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

Ross C Brownson, Rodrigo S Reis, Peg Allen, Kathleen Duggan, Robert Fields, Katherine A Stamatakis, Paul C Erwin, Ross C Brownson, Rodrigo S Reis, Peg Allen, Kathleen Duggan, Robert Fields, Katherine A Stamatakis, Paul C Erwin

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.

Conflict of interest statement

Conflict of interest statements:

Ross C. Brownson has no financial disclosures.

Rodrigo S. Reis has no financial disclosures.

Peg Allen has no financial disclosures.

Kathleen Duggan has no financial disclosures.

Robert Fields has no financial disclosures.

Katherine A. Stamatakis has no financial disclosures.

Paul C. Erwin has no financial disclosures.

© 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

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