National Academy of Medicine

Dose Matters: An Approach to Strengthening Community Health Strategies to Achieve Greater Impact

By Pamela Schwartz, Suzanne Rauzon, and Allen Cheadle
August 26, 2015 | Discussion Paper

Dose Matters describes the concept of “population dose”—an approach to strengthening and evaluating the impact of complex multisector, multilevel, place-based initiatives. This discussion paper reports on what is promising about the approach while recognizing the measurement and other challenges that still lie ahead. The concept emerged from ongoing evaluations of Kaiser Permanente’s Community Health Initiative investments, conducted by the Center for Community Health and Evaluation (CCHE) at the Group Health Research Institute in collaboration with partners at the University of California. Following an overview of the Community Health Initiative, this report describes the concept in more detail and explains how it can be used to estimate the population-level impact of a set of related interventions. The estimated impact or dose of an intervention is the product of reach (the number of people touched by the intervention) and strength (the effect size or impact on each person reached). The dose concept can also be used in planning and implementation to yield greater impact



Suggested Citation

Schwartz, P., S. Rauzon, and A. Cheadle. 2015. Dose Matters: An Approach to Strengthening Community Health Strategies to Achieve Greater Impact. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201508a


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.