Comparative Analysis of Community Health Assessments and Community Health Improvement Plans by PHAB Accreditation Status Among Local Health Departments in Kentucky, 2015-2022.

Abstract

Objective: This study investigates the variation in quality of community health assessments (CHAs) and community health improvement plans (CHIPs) between Public Health Accreditation Board (PHAB)-accredited and unaccredited local health departments (LHDs) in Kentucky. Building upon prior research examining the quality of CHA/CHIPs among PHAB-accredited LHDs in Kentucky, this study sought to compare CHA/CHIP quality between PHAB-accredited and unaccredited LHDs in Kentucky.

Design: Quality assessment of publicly available CHA/CHIP documents used criteria adapted from the study by Pennel et al. (Nonprofit hospitals approach to community health needs assessment. Am J Public Health. 2015;105(3):e103-e113. doi:10.2105/ajph.2014.302286). LHDs were ranked across 17 criteria on a 6-point scale to generate composite scores for report quality. A Welch's corrected unpaired t test was performed to assess the difference in report quality between accredited and unaccredited departments.

Setting: PHAB-accredited and unaccredited LHDs in Kentucky. The study included publicly available CHA/CHIP reports generated by LHDs in Kentucky between 2015 and 2022.

Participants: Seventeen CHAs and CHIP documents from PHAB-accredited LHD. The study analyzed 17 publicly available CHA/CHIP reports from PHAB-accredited LHDs and 15 publicly available CHA/CHIP reports from unaccredited LHDs.

Main outcome measures: Quality scores were based on 17 evaluation criteria, including stakeholder involvement, data examination, plan feasibility, and LHD-hospital collaboration.

Results: The study found significant variation in the quality of CHAs and CHIP documents across all LHDs. The highest criterion scores were for partner involvement, data examination, and plan feasibility. The lowest scores were for LHD-hospital collaboration, use of evidence-based strategies, and plan evaluation. No community variables significantly predicted overall report scores. The study found that accredited LHDs scored significantly higher than unaccredited LHDs on overall report quality.

Conclusions: The quality of CHAs and CHIP documents varies among Kentucky LHDs, highlighting the need for more robust guidance and standardized criteria, particularly for LHDs not yet pursuing accreditation. Strengthening hospital-LHD collaboration and focusing on evidence-based strategies can improve public health outcomes. High-quality CHA/CHIP reporting is essential for effective public health interventions and improved health outcomes. Enhancing CHA/CHIP processes through legislative changes, departmental guidance, and the pursuit of public health accreditation are promising avenues for improvement.