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Perspectives on program mis-implementation among U.S. local public health departments.


ABSTRACT:

Background

Public health resources are limited and best used for effective programs. This study explores associations of mis-implementation in public health (ending effective programs or continuing ineffective programs) with organizational supports for evidence-based decision making among U.S. local health departments.

Methods

The national U.S. sample for this cross-sectional study was stratified by local health department jurisdiction population size. One person was invited from each randomly selected local health department: the leader in chronic disease, or the director. Of 600 selected, 579 had valid email addresses; 376 completed the survey (64.9% response). Survey items assessed frequency of and reasons for mis-implementation. Participants indicated agreement with statements on organizational supports for evidence-based decision making (7-point Likert).

Results

Thirty percent (30.0%) reported programs often or always ended that should have continued (inappropriate termination); organizational supports for evidence-based decision making were not associated with the frequency of programs ending. The main reason given for inappropriate termination was grant funding ended (86.0%). Fewer (16.4%) reported programs often or always continued that should have ended (inappropriate continuation). Higher perceived organizational supports for evidence-based decision making were associated with less frequent inappropriate continuation (odds ratio?=?0.86, 95% confidence interval 0.79, 0.94). All organizational support factors were negatively associated with inappropriate continuation. Top reasons were sustained funding (55.6%) and support from policymakers (34.0%).

Conclusions

Organizational supports for evidence-based decision making may help local health departments avoid continuing programs that should end. Creative mechanisms of support are needed to avoid inappropriate termination. Understanding what influences mis-implementation can help identify supports for de-implementation of ineffective programs so resources can go towards evidence-based programs.

SUBMITTER: Allen P 

PROVIDER: S-EPMC7106610 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Perspectives on program mis-implementation among U.S. local public health departments.

Allen Peg P   Jacob Rebekah R RR   Parks Renee G RG   Mazzucca Stephanie S   Hu Hengrui H   Robinson Mackenzie M   Dobbins Maureen M   Dekker Debra D   Padek Margaret M   Brownson Ross C RC  

BMC health services research 20200330 1


<h4>Background</h4>Public health resources are limited and best used for effective programs. This study explores associations of mis-implementation in public health (ending effective programs or continuing ineffective programs) with organizational supports for evidence-based decision making among U.S. local health departments.<h4>Methods</h4>The national U.S. sample for this cross-sectional study was stratified by local health department jurisdiction population size. One person was invited from  ...[more]

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