PMID- 28079646
OWN - NLM
STAT- MEDLINE
DCOM- 20180910
LR  - 20190122
IS  - 1550-5022 (Electronic)
IS  - 1078-4659 (Linking)
VI  - 24
IP  - 1
DP  - 2018 Jan/Feb
TI  - Public Health Agency Accreditation Among Rural Local Health Departments: 
      Influencers and Barriers.
PG  - 49-56
LID - 10.1097/PHH.0000000000000509 [doi]
AB  - OBJECTIVE: Health department accreditation is a crucial strategy for 
      strengthening public health infrastructure. The purpose of this study was to 
      investigate local health department (LHD) characteristics that are associated 
      with accreditation-seeking behavior. This study sought to ascertain the effects 
      of rurality on the likelihood of seeking accreditation through the Public Health 
      Accreditation Board (PHAB). DESIGN: Cross-sectional study using secondary data 
      from the 2013 National Association of County & City Health Officials (NACCHO) 
      National Profile of Local Health Departments Study (Profile Study). SETTING: 
      United States. PARTICIPANTS: LHDs (n = 490) that responded to the 2013 NACCHO 
      Profile Survey. MAIN OUTCOME MEASURES: LHDs decision to seek PHAB accreditation. 
      RESULTS: Significantly more accreditation-seeking LHDs were located in urban 
      areas (87.0%) than in micropolition (8.9%) or rural areas (4.1%) (P < .001). LHDs 
      residing in urban communities were 16.6 times (95% confidence interval [CI], 
      5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to 
      seek PHAB accreditation than rural LHDs (RLHDs). LHDs that had completed an 
      agency-wide strategic plan were 8.5 times (95% CI, 4.0-17.9), LHDs with a local 
      board of health were 3.3 times (95% CI, 1.5-7.0), and LHDs governed by their 
      state health department were 12.9 times (95% CI, 3.3-50.0) more likely to seek 
      accreditation. The most commonly cited barrier was time and effort required for 
      accreditation application exceeded benefits (73.5%). CONCLUSION: The strongest 
      predictor for seeking PHAB accreditation was serving an urban jurisdiction. 
      Micropolitan LHDs were more likely to seek accreditation than smaller RLHDs, 
      which are typically understaffed and underfunded. Major barriers identified by 
      the RLHDs included fees being too high and the time and effort needed for 
      accreditation exceeded their perceived benefits. RLHDs will need additional 
      financial and technical support to achieve accreditation. Even with additional 
      funds, clear messaging of the benefits of accreditation tailored to RLHDs will be 
      needed.
FAU - Beatty, Kate E
AU  - Beatty KE
AD  - Department of Health Services Management and Policy, College of Public Health, 
      East Tennessee State University, Johnson City, Tennessee (Dr Beatty); Department 
      of Public Health, College of Education, Health, and Human Sciences, University of 
      Tennessee, Knoxville, Tennessee (Dr Erwin); Brown School, Prevention Research 
      Center in St Louis, Division of Public Health Sciences and Alvin J. Siteman 
      Cancer Center, School of Medicine, Washington University in St Louis, St Louis, 
      Missouri (Dr Brownson); and NORC Walsh Center for Rural Health Analysis, NORC at 
      the University of Chicago, Bethesda, Maryland (Messrs Meit and Fey).
FAU - Erwin, Paul Campbell
AU  - Erwin PC
FAU - Brownson, Ross C
AU  - Brownson RC
FAU - Meit, Michael
AU  - Meit M
FAU - Fey, James
AU  - Fey J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Public Health Manag Pract
JT  - Journal of public health management and practice : JPHMP
JID - 9505213
MH  - Accreditation/*methods/standards
MH  - Cross-Sectional Studies
MH  - Humans
MH  - Local Government
MH  - Multivariate Analysis
MH  - Public Health/*standards
MH  - Public Health Administration/standards
MH  - Quality Improvement/trends
MH  - Rural Health/trends
MH  - Statistics, Nonparametric
MH  - Surveys and Questionnaires
MH  - United States
EDAT- 2017/01/13 06:00
MHDA- 2018/09/11 06:00
CRDT- 2017/01/13 06:00
PHST- 2017/01/13 06:00 [pubmed]
PHST- 2018/09/11 06:00 [medline]
PHST- 2017/01/13 06:00 [entrez]
AID - 10.1097/PHH.0000000000000509 [doi]
PST - ppublish
SO  - J Public Health Manag Pract. 2018 Jan/Feb;24(1):49-56. doi: 
      10.1097/PHH.0000000000000509.