Allen Peg, Mazzucca Stephanie, Parks Renee G, Robinson Mackenzie, Tabak Rachel G, Brownson Ross
Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States.
Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States.
Front Public Health. 2019 Dec 17;7:374. doi: 10.3389/fpubh.2019.00374. eCollection 2019.
Recent studies show that health department accreditation from the U.S. Public Health Accreditation Board (PHAB) drives performance management and quality improvement. PHAB standards call for agencies to use evidence in decision making. It is unknown whether accreditation is associated with organizational supports for evidence-based decision making (EBDM). Self-report data from a 2017 survey of U.S. local health departments were analyzed to test relationships of accreditation status with organizational supports for EBDM. A cross-sectional survey was conducted in this observational study. A total of 579 local health departments were invited to complete an online survey; 350 (60.4%) provided complete data for the present study. The dependent variables were six factors of organizational supports for EBDM previously validated through confirmatory factor analyses. Accreditation status (PHAB-accredited, preparing, not preparing) was the independent variable of interest. Logistic regression analyses controlled for governance (presence of a local board of health; state, local, or shared state and local governance) and jurisdiction population size. PHAB-accredited health departments were more likely to report higher capacity for EBDM, resource availability for EBDM, and evaluation capacity than health departments that reported not yet preparing for accreditation. Health departments that reported preparing for PHAB accreditation showed a non-significant pattern of higher perceived supports for EBDM compared to departments not preparing for accreditation. PHAB standards and the accreditation process may help stimulate health department organizational supports for EBDM.
近期研究表明，美国公共卫生认证委员会（PHAB）的卫生部门认证推动绩效管理和质量改进。PHAB标准要求各机构在决策中运用证据。目前尚不清楚认证是否与基于证据的决策制定（EBDM）的组织支持相关。对2017年美国地方卫生部门调查的自我报告数据进行分析，以检验认证状态与EBDM组织支持之间的关系。在这项观察性研究中进行了横断面调查。总共邀请了579个地方卫生部门完成一项在线调查；350个（60.4%）为本研究提供了完整数据。因变量是先前通过验证性因素分析验证的EBDM组织支持的六个因素。认证状态（PHAB认证、准备中、未准备）是感兴趣的自变量。逻辑回归分析控制了治理（地方卫生委员会的存在；州、地方或州与地方共享治理）和辖区人口规模。与报告尚未准备认证的卫生部门相比，获得PHAB认证的卫生部门更有可能报告更高的EBDM能力、EBDM资源可用性和评估能力。与未准备认证的部门相比，报告正在准备PHAB认证的卫生部门在EBDM方面的感知支持较高，但差异不显著。PHAB标准和认证过程可能有助于激发卫生部门对EBDM的组织支持。
