Shah Gulzar H, Corso Liza, Sotnikov Sergey, Leep Carolyn J
Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia (Dr Shah); Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Corso and Dr Sotnikov); and National Association of County & City Health Officials, Washington, District of Columbia (Ms Leep).
J Public Health Manag Pract. 2019 Sep/Oct;25(5):423-430. doi: 10.1097/PHH.0000000000000847.
Local health departments (LHDs) are increasingly using national standards to meet the challenges presented by the complex environments in which these agencies operate. Local boards of health (LBoHs) might play an instrumental role in improving LHDs' engagement in activities to meet these standards.
To assess the impact of LBoH performance of governance functions on LHDs having a current (completed within 5 years) community health assessment (CHA), community health improvement plan (CHIP), strategic plan, and level of engagement in the Public Health Accreditation Board (PHAB) accreditation program.
Binary and multinomial logistic regression models were used to analyze linked data from 329 LHDs participating in both the 2015 Local Board of Health Survey and the 2016 National Profile of LHDs Survey.
Higher performance of LBoH governance functions, measured by an overall scale of LBoH taxonomy consisting of 60 items, had a significant positive effect on LHDs having completed CHA (P < .001), CHIP (P = .01), and strategic plan (P < .001). LHDs operating in communities with a higher score on the overall scale of LBoH taxonomy had significantly higher odds (P = .03) of having higher level of participation in the PHAB national voluntary accreditation program-that is, being accredited, having submitted application for accreditation, or being in the e-PHAB system (eg, by submitting a letter of intent).
LBoHs serve as governance bodies for roughly 71% of LHDs and can play a significant role in encouraging LHDs' participation in these practices. That positive influence of LBoHs can be seen more clearly if the complexity and richness of LBoH governance functions and other characteristics are measured appropriately. The study findings suggest that LBoHs are a significant component of the public health system in the United States, having positive influence on LHDs having a CHA, CHIP, strategic plan, and participation in accreditation.
地方卫生部门（LHDs）越来越多地采用国家标准来应对这些机构运作所处复杂环境带来的挑战。地方卫生委员会（LBoHs）可能在提高LHDs参与符合这些标准的活动方面发挥重要作用。
评估LBoH履行治理职能对LHDs开展当前（5年内完成）社区健康评估（CHA）、社区健康改善计划（CHIP）、战略计划以及参与公共卫生认证委员会（PHAB）认证项目的参与程度的影响。
使用二元和多项逻辑回归模型分析来自329个参与2015年地方卫生委员会调查和2016年LHDs全国概况调查的LHDs的关联数据。
以包含60个项目的LBoH分类法总体量表衡量，LBoH治理职能的更高绩效对已完成CHA（P <.001）、CHIP（P =.01）和战略计划（P <.001）的LHDs有显著的积极影响。在LBoH分类法总体量表得分较高的社区中运作的LHDs参与PHAB国家自愿认证项目的程度显著更高（P =.03），即获得认证、提交认证申请或进入电子PHAB系统（例如通过提交意向书）。
LBoHs是大约71%的LHDs的治理机构，并且在鼓励LHDs参与这些实践中可以发挥重要作用。如果对LBoH治理职能的复杂性和丰富性以及其他特征进行适当衡量，LBoHs的积极影响会更明显。研究结果表明，LBoHs是美国公共卫生系统的重要组成部分，对拥有CHA、CHIP、战略计划以及参与认证的LHDs有积极影响。
