Online Program

Measuring quality in local public health emergency preparedness: The Connecticut H1N1 experience

Monday, November 4, 2013

Steven Huleatt, MPH, West Hartford-Bloomfield Health District, Bloomfield, CT
Emil Coman, PhD, Ethel Donaghue Tripp Center, University of Connecticut Health Center, Farmington, CT
Jennifer Kertanis, MPH, Farmington Valley Health District, Canton, CT
Marion Wearing, BS, West Hartford-Bloomfield Health District, Bloomfield, CT
Connecticut is a home rule State with a diverse local public health infrastructure. The Connecticut Practice Based Research Network determined a need to explore measuring the quality of the publc health services performed at the local health agency level. To standardize the quality of service performed, the 2009 local health agency H1N1 pre-vaccine and post-vaccine reponses were selected. A strategy was using available public report data released by the Conneticut Deaprtment of Public Health and self-reported survey responses from local health agencies provided measurement data to assess local health quality performance. Systematic testing of a new QI public health measures using advanced psychometric techniques based on Structural Equation Modeling (SEM) has been performed. We used in particular an appropriate index construction and validation procedures for causal indicators measures (known also as formative measures). The measure items (indicators) were identified in a qualitative phase of measure development which consisted of four focus group session with LHD representatives from four regions of CT. A list of activities performed before and after the H1N1 vaccine became available, was arrived at using the focus groups findings, the timeline of actual events, and the expertise of the research team. LHD participants were then asked in an online survey which activities they performed in what specific month during the two distinct periods. These variables representing activities were then analyzed with MIMIC (Multiple Cause Multiple Indicator) structural models which specified initially all indicators predicting a latent factor, which in turns predicted 2 presumed outcomes of QI/performance, self-reported overall performance (overall and during the pre-vaccine period), and vaccines administered by LHDs (as percent of all vaccines, which included the privately administered ones).

Learning Areas:

Public health or related research

Learning Objectives:
Describe the purpose of the Connecticut Practice Based Research Network. Identify the structure of the Local Public Health System in Connecticut. Differentiate three quality measures of local health department performance during H1N1 experience Assess a systematic method approach to measure the quality of performance in Connecticut's local health department's H1N1 experience through development of sound and valid measures from a psychometric perspective. Compare the findings of a psychometric systematic method of local health department performace to local public health practice in Connecticut.

Keyword(s): Practice-Based Research, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director of Health for the West Hartford-Bloomfield Health District with over 30 years of public health practice experience. Iam a member of the steering committee of the Connecticut Practice Based Research Network. As a the Health Director in Connecticut I was responsible for our Health District's response to the 2009 H1N1 threat. Our program provides childhood and adult vaccination services at regularly scheduled clinics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.