2018 Conference Theme

Michael O'Donnell
Michael P. O’Donnell, PhD, MBA, MPH

Best Science + Expert Implementation = Best Outcomes

How Do We Meld Scientific Knowledge with Human Sensitivity and Expert Management to Produce the Best Health Outcomes?

Scientific discoveries have been remarkably important in shaping the strategies we use and the outcomes we achieve in improving health behaviors. Major advances in the past forty years include discovering the protocols necessary to not only prevent but reverse heart disease through lifestyle change; the combination of clinical and policy approaches necessary to increase rates of tobacco prevention and cessation by 10 times; shifting the perception of exercise from something to be done with caution under a doctor’s care to a legitimate “magic bullet” that helps prevent or treat the vast majority of major diseases; recognition that education is not sufficient to produce behavior unless combined with motivation enhancement, skills training and opportunities to practice healthy lifestyle; that increased self-efficacy, targeted enticements and stage based tailored interventions increase success rates; that social influences and the physical environment can enable or sabotage even the best designed interventions; that lifestyle behaviors drive a significant portion of medical costs, and well-designed health promotion programs cost less than they save; and of course the underlying math and physics that provided the technology supporting web communication and high speed computing. These discoveries tend to be well documented and broadly disseminated.

But even the most scientifically valid programs fail when they are implemented poorly. Sometimes the
failure is caused by a lack of trust between employees and top management, between citizens and local, state or federal governments, or between a clinician and a patient. Sometimes failure is caused by placing the wrong people in the wrong jobs, with mismatches in training, personality, or experience. Sometimes failure is caused by a poor communication campaign, a breakdown in technology, or poor timing. Sometimes failure is caused by not adhering to the scientific principles on which the program as
developed, or an insufficient budget to reach the target market in the time allotted.

Other times, all of these problems are overcome by having the right individual or team guiding the program or the right leader injecting the critical support or energy necessary at the critical time. The critical factor might be charisma, integrity, determination, credibility, personal relationships or some other quality possessed by the individual or the team. These processes and human factors critical to successful implementation tend to be poorly documented and rarely disseminated.