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1

Keshia M. Pollack Porter, PhD, MPH

TEACHING HEALTH IMPACT ASSESSMENT
IN AN ONLINE FORMAT



Teaching Health Impact Assessment in an Online Format Pollack Porter

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Background
During the 2010-11 academic year at the 
Johns Hopkins Bloomberg School of Public 
Health (BSPH), I created and launched a 
course on health impact assessment (HIA) 
in the Department of Health Policy and 
Management (HPM). Since the course sits 
in HPM, and because I am a “policy person,” 
I promote HIA as a tool to elevate health and 
equity considerations for proposed policies 
such as legislation and regulation, at both the 
governmental (e.g., federal, tribal, state, and 
local) and nongovernmental (e.g., private/
institutional) levels (Pollack Porter et al., 2018). 
Students must have completed a graduate 
level course in health policy or seek permission 
prior to enrolling. The course is typically taught 
during an 8-week term, when it meets once 
each week for three hours. 

The course is limited to graduate students 
and has primarily been taken by graduate 
students in public health. I have never had to 
recruit students to the course per se. Each year, 
I discuss HIAs during lectures I give in policy 
courses and a course on the built environment 
and health. During these sessions I mention 
the HIA course so people are aware that they 
can learn more about the topic. In addition, the 
HIA course was added as one of the courses 
to meet competencies for several degree 
programs, which helped increase enrollment 
annually. During the first year when I taught HIA, 
I capped the course at 15 students and because 
of increased popularity and interest, I increased 
the cap to 30 students in 2011-12. In the 2014-
15 academic year I increased the cap to 40 and 
then in 2019-2020, I increased it again to 60, 
which is where it stayed through the 2021-22 
academic year. 

In addition to teaching the course during a full 
term for over a decade, the course has been 
taught three times in a condensed format; 

the 8-week course was taught over 2-3 days 
during the BSPH Fall and Summer Institutes. 
This shortened format draws students from the 
part-time degree programs or other non-degree 
students. For example, learners from public 
health agencies, nonprofits, and the World 
Health Organization have completed the course 
in the condensed format. 

The course includes an option for students 
in the School’s MPH program to obtain 25 
practicum hours (towards the minimum of 100 
hours they must complete) in support of hands-
on public health training. These credits are 
obtained by providing additional opportunities 
for students to collaborate with a community-
based organization or local government partner. 
For example, one year, we partnered with a 
state legislator and conducted rapid HIAs on 
a proposal bill. Students who took the course 
for practicum hours did additional work with 
the legislator and supported their efforts on 
a bill that would require HIAs. The students 
helped create materials for the bill hearing to 
educate the committee on social determinants 
of health and HIAs and attended the bill hearing. 
Approximately, 5% of the number of enrolled 
learners in the HIA course opt to use the course 
towards their 100 hours.

While the pandemic forced many of us to move 
our in person courses online, in 2019 I decided 
that I would create an online offering of my 
HIA course. The BSPH has fully online degree 
programs, and these students repeatedly asked 
if I would create an online offering. During the 
2019-20 academic year one part-time master’s 
student even flew to Baltimore each week just to 
take the class because they thought the content 
was critical for their career aspirations! I finally 
decided to create an online version once the 
Bloomberg American Health Initiative wanted to 
add the course as one of the elective offerings 
for their fellows (Bloomberg American Health 



Teaching Health Impact Assessment in an Online Format Pollack Porter

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Initiative, n.d.). As such, I applied for funds from 
the Initiative to support some of my time to 
record the lectures and launch an online offering 
of HIA during the 2020-21 academic year. 

Online Format
I greatly benefited from the BSPH Center for 
Teaching and Learning (CTL) that supports, 
“educational excellence in public health, 
ensuring innovative and engaging learning 
experiences in the classroom and online” 
(Center for Teaching and Learning, n.d.). Once I 
initiated creating an online version of my course, 
I worked with an instructional designer from CTL 
to create a syllabus that would work well in a 
fully online course. The course was designed for 
asynchronous learners, with required “LiveTalks” 
for synchronous learning. I was paired with 
excellent producers who worked with me to 
ensure the recordings were clear and accessible, 
and over several months I recorded all the 
lectures.

My approach to developing on online offering 
of HIA was consistent with the skills and 
competencies some colleagues and I promoted 
in an article we wrote in 2014 about teaching 
HIA at the graduate level (Pollack KM et al. 
2014).  The schedule required students to 
watch recordings each week that began with 
an introduction of Health in All Policies (HiAP), 
review of each step of the HIA process, including 
separate lectures on equity and stakeholder 
engagement. The students also learned about 
HIAs applied for policy decisions and the types 
of policies that can support institutionalization 
or routinization of HIAs. The course was 
designed to front load the initial weeks with 
lectures on the steps of the HIAs process so that 
learners would have the knowledge to complete 
the first assignment, which was a critique of a 
completed HIA. The first LiveTalk of the course 
involved a discussion of the HIAs that were 
critiqued. The second LiveTalk was a discussion 

involving a panel of HIA practitioners. The final 
assignment was a brief written reflection that 
involved learners sharing their thoughts about 
the value of HIAs, how to support their growth, 
and any personal insight from working on a 
rapid HIA, which was required for the course.

The course has a hands-on component that 
involves working on a rapid HIA. Since the 
course is in HPM, HIAs are always applied to 
proposed governmental or nongovernmental 
policies. Students are placed into groups of 
5-6 to work on a rapid HIA. A final report is 
not produced, instead students submit their 
PowerPoint presentations and have to clearly 
delineate each group member’s contribution 
to the project. We typically work with a partner 
involved with the proposal that is the subject 
of HIA.  We remain in close contact with the 
partner throughout the course and they attend 
the final LiveTalk to watch the groups present. 
Once the course is complete, with permission 
from the students, I provide the partners with 
slides and other resources compiled by the 
students. 

During the first year that I taught the course 
online, we worked on a proposed policy by the 
Washington D.C. City Council. A representative 
from the Washington D.C. government served 
as a resource for the students. For the second 
year of the online course offering, we partnered 
with the Baltimore City Health Department on a 
bill being consider by the state legislature that 
would impact city residents. These partners 
were identified by leveraging my existing 
partnerships. 

Reflections on Teaching Online
In reflecting on creating a fully online HIA 
course, there are three insights that I want to 
share.  First, during the initial year that I taught 
the course online, I tried to essentially replicate 
what I had done onsite because the onsite 



Teaching Health Impact Assessment in an Online Format Pollack Porter

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course worked well, and my course had always 
been highly rated. Overall, the evaluations for 
the online course were good, but I noted that 
the students hoped for more interactions with 
me. In reflecting on when the course was in 
person, the students saw me each week and 
could speak with me before and after class (I 
want to note that students are always able to 
schedule 1-on-1 meetings with me). With most 
of the sessions being recorded, the learners 
heard from me each week but did not have live 
interactions with me. As a result, during the 
second time that I taught the course online, I 
added weekly optional office hours via Zoom. 
This created a drop-in space for learners to 
speak with me about the field, to ask additional 
questions, and to feel connected. As I continue 
to offer the course online, I will ensure that there 
are always regularly scheduled optional office 
hours.

Second, the 8-week term continues to be a 
challenge, especially because it means that 
learners only have a few weeks to become 
familiar with the HIA process to successfully 
complete the assignment and then work in 
groups on a rapid HIA. The final presentations 
occur during the eighth week, which essentially 
means that students have seven weeks to 
learn all the material and complete a rapid 
HIA. Having additional office hours and several 
teaching assistants (TAs) to serve as resources 
for the students are a couple of ways that I 
provided them with support during the 8-week 
term. Despite this, the short time frame to grasp 
the content is a challenge for students.

This comment about TAs brings me to my third 
point – the course size. During the 2021-22 
academic year, 182 students took my course 
(and about 12% opted to obtain practicum 
hours). While exciting for the field, the course 
was very large, which created administrative 
challenges regarding engagement, 

responsiveness, grading, etc. Even though I had 
four TAs, the workload was high for everyone. 
An additional challenge with the size was that 
course enrollments were large for all classes 
at BSPH, which meant that TAs were in high 
demand, so I ended up having TAs who had not 
taken HIA before. Although the TAs played a 
critical role and were able to respond to student 
inquiries, and with clear instructions and 
rubric help grade, I had to answer all technical 
questions. For the upcoming 2022-23 academic 
year, I decided to add a cap to the class (100 
students) to make it more manageable. I am 
now the Chair of my department, which means 
time is limited; thus, I will not offer additional 
practicum hours. 

Conclusions
I have taught HIA for a dozen years. I have 
adapted the course in recent years, so it remains 
relevant. For instance, while the core elements 
of the course have remained the same, I have 
added more content regarding HiAP, including 
discussing other tools like the Washington 
Health Impact Review (Pollack Porter KM, et al. 
2019) and the health note, which I helped create 
and implement with colleagues at the Health 
Impact Project (Health Impact Project, 2021). 

The course has received strong ratings and 
in terms of the impacts on the learners, the 
following quote from a former student reflects 
many that I have received: “I have thoroughly 
enjoyed the process of learning and thinking of 
ways that I can apply the HIA in the way that I 
think through my other public health courses, 
and as a future public health professional.” Over 
the years the partners that I have worked with 
have noted how valuable it was to receive the 
PowerPoint slides at the end of the term. One 
partner described the presentation slides and 
resources as follows, “It truly is a treasure trove 
of information! Please pass along my thanks to 
your students.”



Teaching Health Impact Assessment in an Online Format Pollack Porter

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Any time that I ask myself if I should take a 
break from teaching the course, I seem to 
receive an email from a student sharing how 
much they are looking forward to taking the 
course or from a former student sharing how 
valuable the course was for their current 

position. I believe that HIAs are one important 
tool to help change to advance health equity, 
and as long as there is progress to be made 
towards this goal, I will continue to teach the 
course. 



Teaching Health Impact Assessment in an Online Format Pollack Porter

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References
Bloomberg American Health Initiative. The Bloomberg Fellows Program. Retrieved 15 August 2022 from 

https://americanhealth.jhu.edu/fellowship.  

Center for Teaching and Learning. Retrieved 14 August 2022 from https://publichealth.jhu.edu/offices-and-
services/center-for-teaching-and-learning. 

Health Impact Project. (2021) A User’s Guide to Legislative Health Notes. Retrieved 14 August 2022 from 
https://www.pewtrusts.org//media/assets/2021/04/apractitionersguidereportfinal.pdf. 

Pollack, K.M., Dannenberg, A.L., Botchwey, N., Stone, C.L., Seto, E. (2014). Developing a model curriculum 
for a university course in health impact assessment in the United States. Impact Assessment and 
Project Appraisal. http://dx.doi.org/10.1080/14615517.2014.960213. 

Pollack Porter, K.M., Rutkow, L., McGinty, E.B. (2018). The Importance of Policy Change forAddressing 
Leading Public Health Problems. Public Health Reports, 133(1S):9(S)-14(S).

Pollack Porter, K.M., Lindberg, R., McInnis-Simoncelli, A. (2019) Considering Health and Health Disparities 
During State Policy Formulation: Examining Washington State Health Impact Reviews. BMC Public 
Health 19:862. https://doi.org/10.1186/s12889-019-7165-7. 

CORRESPONDING AUTHOR
Keshia M. Pollack Porter, PhD, MPH
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 212105
kpollac1@jhu.edu

CHIA Staff:

Editor-in-Chief 
Cynthia Stone, DrPH, RN, Professor, Richard M. Fairbanks School of Public Health, Indiana 
University-Purdue University Indianapolis

Journal Manager 
Angela Evertsen, BS, Richard M. Fairbanks School of Public Health, Indiana University-Purdue 
University Indianapolis 

Chronicles of Health Impact Assessment Vol. 7 Issue 1 (2022) DOI: 10.18060/26471
© 2022 Author(s): Pollack Porter, K. 
        This work is licensed under a Creative Commons Attribution 4.0 International License

https://americanhealth.jhu.edu/fellowship
https://publichealth.jhu.edu/offices-and-services/center-for-teaching-and-learning
https://publichealth.jhu.edu/offices-and-services/center-for-teaching-and-learning
https://www.pewtrusts.org//media/assets/2021/04/apractitionersguidereportfinal.pdf
http://dx.doi.org/10.1080/14615517.2014.960213
https://doi.org/10.1186/s12889-019-7165-7

