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331846
A conceptual model for EBI adoption in local health departments


Wednesday, November 4, 2015 : 1:30 p.m. - 1:50 p.m.

Nancy Winterbauer, PhD, Department of Public Health, East Carolina University, Greenville, NC
Huabin Luo, PhD, Department of Public Health, East Carolina University, Greenville, NC
Ashley Tucker, MPH, BSOM. Department of Public Health, East Carolina University, Greenville, NC
Colleen Bridger, PhD, Orange County Health Department, Hillsborough, NC
Katharine Hyatt Hawkins, School of Communication, East Carolina University, Greenville, NC
Audio (mp3) recording Recorded Presentation (mp4)
Background: Evidence-based interventions (EBIs) are promoted to improve public health practice and ameliorate health disparities. Despite increasing availability of EBIs, the translation of interventions with demonstrated efficacy under ideal conditions to practice settings remains a challenge. Although local health departments (LHDs) provide a critical venue for achieving population health goals, adoption of EBIs in these settings is inconsistent and challenges to adoption are not well-described. This paper presents a conceptual framework for EBI adoption in LHDs.

Methods: We drew on theory, limited existing literature, and a recent mixed-method study that examined adoption decisions regarding an evidence-based HPV video prevention intervention made available to North Carolina (NC) LHDs. In logistic regression, the NC study compared adopting and non-adopting LHDs (n=85) on structural characteristics, such as leadership characteristics and capacity.  Additionally, qualitative interviews (n=22) were conducted with LHD directors to better understand decisions for or against adoption of the intervention.

Results: Results from the NC study suggested that aspects of communication (opinion leaders, awareness, and positive attitudes), as well as agency directors’ evaluation of resources, balanced against intervention complexity and flexibility, competing priorities, and mandates influenced the adoption decision. These results were integrated with what is already known about EBI adoption to create a conceptual framework, grounded in diffusion of innovations theory, that describes drivers of EBI adoption in LHDs.

Conclusions: A conceptual framework for EBI adoption in LHDs is useful to guide the design and dissemination of practical EBIs. This is particularly important, given contextual characteristics that make these settings unique.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the importance of conducting EBIs in local health departments List unique characteristics of local health departments that may affect EBI adoption Discuss factors that promote or inhibit EBI adoption in local health departments

Keyword(s): Community Health Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am partnering with a faculty member in Public Health department at ECU who is an expert in the area. I have written numerous papers that focus on communication and health, and have served as a graduate assistant in the School of Communication for over a year.
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: 5175.0: Addressing the Social Determinants of Health through Community-Based Initiatives