Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
Pontifical Catholic University of Parana, School of Health and Biosciencesand the Federal University of Parana, Department of Physical Education, Curitiba, Brazil.
Am J Prev Med. 2014 Jan;46(1):49-57. doi: 10.1016/j.amepre.2013.08.013.
There are sparse data showing the extent to which evidence-based public health is occurring among local health departments.
The purpose of the study was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance measures) in a representative sample of local health departments in the U.S.
A cross-sectional study of 517 local health department directors was conducted from October through December 2012 (analysis in January-March 2013). The questions on administrative evidence-based practices included 19 items based on a recent literature review (five broad domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, financial processes).
There was a wide range in performance among the 19 individual administrative evidence-based practices, ranging from 35% for providing access to current information on evidence-based practices to 96% for funding via a variety of sources Among the five domains, values were generally lowest for organizational climate and culture (mean for the domain=49.9%) and highest for relationships and partnerships (mean for the domain=77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted ORs [aORs] ranging from 4.4 to 7.5) and state governance structure (aOR=3.1).
This research on the patterns and predictors of administrative evidence-based practices in health departments provides information on gaps and areas for improvement that can be linked with ongoing quality improvement processes.
关于循证公共卫生在地方卫生部门的实施程度，相关数据十分有限。
本研究旨在描述美国具有代表性的地方卫生部门行政循证实践（与绩效指标相关的结构和活动）的模式和预测因素。
2012 年 10 月至 12 月期间对 517 名地方卫生部门主管进行了横断面研究（分析于 2013 年 1 月至 3 月进行）。行政循证实践相关问题包括基于近期文献综述的 19 项内容（五个广泛领域：劳动力发展、领导力、组织氛围和文化、关系和伙伴关系、财务流程）。
19 项行政循证实践的表现差异较大，从提供获取循证实践当前信息的机会（35%）到通过各种来源提供资金（96%）不等。在五个领域中，组织氛围和文化的价值观普遍最低（领域平均得分 49.9%），关系和伙伴关系的价值观最高（领域平均得分 77.1%）。与达到行政循证实践最高三分位数相关的变量包括人口管辖范围为 25,000 或更大（调整后的比值比 [aOR] 范围为 4.4 至 7.5）和州治理结构（aOR=3.1）。
本研究关于卫生部门行政循证实践模式和预测因素的研究提供了差距和改进领域的信息，这些信息可以与正在进行的质量改进过程相关联。
