Last fall, Janina Lord Morrison, MD, MPH, was presented the 2018 Research to Practice award at the APHA annual meeting in San Diego, California, for her winning abstract “Wellness Center as a Model for Strengthening Community-clinical Linkages to Improve Chronic Disease Management.” Christina Welter was awarded Runner-up for her abstract, “Understanding and Catalyzing Sustainable Policy, Systems and Environmental Change Using Participatory Research with a Local Health Department and Its Partners to Drive Population Health Improvements and Address Health Equity.” APHA Health Administration Section Chair Claude Jacob officiated and presented the awards.

For the past three years, the Journal of Public Health Management and Practice and the APHA Health Administration Section have sought to solicit best examples of current research that has effectively been put into the practice of health administrators. These papers may demonstrate translation of research findings to inform decision making and action by public health practice and policy stakeholders, development of new and/or effective dissemination strategies for research, or demonstrated achievement of work being utilized beyond peer-reviewed manuscripts.

As in previous years, the Journal of Public Health Management and Practice has invited the winning author to submit her work for publication consideration. As an invited article, Dr. Morrison’s manuscript will receive special editorial guidance from the JPHMP editors before it is then submitted for regular peer review.        

Dr. Morrison is the Director of Clinical and Preventive Services for the Division of Chronic Disease and Injury Prevention at the Los Angeles County Department of Public Health, the Medical Director of The Wellness Center at LAC+USC medical center and a primary care provider. JPHMP Direct recently caught up with Dr. Morrison to speak about the award and her research. Q&A Janina Lord Morrison

JPHMP Direct: How did you hear about the Research to Practice Award?

Dr. Morrison: I first heard about the award when my colleague, Dr. Jennifer Torres Mosst, received it in 2017 and I had the chance to attend the reception. This was my first introduction to the lovely community of the APHA Health Administration section. Q&A Janina Lord Morrison

JPHMP Direct:Why is this award important?

Dr. Morrison: I think this award is important because it draws attention to the work being done to implement tangible change in public health systems. We all work in very complex and busy environments. It takes time just to step back and evaluate the impact of our work, let alone to turn those evaluations around into improvements and innovations in practice. This award highlights work that has gone that final step to change public health practice, which can be educational and inspirational to our whole community of scholars and practitioners. Q&A Janina Lord Morrison

JPHMP Direct: What is the objective of your article/abstract? Why is it important to public health?

Dr. Morrison: My article aims to describe the results of a 5-year initiative to connect patients of a large urban safety-net hospital to community-based organizations that address health and wellness through the creation of an onsite “Wellness Center” staffed by Patient Navigators. In particular, we have focused on linking vulnerable patients to services for chronic disease management and prevention. Generally, there is a lot of interest within public health and within the health services sector on best practices to address the social determinants of health. This article describes the implementation of an intervention to efficiently link patients to a myriad of supplementary health and wellness services, a system that can be generalized and replicated in a variety of settings. Q&A Janina Lord Morrison

JPHMP Direct: What motivated you to conduct this study?

Dr. Morrison: I was lucky to join the team at The Wellness Center at the Historic General Hospital only a few months after it opened. I have been directing the program development, data collection and evaluation efforts at The Wellness Center ever since and have seen the evolution of our system from pilot phase to expansion phase to where we are today, offering a bouquet of high value services to a large safety-net hospital. We had the opportunity in 2018 to partner with the Los Angeles County Department of Health to undertake a comprehensive evaluation of our service model by accessing health system data on utilization and disease-specific outcomes. This study is the culmination of that partnership.

JPHMP Direct: Were any of your findings surprising? Q&A Janina Lord Morrison

Dr. Morrison: Truth be told, our analyses are still underway, so I’m not sure how many surprising findings we will uncover. In the preliminary analyses, we were surprised to see the number of individuals willing to travel relatively long distances to regularly access community-based services, signifying the importance of these services. We were also interested to note that our population receiving services for chronic disease management and prevention was younger that the majority of research on evidence-based programs for the self-management of chronic diseases. We attribute this finding somewhat to the demographics of the adjacent medical center, which has relatively few Medicare patients, but also encouraging evidence that this age group can be linked to these services, likely avoiding costly complications of chronic disease. Q&A Janina Lord Morrison

JPHMP Direct: What are the public health implications of your work?

Dr. Morrison: Our work has important implications for anyone working at the intersection of public health, health systems, and community-based organizations. We provide a model for how these three domains can partner to promote health and wellness in vulnerable communities. I believe health departments and health systems across the United States can look at this work and consider investing in the infrastructure and personnel necessary to make it easy for health care providers to link to community-based services. Particularly, I encourage our readers to consider the incorporation of Navigators into any health care team or public health initiative. Navigators are called by many different names in different systems: Community Health Workers, Promotoras, or, in our case, Wellness Navigators. They were the backbone of our intervention and can be integrated into a wide range of public health and health care improvement efforts to provide invaluable connections between sectors.

JPHMP Direct: What’s next relating to this field? Q&A Janina Lord Morrison

Dr. Morrison: For me, the next frontiers in the field of community-clinical linkages are how to facilitate ongoing data exchange between sectors and how to sustainably fund these collaborative systems. In Los Angeles County, we are continuing to work with several national networks to break new ground on data-sharing between health sectors. We are also exploring funding mechanisms that will allow health navigators and community-based organizations to sustainably integrate into a wide range of health care settings.

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Related Reading:

• A Cost Reimbursement Model for Hepatitis C Treatment Care Coordination
• Check Hep C: A Community-Based Approach to Hepatitis C Diagnosis and Linkage to Care in High-Risk Populations
• Community Health Workers: Addressing Client Objectives Among Frequent Emergency Department Users
• The Role of Patient Navigators in Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations

Learn more about previous winners:

• Jennifer Torres Mosst – 2017
• Sandra Liu – 2016