Health Promotion and Disease Prevention Program

Prevention science has the potential to avert or delay most of the major causes of disease and premature death in the United States. Unintentional injuries, cardiovascular disease, diabetes, and influenza are all major causes of premature death—and are often preventable. Prevention science can also deepen our understanding of how environmental, physiological, and psychological influences at the beginning of life relate to health outcomes during later years—and the action steps we can take to promote population health.

For many years, RAND Health has been at the forefront of research on health and health care. A recent reorganization was designed to further develop and intensify RAND's research in key areas. RAND Health is now organized around three major programs— Economics, Finance, and Organization; Health Promotion and Disease Prevention; and Quality Assessment and Quality Improvement—and four strategic initiatives: COMPARE, Global Health, Military Health, and Public Health Systems and Preparedness.

The Health Promotion and Disease Prevention

The Health Promotion and Disease Prevention program provides a supportive environment for researchers to conduct studies on a wide range of topics. Among its goals are to:

  • Determine what behaviors promote healthy lifestyles
  • Find effective ways to integrate these behaviors into daily life (including research on why people do—and do not—engage in health promotion activities)
  • Improve delivery of preventive care, including encouraging health screenings and diagnosis of under-recognized disorders such as depression
  • Promote healthy aging
  • Understand how people assess probabilities and conceptualize risk
  • Make well-child care effective and efficient
  • Develop strategies to address specific health problems, such as:
    • Obesity
    • HIV and other sexually transmitted diseases
    • Accidents and injuries
  • Promote health at worksites, schools, faith-based institutions and other community settings

Research Approach

The program's approach is multi-disciplinary. Creating strategies to promote health and prevent disease requires wide-ranging expertise. The program includes more than 70 researchers, whose disciplines include anthropology, communications, economics, epidemiology, medicine, nursing, political science, psychology, public policy, sociology, and statistics. Many are nationally recognized.

RAND pioneered the application of rigorous empirical research designs to health care issues. Research approaches can be as diverse as the complex problems being studied. Depending on the project, health promotion and disease prevention methodologies can include descriptive studies, qualitative studies, the development and testing of interventions, secondary data analyses, and policy analyses. Many projects are developed and implemented in partnership with local communities. Strategies to promote health can include clinical interventions, community programs, environmental re-engineering, and media campaigns.

Achievements

Examples of RAND's ground-breaking work include:

Substance Abuse – Our work on substance abuse prevention has won national awards and resulted in widely adopted programs for adolescents such as Project ALERT (for middle schools) and Project ALERT Plus (for high schools). Both use classroom-based activities to help students identify and resist pro-drug pressures. The Project ALERT curriculum is currently used in all 50 states. It has proven effective in curbing cigarette and marijuana use and alcohol misuse. It helps even high-risk youth, whom many felt were beyond reach.

Violence Prevention and Recovery – Another classroom-based program (the Cognitive-Behavioral Intervention for Trauma in Schools) is an intervention designed to help children who have been traumatized by violence, either as victims or witnesses. The intervention—the first randomized controlled study of a program designed to help traumatized children—significantly reduced symptoms of post-traumatic stress. The schools participating in the pilot study are located in economically disadvantaged neighborhoods with a high percentage of Latino students, demonstrating the program's ability to reach poor and minority children.

Understanding Neighborhood Influences on Health – A RAND-led research team created a "broken windows index" – a scale that rates neighborhood problems such as trash, abandoned cars, graffiti, and homes and schools in poor repair. The team then used the index to examine the association between neighborhood deterioration and health. The researchers found that, even after controlling for poverty, neighborhoods with a high "broken windows index" also had higher rates of premature deaths from all causes and from several specific causes (diabetes, homicide, and suicide), as well as higher rates of gonorrhea and other sexually transmitted diseases.

Funding Sources

Projects in the Health Promotion and Disease Prevention Program are funded by government grants (primarily from the National Institutes of Health and the Centers for Disease Control and Prevention), other government agencies, private foundations, and individuals interested in furthering the program's mission.