From policy to practice: Lessons learned in implementing statewide health improvement plans

The purpose of this project is to identify state's systems-level processes that contributed to improved rankings in United Health Foundation's America's Health Rankings. Project leads from the Association of State and Territorial Health Officials (ASTHO) identified four states that have improved their rankings in selected measures. ASTHO conducted interviews with four to five key informants from each state. Interviewees included state, local, and community level public health practitioners. Following the Social Ecological Model, ASTHO adapted a framework used in the education sector to understand the drivers for systems change. The framework includes context, key actions, and accountability for the changes that occurred in each state. Qualitative data from interviews with state, local and community level practitioners were analyzed to arrive at themes that described how state health improvement policy was implemented at the local and community levels. There was a core set of themes that were common across all states, but also themes unique to each state that were based on the context and change process in the state. This research helps understand the mechanism for successful statewide health improvement programs, so that best practices can be disseminated across the states. ASTHO will facilitate sharing of lessons learned among public health leaders in order to improve health outcomes.