School of Nursing and Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.
J Public Health Manag Pract. 2012 Nov;18(6):602-8. doi: 10.1097/PHH.0b013e31825d20ac.
To determine how a health officials' advice network might contribute to a high-performing public health systems by facilitating diffusion of innovation and best practices.
A secondary analysis of cross-sectional data obtained from the National Association of County and City Health Officials 2010 Profile of local health departments (LHDs) using network analysis.
The Profile survey is distributed biannually to all 2565 LHDs in the United States. In 2010, it included a network question: "In thinking about your peers who lead other local health departments in the U.S., list the five LHDs whose leaders you communicate with most frequently about administrative, professional, and leadership issues in public health."
The network question was answered only by the top executive. The subjects are 1522 health officials who answered the network question plus 477 named as contacts (n = 1999).
Measurements to assess network topology were density, centralization, transitivity, and reciprocity. At the node level, average centrality, clustering, effective network size, and clique count were measured. The convergence of iterated correlations algorithm was used to detect subgroups.
: A sparsely connected core periphery network exhibited minimal evidence of unified communication. Mutually connected small groups tend to clump within state boundaries suggesting gaps in information flow. The pattern persisted at the regional level with an average health official having an effective network of only 2 others.
Communication between peers may not be the primary way professional information diffuses among local health officials. National groups involved in performance improvement may wish to consider strategies to increase the diffusion of best practices and innovations through this network.
通过促进创新和最佳实践的传播，确定卫生官员咨询网络如何有助于提高高效的公共卫生系统。
使用网络分析对 2010 年全国县和市卫生官员协会（National Association of County and City Health Officials）对当地卫生部门（LHD）的概况（Profile）调查的横断面数据进行二次分析。
该概况调查每两年向美国所有 2565 个 LHD 分发一次。在 2010 年，它包括一个网络问题：“在考虑领导美国其他地方卫生部门的同行时，请列出您与哪些 LHD 领导人就公共卫生领域的行政、专业和领导问题进行最频繁沟通的五个 LHD。”
只有最高行政人员回答了网络问题。研究对象是 1522 名回答网络问题的卫生官员和 477 名被提名的联系人（n = 1999）。
评估网络拓扑结构的测量包括密度、集中化、传递性和互惠性。在节点水平上，测量平均中心性、聚类、有效网络规模和集团数。使用迭代相关算法的收敛性来检测子群。
稀疏连接的核心边缘网络显示出最小的统一通信证据。相互连接的小团体往往聚集在州界内，表明信息流存在差距。这种模式在区域层面上持续存在，平均每个卫生官员的有效网络只有另外 2 人。
同行之间的沟通可能不是地方卫生官员之间专业信息传播的主要方式。参与绩效改进的国家团体可能希望考虑通过这个网络增加最佳实践和创新的传播策略。
