Notes from the Field: Planting, Nurturing, and Watching Things Grow

Notes from the Field: Planting, Nurturing, and Watching Things Grow Editors’ Note: We invited a sample of AJPM’s Editorial Board, supplement guest editors, and longtime colleagues and contributors to share their experiences and impressions of the impact of AJPM on their respective domains. We were particularly fond of Ken Powell’s analogy to being “tenders of the planted seed”—as planters, weeders, and harvesters—watching and nurturing the growth of AJPM, and have elected to lead with his commentary.

In the mid-1940s my brothers and I helped our father tend our victory garden. We were suburbanites and our small garden shared a vacant lot with the concrete foundation of a home abandoned in mid-construction during the Depression. We helped plant, weed, and harvest the crops. I especially liked the tall stalks of sweet corn that grew taller than I was. Many years later, in the mid-1990s, I met a couple of other gardeners: Kevin Patrick and Doug Scutchfield visited the Centers for Disease Control (now the Centers for Disease Control and Prevention) to discuss their plans as the editors of the American Journal of Preventive Medicine. I was working in a Branch that was trying to understand the public health importance of regular physical activity, and they had the foresight to know we were planting some seeds in an important new area. I’m not sure that I had even heard of AJPM before their visit. A few years later, while the field of physical activity and public health continued to grow, I shifted my focus to violence and injury prevention. Once again, the team of Patrick and Scutchfield recognized the importance of this topic to the field of preventive medicine. By the turn of the century my work had shifted from the national to the state level. I tried to keep up with the literature by reading or scanning articles as I rode the subway to and from work. The Georgia Division of Public Health had no access to a library so I circulated my personal copy of the American Journal of Preventive Medicine to my team in the Chronic Disease and Injury Epidemiology Section because it contained by far the most articles of interest and practical application for us. Isn’t it interesting to watch things grow. Gardens, journals, and the fields of public health and preventive medicine. Kenneth E Powell, MD, MPH [email protected] Over the last decade, the American Journal of Preventive Medicine has become one of the top “go to” & 2013 American Journal of Preventive Medicine

Journals for public health aspects of vaccination. The Journal is publishing articles that affect policy and report on the state of vaccination in the U.S. On the policy side, articles range from the important topic of vaccine safety to exemptions in immunization laws1 to the cost effectiveness of various vaccine policy options.2 On the state of vaccination, articles have been published on vaccination rates, racial disparities in rates, reported adoption of Advisory Committee on Immunization Practices guidelines, and randomized trials to increase immunization rates.3 Barriers and facilitators to vaccination have been explored—from the patient perspective, to vaccine delivery in the medical office,4 at retail clinics,5 to system issues such as vaccine supply6 and state immunization registries7,8—in keeping with the preventive medicine aspect of the Journal. Major health services research teams, vaccine safety research teams, and federal investigators have reported their findings in the Journal. The rise in impact factor for the AJPM corresponds with the rise in the Journal’s importance as seen by researchers and policy officials. Richard K. Zimmerman, MD, MPH, MA Department of Family Medicine and Clinical Epidemiology University of Pittsburgh School of Medicine [email protected] In November 2002 the Robert Wood Johnson Foundation (RWJF) announced the Health e-Technologies Initiative (HeTI) to stimulate systematic research on emerging eHealth technologies for health behavior change and chronic disease management. Although eHealth at the time was in a nascent stage of evolution, RWJF recognized the importance of applying rigorous scientific methods to the evaluation of these programs. Concomitantly, the editors of the American Journal of Preventive Medicine recognized the need for scientific study and examination of eHealth tools and programs to help establish an evidence base. We invited Kevin Patrick, editor-in-chief of AJPM to become Chair of our National Advisory Committee, given his leadership role in preventive medicine and his strong interest in technology-enabled programs.9–13 His stewardship of HeTI was instrumental in helping us to create a portfolio of eHealth research that truly advanced the science of eHealth. Over the subsequent 7 years of HeTI, AJPM became the preferred venue for publication of both qualitative and quantitative studies of eHealth across diverse populations, prevention targets and interventions, technologies, and methods.14–16

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Fast forward a decade to 2013 and we find that eHealth, mHealth, and the broader Health Information Technology (HIT) landscape has grown exponentially along with a robust and compelling evidence base.17–19 AJPM deserves credit and recognition for its contribution to this evidence base through publication and dissemination of many of the seminal studies in the field of eHealth. David K. Ahern, PhD National Program Director Brigham and Women's Hospital Psychiatry/Health e-Technologies Initiative [email protected] The growth and interest in academic prevention and public health have increased over the last 20 years. The number of graduate public health programs has almost tripled since 1994, when the editorial team at the University of California San Diego took over responsibilities of the American Journal of Preventive Medicine (AJPM). Since that time, AJPM has been a valuable resource to gaining national attention and extending the reach of several important and pioneering activities in academic preventive medicine and public health. The Journal has promoted curriculum innovations that play a vital role in advancing health behavior change, such as the 1990 publishing of “Inventory of Knowledge and Skills Relating to Disease Prevention and Health Promotion.”20 The inventory defined the knowledge and skills appropriate for the instruction of medical students in the disciplines of disease prevention and health promotion. In 2000, the Association for Prevention Teaching and Research (APTR) embarked on advancing interprofessional prevention education by forming the Healthy People Curriculum Task Force. AJPM published a theme issue emphasizing the importance of using an interprofessional approach for both teaching about and delivering preventive services to individuals and populations,21 and the Clinical Prevention and Population Health (CPPH) Curriculum Framework was launched. The Framework was the first structured and comprehensive curriculum agenda for integrating clinical prevention and population health into the education of students across the health professions disciplines. Through AJPM, the rationale for using the CPPH Framework when teaching students and practicing healthcare professionals was delivered. The February 2011 issue of AJPM presented the concept of Healthy People 2020 and Education for

Health, a 10-Year Roadmap for Reaching Public Health Education Goals. The issue featured a series of articles that examined public health educational needs and goals for the U.S. and initiated the discussion and progress needed to achieve an integrated, seamless approach to education for the American public as well as for health professionals.22–29 The Journal served as a tool for increasing the growth of collaborative models in health professions education. According to the Association of American Medical Colleges’ 2013 Medical School Graduation Questionnaire, results show that nearly 75% of graduating medical students report that their education included training in teams with other health professionals. AJPM also had a major impact on the development of undergraduate public health education. A theme issue published in 2008 on undergraduate public health30–35 and a 2011 theme issue on Healthy People 2020 included articles on undergraduate public health at 2-year and at 4-year colleges.25,26 During this time the growth of undergraduate public health has been rapid. The College Board indicates that in 2013 there are approximately 500 undergraduate public health and related programs. AJPM once again played an important role in making this happen due to the reach of the Journal and its reputation. Allison L. Lewis Executive Director Association for Prevention Teaching and Research Washington DC [email protected] The Hispanic population continues to boom, rising from just 6% of the U.S. population in 1980 to more than 16% in 2010 and up to an expected 30% by 2050. That is hardly a shock to anyone. But what shocked me as I jumped into the public health research field in the 1980s was that, even though this surging, dynamic population suffered dire inequalities in cancer and chronic disease incidence and mortality, there was a lack of research by Hispanics on Hispanics. The AJPM helped change the tide, fortunately. The Journal became a critical platform to both stimulate and promote research on health disparities. Disparities are undoubtedly a challenging topic for clinicians and researchers. Healthy lifestyle promotion, behavioral interventions, educational and outreach programs, and knowledge of screening compliance can help mitigate disparities—and even may decrease

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cancer incidence and improve both screening and comorbidities among minorities, according to a systematic review published recently in AJPM.36 For me, AJPM is a conduit for showcasing solutions to Hispanic disparities. For example, in 2000, years before online social networks like Facebook and Twitter, AJPM published our findings37 that, independent of socioeconomic factors, social integration and networks appear to influence cancer screening participation of Hispanic women (although differences occurred among Hispanic subgroups). This helped push researchers to recognize Hispanic-group differences in social network characteristics and the potential of social networks to change screening behavior. AJPM also published our supplement38 that identified guided grocery store trips, menu labeling at restaurants, community gardens, and video game–based exercise programs as among several promising, culturally appropriate ways to prevent obesity among Latino children. Given the importance of cancer and obesity research and interventions to help alleviate related inequalities amid the fast-rising Hispanic population, I sincerely thank the AJPM for its commitment to feature work that could make health disparities a thing of the past. Amelie G. Ramirez, DrPH Director, Institute for Health Promotion Research The University of Texas Health Science Center at San Antonio [email protected] In 2007, AJPM published a supplement entitled Critical Issues in eHealth Research to showcase cutting-edge research methods from thought leaders in the field.16 A subsequent special theme issue titled eHealth Research and Patient-Centered Care: Examining Theory, Methods, and Application was published in 2010; these articles highlighted innovative methods specifically relevant to patient care.39–42 The ideas discussed in these AJPM special issues have only increased in relevance for health research given the astounding adoption and proliferation of information technology (interactive websites, social media, smart phones, cloud computing, EHRs, wearable sensors, GPS devices). This is but one example of AJPM bringing to light key scientific ideas with future relevance to prevention research. Mark Twain once wrote: “Supposing is good, but finding out is better.” As the field of eHealth has matured, AJPM has clearly strived for the better. The Journal has not just highlighted novel scientific ideas in eHealth, the editors have made a concerted effort to publish rigorous

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empirical studies that test these new ideas. The names of this class of research have expanded over time (eHealth, mHealth, digital health, health IT), but the Journal has kept a steady pulse on the core issues that can influence technology-based health research. I applaud AJPM’s editors for their foresight over the past 20 years and hope in the years to come that the Journal continues to serve as a bright beacon, encouraging researchers to explore new ideas and utilize creative research tools to address often complex and persistent health issues in preventive medicine. Audie Atienza, PhD National Institutes of Health Health Promotion Research Branch Bethesda, Maryland [email protected] Nearly 20 years have passed since Doug Scutchfield, Kevin Patrick, and their team took over the helm of AJPM. Over those years, as a composite, the hundreds of article published in AJPM underscore the important functions of the physical/built and social/cultural environments in our understanding of how to promote health, while concurrently acknowledging the centrality of community members’ roles in determining prevention approaches. This body of work reflects a major paradigm shift in the field of prevention science and health promotion. And this shift has helped to foster the intersection of various disciplines to create new ones (e.g., human health dynamics and geography) and ultimately to generate new research ideas, new educational approaches, and new policy initiatives. This is reflected most clearly in the selection of supplements and theme issues, including but not limited to the GOL studies43–47 and Salud America! research and policy efforts so important to promoting not only Latino health but also the expanded role of Latino researchers.38 Over these 20 years AJPM has served as a platform for presenting innovative ideas to a discerning readership. AJPM readers expect rigorous, theoretically sound, and thoughtful work, but also efforts that push the boundaries in terms of the types of methods used to promote health and the populations these methods reach. Given its readership, AJPM has always been at the top of our list of journals in which to publish our intervention findings. Twenty years ago, one of us (JPE) was a Professor at SDSU, working alongside Dr. Patrick in his role as Medical Director of SDSU’s Student Health Services and Dr. Scutchfield as Director of the Graduate School of Public Health; while the other (GXA) was entering a masters in experimental psychology program, and as

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yet, not introduced to the field of prevention science and public health. Together we have witnessed, and in some cases participated and led, this wonderful expansion of our field and the diversity of its leaders, one that reflects the realities of people’s lives. Guadalupe X. Ayala, PhD, MPH San Diego State University Graduate School of Public Health [email protected] John P. Elder, PhD, MPH San Diego State University Graduate School of Public Health As current members of the Community Preventive Services Task Force, and on behalf of our colleagues at CDC and of past members of the Task Force, we owe a debt of gratitude to AJPM for the enormous increase in the reach and impact of our efforts your publications of scores of our systematic reviews and Task Force recommendations (in 15 supplements and numerous stand-alone articles) have made since 2000. The CDC outlet for the continuously updated and applied guidance from the full range of Task Force work and CDC staff support has been the online resource—www. thecommunityguide.org. But having the Journal’s publication of the systematic reviews and Task Force recommendations for policy, programs, practice, and needed research has resulted in a major impact, indicated by the “massive” increase in the hits on that website in 2009 and an accelerated rate of increase in the use of the Guide since then. The pressure for justifying public expenditures on the basis of evidence-based practices has increased the demand for authoritative assessments of “what works” and raised Congressional interest in using the systematic reviews and recommendations of its mandated task forces (see our Report to Congress via the Guide website). The inclusion of your Journal as an outlet has also extended our reach and impact with the bridging of community and clinical preventive health services, reaching as you do both the public health and the preventive medicine communities. We thank you for this collaboration and applaud your vision for the Journal in making it happen. Ned Calonge, MD, MPH Marshall Chin, MD, MPH John Clymer, AB Jonathan Fielding, MD, MPH, MA, MBA Karen Glanz, PhD, MPH Ron Goetzel, PhD

Lawrence W. Green, DrPH [email protected] David Grossman, MD, MPH Robert L. Johnson, MD Shiriki Kumanyika, PhD Tracy Orleans, PhD Nico Pronk, PhD Gilbert Ramirez, DrPH Patrick L. Remington, MD, MPH Barbara Rimer, DrPH …on behalf of the Task Force and its staff past, present, and future On April 26, 2011, representatives from government, academia, and industry gathered at the National Press Club in Washington DC to celebrate the publication of a supplement dedicated to the topic of Cyberinfrastructure for Consumer Health.48 The topic of cyberinfrastructure (i.e., platforms of broadly connected data systems used to accelerate science) had become central to leaders at the National Science Foundation, who understood that connected data systems would bring new computational thinking into the center of all disciplines. For many in preventive medicine, though, the topics were unfamiliar and innovative. It took AJPM, and the foresight of its editors, to bring concepts such as big data, cloud computing, and transdisciplinary science into the mainstream of public health research. For me, that moment seemed like a microcosm of what the Journal and its editors have been accomplishing over the last 20 years. The insights I have gleaned from the many high-quality submissions to the Journal have helped me, as a funder within the National Institutes of Health, to identify where innovation was happening and what the cutting-edge tools in prevention research might be. Moreover, as the world of publishing changed, I could count on the Journal’s website to stay ahead of the curve in providing content that is up-to-date and topical, in a format that is engaging and informative. As Louis Pasteur once said, “chance favors the prepared mind.” My hope is that the Journal continues to prepare all of its readers for new opportunities ahead. Bradford W. Hesse, PhD Chief, Health Communication and Informatics Research Branch National Cancer Institute [email protected] One of the happy developments in our field in recent years has been the growing recognition that good health is a function of factors well outside the medical arena. www.ajpmonline.org

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Many of us are now what Dr. Rishi Manchanda has called “upstreamists”49—students of climate science, transportation engineering, energy policy, urban planning, architecture, agriculture, poverty reduction, and more. This of course reflects rediscovery more than invention; our professional forbearers, in the 19th century, were as much social reformers and civil engineers as clinicians.50 But the recent reconnection of public health and preventive medicine with other arenas has been dramatic, and even transformative. The American Journal of Preventive Medicine has been instrumental in this transformation. It has become the primary forum for research on the health impacts of the built environment. It has published seminal papers on food systems, on climate change, on nature contact, and on other upstream determinants of health.51–59 Its editors have brilliantly sought editorials on a wide range of topics well outside medicine. So after almost 20 years, the outstanding editorial team at AJPM is bequeathing not only a leading journal, but also a delicious irony, to the new editors: the notion that (despite the Journal’s name), disease and injury prevention, and health promotion, are about much more than just medicine. Howard Frumkin, MD, DrPH Dean, University of Washington School of Public Health [email protected] While the American Journal of Preventive Medicine (AJPM) publishes numerous articles on military public health and preventive medicine activities, the Journal’s contribution to military injury prevention is less well known. In 2000, the first of two supplements dedicated to military injury prevention was published—Injuries in the U.S. Armed Forces: Surveillance, Research, and Prevention.60 This supplement described the five steps of the public health process, evaluated databases with potential for use in injury surveillance, and provided examples of military research relevant to injury prevention. It documented work performed by the Armed Forces Epidemiology Board, which built upon prior efforts of the DoD Injury Surveillance and Prevention Work Group.61 Articles from that first AJPM supplement have been cited in almost 1000 other publications. A second dedicated AJPM supplement in 2010— A Public Health Approach to Injury Prevention: the U.S. Military Experience62—provided an update on the military’s evidence-based approach to injury prevention and criteria for setting prevention priorities. This supplement provided military examples of key steps of

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the public health process: surveillance, field investigations, and program evaluations. Since its publication, articles from the supplement have been cited in over 200 other publications and have been downloaded from the Army Public Health Command website more than 52,000 times. We feel that it was no accident that the Secretary of Defense made injury prevention and mishap reduction a top priority for the Department of Defense in 2003, just 3 years after publication of the first AJPM supplement documenting the extent of the military injury problem and how it might be mitigated. In addition, publication in these AJPM supplements enhanced the credibility, durability, and accessibility of key military injury prevention data and made it possible to document the tremendous progress accomplished by the military from 2000 to 2010. Bruce H. Jones, MD, MPH Michelle Canham-Chervak, PhD, MPH [email protected] Injury Prevention Program U.S. Army Institute of Public Health Aberdeen Proving Ground Reflecting on the many accomplishments of the Journal under the leadership of Kevin Patrick, Doug Scutchfield, and their outstanding team, it is difficult to highlight just one area of success. However, one important theme does come to mind: namely, the linkage of individual- and population-based perspectives on health. This linkage was advanced through the Journal’s role as being a major publication platform for both the Community Preventive Services Task Force (Task Force)63–65 and the U.S. Preventive Services Task Force (USPSTF).66–68 The recommendations from each task force have been, and continue to be, incredibly important in shaping practice and policy. Part of this impact has been created and magnified through the Journal, which has been a prominent showcase for both The Community Guide and the recommendations of the USPSTF. The Task Force arose after the USPSTF to address the major gap in evidence-based, population health recommendations, creating the public health analog of the USPSTF guidance. The Journal published the foundational methods articles of the Task Force as well as providing the contextual framework explaining the need for this advance in evidence-based public health. In linking clinical prevention with population-based prevention, through the advancement of the work of both the USPSTF and the Task Force, the Journal once again played a leadership role, advancing the broader field of preventive medicine. Most importantly, under the

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Patrick–Scutchfield team, the Journal has contributed in a substantive way to improving the health of the nation. Neal D. Kohatsu, MD, MPH Medical Director California Department of Health Care Services [email protected]

and population health are providing early demonstrations of the power of these approaches. Consequently, we believe that AJPM’s readers are better prepared to lead not just within the discipline of medicine, but to lead efforts to integrate medicine and public health, and to help our healthcare systems shift from illness and disease care to systems that promote and support health. Denise Koo, MD, MPH Office of the Director Scientific Education and Professional Development Program Office Centers for Disease Control and Prevention [email protected]

Jeffrey R. Harris, MD, MPH, MBA Director, Health Promotion Research Center (a CDC PRC) University of Washington In 1998, near the beginning of the tenure of the current editors of the American Journal of Preventive Medicine (AJPM), an editorial called on preventive medicine professionals to provide leadership to the field of medicine.69 Strikingly, the key word here is medicine— AJPM, like preventive medicine at the time, prided itself on its strong emphasis on such clinical concerns as clinical prevention, outcomes measurement, program evaluation, and quality improvement. Leap ahead 2 decades, and it is striking how preventive medicine, with AJPM often leading the way, is beginning to broaden its scope and reach. Prevention of illness is and always has been the work of many, not just those with training in medicine, and not just in the clinical world. The National Prevention Strategy underscores this by emphasizing recommendations and indicators related to where we work, live, pray, play, and go to school in addition to those related to health care.70 The power of prevention comes not from being separate but equal and focused in clinical settings, but from having its methods and findings integrated into clinical practice, public health, and the broader environment (Health in All Policies). Thus, AJPM now includes a range of articles that strengthen the evidence base for how we protect and preserve health, including articles on integrating population health into all health professional education, not only that of physicians, and the importance of such skills for reintegrating primary care and public health. Today’s AJPM regularly presents nonclinical interventions (e.g., health impact assessments and policy changes) and the contributions of community-based partnerships, including those with schools, businesses, and community groups. AJPM has published salient articles that identify not solely biomedical interventions to improve health, but interventions that do not need to be undertaken by physicians or even within the healthcare system. The emergence of community–health system partnerships and the redesign of models of care to improve personal

J. Lloyd Michener, MD Department of Community and Family Medicine Duke Center for Community Research Duke University Medical Center The American Journal of Preventive Medicine has created high expectations for relevance. As Medical Director for Population Health at HealthPartners, I am constantly faced with two questions: What is the evidence that a behavior or condition is associated with health? and What is the evidence that there are interventions that can improve health and well-being? I find that, while there are occasional papers in the New England Journal, JAMA, or American Journal of Public Health that help me answer these two questions, it is the papers published in AJPM that are most likely to answer these questions for me. I have come to expect that each monthly issue will be a cornucopia of observations, trials, and task force reports that are directly relevant to my evidentiary needs. And as I look around my office and view the paper copies of entire issues of Journals that I have saved because they are special, the stacks are dominated by the American 5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0

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Figure 1. The impact factors of the American Journal of Preventive Medicine and The American Journal of Public Health, 1992–2012 www.ajpmonline.org

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Journal of Preventive Medicine. This is not my experience alone. As the figure that displays the impact factors of the American Journal of Preventive Medicine and The American Journal of Public Health demonstrates, over the past 20 years the American Journal of Preventive Medicine has become a most trusted and valued resource for information about the delivery of preventive services in the clinic and the community (Figure 1). Thomas E. Kottke, MD, MSPH Medical Director for Population Health HealthPartners Minneapolis, Minnesota [email protected] Many of us remember that the first report of the U.S. Preventive Services Task Force (USPSTF) published in 1989 not only set the standards for clinical preventive services delivery in practice but also for the quality of scientific review used by expert panels in making clinical practice recommendations. The USPSTF’s explicit methodology was adopted in one form or another by scores of other expert committees, and it was amazing to see prevention, previously Medicine’s too-often-forgotten stepchild, lead the way into the new world of evidencebased medicine. The USPSTF was by no means alone in this effort. Academic preventive medicine journals, and particularly the American Journal of Preventive Medicine under the leadership of Kevin Patrick and Doug Scutchfield, were at the forefront helping to lead the charge for scientific rigor and integrity. It has been gratifying as an AJPM Editorial Board member to watch the scientific quality of submitted and published articles steadily increase over the years. It is undoubtedly no coincidence that both the reputation of the Journal and the field in general also increased during this time. I’ve been consistently impressed by the quality of comments and suggestions of reviewers. As for my own review comments, I have found the editorial office to always take them seriously, particularly when they have concerned scientific validity and integrity. There have been no scientific shortcuts with AJPM. The AJPM editorial office under the leadership of the Patrick–Scutchfield team deserves much credit for elevating the level of discourse about prevention over the last 2 decades, such that now science and prevention are inextricably intertwined. Larry L. Dickey, MD, MPH Medical Director, Office of Health Information Technology California Department of Health Care Services

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Over the past quarter century, strategic communication—defined as the planned and purposeful use of communication by an organization to advance its mission—has emerged fully as a core element of public health and preventive medicine strategy and practice. A discipline that was once considered to be little more than a set of tactics, if considered at all, is now widely understood to be a strategic asset that is routinely integrated into prevention planning in government, industry, and the civic sectors. A possibly apocryphal story, as conveyed to me in the late 1980s by Nathan Maccoby (known to his friends, colleagues and students as “Mac”), nicely illustrates both the humble origins and the potential of communication in preventive medicine: In 1970, Mac, a professor of communication at Stanford, was approached by John (Jack) Farquhar, a young professor of medicine at Stanford. As a lipid researcher, Jack was convinced that heart disease in America was largely preventable; he asked Mac: Will you help me make a movie that educates Americans about heart disease, and saves thousands of lives? Mac’s reply: I think it may take more than that, but let’s think this through and give it a try. The Stanford Three Community Study,71 which spawned the field of public health communication, was conceived in that conversation. As illustrated in this story, scholarship—the application and development of social and behavioral science theories and rigorous empirical tests of their application to important public health challenges—has been a driving factor in the emergence of health communication. Over the past 20 years, the American Journal of Preventive Medicine has consistently played an important role in fostering that scholarship. From their first days at the helm, the outbound editorial team recognized the potential of strategic communication as a public health asset, and consistently encouraged its development by giving authors, along with the sponsors of supplements (which have proved to be highly influential), the latitude to think broadly and deeply, and to be creative. The ultimate measure of public health and preventive medicine scholarship is whether or not it improves practice and outcomes. A critically important task for journal editors, therefore, is to ensure that their publication is read and considered by the people who influence practice. The editors of AJPM have performed this task well; over the past quarter century, AJPM has become one of the most effective vehicles through which to reach government policymakers and program directors, health and insurance industry leaders, innovators in the civic sector, academics, and journalists. In short, AJPM has

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become a “go to” vehicle for public health communication scholars who are seeking to have an impact through their scholarship.

Glen P. Mays, PhD, MPH Professor of Health Services and Systems Research University of Kentucky

Edward Maibach, MPH, PhD Director, Center for Climate Change Communication George Mason University [email protected]

Paul K. Halverson, DrPH, MHSA Founding Dean and Professor Fairbanks School of Public Health Indiana University–Purdue University Indianapolis

Filling the toolbox and using the toolbox are equally important tasks in building a healthier nation, but the latter component is often neglected in medicine and public health. The American Journal of Preventive Medicine has a long and distinguished history of engaging the scientific enterprise to discover new prevention tools, but in our view its most powerful contributions over the past 2 decades lie in fueling the scholarship of application. A case in point is the field of public health services and systems research (PHSSR), which seeks to identify how best to organize, finance, and deliver strategies that prevent disease and injury on a populationwide basis. The Journal recognized the importance of this nascent area of inquiry at least as far back as 1995, when it published a series of studies sponsored by CDC that focused on measuring and comparing dimensions of public health delivery.72 We were fortunate enough as a newly-minted assistant professor (PKH) and graduate student (GPM) to find ourselves working on some of the early studies in this CDC series. Harvey Fineberg, the Harvard dean who would become president of the Institute of Medicine a few years later, noted in his commentary that this endeavor was “not yet a science” but offered valuable guidance for the public health profession.73 The Journal continued to cultivate this line of investigation, and in the years that followed a steady stream of empirical articles demonstrated that public health organizations and their actions could be measured, compared, and evaluated objectively based on their health and economic impact. At some point along the way, a science was born. A national research agenda now exists.74 Systematic reviews track the advancing evidence base. Practicebased research networks (PBRNs) proliferate in public health settings across the U.S.75 Even the Affordable Care Act is now getting into the game, authorizing new federal research programs on public health delivery. As for us, we can swing the hammers much more confidently as we train the next generation of public health practitioners and scholars.

How quickly time passes. It seems only last week, not January 2010, that Kevin Patrick and Doug Scutchfield gave word that they would be stepping down as editors of the American Journal of Preventive Medicine at the end of 2013. When important contributors express intents of this sort, an element of denial naturally sets in. Over the past 2 decades, AJPM has been instrumental in not only growing the field of prevention science, but in helping to define its character. This is not an easy task. Health is shaped by the dynamics at the intersections of domain forces—our predispositions, cultures, environments, behaviors, and services. Prevention, and the promotion of good health, is then inherently complicated to define, to study, to change. It has been the task of the AJPM editors to engage issues as diverse as physical activity, violence, immunization, communication strategies, and digital infrastructure, and to do so in a fashion that authors from far flung corners of the research world—designers, systems engineers, physicians, community leaders, and many more—feel that they are not only united by a common cause, but served by editorial stewards who bring wisdom, understanding, sound judgment, and solid appreciation for the issues in play. An important contribution of the editors has been to expand the reach and influence of the Journal—and the field—through the publication of special supplemental issues on compelling contemporary topics ranging from the relationship between research and practice in prevention, to firearm injury surveillance, clinical preventive services, motor vehicle injuries, HIV, healthcare costs, tobacco control, health disparities, design strategies for active living, and beyond. In doing so, they have grown the Journal family through the recruitment of stellar guest editors, while drawing attention to key opportunities and improving access of researchers, practitioners, and policymakers alike to the best information on the state of play. My gratitude, however, is not just professional, it is personal. I have learned a great deal from Kevin Patrick over the years of our association. It has been my good fortune to have the direct benefit of his counsel when we

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were colleagues in public service, as well as the reward of his friendship in many venues since. Both the counsel and the friendship will continue, and the occasion of this milestone offers the opportunity to celebrate it, and to thank Kevin, Doug, and all of the AJPM staff for their extraordinary contributions to us all. J. Michael McGinnis, MD, MPP Senior Scholar The Institute of Medicine of the National Academies [email protected] This being the final issue of AJPM published under the stellar editorial team led by Drs. Kevin Patrick and Doug Scutchfield, I was asked to share some brief comments on behalf of ACPM about the impact the Journal has had over the years on prevention science, education, practice, or policy. Metrics documenting the steady growth of the Journal’s impact factor and rankings within both medical and public health Journal indices, as well as the explosive growth in manuscript submissions and the rejection rates, are impressive, for sure, and are well documented in other articles in this issue. But impact can also be felt, if not quantitatively measured, by talking to some of the readers of the Journal, in this case, ACPM members. In having such conversations with several ACPM leaders, what I typically heard was that AJPM includes information that actually can be used, and that its strength and impact are in its relevance. Examples provided include regularly citing Journal articles in applying for research grants, which requires citation of the evidence or gaps in the evidence; referring to the Guide to Community Preventive Services reviews and recommendations—published routinely in the supplement series—as well as evidence of USPSTF recommendations in practice; lecturing students or medical professionals, or making media appearances, focused on cancer screening, with the August 2013 issue cited as a great example76; and working in elementary schools to reduce childhood obesity, or with obese children in pediatric practice.38,77,78 However, as executive director of the medical specialty society that co-sponsors the Journal, I would be remiss if I didn’t also mention a few of the many ways the Journal has had an impact on our organization: ACPM. First and foremost, the Journal has always and continues to be an important member benefit. More recently, it also has become a key source of continuing medical education (CME) and Maintenance of Certification (MOC) credit for our members. The Journal adds scientific credibility to the organization and extends ACPM’s visibility to external audiences. Increasingly, the Journal has become

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a voice in the popular press, which drives public interest in prevention, the specialty, and ACPM. The Journal also helps support ACPM’s connections with federal agencies, policymakers, kindred organizations and coalitions, and industry partners. We use the Journal and its content extensively in our advocacy and to showcase why preventive medicine needs to be at the table in key policy discussions. In closing, I and the ACPM leadership are very excited about the direction in which the Journal is headed. In its 2010 strategic plan, AJPM set out on a course to take the Journal’s policy and practice relevance to a new level, which included leveraging its partnership and joint branding with the sponsoring societies. Recent co-sponsored press briefings in Washington DC and the scientific research symposium at ACPM’s Preventive Medicine 2013 conference are prime examples. Both as a field and a specialty society, preventive medicine is indebted to the great work of the Patrick–Scutchfield team and the outgoing editorial staff for making the Journal as relevant as it is. ACPM is looking forward to working with Dr. Boulton and the incoming team to build on these successes and take the Journal and its relationship with ACPM to even higher levels. Michael A. Barry, CAE Executive Director American College of Preventive Medicine Washington DC [email protected] From a perspective Down Under, the American Journal of Preventive Medicine has been a beacon for research initiatives and a forum in which the outcomes of our best work have been shared. We feel privileged to be participants in AJPM’s informed and critical scientific community—pushing the envelope for chronic disease prevention and preventive medicine. Australians do research that can seem to be odd by prevailing U.S. standards. AJPM’s distinctly nonparochial interest and positive and proactive consideration of work from this other hemisphere have been much appreciated. It has enabled us to share innovative findings and to help shape population-health research on physical activity—a crucial but underrated aspect of preventive medicine and public health. For example: From our research on influencing physical activity, AJPM is home to findings on broadreach intervention trials,79 reviews,80,81 and evaluations of community-wide campaigns.82 The fruits of epidemiologic and behavioral science concepts and analytic

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methods to deal with the correlates and determinants of physical activity have pride of place among the Journal’s highly cited papers.83 As our thinking shifted through seeing consistent evidence of modest intervention effects, AJPM welcomed and improved the reports of our original empirical studies84,85 and our review papers identifying the likely role of environmental attributes as determinants of physical activity.86,87 More recently, AJPM has featured some of our best findings and ideas on understanding and influencing sedentary behaviors: too much sitting as distinct from too little exercise.88–92 Every one of our AJPM published papers has been hard-earned. The Journal has presented us with a plethora of memorable peer-review rejoinder challenges— often mixed sets of comments from up to 4 reviewers— moderated, however, with firm and strategic editorial guidance. Particularly memorable is one of our rejoinder letters having a higher word count than our revised manuscript! I can speak for the cohort of physical activity and sedentary behavior researchers in Australia who are proud and delighted to have track records of success with AJPM. We have also learned some great lessons in contributing to the Journal as peer reviewers; we have had our skills and research agendas shaped and refined significantly through doing so. Many thanks, AJPM Neville Owen, PhD Baker IDI Heart and Diabetes Institute Monash University Universities of Melbourne and Queensland [email protected] Since 1994, the field of worksite health has enjoyed tremendous growth. As a result, interest in knowing “what works” to protect and promote health at the workplace has peaked. How changes in worker health affect healthcare expenditures, worker productivity, workforce morale, and a host of other variables, are important considerations for employers when making resource allocation decisions. Your efforts in providing a trusted source of information and guidance for these matters have been noted—the American Journal of Preventive Medicine has become a “destination journal” for worksite and occupational health researchers and practitioners. Over the past 2 decades, you have welcomed research and perspectives on different applications and views of worksite and occupational health including prevention science, education, practice, and policy. You have also had the vision to become an important partner to the

Community Preventive Services Task Force and supported its work by disseminating systematic reviews and associated commentaries. Many of these papers were related to workplace health, and the impact of these papers on the relative importance and visibility of the worksite and occupational health field as a whole has been tremendous. The importance of dissemination partners for researchers and practitioners cannot be overstated. My view is one of sincere gratitude for your many years of service to the field of prevention and health promotion in general and to the field of worksite health in particular. Nico Pronk, PhD HealthPartners Harvard School of Public Health [email protected] A significant paradigm shift in preventive medicine and public health over the past 15–20 years has been the rise of environment and policy research on physical activity, healthy eating, and obesity. In 1994, the dominant approach to research and practice on these topics was individual behavior change, based on theories that excluded environment and policy factors. By 2013, multi-level research and interventions that emphasize environmental changes are now mainstream. Built environments that make health-promoting choices easier for whole populations include the presence and quality of parks, healthy food outlets, walkable communities, and pedestrian and bicycle facilities. Major governmental and foundation health improvement initiatives are drawing on hundreds of built environment studies. American Journal of Preventive Medicine (AJPM) has played a special role in the built environment paradigm shift. One of the first papers articulating the concept as applied to physical activity was published in AJPM.93 The Journal published papers from the first Active Living Research Conference, with authors from several nonhealth disciplines writing on built environment topics.94 AJPM has published many papers and several supplements on built environment and health. In annual literature searches of built environment and policy papers related to physical activity and obesity conducted by Active Living Research, AJPM consistently publishes the most papers (http://activelivingresearch.org/ resourcesearch/referencelist). The high number of built environment studies does not seem to have hindered AJPM, because its impact factor has increased dramatically over the past 20 years. As of July 2013, the two most cited AJPM papers are both related to built environments.95,96 I thank the editors and reviewers of the

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Journal for helping built environment research and practice become a core approach to preventive medicine. James F. Sallis, PhD Distinguished Professor of Family and Preventive Medicine University of California, San Diego [email protected] As the American Journal of Preventive Medicine transitions to new leadership, we want to highlight some of the impressive contributions of the Journal under the current AJPM editorial team. The Journal has played a major role in advancing the fields of preventive medicine and public health over the past 2 decades, owing largely to the sustained editorial stewardship of Kevin Patrick, Douglas Scutchfield, Jill Waalen, and their colleagues at AJPM. One of the most important contributions of the Journal during these years has been the publication of theme-oriented supplement issues that have charted new horizons and opened new vistas in prevention research, teaching, practice, and policy. One emergent and rapidly growing area of health research is the science of team science (SciTS), or the study and management of circumstances that influence the processes and outcomes of research teams and translational partnerships, in particular, cross-disciplinary collaborations. In 2006, the National Cancer Institute (NCI) organized an international conference on The Science of Team Science: Assessing the Value of Transdisciplinary Research. In 2008, we had the privilege of guest-editing and contributing articles for an AJPM supplement on this topic,97,98 which has been the most frequently downloaded and highly cited AJPM supplement following its publication (personal communication, Charlotte Seidman, Managing Editor, AJPM, July 22, 2013). The supplement provided a foundation for subsequent research on transdisciplinary scientific teams and the expansion of scholarship and educational and translational initiatives in the emerging SciTS field. The critical role of this supplement is evidenced by its formative influence on the establishment of an annual SciTS conference series at Northwestern University in 2010 (www.scienceofteamscience.org); the formation of a National Academies SciTS Committee in 2013 (sites. nationalacademies.org/DBASSE/BBCSS/CurrentProjects/ DBASSE_080231#.UebhNFMd6jo); and the development of numerous resources for team science research and practice (including the web-based NCI Team Science Toolkit and listserv [www.teamsciencetoolkit.cancer.gov/ public/home.aspx?js=1]). Moreover, in 2009 and 2012, AJPM published two longitudinal studies assessing the

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educational and scientific outcomes of NIH-supported transdisciplinary health science training programs and research centers.99,100 Cumulatively, these published works helped launch a crucial area of science aimed at enhancing the effectiveness, efficiency, and synergies across multiple research domains. We have begun to see the benefits of this research through the optimization of transdisciplinary research and training centers initiatives at NCI.101,102 We salute AJPM’s editorial team for its outstanding efforts over the past 20 years, which have strengthened the empirical foundations of prevention research, training, and practice and have broadened scholarship in these fields to encompass newly emerging and important research domains including transdisciplinary and translational team science. Daniel Stokols, PhD School of Social Ecology University of California, Irvine [email protected] Kara L. Hall, PhD Division of Cancer Control and Population Sciences National Cancer Institute The first article from the Adverse Childhood Experiences (ACE)103 Study was published in AJPM in 1998. Since then, it has been one of the most cited papers and the most requested full-text articles from AJPM in the past 15 years. The ACE Study provides a converging point for multiple sciences and services104 and a framework for addressing an array of childhood adversities and related outcomes that had previously been addressed in a categorical fashion. More than 70 scientific articles have been published from the ACE Study105–108 including those from the ongoing prospective arm of the study documenting the impact of ACEs on health care utilization, disease incidence, and premature mortality.109–112 The body of literature from the Study highlights the wide-ranging public health, social, and economic impact of ACEs throughout the lifespan and has been reviewed in the book The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic.113 The concepts from the ACE Study have spawned a great deal of interest and activity. Multiple states are now using questions about ACEs in the Behavioral Risk Factor Surveillance System to document the population impact of ACEs.114 In addition, WHO has adopted the paradigm from the ACE study103–115 as a central pillar in its public health approach to understanding and preventing child maltreatment, and is using the survey

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methodology throughout the world.114 The CDC website (www.cdc.gov/ace/) dedicated to the ACE Study provides background information, the conceptual framework for the study, a list of publications, and the questionnaires. The interest from numerous professional sectors and the general public116 is evidenced by the proliferation of information and opinions about uses of the ACE Study using web journalism and social media at www. ACEsTooHigh.com and www.ACEsConnection.com. We thank AJPM for the foresight in 1998 to publish our first article from the ACE Study. Fifteen years later this foresight culminated in a National Summits on ACEs,115 and paradigm shift for improving the health of children and families around the world.117 Vincent J. Felitti, MD [email protected] Robert F. Anda, MD, MS ACE Interface Fayetteville GA Internationally, the WHO has adopted the paradigm from the Adverse Childhood Experiences (ACE) study103 as a central pillar in its public health approach to understanding and preventing child maltreatment. In 2002, WHO’s World Report on Violence and Health,118 citing the first AJPM Felitti et al. paper,103 noted that “importantly, there is now evidence that major adult forms of illness … are related to experiences of abuse during childhood.” Subsequently, WHO has routinely referred to child maltreatment as a significant public health and human rights problem, and a major contributor to risktaking behaviors later in life, and via these some of the principal causes of death, disease, and disability. Recognizing the value of the ACE survey methodology in assessing these relationships, WHO has promoted its uptake by publishing the original ACE family health history and health appraisal questionnaires in its widely disseminated guide on preventing child maltreatment.119 In addition to a study in the Philippines,120 the WHO Regional Office for Europe has been at the forefront of supporting national-level surveys that implement these questionnaires (typically among young adults studying at universities and technical colleges). As of July 2012, ACE surveys had been completed in Albania, Latvia, Lithuania, and the former Yugoslav Republic of Macedonia, with further studies underway in Montenegro, Romania, Russian Federation, and Turkey. In countries where ACE surveys have been completed, the findings have been presented at policy dialogues where they have received wide media coverage and have substantially

raised awareness of the importance of preventing child maltreatment among government and civil society stakeholders. At a global level, WHO and the National Center for Chronic Disease Prevention and Health Promotion at the U.S. CDC undertook a collaborative effort to build a framework for public health surveillance that can be used to defıne the global health burden of ACEs.114 Central to this has been development of the Adverse Childhood Experiences International Questionnaire (ACE-IQ), a short form of the original family health history questionnaire with questions added to cover additional adversities that children in low- and middle-income countries might experience (e.g., witnessing community violence and/or war). The questions in ACE-IQ have been formulated after testing an earlier version for acceptability and comprehensibility in China, the former Yugoslav Republic of Macedonia, Philippines, Saudi Arabia, South Africa, Thailand, and Viet Nam. In addition, an early version was applied in Viet Nam as part of a broader mental health survey. The current priority is to test the reliability and validity of ACE-IQ Version 1 by implementing it as part of broader health surveys in 6–8 countries: (http://bit.ly/wphu71). The WHO appreciates AJPM’s efforts to highlight this critical issue by publishing the original ACE study.103 Alexander Butchart, PhD Coordinator, Prevention of Violence Department of Violence and Injury Prevention and Disability World Health Organization Switzerland [email protected] Dinesh Sethi, MSc, MD, MRCP, FFPH Programme Manager Violence and Injury Prevention WHO Regional Office for Europe It is an honor and a pleasure to reflect upon the synergistic growth of AJPM and physical activity and public health over the last two decades. The path of physical activity’s emergence as a central part of public health over this period can be tracked through key publications in AJPM. It is difficult to believe today how few of what we think of as core elements of the public health approach to physical activity existed a mere 20 years ago: no public health recommendations, no Surgeon General’s Report, no evidence-based reviews, no economic analyses, no advanced training courses, no branch within CDC, and no international society or congress devoted solely to physical activity and public

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health. AJPM provided a platform that embraced creative new research methods and public health tools, often coming from nontraditional public health disciplines. The concept of environmental and policy strategies for physical activity promotion was introduced in AJPM in 1998121; AJPM pioneered research to practice publications such as the evidence-based physical activity recommendations of the Task Force on Community Preventive Services122; rigorous and policy relevant economic models found a home in AJPM123; and AJPM was open not just to extending the application of evidence-based chronic disease prevention strategies to low and middle income countries, but to actually publishing a review of physical activity interventions in Latin America in the languages of public health practice in the region, Spanish and Portuguese, as well as in English.124 Public health is better today for the inclusion of physical activity and AJPM has been a crucial vehicle for this transformation. Disclaimer: The findings and conclusions in this report are those of the author and do not necessarily represent the official position of the CDC. Michael Pratt, MD, MPH, MSPE Centers for Disease Control and Prevention Elsevier has been privileged to serve as publisher of the American Journal of Preventive Medicine (AJPM) since 1998. During this time we have had the pleasure and honor of working with the editorial team led by Kevin Patrick, Doug Scutchfield, and Jill Waalen. Journals publishing has changed significantly since 1998, and the roles of the publisher and editor have become increasingly complex. With these changes came exciting opportunities for the Journal’s expansion and development in print and digital formats, including, in 2013, the launch of the AJPM iPad app. My colleagues and I have watched AJPM grow in so many ways: in online circulation, Impact Factor (over 4), online usage, the number of full-text and PDF downloads per month (over 90,000/month in 2013), access in the developing world via Research4Life, and meaningful development of its academic supplement program. During this development, we have been impressed by the AJPM team’s energy and dedication. Through their efforts, the Journal has expanded its coverage and influence, to become a critical source of preventive medicine initiatives, such as the AJPM Childhood Obesity Challenge. With their attention to quality and innovation, Kevin, Scutch, Jill, and Charlotte have been an inspiration to me and many of my colleagues, including Sarah Pratta, AJPM’s publisher for the past 6 years. Not only have we admired the Editors’ dedication to the Journal, but we December 2013

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have appreciated their collaborative spirit. I have fond memories of my first visit to UCSD, impressed by Kevin’s vision for AJPM, Charlotte’s focus on editorial quality and timeliness, and their gracious hospitality, including the delicious fish tacos of Southern California. It is with the utmost respect that we extend our thanks and best wishes to the AJPM editorial team, and welcome the new Editors. We look forward to our continued collaboration with the Editors, the American College of Preventive Medicine, and the Association for Prevention Teaching and Research, as the Journal continues its evolution. Linda Gruner Vice President Health & Medical Sciences, STM Journals Elsevier New York City

Address correspondence to: Charlotte Seidman, AJPM Editorial Office, UCSD, 9500 Gilman Drive, La Jolla CA 92093 E-mail: [email protected] http://dx.doi.org/10.1016/j.amepre.2013.09.006 Disclaimer: Comments from Bruce Jones and Michelle Canham-Chervak: The information contained herein shall not be construed or interpreted in any manner to be official federal endorsement of any nonfederal entity or its products or services. Comments from Denise Koo: The findings and conclusions are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention. No financial disclosures were reported by the authors of these comments.

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