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Member Research & Reports

Member Research & Reports

WashU: Funding and Lack of Support – Not Effectiveness – Tied to Chronic Disease Program Life

A survey of local public health practitioners in four nations about the termination of evidence-based chronic disease prevention programs showed that evidence and impact were rarely factors, according to research from the Brown School at Washington University in St. Louis.

Researchers surveyed 400 local public health practitioners in Australia, Brazil, China, and the United States from November 2015 to April 2016. Online survey questions focused on mis-implementation, or the premature termination or inappropriate continuation of public health programs.

Nearly universal reasons reasons for program termination included the ending or diverting of funding and a lack of support from key stakeholders. Practitioners from Australia and Brazil reported that changes in political leadership often led to program termination. In Brazil, lack of support from agency leadership was also one of the most frequently cited reasons for programs ending. China’s top reasons differed significantly from those of other countries’ and included that programs were difficult to maintain, not demonstrating impact, and lacking support from the public. In the United States, funding was by far the prevailing issue.

“While the reasons programs end and continue inappropriately vary from country to country, they generally support the common theme that the culture of public health practice seems to be too often focused on what is easy, familiar, and appealing to external stakeholders as opposed to what is impactful, evidence-based, or challenging,” wrote Ms. Karishma Furtado, the study’s lead author and a doctoral student at the Brown School’s Prevention Research Center.

The study was published March 6 in BMC Public Health.