Evidence-Based Public Health Practice Among Program Managers in Local Public Health Departments
Evidence-Based Public Health Practice Among Program Managers in Local Public Health Departments
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DOI：
10.1097/phh.0000000000000027
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发表时间：
2014-09-01
影响因子：
3.3
通讯作者：
Brownson, Ross C.
中科院分区：
文献类型：
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作者：
Erwin, Paul Campbell;Harris, Jenine K.;Brownson, Ross C.
目的：我们评估了使用行政循证实践（A-EBP）的项目管理人员在慢性病，环境卫生和传染病的样本在美国的地方卫生部门（LHD）。设计图：项目经理完成了一项调查，包括6个部分（传记数据，A-EBP的使用，扩散属性，资源的使用，以及循证公共卫生的障碍和能力），共66个问题。参会人员：该调查以电子方式发送给168名慢性病项目经理，179名环境卫生项目经理和175名传染病项目经理，代表228名LHD。该调查先前由517名LHD董事完成。测量：对19个单独的A-EBP、5个A-EBP领域以及所有领域的组合使用A-EBP进行评分。个人特征来自调查答复，LHD的其他数据来自全国县市卫生官员概况调查数据。项目经理的结果在3种类型的项目中进行了比较，并与之前对LHD董事的调查结果进行了比较。将分数排序并分类为三分位数。使用无条件logistic回归模型计算比值比和95%置信区间，比较A-EBP得分最高的三分之一与最低的三分之一的个人和机构特征。结果：来自项目经理的332份答复代表了196名LHD。项目经理在人口统计学特征、教育和经验方面存在差异（在3个项目中，并与LHD总监进行比较）。A-EBP的使用在特定的实践和个人之间有很大的差异，但大多数A-EBP的董事和项目经理的反应模式非常相似。结论：了解项目经理和LHD主任之间教育背景、经验、组织文化和A-EBP绩效的差异是提高循证公共卫生能力的必要步骤。
Objectives: We assessed the use of administrative-evidence based practices (A-EBPs) among managers of programs in chronic diseases, environmental health, and infectious diseases from a sample of local health departments (LHDs) in the United States. Design: Program managers completed a survey consisting of 6 sections (biographical data, use of A-EBPs, diffusion attributes, use of resources, and barriers to, and competencies in, evidence-based public health), with a total of 66 questions. Participants: The survey was sent electronically to 168 program managers in chronic diseases, 179 in environmental health, and 175 in infectious diseases, representing 228 LHDs. The survey had previously been completed by 517 LHD directors. Measures: The use of A-EBPs was scored for 19 individual A-EBPs, across the 5 A-EBP domains, and for all domains combined. Individual characteristics were derived from the survey responses, with additional data on LHDs drawn from linked National Association of County & City Health Officials Profile survey data. Results for program managers were compared across the 3 types of programs and to responses from the previous survey of LHD directors. The scores were ordered and categorized into tertiles. Unconditional logistic regression models were used to calculate odds ratios and 95% confidence intervals, comparing individual and agency characteristics for those with the highest third of A-EBPs scores with those with the lowest third. Results: The 332 total responses from program managers represented 196 individual LHDs. Program managers differed (across the 3 programs, and compared with LHD directors) in demographic characteristics, education, and experience. The use of A-EBPs varied widely across specific practices and individuals, but the pattern of responses from directors and program managers was very similar for the majority of A-EBPs. Conclusions: Understanding the differences in educational background, experience, organizational culture, and performance of A-EBPs between program managers and LHD directors is a necessary step to improving competencies in evidence-based public health.