142nd APHA Annual Meeting and Exposition

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Learning from positive outlier local health departments in Maternal and Child Health

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 9:10 AM - 9:30 AM

Tamar Klaiman, PhD, MPH , Department of Health Policy and Public Health, University of the Sciences in Philadelphia, Philadelphia, PA
Betty Bekemeier, PhD, MPH, FAAN , Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA
Anjali Chainani, MPH/MSW , Department of Health Policy and Public Health, University of the Sciences in Philadelphia, Philadelphia, PA
Audio (mp3) recording Recorded Presentation (mp4)
Local health departments (LHDs) are responsible for administering various maternal and child health (MCH) services. However, the current economic climate has strained LHDs. There are, however, some LHDs that have maintained better than expected MCH outcomes compared to their peers - positive deviants.

The goals of this project was to identify from positive deviant LHDs in terms of MCH outcomes in Washington and Florida and to learn from their experience.

We used county level data from the Public Health Activities and Services Tracking database from FL and WA for 2009 and 2010 to assess which LHDs had better than expected rates of teen pregnancy/births, rates of late or no prenatal care, infant mortality rate, and rates of low birth weight. We used multiple regression analysis, and we identified positive deviants as those with standardized residuals less than -1, for at least two outcomes and/or years. We are conducting in-depth qualitative interviews with LHD MCH staff in order to understand the practices that led to better than expected outcomes.

We have identified 10 LHDs in Washington and 24 in Florida that showed consistently exceptional outcomes MCH outcomes. We are currently undergoing qualitative interviews, the findings of which will be reported in our presentation.

The methods used in this project can be replicated in other areas of MCH to improve health outcomes. Our quantitative analysis has allowed us to objectively identify positive outlier LHDs. The qualitative analysis will help us to better understand why some LHDs have achieved good outcomes.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health administration or related administration
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the use of positive deviance to identify high performing local health departments in maternal and child health. Identify the practices implemented by high performing local health departments to achieve exceptional outcomes in maternal and child health.

Keyword(s): Public Health Administration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of foundation and federally funded grants focused on public health systems and services research using positive deviance methodology.
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.

Back to: 5065.0: Policy & Finance in MCH