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Public Health Senior Deputy's Perceptions of State Health Officials' Success Factors

Professional Characteristics, Personal Attributes, and Signs of Derailment

Boedigheimer, Steven F. MBA; Yeager, Valerie A. DrPH; Chapple-McGruder, Theresa PhD; Moffatt, Sharon BSN, MS; Halverson, Paul K. DrPH for the SHO-CASE Steering Committee

Journal of Public Health Management and Practice: January/February 2020 - Volume 26 - Issue 1 - p 16–22
doi: 10.1097/PHH.0000000000000934
Research Reports: Research Full Report

Context: Senior deputies work closely with state health officials (SHOs) in state public health agencies and are a valuable resource for understanding their roles, responsibilities, and characteristics.

Objective: Examine senior deputies' perceptions of SHO success factors.

Design: Qualitative study including nominal group technique focus groups, a small expert focus group, and interviews.

Setting: US state public health agencies.

Participants: Senior deputies in state public health agencies 2016/2017.

Main Outcome Measures: Perceptions of SHO success factors.

Results: The most commonly perceived professional characteristics of a successful SHO included the following: credible trusted voice with internal respect/external credibility; improves public health prominence/visibility with an evidence-based agenda; and grows the agency/leaves it stronger. Perceptions of the most common personal attributes for success included excellent listening skills; credibility/honesty/trustworthiness; and public health experience/knowledge. The most commonly perceived signs of SHO derailment included when SHOs have a visible lack of support of elected officials (eg, governor/legislators) and when the SHO is “bypassed” by elected officials.

Conclusions: A key finding of this study centers on the relationship between the SHO and the governor; meeting the expectations of the governor was identified as a significant professional characteristic of success. Findings highlight the expectation that SHOs have a clear understanding of the governor's priorities and how to relate to the governor's office early in their tenure. This goal should be a priority for transition teams that aid new SHOs as they begin in their new roles. Study insights can help better prepare for orientation/onboarding of new SHOs. Development of key transition documents and tools for rapid onboarding should be considered. Transition teams should assist new SHOs in establishing an understanding of the governor's priorities and how to best communicate with to the governor's office early in their tenure. Strong senior management teams should be prioritized and fostered.

Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Mr Boedigheimer and Drs Yeager and Halverson); de Beaumont Foundation, Bethesda, Maryland (Dr Chapple-McGruder); and Association of State and Territorial Health Officials, Arlington, Virginia (Ms Moffatt).

Correspondence: Valerie A. Yeager, DrPH, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN 46202 (

Additional authors for the SHO-CASE Steering Committee include Edward L. Baker, Brian C. Castrucci, Elizabeth Gould, Corey M. Jacinto, Glen Mays, Nir Menachemi, and Hugh Tilson. The SHO-CASE study is a collaborative effort between the Indiana University Richard M. Fairbanks School of Public Health, de Beaumont Foundation, and the Association of State and Territorial Health Officials (ASTHO). The authors thank Sue Hancock and Edward Baker for assistance in facilitating the focus groups and interviews. The authors thank the senior deputies who participated in this work, ASTHO for supporting the collection of these data, and the de Beaumont Foundation for their financial support of the project.

This work was funded by the de Beaumont Foundation.

The authors declare no conflicts of interest.

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