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Lea Ayers LaFave, PhD, RN


Senior Project Director,
John Snow, Inc.,
New Hampshire’s Community Health Institute


Lea Ayers LaFave, PhD, RN, is a senior project director for John Snow, Inc. at New Hampshire’s Community Health Institute.  Dr. LaFave provides consultation in the areas of systems change, quality improvement, action learning collaboratives, qualitative research methods, and program assessment and evaluation. She embraces an improvement model that fosters empowerment through the development of action learning collaboratives (ALCs).  Dr. LaFave’s recent work in community-based systems development, as Project Director for the RWJF-funded Multistate Learning Collaborative (MLC): Lead States in Public Health QI included leading the statewide public health capacity assessment based on the Public Health Essential Services for twelve public health regions as part of the NH public health accreditation readiness strategy. As the MLC Project Director, Dr. LaFave collaborated with two cohorts of learning teams comprised of community-based organizations to link health status and capacity targets: 1) reducing childhood obesity and health improvement planning, and 2) tobacco cessation among pregnant women and workforce development. The successful QI initiative with prenatal services has spread horizontally to support reducing tobacco use among women of childbearing age in NH through WIC programs, and vertically to improve the interface between community-based WIC service delivery programs with the state level program office. 
Dr. LaFave’s work with the NH Center for Excellence New Hampshire’s Resource for Best Practices in Alcohol and Other Drug Services has included supporting systems change and improvement by fostering engagement of players at multiple levels.  In the context of this work, she developed ALCs on community mobilizing around substance abuse prevention and youth leadership development, which represent elements of a community-based participatory research project aiming to build synergy and social capital among prevention providers in NH, and currently leads the evaluation of stakeholder collaboration within and across the NH Regional Network, which includes the application of social network analysis. At the international level, Dr. LaFave contributes evaluation expertise as part of a Gates Foundation-funded research team from the Dartmouth Institute for Health Policy and Clinical Practice evaluating ALCs as a community health improvement methodology applied to sustaining and enhancing routine immunization in a high performing Ugandan health district.
Dr. LaFave has broad experience as a registered nurse working across the healthcare system and the continuum of care, focusing on community-based services.  She earned her BA in Psychology from Smith College, her Master's in Nursing from Yale University School of Nursing in Nursing Management and Policy in Community Health, and PhD from the University of Massachusetts Graduate School of Nursing at Worcester. Doctoral research included qualitative studies focusing on successful characteristics of quality improvement learning collaboratives and on nurses’ organizational systems knowledge. She currently serves as a QI Coach and member of the Accreditation and QI Advisory Board for the National Network of Public Health Institutes, and on the New Hampshire Public Health Improvement Services Council.  She is trained as a Clinical Microsystems Coach through The Dartmouth Institute for Health Policy and Clinical Practice.