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Assessing Organizational Supports for Evidence-Based Decision Making in Local Public Health Departments in the United States

Development and Psychometric Properties of a New Measure

Mazzucca, Stephanie PhD; Parks, Renee G. MS; Tabak, Rachel G. PhD, RD; Allen, Peg PhD, MPH; Dobbins, Maureen PhD, RN; Stamatakis, Katherine A. PhD, MPH; Brownson, Ross C. PhD

Journal of Public Health Management and Practice: January 08, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000000952
Research Full Report: PDF Only
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Context: Fostering evidence-based decision making (EBDM) within local public health departments and among local health department (LHD) practitioners is crucial for the successful translation of research into public health practice to prevent and control chronic disease.

Objective: The purpose of this study was to identify organizational supports for EBDM within LHDs and determine psychometric properties of a measure of organizational supports for EBDM in LHDs.

Design: Cross-sectional, observation study.

Setting: Local public health departments in the United States.

Participants: Local health department practitioners (N = 376) across the United States participated in the study.

Main Outcome Measures: Local health department practitioners completed a survey containing 27 items about organizational supports for EBDM. Most items were adapted from previously developed surveys, and input from researchers and practitioners guided survey development. Confirmatory factor analysis was used to test and refine the psychometric properties of the measure.

Results: The final solution included 6 factors of 22 items: awareness of EBDM (3 items), capacity for EBDM (7 items), resources availability (3 items), evaluation capacity (3 items), EBDM climate cultivation (3 items), and partnerships to support EBDM (3 items). This factor solution achieved acceptable fit (eg, Comparative Fit Index = 0.965). Logistic regression models showed positive relationships between the 6 factors and the number of evidence-based interventions delivered.

Conclusions: This study identified important organizational supports for EBDM within LHDs. Results of this study can be used to understand and enhance organizational processes and structures to support EBDM to improve LHD performance and population health. Strong measures are important for understanding how LHDs support EBDM, evaluating interventions to improve LHD capacity, and to guide programmatic and policy efforts within LHDs.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St Louis, Missouri (Drs Mazzucca, Tabak, Allen, and Brownson and Ms Parks); National Collaborating Centre for Methods and Tools and Health Evidence, McMaster University, Ontario, Canada (Dr Dobbins); Department of Epidemiology, College for Public Health & Social Justice, Saint Louis University, St Louis, Missouri (Dr Stamatakis); and Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson).

Correspondence: Stephanie Mazzucca, PhD, Prevention Research Center in St Louis, Brown School, Washington University in St Louis, One Brookings Dr, Campus Box 1196, St Louis, MO 63130 (smazzucca@wustl.edu).

The authors appreciate the LHD practitioners for their participation in the national survey. They thank Dr Derek Hales for critical review of the analyses and statistical support. The authors thank their collaborators Diane Weber, executive director for Missouri Association for Local Public Health Agencies (MoALPHA), and the National Association of County & City Health Officials (NACCHO). With gratitude, they acknowledge the administrative support of Linda Dix, Mary Adams, and Cheryl Valko at the Prevention Research Center in St Louis, Brown School, Washington University in St Louis.

The authors’ contributions are as follows. Conceptualization and design: S.M., R.C.B., and K.A.S.; survey instrument development: R.C.B., R.G.T., P.A., K.A.S., and M.D.; statistical analysis: S.M.; review of analyses: S.M., R.C.B., R.G.P., R.G.T., P.A., K.A.S., and M.D.; writing: S.M., R.G.P., and R.C.B.; and manuscript content revisions: R.C.B., R.G.T., P.A., M.D., and K.A.S. All authors read and approved the final manuscript.

This study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award numbers 5R01DK109913, 1P30DK092950, and P30DK020579. The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the National Institutes of Health.

The authors declare that they have no competing interests.

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