Journal of Public Health Management and Practice最新文献

Objectives: The aim is to determine if comprehensive messages about public health situations that acknowledge uncertainty and explain scientific processes increase perceived trustworthiness and scientific understanding relative to less enhanced messages focusing on situational facts.

Design: Participants were randomly assigned to 1 of 4 message groups across which messages about a hypothetical foodborne illness outbreak varied.

Participants: A total of 4040 participants who completed Porter Novelli's PN View survey in August 2024.

Main outcome measures: Perceived trustworthiness of the message and perceived understanding of the foodborne illness outbreak investigation process.

Results: Messages varied in their effects on perceived trustworthiness and understanding. Participants who viewed an enhanced message (including an explicit statement of a reason for stated uncertainty, assurance that uncertainty is normal in such circumstances, a statement about when new information will be provided, and a commitment to providing an update) reported significantly greater perceived message trustworthiness and reported the highest average score on a scale measure of assurance and understanding in response to the message.

Discussion: Public health staff face important challenges in attempting to inform communities about complex and evolving circumstances such as the outbreak of foodborne illness. Although staff may be tempted to minimize announcements and only report the most basic facts about a known situation, our study demonstrates that enhanced communication efforts can improve perceived trustworthiness and community understanding. Including additional message elements that express compassion, acknowledge uncertainty, and explain the scientific efforts being conducted to investigate the situation appears to positively affect audience response and hold potential to improve community relations.

Objectives: To evaluate the United States' National HIV Surveillance System (NHSS), 2018-2023.

Design: Surveillance performance outcome standards were calculated by health departments using a SAS program provided by the Centers for Disease Control and Prevention (CDC) and were reported to CDC through an annual report.

Setting: Submitted data from 59 health departments including the 50 US states, the District of Columbia, 6 separately funded cities (Chicago, Houston, Los Angeles County, New York City, Philadelphia, and San Francisco), and 2 territories (Puerto Rico and the US Virgin Islands).

Participants: Cases of HIV reported to the health departments based on data reported through the end of each year, 2018-2023.

Main outcome measures: Outcome standards included measures for case ascertainment, duplicate review, risk factor information, data quality, laboratory reporting, antiretroviral use history information, cause of death, previous negative test result, geocoding, and data dissemination.

Results: Achievement varied by standard with almost all health departments (HDs) meeting certain standards every year and fewer than 10 HDs achieving other standards.

Conclusions: During the period of assessment, results showed steady and improved performance in several measures. Standards related to recent enhancements in the surveillance system were not as resilient and showed potential for improvement. Continued monitoring is necessary to ensure further strengthening of NHSS.

Objectives: To advance the public health system's understanding and ability to measure the extent to which agencies reflect the communities they serve, our objective was to develop and deploy an agency-level representation index. This measure will quantify the extent to which each agency's workforce demographics align with the demographics of the agency's catchment area.

Design: Data for this analysis came from the 2024 Public Health Workforce Interests and Needs Survey (PH WINS), US Census Bureau American Community Survey (ACS), the Association of State and Territorial Health Officials Profile, and the National Association of County and City Health Officials Profile.

Setting: Representation index was calculated for 48 state health agency central offices and for 34 Big City Health Coalition (BCHC) member agencies.

Participants: The 2024 PH WINS was distributed online to state and local government public health workers across 48 state health agencies and 1178 local health departments in 49 states, with a total of 56 595 employees completing the survey, representing a 37% response rate of eligible employees.

Main outcome measures: Representation index was calculated, with demographic categories and agency characteristics explored for agencies and the populations they serve.

Results: Representation varied for state health agency central offices and BCHC agencies across the US. In general, greater demographic representation was found for ethnicity and race than for age and gender. We found few agency characteristics that were significantly associated with representation index values, although substantively important variation across agencies was noted.

Conclusions: Representativeness varies across state and big city health departments. Substantively large variation across settings, coupled with the lack of significant agency characteristic correlations, suggests a potential opportunity for improvement and for further research. Findings may inform public health practitioners in assessing current staff composition and provide insight into organizational strategies to increase diversity in the public health workforce.

Public health data and tools have proliferated, yet practical guidance for community-engaged data-driven decision making is limited. The HEALing Communities Study (HCS) was a randomized, wait-list controlled trial to assess the impact of an intervention to reduce fatal opioid overdoses in 67 highly affected communities across 4 sites (Kentucky, Massachusetts, New York, and Ohio). HCS researchers implemented the Communities That HEAL intervention, a phased approach which included a coalition-engaged, data-driven approach to selection of evidence-based practice strategies to reduce fatal opioid overdoses. Core steps to the data-driven approach included data selection, access, display, and engagement. Staff selected metrics that aligned with study goals, accessed data from numerous sources, created visualizations, and engaged coalition members to assess resource gaps and intervention opportunities. At the intervention conclusion, all 4 sites' staff collectively workshopped best practices and barriers encountered to data-driven decision making. This article explains the data-driven decision-making approach implemented, assessment results, alterations for subsequent implementation, and guidance for future implementations.

We analyzed a nationally representative sample of local public health professionals (LPHPs) from varying jurisdiction sizes across the United States who responded to the 2024 Public Health Workforce Interests and Needs Survey (PH WINS). Our goal was to explore experiences of burnout; perceived belonging within an agency; self-rated mental and emotional well-being; and intentions to leave an organization. Results showed that burnout was negatively associated with and perceived belonging within an agency was positively associated with ratings of mental and emotional health. Each of these 3 variables were associated with an intent to leave an organization in the next year. We discuss implications to-and recommendations for mitigating-attrition of the nation's local public health workforce after the size of the LPHP workforce rebounded following over a decade of decline.

Objective: This analysis examines the alignment of the Public Health Accreditation Board (PHAB) standards, the Mobilizing for Action through Planning and Partnerships (MAPP) model, and the Pennel evaluation tool. Despite the growing use of Community Health Assessments (CHAs) and Community Health Improvement Plans (CHIPs), variation in quality and evaluation persists. The analysis identifies convergence, divergence, and integration opportunities to inform more cohesive and sustainable public health improvement strategies.

Design: An alignment analysis was conducted through a document review of the PHAB Standards (v2022, initial accreditation), the MAPP model, and the 17-item Pennel evaluation tool. A structured matrix categorized alignment as full, partial, or absent, supported by thematic coding and expert validation for consistency and reliability.

Setting: The present analysis focuses on the approaches used by US local health departments conducting CHA/CHIP development and accreditation activities.

Participants: The unit of analysis was not individuals but rather the core components of each approach as articulated in public documentation, handbooks, and peer-reviewed sources.

Main outcome measures: Alignment was evaluated across three themes: Community Engagement & Governance, Data and Health Equity, and Strategy Development & Implementation.

Results: The analysis revealed strong alignment across the approaches in stakeholder engagement, data-informed decision-making, and goal setting. Divergence was observed in implementation specificity and sustainability planning. PHAB emphasized compliance documentation; MAPP prioritized participatory planning; and the Pennel tool provided guidance on evaluation and accountability.

Conclusions: A complementary approach that integrates the evaluative rigor of the Pennel tool, the procedural depth of MAPP, and the accountability of PHAB could foster a more equitable, responsive, and sustainable public health improvement. Findings underscore the need for public health agencies to support this integration by developing implementation guidance, training, and resources for evaluation. This integration has the potential to bridge accreditation compliance and meaningful health outcomes, advancing toward Public Health 3.0.

Context: Governmental public health workers age 35 or younger have been shown to experience lower retention rates than older workers. Salaries are often a factor in retention, but because health departments sometimes face restrictions in improving salaries, health departments might explore offering nontraditional benefits to attract and retain workers.

Objective: We sought to analyze data from the 2024 Public Health Workforce Interests and Needs Survey (PH WINS) to determine whether nontraditional benefits are more highly valued by younger workers than older workers.

Design: We selected respondents of 2024 PH WINS who were permanent, full-time health department employees, then created 2 subgroups of these respondents, one age 35 and younger, and the other over age 35, and compared their responses to survey questions regarding nontraditional benefits, reasons to stay in their jobs, and, for those 35 and younger, the factors which attracted them to governmental public health.

Results: Younger PH WINS respondents were significantly more likely to value nontraditional benefits than older workers. The findings were generally consistent with the literature.

Conclusions: Health departments could improve retention of younger workers by offering nontraditional benefits.