Send to

Choose Destination
Am J Public Health. 2014 Apr;104(4):e27-33. doi: 10.2105/AJPH.2013.301809. Epub 2014 Feb 13.

Enhancement of health department capacity for health care-associated infection prevention through Recovery Act-funded programs.

Author information

Katherine Ellingson, Kelly McCormick, Ronda Sinkowitz-Cochran, Tiffanee Woodard, John Jernigan, and Arjun Srinivasan are with the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta GA. Kimberly Rask is with the Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta.



We evaluated capacity built and outcomes achieved from September 1, 2009, to December 31, 2011, by 51 health departments (HDs) funded through the American Recovery and Reinvestment Act (ARRA) for health care-associated infection (HAI) program development.


We defined capacity for HAI prevention at HDs by 25 indicators of activity in 6 categories: staffing, partnerships, training, technical assistance, surveillance, and prevention. We assessed state-level infection outcomes by modeling quarterly standardized infection ratios (SIRs) for device- and procedure-associated infections with longitudinal regression models.


With ARRA funds, HDs created 188 HAI-related positions and supported 1042 training programs, 53 surveillance data validation projects, and 60 prevention collaboratives. All states demonstrated significant declines in central line-associated bloodstream and surgical site infections. States that implemented ARRA-funded catheter-associated urinary tract infection prevention collaboratives showed significantly greater SIR reductions over time than states that did not (P = .02).


ARRA-HAI funding substantially improved HD capacity to reduce HAIs not targeted by other national efforts, suggesting that HDs can play a critical role in addressing emerging or neglected HAIs.

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center