Online Program

332900
Influence of Local Health Department Structure on Quality, Process, and Priorities of Community Health Assessment and Health Improvement Planning


Monday, November 2, 2015 : 11:10 a.m. - 11:30 a.m.

Scott Frank, MD, MS, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
Alexandria Drake, MPH, Ohio Research Association for Public Health Improvement, Case Western Reserve University, Cleveland, OH
Melanie Golembiewski, MD, MPH Candidate, Preventive Medicine Residency, Case Western Reserve University School of Medicine, Cleveland, OH
Katie Gardner, MPH Student, Master of Public Health Program, Case Western Reserve University, Cleveland, OH
Sara Tillie, MPH Student, Master of Public Health Program, Case Western Reserve University, Cleveland, OH
Purpose: Investigate the variations of Community Health Assessment (CHA) and Community Health Improvement Planning (CHIP) process, quality, and outcomes based on structural organization of Local Health Departments (LHD), including LHD type; jurisdictional size; region; and LHD resources. Compare process, quality, and outcomes of joint jurisdictional CHAs and CHIPs with single jurisdiction process. Methods: Comparative case study utilizing mixed methods.  The adapted CHIPP Quality Measurement Tool was used to analyze the quality of CHIP/CHA process in all 124 Ohio LHDs.  The LHDs with the highest quality process for CHA (4) and CHIP (4) were surveyed and interviewed. Results: Regardless of structural issues, LHD demonstrated a high degree of CHA/CHIP quality. Structural differences included:  County departments were less likely to progress from CHA to CHIP, involve stakeholders, or establish guiding principles. City departments were less likely to identify measurable objectives and time framed targets. There were no significant differences in CHA/CHIP quality or process based on Board of Health or on jurisdictional size. Lower budget health departments performed with similar quality to higher budget programs, with more use of guiding principles, but less use of measurable objectives. The largest structural differences were geographic. There were distinct regional differences in CHA/CHIPs quality and process. Conclusion: Despite enormous differences in size, staffing, and resources diverse health departments showed more similarities than difference. Differences in quality based on budget and region raise concern about disparities in community health improvement. Quality differences based on LHD structure are identified to encourage eliminating these structural differences.

Learning Areas:

Administration, management, leadership
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health administration or related administration
Public health or related research

Learning Objectives:
Describe variations in Community Health Assessment (CHA) and Community Health Improvement Planning (CHIP) process, quality, and outcomes based on structural organization of Local Health Departments. Compare process, quality, and outcomes of joint jurisdictional CHAs and CHIPs with LHDs conducting a single jurisdiction process.

Keyword(s): Community Health Assessment, Community Health Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Principal investigator of the Ohio public health practice-based research network; health commissioner of the Shaker Heights Health Department; and director of the Master of Public Health Program at Case Western Reserve University.
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.