An analysis of health officers advice networks based on NACCHO 2010 Profile data

The objective of this study is to understand how communication between public health officers diffuses innovation and new practices. Advice networks sustain professional values and can introduce ideas that change the professional outlook of leaders and how they and others in their organizations practice public health. When individuals interact in a network their attitudes and beliefs tend to converge. The 2010 Profile of Local Health Departments provided data on 2073 local health systems and the health officers that lead them. These data were supplemented by response from 1531 local health officers who listed up to five other LHDs with whom they communicated on administrative, professional, and leadership issues. The data were examined using network analysis. To allow comparisons within and between groups network theory was used to identify information spreaders, and innovative LHDs were identified with expert opinion. Measurements included network centralization, clustering, and embeddedness. Spatial auto-correlation was measured. LHD network measurements and LHD characteristics captured by the larger survey (i.e. education of health officer, budget, FTEs, etc.) were examined using bi-variate and multi-variate models. Analysis captures the structure of communication in the network and characteristics of LHDs. The findings show a scale free network with few nodes having many links and many nodes having few links, suggesting a pattern of preferential affiliation. Sub groups cluster by state or DHHS region rather than around similarities in the population served, with cliques of 3- 4 LHDs predominating. The results identify LHDs in positions to influence the spread of ideas. These baseline findings suggest how innovation may diffuse among local public health systems. Longitudinal data from ongoing surveys can track dynamic change in the network. The findings suggest how information and innovation can be fostered through collegial networks.