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Summary of the Robert Wood Johnson Foundation National Survey of Health Attitudes

Core Content

The Robert Wood Johnson Foundation (RWJF), in collaboration with RAND Corporation, developed the RWJF National Survey of Health Attitudes as part of its Culture of Health (CoH) initiative, which aims to create a society where everyone leads healthier lives now and for generations to come. The survey was designed to measure key constructs that are central to the CoH framework, particularly those that are not captured by existing data sources.

The survey focuses on five main measures:

• Value on health interdependence
• Value on well-being
• Sense of community
• Social support
• Caregiving burden

These measures are intended to provide insights into public attitudes and values that support the CoH action framework. The survey was conducted using two nationally representative Internet panels: the RAND American Life Panel (ALP) and the KnowledgePanel from GfK Custom Research, resulting in a total of 11,555 completed surveys. The sample was weighted to match the population distribution from the 2014 Current Population Survey (CPS).

The survey's design process included four steps:

1. A literature review to identify relevant data and concepts.
2. Team meetings involving RAND, RWJF, and NORC at the University of Chicago.
3. Engagement with stakeholders to refine the survey content.
4. Cognitive testing and a brief pilot test to ensure clarity and effectiveness.

The survey was not meant to capture the entire CoH action framework, but rather to focus on specific measure areas that were critical to understanding the shared values and attitudes that underpin the CoH vision. It includes questions on health interdependence, civic engagement, social support, and caregiving burden, among others.

Main Action Areas and Drivers

The CoH framework is built on four action areas and their corresponding drivers, which guide where national change is needed:

1. Making Health a Shared Value

Drivers:

• Mindset and expectations
• Civic engagement
• Sense of community

This action area emphasizes the importance of shared values around health and well-being, and how these values influence individual and community behaviors. The survey aimed to capture public attitudes on these drivers, as existing data were limited or outdated.

2. Fostering Cross-Sector Collaboration to Improve Well-Being

Drivers:

• Quality of partnerships
• Investment in cross-sector collaboration
• Policies that support collaboration

This action area seeks to promote collaboration across sectors (health, social, business, economic, environmental) to improve well-being and health outcomes.

3. Creating Healthier, More Equitable Communities

Drivers:

• Built environment and physical conditions
• Social and economic environment
• Policy and governance

This action area focuses on ensuring equitable opportunities for health and well-being across different communities and environments.

4. Strengthening Integration of Health Services and Systems

Drivers:

• Access
• Balance and integration
• Consumer experience

This action area emphasizes system-level integration of health services and social support to ensure equitable and efficient care for all populations.

Key Survey Features

• Survey Length: The survey was designed to be concise, covering a range of topics related to health attitudes and behaviors.
• Randomization: Questions were randomized to avoid bias.
• Demographics: The survey included questions about age, race/ethnicity, gender, region, education level, marital status, household size, and income.
• Margin of Error: For the full sample, the margin of error ranges from 0.2% to 1.0%, based on a 95% confidence interval.
• Limitations: The survey was not intended to capture the full CoH framework, but rather selected measure areas. It was also not designed to be a comprehensive national health survey.

Survey Content and Purpose

The survey content was designed to assess the following:

• Health interdependence (peer, family, neighborhood, and workplace influences on health)
• Values related to health and well-being (national and community investment)
• Behaviors around health and well-being (including civic engagement)
• Community engagement and sense of community
• Caregiving burden (financial and emotional impact of caregiving)

These questions were either adapted from existing surveys or newly developed to reflect the unique aspects of the CoH framework.

Conclusion

This report provides a brief overview of the development and content of the RWJF National Survey of Health Attitudes and includes top-line summary data. It is intended to support national, state, and local leaders in understanding public attitudes and values related to the Culture of Health and to inform the implementation of the CoH action framework. The survey highlights the importance of shared values, community engagement, and cross-sector collaboration in shaping a healthier society.