Community perceptions of the implementation and results of the local public health system assessment in three rural North Carolina counties

Mobilizing for Action through Planning and Partnerships (MAPP) is a planning tool that encourages a participatory approach to community health improvement planning. While it is similar in many respects to the community health assessment and improvement planning required of North Carolina local health departments, MAPP is new in emphasizing a systems approach. The Local Public Health System Assessment (LPHSA), one of four MAPP assessments, relies on participation of a broad array of non-traditional community health partners (e.g. higher education, business) to evaluate the capacity of the system to provide the 10 Essential Public Health Services. The LPHSA is considered an arduous process due to the length/complexity of the tool and level of participation needed to complete it. This may be especially challenging for rural communities with limited financial/human resources. Three rural North Carolina counties participated in MAPP in 2011-2012. This is the first known application of the LPHSA in North Carolina. In this study, four focus groups were conducted with LPHSA participants (n =25) to gain insight into community partners' perspectives regarding the process and outcomes of participation. Results indicate that participants valued participation, were educated about the scope of the public health system and their role in it, appreciated the opportunity to engage with non-traditional health partners and felt LPHSA results were accurate. Study results provide encouragement to LHD staff hesitant to conduct the LPHSA that community partners will appreciate the experience and suggest that the assessment offers additional opportunities to educate and engage partners in systems thinking. g.