RecommendationSupporting Evidence-Based Interventions
HEALTHY AND SAFE COMMUNITY ENVIRONMENTS
Improve quality of air, land, and water.
Design and promote affordable, accessible, safe, and healthy housing.
Strengthen state, tribal, local, and territorial public health departments to provide essential services.
Integrate health criteria into decision making, where appropriate, across multiple sectors.
Enhance cross-sector collaboration in community planning and design to promote health and safety.
Expand and increase access to information technology and integrated data systems to promote cross-sector information exchange.
Identify and implement strategies that are proven to work and conduct research where evidence is lacking.
Maintain a skilled, cross-trained, and diverse prevention workforce.
  • IOM: Greater emphasis in public health curricula should be placed on managerial and leadership skills, such as the ability to communicate important agency values to employees and enlist their commitment; to sense and deal with important changes in the environment; to plan, mobilize, and use resources effectively; and to relate the operation of the agency to its larger community role.
  • IOM: Schools of public health should strengthen their response to the needs for qualified personnel for important, but often neglected aspects of public health such as the health of minority groups and international health.
  • IOM: Schools of public health should encourage and assist other institutions to prepare appropriate, qualified public health personnel for positions in the field. When educational institutions other than schools of public health undertake to train personnel for work in the field, careful attention to the scope and capacity of the educational program is essential.
CLINICAL AND COMMUNITY PREVENTIVE SERVICES
Support the National Quality Strategy’s focus on improving cardiovascular health.
Use payment and reimbursement mechanisms to encourage delivery of clinical preventive services.
  • IOM: That purchasers, regulators, health professions, educational institutions, and the Department of Health and Human Services create an environment that fosters and rewards improvement by (1) creating an infrastructure to support evidence-based practice, (2) facilitating the use of information technology, (3) aligning payment incentives, and (4) preparing the workforce to better serve patients in a world of expanding knowledge and rapid change.
Expand use of interoperable health information technology.
Support implementation of community-based preventive services and enhance linkages with clinical care.
Reduce barriers to accessing clinical and community preventive services, especially among populations at greatest risk.
Enhance coordination and integration of clinical, behavioral, and complementary health strategies.
EMPOWERED PEOPLE
Provide people with tools and information to make healthy choices.
  • HP: Increase the proportion of elementary, middle, and senior high schools that provide school health education to promote personal health and wellness in the following areas: hand washing or hand hygiene, oral health, growth and development, sun safety and skin cancer prevention, benefits of rest and sleep, ways to prevent vision and hearing loss, and the importance of health screenings and checkups.
  • HP: Increase the proportion of college and university students who receive information from their institution on each of the priority health risk behavior areas (all priority areas; unintentional injury; violence; suicide; tobacco use and addiction; alcohol and other drug use; unintended pregnancy, HIV/AIDS, and STD infection; unhealthy dietary patterns; and inadequate physical activity).
Provide people with tools and information to make healthy choices.
Promote positive social interactions and support healthy decision making.
Engage and empower people and communities to plan and implement prevention policies and programs.
Engage and empower people and communities to plan and implement prevention policies and programs.
Improve education and employment opportunities.
ELIMINATION OF HEALTH DISPARITIES
Ensure a strategic focus on communities at greatest risk.
  • HP: Increase the number of community-based organizations (including local health departments, tribal health services, nongovernmental organizations, and state agencies) providing population-based primary prevention services in the following areas: injury, violence, mental illness, tobacco use, substance abuse, unintended pregnancy, chronic disease programs, nutrition, and physical activity.
  • IOM: Private and public (e.g., federal, state, and local governments) entities should convene major community benefit stakeholders (e.g., community advocates, academic institutions, health care providers), to inform them about community benefit standards and to build awareness that placing a priority on diversity and cultural competency programs is a societal expectation of all institutions that receive any form of public funding.
Reduce disparities in access to quality health care.
Increase the capacity of the prevention workforce to identify and address disparities.
  • IOM: Health professions education accreditation bodies should develop explicit policies articulating the value and importance of providing culturally competent health care and the role it sees for racial and ethnic diversity among health professionals in achieving this goal.
  • IOM: Health professions education accreditation bodies should develop standards and criteria that more effectively encourage health professions schools to recruit URM students and faculty, to develop cultural competence curricula, and to develop an institutional climate that encourages and sustains the development of a critical mass of diversity.
  • IOM: Private entities should be encouraged to collaborate through business partnerships and other entrepreneurial relationships with HPEIs to support the common goal of developing a more diverse health care workforce.
Support research to identify effective strategies to eliminate health disparities.
  • IOM: Additional data collection and research are needed to more thoroughly characterize URM participation in the health professions and in health professions education and to further assess the benefits of diversity among health professionals, particularly with regard to the potential economic benefits of diversity.
Standardize and collect data to better identify and address disparities.
  • IOM: Collect data on granular ethnicity using categories that are applicable to the populations it serves or studies. Categories should be selected from a national standard on the basis of health and health care quality issues, evidence or likelihood of disparities, or size of subgroups within the population. The selection of categories should also be informed by analysis of relevant data (e.g., Census data) on the service or study population. In addition, an open-ended option of “Other, please specify:—” should be provided for persons whose granular ethnicity is not listed as a response option.
TOBACCO-FREE LIVING
Support comprehensive tobacco-free policies and other evidence-based tobacco control policies.
Support full implementation of the 2009 Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act).
Expand use of tobacco cessation services.
Use media to educate and encourage people to live tobacco free.
  • CG: Reducing Tobacco Use Initiation: Mass Media Campaigns When Combined with Other Interventions.
  • HP: Reduce the proportion of adolescents and young adults in grades 6–12 who are exposed to tobacco advertising and promotion.
  • IOM: A national, youth-oriented media campaign should be funded as a permanent component of the nation’s strategy to reduce tobacco use. State and community tobacco control programs should supplement the national media campaign with coordinated youth prevention activities. The campaign should be implemented by an established public health organization with funds provided by the federal government, public-private partnerships, or the tobacco industry (voluntarily or under litigation settlement agreements or court orders) for media development, testing, and purchases of advertising time and space. Institute of Medicine. Ending the Tobacco Problem: A Blueprint for the Nation.
PREVENTING DRUG ABUSE AND EXCESSIVE ALCOHOL USE
Support state, tribal, local, and territorial implementation and enforcement of alcohol control policies.
Create environments that empower young people not to drink or use other drugs.
Create environments that empower young people not to drink or use other drugs.
  • IOM: Alcohol companies, advertising companies, and commercial media should refrain from marketing practices (including product design, advertising, and promotional techniques) that have substantial underage appeal and should take reasonable precautions in the time, place, and manner of placement and promotion to reduce youthful exposure to other alcohol advertising and marketing activity.
  • IOM: The alcohol industry trade associations, as well as individual companies, should strengthen their advertising codes to preclude placement of commercial messages in venues where a significant proportion of the expected audience is underage, to prohibit the use of commercial messages that have substantial underage appeal, and to establish independent external review boards to investigate complaints and enforce the codes.
  • IOM: The entertainment industries should use rating systems and marketing codes to reduce the likelihood that underage audiences will be exposed to movies, recordings, or television programs with unsuitable alcohol content, even if adults are expected to predominate in the viewing or listening audiences.
  • IOM: The film rating board of the Motion Picture Association of America should consider alcohol content in rating films, avoiding G or PG ratings for films with unsuitable alcohol content, and assigning mature ratings for films that portray underage drinking in a favorable light.
  • IOM: The music recording industry should not market recordings that promote or glamorize alcohol use to young people; should include alcohol content in a comprehensive rating system, similar to those used by the television, film, and video game industries; and should establish an independent body to assign ratings and oversee the industry code.
  • IOM: Television broadcasters and producers should take appropriate precautions to ensure that programs do not portray underage drinking in a favorable light, and that unsuitable alcohol content is included in the category of mature content for purposes of parental warnings.
  • Cochrane: Social norms interventions to reduce alcohol misuse in university and college students.
Identify alcohol and other drug abuse disorders early and provide brief intervention, referral, and treatment.
Reduce inappropriate access to and use of prescription drugs.
HEALTHY EATING
Increase access to healthy and affordable foods in communities.
Implement organizational and programmatic nutrition standards and policies.
Improve nutritional quality of the food supply.
Help people recognize and make healthy food and beverage choices.
Support policies and programs that promote breastfeeding.
Enhance food safety.
ACTIVE LIVING
Encourage community design and development that supports physical activity.
Promote and strengthen school and early learning policies and programs that increase physical activity.
Facilitate access to safe, accessible, and affordable places for physical activity.
Support workplace policies and programs that increase physical activity.
Assess physical activity levels and provide education, counseling, and referrals.
INJURY AND VIOLENCE-FREE LIVING
Implement and strengthen policies and programs to enhance transportation safety.
Support community and streetscape design that promotes safety and prevents injuries.
Promote and strengthen policies and programs to prevent falls, especially among older adults.
Promote and enhance policies and programs to increase safety and prevent injury in the workplace.
Strengthen policies and programs to prevent violence.
Provide individuals and families with the knowledge, skills, and tools to make safe choices that prevent violence and injuries.
REPRODUCTIVE AND SEXUAL HEALTH
Increase utilization of preconception and prenatal care.
Support reproductive and sexual health services and support services for pregnant and parenting women.
Provide effective sexual health education, especially for adolescents.
Enhance early detection of HIV, viral hepatitis and other STIs, and improve linkage to care.
MENTAL AND EMOTIONAL WELL-BEING
Promote positive early childhood development, including positive parenting and violence-free homes.
Facilitate social connectedness and community engagement across the life span.
Provide individuals and families with the support necessary to maintain positive mental well-being.
Promote early identification of mental health needs and access to quality services.

SOURCE: Adapted from Appendix 5, National Prevention Council (2011).

From: Appendix A, Recommendations of the National Prevention Council and Evidence Cited in Its Report

Cover of U.S. Health in International Perspective
U.S. Health in International Perspective: Shorter Lives, Poorer Health.
National Research Council (US); Institute of Medicine (US); Woolf SH, Aron L, editors.
Washington (DC): National Academies Press (US); 2013.
Copyright © 2013, National Academy of Sciences.

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