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Am J Prev Med. 2014 Jan;46(1):49-57. doi: 10.1016/j.amepre.2013.08.013.

Understanding administrative evidence-based practices: findings from a survey of local health department leaders.

Author information

1
Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri. Electronic address: rbrownson@wustl.edu.
2
Pontifical Catholic University of Parana, School of Health and Biosciencesand the Federal University of Parana, Department of Physical Education, Curitiba, Brazil.
3
Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri.
4
College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri.
5
Department of Public Health, University of Tennessee, Knoxville, Tennessee.

Abstract

BACKGROUND:

There are sparse data showing the extent to which evidence-based public health is occurring among local health departments.

PURPOSE:

The purpose of the study was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance measures) in a representative sample of local health departments in the U.S.

METHODS:

A cross-sectional study of 517 local health department directors was conducted from October through December 2012 (analysis in January-March 2013). The questions on administrative evidence-based practices included 19 items based on a recent literature review (five broad domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, financial processes).

RESULTS:

There was a wide range in performance among the 19 individual administrative evidence-based practices, ranging from 35% for providing access to current information on evidence-based practices to 96% for funding via a variety of sources Among the five domains, values were generally lowest for organizational climate and culture (mean for the domain=49.9%) and highest for relationships and partnerships (mean for the domain=77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted ORs [aORs] ranging from 4.4 to 7.5) and state governance structure (aOR=3.1).

CONCLUSIONS:

This research on the patterns and predictors of administrative evidence-based practices in health departments provides information on gaps and areas for improvement that can be linked with ongoing quality improvement processes.

PMID:
24355671
PMCID:
PMC3982585
DOI:
10.1016/j.amepre.2013.08.013
[Indexed for MEDLINE]
Free PMC Article

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