Journal of Public Health Management and Practice最新文献

{"title":"Validation of a Simplified Laboratory-Based HCV Clearance Definition Using New York City Hepatitis C Program and Surveillance Data.","authors":"Christina S Hwang, Martha P Montgomery, Diana I Diaz Munoz, Shaoman Yin, Eyasu H Teshale, Angelica Bocour","doi":"10.1097/PHH.0000000000002077","DOIUrl":"10.1097/PHH.0000000000002077","url":null,"abstract":"<p><strong>Context: </strong>Laboratory-based hepatitis C virus (HCV) clearance cascades are an important tool for health departments to track progress toward HCV elimination, but a laboratory-based definition of HCV clearance has not yet been validated.</p><p><strong>Objective: </strong>To compare agreement between a laboratory-based HCV clearance definition with a clinical cure definition.</p><p><strong>Design: </strong>Observational.</p><p><strong>Setting: </strong>New York City Department of Health and Mental Hygiene HCV surveillance system data and New York City hepatitis C linkage-to-care program data.</p><p><strong>Participants: </strong>Linkage-to-care program participants who were diagnosed with hepatitis C and enrolled in the linkage-to-care program from July 1, 2016, through June 30, 2020.</p><p><strong>Main outcome measure: </strong>Percent agreement between a laboratory-based HCV clearance definition (surveillance system) and a clinical cure definition (program data).</p><p><strong>Results: </strong>Among 591 program participants with known treatment outcome, the laboratory-based HCV clearance definition and clinical cure definition were concordant in 573 cases (97%).</p><p><strong>Conclusions: </strong>A laboratory-based HCV clearance definition based on public health surveillance data can be a reliable source for monitoring HCV elimination.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"360-367"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Adaptive Leaders: A Formative Evaluation of the Region V Public Health Leadership Institute Using Ripple Effect Mapping and Focus Groups.","authors":"Harshada Karnik, Julieta Barbiero, Danielle J Zemmel, Nicole M Weiss, Phoebe K G Kulik, Laura E Power, Jonathon P Leider","doi":"10.1097/PHH.0000000000002150","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002150","url":null,"abstract":"<p><strong>Objectives: </strong>The Region V Public Health Training Center implemented an inaugural Leadership Institute (RVPHLI) from January to June 2023. This paper outlines a formative evaluation of the program to qualitatively assess its potential outcomes and influence on participants' leadership capacity.</p><p><strong>Design, setting, and participants: </strong>Thirty-eight public health and primary care professionals participated in 40 hours of online learning activities focused on adaptive leadership themes.</p><p><strong>Main outcome measure: </strong>We conducted ripple effect mapping (REM) exercises and focus group discussions with 32 participants.</p><p><strong>Results: </strong>REM analysis using the Community Capitals Framework suggested benefits to participants' cultural, social, and human capital. The following themes emerged as takeaways from the focus groups: leaders as collaborators, new approaches to work and leadership, better understanding of individual leadership qualities and skills, current challenges, and validated existing definitions of leadership.</p><p><strong>Conclusions: </strong>REM analysis showed participants gaining confidence and skills. They identified beneficiaries beyond themselves and shared challenges and resources. Findings will shape future RVPHLI iterations and potentially enhance development of other leadership programs in both the public health and primary care sectors.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting the Dots: Facilitating Resource Access for Health and Wellness in Chicago Public Schools (CPS) Through the Healthy CPS Network Specialist.","authors":"Elizabeth Jarpe-Ratner, Sabrina Arancibia, Maddie Offstein, Cassidy Malner, Julien Leider, Jamie F Chriqui","doi":"10.1097/PHH.0000000000002130","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002130","url":null,"abstract":"<p><strong>Context: </strong>To comply with local, state, and federal health and wellness policies, districts and schools must connect students with needed services and resources (eg, mobile medical units and community health educators). Yet, schools struggle to navigate fragmented service landscapes. In Chicago Public Schools (CPS), the Healthy CPS Network Specialist position was created to help connect schools to such resources and services.</p><p><strong>Objectives: </strong>This study explores how the Specialist connects schools to resources and services and describes the experiences of schools working with the Specialist.</p><p><strong>Design: </strong>This mixed-methods study includes key informant interviews and survey data.</p><p><strong>Setting: </strong>The study was conducted in one of CPS's geographic networks, serving roughly 2 dozen schools on the district's West side.</p><p><strong>Participants: </strong>Interviews with the Specialist and interviews and surveys with school-level staff served by the Specialist were conducted from 2021 through 2023.</p><p><strong>Main outcome measures: </strong>Interviews and surveys measured participants' reported experiences working with the Specialist to get connected to 12 needed health and wellness resources and services.</p><p><strong>Results: </strong>Over 50% of schools reported being connected to resources and services by working with the Specialist. The most common supports were connections to sexual health education supports (75%), nutrition education supports (71%), and supports for LGBTQ+ students (68%). Interviewees reported that the Specialist makes connections internally, between schools and district-level staff, as well as externally across the city. Connections are made both through planning conversations and in response to school requests. Interviewees saw value in these connections, noting the Specialist addresses gaps in schools' knowledge, helps them plan for resource use, eases burdens, builds trusting relationships, and ensures follow-through.</p><p><strong>Conclusions: </strong>The Specialist position serves as a model for how to help schools build capacity to achieve health and wellness policy compliance through the connections made in a fragmented service landscape, ensuring services meet students' needs.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Project HCV Connect: Using a County Surveillance Registry to Link Hepatitis C Virus-Infected Residents to Cure-Los Angeles County, April 2023 to March 2024.","authors":"Chrysovalantis Stafylis, Cassidy Hernandez-Tamayo, Lokesh Bhardwaj, Riya Shah, Tatiana Becerra, Dara Bruce, Roopkamal Saini, Natalie Saremi, Immanuel Thomas, Krzel Manansala-Tan, Arjun P Vij, Alison Li, Nathan Sudeep, Jacob Gizamba, Bijan Hosseini, Sabrina Navarro, Sofia Ufret-Rivera, Mirna Ponce Jewell, Prabhu Gounder, Jeffrey D Klausner","doi":"10.1097/PHH.0000000000002139","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002139","url":null,"abstract":"<p><p>Los Angeles County has a high prevalence of chronic hepatitis C virus (HCV) infection, but resources and infrastructure to notify and increase treatment uptake among county residents are absent. Through an innovative academic-public partnership, we developed a linkage-to-cure program utilizing the Department of Public Health's HCV surveillance registry. Case workers contacted reported cases via phone, to offer education, and treatment referral. Three months after the initial communication, individuals that reported that they were untreated were recontacted to evaluate treatment status. Between April 2023 and March 2024, a total of 639 individuals with HCV were interviewed; 84% of them were aware of their infection status, and 70% were untreated. Among those interviewed three months after initial communication (n = 260), 22% started or completed treatment and 30% were under evaluation for treatment. Leveraging existing resources and new partnerships Public Health Departments could mobilize individuals to seek medical care and lead the effort towards elimination of HCV.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic and Performance Planning in US Local Health Departments: A Comparative Analysis of Strategic, Community Health Improvement, and Quality Improvement Plans.","authors":"Jacquelyn Jacobs, Britney Smart, Maureen Benjamins, Jesus Valencia, Anna Clayton, Krishna Patel, Joi Lee, Tim McCall, Ashley Edmiston","doi":"10.1097/PHH.0000000000002152","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002152","url":null,"abstract":"<p><strong>Context: </strong>Local health departments (LHDs) are a critical component of the US public health infrastructure. To guide their work and evaluate progress, LHDs develop and maintain a range of planning documents, including strategic plans (SPs), community health improvement plans (CHIPs), and quality improvement plans (QIPs).</p><p><strong>Objective: </strong>The goal of this study was to provide information on current LHD practices related to strategic planning and performance improvement.</p><p><strong>Design: </strong>The study used an environmental scan and document analysis of a sample of 93 plans from 31 LHDs to explore commonalities and differences within the strategies, goals, and priorities of SPs, CHIPs, and QIPs. Framework analysis was used, involving initial document review, development of a coding framework, and applying this framework to all documents iteratively. To ensure reliability, 19% of documents were double-coded, with discrepancies resolved through team discussions.</p><p><strong>Results: </strong>Of the 31 LHDs included in this analysis, most were urban (89.7%) and medium-sized (64.5%), with a large percentage from the Midwest (41.9%). The analysis revealed that most LHDs used established frameworks to develop plans and identify priority areas. Frequently listed priority areas included behavioral health, social determinants of health, access to care, chronic disease, and nutrition and physical activity. Frequently listed strategies to improve priority areas included building collaborations and partnerships, advocating for policy change, increasing access to services and resources, and increasing awareness of issues. While CHIPs frequently incorporated social determinants of health as part of a guiding framework, QIPs focused on fostering continuous quality improvement. Differences were documented based on jurisdiction size, degree of rurality, and region.</p><p><strong>Conclusions: </strong>The study identified a widespread commitment to develop plans using established frameworks, community engagement, and data-driven decision-making, while also highlighting the diverse needs and capacities of LHDs in addressing public health challenges.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Preventive Care Utilization at the Intersection of Socioeconomic and Demographic Characteristics: A Survival Analysis of COVID-19 Vaccination Uptake in the United States.","authors":"Biplab Kumar Datta, Santu Ghosh, Jennifer E Jaremski, Benjamin E Ansa, K M Monirul Islam, J Aaron Johnson","doi":"10.1097/PHH.0000000000002151","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002151","url":null,"abstract":"<p><strong>Context: </strong>Vaccination coverage against COVID-19 varied across populations. While previous studies primarily documented disparities at a point of time, how uptake rates evolved over time across categories of socioeconomic status (SES) is less visited.</p><p><strong>Objective: </strong>This study utilizing timing (month and year) of the first dose of COVID-19 vaccination, assessed the differences in vaccination progress by different categories of SES across demographic groups in the United States (US).</p><p><strong>Design/setting/participants: </strong>Using data from the 2022 Behavioral Risk Factor Surveillance System for 135 730 individuals aged 18+ years, living in 29 US states, we estimated Kaplan-Meier failure functions and stratified Cox proportional hazard models for the event of first vaccination.</p><p><strong>Main outcome measures: </strong>We assessed how monthly survival probabilities, from December 2020 to December 2022, varied across categories of SES represented by educational attainment and household income in the full sample and in sub-samples of demographic characteristics including age groups, sex, and race and ethnicity.</p><p><strong>Results: </strong>Estimates of the K-M failure functions suggested a SES gradient of COVID-19 vaccination uptake rates, which were highest among adults with a college degree and income of ≥400% of Federal Poverty Level (FPL), and lowest among adults with educational attainment of less than high school diploma and income of <100% of FPL. Compared to college graduates, adults without a high school diploma were 0.50 (95% confidence interval: 0.48-0.52) times, and compared to adults with income of ≥400% of FPL, adults with income of <100% of FPL were 0.60 times as likely to receive the first dose of vaccination. The hazard ratios of vaccination were 0.61 and 0.70 for adults with high school diploma and some college education, and 0.69 and 0.80 for adults with income of 100% to 199% and 200% to 399% of FPL, respectively. The differences between high and low SES categories were qualitatively similar, though differed by magnitudes across the demographic groups.</p><p><strong>Conclusions: </strong>Our findings highlight a significant difference in the trends of COVID-19 vaccination uptake between individuals from high and low SES backgrounds and may offer insights for designing policies aimed at equitable vaccination coverage.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use and Characteristics of Clinical Coding for Post-COVID Conditions in a Retrospective US Cohort.","authors":"Nicole D Ford, Sarah Baca, Alexandra F Dalton, Emilia H Koumans, Julia Raykin, Priti R Patel, Sharon Saydah","doi":"10.1097/PHH.0000000000002137","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002137","url":null,"abstract":"<p><strong>Context: </strong>Little is known about when and how the ICD-10-CM diagnosis code for Post-COVID Conditions (PCC; U09.9) is being used to document PCC.</p><p><strong>Objectives: </strong>To examine the use and characteristics of clinical coding for PCC.</p><p><strong>Design: </strong>A retrospective cohort.</p><p><strong>Setting: </strong>Transaction-level medical encounters, laboratory testing results, pharmacy claims, and medical claims for inpatient and outpatient care from the HealthVerity database.</p><p><strong>Participants: </strong>382 400 US adults and children with private health insurance, Medicare, and Medicaid who had U09.9 code documented during October 1, 2021-June 30, 2023.</p><p><strong>Outcome measures: </strong>Count of first use of the U09.9 code, (a) overall, over time, and proportion by provider type; (b) prevalence of PCC-associated incident conditions co-documented with U09.9; (c) number of documented SARS-CoV-2 infections preceding U09.9; (d) timing between infection and U09.9; (e) encounters during the 6 months following first use of U09.9.</p><p><strong>Results: </strong>Overall, 0.6% of 65 556 068 patients had a PCC diagnosis code (64.6% female; 6 in 10 had ≥1 preexisting conditions). The highest count of new U09.9 codes occurred during Quarter 1 and Quarter 3 of 2022 and was documented by a variety of provider specialties. The most prevalent co-documented PCC-associated incident conditions were respiratory (13.4%) and malaise and fatigue (7.8%). Only 62% of patients had SARS-CoV-2 infection documented preceding U09.9; median time to PCC documentation was 17.0 days (interquartile range [IQR] = 5.0, 61.0). Patients with ≥1 encounters during which PCC was documented in the 6 months following their index encounter (n = 109 794) had, on average, 25.5 additional encounters (median = 14 [IQR = 7, 29]).</p><p><strong>Conclusions: </strong>Our study describes the sociodemographic characteristics, complex clinical manifestations, and high healthcare use of patients following a PCC diagnosis. These findings may inform efforts to identify and treat PCC, inform healthcare planning, and support efforts to educate clinicians about the definition of PCC and accurate application of the code.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active and Passive Vector Surveillance Systems in Lyme Endemic Minnesota and Their Correlation to Human Disease.","authors":"Kathleen E Angell, Janet Jarnefeld, Elizabeth K Schiffman, M Jana Broadhurst, Jianghu James Dong, Abraham Degarege, Roberto Cortinas, David M Brett-Major","doi":"10.1097/PHH.0000000000002140","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002140","url":null,"abstract":"<p><strong>Context: </strong>Vector surveillance is often used to predict tick-borne diseases in endemic regions. Active and passive vector surveillance systems offer differing benefits and limitations; understanding how the outputs of these systems differ and how they correlate to human disease is essential to public health decision-making. Active and passive vector surveillance systems in Minnesota between 2018 and 2023 present an opportunity for comparison between these surveillance methods.</p><p><strong>Objective: </strong>To (1) analyze, compare, and contrast the results of active vector surveillance with crowd-sourced approaches, and (2) explore how these sources predict risk of Lyme disease.</p><p><strong>Methods: </strong>In this ecological comparative analysis, descriptive statistics were performed to evaluate characteristics of each surveillance method to assess differences in seasonality, life stage, and species of ticks. Negative binomial regression was used to analyze correlation to Lyme disease.</p><p><strong>Results: </strong>There are differences between data sources in tick life stage, species, and seasonality. Active surveillance using small mammal trapping had a majority larval (85%) and I. scapularis (76%) ticks. In contrast, passive surveillance had a majority of adult (96%) and D. variabilis (75%) ticks. Observations in both data sources were skewed to the early third of the tick season, although this was more exaggerated in the passive surveillance data. Observations of ticks from both data sources positively correlated with cases of Lyme disease.</p><p><strong>Conclusions: </strong>Observed differences in tick characteristics between the 2 data sources may represent real differences between tick populations and human encounters. Some differences may be explained by observation, reporting, and sampling biases. Increased observations of ticks at the beginning of the season indicate potential utility of enhanced human Lyme disease surveillance at that time. These One Health findings signal an opportunity for early identification of high tick-borne disease years through integrated active and passive tick surveillance that informs the conduct of human disease surveillance.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Definition to Identify Severe Opioid Overdoses Treated in Emergency Departments, 2019-2022.","authors":"Stephen J Liu, Herschel Smith, Vikram Krishnasamy, R Matthew Gladden","doi":"10.1097/PHH.0000000000002045","DOIUrl":"10.1097/PHH.0000000000002045","url":null,"abstract":"<p><strong>Background: </strong>Existing surveillance systems monitor nonfatal and fatal opioid overdoses but do not monitor severe nonfatal overdoses that require intensive medical interventions.</p><p><strong>Methods: </strong>The Centers for Disease Control and Prevention's Drug Overdose Surveillance and Epidemiology system was used to query emergency department data from local syndromic systems and the National Syndromic Surveillance Program from January 2019 to August 2022. Opioid overdoses were classified as not severe or severe using a definition from the patient's chief complaint terms and discharge diagnosis codes. The percentage of opioid overdoses treated in emergency departments classified as severe was described by patient demographics, US Census region, and month.</p><p><strong>Results: </strong>Among 503 156 opioid overdoses in 29 states and Washington, DC, from January 2019 to August 2022, 17.4% were classified as severe. Common key terms found among severe opioid overdoses were hypoxia (34.8%), unresponsive (32.9%), and naloxone/Narcan (20.9%). The largest severity percentage was in the South Census region (19.6%). The trends of severe opioid overdoses remained stable during the study period.</p><p><strong>Discussion: </strong>Based on the severe opioid overdose definition, there was minimal change in the severity of opioid overdoses during the study period. This definition can help monitor trends of severe opioid overdoses, guiding public health action such as focusing on naloxone and fentanyl test strip distribution to areas of need.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"252-262"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaccreditation and Pathways Recognition Experiences of Small Local and Tribal Health Departments.","authors":"Peg Allen, Matthew Fifolt, Andrew N Crenshaw, Paul C Erwin, Britt Lang, Amy Belflower Thomas, Paul Kuehnert, Ross C Brownson","doi":"10.1097/PHH.0000000000002084","DOIUrl":"10.1097/PHH.0000000000002084","url":null,"abstract":"<p><strong>Context: </strong>This paper describes experiences and views of leadership teams from 4 small local health departments (LHDs) seeking Public Health Accreditation Board (PHAB) reaccreditation or Pathways Recognition using PHAB Standards & Measures Version 2022. The Pathways program launched in 2022 provides additional supports for improvement of public health practice.</p><p><strong>Objective: </strong>Given the need to accelerate accreditation among small health departments, the purpose of this study is to share small health departments' strategies for overcoming accreditation challenges and actionable advice for use by other health departments.</p><p><strong>Design: </strong>In this descriptive qualitative study, the study team conducted 22 individual interviews with 4 small LHDs from January to March 2024.</p><p><strong>Setting: </strong>Participating small health departments were located in the Midwestern and Western United States with staff sizes ranging from 3 to 47.</p><p><strong>Participants: </strong>Interview participants included small health department leadership teams, a local board of health member, and a contracted external accreditation consultant.</p><p><strong>Main outcome measures: </strong>We used a semi-structured interview guide to elicit participant experiences and views on accreditation processes, benefits, facilitators, strategies for overcoming challenges, and advice for other small health departments.</p><p><strong>Results: </strong>Participants suggested that accreditation benefits far outweighed the challenges. Perceived benefits included improved organizational procedures, equitable delivery of needed effective programs and services, and enhanced public perception. Key strategies to overcome staff capacity challenges were establishing a team approach and orienting and mentoring new staff in the \"why\" and \"how\" of accreditation. Advice included learning what is involved, taking the time to lay a foundation beforehand, and not waiting for a perfect time as accreditation is about improvement, not perfection.</p><p><strong>Conclusions: </strong>Small health departments can achieve and maintain PHAB accreditation by strategically implementing strategies to overcome staff capacity and other challenges. The Pathways Recognition program is a supportive option for small health departments wanting to improve public health practice.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"173-182"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}