Foundations of Population Health Domains

Domain 1: Descriptive Epidemiology – Health of Populations

A. Health impact, trajectories and disease burden
1. Basic epidemiologic terms, including:
a. Morbidity, mortality
b. Incidence, prevalence, case-fatality
c. Endemic, epidemic, pandemic
2. Leading causes of death and disability
3. Natural history of infectious and chronic diseases
4. Health indicators and population-level determinants
B. Data sources
1. Governmental sources of data at local, state, and national levels
2. Public health surveillance data from governmental and non-governmental sources
3. Electronic health records, patient registries, and other sources of clinical data
4. Geographic information systems (GIS), property records, zoning and land use records, and other sources of environmental records
5. Use of valid and trusted sources

Domain 2: Health Research Evaluation - Etiology, Benefits and Harms

A. Hypothesis generation
1. Case reports, case series, epidemiologic reports
2. Knowledge, research, and implementation gaps in existing research
3. Translation and prioritization of hypotheses
B. Study designs and sampling approaches
1. Quantitative data collection methods
a. Clinical record abstraction and surveys
b. Biometric and physiological measurements
c. Digital health technologies and remote sensing
d. Administrative and claims data, population health surveys, environmental measures
2. Qualitative data collection methods
a. Individual and interview approaches
b. Group approaches
c. Ethnographic approaches
d. Case studies
3. Community-engaged research methodologies
e. Community-Engaged Research (CEnR), Community-Based Participatory Research (CBPR)
f. Principles of equitable partnerships and shared governance
g. Accessibility considerations in data collection methodologies
3. Sampling and power
a. Probability and non-probability sampling methods
b. Sample size determination and power calculations, sufficiency and saturation
C. Data analysis and interpretation
1. Quantitative analysis
a. Parametric and non-parametric statistical tests
b. Statistical significance testing, probabilities, confidence intervals, effect sizes
2. Qualitative analysis and interpretive frameworks
a. Coding and thematic analysis
b. Phenomenology
c. Grounded Theory and Qualitative Content Analysis
3. Applications of health data using machine learning and artificial intelligence (AI)
a. Data privacy-by-design
b. Secure storage and data protection
c. Bias identification and mitigation
4. Data quality and limitations
a. Accuracy and precision of statistical estimates
b. Impact of bias, confounding, error, and interaction in statistical analysis
c. Misinformation identification, data misinterpretation
D. Data presentation and dissemination
1. Dissemination planning
a. Tailored strategies to reach target lay and scientific audiences
b. Co-creation of reports and materials with community partners
c. Digital dissemination platforms and social media
2. Scientific integrity and disclosure
a. Disclosure of study methods, participants, analytic methods, limitations
b. Drawing conclusions consistent with study methods and results
c. Presentation of results free of bias
3. Data visualization and outputs
a. Tables and figures that accurately summarize data
b. Scientific manuscripts, posters, presentations, and briefs
c. Accessible materials for community partners
E. Research ethics
1. Institutional Review Board policies and procedures
2. Community endorsement and approvals
3. Applicable standards governing the ethical conduct of human subjects’ research
a. Belmont Report
b. Common Rule
4. Impact of basic ethical principles on study design and methods
a. Respect for persons
b. Beneficence
c. Justice
5. History of unethical human subjects research
6. Digital privacy and data security
a. Safeguards for data storage, anonymization, and third-party data sharing

Domain 3: Evidence-Based Practice

A. Assessing the quality and significance of evidence
1. Standardized protocols for evaluating practice recommendations
2. Statistical significance and clinical/practical implications
3. Short- and long-term benefits and risks associated with recommendations
B. Synthesizing evidence
1. Systematic, narrative, and scoping reviews of the scientific and professional literature
2. Statistical approaches to evidence synthesis
3. Integrative reviews combining qualitative and quantitative findings
C. Applying evidence to practice
1. Translation of research findings into clinical and community practice
2. Adapting evidence to local populations
3. Balancing evidence with patient preferences and values
4. Continuous quality improvement informed by evidence
D. Barriers and facilitators of evidence use
1. Organizational and system-level factors influencing uptake
2. Clinician, educator, and learner attitudes toward evidence use
3. Resource constraints and feasibility considerations
4. Policy and accreditation requirements supporting evidence-based practice
5. Strategies for promoting adoption and reducing resistance to evidence use

Domain 4: Health Promotion and Disease Prevention Interventions

A. Types and levels of prevention
1. Primordial, primary, secondary, tertiary prevention strategies
2. Universal, selective, indicated approaches
B. Target audience for interventions
1. Individuals, families, caregivers
2. High-risk populations, underserved populations
3. Vulnerable groups including people with disabilities or limited access to care
4. Local, regional, national, and global populations
C. Health promotion approaches
1. Core strategies
a. Education, communication, social marketing, collaboration, and advocacy
b. Meaningful engagement of stakeholders in program development
2. Levels of application
a. Individual-level interventions, community-level approaches, and policy/system-level strategies
D. Health behavior models and theories
1. Individual and interpersonal level
a. Health Belief Model
b. Transtheoretical Model
c. Theory of Planned Behavior
d. Social Cognitive Theory
2. Community and societal level
a. Health Promotion Model
b. Social Ecological Model
c. Diffusion of Innovations Theory
d. Community Organization Theory
E. Interventions addressing social determinants of health
1. Income assistance and access to education, food, and transportation
2. Consideration of culture, social and community context, language, and literacy levels
3. Built environment to promote accessibility, active lifestyles, and improved nutrition
4. Addressing root causes of health inequities
F. Roles in intervention design and delivery
1. Clinician, interprofessional team, and community members
2. Provision of patient and community education
3. Use of incentives for behavioral and structural change
4. Shaping policy to improve community health
5. Collaboration with partners and community members
G. Practice‐based systems supporting preventive services
1. New and emerging technologies to enhance interactions
2. Patient navigators and community health workers
3. Home visits by appropriate health professionals
4. Telehealth, telemedicine, and telecare

Domain 5: Determinants of Health

A. Social factors
1. Economic stability
2. Education access and quality
3. Health care access and quality
4. Neighborhood and the built environment
5. Social and community context
B. Biological and psychological factors
1. Biological characteristics
a. Genetics, microbiome, age, sex, weight, immune status
2. Physiological burden
a. Allostatic load and clinical comorbidities
3. Mental health
a. Psychiatric, cognitive, and emotional
4. Psychosocial stressors
a. Stress, burnout, trauma exposure
5. Level of resilience and coping strategies
C. Environmental factors
1. Climate and natural events
a. Impacts of climate change, extreme weather, and natural disasters on health
2. Environmental exposures
a. Impacts of environmental contamination, sanitation, pollution, public safety threats, and human-caused events and disasters on health
3. Built environment impacts on health
a. Influence of residential and workplace hazards, food and pharmacy deserts, urban design, zoning and land use decisions
4. Policy and governance
a. Influence of International, federal, state, and local laws, policies, and practices
D. Ecological factors
1. Microbiological influences
a. Pathogen dynamics and microbial ecosystems
2. Ecosystem health
a. Biodiversity, natural resource use, and environmental degradation
3. Human–animal interactions
a. Zoonotic transmission and impacts of agricultural practices
4. Infectious disease threats
a. Emerging infections, antibiotic resistance, and vector-borne diseases
E. Healthcare system factors
1. Investment in prevention
2. Access and affordability of health care services
3. Quality of patient-health professional interactions
4. Health care quality and patient safety
5. Health care workforce

Domain 6: Population Health Informatics

A. Data sources and collection
1. Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and Community Information Exchange (CIE)
2. Public health surveillance systems and population assessments
3. Wearable devices/sensors for personal health monitoring
4. Social media and online platforms as health information sources
5. Collection methodologies
a. Surveys, digital platforms, real-time monitoring
B. Data standards and interoperability
1. Importance of standardized data
2. Strategies to standardize and integrate data across systems
3. Interoperability challenges and solutions
C. Analytics and predictive modeling
1. Clinical and population health
a. Readmission risk prediction
b. Chronic disease progression and management
c. Infectious disease outbreak prediction and surveillance
d. Behavioral health risk assessment
e. Population health trend analyses
2. Health care operations
a. Resource utilization and allocation
b. Supply chain optimization for health services
c. Reducing waste and improving efficiency in service delivery
3. Precision and innovation
a. Patient stratification for precision medicine
b. Personalized health recommendations using predictive algorithms
c. Pharmaceutical research and development applications
D. Digital health technologies
1. Telehealth, telemedicine, and telecare
2. Mobile health (mHealth) applications
3. Remote patient monitoring
4. Health information exchange platforms
E. Population health surveillance and management
1. Risk stratification and profiling
2. Care coordination and case management strategies
3. Patient and population engagement approaches
4. Chronic disease monitoring and management
5. Early detection and response to outbreaks and epidemics
6. Syndromic surveillance systems
7. Use of dashboards and visualization tools for monitoring
F. Ethical and legal considerations
1. Privacy and security of digital health information
2. Informed consent and patient rights in data sharing
3. Compliance with digital health data laws and regulations
4. Addressing equity, bias, and fairness in algorithms and model development
5. Transparency, accessibility, and public trust in digital health systems
6. Data democratization
G. Interprofessional collaboration
1. Collaboration among health care, IT, and data analysis professionals
2. Cross-disciplinary training in informatics skills
3. Team-based decision making for population health improvement
H. Digital innovations and future trends
1. Artificial intelligence and machine learning
2. Genomic and personalized medicine applications
3. Emerging technologies and impact on population health

Domain 7: Project Evaluation and Dissemination

A. Frameworks and models for evaluation
1. Selecting an appropriate evaluation framework
2. Conceptualizing inputs, outputs, goals, and relationships among various factors
3. Developing evaluation measures to assess program implementation and effectiveness
B. Evaluation activities
1. Formative evaluation
a. Needs assessments and pre-intervention assessments
2. Process evaluation examining program implementation
3. Outcome evaluation measuring changes in knowledge, attitudes, and behaviors
4. Impact evaluation addressing long-term effects on health outcomes
5. Summative evaluation addressing overall program effectiveness for decision-making and continuous quality improvement (CQI)
C. Cultural and ethical considerations
1. Recognizing and addressing cultural differences
2. Developing inclusive evaluation design and implementation
3. Respecting rights and privacy
4. Ensuring informed consent
5. Addressing potential conflicts of interest
D. Dissemination of evaluation findings
1. Digital tools and software for sharing results
2. Data visualization for effective communication
3. Strategies for dissemination to stakeholders
4. Partner engagement in dissemination
5. Transparent, clear communication tailored to target audiences