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 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.
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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
Assessing the spatial heterogeneity in overall health across the United States using spatial regression methods : The contribution of health factors and county-level demographics
AbstractTabb, L. P., McClure, L. A., Quick, H., Purtle, J., & Diez Roux, A. V. (n.d.).Publication year
2018Journal title
Health and PlaceVolume
51Page(s)
68-77Abstract~Audience segmentation to disseminate behavioral health evidence to legislators : An empirical clustering analysis
AbstractPurtle, J., Lê-Scherban, F., Wang, X., Shattuck, P. T., Proctor, E. K., & Brownson, R. C. (n.d.).Publication year
2018Journal title
Implementation ScienceVolume
13Issue
1AbstractBackground: Elected officials (e.g., legislators) are an important but understudied population in dissemination research. Audience segmentation is essential in developing dissemination strategies that are tailored for legislators with different characteristics, but sophisticated audience segmentation analyses have not been conducted with this population. An empirical clustering audience segmentation study was conducted to (1) identify behavioral health (i.e., mental health and substance abuse) audience segments among US state legislators, (2) identify legislator characteristics that are predictive of segment membership, and (3) determine whether segment membership is predictive of support for state behavioral health parity laws. Methods: Latent class analysis (LCA) was used. Data were from a multi-modal (post-mail, e-mail, telephone) survey of state legislators fielded in 2017 (N=475). Nine variables were included in the LCA (e.g., perceptions of behavioral health treatment effectiveness, mental illness stigma). Binary logistic regression tested associations between legislator characteristics (e.g., political party, gender, ideology) and segment membership. Multi-level logistic regression assessed the predictive validity of segment membership on support for parity laws. A name was developed for each segment that captured its most salient features. Results: Three audience segments were identified. Budget-oriented skeptics with stigma (47% of legislators) had the least faith in behavioral health treatment effectiveness, had the most mental illness stigma, and were most influenced by budget impact. This segment was predominantly male, Republican, and ideologically conservative. Action-oriented supporters (24%) were most likely to have introduced a behavioral health bill, most likely to identify behavioral health issues as policy priorities, and most influenced by research evidence. This was the most politically and ideologically diverse segment. Passive supporters (29%) had the greatest faith in treatment effectiveness and the least stigma, but were also least likely to have introduced a behavioral health bill. Segment membership was a stronger predictor of support for parity laws than almost all other legislator characteristics. Conclusions: State legislators are a heterogeneous audience when it comes to behavioral health. There is a need to develop and test behavioral health evidence dissemination strategies that are tailored for legislators in different audience segments. Empirical clustering approaches to audience segmentation are a potentially valuable tool for dissemination science.Inter-Agency Strategies Used by State Mental Health Agencies to Assist with Federal Behavioral Health Parity Implementation
AbstractPurtle, J., Borchers, B., Clement, T., & Mauri, A. (n.d.).Publication year
2018Journal title
Journal of Behavioral Health Services and ResearchVolume
45Issue
3Page(s)
516-526Abstract~Legislators' Sources of Behavioral Health Research and Preferences for Dissemination : Variations by Political Party
AbstractPurtle, J., Dodson, E. A., Nelson, K., Meisel, Z. F., & Brownson, R. C. (n.d.).Publication year
2018Journal title
Hospital and Community PsychiatryVolume
69Issue
10Page(s)
1105-1108AbstractOBJECTIVES: This study sought to characterize primary sources of behavioral health research and dissemination preferences of state legislators and assess differences by political party. METHODS: A 2017 cross-sectional survey of state legislators (N=475) assessed where legislators seek, and the most important features of, behavioral health research. Bivariate analyses and multivariate logistic regression were conducted. RESULTS: Advocacy organizations (53%), legislative staff (51%), and state agencies (48%) were identified most frequently as sources of behavioral health research. Universities were identified by significantly more Democrats than Republicans (34% versus 19%; adjusted odds ratio=1.79). Data about budget impact and cost-effectiveness were most frequently rated as very important, but by significantly fewer Democrats than Republicans (77% versus 87% and 76% versus 89%, respectively). CONCLUSIONS: To reach legislators and satisfy their information preferences, behavioral health researchers should target diverse audiences, partner with intermediary organizations, and craft messages that include economic evaluation data.The Impact of Law on Syndromic Disease Surveillance Implementation
AbstractPurtle, J., Field, R. I., Hipper, T., Nash-Arott, J., Chernak, E., & Buehler, J. W. (n.d.).Publication year
2018Journal title
Journal of Public Health Management and PracticeVolume
24Issue
1Page(s)
9-17AbstractContext: Legal environments influence how health information technologies are implemented in public health practice settings. Syndromic disease surveillance (SyS) is a relatively new approach to surveillance that depends heavily on health information technologies to achieve rapid awareness of disease trends. Evidence suggests that legal concerns have impeded the optimization of SyS. Objectives: To (1) understand the legal environments in which SyS is implemented, (2) determine the perceived legal basis for SyS, and (3) identify perceived legal barriers and facilitators to SyS implementation. Design: Multisite case study in which 35 key informant interviews and 5 focus groups were conducted with 75 SyS stakeholders. Interviews and focus groups were audio recorded, transcribed, and analyzed by 3 coders using thematic content analysis. Legal documents were reviewed. Setting: Seven jurisdictions (5 states, 1 county, and 1 city) that were purposively selected on the basis of SyS capacity and legal environment. Participants: Health department directors, SyS system administrators, legal counsel, and hospital personnel. Results: Federal (eg, HIPAA) and state (eg, notifiable disease reporting) laws that authorize traditional public health surveillance were perceived as providing a legal basis for SyS. Financial incentives for hospitals to satisfy Meaningful Use regulations have eased concerns about the legality of SyS and increased the number of hospitals reporting SyS data. Legal issues were perceived as barriers to BioSense 2.0 (the federal SyS program) participation but were surmountable. Conclusion: Major legal reforms are not needed to promote more widespread use of SyS. The current legal environment is perceived by health department and hospital officials as providing a firm basis for SyS practice. This is a shift from how law was perceived when SyS adoption began and has policy implications because it indicates that major legal reforms are not needed to promote more widespread use of the technology. Beyond SyS, our study suggests that federal monetary incentives can ameliorate legal concerns regarding novel health information technologies.Understanding policymakers' opinions can help foster policy change
AbstractPurtle, J., Henson, R. M., Carroll-Scott, A., Kolker, J., Joshi, R., & Roux, A. V. (n.d.).Publication year
2018Journal title
American journal of public healthVolume
108Issue
9Page(s)
e6Abstract~US mayors’ and health commissioners’ opinions about health disparities in their cities
AbstractPurtle, J., Henson, R. M., Carroll-Scott, A., Kolker, J., Joshi, R., & Diez Roux, A. V. (n.d.).Publication year
2018Journal title
American journal of public healthVolume
108Issue
5Page(s)
634-641AbstractObjectives. To characterize US mayors’ and health commissioners’ opinions about health disparities in their cities and identify factors associated with these opinions. Methods. We conducted a multimodal survey of mayors and health commissioners in fall-winter 2016 (n = 535; response rate = 45.2%). We conducted bivariate analyses and multivariable logistic regression. Results. Forty-two percent of mayors and 61.1% of health commissioners strongly agreed that health disparities existed in their cities. Thirty percent of mayors and 8.0% of health commissioners believed that city policies could have little or no impact on disparities. Liberal respondents were more likely than were conservative respondents to strongly agree that disparities existed (mayors: odds ratio [OR] = 7.37; 95% confidence interval [CI] = 3.22, 16.84; health commissioners: OR = 5.09; 95% CI = 3.07, 8.46). In regression models, beliefs that disparities existed, were avoidable, and were unfair were independently associated with the belief that city policies could have a major impact on disparities. Conclusions. Many mayors, and some health commissioners, are unaware of the potential of city policies to reduce health disparities. Ideology is strongly associated with opinions about disparities among these city policymakers. Public Health Implications: Information about health disparities, and policy strategies to reduce them, needs to be more effectively communicated to city policymakers.An audience research study to disseminate evidence about comprehensive state mental health parity legislation to US State policymakers : Protocol
AbstractPurtle, J., Lê-Scherban, F., Shattuck, P., Proctor, E. K., & Brownson, R. C. (n.d.).Publication year
2017Journal title
Implementation ScienceVolume
12Issue
1AbstractBackground: A large proportion of the US population has limited access to mental health treatments because insurance providers limit the utilization of mental health services in ways that are more restrictive than for physical health services. Comprehensive state mental health parity legislation (C-SMHPL) is an evidence-based policy intervention that enhances mental health insurance coverage and improves access to care. Implementation of C-SMHPL, however, is limited. State policymakers have the exclusive authority to implement C-SMHPL, but sparse guidance exists to inform the design of strategies to disseminate evidence about C-SMHPL, and more broadly, evidence-based treatments and mental illness, to this audience. The aims of this exploratory audience research study are to (1) characterize US State policymakers' knowledge and attitudes about C-SMHPL and identify individual- and state-level attributes associated with support for C-SMHPL; and (2) integrate quantitative and qualitative data to develop a conceptual framework to disseminate evidence about C-SMHPL, evidence-based treatments, and mental illness to US State policymakers. Methods: The study uses a multi-level (policymaker, state), mixed method (QUAN→qual) approach and is guided by Kingdon's Multiple Streams Framework, adapted to incorporate constructs from Aarons' Model of Evidence-Based Implementation in Public Sectors. A multi-modal survey (telephone, post-mail, e-mail) of 600 US State policymakers (500 legislative, 100 administrative) will be conducted and responses will be linked to state-level variables. The survey will span domains such as support for C-SMHPL, knowledge and attitudes about C-SMHPL and evidence-based treatments, mental illness stigma, and research dissemination preferences. State-level variables will measure factors associated with C-SMHPL implementation, such as economic climate and political environment. Multi-level regression will determine the relative strength of individual- and state-level variables on policymaker support for C-SMHPL. Informed by survey results, semi-structured interviews will be conducted with approximately 50 US State policymakers to elaborate upon quantitative findings. Then, using a systematic process, quantitative and qualitative data will be integrated and a US State policymaker-focused C-SMHPL dissemination framework will be developed. Discussion: Study results will provide the foundation for hypothesis-driven, experimental studies testing the effects of different dissemination strategies on state policymakers' support for, and implementation of, evidence-based mental health policy interventions.Factors Perceived as Influencing Local Health Department Involvement in Mental Health
AbstractPurtle, J., Peters, R., Kolker, J., & Klassen, A. C. (n.d.).Publication year
2017Journal title
American journal of preventive medicineVolume
52Issue
1Page(s)
64-73AbstractIntroduction Local health departments (LHDs) are potentially well positioned to implement population-based approaches to mental health promotion, but research indicates that most LHDs are not substantively engaged in activities to address mental health. Little is known about factors that influence if and how LHDs address population mental health. The objectives of this qualitative study were to (1) understand how LHD officials perceive population mental health; (2) identify factors that influence these perceptions and LHD activities to address population mental health; and (3) develop an empirically derived conceptual framework of LHD engagement in population mental health. Methods Twenty-one semi-structured interviews were conducted with a purposive sample of LHD officials and analyzed using thematic content analysis in 2014–2015. Transcripts were double coded, inter-rater reliability statistics were calculated, and categories with κ ≥0.60 were retained. Results Respondents perceived mental health as a public health issue and expressed that it has emerged as a priority through community health needs assessment processes, such as those conducted for health department accreditation. However, most LHDs were not substantively engaged in population mental health activities because of limited resources, knowledge, data, and hesitancy to infringe upon the territory of local behavioral health agencies. LHDs and local behavioral health agencies had difficulty communicating and collaborating because of divergent perspectives and financing arrangements. Conclusions LHD officials are eager to embrace population mental health, but resources, training and education, and systems-level changes are needed. Contemporary reforms to the structure and financing of the U.S. health system offer opportunities to address these challenges.Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax' : Simulating effects of using an excise tax to address a social determinant of health
AbstractLangellier, B. A., Lê-Scherban, F., & Purtle, J. (n.d.).Publication year
2017Journal title
Public Health NutritionVolume
20Issue
13Page(s)
2450-2458AbstractObjective Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. Design We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics-Child Development Supplement. Setting Philadelphia, Pennsylvania, USA. Subjects Philadelphia children and adolescents aged 4-18 years. Results A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. Conclusions Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.Infusing Science into Politics and Policy : The Importance of Legislators as an Audience in Mental Health Policy Dissemination Research
AbstractPurtle, J., Brownson, R. C., & Proctor, E. K. (n.d.).Publication year
2017Journal title
Administration and Policy in Mental Health and Mental Health Services ResearchVolume
44Issue
2Page(s)
160-163AbstractLegislators (i.e., elected Senators and House Representatives at the federal- and state-level) are a critically important dissemination audience because they shape the architecture of the US mental health system through budgetary and regulatory decisions. In this Point of View, we argue that legislators are a neglected audience in mental health dissemination research. We synthesize relevant research, discuss its potential implications for dissemination efforts, identify challenges, and outline areas for future study.Is this thing on? Getting the public to listen to the pro-vaccine message
AbstractGoldstein, N. D., LeVasseur, M. T., & Purtle, J. (n.d.).Publication year
2017Journal title
VaccineVolume
35Issue
9Page(s)
1208Abstract~Mapping “Trauma-Informed” Legislative Proposals in U.S. Congress
AbstractPurtle, J., & Lewis, M. (n.d.).Publication year
2017Journal title
Administration and Policy in Mental Health and Mental Health Services ResearchVolume
44Issue
6Page(s)
867-876AbstractDespite calls for translation of trauma-informed practice into public policy, no empirical research has investigated how the construct has been integrated into policy proposals. This policy mapping study identified and analyzed every bill introduced in US Congress that mentioned “trauma-informed” between 1973 and 2015. Forty-nine bills and 71 bill sections mentioned the construct. The number of trauma-informed bills introduced annually increased dramatically, from 0 in 2010 to 28 in 2015. Trauma-informed bill sections targeted a range of sectors, but disproportionally focused on youth (73.2%). Only three bills defined “trauma-informed.” Implications within the context of a changing political environment are discussed.Policy dissemination research
AbstractPurtle, J., Dodson, E. A., & Brownson, R. C. (n.d.).Publication year
2017Page(s)
433-448AbstractPolicy 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.Population mental health & community violence : Advancing the role of local health departments
AbstractPurtle, J. (n.d.).Publication year
2017Journal title
American journal of public healthVolume
107Issue
9Page(s)
1358-1360Abstract~The role of nonprofit hospitals in identifying and addressing health inequities in cities
AbstractCarroll-Scott, A., Henson, R. M., Kolker, J., & Purtle, J. (n.d.).Publication year
2017Journal title
Health AffairsVolume
36Issue
6Page(s)
1102-1109AbstractFor nonprofit hospitals to maintain their tax-exempt status, the Affordable Care Act requires them to conduct a community health needs assessment, in which they evaluate the health needs of the community they serve, and to create an implementation strategy, in which they propose ways to address these needs. We explored the extent to which nonprofit urban hospitals identified equity among the health needs of their communities and proposed health equity strategies to address this need. We conducted a content analysis of publicly available community health needs assessments and implementation strategies from 179 hospitals in twenty-eight US cities in the period August-December 2016. All of the needs assessments included at least one implicit health equity term (such as disparities, disadvantage, poor, or minorities), while 65 percent included at least one explicit health equity term (equity, health equity, inequity, or health inequity). Thirty-five percent of implementation strategies included one or more explicit health equity terms, but only 9 percent included an explicit activity to promote health equity. While needs assessment reporting requirements have the potential to encourage urban nonprofit hospitals to address health inequities in their communities, hospitals need incentives and additional capacity to invest in strategies that address the underlying structural social and economic conditions that cause health inequities.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 ="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.