Thursday, November 15, 2012 IOM Provides Framework to Assess Community-based Prevention and Wellness Strategies A new report from the Institute of Medicine (IOM) proposes a framework to assess the value of community-based, nonclinical prevention policies and wellness strategies, especially those targeting the prevention of long-term, chronic diseases. The report's authors conclude that a comprehensive framework for valuing community-based prevention programs and policies should meet 3 major criteria. First, the framework should account for benefits and harms in physical and mental health, community well-being, and community process. The physical and mental health domain includes reductions in the incidence and prevalence of disease, declines in mortality, and increases in health-related quality of life. Second, the framework should consider the resources used and compare the benefits and harms associated with those resources. To effectively compare interventions, it is essential to quantify the magnitude of benefits in relation to the associated cost for each intervention. Third, the framework must take into account differences among communities that can affect the link between interventions and outcomes. Because selecting 1 community-based prevention policy or program over another can be difficult, the report recommends that decision makers weigh the benefits and harms to health, community well-being, and community process as they assign value to specific interventions. The authors caution that although a community-based prevention action may improve the overall health of a community, it may achieve more strikingly positive results among citizens with a certain income level or occupation, exacerbating health disparities. If achieving health equity is at odds with improving overall community health, priorities will have to be determined, they say.