Core aspects of leadership in local health departments: A mixed-method exploration

Research Objective: This study examines public health leadership using a two-phase, sequential, mixed-method design. Specifically, the study looks to: 1) measure the extent of transformational or transactional leadership styles among local health department directors in selected local health departments and 2) develop an increased understanding of the factors which facilitate the development and use of different leadership styles in local health departments.

Data Source: The study utilizes survey, interview, and focus group data from the doctoral capstone research of the lead author. Survey data consist of demographics and questions from the Multifactoral Leadership Questionnaire (MLQ). Qualitative data were obtained using a semi-structured interview guide.

Analysis: Data were analyzed using SPSS v18.0 for quantitative data and ATLAS.ti v6.2 for qualitative data. Descriptive statistics were used to examine the extent of transformational and transactional leadership styles reported by study participants. Code-recode and member-checking procedures were used to analyze interview and focus group data.

Principal Findings: Local health department directors reported a variety of transformational and transactional leadership styles related to organizational performance and employee satisfaction. Preliminary themes from qualitative data suggest that leadership styles depend heavily situational context and that organizational resources and focus on leadership development varies widely. Ideal qualities of public health leaders and factors which facilitate different leadership styles are discussed.

Conclusions/Implications: Findings from this study have important implications for the field of public health, including: (1) establishing a framework for preparing the next generation of public health practitioners to be effective in leadership roles; (2) training and developing current public health practitioners to utilize effective and appropriate leadership styles; and (3) assisting local boards of health and/or health department directors in the identification of potential leaders whose leadership styles fit those desired or expected by the board, director, organizational environment, and/or community.