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Effectiveness of Public Health Quality Improvement Training Approaches: Application, Application, Application

Davis, Mary V. DrPH, MSPH, NCIPH; Vincus, Amy MPH; Eggers, Matthew MPH; Mahanna, Elizabeth MPH; Riley, William PhD; Joly, Brenda PhD; Fisher, Jessica Solomon MCP; Bowling, Michael J. PhD

Journal of Public Health Management and Practice: January/February 2012 - Volume 18 - Issue 1 - p E1–E7
doi: 10.1097/PHH.0b013e3182249505
Research Articles

Context: Quality improvement (QI) has been identified as a key strategy to improve the performance of state and local public health agencies. Quality improvement training effectiveness has received little attention in the literature.

Objectives: To evaluate the effectiveness of 3 QI training types: webinars, workshops, and demonstration site activities on improving participant knowledge, skill, and ability to conduct QI through a questionnaire conducted after training participation.

Design: We used a natural experimental design hypothesizing that demonstration site participants would have the greatest gains on outcomes of interest compared with webinar and workshop participants. Bivariate and multivariate models were used to examine outcome differences between questionnaire respondents who participated in various training types.

Participants: Local health department employees who participated in the 3 training strategies.

Main Outcome Measures: Measures included knowledge and skill gain, skill application, QI receptivity, and ability to successfully participate in a QI project.

Results: Two hundred eighty-four unique individuals who work in 143 health departments completed the questionnaire for a 59% response rate. The majority of these health departments serve midsize populations. Demonstration site respondents had significantly greater gains in knowledge and skills, skill application, and ability to successfully participate in a QI project. Webcast training participants had significantly higher QI receptivity in adjusted models. Respondents who participated in both webcast and demonstration site trainings had higher mean scores on all outcomes when compared with demonstration site single training participants, these differences were significant in unadjusted models.

Conclusion: Our findings suggest that QI training for public health agency employees should include both didactic training on QI content and opportunities for QI application. Future research should examine if this approach can effectively increase successful participation in QI projects for staff in LHDs of all sizes.

This study evaluates the effectiveness of three quality improvement training types—webinars, workshops, and demonstration site activities—on improving participant knowledge, skill, and ability to conduct quality improvement through a questionnaire conducted after training participation.

North Carolina Institute for Public Health (Dr Davis, Mr Eggers, and Mss Vincus and Mahanna), Department of Health Behavior and Health Education (Drs Davis and Bowling and Mr Eggers), and Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill; School of Public Health, University of Minnesota (Dr Riley); Muskie School of Public Service, University of Southern Maine, Portland (Dr Joly); and National Association of County and City Health Officials, Washington, District of Columbia (Ms Fisher).

Correspondence: Mary V. Davis, DrPH, MSPH, NCIPH, UNC Gillings School of Global Public Health, CB 8165,Chapel Hill, NC 27599 (

Funding for this study was provided by Robert Wood Johnson Foundation, Human Capital Group, Evidence for Improvement: Evaluating Quality Improvement Training Programs. The authors thank Carolyn Leep, Penney Berryman, Grace Gorenflo, Pooja Varma, and the National Association of County and City Health Officials for assistance with this project.

Disclosure: The authors declare no conflict of interest.

© 2012 Lippincott Williams & Wilkins, Inc.