“An investment in knowledge pays the best interest,” Ben Franklin astutely remarked. That lesson, which stands true today, is understood by the Robert Wood Johnson Foundation (RWJF) as it invests in ways to improve the quality and impact of the public health system. One such area of investment is in public health systems and services research (PHSSR), which examines how public health systems and services are organized, financed, and delivered to protect and promote the public’s health and safety.  When the Foundation and the Centers for Disease Control and Prevention (CDC) sought to increase the visibility and level of investment in the emerging field of PHSSR, the Foundation asked Altarum Institute, a leader in health systems research, to assess the current state of PHSSR and facilitate the development of a comprehensive research agenda. Altarum supported the Foundation and CDC in this initiative by synthesizing the PHSSR literature and bringing together representatives from the research and practice community to identify research gaps and establish new research priorities to guide future PHSSR studies and investments.

PHSSR has evolved over the past decade and has yielded several research agendas developed by various organizations in the public health field. As the Foundation and CDC began looking to other organizations to see where this research was headed, they found that the research agendas that public health agencies and organizations had developed were largely focused on specific areas of public health practice and were giving insufficient attention to the underlying and cross-cutting characteristics of public health delivery systems.

The Foundation asked Altarum to draw on the valuable insights and priority needs identified in the existing research agendas and examine the broad body of PHSSR literature to identify areas where research was needed to help improve population health outcomes.  Altarum’s work was complemented by a series of targeted systematic reviews commissioned by the Foundation and the National Coordinating Center for PHSSR at the University of Kentucky, College of Public Health. The synthesis and reviews of the literature were based on the four core areas of PHSSR: workforce; organization and structure; finance; and technology, data, and methods. Some key research questions that emerged from the literature included:  What methods and practices help to facilitate and sustain collaboration between partners with the public health system? How does public health financing impact public health system performance? How do public health officials use electronic health data and public health technology to provide better services? How will the public health workforce meet future health demands?

Using the review and synthesis of the PHSSR literature as a basis for further discussion, Altarum convened researchers, practitioners, and policymakers in PHSSR to discuss the findings from the literature, identify current research gaps, and build consensus around priority research questions and areas. This process entailed a series of meetings that brought together members of public health associations, research and university faculty, the CDC and other federal agencies, as well as public health officials in state and local governments. The findings were summarized to inform the national agenda for PHSSR and are intended to serve as a starting point in understanding PHSSR priorities for the research and practice communities and for funding entities.

This project is an example of the type of work in which the Altarum Policy, Planning, and Evaluation team excels. Using a collaborative approach, Altarum Institute designs and implements evaluations of programs, interventions, and policies designed to improve human health, facilitates organizational and programmatic strategic planning, and produces meaningful results that are actionable and solutions-oriented.