Keeneland Conference – Conference Perspective

By Megan Kirk

Last year in February I attended a think tank where public health researchers, knowledge users, and practitioners from across the province of British Columbia, Canada sat down to collaboratively develop a new research agenda based on the joint work over the prior 8 years. The main focus of this think tank was to set the priorities to guide provincial research to study our public health systems and services. This area of study is an emerging field of research within the United States, and has recently been launched within Canada. This field of research is commonly referred to as PHSSR, or public health systems and services research, which is conceptualized as “a field of study that examines the organization, funding and delivery of public health services within communities, and the impact of these services on public health” (Mays, Halverson, & Scutchfield, 2003, p. 1801). Dr. Glen Mays, a leader in PHSSR in the United States located at the University of Kentucky, College of Public Health and co-PI of the National Coordinating Center for PHSSR, was the keynote presenter at this think tank on the status of PHSSR in the United States and lessons for British Columbia as we move forward.

Fast forward a little over a year and now I am headed down to the University of Kentucky to attend the annual PHSSR Keeneland Conference hosted by Dr. Glen Mays and his team at the National Coordinating Center for PHSSR. What seemed to really capture the think tank audience and my own attention is his work on public health economics and its impact on informing policy and programming in the United States. For instance, he has demonstrated through his research reductions in mortality attributed to public health spending, as well as, decreased medical expenditures with increased in public health spending. Those of us invested in public health, and health promotion, can appreciate this effort to demonstrate the value of public health spending and its impact on health and health care costs. His presentation is available here: I was so impressed with the work of Dr. Mays and his team that I am headed to their annual conference to continue my learning and development in PHSSR.

Another component of interest in attending this conference is to provide space to continue talks that commenced last year during Dr. Mays’ visit to the University of Victoria in British Columbia. These conversations revolved around envisioning a US-Canada research partnership to conduct comparative cross boarder research. The hope is to learn form each other and identify pathways for public health systems improvement by examining the organization, financing and delivery of public health programs and services. The Canadian academic lead on this research partnership is Dr. Marjorie MacDonald (my supervisor), with whom, I have gained vast experience in public health research as part of her team. We hope to continue building on our partnership with Dr. Glen Mays and his PHSSR team at the Keeneland Conference and beyond.

Now if you are wondering how this all fits under the banner of health promotion, I assure you its intent is well aligned. My professional and research interests lie with public health nursing practice and a large component of this practice is health promotion. Public health nursing practice has been described as a trombone slide, as public health nurses are often witnessing health and social injustices downstream when providing services and programs in their communities, and as a result aim to address these inequities through advocacy efforts upstream (Falk-Rafael & Betker, 2012). I am dedicated to advocating on behalf of nurses and their work. Since public health nurses are the largest contingent within the public health workforce, it is important that we understand how public health organization and (re)structuring impact the delivery of services within the public health system. For instance, at the conference I will be presenting research examining how evidence is used within the delivery of public health services and program development as public health renewal takes place across the province. In order to improve the use of evidence in public health practice and decision-making, we need to better understand how frontline practitioners and managers value and utilize evidence and what influences the use of evidence in practice and program decision-making. By improving our knowledge of how key public health players, frontline practitioners and managers, understand, value, and utilize evidence in their practice, we will be better positioned to facilitate knowledge translation activities and evidence based practice. Overall, the aim of this research is to improve public health systems and services resulting in improved population health.

I am looking forward to the PHSSR Keeneland Conference to inform and shape my program of research moving forward. The overall goal of the conference is to improve our public health systems in order to improve population health, aligning well with the aim of public health nursing, and health promotion efforts too.


To find out more about the work of Dr. Mays and his team at the National Coordinating Center for Public Health Services and Systems Research at the University of Kentucky visit the following site

Also, to find out what is taking place north of the border at the University of Victoria in British Columbia, this site will provide information



Falk-Rafael, A., & Betker, C. (2012). Witnessing social justice downstream and advocating for health equity upstream: “The Trombone Slide” of Nursing. Advances of Nursing Science, 35(2), 98-112.

Mays, G., Halverson, P. & Scutchfield, F. (2003). Behind the curve? What we need to know from public health systems research. Journal of Public Health Management and Practice, 9(3), 179-82.

Published: April 2015, HPC

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