Four Research Teams to Evaluate New Ways to Strengthen Health Care Delivery

Lexington, KY (June 28, 2016) – Four new research studies aim to improve health across entire communities by integrating the delivery and financing of medical care, public health, and social services. As part of the new Systems for Action: Systems and Services Research to Build a Culture of Health Research Program, the Robert Wood Johnson Foundation today announced $1 million in funding to support studies led by the Los Angeles County Department of Public Health, Drexel University, Michigan State University, and the University of Delaware. The Systems for Action National Coordinating Center, housed at the University of Kentucky College of Public Health, will manage these studies as part of its national portfolio of research focused on systems and services research.

Systems for Action uses thorough scientific methods to discover how best to deliver and finance the constellation of services that support health in American communities. These studies include, but extend beyond, the medical and health sectors to address issues such as housing, transportation, food security, employment, education, and criminal justice that support a Culture of Health in U.S. communities.

Each team of investigators will receive up to $250,000 in funding over two years to test innovative ways of aligning the delivery and financing systems for multiple services, with a focus on the health and economic outcomes that result. Research findings will shape future directions in health and social policy, while informing clinical and administrative practices used by the professionals that work in these diverse but inter-related sectors.

“Health and social services are supported through a fragmented mix of agencies, community institutions, and funding streams that contribute to the large differences in health outcomes and costs that we see across the U.S.,” said Dr. Glen Mays, director of the Systems for Action National Coordinating Center. “These studies will help us learn how to restructure delivery and financing systems in ways that give everyone an equal chance to be healthy.”

The four projects and their investigators are:

Housing for Health: Assessing the Cross-Sector Impacts of Providing Permanent Supportive Housing to Homeless High Utilizers of Health Care Services
Principal Investigators: Ricardo Basurto Davila, PhD, MS, Los Angeles County Department of Public Health & Corrin Buchanan, MPP, Los Angeles County Department of Health Services

This study evaluates the Housing for Health initiative, which aims to reduce homelessness and the unnecessary use of health care resources, and improve outcomes for vulnerable populations by providing permanent housing and supportive services.

Research methodology: Using a propensity score-matched difference-in-difference research design with longitudinally-linked medical and social service record data, the research team will assess the housing initiative’s cross-sector impacts and organizational and financing issues.

The Impact of Integrating Behavioral Health with Temporary Assistance for Needy Families to Build a Culture of Health across Two-Generations

Principal Investigators: Mariana Chilton, PhD, MPH, and Sandra Bloom, MD
Drexel University Dornsife School of Public Health

This study evaluates the Center for Hunger-Free Communities’ Building Wealth and Health Network. Aligning Medicaid coverage for behavioral services and Temporary Assistance for Needy Families (TANF) in Pennsylvania, the Network aims to reduce children’s developmental risks and improve future income and employment, while reducing the number of returning beneficiaries to the TANF program.

Research methodology: Using a propensity score-matched difference-in-differ­ence research design with longitudinally-linked service records and client-reported survey data, this study will assess the network’s impacts and identify ways to improve support systems to promote a Culture of Health within anti-poverty programming.

Testing of a Community Complex Care Response Team to Improve Geriatric Public Health Outcomes
Principal Investigator: Carolyn E. Ziminski Pickering, PhD, MSN, BSN, RN
Michigan State University

This study evaluates Michigan’s Community Complex Care Response Team, a collaboration of three community agencies that provide services across the medical care, public health, and social and community services to decrease potential vulnerabilities and promote health, wellness, and independence in older adults.

Research methodology: The research team will use a pragmatic randomized controlled trial to examine the impact of coordinated service delivery on emergency department utilization; will explore which institutions are best positioned to perform integrator roles that connect vulnerable older adults to needed services and supports; and will identify data sharing and storage challenges across health and human service sectors.

Implementing a Culture of Health among Delaware's Probation Population
Principal Investigators: Daniel J. O’Connell, PhD
University of Delaware

This study investigates the process and impact of the implementation of a multi-agency “Culture of Health” team in the Delaware Department of Probation, which aims to address the health, substance abuse, mental illness, education, transportation, employment, and housing issues faced by those individuals under probationary supervision in Delaware.

Research methodology: Using a pragmatic randomized controlled trial, this study will test the efficacy of using the team approach to leverage different financing systems and service coordination by providing education, screening, testing and referral with follow-up services.


MEDIA CONTACT: Kara Richardson,


About the Systems for Action National Coordinating Center: The Systems for Action (S4A) National Coordinating Center conducts and supports rigorous research on ways of aligning the delivery and financing systems that support a Culture of Health. Building on a foundation of scientific progress from both health services research (HSR) and public health services and systems research (PHSSR), S4A seeks to identify system-level strategies for improving the reach, quality, efficiency, and equity of services and supports that promote health and well-being on a population-wide basis. S4A uses a wide research lens that includes and extends beyond medical care and public health systems to incorporate sectors such as housing, transportation, social services, community services and supports, education, criminal and juvenile justice, and economic and community development. The Center is funded by the Robert Wood Johnson Foundation and based at the University of Kentucky College of Public Health. For more information, visit

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