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A Patient-Centered Approach for Evaluating Public Health Roles within Systems of Care for Children with Special Healthcare Needs

Danielle M. Varda & Ayelet Talmi
Despite the apparent success that local and state health departments have had integrating a public health approach to provide programs and services for families with children who have complex health needs, there continues to be mixed results in terms of satisfaction and degree of support from this system. Current evaluations collect performance data from system stakeholders, rarely including the patient perspective. Examining the system holistically using Social Network Analysis, to include both the stakeholder and...

Health Department–Hospital Collaboration on Community Health Assessments

F. Douglas Scutchfield & Kaylee R. Hicks
The paper by Carlton and Singh in the March 2015 issue of Frontiers in Public Health Services and Systems Research represents an effort to show that, at least indirectly, hospitals and health departments in some communities apparently are in partnership, at least in the health department’s judgment: That is, the health department listed hospitals as a partner in the National Association of County and City Health Officials (NACCHO) survey of local health departments. They also...

Measures of Highly Functioning Health Coalitions

Priscilla A. Barnes, Paul C. Erwin & Ramal Moonesinghe
In Tennessee, health coalitions provide guidance in conducting community assessments, health improvement plans and policies and delivering of health and human services, which are considered core functions of public health. In fact, it has been postulated that these coalitions may serve as the organizational embodiment of the local public health system (LPHS). This study identifies functional characteristics of 63 Tennessee County Health Councils (CHCs), advisory councils to local and regional governmental public health agencies on...

Developing a Tool to Assess Administrative Evidence-Based Practices in Local Health Departments

Rodrigo S. Reis, Kathleen Duggan, Peg Allen, Katherine A. Stamatakis, Paul C. Erwin & Ross C. Brownson
There is need for assessing the practices undertaken by local health departments in order to improve the implementation of evidence-based actions. This paper describes the development and testing of a survey instrument for assessing Administrative Evidence-Based Practices (A-EBPs) in Local Health Departments. A-EBPs identified through a review of the literature were used to develop a survey composed of nine sections and tested in a sample of local health department practitioners. The resulting tool showed adequate...

Racial Disparities in Access to Community Water Supply Service in Wake County, North Carolina

Jacqueline MacDonald Gibson, Nicholas DeFelice, Daniel Sebastian & Hannah Leker
Anecdotal evidence suggests that historically African American communities on the fringes of cities and towns in North Carolina have been systematically denied access to municipal drinking water service. This paper presents the first statistical analysis of the role of race in determining water access in these fringe areas, known as extraterritorial jurisdictions. Using publicly available property tax data, we quantified the percentage of residences with municipal water service in each census block in Wake County...

Monitoring QI Maturity of Public Health Organizations and Systems in Minnesota

Kimberly J. Miner Gearin, M. Elizabeth Gyllstrom, Brenda M. Joly, Renee S. Frauendienst, Julie Myhre & William Riley
Public health departments and systems are increasing investments in quality improvement. This paper presents methods used to identify a select number of items from a previously validated QI Maturity Tool as the basis for calculating organizational and system-level QI maturity scores that could be followed over time. Findings suggest that the abbreviated tool measures variation in QI maturity across LHDs, and differences in scores among divisions within a state health department. Minnesota has incorporated the...

Perceptions of School and Health Department Emergency Preparedness Collaboration

Kaitlin A. O'Keefe, Katharine D. Arrington, Michael Prelip & Kimberley I. Shoaf
Background: School systems often have the vital responsibility of protecting students during emergency situations. Collaborations with the local health department (LHD) can be invaluable in helping schools effectively fulfill this responsibility. Purpose: An evaluation of existing organizational collaborations is needed to describe attitudes toward current efforts and to form recommendations for enhancing the effectiveness of future joint programs. Methods: Questionnaires regarding perceptions of existing collaborations were distributed to a sample of LHDs and schools districts...

Do PHAB accreditation prerequisites predict local health departments’ intentions to seek voluntary national accreditation?

Gulzar H. Shah, Kate Beatty & Carolyn Leep
Accreditation has been identified as a crucial strategy for strengthening the public health infrastructure. As agencies prepare for accreditation, it is important to understand how intentions to seek accreditation are related to the current level of readiness based on the three Public Health Accreditation Board (PHAB) prerequisites. Using the National Association of County and City Health Officials’ (NACCHO) 2010 Profile Study, we examined the relationship between the PHAB accreditation prerequisites and local health department (LHD)...

Best Practice Use to Address Tobacco-Related Disparities By California Community Coalitions

Rodney K. McCurdy
Tobacco-related disparities (TRDs) are a major public health concern. This study surveyed community tobacco coalition project directors in California to determine the usage of 11 CDC-published best practices to address TRDs. Response rate was 80 percent. Communities had implemented, on average, one-half of the 11 practices surveyed. Differences were observed between rankings for best practice implementation and perceived level of importance in addressing TRDs in the community. Resource constraints and community context were the highest...

Editorial Comment: Local Health Department Provision of WIC Services Relative to Local Need

Paul C. Erwin

Editorial Comment: Public Health Governance and Population Health Outcomes

F. Douglas Scutchfield & Elizabeth Harper

Efficiency in Public Health Service Delivery

Simone R. Singh
The ability of local health departments (LHDs) to provide public health services to improve the health of their communities depends to a large extent on their financial resources. More money by itself, however, does not necessarily translate into better population health. LHDs also have to use their resources in an efficient manner to achieve the best possible outcomes. This article first describes two techniques that LHDs can use to assess their efficiency at providing public...

Evaluating Quality Improvement to Improve HIV Reporting

Nandi A. Marshall, William C. Livingood, Angela Peden, Gulzar H. Shah, Russ Toal, Dayna Alexander, Alesha Wright, Sandra Jump, Shelby Freeman, Kay Davis, Lynn Woodhouse & Kellie Penix
The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts.

Carrots, Sticks and False Carrots

Harald Schmidt
Employers are increasingly using wellness incentives, including penalties for unhealthy behavior. Survey data suggests that people are willing to accept the principle of penalizing those perceived to take health risks, but the equally relevant question of the magnitude of acceptable penalties is unclear. While the principle of penalizing overweight and obese people has some support, findings from a population-level experiment (n=1,000) suggest that the acceptable size of penalties is comparatively small, around $50: more than...

Commentary: Models of Dissemination and Implementation in Public Health

Glen Mays
As public health researchers and public health practitioners, we need to become much more skilled in applying dissemination and implementation models within our research designs and within our delivery systems if we want the accumulating scientific knowledge to result in improvements in population health. Many of our standard public health tools can be affective in facilitating D&I – regulation, education, measurement and reporting, peer pressure, social media, and economic incentives – but context really matters....

Public Health Services Most Commonly Provided by Local Health Departments in the United States

Gulzar H. Shah, Huabin Luo & Sergey Sotnikov
The primary purpose of this research is to identify the most commonly performed public health services by local health departments (LHDs) and highlight variation by LHD characteristics. Data were drawn from the 2008 and 2010 National Profile of LHDs, conducted by the National Association of County and City Health Officials (NACCHO). The descriptive analysis aims to further the essential dialogue triggered by a recent Institute of Medicine (IOM) report about the standard minimum set of...

The Effects of the State of Tennessee Immunization Policy Change of 2011 - 2012 on Vaccination Uptake in East Tennessee

Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley & Paul C. Erwin
In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds...

Commentary: Hospital Tax-Exempt Policy

Laura L. Hitchcock
In Hospital Tax-Exempt Policy: A Comparison of Schedule H and State Community Benefit Reporting Systems, Rosenbaum et aldescribe the numerous variations between current state law in 24 states and federal requirements regarding nonprofit hospitals’ community benefit activities. The potential for nonprofit hospitals to help shape community health is great, and how states choose to address requirements regarding community benefit, and potentially reinforce the new federal requirements to incentivize hospital participation in addressing root causes of...

Addressing health inequalities in the United States

Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell & Thomas A. LaVeist
Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting...

What’s in a username?

Jenine K. Harris, Ryan C. Maier & Nina Jolani
Social media platforms such as Twitter may be useful for local health departments (LHDs) in providing the essential service of educating and informing constituents.1 However, health departments have relatively few Twitter followers overall.1 One of the challenges that may be associated with following LHDs on Twitter is knowing how to find an LHD Twitter feed. With no suggested or required conventions for LHDs adopting social media, practitioners are left to independently develop their name and...

Diffusion of Innovation Across a National Local Health Department Network

Mark Orr & Jacqueline Merrill
The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is...

Effectiveness and Challenges for Implementing Quality Improvement Activities in Nebraska’s Local Health Departments

Li-Wu Chen, Anh Nguyen, Janelle J. Jacobson, Diptee Ojha & David Palm
What is already known on this topic? Although the implementation strategies and effectiveness of quality improvement (QI) activities have been examined extensively for many industries, including the health care sector, very few studies have focused on QI activities in the public health context. What is added by this report? The study results indicated that Nebraska’s LHDs still face significant barriers for QI implementation, including low capacity, knowledge gaps, inadequate resources, and low institutional QI maturity....

Keeneland Conference Plenary Sessions

Richard J. Umbdenstock
Historically individual and community health problems fed off one another, nonetheless the connection eventually became clear and individual health and population health solutions started to emerge and built off one another. Somewhere along the line, population health and patient health seemed to become divided by a brighter line into 2 separate realms, few of us crossing from one to the otherToday we are looking out for the good of our respective communities. As hospitals move...

Use of the County Health Rankings by Local Health Departments in Florida, 2010 - 2011

Nancy L. Winterbauer, Bonita Winterbauer & James B. Tidwell
This paper describes how local health departments (LHDs) in Florida used the County Health Rankings over the first two years of their release (2010 – 2011). We surveyed LHD leadership to describe if, how and to what extent the Rankings were used by Florida’s 67 LHDs to improve the health of their communities and describe changes in use from the 2010 to the 2011 release. Our results indicate substantial use of the Rankings by Florida’s...

Policymakers Identify Priorities for PHSSR

Katherine Froeb Papa
A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund. In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes...

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