Practitioner perspectives on building capacity for evidence-based public health in state health departments in the United States: a qualitative case study

...The Tuskegee Study of Untreated Syphilis in the Negro Male, a 40-year deathwatch over the lives of more than 400 black sharecroppers in Macon County, Ala. [was a nightmare]. ...There, from 1932 to 1972, the United States Public Health Service conducted a "study," which was actually, as historian James H. Jones shows, an ugly collaboration involving Public Health Service physicians, local private practitioners (white and black), the prestigious all-black Tuskegee Institute and Hospital, the county and state health departments, even draft boards.

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A Qualitative Case Study of Exemplary Principal Leadership in the United States Virgin Islands: An Application of Kouzes and Posner’s Five Practices of Exemplary Leadership

Journal of Research on Leadership Education ◽

10.1177/1942775121990054 ◽

2021 ◽

pp. 194277512199005

Author(s):

Suetania Emmanuel ◽

Clinton A. Valley

Keyword(s):

United States ◽

Principal Leadership ◽

Qualitative Case Study ◽

United States Virgin Islands ◽

The United States ◽

Virgin Islands ◽

Staff Members ◽

Exemplary Leadership ◽

Five Practices

Effective leadership is foundational to the success of all organizations. This qualitative case study aimed to explore exemplary principal leadership in the United States Virgin Islands (USVI). The study was based on Kouzes and Posner’s model of exemplary leadership. Interviews were held with school principals, teachers, and nonteaching staff members in three schools in USVI. The principal leaders in the USVI were found to exhibit the five practices of exemplary leadership as postulated by Kouzes and Posner. The study recommends that the Education department in USVI should develop guidelines and professional development opportunities to enhance exemplary leadership practices among principals.

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Training needs and supports for evidence-based decision making among the public health workforce in the United States

BMC Health Services Research ◽

10.1186/s12913-014-0564-7 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 30

Author(s):

Rebekah R Jacob ◽

Elizabeth A Baker ◽

Peg Allen ◽

Elizabeth A Dodson ◽

Kathleen Duggan ◽

...

Keyword(s):

Public Health ◽

United States ◽

Decision Making ◽

Health Workforce ◽

The United States ◽

Training Needs ◽

Public Health Workforce ◽

Evidence Based ◽

The Public ◽

Evidence Based Decision Making

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Implementing a Data to Care Strategy to Improve Health Outcomes for People With HIV: A Report From the Care and Prevention in the United States Demonstration Project

Public Health Reports ◽

10.1177/0033354918805987 ◽

2018 ◽

Vol 133 (2_suppl) ◽

pp. 60S-74S ◽

Cited By ~ 13

Author(s):

Patricia Sweeney ◽

Tamika Hoyte ◽

Mesfin S. Mulatu ◽

Jacquelyn Bickham ◽

Antoine D. Brantley ◽

...

Keyword(s):

United States ◽

Health Outcomes ◽

Medical Care ◽

Treatment Adherence ◽

Viral Suppression ◽

The United States ◽

Health Departments ◽

State Health ◽

Improve Health

Objectives: The Care and Prevention in the United States Demonstration Project included implementation of a Data to Care strategy using surveillance and other data to (1) identify people with HIV infection in need of HIV medical care or other services and (2) facilitate linkages to those services to improve health outcomes. We present the experiences of 4 state health departments: Illinois, Louisiana, Tennessee, and Virginia. Methods: The 4 state health departments used multiple databases to generate listings of people with diagnosed HIV infection (PWH) who were presumed not to be in HIV medical care or who had difficulty maintaining viral suppression from October 1, 2013, through September 29, 2016. Each health department prioritized the listings (eg, by length of time not in care, by viral load), reviewed them for accuracy, and then disseminated the listings to staff members to link PWH to HIV care and services. Results: Of 16 391 PWH presumed not to be in HIV medical care, 9852 (60.1%) were selected for follow-up; of those, 4164 (42.3%) were contacted, and of those, 1479 (35.5%) were confirmed to be not in care. Of 794 (53.7%) PWH who accepted services, 694 (87.4%) were linked to HIV medical care. The Louisiana Department of Health also identified 1559 PWH as not virally suppressed, 764 (49.0%) of whom were eligible for follow-up. Of the 764 PWH who were eligible for follow-up, 434 (56.8%) were contacted, of whom 269 (62.0%) had treatment adherence issues. Of 153 PWH who received treatment adherence services, 104 (68.0%) showed substantial improvement in viral suppression. Conclusions: The 4 health departments established procedures for using surveillance and other data to improve linkage to HIV medical care and health outcomes for PWH. To be effective, health departments had to enhance coordination among surveillance, care programs, and providers; develop mechanisms to share data; and address limitations in data systems and data quality.

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Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

American Journal of Public Health ◽

10.2105/ajph.2020.306007 ◽

2020 ◽

pp. e1-e8

Author(s):

Jonathon P. Leider ◽

Jessica Kronstadt ◽

Valerie A. Yeager ◽

Kellie Hall ◽

Chelsey K. Saari ◽

...

Keyword(s):

Public Health ◽

United States ◽

Latent Class ◽

The United States ◽

Local Health ◽

Health Departments ◽

Local Health Departments ◽

Profile Data ◽

The Public ◽

Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

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Epidemiology Workforce Capacity in 27 Large Urban Health Departments in the United States, 2017

Public Health Reports ◽

10.1177/0033354919856935 ◽

2019 ◽

Vol 134 (4) ◽

pp. 386-394

Author(s):

Meghan D. McGinty ◽

Nancy Binkin ◽

Jessica Arrazola ◽

Mia N. Israel ◽

Chrissie Juliano

Keyword(s):

Public Health ◽

United States ◽

Urban Health ◽

The United States ◽

Health Problems ◽

Full Time ◽

Health Departments ◽

Public Health Services ◽

Full Time Equivalent ◽

Workforce Capacity

Objectives: The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments. Methods: BCHC, in partnership with CSTE, modified the 2017 State Epidemiology Capacity Assessment for its 30 member departments. Topics in the assessment included epidemiology leadership, staffing, funding, capacity to perform 4 epidemiology-related Essential Public Health Services, salary ranges, hiring requirements, use of competencies, training needs, and job vacancies. Results: The 27 (90%) BCHC-member health departments that completed the assessment employed 1091 full-time equivalent epidemiologists. All or nearly all health departments provided epidemiology services for programs in infectious disease (n = 27), maternal and child health (n = 27), preparedness (n = 27), chronic diseases (n = 25), vital statistics (n = 25), and environmental health (n = 23). On average, funding for epidemiology activities came from local (47%), state (24%), and federal (27%) sources. Health departments reported needing a 40% increase from the current number of epidemiologists to achieve ideal epidemiology capacity. Twenty-five health departments reported substantial-to-full capacity to monitor health problems, 21 to diagnose health problems, 11 to conduct evaluations, and 9 to perform applied research. Conclusions: Strategies to meet 21st century challenges and increase substantial-to-full epidemiological capacity include seeking funds from nongovernmental sources, partnering with schools and programs of public health, and identifying creative solutions to hiring and retaining epidemiologists.

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Assessing Organizational Supports for Evidence-Based Decision Making in Local Public Health Departments in the United States

Journal of Public Health Management and Practice ◽

10.1097/phh.0000000000000952 ◽

2019 ◽

Vol 25 (5) ◽

pp. 454-463 ◽

Cited By ~ 2

Author(s):

Stephanie Mazzucca ◽

Renee G. Parks ◽

Rachel G. Tabak ◽

Peg Allen ◽

Maureen Dobbins ◽

...

Keyword(s):

Public Health ◽

Decision Making ◽

The United States ◽

Evidence Based ◽

Health Departments ◽

Local Public Health ◽

Public Health Departments ◽

Organizational Supports ◽

Local Public Health Departments ◽

Evidence Based Decision Making

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The United States confronts Ebola: suasion, executive action and fragmentation

Health Economics Policy and Law ◽

10.1017/s1744133116000244 ◽

2016 ◽

Vol 12 (1) ◽

pp. 81-104 ◽

Cited By ~ 6

Author(s):

Scott L. Greer ◽

Phillip M. Singer

Keyword(s):

Public Health ◽

United States ◽

Republican Party ◽

Ebola Virus ◽

The United States ◽

Health Politics ◽

Variable Capacity ◽

The Media ◽

Executive Action

AbstractThe United States’ experience with the Ebola virus in 2014 provides a window into US public health politics. First, the United States provided a case study in the role of suasion and executive action in the management of public health in a fragmented multi-level system. The variable capacity of different parts of the United States to respond to Ebola on the level of hospitals or state governments, and their different approaches, show the limitations of federal influence, the importance of knowledge and executive energy, and the diversity of both powerful actors and sources of power. Second, the politics of Ebola in the United States is a case study in the politics of partisan blame attribution. The outbreak struck in the run-up to an election that was likely to be good for the Republican party, and the election dominated interest in and opinions of Ebola in both the media and public opinion. Democratic voters and media downplayed Ebola while Republican voters and media focused on the outbreak. The media was a key conduit for this strategic politicization, as shown in the quantity, timing and framing of news about Ebola. Neither fragmentation nor partisanship appears to be going away, so understanding the politics of public health crises will remain important.

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