Principal Investigator: K. "Vish" Viswanath, PhD

Co-Principal Investigator: Michael A. Stoto, PhD

A unique multidisciplinary team from Harvard University, Georgetown University, Dana-Farber Cancer Institute (DFCI), the Massachusetts General Hospital (MGH), the Massachusetts Institute of Technology (MIT), Boston University, the Institute for Healthcare Improvement (IHI), and other institutions will employ a public health systems research approach to generate valid and reliable criteria and metrics to assess, and ultimately improve, public health emergency preparedness (PHEP) in the United States.  To date, the advancement of the science and practice of PHEP has been severely hindered by the lack of appropriate criteria and metrics. Despite the national investment of billions of dollars in PHEP training since 9/11, the country lacks the ability to assess objectively capabilities and performance.  As the Institute of Medicine (IOM) Research Priorities in Emergency Preparedness and Response for Public Health Systems: A Letter Report has recently summarized: "it is difficult to measure objectively the progress that has been made and the preparedness gaps.  A critical need exists for validated criteria and metrics that enable public health systems to achieve continuous improvement and to demonstrate the value of society's investment."  The success of the overall PHEP system depends on developing a measurement science that assesses how well its individual subsystems (a) perform on their own and (b) interact synergistically to achieve the goal of minimizing morbidity and mortality in the face of threats.  Advancing such a science requires valid and reliable measures/metrics that are robust and rigorously collected.  Complicating this advancement, however, is that while the standard process of establishing performance measures requires linking capacities and structures to process measures and eventually outcomes, this process is hindered in PHEP by the rarity of serious public health emergencies and by the complexity of the response. To address this glaring need, we are proposing a performance measurement center that not only addresses criteria and metrics for various subsystems of PHEP but, indeed, for the overall public health system, defined by the IOM as "complex networks of individuals and organizations that have the potential to play critical roles in creating the conditions for health."  This center, called LAMPS (Linking Assessment and Measurement to Performance in PHEP Systems), will pursue a coordinated and integrated four-step approach to the development of PHEP criteria and metrics.  Collectively, our four projects use as a framework the measurement development cycle ("the Cycle") (see Figure 1) that addresses four key questions: (1) Why measure? (clarification of the purposes and uses of the measurement effort); (2) What to measure? (identification of the domains and criteria to be measured); (3) How to measure? (development of specific metrics for each concept); and (4) How well do the metrics work? (assessment of the validity, reliability, utility, and practicality of the measures developed). Each of the research projects initially focuses on one of the steps in the Cycle before moving through subsequent steps or even the entire Cycle in iterative fashion, as appropriate to the project.

The project will be led by Dr. K. "Vish" Viswanath. Dr. Viswanath is an Associate Professor at HSPH and an investigator in the HSPH CPHP as well as at the Dana-Farber Cancer Institute (DFCI). Dr. Viswanath is a national leader in health communication science who has pioneered studies on communication inequalities and social change in both the U.S. and abroad.  Dr. Michael Stoto, Professor of Health Systems Administration and Population Health at Georgetown University will be the co-PI. Individual projects are addressed in the menu on the left. LAMPS will be a collaborative project partnering with the above mentioned educational and medical institutions. An Advisory Committee will be comprised of 20 national experts and will provide guidance and support in the research and design of public health preparedness metrics.