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
Use, Potential Use, and Awareness of the 988 Suicide and Crisis Lifeline by Level of Psychological Distress
AbstractPurtle, J., McSorley, A.-M. M., Adera, A. L., & Lindsey, M. A. (n.d.). In JAMA network open.Publication year
2023Volume
6Issue
10AbstractIntroductionThe 988 Suicide and Crisis Lifeline was launched nationally on July 16, 2022. Increases in call volume following the launch of 988 hotline1 and public awareness2 and policy maker communication3 about the 988 Lifeline have been documented. However, little is known about how use or awareness of the 988 Lifeline varies across populations with different levels of psychological distress. This represents an important area of study.4 To address this, we assessed variations in use, potential use, and awareness of the 988 Lifeline among people with varying levels of psychological distress.Use, Potential Use, and Awareness of the 988 Suicide and Crisis Lifeline by Level of Psychological Distress
AbstractPurtle, J., McSorley, A. M., Adera, A. L., & Lindsey, M. A. (n.d.).Publication year
2023Journal title
JAMA network openVolume
6Issue
10Page(s)
e2341383Abstract~Uses of Population Health Rankings in Local Policy Contexts : A Multisite Case Study
AbstractPurtle, J., Peters, R., Kolker, J., & Diez Roux, A. V. (n.d.).Publication year
2019Journal title
Medical Care Research and ReviewVolume
76Issue
4Page(s)
478-496AbstractPopulation health rankings are a common strategy to spur evidence-informed health policy making, but little is known about their uses or impacts. The study aims were to (1) understand how and why the County Health Rankings (CH-Rankings) are used in local policy contexts, (2) identify factors that influence CH-Rankings utilization, and (3) explore potentially negative impacts of the CH-Rankings. Forty-four interviews were conducted with health organization officials and public policy makers in 15 purposively selected counties. The CH-Rankings were used instrumentally to inform internal planning decisions, conceptually to educate the public and policy makers about determinants of population health, and politically to advance organizational agendas. Factors related to organizational capacity, county political ideology, and county rank influenced if, how, and why the CH-Rankings were used. The CH-Rankings sometimes had the negative impacts of promoting potentially ineffective interventions in politically conservative counties and prompting negative media coverage in some counties with poor rank.Uses 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.Using 911 Financing Data as a Model for 988
AbstractPurtle, J., Mauri, A. I., Cantor, J. H., & McBain, R. K. (n.d.).Publication year
2024Journal title
Psychiatric ServicesVolume
75Issue
7Page(s)
613Abstract~Using audience segmentation to identify implementation strategies to improve PrEP uptake among at-risk cisgender women : a mixed-methods study protocol
AbstractPellowski, J. A., Price, D. M., Desir, A., Golub, S., Operario, D., & Purtle, J. (n.d.).Publication year
2023Journal title
Implementation Science CommunicationsVolume
4Issue
1AbstractBackground: In the USA, 19% of new HIV infections occur among cisgender women (cis women); however, only 10% of eligible cis women have been prescribed pre-exposure prophylaxis (PrEP) for the prevention of HIV infection (an evidence-based intervention). A fundamental challenge for expanding HIV prevention to cis women is ensuring implementation strategies are tailored to the various healthcare settings in which cis women seek care and the heterogeneous providers nested within these settings. This project’s specific aims are to (1) explore clinician-level characteristics and organizational climate factors that are related to variability in adoption of PrEP service delivery as an evidence-based intervention for cis women; (2) identify latent audience segments of women’s health providers as the related to PrEP acceptability, adoption, and maintenance and analyze demographic correlates of these segments; and (3) identify audience segment-specific implementation strategies to facilitate the adoption of PrEP as an evidence-based intervention among at-risk cis women. Methods: Using the i-PARIHS framework, this mixed-methods study examines three domains for guiding audience segmentation to facilitate PrEP implementation for cis women: innovation (degree of fit with existing practices, usability), recipient beliefs and knowledge and context factors (organizational culture, readiness for change), needs to determine appropriate facilitation methods. To achieve aim 1, qualitative interviews will be conducted with PrEP-eligible cis women, women’s health providers, and other key stakeholders. Aim 2 will consist of a quantitative survey among 340 women’s health providers. Latent class analysis will be used to facilitate audience segmentation. To achieve aim 3, a panel of 5–8 providers for each audience segment will meet and engage in iterative discussions guided by Fernandez’s implementation mapping to identify (1) implementation outcomes and performance objectives, determinants, and change objectives and (2) determine and refine of implementation strategies for each audience segment. Discussion: This exploratory mixed methods study will provide an empirical foundation to inform the development implementations strategies aimed at increasing PrEP delivery to cis women among heterogenous groups of providers.Using policy codesign to achieve multi-sector alignment in adolescent behavioral health : a study protocol
AbstractWalker, S. C., Ahrens, K. R., Owens, M. D., Parnes, M., Langley, J., Ackerley, C., Purtle, J., Saldana, L., Aarons, G. A., Hogue, A., & Palinkas, L. A. (n.d.).Publication year
2024Journal title
Implementation Science CommunicationsVolume
5Issue
1AbstractBackground: Policymaking is quickly gaining focus in the field of implementation science as a potential opportunity for aligning cross-sector systems and introducing incentives to promote population health, including substance use disorders (SUD) and their prevention in adolescents. Policymakers are seen as holding the necessary levers for realigning service infrastructure to more rapidly and effectively address adolescent behavioral health across the continuum of need (prevention through crisis care, mental health, and SUD) and in multiple locations (schools, primary care, community settings). The difficulty of aligning policy intent, policy design, and successful policy implementation is a well-known challenge in the broader public policy and public administration literature that also affects local behavioral health policymaking. This study will examine a blended approach of coproduction and codesign (i.e., Policy Codesign), iteratively developed over multiple years to address problems in policy formation that often lead to poor implementation outcomes. The current study evaluates this scalable approach using reproducible measures to grow the knowledge base in this field of study. Methods: This is a single-arm, longitudinal, staggered implementation study to examine the acceptability and short-term impacts of Policy Codesign in resolving critical challenges in behavioral health policy formation. The aims are to (1) examine the acceptability, feasibility, and reach of Policy Codesign within two geographically distinct counties in Washington state, USA; (2) examine the impact of Policy Codesign on multisector policy development within these counties using social network analysis; and (3) assess the perceived replicability of Policy Codesign among leaders and other staff of policy-oriented state behavioral health intermediary organizations across the USA. Discussion: This study will assess the feasibility of a specific approach to collaborative policy development, Policy Codesign, in two diverse regions. Results will inform a subsequent multi-state study measuring the impact and effectiveness of this approach for achieving multi-sector and evidence informed policy development in adolescent SUD prevention and treatment.What Predicts a Mayoral Official’s Opinion about the Role of Stress in Health Disparities?
AbstractCuevas, A. G., Levine, S., & Purtle, J. (n.d.).Publication year
2020Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
7Issue
1Page(s)
109-116AbstractHigh stress is a public health issue in the United States (US), that disproportionately affects socially-marginalized group members, including racial and ethnic minorities and those of low socioeconomic status. While city governments have the potential to reduce stress exposure and health disparities through municipal policies, very little is known about factors that are associated with mayor officials’ beliefs about stress as a determinant of disparities. This information is important because it can inform the design of interventions to educate city policymakers about evidence related to stress and health disparities. Using data from a 2016 survey of 230 mayor officials (101 mayors, 129 senior staff), multivariable logistic regression was used to determine the extent to which respondents’ individual characteristics (e.g., ideology, highest level of education) and the characteristics of their city’s population (e.g., percentage of residents non-white) were associated with their identification of stress as a factor that has a “very strong effect” on health disparities. Forty-four percent of respondents identified stress as having a very strong effect on health disparities. In the fully adjusted model, every percentage point increase in the proportion of a respondent’s city population that was non-White increased the odds of identifying stress as having a very strong effect on health disparities by 2% [adjusted odds ratio (aOR) = 1.02; 95% CI = 1.00,1.04]. Interventions are needed to increase city policymakers’ knowledge about the role of stress in the production of health disparities, which could, in turn, help cultivate political will for city policies that reduce disparities.What social norms are associated with parenting programs?
AbstractSrivastav, A., Nelson, K. L., McRell, A. S., Wilson, A., & Purtle, J. (n.d.).Publication year
2022Journal title
Child and Adolescent Social Work JournalAbstractPurpose: Positive parenting and parental skill building are associated with child well-being and can be enhanced through community-based parenting interventions. Although parenting intervention access and participation are influenced by individual and community-level factors, little is known about how social norms around parenting predict support for parenting interventions and parenting programs. To better understand the association between personal beliefs, help seeking social norms and support for parenting interventions, we examined survey data collected through phone interviews of adults living in South Carolina, United States (n = 1,143). Methods: One-way ANOVAs assessed the relationship between personal beliefs and perceived social norms (what participants think are norms in their community) about seeking help for parenting and support for parenting interventions. Results: The extent to which personal beliefs and social norms related to parenting support were associated with parenting support was estimated using ordinary least squares regression models. After adjustment for demographic characteristics, awareness of where to go to get parenting knowledge and skills, believing that the government and other organizations should help parents who do not have support from family and friends, and believing that parents need support from family and friends “when parenting gets hard” all predicted support for believing that “all first-time parents should have the option of no cost in-home parenting support.” Believing that parents need support from family and friends when parenting gets hard predicted support for state government tax credits for attending positive parenting classes. Discussion: Activating these specific norms can help home visiting and positive parenting program investment and use and can encourage positive parenting practices.Where do psychologists turn to inform clinical decisions? Audience segmentation to guide dissemination strategies
AbstractKwon, N., Stewart, R. E., Wang, X., Marzalik, J. S., Bufka, L. F., Halfond, R. W., & Purtle, J. (n.d.).Publication year
2023Journal title
Implementation Research and PracticeVolume
4AbstractBackground: Audience segmentation is an analysis technique that can identify meaningful subgroups within a population to inform the tailoring of dissemination strategies. We have conducted an empirical clustering audience segmentation study of licensed psychologists using survey data about the sources of knowledge they report most often consulting to guide their clinical decision-making. We identify meaningful subgroups within the population and inform the tailoring of dissemination strategies for evidence-based practice (EBP) materials. Method: Data come from a 2018–2019 web-based survey of licensed psychologists who were members of the American Psychological Association (APA; N = 518, response rate = 29.8%). Ten dichotomous variables assessed sources that psychologists regularly consult to inform clinical decision-making (e.g., colleagues, academic literature, and practice guidelines). We used latent class analysis to identify segments of psychologists who turn to similar sources and named each segment based on the segment's most salient characteristics. Results: Four audience segments were identified: the No-guidelines (45% of psychologists), Research-driven (16%), Thirsty-for-knowledge (9%), and No-reviews (30%). The four segments differed not only in their preferred sources of knowledge, but also in the types of evidence-based posttraumatic stress disorder (PTSD) treatments they provide, their awareness and usage intention of the APA PTSD clinical practice guideline, and attitudes toward clinical practice guidelines. Conclusion: The results demonstrate that licensed psychologists are heterogeneous in terms of their knowledge-seeking behaviors and preferences for knowledge sources. The distinctive characteristics of these segments could guide the tailoring of dissemination materials and strategies to subsequently enhance the implementation of EBP among psychologists.Who Is Talking About Adverse Childhood Experiences? Evidence From Twitter to Inform Health Promotion
AbstractSrivastav, A., Park, K., Koziarski, A., Strompolis, M., & Purtle, J. (n.d.).Publication year
2021Journal title
Health Education and BehaviorVolume
48Issue
5Page(s)
615-626AbstractBackground: Growing availability of research about addressing adverse childhood experiences (ACEs) has recently been embraced by the mainstream media and public. Social media, especially Twitter, provides a unique forum and platform for the public to access and share information about this topic. Objective: This study aims to better understand how the public is framing, sharing, and using research about ACEs on Twitter and to examine the information being commonly discussed about ACEs. Method: We obtained tweets on the topics of ACEs, childhood resilience, and childhood trauma between January 1, 2018, and December 31, 2019. This timeframe was determined based on key related events in the mainstream media. Crimson Hexagon, a social media analytics system using Boolean logic, was used to identify salient topics, influencers, and conduct a content analysis. Results: A total of 195,816 relevant tweets were obtained from our search. The weekly volume was approximately 1,864 tweets. Key topics included general use of the term ACEs (23%), trauma and ACEs (19%), long-term impact of ACEs (12%), preventing ACEs (11%), short-term effects of ACEs (8%), the 1997 ACE Study (5%), and students with ACEs (5%). The top two sentiments were fear and joy. Top conversation influencers included pediatricians, child health advocacy organizations, California’s state government, the Centers for Disease Control and Prevention, and National Public Radio. Conclusion: This analysis provides insight to the ways the public is conversing about ACEs and related topics. Results indicated that conversations focus on increasing awareness of ACEs by content experts and public health organizations. This presents an opportunity to leverage social media tools to increase public engagement and awareness.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.Who’s “in the room where it happens”? A taxonomy and five-step methodology for identifying and characterizing policy actors
AbstractCruden, G., Crable, E. L., Lengnick-Hall, R., & Purtle, J. (n.d.).Publication year
2023Journal title
Implementation science communicationsVolume
4Issue
1AbstractBackground: Engaging policy actors in research design and execution is critical to increasing the practical relevance and real-world impact of policy-focused dissemination and implementation science. Identifying and selecting which policy actors to engage, particularly actors involved in “Big P” public policies such as laws, is distinct from traditional engaged research methods. This current study aimed to develop a transparent, structured method for iteratively identifying policy actors involved in key policy decisions—such as adopting evidence-based interventions at systems-scale—and to guide implementation study sampling and engagement approaches. A flexible policy actor taxonomy was developed to supplement existing methods and help identify policy developers, disseminators, implementers, enforcers, and influencers. Methods: A five-step methodology for identifying policy actors to potentially engage in policy dissemination and implementation research was developed. Leveraging a recent federal policy as a case study—The Family First Prevention Services Act (FFPSA)—publicly available documentation (e.g., websites, reports) were searched, retrieved, and coded using content analysis to characterize the organizations and individual policy actors in the “room” during policy decisions. Results: The five steps are as follows: (1) clarify the policy implementation phase(s) of interest, (2) identify relevant proverbial or actual policymaking “rooms,” (3) identify and characterize organizations in the room, (4) identify and characterize policy actors in the “room,” and (5) quantify (e.g., count actors across groups), summarize, and compare “rooms” to develop or select engagement approaches aligned with the “room” and actors. The use and outcomes of each step are exemplified through the FFPSA case study. Conclusions: The pragmatic and transparent policy actor identification steps presented here can guide researchers’ methods for continuous sampling and successful policy actor engagement. Future work should explore the utility of the proposed methods for guiding selection and tailoring of engagement and implementation strategies (e.g., research-policy actor partnerships) to improve both “Big P” and “little p” (administrative guidelines, procedures) policymaking and implementation in global contexts.“If I was to post something, it would be too vulnerable:” University students and mental health disclosures on instagram
AbstractBudenz, A., Klassen, A., Purtle, J., Yom-Tov, E., Yudell, M., & Massey, P. (n.d.).Publication year
2022Journal title
Journal of American College HealthVolume
70Issue
2Page(s)
615-624AbstractObjective: Assess Instagram use for mental health disclosure in university students to assess the potential for Instagram use as mental health support-seeking. Participants: Twenty-one students using mental health services while attending a private, Mid-Atlantic university between 6/2017-12/2017. Methods: Collected qualitative interview and Instagram data and analyzed them in parallel. Instagram data supplemented interview themes and were coded and analyzed quantitatively to define features of participants’ Instagram use. Results: Participants displayed aversions to posting mental health disclosures on Instagram, citing public and self-stigma as barriers to disclosure. Despite this, participants reported instances in which their Instagram posts directly or indirectly reflected their lived experiences. Some also maintained second anonymous accounts for fuller disclosure. Conclusions: Given the benefits of mental health disclosures to well-being and the predilection for social media use in university students, student and university-led initiatives to promote social media environments conducive to disclosures could have widespread mental health benefits.