University of Pennsylvania
Graduate Program in Public Health
MPH Degree Program
Course Syllabus – Spring 2011
Title: PUBH 537 – Achieving Evidence-Based Health Policy
Course Units: 1. 0 c.u., Contact Hours: 42 hours
Course Description: Achieving Evidence-Based Health Policy examines how research can
influence health policy. Individual sessions will be devoted to topics such as the Nurse-Family
Partnership program, health insurance, smoking, and early childhood mental health. Sessions
will examine: how selection of research methods may influence results; the dialectical
relationship between research and policy; and the role of various stakeholders (the media,
foundations, government, advocates) in both research and policy debates. Didactic topical
research presentations will be followed by interactive discussions examining how research
findings translate (or, as the case may be, do not translate) into policy. Guest speakers will
include research and policy experts from the public and private sectors. Prerequisites are
Fundamentals of Health Policy (offered through the Master‟s of Science in Health Policy);
PUBH 505 Public Health Administration and Policy: An Introduction; or permission of
instructor. Enrollment limited to 12.
Placement / Room Assignment:
Course Directors: Marsha Gerdes, Ph.D.
CHOP North, 15th Floor
3535 Market Street (corner of 36th & Market)
Philadelphia, PA 19104
Office Hours: By Appointment
Sarah Zlotnik, MSPH, MSW
CHOP North, 15th Floor, Room 1541
3535 Market Street (corner of 36th & Market)
Philadelphia, PA 19104
Office Hours: By Appointment
Course Objectives: This course is an advanced seminar on health research and policy. The goal
is to give students an opportunity to consider the complex relationship between evidence and
public policy. Policy decisions, by definition, involve choices. Policymakers may be influenced
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by factors other than - or even contrary to - research. Good research can lead to better policy.
But, as experience with cigarettes and stem cells suggests, research alone may not carry the day.
Conversely, we know that sometimes research can produce (or be the product of)
unacceptable policy goals. The infamous experiments of Nazi scientists and Tuskegee were all
undertaken in attempts to promote particular policy goals. We may not support those goals today,
but we cannot deny the role that research played in advancing them at the time.
Our hope is to engage students in thoughtful discussions about how research can influence
policy, and policy impacts research. By the end of the seminar, students should be able to:
1. Consider the strengths and weaknesses of selected research methods in light of policy
goals and the extent to which research choices are policy choices;
2. Draft a policy brief with an understanding of evidence, audience and context;
3. Understand how policy decisions are made, including the role of key stakeholders in
4. Frame research questions with a deeper understanding of the policy environment that
research seeks to influence.
Evaluation Methods: 30% Class participation
10% Policy brief
15% Midterm presentation
35% Final presentation
10% Discussant role
Course grades reflect the extent to which each student has incorporated the requisite knowledge
and skills in her/his assignments. The final course grade is based on a composite of the student‟s
performance in class and the student‟s presentations (policy brief, midterm, final, and discussant
role). The final grade is based on the following weighting:
Class Participation: Students are expected to attend all classes, be prepared to discuss
assigned readings, and participate fully in class exercises. Because the class is a small
seminar, discussion is an important part of the class. We have attempted to assign a very
modest amount of reading per session so that everyone can read what is assigned and be
able to participate fully in classes. Students should let an instructor know in advance of
Additionally, for each class, two students will be responsible for helping guide the
discussion. For that session, students will email the instructors a few guide questions by
Monday at 2pm, the day before class.
Policy Brief: Students will complete an exercise in drafting a policy brief related to a
health policy area of interest. This brief must follow the guidelines provided in class. This
exercise will be an opportunity to get feedback on written policy communications from
the instructors. Policy briefs should be no longer than one page.
Midterm: The midterm will be an opportunity for students to experience a real world
scenario often required of those in the policy field. Students will serve as a “staffer” to a
legislative committee seeking a policy analysis on a topic in which the staffer has limited
prior knowledge. The staffer will have no more than 72 hours to become fluent in that
topic, developing a short 5-10 minute oral briefing on the topic for the legislative
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committee. The briefing should include the staffer‟s recommendation to the committee
and should review some potential policy alternatives. Accompanying the presentation, the
staffer should provide the committee a policy brief (e.g., one page prose or bullets)
overviewing the staffer‟s recommendation.
Final Expert Presentation and Discussant Role: Each student is required to give a final
presentation at the end of the semester that critically examines policy from multiple
perspectives. Your assignment should be focused on an area of special interest to you.
Ideally this will be an area in which you plan to work in the future. Also as a component
of this project, every student will be assigned and graded on their role as “discussant” of
another student‟s presentation. As a discussant, students will be expected to review their
colleague‟s presentation in advance of class, and present their reactions in class.
Required Course Materials:
Bardarch E. Practical Guide for Policy Analysis: The Eightfold Path to More Effective Problem
Solving. Washington, DC: CQ Press; 2009.
Recommended Course Materials:
Gordis L. Epidemiology. 4th ed. Philadelphia: Elsevier/Saunders; 2009.
(for more information on epidemiology and research design)
Academic Integrity: Students are expected to adhere to the University‟s Code of Academic
Integrity. Care should be taken to avoid academic integrity violations, including: plagiarism,
fabrication of information, and multiple submissions. Students who engage in any of these
actions will be referred to the Office of Academic Integrity, which investigates and decides on
sanctions in cases of academic dishonesty.
See link for more information: http://www.upenn.edu/academicintegrity/index.html
MPH Academic Standing Policy/Academic Probation: According to University policy, a
graduate student must maintain a „B‟ average or better to be considered in good academic
standing. A student who does not meet the University policy of a „B‟ /3.0 average will be
reviewed by the MPH Program Director, the Associate Director and the Academic Progressions
Committee. A student may be put on academic probation for a period of 1 semester to improve
his/her overall average may be put on academic probation for a period of 1 semester to improve
his/her overall average.
Any course in which the student receives a grade below a B- will not be applied toward
the Master of Public Health degree. The record of any student who receives an unsatisfactory
grade (less than a „B-„) in a course or who does not meet the University policy of a „B‟ /3.0
average will be reviewed by the MPH Program Director, the Associate Director and the
Academic Progressions Committee. A student may be put on academic probation for a period of
1 semester to improve his/her overall average
Students may continue to take other courses during the probation period and the student
must make arrangements with the course director to remediate any grades lower than a B-. These
arrangements must be approved by the MPH Program Director with input from the Academic
Progressions Committee as needed. Any student who is on academic probation for a period
greater than 1 semester will be referred to the Academic Progressions Committee for review and
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recommendation. This committee is authorized to dismiss the student or allow the student to
remain in the program on a probationary basis. A return to good academic standing is contingent
on receiving an acceptable grade (B or higher) in all remaining courses.
The MPH grading policy is at the discretion of the individual course instructors.
Please find below the generally used grading scale for the MPH Program.
A+ 97-100 B+ 87-89 C+ 77-79
A 93-96 B 83-86 C 73-76
A- 90-92 B- 80-82 C- 70-72 F 0-69
Please note that an A+ carries the same weight (4.0) as an A.
Incomplete Grade: It is expected that a matriculated Master of Public Health student shall
complete the work of a course during the semester in which that course is taken. A student who
fails to complete a course within the prescribed period shall receive at the instructor‟s discretion
either a grade of I (incomplete) or F (failure). If the incomplete is given, the instructor may
permit an extension of time up to one year for the completion of the course. In such cases, any
course which is still incomplete after one calendar year from its official ending must remain as
incomplete on the student‟s record and shall not be credited toward the MPH degree. Students
who receive two or more incompletes within a semester may not register for the subsequent
semester(s) without the permission of the Department.
For additional information on academic policies, please refer to the corresponding sections in the
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Course Outline / Assignments:
**[Please note: Speakers & Case Study Topics are subject to updated for the semester]**
Class Class Topics Readings
1 1/19 WHAT IS POLICY AND Oberlander J. Learning from failure in health care
THE POLICY reform. N Engl J Med. 2007;357:1677-9.
CHALLENGE Brandt AM. The cigarette, risk, and American
culture. Daedalus. 1990;119:155-76.
Bardach E. A Practical Guide for Policy Analysis:
The Eightfold Path to More Effective Problem
Solving. Washington, DC: CQ Press; 2009: 1-64.
Kolata G. Panel urges mammograms at 50, not 40.
The New York Times. November 17, 2009.
2 1/26 RESEARCH DESIGN AND Gambrill E. Evidence-based practice and policy:
THE CHALLENGE OF Choices ahead. Research on Social Work Practice.
POLICY Chalmers I. Trying to do more good than harm in
policy and practice: The role of rigorous,
GUEST SPEAKER: transparent, up-to-date evaluations. The ANNALS
Susmita Pati, MD MPH of the American Academy of Political and Social
(Assistant Professor of Science. 2003;589:22-40.
Pediatrics, UPenn Robinson TN, Sirard JR. Preventing childhood
School of Medicine, and obesity: A solution-oriented research paradigm.
from PolicyLab at the Am J Prev Med. Feb 2005;28(2 Suppl 2):194-201.
Children‟s Hospital of US Government Accountability Office. A variety
Philadelphia) of rigorous methods can help identify effective
interventions. 2009: Publication No. GAO-10-30.
[Read pages 1-8 and 20-32, skim the rest]
3 2/2 CREATING A POLICY Bardach E. A practical guide for policy analysis:
BRIEF the eightfold path to more effective problem
solving. Washington, DC: CQ Press; 2009:
POLICY BRIEF Appendix A:111-25.
ANALYSIS: Review four Sorian R, Baugh T. Power of information: Closing
briefs from the class the gap between research and policy. Health
folder Affairs. 2002;21:264-73.
[How do they use Brownson RC, Royer C, Ewing R, McBride TD.
evidence? What is the Researchers and policymakers: travelers in parallel
quality of the research? universes. Am J Prev Med. 2006;30(2):164-172.
Do they effectively POLICY BRIEF EXERCISE: Based on the guidelines
present their argument? reviewed in this class, draft a policy brief (no more
] than one page) on a health topic of your choice to
be submitted in class, February 16th (Week 5).
4 2/9 ENGAGING Barber M. Instruction to Deliver: Tony Blair, the
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CONSTITUENCIES AND Public Services and the Challenge of Achieving
THE IMPLEMENTATION Targets. London: Politico's Publishing; 2007:
CHALLENGE Chapter 2, 45-69; Chapter 3, 70-79, 87-97.
Atkins D, Siegel J, Slutsky J. Making policy when
GUEST SPEAKER: the evidence is in dispute. Health Affairs.
Feather Houstoun 2005;24(1):102-113.
(President, William Landman A, Glantz SA. Tobacco industry efforts
Penn Foundation, and to undermine policy-relevant research. Am J
former Secretary, Public Health. 2009;99:45-58.
Pennsylvania Lantz PM, Lichtenstein R, Pollack HA. Health
Department of Public policy approaches to population health: The limits
Welfare) of medicalization. Health Affairs.
EXERCISE: Each student
will be assigned one to
two constituency groups
to examine health care
5 2/16 NURSE FAMILY Olds DL. The nurse-family partnership: An
PARTNERSHIPS evidence-based preventive intervention. Infant
Mental Health Journal. 2006;27:5-25.
(SUBMIT POLICY BRIEF) Mercy J, Saul J. Creating a healthier future through
early interventions for children. JAMA.
GUEST SPEAKER: David 2009;301:2262-4.
Rubin, MD MSCE Council on Community Pediatrics. The role of
(Associate Professor of preschool home-visiting programs in improving
Pediatrics, UPenn children's developmental and health outcomes.
School of Medicine, and Pediatrics. 2009;123:598-603.
Senior Co-Director, Pew Center on the States. Federal Health Care
PolicyLab at The Reform Legislation Home Visiting Summary.
Children‟s Hospital of State Home Visiting Legislation. Prepared by
Philadelphia) and Tara Prevent Child Abuse America for the Home Visit
Dechert (Public/Private Forum. 2002. [just skim to see the range of
Ventures) funding providers]
Fixsen, D. L., & Blase, KA. Implementation: The
missing link between research and practice. NIRN
Implementation Brief #1. 2009, January. Chapel
Hill: The University of North Carolina, FPG,
Fixsen DL, Naoom SF, Blase KA, Friedman RM,
Wallace F. Implementation Research: A Synthesis
of the Literature. Chapter 1: Introduction. Tampa,
FL: University of South Florida, Louis de la Parte
Florida Mental Health Institute, The National
Implementation Research Network, 2005 (FMHI
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6 2/23 AUTISM AND THE Bouder JN, Spielman S, Mandell DS. Brief report:
INSURANCE INDUSTRY Quantifying the impact of autism coverage on
private insurance premiums. J Autism Dev Disord.
GUEST SPEAKER: David 2009 Jun;39(6):953-7. Epub 2009 Feb 13.
Mandell, ScD (Assistant Shattuck PT, Grosse SD. Issues related to the
Professor of Psychiatry diagnosis and treatment of autism spectrum
and Pediatrics, UPenn disorders. Mental Retardation and Developmental
School of Medicine and Disabilities Research Reviews. 2007;13(2):129-
Associate Director 135.
Center for Autism Shattuck PT, Parish SL. Financial burden in
Research, The families of children with special health care needs:
Children‟s Hospital of Variability among states. Pediatrics.
Coffman JM, Hong MK, Aubry WM, et al.
Translating medical effectiveness research into
policy: Lessons from the California Health
Benefits Review Program. Milbank Quarterly.
7 3/2 CONDITIONAL CASH Lagarde M, Haines A, Palmer N. Conditional cash
TRANSFERS transfers for improving uptake of health
interventions in low- and middle-income countries:
GUEST SPEAKER: Kevin a systematic review. JAMA. 2007;298:1900-10.
Volpp, MD PhD Volpp KG, Troxel AB, Pauly MV, et al. A
(Professor, Wharton randomized, controlled trial of financial incentives
School and UPenn for smoking cessation. N Engl J Med.
School of Medicine) 2009;360:699-709.
Volpp KG, John LK, Troxel AB, Norton L,
Fassbender J, Loewenstein G. Financial incentive-
based approaches for weight loss: A randomized
trial. JAMA. 2008;300:2631-7.
Fernald LC, Gertler PJ, Neufeld LM. Role of cash
in conditional cash transfer programmes for child
health, growth, and development: an analysis of
Mexico's Oportunidades. Lancet. 2008;371:828-
Mayor Bloomberg and major philanthropic
foundations unveil size, scope, and schedule of
Opportunity NYC, the nation‟s first-ever
conditional cash transfer program [press release,
no. 93]. The City of New York; March 29, 2007.
8 3/16 GLOBAL HEALTH Denny CC, Emanuel EJ. US health aid beyond
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INTERVENTION & PEPFAR: The Mother & Child Campaign. JAMA.
FUNDING PRIORITIES – 2008;300(17):2048-2051.
HIV/AIDS CASE Mayer KH, Hamilton CD. Distributing US health
STUDY aid. JAMA. 2009; 301(13) 1339-40.
Dugger CW. As donors focus on AIDS, child
GUEST SPEAKER: Carol illnesses languish. The New York Times. October
McLaughlin, MD MPH 29, 2009. (Available at:
(University of http://www.nytimes.com/2009/10/30/world/30chil
Pennsylvania‟s Center d.html)
for High Impact Smith AD. Experts want African aid funds
Philanthropy) channeled away from HIV. The Observer
(Guardian UK). October 25, 2009. (Available at:
McNeil DG. Obama is criticized on AIDS
Program. The New York Times. December 8, 2009.
Disease Control Priorities Project. Using cost-
effectiveness analysis for setting health priorities.
March 2008. (Available at:
Kaiser Family Foundation. The US Global Health
Initiative: Overview and budget analysis. Policy
Brief. December 2009. (Available at:
9 3/23 MIDTERM
GUEST EXPERT: Joined
by Peter Grollman,
MGA (federal and state
lobbyist with The
Children‟s Hospital of
10 3/30 HEALTH INSURANCE Sparer M. Medicaid and the US path to national
health insurance. N Engl J Med. Jan
GUEST SPEAKER: 2009;360(4):323-5.
Susmita Pati, MD MPH Gruber J. Universal health insurance coverage or
(Assistant Professor of economic relief – a false choice. N Engl J Med. Jan
Pediatrics, UPenn 2009;360(5):437-9.
School of Medicine, and Lee TH, Mongan JJ, Oberlander J, Rosenthal MB.
from PolicyLab at the Perspective roundtable: Health care and the
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Children‟s Hospital of recession. N Engl J Med. Jan 2009;360(4):e5.
Philadelphia) Fuchs V. Health care reform – why so much talk
and so little action? N Engl J Med. Jan
Gais T, Dadayan L. The new retrenchment: Social
welfare spending, 1977-2006. Nelson Rockefeller
Institute on New Government. September 15, 2008.
Pati P, Keren R, Allessandrini E, Schwarz D.
Generational differences in US public spending,
1980-2000. Health Affairs. 2004;23(5):131-41.
Davis K. Investing in health care reform. N Engl J
Med. Feb 2009;360(9)852-5.
11 4/6 PERFORMANCE Utah Department of Human Services. Qualitative
MANAGEMENT Case Review Protocol. Human Systems &
Outcomes, Inc. August 2007. (Available at:
Additional readings to be announced
12 4/13 COURSE WRAP UP Readings to be determined
13 4/20 STUDENT Readings selected by student presenters
14 4/27 STUDENT Readings selected by student presenters
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