142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Public Health Agencies' Level of Engagement in and Perceived Barriers to PHAB National Voluntary Accreditation

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:30 PM - 3:50 PM

Gulzar Shah, PhD, MStat, MS , Health Policy and Management, Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA
Carolyn J. Leep, MS, MPH , Research & Evaluation, National Association of County and City Health Officials, Washington, DC
Jiali Ye, Ph.D , National Association of County & City Health Officials, Washington, DC
Katie Sellers, DrPH, CPH , Research and Evaluation, Association of State and Territorial Health Officials, Arlington, VA
Karmen Williams, MSPH, MA, DrPH(c) , Health Policy and Management, Jian-Ping Hsu College of Public Health, GSU, Statesboro, GA
Rivka Liss-Levinson, PhD , Research and Evaluation, Association of State and Territorial Health Officials, Arlington, VA
Background:  The national accreditation of health agencies is anticipated to be a driving force for improving public health agencies’ administration, governance, and the capacity to provide essential public health services. Purpose:  This study examines local health departments’ (LHDs) and state health agencies’ (SHAs) engagement in accreditation, barriers to accreditation, and factors associated with level of engagement in accreditation. Method:  Data from The National Association of County and City Health Officials’ 2013 Profile of LHDs and The Association State and Territorial Health Officials’ 2012 Profile of SHAs were used. Multinomial logistic regression was performed with levels of engagement as the outcome variable. Results:  Six percent of LHDs and 27% of SHAs had either submitted an application or statement of intent, whereas 15% of LHDs and 4% of SHAs had decided not to pursue accreditation. Significant predictors of variation in level of LHD engagement in accreditation included population size in the LHD jurisdiction, governance category, MD degree of top executive, LHD with one or more local boards of health, LHD’s collaboration with other organizations, per capita expenditures, and performance of two of the PHAB accreditation pre-requisites, namely community health improvement plan (CHIP), and agency-wide strategic plan (SP). Most frequently reported reasons for LHDs for not pursuing accreditation were time/effort required for accreditation exceeds benefits (72%), fee too high (54%), and standards exceed the capacity of their LHD (39%). SHA’s did not perceive the same barriers; only 2% indicated fees being too high, and 2% reported ‘other’ reasons. Discussion/Conclusion:  Accreditation is expected to provide the pathways to ensure accountability, consistency, better fit between community needs and public health services, and uniformity across health departments. National strategies targeting rapid diffusion of accreditation among public health agencies should include elements that address the needs of LHDs with varying degrees of intent to pursue accreditation.

Learning Areas:

Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Analyze the current status of LHDs engagement in seeking national voluntary accreditation through PHAB. Identify barriers in LHDs and SHAs seeking national voluntary accreditation through PHAB. Describe the factors associated with LHD accreditation engagement using multivariate analyses.

Keyword(s): Accreditation, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Professor and the Director of Research at the Jiann-Ping Hsu College of Public Health, Georgia Southern University. My multisector work experience spans over 18 years, with appointments in both academia and public health practice agencies, nationally and internationally. For last 18 years, I have been involved in design and implementation of various initiatives in public health systems research. I have conducted extensive research on local health departments in the United States.
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.