Luo Huabin, Winterbauer Nancy L, Shah Gulzar, Tucker Ashley, Xu Lei
Department of Public Health, Brody School of Medicine (Drs Luo and Winterbauer and Ms Tucker), and Department of Health Education and Promotion, College of Health and Human Performance (Dr Xu), East Carolina University, Greenville, North Carolina; and Department of Health Policy & Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah).
J Public Health Manag Pract. 2016 Jul-Aug;22(4):E21-8. doi: 10.1097/PHH.0000000000000353.
To describe levels of partnership between local health departments (LHDs) and other community organizations in maternal and child health (MCH), communicable disease prevention, and chronic disease control and to assess LHD organizational characteristics and community factors that contribute to partnerships.
Data were drawn from the National Association of County & City Health Officials' 2013 National Profile Study (Profile Study) and the Area Health Resources File. LHDs that received module 1 of the Profile Study were asked to describe the level of partnership in MCH, communicable disease prevention, and chronic disease control. Levels of partnership included "not involved," "networking," "coordinating," "cooperating," and "collaborating," with "collaborating" as the highest level of partnership. Covariates included both LHD organizational and community factors. Data analyses were conducted using Stata 13 SVY procedures to account for the Profile Study's survey design.
About 82%, 92%, and 80% of LHDs partnered with other organizations in MCH, communicable disease prevention, and chronic disease control programs, respectively. LHDs having a public health physician on staff were more likely to partner in chronic disease control programs (adjusted odds ratio [AOR] = 2.33; 95% confidence interval [CI], 1.03-5.25). Larger per capita expenditure was also associated with partnerships in MCH (AOR = 2.43; 95% CI, 1.22-4.86) and chronic disease prevention programs (AOR = 1.76; 95% CI, 1.09-2.86). Completion of a community health assessment was associated with partnership in MCH (AOR = 7.26; 95% CI, 2.90-18.18), and chronic disease prevention (AOR = 5.10; 95% CI, 2.28-11.39).
About 1 in 5 LHDs did not have any partnerships in chronic disease control. LHD partnerships should be promoted to improve care coordination and utilization of limited health care resources. Factors that might promote LHDs' partnerships include having a public health physician on staff, higher per capita expenditure, and completion of a community health assessment. Community context likely influences types and levels of partnerships. A better understanding of these contextual factors may lead to more complete and effective LHD partnerships.
描述地方卫生部门(LHDs)与其他社区组织在母婴健康(MCH)、传染病预防和慢性病控制方面的合作水平,并评估有助于合作的LHD组织特征和社区因素。
数据取自全国县市卫生官员协会2013年的全国概况研究(概况研究)和地区卫生资源文件。接受概况研究模块1的LHDs被要求描述在MCH、传染病预防和慢性病控制方面的合作水平。合作水平包括“未参与”“建立联系”“协调”“合作”和“协作”,其中“协作”是最高级别的合作。协变量包括LHD组织因素和社区因素。使用Stata 13的SVY程序进行数据分析,以考虑概况研究的调查设计。
分别约有82%、92%和80%的LHDs在MCH、传染病预防和慢性病控制项目中与其他组织合作。配备公共卫生医师的LHDs更有可能在慢性病控制项目中开展合作(调整后的优势比[AOR]=2.33;95%置信区间[CI],1.03 - 5.25)。人均支出较高也与MCH(AOR = 2.43;95% CI,1.22 - 4.86)和慢性病预防项目中的合作相关(AOR = 1.76;95% CI,1.09 - 2.86)。完成社区健康评估与MCH(AOR = 7.26;95% CI,2.90 - 18.18)和慢性病预防方面的合作相关(AOR = 5.10;95% CI,2.28 - 11.39)。
约五分之一的LHDs在慢性病控制方面没有任何合作。应促进LHDs的合作,以改善护理协调和有限医疗资源的利用。可能促进LHDs合作的因素包括配备公共卫生医师、较高的人均支出以及完成社区健康评估。社区背景可能影响合作的类型和水平。更好地了解这些背景因素可能会带来更全面、有效的LHDs合作。