Public health program capacity for sustainability: a new framework

Abstract

BackgroundPublic health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health.MethodsThis developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention).ResultsThe literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program’s capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity—89% of the individual items composing the framework had specific support in the sustainability literature.ConclusionsThe sustainability framework presented here suggests that a number of selected factors may be related to a program’s ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing and implementing prevention and intervention programs. The sustainability framework will be useful for public health decision makers, program managers, program evaluators, and dissemination and implementation researchers.

The words of prevention, part II: ten terms in the realm of quaternary prevention

“…In this sense, all the means dedicated to establish quaternary prevention are powerful tools to avoid the chaos and the terrible waste of resources either of human or economic, leading to a more sustainable health care by effectively implementing and maintaining of evidence-based policies and activities. 22 The rules in terminological development aspire to cover the whole field of a concept and, in the meantime, they help to avoid the noise due to proxy and not exactly related issues. This refers to exhaustivity and specificity in information retrieval.…”

Dissemination of a Web-Based Tool for Supporting Health Insurance Plan Decisions (Show Me Health Plans): Cross-Sectional Observational Study (Preprint)

“…There is increasing interest and investment in disseminating and translating effective study interventions more broadly to target populations [17][18][19]. Political support, funding agency priorities, capacity of the dissemination organization, and knowledge of researchers in how to apply research findings can influence the success of study translation [20][21][22][23]. Although many researchers have dissemination expectations from funders [20], the majority of public health professionals spend little time and efforts on program dissemination [24], and few studies reported sustainability and challenges of disseminating an online decision aid tool from an effective intervention study.…”

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“…[4] However, public health programs have only proven to be beneficial to communities over time if the community is able to sustain the initiatives. [5] There are numerous barriers associated with sustaining relationships and commitments to community programs, such as lack of resources and challenges in maintaining morale. [6] Academic partners play a key role in catalyzing change in a community, but it is the engage-ment of community members that yields a sustainable change overtime.…”