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Johnson K, Jensen T, Cilenti D, Wiesman J, Lich KH. Investigating the Role of Local Board of Health Governance on Local Health Department Policymaking Behavior. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:E255-E263. [PMID: 38743404 DOI: 10.1097/phh.0000000000001903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This study sought to identify groupings of policymaking behavior among local governmental health departments (LHDs) across the country and assess whether such groupings were associated with the governance activity of their board of health (BOH). DESIGN We conducted latent class analysis (LCA) to identify possible classes of policymaking behavior among LHDs. Once classes were identified, we used multinomial logistic regression (MLN) to estimate the association between an LHD's policymaking behavior and the governance activity of their BOH. SETTING 2019 wave of the National Association of City and County Health Officials (NACCHO) Profile Survey. PARTICIPANTS All LHDs with BOHs in the 2019 NACCHO Profile Survey (n = 1003). OUTCOME MEASURES Within our MLN, our primary outcome of interest was the association between an LHD's policymaking class (the main dependent variable) and the governance activity of its BOH (the main independent variable). RESULTS Based on our LCA, we determined our sample to be composed of what we characterized as "Limited Policy-Involvement," "Average Policy Involvement," and "Expanded Policy Involvement" LHDs. Those in the Expanded Class were more likely to be involved across all policy areas compared to the Limited and Average class, especially among social determinants of health (SDOH)-related areas. Our MLN estimated that having a BOH active in legal authority was associated with an 86% increased chance that an LHD would be in the "Average Class" compared to the "Limited Class" and having a BOH active in partnership engagement was associated with an 86% more likely chance that an LHD is in the "Expanded Class" compared to the "Average Class." CONCLUSION Using nationally representative data on LHD activity, we found distinct groups of policymaking behavior, including a quarter of LHDs that are highly active in traditional and SDOH-related policy areas. We also found that groupings of policymaking behavior, as indicated by class designation, are strongly associated with the BOH's governance activity.
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Affiliation(s)
- Karl Johnson
- Department of Health Policy and Management (Drs Johnson, Wiesman, and Hassmiller Lich), Department of Maternal and Child Health (Dr Cilenti), Gillings School of Global Public Health, School of Social Work (Dr Jensen), University of North Carolina, Chapel Hill, North Carolina
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Hedayatipour M, Etemadi S, Hekmat SN, Moosavi A. Challenges of using evidence in managerial decision-making of the primary health care system. BMC Health Serv Res 2024; 24:38. [PMID: 38183009 PMCID: PMC10770934 DOI: 10.1186/s12913-023-10409-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 11/30/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Managerial Evidence-Based Decision-Making [EBDM] in the primary is a systematic approach that directs the decision-maker in a conscientious, explicit, and judicious utilization of reliable and best evidence based on the professional experiences and preferences of stakeholders and patients from various sources. This study aimed to investigate the challenges primary healthcare managers encounter while undertaking decision-making processes. METHOD A systematic review was conducted in 2022 with the aim of identifying and collecting all qualitative articles pertaining to evidence-based decision-making in the primary healthcare system. To achieve this, a meticulous search was conducted using the relevant keywords, including primary health care and evidence-based decision making, as well as their corresponding synonyms, across the databases Web of Science, Scopus, and Pubmed. Importantly, there were no limitations imposed on the timeframe for the search. To carefully analyze and consolidate the findings of this systematic review, the meta-synthesis approach was employed. RESULTS A total of 22 articles were assessed in this systematic review study. The results revealed the main categories including evidence nature, EBDM barriers, utilizing evidence, decision-makers ability, organizational structure, evidence-based, EBDM support, communication for EBDM, evidence sides, EBDM skill development, public health promotion, and health system performance improvement. CONCLUSION The primary healthcare system is crucial in improving health outcomes and ensuring access to healthcare services for all individuals. This study explored the utilization of evidence-based EBDM within the primary healthcare system. We identified five key dimensions: causal, contextual, and intervening conditions, strategies, and consequences of EBDM as a core phenomenon. The findings will help policymakers and administrators comprehend the importance of evidence-based decision-making, ultimately leading to enhanced decision quality, community well-being, and efficiency within the healthcare system. EBDM entails considering the best reliable evidence, and incorporating community preferences while also exploiting the professional expertise and experiences of decision-makers. This systematic review has the potential to provide guidance for future reforms and enhance the quality of decision-making at the managerial level in primary healthcare.
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Affiliation(s)
- Marjan Hedayatipour
- Department of Healthcare Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Etemadi
- Department of Healthcare Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Noori Hekmat
- Department of Healthcare Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Alisadat Moosavi
- Department of Medical Library & Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
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Dada OO, Bekemeier B, Flaxman A, de Castro AB. Associations Between Local Health Department Expenditures on Foundational Capabilities and PHAB Accreditation Standards Scores. Front Public Health 2022; 10:861587. [PMID: 35692346 PMCID: PMC9174657 DOI: 10.3389/fpubh.2022.861587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/27/2022] [Indexed: 02/03/2023] Open
Abstract
Context Foundational Capabilities (FC) are the public health (PH) infrastructure areas that are essential for local health departments (LHDs) to support a "minimum package" of programs and services that promote population health. Despite being a critical component of LHD programs, FC are chronically underfunded, and studies specific to the relationship between LHD FC expenditures and their performance-the LHDs' ability to provide essential PH programs and services to their community-have not been previously reported. Public Health Accreditation Board (PHAB) accreditation is a nationally recognized accreditation program for PH agencies. PHAB accreditation assesses LHDs' performance against sets of standards that are based on the 10 essential PH services. Alignment between FC and the PHAB standards presents a means for assessing LHD FC expenditures relative to their performance in PHAB accreditation standards. Objectives We examined the association between LHD total FC expenditures, as well as FC funding allocation patterns, and performance score on selected PHAB accreditation standards. Methods We used Bayesian regression methods to estimate the coefficients for the aggregate performance score, and performance scores on individual PHAB standards. Results Analyses showed that a dollar increase in total FC expenditures is associated with a 0.2% increase in the aggregate performance score in selected PHAB standards as well as the performance score on most of the standards examined. LHDs that allocated FC budgets more evenly across FC programs were found to be more likely to have higher scores. Conclusions Investment in FC could improve LHD performance scores in PHAB accreditation standards and support LHDs' capability for improving community health outcomes. Allocating available FC resources across the various FC programs could support better LHD performance, as indicated by accreditation scores. This study contributes to advancing the understanding of public health finances in relation to performance and could help guide effective LHD resource allocation.
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Affiliation(s)
- Oluwatosin O. Dada
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States,*Correspondence: Oluwatosin O. Dada
| | - Betty Bekemeier
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States
| | - Abraham Flaxman
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States,Department of Global Health, School of Public Health, University of Washington, Seattle, WA, United States
| | - A. B. de Castro
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States
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Kava CM, Strait M, Brown MC, Hammerback K, Harris JR, Alongi J, Hannon PA. Partnerships to expand worksite wellness programs - A qualitative analysis of state and local health department perspectives. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221092822. [PMID: 35593231 PMCID: PMC9130807 DOI: 10.1177/00469580221092822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022]
Abstract
Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the U. S. Because the central mission of state and local health departments (HDs) is to protect, promote, and improve population health, these agencies are well-positioned to address risk behaviors for chronic disease. HD-employer partnerships could enhance worksite wellness programming, but few studies have explored this topic. Building upon previously published findings, the purpose of this qualitative study was to describe the context and environment for HDs' delivery of worksite wellness programs, including interest, barriers, facilitators, and decision-making processes. We conducted 12 interviews with directors of state chronic disease programs, 21 interviews with local directors, and three focus groups with local staff. We performed a thematic analysis of the data. Key themes include the following: (1) worksite wellness programs delivered by HDs were diverse in topic and scope and delivered both internally (at the HD for their agency) and externally (for other employers); (2) decisions made about chronic disease prevention were largely driven by funding priorities, with federal, state, and local entities playing roles in the decision-making process; and (3) HDs expressed potential interest in worksite wellness program delivery, dependent upon staff capacity, available funding, and employer buy-in. Our results suggest that funding should be increased for and reallocated towards chronic disease prevention, including worksite wellness. To overcome HD barriers to program delivery, key funders and stakeholders should prioritize and communicate the importance of worksite wellness.
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Affiliation(s)
- Christine M. Kava
- Health Promotion Research Center,
Department of Health Systems and Population Health, University of Washington,
Seattle, WA, USA
| | - Michelle Strait
- Health Promotion Research Center,
Department of Health Systems and Population Health, University of Washington,
Seattle, WA, USA
| | - Meagan C. Brown
- Health Promotion Research Center,
Department of Health Systems and Population Health, University of Washington,
Seattle, WA, USA
| | - Kristen Hammerback
- Health Promotion Research Center,
Department of Health Systems and Population Health, University of Washington,
Seattle, WA, USA
| | - Jeffrey R. Harris
- Health Promotion Research Center,
Department of Health Systems and Population Health, University of Washington,
Seattle, WA, USA
| | - Jeanne Alongi
- National Association for Chronic
Disease Directors, Sacramento, CA, USA
| | - Peggy A. Hannon
- Health Promotion Research Center,
Department of Health Systems and Population Health, University of Washington,
Seattle, WA, USA
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Park S, Bekemeier B, Flaxman AD. Understanding data use and preference of data visualization for public health professionals: A qualitative study. Public Health Nurs 2021; 38:531-541. [PMID: 33569821 DOI: 10.1111/phn.12863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to assess public health professionals' use of data, information, and evidence and to understand perceptions and preferences regarding data visualization to inform future design of data visualization tools. DESIGN We conducted qualitative interviews with public health professionals who use data for decision making as part of community health assessment and program planning from state and local health departments across six states. RESULTS We identified four themes: 1) collection of data, information, and evidence; 2) management and analysis of data and information to inform decisions; 3) use of data to support public health practice; and 4) preferences for data visualization and how visualization is being used. Public health professionals use data, information, and evidence from various resources for communicating with co-workers, stakeholders, and the public, and decision making regarding their programs and services. CONCLUSION Data visualization tools can help public health professionals improve their understanding and communication, their education of stakeholders, and their decision making using data, information, and evidence. Public health professionals believe in the value of using data, information, and evidence. Opportunities exist in ways to support public health professionals' data use by adopting data visualization tools and by mitigating systematic challenges in public health information systems.
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Affiliation(s)
- Seungeun Park
- Department of Social and Preventive Medicine, School of Medicine, Sungkyunkwan University, Suwon, Korea
| | - Betty Bekemeier
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - Abraham D Flaxman
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington School of Medicine, Seattle, WA, USA
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Rodriguez Weno E, Mazzucca S, Parks RG, Padek M, Allen P, Brownson RC. Use and Awareness of The Community Guide in State and Local Health Department Chronic Disease Programs. Prev Chronic Dis 2020; 17:E133. [PMID: 33092684 PMCID: PMC7587308 DOI: 10.5888/pcd17.200196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The Community Guide (Guide) is a user-friendly, systematic review system that provides information on evidence-based interventions (EBIs) in public health practice. Little is known about what predicts Guide awareness and use in state health departments (SHDs) and local health departments (LHDs). METHODS We pooled data from 3 surveys (administered in 2016, 2017, and 2018) to employees in chronic disease programs at SHDs and LHDs. Participants (n = 1,039) represented all 50 states. The surveys asked about department practices and individual, organizational, and external factors related to decisions about EBIs. We used χ2 tests of independence for analyses. RESULTS Eighty-one percent (n = 498) of SHD and 54% (n = 198) of LHD respondents reported their agency uses the Guide. Additionally, 13% of SHD participants reported not being aware of the Guide. Significant relationships were found between reporting using the Guide and academic collaboration, population size, rated importance of forming partnerships, and accreditation. CONCLUSION Awareness and use of the Guide in LHD and SHD chronic disease programs is widespread. Awareness of the Guide can be vital to implementation practice, because it enhances implementation of EBI practices. However, awareness of the Guide alone is likely not enough for health departments to implement EBIs. Changes at the organizational level, including sharing information about the Guide and providing training on how to best use it, may increase its awareness and use.
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Affiliation(s)
- Emily Rodriguez Weno
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr, Campus Box 1196, St. Louis, MO 63130.
| | - Stephanie Mazzucca
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Renee G Parks
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Margaret Padek
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Peg Allen
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
- Department of Surgery, Division of Public Health Sciences, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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Meschke LL. No Room for Complacency: Employment Trends of Recent Public Health Doctoral Graduates. Am J Public Health 2018; 108:1130-1132. [PMID: 30088986 DOI: 10.2105/ajph.2018.304627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Laurie L Meschke
- Laurie L. Meschke is with the Department of Public Health, University of Tennessee-Knoxville
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Yusuf H, Ekperi L, Groseclose S, Siegfried A, Meit M, Carbone E. Research participation among state and local public health emergency preparedness and response programs. Public Health 2018; 159:133-136. [PMID: 29673556 DOI: 10.1016/j.puhe.2018.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 01/17/2018] [Accepted: 02/18/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The objective of our study was to assess whether state and local health staff participated in public health emergency preparedness research activities and what partner organizations they collaborated with on research. STUDY DESIGN This is a cross-sectional study. METHODS Data were derived from a 2014 web-based survey of state, territorial, and local health departments conducted by the Centers for Disease Control and Prevention and NORC at the University of Chicago as part of a larger project to assess the public health emergency preparedness and response research priorities of state and local health departments. RESULTS Overall, 30% of survey respondents indicated that health department staff were involved in public health preparedness and response research-related activities. Thirty-four percent indicated that they were extremely or moderately familiar with emergency preparedness research and literature. Approximately 67% of respondents reported interest in receiving additional information and/or training related to the preparedness research and literature. The most frequently reported partners for collaboration in preparedness research-related activities were schools of public health (34%). CONCLUSIONS Our findings suggest that there is health department interest in learning more about preparedness and response science and that additional efforts are needed to increase health department participation in public health emergency preparedness and response research-related activities.
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Affiliation(s)
- H Yusuf
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - L Ekperi
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - S Groseclose
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - A Siegfried
- NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814, USA
| | - M Meit
- NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814, USA
| | - E Carbone
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
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Exploring the Link Between Completion of Accreditation Prerequisites and Local Health Departments' Decision to Collaborate With Tax-Exempt Hospitals Around the Community Health Assessment. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23:138-147. [PMID: 27598711 DOI: 10.1097/phh.0000000000000409] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Community health assessments (CHAs) are a core function of local health departments (LHDs). Recently, completing a CHA has become a prerequisite for LHDs seeking accreditation by the Public Health Accreditation Board (PHAB). Similarly, under the Affordable Care Act, nonprofit hospitals are required to conduct periodic community health needs assessments (CHNAs). Opportunities thus exist for LHDs and hospitals to jointly complete CHAs/CHNAs. OBJECTIVE This study examined existing LHD-hospital collaborations around CHAs/CHNAs, focusing specifically on the relationship between LHDs' level of engagement with PHAB accreditation activities and their collaboration with hospitals around CHAs/CHNAs. DESIGN Data came from the 2013 NACCHO (National Association of County & City Health Officials) Profile Study and the Area Health Resource File. Complete data were available for 1332 LHDs that participated in the 2013 NACCHO Profile Study. Logistic regression explored the relationship between LHDs' completion of accreditation prerequisites, in particular completion of a CHA, community health improvement plan, and strategic plan, and their involvement in collaborations with tax-exempt hospitals around CHAs/CHNAs. RESULTS LHDs that collaborated with tax-exempt hospitals on CHAs/CHNAs were larger, more likely to be locally governed, and more likely to have a local board of health. Bivariate analysis showed that CHA/CHNA-related collaboration with hospitals was significantly correlated (P < .01) with an LHD's completion of accreditation prerequisites. In multivariate regression analysis, completion of all 3 PHAB accreditation prerequisites significantly increased the odds of LHDs collaborating with hospitals when controlling for other LHD and community-level characteristics. CONCLUSION PHAB accreditation prerequisites together with IRS requirements for hospitals foster potential for collaboration around CHAs/CHNAs. Joint completion of CHAs/CHNAs not only allows partners to complete the assessment more efficiently but has also been shown to produce higher-quality assessments, thus building a strong foundation for continued collaboration to improve community health.
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Leider JP, Shah G, Rider N, Beck A, Castrucci BC, Harris JK, Sellers K, Varda D, Ye J, Erwin PC, Brownson RC. Challenges and Innovations in Surveying the Governmental Public Health Workforce. Am J Public Health 2017; 106:1967-1974. [PMID: 27715307 DOI: 10.2105/ajph.2016.303424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Surveying governmental public health practitioners is a critical means of collecting data about public health organizations, their staff, and their partners. A greater focus on evidence-based practices, practice-based systems research, and evaluation has resulted in practitioners consistently receiving requests to participate in myriad surveys. This can result in a substantial survey burden for practitioners and declining response rates for researchers. This is potentially damaging to practitioners and researchers as well as the field of public health more broadly. We have examined recent developments in survey research, especially issues highly relevant for public health practice. We have also proposed a process by which researchers can engage with practitioners and practitioner groups on research questions of mutual interest.
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Affiliation(s)
- Jonathon P Leider
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Gulzar Shah
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Nikki Rider
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Angela Beck
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Brian C Castrucci
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Jenine K Harris
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Katie Sellers
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Danielle Varda
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Jiali Ye
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Paul C Erwin
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
| | - Ross C Brownson
- At the time of writing, Jonathon P. Leider was and Brian C. Castrucci is with the de Beaumont Foundation, Bethesda, MD. Gulzar Shah is with the Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Nikki Rider was with the National Network of Public Health Institutes, New Orleans, LA. Angela Beck is with the School of Public Health, University of Michigan, Ann Arbor. Jenine Harris and Ross C. Brownson are with the Brown School, Washington University, St. Louis, MO. Katie Sellers was with the Association of State and Territorial Health Officials, Arlington, VA. Danielle Varda is with the University of Colorado, Denver. Jiali Ye is with the National Association of County and City Health Officials, Washington, DC. Paul C. Erwin is with the University of Tennessee, Knoxville
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11
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Knowing Where Public Health Is Going: Levels and Determinants of Workforce Awareness of National Public Health Trends. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 21 Suppl 6:S102-10. [PMID: 26422478 DOI: 10.1097/phh.0000000000000312] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Several recent developments are trending in public health, providing an important window into the future of policy and practice in the field. The extent to which public health workforce is aware of these trends has not been assessed. OBJECTIVE This research examined the extent to which the public health workforce is familiar with 8 important developments and trends in public health and explored factors associated with variation in awareness levels. DESIGN This study characterizes an observational cross-sectional design, based on analysis of secondary data collected by the Association of State and Territorial Health Officials through the Public Health Workforce Interests and Needs Survey (PH WINS). SETTING Our study used data from those states for which representative samples for the local health department (LHD) employees were also available. PARTICIPANTS We included survey responses from employees of state health agencies' central offices and LHDs. MAIN OUTCOME MEASURE The primary outcome variable for the analysis was the level of awareness about emerging public health trends in the public health workforce. RESULTS Awareness of emerging trends was lowest for Public Health Systems and Services Research; roughly 1 in 4 employees were aware of this trend. The second least heard of trends were Health in All Policies, and cross-jurisdictional sharing. The public health trends about which the highest proportion of public health employees had heard were implementation of the Patient Protection and Affordable Care Act and evidence-based public health practice. Awareness about public health trends was generally higher among state health agency employees than among LHD employees. Work environment, supervisory status, employee education, and female gender were significantly associated with higher awareness levels for both state health agency and LHD employees. CONCLUSIONS Public health trends that are important for health agencies should be brought to the spotlight in national dialogue in order to increase practitioner involvement in those initiatives.
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Shah GH, Sotnikov S, Leep CJ, Ye J, Van Wave TW. Creating a Taxonomy of Local Boards of Health Based on Local Health Departments' Perspectives. Am J Public Health 2016; 107:72-80. [PMID: 27854524 DOI: 10.2105/ajph.2016.303516] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To develop a local board of health (LBoH) classification scheme and empirical definitions to provide a coherent framework for describing variation in the LBoHs. METHODS This study is based on data from the 2015 Local Board of Health Survey, conducted among a nationally representative sample of local health department administrators, with 394 responses. The classification development consisted of the following steps: (1) theoretically guided initial domain development, (2) mapping of the survey variables to the proposed domains, (3) data reduction using principal component analysis and group consensus, and (4) scale development and testing for internal consistency. RESULTS The final classification scheme included 60 items across 6 governance function domains and an additional domain-LBoH characteristics and strengths, such as meeting frequency, composition, and diversity of information sources. Application of this classification strongly supports the premise that LBoHs differ in their performance of governance functions and in other characteristics. CONCLUSIONS The LBoH taxonomy provides an empirically tested standardized tool for classifying LBoHs from the viewpoint of local health department administrators. Future studies can use this taxonomy to better characterize the impact of LBoHs.
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Affiliation(s)
- Gulzar H Shah
- Gulzar H. Shah is with Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Sergey Sotnikov and Timothy W. Van Wave are with the Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. Carolyn J. Leep and Jiali Ye are with National Association of County and City Health Officials, Washington, DC
| | - Sergey Sotnikov
- Gulzar H. Shah is with Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Sergey Sotnikov and Timothy W. Van Wave are with the Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. Carolyn J. Leep and Jiali Ye are with National Association of County and City Health Officials, Washington, DC
| | - Carolyn J Leep
- Gulzar H. Shah is with Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Sergey Sotnikov and Timothy W. Van Wave are with the Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. Carolyn J. Leep and Jiali Ye are with National Association of County and City Health Officials, Washington, DC
| | - Jiali Ye
- Gulzar H. Shah is with Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Sergey Sotnikov and Timothy W. Van Wave are with the Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. Carolyn J. Leep and Jiali Ye are with National Association of County and City Health Officials, Washington, DC
| | - Timothy W Van Wave
- Gulzar H. Shah is with Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro. Sergey Sotnikov and Timothy W. Van Wave are with the Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. Carolyn J. Leep and Jiali Ye are with National Association of County and City Health Officials, Washington, DC
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13
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Lovelace K, Shah GH. Informatics as a Strategic Priority and Collaborative Processes to Build a Smarter, Forward-Looking Health Department. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22 Suppl 6, Public Health Informatics:S83-S88. [PMID: 27684625 PMCID: PMC5049975 DOI: 10.1097/phh.0000000000000452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Health information is critical to surveillance and assessment of public health threats, population and disease trends, management of clinical services, completion of immunizations, identification of disease trends, and communication with community partners. This article explores how a medium-sized local health department using best practices in informatics could implement and use informatics to improve the practice of public health.
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Affiliation(s)
- Kay Lovelace
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro (Dr Lovelace); and Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah)
| | - Gulzar H. Shah
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro (Dr Lovelace); and Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah)
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14
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Harris JK, Beatty K, Leider JP, Knudson A, Anderson BL, Meit M. The Double Disparity Facing Rural Local Health Departments. Annu Rev Public Health 2016; 37:167-84. [PMID: 26735428 DOI: 10.1146/annurev-publhealth-031914-122755] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities.
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Affiliation(s)
- Jenine K Harris
- Brown School, Washington University in St. Louis, St. Louis, Missouri 63130;
| | - Kate Beatty
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee 37614;
| | - J P Leider
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland 21205;
| | - Alana Knudson
- Public Health Department.,NORC Walsh Center for Rural Health Analysis, University of Chicago, Chicago, Illinois 60637; , ,
| | - Britta L Anderson
- NORC Walsh Center for Rural Health Analysis, University of Chicago, Chicago, Illinois 60637; , ,
| | - Michael Meit
- Public Health Department.,NORC Walsh Center for Rural Health Analysis, University of Chicago, Chicago, Illinois 60637; , ,
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15
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Hardy AK, Nevin-Woods C, Proud S, Brownson RC. Promoting Evidence-Based Decision Making in a Local Health Department, Pueblo City-County, Colorado. Prev Chronic Dis 2015; 12:E100. [PMID: 26111156 PMCID: PMC4492218 DOI: 10.5888/pcd12.140507] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Community Context Administrative leaders at the Pueblo City–County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. Methods A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Outcome Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Interpretation Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments.
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Affiliation(s)
- Anna K Hardy
- Saint Louis University, 1312 Carr Lane Ave, Education Union, Rm 110, St Louis, MO 63014.
| | | | - Sylvia Proud
- Pueblo City-County Health Department, Pueblo, Colorado
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, Missouri
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