Choose Effective Policies and Programs
The key concepts below can guide you in creating a balanced portfolio of community-based interventions as you choose effective policies and programs. Also, keep in mind that you will need to Evaluate Actions and the outcomes of these interventions.
When selecting policy and program interventions to address your CHI priorities, consider a combination of activities that address socioeconomic factors, the physical environment, health behaviors, and clinical care to maximize your impact.
- A coordinated plan of action and alignment, where partners may pursue different but complementary activities that are consistent with their strengths and capacities, is developed
- A selection of evidence-informed interventions from databases that have a clear ratings system, and can match the unique populations and stakeholders to appropriately matched interventions, is identified
- Activities and actions chosen for implementation include a mix of individual-based, environmental-change, and policy/systems-change interventions
- Where evidence is lacking, select new and innovative solutions, combined with adequate resources for impact evaluations (see Evaluate Actions section)
Tools for Getting Started
Tools are listed below in an order roughly aligned with the order of the key concept(s) they support above.
For developing a plan of action and alignment:
- Upstream Investment Resolution of Alignment Template
- Click on the Resolution of Alignment Template for a declaration that can be filled out with your partners to confirm the mission, vision, goals, and indicators for your collaborative effort.
- Action Plan Worksheet
- This customizable template can help you create a detailed action plan organized by goals, objectives, and activities with expected results.
- Action Plan Form
- This template can be populated with a breadth of detail ranging from priority issues and audiences to interventions already at work in the community, allowing you to better understand and address Community Health Needs Assessment priorities and meet the needs of your community.
- Developing Strategic and Action Plans
- Go to the Outline and Examples tabs for guidance for developing a vision, mission, objectives, strategies, and action plan for your CHI effort(s).
For selecting evidence-informed interventions
- Find Interventions that Work
- This resource will help you identify evidence-based strategies focusing on four action areas for the greatest impact on community health: socioeconomic factors, physical environment, health behaviors, and clinical care. This resource includes interventions that address determinants of health associated with greatest disease burden in the United States.
For choosing a mix of individual-based, environmental-change, and policy/systems-change interventions:
- A Practitioner’s Guide to Advancing Health Equity—Selecting, Designing, and Implementing Strategies
- Go to pages 22–25 for a collection of health-equity considerations for policy, systems, and environmental strategies. Included are questions to consider and examples of how to integrate health equity into local practice.
- Policy, Systems, and Environmental Strategies Decision-making Resource
- This resource provides information on how to select, carry out, and evaluate policy, systems, and environmental strategies for population health programs and interventions.
For evaluating new and innovative interventions:
- A Conceptual Framework for Planning and Improving Evidence-Based Practices
- This framework provides guidance on how to identify and build an evidence base for best practices. Included are a conceptual framework for defining best practices and questions to consider when assessing quality of evidence and impact.
Click here for additional tools related to the key concepts.
Relevant Excerpts from the Internal Revenue Service (IRS) Final Rule
The IRS Final Rule on Community Health Needs Assessments (CHNA) for Charitable Hospitals contains language related to select key concepts above. An excerpt of this language is provided below. To see the full regulation, click on the hyperlinked references below this paragraph.21
The “final regulations adopt the proposed provision allowing for joint implementation strategies.”22 “[S]uch collaboration is an important way to conserve resources, promote cross-system strategies, and yield better outcomes.”23 This “approach [also] avoids the need to create duplicative separate documents while still ensuring that information for each hospital facility is clearly presented.”24
“These needs may include, for example, the need to address financial and other barriers to accessing care, to prevent illness, to ensure adequate nutrition, or to address social, behavioral, and environmental factors that influence health in the community.”25
Note: The above statements do not constitute legal advice or regulatory guidance from CDC. Questions regarding the application of law to a specific circumstance or circumstances should be submitted to an attorney or other qualified legal professional.
21Additional Requirements for Charitable Hospitals; Community Health Needs Assessments for Charitable Hospitals; Requirement of a Section 4959 Excise Tax Return and Time for Filing the Return, 79 Fed. Reg. 78,953 (December 31, 2014) (to be codified at 26 C.F.R. pts. 1, 53, and 602), available at IRS Final Rule on Community Health Needs Assessments (CHNA) for Charitable Hospitals .
22Id. at 78,970.
25Id. at 79,002.
CHI Guiding Principles
The following resources contain additional information about the underlying principles of collaborative CHI. The key concepts found in this section were derived from a review of these guiding principles.
- County Health Rankings and Roadmaps
- Georgia Health Policy Center Sustainability Framework
- Improving Community Health through Hospital–Public Health Partnerships
- Primary Care and Public Health: Exploring Integration to Improve Population Health (Institute of Medicine 2012)
- Principles to Consider for the Implementation of a Community Health Needs Assessment Process (Rosenbaum 2013)
- Robert Wood Johnson Foundation Culture of Health Prize Criteria
- Adapting Community Interventions for Different Cultures and Communities: Go to the Main Section and Tools tabs for an overview of reasons to adapt an intervention and questions to consider when determining how to adapt interventions for different communities.
- Criteria for Choosing Promising Practices and Community Interventions: Go to the Main Section and Tools tabs for help with identifying, choosing, and prioritizing promising practices or interventions that are a good fit for the community of focus.
- Developing an Intervention: This tool provides support, examples, and additional resources for developing core components of a community intervention and adapting them to fit the community.
- Goals/Strategies: This overview of the fifth phase of the Mobilizing for Action through Planning and Partnerships (MAPP) process includes broad strategies and steps for addressing issues and achieving goals related to the community’s vision.
- What Works for Health: This tool provides information and quick links to help you select and carry out evidence-informed policies, programs, and system changes based on a variety of health factors.