An integrated framework for assessing the value of community-based prevention: A report of the institute of medicine

Since the early 1900s, the major causes of illness and death in the United States have changed from infectious disease to chronic disease. Recognition is growing that nonclinical community- and population-based prevention has a large role in improving the public's health and well-being. Health risks such as obesity, tobacco use, and low levels of physical activity are the result of a set of complex, interrelated factors that are difficult to untangle and identify. Health behaviors are important (1), but the importance of such factors as the physical, psychosocial, socioeconomic, and legal environments cannot be overstated (2). Community-based, nonclinical prevention policies and wellness strategies account for as much as 80% of the overall health of a population (3), yet assessing the value of community-based prevention remains challenging and complex. How should the value of community-based prevention be assessed? What should be measured? What should be counted, for whom, over what time period, and how? To address this issue, the California Endowment, the de Beaumont Foundation, the W.K. Kellogg Foundation, and the Robert Wood Johnson Foundation asked the Institute of Medicine (IOM) to develop a framework for assessing the value of community-based prevention. The charge to the committee included examining the sources of data needed and available for valuing; the concepts of generalization, scaling up, and program sustainability; and the national and state policy implications of implementing such a framework. We provide a brief overview of the report, "An Integrated Framework for Assessing the Value of Community-Based Prevention" developed by the Committee on Valuing Community-Based, Non-Clinical Prevention Programs (4).