North Carolina public health agency accreditation and performance: the climb from good to extraordinary Public Deposited

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Last Modified
  • March 21, 2019
Creator
  • Cilenti, Dorothy
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
Abstract
  • The objective of this study was to determine how local public health agency accreditation impacts public health performance. Survey data collected in October 2008 from 80 local health agencies in North Carolina compared accredited and non-accredited local public health agency performance on three domains: policy development and implementation, community engagement, and leadership behavior. Secondary data analysis using performance data from the NC Center for Health Statistics compared North Carolina counties served by accredited and non-accredited local public health agencies on 13 performance indicators. Finally, key informant interviews with health directors and management team members from high performing local public health agencies supplemented findings from the surveys and performance indicator data. A cross-sectional survey design was used to assess local public health agency performance on key activities associated with the NC Local Health Department Accreditation Program. Descriptive analyses were conducted consisting of question-specific frequency distributions with p-values used to determine whether there were significant differences in scores for each domain based on the accreditation status of the responding agency. Time-series comparisons of performance improvement in accredited and non-accredited local public health agencies were conducted to describe patterns of variation in performance improvement across accredited and non-accredited agencies. A thematic analysis of transcripts from key informant interviews was conducted using across-case matrices derived from within-case summaries. Findings indicated that accredited and non-accredited local public health agencies in North Carolina differed with respect to the degree to which they demonstrated policy development and implementation and community engagement, with accredited local public health agencies demonstrating higher scores on these domains. These findings may provide valuable information to North Carolina public health leaders and the national voluntary accreditation efforts regarding ways to ensure that local public health agency accreditation drives high performance.
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  • In Copyright
Advisor
  • Baker, Edward L.
Degree granting institution
  • University of North Carolina at Chapel Hill
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  • Open access
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