Jonathan Purtle
Jonathan Purtle
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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 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 and suicide prevention.
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/recently led NIMH-funded projects focused on the implementation of financing policies related to the 988 Suicide & Crisis Lifeline (R01MH131649) and policies that earmark taxes for mental health services (R21MH125261) and understanding the dynamics of research evidence in mental health policymaking (P50MH113662). He also recently completed a RWJF-funded project that experimentally tested different ways of communicating evidence about child maltreatment to the public and policymakers.
He has published over 150 peer-reviewed journal articles, is an Associate Editor at Implementation Science, and Co-Chairs the Policy Advisory Board at Psychiatric Services. He is Core Faculty of the NIMH-funded Implementation Research Institute, was Chair of the Policy Section of the AcademyHeath/NIH Dissemination and Implementation in Heath Conference from 2017 to 2022, 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
Who votes for public health? U.S. senator characteristics associated with voting in concordance with public health policy recommendations (1998–2013)
AbstractPurtle, J., Goldstein, N. D., Edson, E., & Hand, A. (n.d.).Publication year
2017Journal title
SSM - Population HealthVolume
3Page(s)
136-140AbstractBackground The voting behaviors of elected officials shape the public's health. Little is known, however, about the characteristics of elected officials who vote in concordance with public health policy recommendations. This article presents the results of study conducted with the aims of: 1) testing the hypothesis that US Democrat Senators vote in concordance with American Public Health Association (APHA) policy recommendations more frequently than US Republican Senators, 2) identifying US Senator characteristics independently associated with voting in concordance with APHA, and 3) assessing trends in APHA voting concordance by political party. Methods We created a legislative dataset of 1434 votes cast on 111 legislative proposals by 184 US Senators during the years 1998 through 2013. Mixed effects linear regression models were used to estimate the independent contributions of political party, gender, geographic region, and year effects to annual APHA voting concordance. Votes were nested within Senators who were nested within States to account for non-independence and models considered potential for time and spatial patterns in the data. Results Adjusting for covariates and accounting for serial and spatial autocorrelation, Democrats averaged 59.1 percentage points higher in annual APHA voting concordance than Republicans (95% CI: 55.5, 62.7), females averaged 7.1 percentage points higher than males (95% CI: 1.9, 12.3), and Northeastern Senators averaged 16.1 percentage points higher than Southern Senators (95% CI: 9.1, 23.1). Conclusions Elected official's political party affiliation, gender, and geographic region are independently associated with public health voting decisions and should be considered when targeting and tailoring science-based policy dissemination strategies."Calculating the toll of trauma" in the headlines: Portrayals of posttraumatic stress disorder in the New York Times (1980-2015)
AbstractPurtle, J., Lynn, K., & Malik, M. (n.d.).Publication year
2016Journal title
American Journal of OrthopsychiatryVolume
86Issue
6Page(s)
632-638AbstractPublic awareness about traumatic stress is needed to address trauma as a public health issue. News media influence public awareness, but little is known about how traumatic-related disorders are portrayed in the news. A content analysis was conducted of all articles that mentioned posttraumatic stress disorder (PTSD) in The New York Times between 1980-2015. There were 871 articles analyzed. The number of PTSD articles published annually increased dramatically, from 2 in 1980 to 70 in 2014. Overall, 50.6% of articles were focused on military populations. Combat was identified as the trauma exposure in 38.0% of articles, while sexual assault was identified in 8.7%. Negative themes such as crimes perpetrated by people with possible PTSD (18.0%) and substance abuse (11.5%) were prominent, substance abuse being more prevalent in articles focused on military populations (16.4% vs. 6.3%, p = <.001). Only 9.1% of articles mentioned PTSD treatment options and this theme became less prevalent over time-ranging from 19.4% of articles published between 1980-1995 to just 5.7% of articles published between 2005-2015 (p = <.001). Results suggest that public awareness of PTSD has increased, but may be incomplete, inaccurate, and perpetuate PTSD stigma at individual- and institutional-levels. These findings can inform advocacy strategies that enhance public awareness about PTSD and traumatic stress."Heroes' invisible wounds of war:" Constructions of posttraumatic stress disorder in the text of US federal legislation
AbstractPurtle, J. (n.d.).Publication year
2016Journal title
Social Science and MedicineVolume
149Page(s)
9-16AbstractPublic policies contribute to the social construction of mental health problems. In this study, I use social constructivist theories of policy design and the methodology of ethnographic content analysis to qualitatively explore how posttraumatic stress disorder (PTSD) has been constructed as a problem in US federal legislation. I analyzed the text of 166 bills introduced between 1989 and 2009 and found that PTSD has been constructed as a problem unique to combat exposures and military populations. These constructions were produced through combat-related language and imagery (e.g., wounds, war, heroism), narratives describing PTSD as a military-specific phenomenon, and reinforced by the absence of PTSD in trauma-focused legislation targeting civilians. These constructions do not reflect the epidemiology of PTSD-the vast majority of people who develop the disorder have not experienced combat and many non-combat traumas (e.g., sexual assault) carry higher PTSD risk-and might constrain public and political discourse about the disorder and reify sociocultural barriers to the access of mental health services.A review of policy dissemination and implementation research funded by the National Institutes of Health, 2007-2014
AbstractPurtle, J., Peters, R., & Brownson, R. C. (n.d.).Publication year
2016Journal title
Implementation ScienceVolume
11Issue
1AbstractBackground: Policy has a tremendous potential to improve population health when informed by research evidence. Such evidence, however, typically plays a suboptimal role in policymaking processes. The field of policy dissemination and implementation research (policy D&I) exists to address this challenge. The purpose of this study was to: (1) determine the extent to which policy D&I was funded by the National Institutes of Health (NIH), (2) identify trends in NIH-funded policy D&I, and (3) describe characteristics of NIH-funded policy D&I projects. Methods: The NIH Research Portfolio Online Reporting Tool was used to identify all projects funded through D&I-focused funding announcements. We screened for policy D&I projects by searching project title, abstract, and term fields for mentions of "policy," "policies," "law," "legal," "legislation," "ordinance," "statute," "regulation," "regulatory," "code," or "rule." A project was classified as policy D&I if it explicitly proposed to conduct research about the content of a policy, the process through which it was developed, or outcomes it produced. A coding guide was iteratively developed, and all projects were independently coded by two researchers. ClinicalTrials.gov and PubMed were used to obtain additional project information and validate coding decisions. Descriptive statistics-stratified by funding mechanism, Institute, and project characteristics-were produced. Results: Between 2007 and 2014, 146 projects were funded through the D&I funding announcements, 12 (8.2 %) of which were policy D&I. Policy D&I funding totaled $16,177,250, equivalent to 10.5 % of all funding through the D&I funding announcements. The proportion of funding for policy D&I projects ranged from 14.6 % in 2007 to 8.0 % in 2012. Policy D&I projects were primarily focused on policy outcomes (66.7 %), implementation (41.7 %), state-level policies (41.7 %), and policies within the USA (83.3 %). Tobacco (33.3 %) and cancer (25.0 %) control were the primary topics of focus. Many projects combined survey (58.3 %) and interview (33.3 %) methods with analysis of archival data sources. Conclusions: NIH has made an initial investment in policy D&I research, but the level of support has varied between Institutes. Policy D&I researchers have utilized a variety of designs, methods, and data sources to investigate the development processes, content, and outcomes of public and private policies.Gender differences in posttraumatic stress symptoms among participants of a violence intervention program at a pediatric hospital: A pilot study
AbstractPurtle, J., Adams-Harris, E., Frisby, B., Rich, J. A., & Corbin, T. J. (n.d.).Publication year
2016Journal title
Family and Community HealthVolume
39Issue
2Page(s)
113-119AbstractHospital-based violence intervention programs (HVIPs) have emerged as a strategy to address posttraumatic stress (PTS) symptoms among violently injured patients and their families. HVIP research, however, has focused on males and little guidance exists about how HVIPs could be tailored to meet gender-specific needs. We analyzed pediatric HVIP data to assess gender differences in prevalence and type of PTS symptoms. Girls reported more PTS symptoms than boys (6.96 vs 5.21, P = .027), particularly hyperarousal symptoms (4.00 vs 2.82, P = .002) such as feeling upset by reminders of the event (88.9% vs 48.3%, P = .005). Genderfocused research represents a priority area for HVIPs.Prevalence and correlates of local health department activities to address mental health in the United States
AbstractPurtle, J., Klassen, A. C., Kolker, J., & Buehler, J. W. (n.d.).Publication year
2016Journal title
Preventive MedicineVolume
82Page(s)
20-27AbstractMental 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.Treating youth violence in hospital and emergency department settings
AbstractPurtle, J., Carter, P. M., Cunningham, R., & Fein, J. A. (n.d.).Publication year
2016Journal title
Adolescent Medicine: State of the Art ReviewsVolume
27Issue
2Page(s)
351-363AbstractYouth violence is a significant US public health problem and a leading cause of adolescent morbidity and mortality.1 Homicide is the third leading cause of death among youth aged 10 to 24 years and has been the leading cause of death among black youth for well over a decade.2 Violently injured youth are at high risk for repeat injury; with recent data indicating that violent reinjury rates among urban youth treated in the emergency department (ED) are as high as 37%.3 Furthermore, these youth have high rates of involvement with severe and escalating forms of violence, with almost 60% reporting involvement with firearm violence as either a victim or aggressor within 2 years after receiving care for an assault injury.4Uses of research evidence by state legislators who prioritize behavioral health issues
AbstractPurtle, J., Dodson, E. A., & Brownson, R. C. (n.d.).Publication year
2016Journal title
Psychiatric ServicesVolume
67Issue
12Page(s)
1355-1361AbstractObjective: Disseminating behavioral health (BH) research t elected policy makers is a priority, but little is known abou how they use and seek research evidence. This explorator study aimed to identify research dissemination preference and research-seeking practices of legislators who prioritiz BH issues and to describe the role of research in determinin policy priorities. The study also assessed whether thes legislators differ from those who do not prioritize BH issues Methods: A telephone-based survey was conducted wit 862 state legislators (response rate, 46%). A validated surve instrument assessed priorities and the factors that determine them, research dissemination preferences, an research-seeking practices. Bivariate analyses were used t characterize and compare the two groups Results: Legislators who prioritized BH issues (N=125) wer significantly more likely than those who did not to identif research evidence as a factor that determined policy prioritie (odds ratio=1.91, 95% confidence interval=1.25-2.90, p=.002) ThosewhoprioritizedBHissues also attributed more importanc to ten of 12 features of research, and the difference was significan for four features (unbiased, p=.014; presented in a concis way, p=.044; delivered by someone known or respected p=.033; and tells a story, p=.030). Those who prioritized BH issue also engaged more often in eight of 11 research-seekin and utilization practices, and a significance difference was foun for one (attending research presentations, p=.012) Conclusions: Legislators who prioritized BH issues activel sought, had distinct preferences for, and were particularl influenced by research evidence. Testing legislator-focuse BH research dissemination strategies is an area for futur research.Cost-benefit analysis simulation of a hospital-based violence intervention program
AbstractPurtle, J., Rich, L. J., Bloom, S. L., Rich, J. A., & Corbin, T. J. (n.d.).Publication year
2015Journal title
American journal of preventive medicineVolume
48Issue
2Page(s)
162-169AbstractBackground: Violent injury is a major cause of disability, premature mortality, and health disparities worldwide. Hospital-based violence intervention programs (HVIPs) show promise in preventing violent injury. Little is known, however, about how the impact of HVIPs may translate into monetary figures. Purpose: To conduct a cost-benefit analysis simulation to estimate the savings anHVIPmight produce in healthcare, criminal justice, and lost productivity costs over 5 years in a hypothetical population of 180 violently injured patients, 90 of whom received HVIP intervention and 90 of whom did not. Methods: Primary data from 2012, analyzed in 2013, on annual HVIP costs/number of clients served and secondary data sources were used to estimate the cost, number, and type of violent reinjury incidents (fatal/nonfatal, resulting in hospitalization/not resulting in hospitalization) and violent perpetration incidents (aggravated assault/homicide) that this populationmight experience over 5 years. Four differentmodels were constructed and three different estimates of HVIP effect size (20%, 25%, and 30%) were used to calculate a range of estimates for HVIP net savings and cost-benefit ratios from different payer perspectives. All benefits were discounted at 5% to adjust for their net present value. Results: Estimates of HVIP cost savings at the base effect estimate of 25% ranged from $82,765 (narrowest model) to $4,055,873 (broadest model). Conclusions: HVIPs are likely to produce cost savings. This study provides a systematic framework for the economic evaluation of HVIPs and estimates of HVIP cost savings and cost-benefit ratios that may be useful in informing public policy decisions.Purtle and Roman respond
Purtle, J., & Roman, L. A. (n.d.). In American journal of public health (1–).Publication year
2015Volume
105Issue
9Page(s)
e2-e3Purtle and roman respond
Purtle, J., & Roman, L. A. (n.d.). In American journal of public health (1–).Publication year
2015Volume
105Issue
10Page(s)
e9-e10Scared safe? Abandoning the use of fear in urban violence prevention programmes
Jonathan, J. P., Cheney, R., Wiebe, D. J., & Dicker, R. (n.d.).Publication year
2015Journal title
Injury PreventionVolume
21Issue
2Page(s)
140-141The youth nonfatal violent injury review panel: An innovative model to inform policy and systems change
AbstractPurtle, J., Rich, L. J., Rich, J. A., Cooper, J., Harris, E. J., & Corbin, T. J. (n.d.).Publication year
2015Journal title
Public Health ReportsVolume
130Issue
6Page(s)
610-615AbstractAmong young people in the United States, nonfatal violent injuries outnumber fatal violent injuries by 171 to 1. The Child Fatality Review Team (CFRT) is a well-established model for informing injury prevention planning. The CFRT’s restricted focus on fatal injuries, however, limits its ability to identify opportunities to prevent violent reinjury and address issues unique to nonfatal violent injuries. We adapted the CFRT model to develop and implement a Youth Nonfatal Violent Injury Review Panel. We convened representatives from 23 agencies (e.g., police, housing, and education) quarterly to share administrative information and confidentially discuss cases of nonfatal violent injury. In this article, we describe the panel model and present preliminary data on participants’ perceptions of the process. Although outcomes research is needed to evaluate its impacts, the Youth Nonfatal Violent Injury Review Panel offers an innovative, promising, and replicable model for interagency collaboration to prevent youth violence and its effects.Gender-specific research on mental illness in the emergency department: Current knowledge and future directions
AbstractRanney, M. L., Locci, N., Adams, E. J., Betz, M., Burmeister, D. B., Corbin, T., Dalawari, P., Jacoby, J. L., Linden, J., Purtle, J., North, C., & Houry, D. E. (n.d.).Publication year
2014Journal title
Academic Emergency MedicineVolume
21Issue
12Page(s)
1395-1402AbstractMental illness is a growing, and largely unaddressed, problem for the population and for emergency department (ED) patients in particular. Extensive literature outlines sex and gender differences in mental illness' epidemiology and risk and protective factors. Few studies, however, examined sex and gender differences in screening, diagnosis, and management of mental illness in the ED setting. Our consensus group used the nominal group technique to outline major gaps in knowledge and research priorities for these areas, including the influence of violence and other risk factors on the course of mental illness for ED patients. Our consensus group urges the pursuit of this research in general and conscious use of a gender lens when conducting, analyzing, and authoring future ED-based investigations of mental illness.The Affordable Care Act’s Medicaid expansion creates incentive for state Medicaid agencies to provide reimbursement for hospital-based violence intervention programmes
Fischer, K., Purtle, J., & Corbin, T. (n.d.).Publication year
2014Journal title
Injury PreventionVolume
20Issue
6Page(s)
427-430The Legislative Response to PTSD in the United States (1989-2009): A Content Analysis
AbstractPurtle, J. (n.d.).Publication year
2014Journal title
Journal of Traumatic StressVolume
27Issue
5Page(s)
501-508AbstractAlthough knowledge about posttraumatic stress disorder (PTSD) has grown over the past 40 years, PTSD policy research is undeveloped. This gap in knowledge warrants attention because policy is among the most powerful tools to prevent and mitigate the effects of PTSD. This study provides a content analysis of all bills introduced in U.S. Congress that explicitly mentioned PTSD. All bills and bill sections mentioning PTSD were coded to create a legislative dataset. Bills that addressed traumatic stress, but did not mention PTSD, were also identified as a comparison group. One hundred sixty-one PTSD explicit bills containing 382 sections of legislative text were identified, as were 43 traumatic stress, non-PTSD bills containing 55 sections (the 2 categories were mutually exclusive). Compared to traumatic stress, non-PTSD sections, PTSD explicit sections were far more likely to target military populations (23.6% vs. 91.4%) and combat exposures (14.5% vs. 91.4%). PTSD, as a discrete diagnostic entity, has been largely defined as a problem unique to combat exposure and military populations in federal legislation. Research is needed to understand knowledge and perceptions of PTSD among policy makers and the public to inform science-based advocacy strategies that translate the full spectrum of PTSD research into policy.The psychological sequelae of violent injury in a pediatric intervention
AbstractPurtle, J., Harris, E., Compton, R., Baccare, R., Morris, A., Dibartolo, D., Campbell, C., Vogel, K., Schwartz, N., & Moront, M. (n.d.).Publication year
2014Journal title
Journal of Pediatric SurgeryVolume
49Issue
11Page(s)
1668-1672AbstractPurpose Pediatric trauma centers have unique potential to prevent violent injury and its psychological sequelae. Hospital-based violence intervention programs (HVIPs) are proliferating across the U.S., but little is known about the psychological needs of pediatric patients who participate in them. The purpose of this study was to describe the prevalence of symptoms of posttraumatic stress and exposure to community violence among pediatric HVIP participants.Methods We conducted a cross-sectional analysis of psychosocial needs assessment data that were collected for 48 participants. The Child Trauma Screening Questionnaire (CTSQ) and modified Survey of Children's Exposure to Community Violence were used to assess primary outcomes.Results The sample was 62.5% male and had a mean age of 14.5 years. Twenty-three percent reported previously sustaining a violent injury resulting in medical care, and 47.8% had witnessed a shooting. The majority (66.0%) had a CTSQ score at/above the threshold for probable PTSD diagnosis. The mean CTSQ score was 5.9 and hyperarousal (3.3) symptoms were more common than re-experiencing symptoms (2.6).Conclusion Pediatric HVIPs and trauma centers should consider integrating PTSD screening and trauma-focused psychoeducation into the practice and protocols. Future research should evaluate the impacts of these interventions.Felon disenfranchisement in the United States: A health equity perspective
AbstractPurtle, J. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
4Page(s)
632-637AbstractApproximately 13% of African American men are disqualified from voting because of a felony conviction. I used ecosocial theory to identify how institutionalized racism helps perpetuate health disparities and to explore pathways through which felon disenfranchisement laws may contribute to racial health disparities in the United States. From a literature review, I identified 2 potential pathways: (1) inability to alter inequitable public policies that differentially allocate resources for health; and (2) inability to reintegrate into society by voting, which contributes to allostatic load.Purtle responds
Purtle, J. (n.d.). In American journal of public health (1–).Publication year
2013Volume
103Issue
11Page(s)
e6-e8The prevalence of trauma and childhood adversity in an urban, hospital-based violence intervention program
AbstractCorbin, T. J., Purtle, J., Rich, L. J., Rich, J. A., Adams, E. J., Yee, G., & Bloom, S. L. (n.d.).Publication year
2013Journal title
Journal of health care for the poor and underservedVolume
24Issue
3Page(s)
1021-1030AbstractHospitals represent a promising locus for preventing recurrent interpersonal violence and its psychological sequella. We conducted a cross- sectional analysis to assess the prevalence of post- traumatic stress disorder (PTSD) and adverse childhood experiences (ACEs) among victims of interpersonal violence participating in a hospital- based violence intervention program. Participants completed PTSD and ACE screenings four to six weeks aft er violent injury, and data were exported from a case management database for analysis. Of the 35 program participants who completed the ACE and/or PTSD screenings, 75.0% met full diagnostic criteria for PTSD, with a larger proportion meeting diagnostic criteria for symptom- specific clusters. For the ACE screening, 56.3% reported three or more ACEs, 34.5% reported five or more ACEs, and 18.8% reported seven or more ACEs. The median ACE score was 3.5. These findings underscore the importance of trauma- informed approaches to violence prevention in urban hospitals and have implications for emergency medicine research and policy.Integrating Racially and Ethnically Diverse Communities Into Planning for Disasters: The California Experience
AbstractAndrulis, D. P., Siddiqui, N. J., & Purtle, J. P. (n.d.).Publication year
2011Journal title
Disaster medicine and public health preparednessVolume
5Issue
3Page(s)
227-234AbstractObjectives: Racially/ethnically diverse communities suffer a disproportionate burden of adverse outcomes before, during and after a disaster. Using California as a locus of study, we sought to identify challenges and barriers to meeting the preparedness needs of these communities and highlight promising strategies, gaps in programs, and future priorities. Methods: We conducted a literature review, environmental scan of organizational Web sites providing preparedness materials for diverse communities, and key informant interviews with public health and emergency management professionals. Results: We identified individual-level barriers to preparing diverse communities such as socioeconomic status, trust, culture, and language, as well as institutional-level barriers faced by organizations such as inadequate support for culturally/linguistically appropriate initiatives. Current programs to address these barriers include language assistance services, community engagement strategies, cross-sector collaboration, and community assessments. Enhancing public-private partnerships, increasing flexibility in allocating funds and improving organizational capacity for diversity initiatives were all identified as additional areas of programmatic need. Conclusions: Our study suggests at least four intervention priorities for California and across the United States: engaging diverse communities in all aspects of emergency planning, implementation, and evaluation; mitigating fear and stigma; building organizational cultural competence; and enhancing coordination of information and resources. In addition, this study provides a methodological model for other states seeking to assess their capacity to integrate diverse communities into preparedness planning and response.