

10.1080/13607863.2018.1426719

Abstract

Abstract

Objectives: This study aimed to: (1) determine if and how perceptions towards healthcare providers differ between older adults with and without clinically signifcant depressive symptoms (CSDS), and (2) assess whether perceptions towards providers are associated with receipt of mental health treatment among older adults with CSDS. Methods: Data from the 2013 and 2014 Medical Expenditure Panel Survey were used to examine CSDS prevalence, receipt of mental health treatment, and perceptions of provider communication among community-dwelling adults ≥ age 65 (N = 6,936) using four of the ‘How Well Doctors Communicate’ composite items from the Consumer Assessment of Healthcare Providers and Systems(CAHPS). Multivariate logistic regression was used. Results: CSDS are associated with greater odds of having ‘poor’ perceptions of provider communication on all four CAHPS communication measures. Perceptions of provider communication are similar among older adults with CSDS who received and did not receive mental health treatment, except on an item measuring a provider's ability to explain information in ways patients understand. Conclusion: Older adults with CSDS have more negative perceptions of the quality of their communication with healthcare providers than their peers. Healthcare systems should consider how to accommodate these patients’ unique needs and communication preferences to ensure receipt of quality care.

Policy dissemination and implementation research

Purtle, J., Crable, E. L., Cruden, G., Lee, M., Lengnick-Hall, R., Silver, D. R., & Raghavan, R. (n.d.).

Publication year

2024

Page(s)

511-533

10.1093/oso/9780197660690.003.0024

Abstract

Abstract

~

Policy dissemination research

Purtle, J., Dodson, E. A., & Brownson, R. C. (n.d.).

Publication year

2017

Page(s)

433-448

10.1093/oso/9780190683214.003.0026

Abstract

Abstract

Policy dissemination research is focused on understanding and addressing these barriers and can be defined as: the study of the targeted distribution of scientific evidence to policymakers to understand how to promote the adoption and sustainment of evidence-based policies. Policy dissemination research studies can be classified as audience research studies–which are formative assessments of policymakers’ knowledge, attitudes, and uses of research evidence and policy contexts–and intervention studies, which test the effectiveness of different policymaker-focused dissemination strategies. Outcomes of policy dissemination research studies include self-report policymaker research utilization, self-report policymaker support for evidence-based policies, and observed policymaker research utilization. There is also a need to grow the field of policy implementation research and integrate theories, frameworks, and methods across the fields of public administration research, political science, and implementation science. Among the topics covered in this book, policy dissemination research is among the least developed.

Policy Makers' Priorities for Addressing Youth Substance Use and Factors That Influence Priorities

Purtle, J., Nelson, K. L., Henson, R. M., Horwitz, S. M., McKay, M. M., & Hoagwood, K. E. (n.d.).

Publication year

2022

Journal title

Hospital and Community Psychiatry

Volume

73

Issue

4

Page(s)

388-395

10.1176/appi.ps.202000919

Abstract

Abstract

OBJECTIVE: Understanding public policy makers' priorities for addressing youth substance use and the factors that influence these priorities can inform the dissemination and implementation of strategies that promote evidence-based decision making. This study characterized the priorities of policy makers in substance use agencies of U.S. states and counties for addressing youth substance use, the factors that influenced these priorities, and the differences in priorities and influences between state and county policy makers. METHODS: In 2020, a total of 122 substance use agency policy makers from 35 states completed a Web-based survey (response rate=22%). Respondents rated the priority of 14 issues related to youth substance use and the extent to which nine factors influenced these priorities. Data were analyzed as dichotomous and continuous variables and for state and county policy makers together and separately. RESULTS: The highest priorities for youth substance use were social determinants of substance use (87%), adverse childhood experiences and childhood trauma (85%), and increasing access to school-based substance use programs (82%). The lowest priorities were increasing access to naloxone for youths (49%), increasing access to medications for opioid use disorder among youths (49%), and deimplementing non-evidence-based youth substance use programs (41%). The factors that most influenced priorities were budget issues (80%) and state legislature (69%), federal (67%), and governor priorities (65%). Issues related to program implementation and deimplementation were significantly higher priorities for state than for county policy makers. CONCLUSIONS: These findings can inform the tailoring of dissemination and implementation strategies to account for the inner- and outer-setting contexts of substance use agencies.

Population mental health & community violence : Advancing the role of local health departments

Purtle, J. (n.d.).

Publication year

2017

Journal title

American journal of public health

Volume

107

Issue

9

Page(s)

1358-1360

10.2105/AJPH.2017.303979

Abstract

Abstract

~

Population-based approaches to mental health : History, strategies, and evidence

Purtle, J., Nelson, K. L., Counts, N. Z., & Yudell, M. (n.d.).

Publication year

2019

Journal title

Annual Review of Public Health

Volume

41

Page(s)

201-221

10.1146/annurev-publhealth-040119-094247

Abstract

Abstract

There is growing recognition in the fields of public health and mental health services research that the provision of clinical services to individuals is not a viable approach to meeting the mental health needs of a population. Despite enthusiasm for the notion of population-based approaches to mental health, concrete guidance about what such approaches entail is lacking, and evidence of their effectiveness has not been integrated. Drawing from research and scholarship across multiple disciplines, this review provides a concrete definition of population-based approaches to mental health, situates these approaches within their historical context in the United States, and summarizes the nature of these approaches and their evidence. These approaches span three domains: (a) social, economic, and environmental policy interventions that can be implemented by legislators and public agency directors, (b) public health practice interventions that can be implemented by public health department officials, and (c) health care system interventions that can be implemented by hospital and health care system leaders.

Posttraumatic stress, depression, and sleep among young survivors of violence

Corbin, T., Tabb, L. P., Waite, D., Purtle, J., Harris, E., Gardner, J., Gentile, N., Rowhani-Rahbar, A., & Rich, J. (n.d.).

Publication year

2021

Journal title

Journal of health care for the poor and underserved

Volume

32

Issue

3

Page(s)

1339-1358

10.1353/HPU.2021.0136

Abstract

Abstract

Survivors of violence often suffer psychological harm in addition to physical wounds. This study explored (1) the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, depression symptoms, and disordered sleep among young, violently injured, emergency department patients; and (2) how PTSD and depression symptoms are associated with sleep quality. Clinical scales for PTSD (PCL-5), depression (PHQ-8), and sleep (PROMIS®) were completed by 88 survivors of violent assault (gunshot, stabbing or assault) one month or less after presenting to an urban emergency department. High proportions of participants met criteria for prospective PTSD (59.1%), major depression (44.3%) or disordered sleep (34.1%), with 27.3% meeting criteria for all three conditions. Poorer sleep quality was correlated with higher levels of depression symptoms and PTSD symptoms. Survivors of violence experience symptoms that may further impair their sleep and behavioral health. Emergency providers should ask survivors about sleep/trauma symptoms and consider referral to trauma-informed behavioral health care.

Prevalence and correlates of local health department activities to address mental health in the United States

Purtle, J., Klassen, A. C., Kolker, J., & Buehler, J. W. (n.d.).

Publication year

2016

Journal title

Preventive Medicine

Volume

82

Page(s)

20-27

10.1016/j.ypmed.2015.11.007

Abstract

Abstract

Mental health has been recognized as a public health priority for nearly a century. Little is known, however, about what local health departments (LHDs) do to address the mental health needs of the populations they serve. Using data from the 2013 National Profile of Local Health Departments - a nationally representative survey of LHDs in the United States (N = 505) - we characterized LHDs' engagement in eight mental health activities, factors associated with engagement, and estimated the proportion of the U.S. population residing in jurisdictions where these activities were performed. We used Handler's framework of the measurement of public health systems to select variables and examined associations between LHD characteristics and engagement in mental health activities using bivariate analyses and multilevel, multivariate logistic regression. Assessing gaps in access to mental healthcare services (39.3%) and implementing strategies to improve access to mental healthcare services (32.8%) were the most common mental health activities performed. LHDs that provided mental healthcare services were significantly more likely to perform population-based mental illness prevention activities (adjusted odds ratio: 7.1; 95% CI: 5.1, 10.0) and engage in policy/advocacy activities to address mental health (AOR: 3.9; 95% CI: 2.7, 5.6). Our study suggests that many LHDs are engaged in activities to address mental health, ranging from healthcare services to population-based interventions, and that LHDs that provide healthcare services are more likely than others to perform mental health activities. These findings have implications as LHDs reconsider their roles in the era of the Patient Protection and Affordable Care Act and LHD accreditation.

Promises and pitfalls in implementation science from the perspective of US-based researchers : learning from a pre-mortem

Beidas, R. S., Dorsey, S., Lewis, C. C., Lyon, A. R., Powell, B. J., Purtle, J., Saldana, L., Shelton, R. C., Stirman, S. W., & Lane-Fall, M. B. (n.d.).

Publication year

2022

Journal title

Implementation Science

Volume

17

Issue

1

10.1186/s13012-022-01226-3

Abstract

Abstract

Background: Implementation science is at a sufficiently advanced stage that it is appropriate for the field to reflect on progress thus far in achieving its vision, with a goal of charting a path forward. In this debate, we offer such reflections and report on potential threats that might stymie progress, as well as opportunities to enhance the success and impact of the field, from the perspective of a group of US-based researchers. Main body: Ten mid-career extramurally funded US-based researchers completed a “pre-mortem” or a group brainstorming exercise that leverages prospective hindsight to imagine that an event has already occurred and to generate an explanation for it — to reduce the likelihood of a poor outcome. We came to consensus on six key themes related to threats and opportunities for the field: (1) insufficient impact, (2) too much emphasis on being a “legitimate science,” (3) re-creation of the evidence-to-practice gap, (4) difficulty balancing accessibility and field coherence, (5) inability to align timelines and priorities with partners, and (6) overly complex implementation strategies and approaches. Conclusion: We submit this debate piece to generate further discussion with other implementation partners as our field continues to develop and evolve. We hope the key opportunities identified will enhance the future of implementation research in the USA and spark discussion across international groups. We will continue to learn with humility about how best to implement with the goal of achieving equitable population health impact at scale.

Proportion of US Counties and Population Served by Certified Community Behavioral Health Clinics

Mauri, A. I., Xiang, N., Adams, D. R., & Purtle, J. (n.d.).

Publication year

2024

Journal title

JAMA Health Forum

Volume

5

Issue

10

10.1001/jamahealthforum.2024.3001

Abstract

Abstract

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Public Opinion About Adverse Childhood Experiences : Social Stigma, Attribution of Blame, and Government Intervention

Purtle, J., Nelson, K. L., & Gollust, S. E. (n.d.).

Publication year

2022

Journal title

Child Maltreatment

Volume

27

Issue

3

Page(s)

344-355

10.1177/10775595211004783

Abstract

Abstract

Adverse 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.

Public opinion about evidence-informed health policy development in U.S. Congress

Purtle, J. (n.d.).

Publication year

2020

Journal title

Translational Behavioral Medicine

Volume

10

Issue

6

Page(s)

1549-1553

10.1093/tbm/ibz083

Abstract

Abstract

Promoting evidence-informed health policymaking is a priority of the Society of Behavioral Medicine and other professional societies. However, politics often impede the translation of research into policy. Public opinion is an important feature of political context that influences policymakers' behaviors, but prior research has not examined public opinion about evidence-informed health policy development. This exploratory study sought to characterize public opinion about the influence that evidence should, and does, have on health policy development in U.S. Congress relative to other factors and examine differences by political party affiliation. A public opinion survey was conducted in 2018 using the SSRS Probability Panel (N = 532). Respondents separately rated the extent to which six factors (e.g., evidence, budget impact, industry interests) "should have"and "currently have"influence on U.S. congresspersons' health policy decisions. Evidence (59%) was the most frequently identified factor that should have "a lot of influence"on health policy development, but only 11% of respondents thought that evidence currently has "a lot of influence"(p

Public transit and depression among older adults : Using agent-based models to examine plausible impacts of a free bus policy

Yang, Y., Langellier, B. A., Stankov, I., Purtle, J., Nelson, K. L., Reinhard, E., Van Lenthe, F. J., & Diez Roux, A. V. (n.d.).

Publication year

2020

Journal title

Journal of Epidemiology and Community Health

Volume

74

Issue

11

Page(s)

875-881

10.1136/jech-2019-213317

Abstract

Abstract

Background Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms. Methods We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price. Results Our model suggests that improving attitudes towards the bus (eg, campaigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre. Conclusion Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.

Purtle and Roman respond

Purtle, J., & Roman, L. A. (n.d.).

Publication year

2015

Journal title

American journal of public health

Volume

105

Issue

9

Page(s)

e2-e3

10.2105/AJPH.2015.302812

Abstract

Abstract

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