Challenges and Supports for Implementing Health Equity During National Accreditation Among Small Local Health Departments in the United States.

Objective: This article focuses on supports and challenges to health equity that small local health departments (LHDs) experienced while working toward national reaccreditation or Pathways Recognition with the Public Health Accreditation Board's Standards & Measures Version 2022 (PHAB S&M v2022).

Design: The study team conducted 22 qualitative interview sessions with members of health department leadership teams.

Setting: In the spring of 2024, participants from 4 small LHDs in the western and midwestern regions of the United States participated in individual remote interview sessions.

Rethinking our future: Describing and enhancing the impacts of dissemination and implementation science for cancer prevention and control.

Background: Researchers generally do an excellent job tracking the scientific impacts of their scholarship in ways that are relevant for academia (e.g., publications, grants) but too often neglect to focus on broader impacts on population health and equity.

Using National Public Health Accreditation to Explore Quality Improvement and Performance Management in Small Local Health Departments.

Context: This article focuses on 4 small local health departments (LHDs) that were in the process of seeking Public Health Accreditation Board (PHAB) reaccreditation or Pathways Recognition using PHAB Standards & Measures Version 2022.

Objective: The objective of this study was to explore the experiences of 4 small LHDs related to Quality Improvement (QI) and Performance Management (PM) in their pursuit of PHAB reaccreditation or Pathways Recognition.

Design: A team of researchers conducted 22 qualitative interviews with health department leaders and staff.

Quantitative measures used in empirical evaluations of mental health policy implementation: A systematic review.

Background: Mental health is a critical component of wellness. Public policies present an opportunity for large-scale mental health impact, but policy implementation is complex and can vary significantly across contexts, making it crucial to evaluate implementation. The objective of this study was to (1) identify quantitative measurement tools used to evaluate the implementation of public mental health policies; (2) describe implementation determinants and outcomes assessed in the measures; and (3) assess the pragmatic and psychometric quality of identified measures.

Understanding Misimplementation in U.S. State Health Departments: An Agent-Based Model.

Introduction: The research goal of this study is to explore why misimplementation occurs in public health agencies and how it can be reduced. Misimplementation is ending effective activities prematurely or continuing ineffective ones, which contributes to wasted resources and suboptimal health outcomes.

Methods: The study team created an agent-based model that represents how information flow, filtered through organizational structure, capacity, culture, and leadership priorities, shapes continuation decisions.

Practices Among Local Public Health Agencies to Support Evidence-Based Decision Making: A Qualitative Study.

Objectives: Evidence-based decision making (EBDM) capacity in local public health departments is foundational to meeting both organizational and individual competencies and fulfilling expanded roles. In addition to on-the-job training, organizational supports are needed to prepare staff; yet, less is known in this area. This qualitative study explores supportive management practices instituted as part of a training and technical assistance intervention.

Program adaptation by health departments.

Introduction: The dissemination of evidence-based interventions (i.e., programs, practices, and policies) is a core function of US state health departments (SHDs).

Facilitators of Multisector Collaboration for Delivering Cancer Control Interventions in Rural Communities: A Descriptive Qualitative Study.

Purpose And Objectives: Multisector collaboration is a widely promoted strategy to increase equitable availability, access, and use of healthy foods, safe places for physical activity, social supports, and preventive health care services. Yet fewer studies and resources exist for collaboration among governmental and nongovernmental agencies to address public problems in rural areas, despite an excess burden of risk factors for cancer morbidity and mortality. We aimed to learn about cancer prevention activities and collaboration facilitators among rural informal interagency networks.

The power of partnerships: state public health department multisector collaborations in major chronic disease programme areas in the United States.

Background: Multisector collaboration between state public health departments (SHDs) and diverse community partners is increasingly recognized as important for promoting positive public health outcomes, addressing social determinants of health, and reducing health inequalities. This study investigates collaborations between SHDs in the United States and different types of organizations addressing chronic disease in and outside of the health sector.

Methods: SHD employees were randomly selected from the National Association of Chronic Disease Directors membership list for participation in an online survey.

How to "Start Small and Just Keep Moving Forward": Mixed Methods Results From a Stepped-Wedge Trial to Support Evidence-Based Processes in Local Health Departments.

Background: Local health departments (LHDs) in the United States are charged with preventing disease and promoting health in their respective communities. Understanding and addressing what supports LHD's need to foster a climate and culture supportive of evidence-based decision making (EBDM) processes can enhance delivery of effective practices and services.

Methods: We employed a stepped-wedge trial design to test staggered delivery of implementation supports in 12 LHDs (Missouri, USA) to expand capacity for EBDM processes.

Mapping the Lay of the Land: Using Interactive Network Analytic Tools for Collaboration in Rural Cancer Prevention and Control.

Background: Cancer mortality rates in the United States are higher in rural than urban areas, especially for colorectal cancer. Modifiable cancer risks (e.g.

"It's good to feel like you're doing something": a qualitative study examining state health department employees' views on why ineffective programs continue to be implemented in the USA.

Background: Mis-implementation, the inappropriate continuation of programs or policies that are not evidence-based or the inappropriate termination of evidence-based programs and policies, can lead to the inefficient use of scarce resources in public health agencies and decrease the ability of these agencies to deliver effective programs and improve population health. Little is known about why mis-implementation occurs, which is needed to understand how to address it. This study sought to understand the state health department practitioners' perspectives about what makes programs ineffective and the reasons why ineffective programs continue.

Approaches for Ending Ineffective Programs: Strategies From State Public Health Practitioners.

Public health agencies are increasingly concerned with ensuring they are maximizing limited resources by delivering evidence-based programs to enhance population-level chronic disease outcomes. Yet, there is little guidance on how to end ineffective programs that continue in communities. The purpose of this analysis is to identify what strategies public health practitioners perceive to be effective in de-implementing, or reducing the use of, ineffective programs.

A systematic review of school health policy measurement tools: implementation determinants and outcomes.

Background: Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed.

Patterns and correlates of mis-implementation in state chronic disease public health practice in the United States.

Background: Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones.

Use and Awareness of The Community Guide in State and Local Health Department Chronic Disease Programs.

Introduction: The Community Guide (Guide) is a user-friendly, systematic review system that provides information on evidence-based interventions (EBIs) in public health practice. Little is known about what predicts Guide awareness and use in state health departments (SHDs) and local health departments (LHDs).

Methods: We pooled data from 3 surveys (administered in 2016, 2017, and 2018) to employees in chronic disease programs at SHDs and LHDs.

The Association Between Evidence-Based Decision Making and Accreditation of State Health Departments.

Objective: To assess the association between evidence-based decision making, including implementation of evidence-based interventions (EBIs), with accreditation of state health departments through the Public Health Accreditation Board (PHAB).

Design: This was a cross-sectional, electronic survey of state health department practitioners. We utilized a survey instrument focused on evidence-based public health, de-implementation, and sustainability of public health programs.

Quantitative measures of health policy implementation determinants and outcomes: a systematic review.

Background: Public policy has tremendous impacts on population health. While policy development has been extensively studied, policy implementation research is newer and relies largely on qualitative methods. Quantitative measures are needed to disentangle differential impacts of policy implementation determinants (i.

Perspectives on program mis-implementation among U.S. local public health departments.

Background: Public health resources are limited and best used for effective programs. This study explores associations of mis-implementation in public health (ending effective programs or continuing ineffective programs) with organizational supports for evidence-based decision making among U.S.

Local Health Department Accreditation Is Associated With Organizational Supports for Evidence-Based Decision Making.

Recent studies show that health department accreditation from the U.S. Public Health Accreditation Board (PHAB) drives performance management and quality improvement.

Assessing Organizational Supports for Evidence-Based Decision Making in Local Public Health Departments in the United States: Development and Psychometric Properties of a New Measure.

Context: Fostering evidence-based decision making (EBDM) within local public health departments and among local health department (LHD) practitioners is crucial for the successful translation of research into public health practice to prevent and control chronic disease.

Objective: The purpose of this study was to identify organizational supports for EBDM within LHDs and determine psychometric properties of a measure of organizational supports for EBDM in LHDs.

Design: Cross-sectional, observation study.

Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis.

Objective: Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners.

Design: In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use.

Evidence-Based Public Health Provided Through Local Health Departments: Importance of Academic-Practice Partnerships.

Objectives: To determine the extent to which US local health departments (LHDs) are engaged in evidence-based public health and whether this is influenced by the presence of an academic health department (AHD) partnership.

Methods: We surveyed a cross-sectional stratified random sample of 579 LHDs in 2017. We ascertained the extent of support for evidence-based decision-making and the use of evidence-based interventions in several chronic disease programs and whether the LHD participated in a formal, informal, or no AHD partnership.

Scaling Up Evidence-Based Public Health Training.

Evidence-based public health (EBPH) is the process of integrating science-based interventions with community preferences. Training in EBPH improves the knowledge and skills of public health practitioners. To reach a wider audience, we conducted scale-up efforts including a train-the-trainer version of the EBPH course to build states' capacity to train additional staff.

Preparing Public Health Professionals to Make Evidence-Based Decisions: A Comparison of Training Delivery Methods in the United States.

Evidence-based decision making (EBDM) in health programs and policies can reduce population disease burden. Training in EBDM for the public health workforce is necessary to continue capacity building efforts. While in-person training for EBDM is established and effective, gaps in skills for practicing EBDM remain.