Baltimore did not disappoint! While each attendee has their own list of “most impactful” sessions, I have taken on the difficult task of reviewing just a few. As a policy analyst interested in improving health and well-being among historically marginalized populations, I’ll recap a fraction of the many ARM sessions pertaining to health disparity-related research and policy work. Below, I highlight information from three sessions, describing: 1) how a successful child health program demonstrated its ROI and became a policy priority across the U.S., 2) how researchers can better meet the needs of policymakers, and 3) an evaluation demonstrating the positive outcomes associated with a public health policy.
Promoting Healthy Parenting in Primary Care: Evidence for Vulnerable Pediatric Populations
This session featured three presentations describing parenting interventions delivered in primary care settings. These interventions (Help Me Grow, Prescription for Play, and The Incredible Years) were all successfully implemented in safety-net clinics, and participants described program outcomes and policy implications. Dr. Paul Dworkin outlined the Help Me Grow program, an intervention that identifies children at risk for developmental issues and connects them to supports. Help Me Grow, first piloted in 1997, has been adopted in over 30 states, and shows a return on investment (ROI) between $3 and $17 saved per dollar spent. Dr. Dworkin emphasized the importance of demonstrating success to policymakers and other stakeholders, ensuring programs are supported and funded. Dr. Dworkin recommends proximate measures, which can demonstrate initial program success and show that efforts will continue to strengthen families and communities in the future. Dr. Dworkin also mentioned that current policy discussions on alternative payment models are an opportunity to advocate for their inclusion of important outcome measures. Illustrating progress and ROI leads to policymakers “investing to reinvest” in your evidence-based program.
My key takeaway from this session was Dr. Dworkin’s explanation of how Help Me Grow’s programmatic and policy goals have evolved, an important concept for all program implementation specialists, researchers, and policymakers. He stated that their goals have moved from helping kids achieve outcomes to helping strengthen families and communities to help kids achieve outcomes.
Insights from the Frontlines: Policymakers’ Perspectives on Research Needs and Priorities
In this session, panelists, including state policymakers and a Centers for Medicare and Medicaid Services (CMS) representative, discussed research priorities and how researchers can best serve policymakers. This session offered a fascinating glimpse into the real-world policy realm, and began with panelists answering the simple question, “How do you use research?” Chad Perman, Director of the Maryland Primary Care Program Office, stressed the importance of providing timely research that is tailored to state, not national, priorities. Dr. Jen Piver-Renna from the Virginia Joint Commission on Health Care explained that research needs vary by legislative session, with most research occurring between sessions. She stated that state legislators want concrete data on costs and impacts of a policy, yet sometimes these data do not exist or are not applicable to a specific setting.
The panelists also discussed best practices in literature reviews. Mr. Perman stressed the importance of including what works on the ground rather than in theory. He used the example of integrated behavioral health care and primary care (IBH), saying we know IBH works but solo providers want to know how they themselves can offer IBH in their own practices. He added that single-page evaluation summaries are helpful, and Dr. Emma Sandoe from North Carolina Medicaid agreed, stating the importance of a well-written executive summary.
When asked about current research gaps, the panelists mentioned the foster care crisis, Medicaid and the justice system, workforce shortages, rapid cycle evaluation, and Tribal health disparities. My biggest takeaway from this session was the importance of concise research findings, with all panelists stressing their preference for research summaries in the form of a few bullet points, a “key takeaways” sheet, or something that they can explain to policymakers in under two minutes.
Policies and Programs to Improve Access to Care and Outcomes for Children and Families
In this session, researchers outlined fascinating work on policies and their effects on health outcomes. In “Impact of State Child Access Prevention Laws on Suicide By Firearm Among Youth and Young Adults,” Everytown for Gun Safety epidemiologist Dr. Kathryn Fingar reviewed her team’s comparison of states with firearm child access prevention (CAP) policies to control states with no CAP policies. They found that in states with these policies, which impose penalties on adults if a child gains access to a firearm, all youth suicides decreased between 2000 and 2021, including an 18 percent decrease in gun suicides. This study has obvious policy implications, including the effectiveness of CAP laws in decreasing youth suicide rates. Dr. Fingar’s team also identified disparities in youth suicide, including higher gun suicide rates among youth who identify as Black or American Indian/Alaska Native compared to white youth. Strikingly, 63 percent of suicides among Black youth involved a firearm, and racial disparities are increasing. My biggest takeaway here was the importance of targeting feasible policies. For example, CAP laws often have bipartisan support, can be easier to implement than other firearm policies, and clearly demonstrate improved health outcomes.
While I’ve recapped just a few sessions, ARM offered countless opportunities to hone my health service research and policy skills. This year’s content had something for everyone, and complemented AcademyHealth’s advocacy priorities (promoting research and science innovation; health systems improvement, resilience, and capacity; and reducing health disparities). As we anticipate the 2025 ARM in Minneapolis, I look forward to using this year’s takeaways to improve health care for the vulnerable and underserved, in the U.S. and globally, through research, education, and policy.