Your browser is unsupported

We recommend using the latest version of IE11, Edge, Chrome, Firefox or Safari.

Identifying Root Causes of Public Health Challenges

Christina Welter Headshot

Christina R. Welter, DrPH, MPH is a clinical assistant professor of community health sciences and serves as Associate Director of the Doctorate in Public Health Leadership Program and the Director of the MidAmerica Center for Public Health Practice. Her passion is to facilitate practice and academic partnerships where practice drives important public health research to understand, collectively create, and translate and implement innovative and enduring change.

Welter’s expertise and scholarship specifically focuses on engaged participatory action based research to understand, influence, and evaluate policy, environment, and systems (PSE) change. She works with diverse communities and intersectoral collaborations to identify the root causes of public health challenges and build the evidence of and take action to address strategic changes in physical, social, political, and economic environments. Her research goal is not only to build systems and policy changes that respond to root causes of inequities in health but also to build capacity and leadership among diverse constituents to sustain PSE efforts.

One of Welter’s most recent projects included a collaboration with her UIC SPH colleague Dr. Elizabeth Jarpe-Ratner, the Cook County Department of Public Health (CCDPH), and The Alliance for Healthy and Active Communities (AHAC), a multi-sector collaborative convened by CCDPH. CCDPH received funding from the Centers for Disease Control and Prevention entitled “Partnerships to Improve Community Health” that supported AHAC in implementing policy, systems, and environmental (PSE) change initiatives. Sustaining these efforts beyond the funding period is vital and required deeper inquiry into the effectiveness and role of CCDPH and AHAC.

Welter and Jarpe-Ratner conducted a practice-based, action-driven evaluation to answer two questions related to the sustainability of their PSE efforts:

1) What factors facilitate sustainability of health-related policy, systems and environmental initiatives? and

2) How can CCDPH and AHAC sustain such efforts?

Using a case study approach, focus groups and key informant interviews were conducted with 50 stakeholders, including representatives from agencies implementing PSE improvements, organizations providing technical assistance, and CCDPH staff members.

Results guided facilitated planning sessions with CCDPH and AHAC in which key evaluation themes influenced the dialogue centered on roles and goals of both CCDPH and AHAC. First, findings revealed that CCDPH plays a vital strategic and systems leadership role in building community capacity and catalyzing PSE change. This understanding informed the development of the CCDPH strategic plan and consideration of its role as a Chief Health Strategist; supported efforts to extend and strengthen community capacity; and created a tracking tool to monitor and evaluate PSE work. Second, findings revealed that AHAC members are committed to continuing PSE efforts focused on core sustainability factors with which to leverage their organizational assets, along with an increased focus on inter-sectoral relationships with housing, transportation, and other sectors. In doing so, AHAC has aligned their work with a more health-equity-oriented vision. In addition, with support from the Illinois Prevention Research Center, Welter and her colleagues are creating a suite of practice-based documents and manuscripts that focus on the gaps in the literature around policy and systems implementation and sustainability and the role of technical assistance in the process. The group was acknowledged at APHA 2018 as the runner-up for the Health Administration Research-to-Practice Award.

Fall 2018 Healthviews Magazine