Direct observation of local public health: The role of the local health departments in prevention of foodborne outbreaks

Background: The purpose of this project is to investigate the process, content, and quality of the Local Health Department (LHD) role in prevention of foodborne outbreaks utilizing a direct observation methodology proven successful in other PBRN disciplines but not yet tested in public health practice. Specifically, this study will develop and test direct observation of local public health (DOLPH) tools intended to establish a richer and more accurate depiction of LHD function and practice variation related to prevention of foodborne outbreaks. Methods: This is a comparative case study design utilizing mixed methods, including direct observation, interview, and publicly available data. Participants: A convenience sample of approximately 30 Ohio LHDs and 100 geographically and demographically diverse Ohio Registered Sanitarians (RS). Protocol: RS will be shadowed during the conduct of food service establishment inspections, with a direct observation form completed by a trained student observer (>1,500 inspections observed). Other tools include RS, LHD, and Jurisdictional Profiles; and brief pre- and post-inspection interviews. Student observers are drawn from all 7 Ohio graduate public health programs. Results: This presentation will focus on findings regarding the process and content of food service establishment inspection. Associations between RS, LHD, or Jurisdictional characteristics and the process or content of food safety inspections will be detailed. Reflections on implementation of the direct observation approach in LHDs will be discussed. Discussion: DOLPH represents a developing methodology in LHDs. Opportunities for reduction of error variance and a more accurate depiction of the complexity of public health practice are abundant.