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In the last few decades great strides have been made in chemistry at the nanoscale, where the atomic granularity of matter and the exact positions of individual atoms are key determinants of structure and dynamics. Less attention, however, has been paid to the mesoscale-it is at this scale, in the range extending from large molecules (10 nm) through viruses to eukaryotic cells (10 microns), where interesting ensemble effects and the functionality that is critical to macroscopic phenomenon begins to manifest itself and cannot be described by laws on the scale of atoms and molecules alone. To further explore how knowledge about mesoscale phenomena can impact chemical research and development activities and vice versa, the Chemical Sciences Roundtable of the National Research Council convened a workshop on mesoscale chemistry in November 2014. With a focus on the research on chemical phenomena at the mesoscale, participants examined the opportunities that utilizing those behaviors can have for developing new catalysts, adding new functionality to materials, and increasing our understanding of biological and interfacial systems. The workshop also highlighted some of the challenges for analysis and description of mesoscale structures. This report summarizes the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction and Overview 2 Growing (Up) from the Nanoscale to the Mesoscale 3 Catalysis 4 Membrane Behavior and Microchemical Systems 5 Biomineralization and Geochemical Processes 6 Computational/Chemical Processes in Self-Assembly References Appendix A: Workshop Agenda Appendix B: About the Chemical Sciences Roundtable Appendix C: Biographical Sketches of Workshop Speakers and Organizing Committee Members Appendix D: Workshop Attendees
The COVID-19 pandemic is transforming the global economy and significantly shifting workforce demand, requiring quick, adaptive responses. The pandemic has revealed the vulnerabilities of many organizations and regional economies, and it has accelerated trends that could lead to significant improvements in productivity, performance, and resilience, which will enable organizations and regions to thrive in the "next normal." To explore how communities around the United States are addressing workforce issues laid bare by the COVID-19 pandemic and how they are taking advantage of local opportunities to expand their science, technology, engineering, mathematics, and medicine (STEMM) workforces to position them for success going forward, the Board of Higher Education and Workforce of the National Academies of Sciences, Engineering, and Medicine convened a series of workshops to identify immediate and near-term regional STEMM workforce needs in the wake of the COVID-19 pandemic. The workshop planning committee identified five U.S. cities and their associated metropolitan areas - Birmingham, Alabama; Boston, Massachusetts; Richmond, Virginia; Riverside, California; and Wichita, Kansas - to host workshops highlighting promising practices that communities can use to respond urgently and appropriately to their STEMM workforce needs. A sixth workshop discussed how the lessons learned during the five region-focused workshops could be applied in other communities to meet STEMM workforce needs. This proceedings of a virtual workshop series summarizes the presentations and discussions from the six public workshops that made up the virtual workshop series and highlights the key points raised during the presentations, moderated panel discussions and deliberations, and open discussions among the workshop participants. Table of Contents Front Matter 1 Introduction 2 Birmingham, Alabama 3 Boston, Massachusetts 4 Richmond, Virginia 5 Riverside, California 6 Wichita, Kansas 7 Regional Observations with National Implications References Appendix A: Statement of Task Appendix B: Workshop Agendas Appendix C: Planning Committee Biographies
Disasters tend to cross political, jurisdictional, functional, and geographic boundaries. As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public's need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Overview 2 Perspectives on the Nation's Capacity to Respond to Threats to Health, Safety, and Security 3 Learning from Experience 4 ASPR's New Vision for a Regional Health Response System 5 Looking to the Future 6 Exploring Opportunities to Improve Private-Sector Investment in Capacity Building 7 Final Thoughts References Appendix A: Workshop Agenda Appendix B: Statement of Task Appendix C: Speaker Biographies
Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson's disease, and dementia?often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost. To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda
The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Issues and Challenges in Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations 3 Accessing and Using Health Care Services 4 Health Literacy Considerations for Outreach 5 Application of Health Literacy to Communication with Immigrants, Refugees, and Migrants 6 Where Do We Go from Here? References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Moderators, Speakers, and Panelists
The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions. To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Health System Transformation to Support Integration 3 Issues and Challenges 4 Addressing the Challenges 5 Break Out Session Reports 6 Reflections on the Day References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers and Moderators
The future competitiveness of the United States in an increasingly interconnected global economy depends on the nation fostering a workforce with strong capabilities and skills in science, technology, engineering, and mathematics (STEM). STEM knowledge and skills enable both individual opportunity and national competitiveness, and the nation needs to develop ways of ensuring access to high-quality education and training experiences for all students at all levels and for all workers at all career stages. The National Science Foundation (NSF) holds a primary responsibility for overseeing the federal government's efforts to foster the creation of a STEM-capable workforce. As part of its efforts in this endeavor, NSF's Directorate on Education and Human Resources asked the National Academies of Sciences, Engineering, and Medicine to convene a workshop that would contribute to NSF's preparation of a theoretical and evidence-based STEM Workforce Development R&D Core Framework. Participants discussed research themes, identified gaps and emerging research opportunities, and recommended refinements in the goals of the framework. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 The STEM Workforce Landscape 3 The Student and Recent Graduate Voice 4 Key Challenges Facing U.S. Employers in High-Demand Fields 5 Maintaining Student Interest in STEM 6 Successful Strategies for Aligning Higher Education Programs, Curricula, and Lab Experiences with Workforce Needs 7 Alternative Pathways and Alternative Providers 8 K-12 STEM Education and Workforce Readiness 9 Breakout Discussion Groups 10 Potential Next Steps References Appendixes Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers and Planning Committee Members Appendix C: Anonymous Participant Responses to the Pre-summit Question Appendix D: List of Workshop Registrants
In 2004, the Institute of Medicine released Health Literacy: A Prescription to End Confusion, a report on the then-underappreciated challenge of enabling patients to comprehend their condition and treatment, to make the best decisions for their care, and to take the right medications at the right time in the intended dose. That report documented the problems, origins, and consequences of the fact that tens of millions of U.S. adults are unable to read complex texts, including many health-related materials, and it proposed possible solutions to those problems. To commemorate the anniversary of the release of the 2004 health literacy report, the Institute of Medicine's Roundtable on Health Literacy convened a 1-day public workshop to assess the progress made in the field of health literacy over the past decade, the current state of the field, and the future of health literacy at the local, national, and international levels. Health Literacy: Past, Present, and Future summarizes the presentation and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Health Literacy at the U.S. Department of Health and Human Services: Progress and Possibilities 3 Health Literacy and Medications 4 Use and Delivery of Health Care 5 Education 6 Looking to the Future 7 Where Do We Go from Here? References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers
Consumer genomics, encompassing both direct-to-consumer applications (i.e., genetic testing that is accessed by a consumer directly from a commercial company apart from a health care provider) and consumer-driven genetic testing (i.e., genetic testing ordered by a health care provider in response to an informed patient request), has evolved considerably over the past decade, moving from more personal utility-focused applications outside of traditional health care to interfacing with clinical care in nontraditional ways. As consumer genomics has increasingly intersected with clinical applications, discussions have arisen around the need to demonstrate clinical and analytical validity and clinical utility due to the potential for misinterpretation by consumers. Clinical readiness and interest for this information have presented educational and training challenges for providers. At the same time, consumer genomics has emerged as a potentially innovative mechanism for thinking about health literacy and engaging participants in their health and health care. To explore the current landscape of consumer genomics and the implications for how genetic test information is used or may be used in research and clinical care, the Roundtable on Genomics and Precision Health of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop on October 29, 2019, in Washington, DC. Discussions included such topics as the diversity of participant populations, the impact of consumer genomics on health literacy and engagement, knowledge gaps related to the use of consumer genomics in clinical care, and regulatory and health policy issues such as data privacy and security. A broad array of stakeholders took part in the workshop, including genomics and consumer genomics experts, epidemiologists, health disparities researchers, clinicians, users of consumer genomics research applications, representatives from patient advocacy groups, payers, bioethicists, regulators, and policy makers. This publication summarizes the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction and Workshop Overview 2 Understanding Consumer Genomics Use 3 Exploring the Role of Diversity and Health Disparities in Consumer Genomics 4 Integration Within Scientific and Medical Communities 5 Regulatory and Health Policy Issues 6 How Can Consumer Genomics Be Better Integrated to Improve Health? References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: Statement of Task Appendix D: Registered Attendees
Despite spending far more on medical care than any other nation and despite having seen a century of unparalleled improvement in population health and longevity, the United States has fallen behind many of its global counterparts and competitors in such health outcomes as overall life expectancy and rates of preventable diseases and injuries. A fundamental but often overlooked driver of the imbalance between spending and outcomes is the nation\'s inadequate investment in non-clinical strategies that promote health and prevent disease and injury population-wide, strategies that fall under the rubric of "population health." Given that it is unlikely that government funding for governmental public health agencies, whether at the local, state, or federal levels, will see significant and sustained increases, there is interest in finding creative sources of funding for initiatives to improve population health, both through the work of public health agencies and through the contributions of other sectors, including nonhealth entities. Financing Population Health Improvement is the summary of a workshop convened by the Institute of Medicine Roundtable on Population Health Improvement in February 2014 to explore the range of resources that might be available to provide a secure funding stream for non-clinical actions to enhance health. Presenters and participants discussed the range of potential resources (e.g., financial, human, and community) explored topics related to financial resources. This report discusses return on investment, the value of investing in population-based interventions, and possible sources of funding to improve population health. Table of Contents Front Matter 1 Introduction and Overview 2 Paying for Population Health Improvement: An Overview 3 Health Care System Investments in Population Health Improvement 4 Community Development and Population Health 5 Pay-for-Success Financing and Population Health 6 Implications of New and Emerging Sources of Population Health Funding Appendix A--References Appendix B--Workshop Agenda Appendix C--Biographical Sketches of Workshop Speakers and Moderators
The COVID-19 pandemic has highlighted existing weaknesses in the United States health care system, while creating a new set of challenges related to caring for people with serious illness. The National Academy of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a three-part workshop to explore the initial responses to the pandemic by health care teams providing care to people with serious illness, the impact of the pandemic on the health care workforce, the use of telehealth, issues related to clearly communicating with the public about health emergencies, and policy opportunities to improve care for people with serious illness. Issues related to health equity were discussed throughout the three webinars. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda
Approximately five percent of Medicare beneficiaries (2.2 million Americans) are living with serious illness, as are many other non-Medicare eligible individuals. This number is expected to grow rapidly as the population ages and the prevalence of progressive illness increases. In many communities, particularly urban and rural underserved communities, primary care clinicians are the main workforce caring for people with serious illness, which underscores the need to integrate high quality serious illness care into primary care delivery. To better understand the challenges and opportunities for integrating serious illness care into primary care settings, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a virtual workshop on June 10 and 17, 2021. The workshop, titled Integrating Serious Illness Care into Primary Care Delivery, explored the shared principles of primary and serious illness care, the interdisciplinary teams that power both disciplines, the policy issues that can act as barriers to or incentives for integration, and best practices for integrating primary care and serious illness care. This Proceedings of a Workshop summarizes the presentations and discussions that occurred during the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda
In November 2020, the National Academies of Sciences, Engineering, and Medicine convened a multi-day virtual symposium on imaging the future of undergraduate STEM education. Speakers and participants pondered the future and the past and shared their goals, priorities, and dreams for improving undergraduate STEM education. Expert speakers presented information about today's students and approaches to undergraduate STEM education, as well as the history of transformation in higher education. Thoughtful discussions explored ideas for the future, how student-centered learning experiences could be created, and what issues to consider to facilitate a successful transformation. This publication summarizes the presentation and discussion of the symposium. Table of Contents Front Matter 1 Introduction 2 Goals for the Future: Changing Purposes of Undergraduate STEM Education 3 Transformation in the U.S. Higher Education System 4 Learning from Today's Students 5 Designing for Tomorrow's Students: Creating Equitable Opportunities for Undergraduate STEM Students 6 The Role of Technology 7 Innovations and Strategies for Moving Forward 8 Final Reflections References Appendix A: Statement of Task Appendix B: Symposium Agenda Appendix C: Biographical Sketches of Symposium Speakers and Moderators
The United States faces an alarmingly high rate of maternal morbidity and mortality, distinguishing it from other high-income countries that have achieved decreases in these rates in recent years. U.S. maternal morbidity and mortality rates are disproportionate across racial, ethnic, socioeconomic, and geographic groups. Statistics on maternal health outcomes reveal that there are challenges to protecting both the lives and future health of birthing people and their children. Recognizing the urgency of this growing problem, the National Academies Board on Population Health and Public Health Practice convened a 2-day virtual workshop, Advancing Maternal Health Equity and Reducing Maternal Mortality. The workshop examined the current state of maternal health in the United States and explored the factors needed to help communities and health care systems become more effective in reducing maternal morbidity and mortality and improving health outcomes through the fourth trimester. This publication summarizes the presentations and discussions of the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers, Moderators, and Planning Committee Members
The field of health literacy has evolved from early efforts that focused on individuals to its current recognition that health literacy is a multidimensional team and system function. Health literacy includes system demands and complexities as well as individual skills and abilities. While communicating in a health-literate manner is truly important for everyone, it can be especially important for those with mental or behavioral health issues and for the systems and teams that interact with them and treat these individuals. The purpose of the workshop, which was held on July 11, 2018, in Washington, DC, was to explore issues associated with effective communication with individuals with mental or behavioral health issues and to identify ways in which health literacy approaches can facilitate communication. In particular, the workshop aimed to gain a better understanding of how behavioral health and mental health concerns can adversely affect communications between providers and patients and their families. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 The Personal Experience 3 Setting the Stage 4 Exploring Innovative Approaches 5 Where Do We Go from Here? 6 Reflections of the Day Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Moderators, Speakers, and Panelists
Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Workshop Statement of Task Appendix B: Virtual Workshop Agenda
With U.S. health care costs projected to grow at an average rate of 5.5 percent per year from 2018 to 2027, or 0.8 percentage points faster than the gross domestic product, and reach nearly $6.0 trillion per year by 2027, policy makers and a wide range of stakeholders are searching for plausible actions the nation can take to slow this rise and keep health expenditures from consuming an ever greater portion of U.S. economic output. While health care services are essential to heath, there is growing recognition that social determinants of health are important influences on population health. Supporting this idea are estimates that while health care accounts for some 10 to 20 percent of the determinants of health, socioeconomic factors and factors related to the physical environment are estimated to account for up to 50 percent of the determinants of health. Challenges related to the social determinants of health at the individual level include housing insecurity and poor housing quality, food insecurity, limitations in access to transportation, and lack of social support. These social needs affect access to care and health care utilization as well as health outcomes. Health care systems have begun exploring ways to address non-medical, health-related social needs as a way to reduce health care costs. To explore the potential effect of addressing non-medical health-related social needs on improving population health and reducing health care spending in a value-driven health care delivery system, the National Academies of Science, Engineering, and Medicine held a full-day public workshop titled Investing in Interventions that Address Non-Medical, Health-Related Social Needs on April 26, 2019, in Washington, DC. The objectives of the workshop were to explore effective practices and the supporting evidence base for addressing the non-medical health-related social needs of individuals, such as housing and food insecurities; review assessments of return on investment (ROI) for payers, healthy systems, and communities; and identify gaps and opportunities for research and steps that could help to further the understanding of the ROI on addressing non-medical health-related social needs. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Setting the Stage 3 Housing Interventions 4 Interventions Addressing Food Insecurity 5 Interventions Addressing Multiple Social Needs 6 Return on Investment 7 Research Gaps 8 Reflections on the Day References Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Speaker Biographical Sketches
Firearm injuries and death are a serious public health concern in the United States. Firearm-related injuries account for tens of thousands of premature deaths of adults and children each year and significantly increase the burden of injury and disability. Firearm injuries are also costly to the health system, accounting for nearly $3 billion in emergency department and inpatient care each year. The National Academies of Sciences, Engineering, and Medicine convened a workshop to examine the roles that health systems can play in addressing the epidemic of firearm violence in the United States. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Why Do Health Systems Have a Role? 3 The Toll on Individuals and Communities 4 Identifying Individuals at Higher Risk for Firearm Violence 5 Developing Health System Interventions 6 Key Issues from the Workshop's First Day 7 Programs and Research 8 Developing Networks and Sharing Information 9 Developing a Culture of Health Care Providers as Interveners 10 Closing Remarks References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches
On July 30-31, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop titled Continuous Manufacturing for the Modernization of Pharmaceutical Production. This workshop discussed the business and regulatory concerns associated with adopting continuous manufacturing techniques to produce biologics such as enzymes, monoclonal antibodies, and vaccines. The participants also discussed specific challenges for integration across the manufacturing system, including upstream and downstream processes, analytical techniques, and drug product development. The workshop addressed these challenges broadly across the biologics domain but focused particularly on drug categories of greatest FDA and industrial interest such as monoclonal antibodies and vaccines. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Workshop Agenda Appendix B: Biographies of Planning Committee Members, Speakers, and National Academies of Sciences, Engineering, and Medicine Staff Appendix C: Running Themes Across Workshop Sessions
The Centers for Disease Control and Prevention estimates that approximately 40 million people in the United States suffer from a serious illness that limits their daily activities. These illnesses include heart and lung disease, cancer, diabetes, and Alzheimer's disease and other forms of dementia. However, significant disparities exist across different communities in the quality and access to care for these illnesses. Factors such as race, ethnicity, gender, geography, socioeconomic status, or insurance status exacerbate these complex disparities. It is critical to reevaluate the current models of care delivery across diverse communities and vulnerable populations. On April 4, 2019, The National Academies of Sciences, Engineering, and Medicine convened a workshop to investigate barriers, policy initiatives, and opportunities for improving access to and equity of care for people living with a serious illness. Discussions explored the current climate of health care and opportunities to improve access to care using organizational, community, patient and family, and clinician perspectives. This publication summarizes the discussions and presentations from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda
Solving the world's health challenges requires multidisciplinary collaborations that bring together the talents, experiences, resources, and ideas from multiple sectors. These collaborations in global health frequently occur through public?private partnerships (PPPs) in which public and private parties share risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. However, these numerous stakeholders bring varying strengths and resources to global health partnerships, but they also bring their own organizational cultures, regulations, and expectations. Managing partnerships among them is complex and requires intentional and thoughtful governance. Over the last several decades, as the number of interested stakeholders, resources invested, and initiatives launched within the global health field has grown, effective governance of global health PPPs has become increasingly critical. To explore the role of governance in PPPs for global health, the Forum on Public?Private Partnerships for Global Health and Safety convened a workshop. Participants explored best practices, common challenges, and lessons learned in the varying approaches to partnership governance. They also highlighted key issues in the governance of PPPs for global health with the goal of increasing their effectiveness in improving health outcomes. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Global Health and Governance of PublicPrivate Partnerships in the Current Context 3 Legal Considerations for PublicPrivate Partnership Governance in Global Health 4 Examining Lessons Learned from the Development and Iterative Improvement of PublicPrivate Partnerships and Their Governance 5 Evaluating and Reporting on PublicPrivate Partnerships in Global Health 6 Identifying Key Issues in the Governance of PublicPrivate Partnerships in Global Health Appendix A: Commissioned Paper: The Core Roles of Transparency and Accountability in the Governance of Global Health PPPs Appendix B: World Caf Reports on Internal Governance of Individual Partners and Impacts on Approaches to PublicPrivate Partnerships Appendix C: Speaker and Moderator Biographical Sketches Appendix D: Workshop Agenda Appendix E: References
In its landmark report, Health Literacy: A Prescription to End Confusion, the Institute of Medicine noted that there are 90 million adults in the United States with limited health literacy who cannot fully benefit from what the health and health care systems have to offer. Since the release of that report, health literacy has become a vibrant research field that has developed and disseminated a wide range of tools and practices that have helped organizations, ranging in size from large health care systems to individual health care providers and pharmacists, to engage in health literate discussions with and provide health literate materials for patients and family members. Improving the health literacy of organizations can be an important component of addressing the social determinants of health and achieving the triple aim of improving the patient experience, improving the health of populations, and reducing the cost of care. However, the focus on organizations does not address the larger issue of how to improve health literacy across the U.S. population. To get a better understanding of the state of community-based health literacy interventions, the Roundtable on Health Literacy hosted a workshop on July 19, 2017 on community-based health literacy interventions. It featured examples of community-based health literacy programs, discussions on how to evaluate such programs, and the actions the field can take to embrace this larger view of health literacy. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Presentation and Discussion on the Commissioned Paper 3 Examples of Community-Based Health Literacy Programs 4 Evaluating Community-Based Health Literacy Interventions 5 Where Do We Go from Here? 6 Reflections on the Day References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Moderators, Speakers, and Panelists Appendix C: A Review and Report of Community-Based Health Literacy Interventions - by Cynthia Baur, Lourdes M. Martinez, Nedelina Tchangalova, and Don Rubin
The surface of the human body and its mucous membranes are heavily colonized by microorganisms. Our understanding of the contributions that complex microbial communities make to health and disease is advancing rapidly. Most microbiome research to date has focused on the mouse as a model organism for delineating the mechanisms that shape the assembly and dynamic operations of microbial communities. However, the mouse is not a perfect surrogate for studying different aspects of the microbiome and how it responds to various environmental and host stimuli, and as a result, researchers have been conducting microbiome studies in other animals. To examine the different animal models researchers employ in microbiome studies and to better understand the strengths and weaknesses of each of these model organisms as they relate to human and nonhuman health and disease, the Roundtable on Science and Welfare in Laboratory Animal Use of the National Academies of Sciences, Engineering, and Medicine convened a workshop in December 2016. The workshop participants explored how to improve the depth and breadth of analysis of microbial communities using various model organisms, the challenges of standardization and biological variability that are inherent in gnotobiotic animal-based research, the predictability and translatability of preclinical studies to humans, and strategies for expanding the infrastructure and tools for conducting studies in these types of models. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 A Trans-Kingdom Perspective on Animal Models and Microbiome Research 3 Non-Rodent Models for Microbiome Research 4 Modeling Human Microbiota in Animal Systems 5 Experimental Reproducibility Using Gnotobiotic Animal Models 6 Establishing and Evolving Gnotobiotic Facilities 7 Reflections on the Workshop References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Planning Committee Appendix C: Biographical Sketches of Workshop Speakers and Moderators Appendix D: Glossary
To explore how the use of technology can facilitate progress toward globally recognized health priorities, the Forum on Public?Private Partnerships for Global Health and Safety organized a public workshop. Participants identified and explored the major challenges and opportunities for developing and implementing digital health strategies within the global, country, and local context, and framed the case for cross-sector and cross-industry collaboration, engagement, and investment in digital health strategies. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Digital Health Within the Current Global Context 3 Enabling a Multidisciplinary Approach to Health 4 Country-Level Digital Health Strategies 5 Push Versus Pull at the Community Level 6 Tapping into Grassroots Initiatives and Entrepreneurs 7 Final Thoughts Appendix A: References Appendix B: Workshop Agenda Appendix C: Speaker and Moderator Biographical Sketches
Health literacy, cultural competence, and language access services are distinct but inextricably linked concepts for delivering equitable care to all members of the increasingly diverse population of the United States. These concepts are linked, but they developed via different paths, and each has its own unique focus with regard to enabling every individual to obtain the ability to process and understand basic health information and services needed to make appropriate health care decisions. Fragmentation of these disciplines has impeded implementation of relevant measures for quality improvement and accountability. To foster an integrated approach to health literacy, cultural competency, and language access services, the Roundtable on Health Literacy initiated a project with three components: a commissioned paper to propose a framework for integrating measurements of health literacy, cultural competency, and language access; a workshop to review and discuss the framework; and a second commissioned paper that will provide a roadmap for integrating health literacy, cultural competency, and language access services as well as a revised measurement framework. Held on May 4, 2017, the workshop explored the quality performance measures for integration of health literacy, cultural competence, and language access services. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 A Proposed Framework 3 Reaction Panel of Developers and Users 4 Moderated Discussion with Implementer Panel 1 5 Moderated Discussion with Implementer Panel 2 6 Reflections on the Day References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Moderators, Speakers, and Panelists Appendix C: Commissioned Paper on a Proposed Framework for Integration of Health Care Quality Measures Related to Health Literacy, Language Access, and Cultural Competence Appendix D: Accompanying Exhibits to the Commissioned Paper |
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