Center Research

About the Research

Systems for Action (S4A) is a national program of the Robert Wood Johnson Foundation (RWJF) that aims to discover and apply new evidence about ways of aligning the delivery and financing systems that support a Culture of Health.


Accreditation and Multi-Sector Contributions to Population Health Activities

Principal Investigators: Glen P. Mays, PhD, MPH & Rick C. Ingram, DrPH

Local Health Departments (LHDs) undergoing the Public Health Accreditation Board (PHAB) process engage with a number of public health systems partners to satisfy accreditation standards and pre-requisites. In addition, the accreditation process positions LHDs to more effectively deliver core and foundational public health services due to PHAB’s emphasis on core public health activities. This results in the development of more comprehensive public health systems with multi-sector partners, delivery of a greater variety of services, and more organizations engaged in the services delivered. This project studies differences in comprehensive public health system structure including the involvement of multiple sector partners, and the effectiveness of the services delivered, comparing LHDs that have achieved PHAB accreditation and those that have not.

Affordable Care Act Implementation and Multi-Sector Contributions to
Public Health Delivery Systems

Principal Investigators: Glen P. Mays, PhD, MPH & James P. Ziliak, PhD

The Affordable Care Act established new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the degree and nature of change in multi-sectoral contributions to public health activities; and (2) the extent to which these system changes are attributable to key ACA provisions including coverage expansions, Prevention and Public Health funding, and adoption of public health accreditation standards.

National Longitutindal Survey of Public Health Systems

Principal Investigator: Glen P. Mays, PhD, MPH

Since 1998, the National Longitudinal Survey of Public Health Systems (NLSPHS) has followed a nationally representative cohort of U.S. communities to  measure the implementation and impact of multi-sector population health improvement activities. The survey asks local public health officials in each community to report information on a set of 20 activities that are nationally recommended for monitoring, protecting and improving health status at the population level.

A Network View of Population Health Delivery Systems

Principal Investigators: Rachel Hogg Graham, DrPH & Glen P. Mays, PhD, MPH

The delivery of population health services is a cross-sector effort that involves many different organizations in the community. While research has shown the collaborative nature of public health, very little has examined the relationship between community characteristics and the nature and volume of multi-sector partnerships that form. This study describes use of Social Network Analysis (SNA) methods to examine how the composition of population health systems evolve over time and how socioeconomic and demographic factors impact network structure.