title: Characteristics of Kentucky local health departments that influence public health communication during times of crisis: information dissemination associated with H1N1 novel influenza.
abstract: OBJECTIVE
  The purpose of this study was to investigate the association of selected characteristics of local health departments (LHDs) in Kentucky with the receipt of information by external stakeholders, specifically physicians and pharmacists, during the initial H1N1 outbreak of 2009.
  
  
  METHODS
  This study utilized a cross-sectional survey to gather characteristic information from local health departments. In addition, cross sectional surveys of physicians and pharmacists were used to determine information receipt. All 54 LHDs in Kentucky were surveyed; however, only those physicians belonging to the Kentucky Family Physician Association or the Kentucky Ambulatory Network were surveyed. Also, pharmacists included in this survey were members of the Kentucky Pharmacist Association. Descriptive data analyses, including chi-square test of independence, were conducted, and generalized estimating equations were used to calculate odds ratios to depict associations related to information exchange in this study.
  
  
  RESULTS
  Response rates for the study were as follows: LHDs 65% (35/54), physicians 18.5% (96/518), and pharmacists 21.1% (211/1000). Of the 35 participating LHDs the most common characteristic identified was the presence of a public information officer (PIO) and a pandemic influenza plan, 76% and 64%, respectively. Despite these factors, 72% of external stakeholders did not receive any information regarding H1N1 from the LHD. Generalized estimating equations also indicated that stakeholders in jurisdictions lacking a PIO had 6 (95% confidence interval, 1.3-26.95) greater odds of not receiving information from the LHD. External stakeholders in jurisdictions without a pandemic influenza plan had 3.38 (95% confidence interval, 0.80-1.17) increased odds of not receiving information but this association was not statistically significant.
  
  
  CONCLUSIONS
  Observations from this study indicate a need to improve information exchange between LHDs and their external stakeholders, specifically physicians and pharmacists. Present results suggest the designation of a PIO may positively influence communication between LHDs and other health care providers, particularly physicians.
authors.affiliation: College of Public Health, University of Kentucky, Lexington, KY 40536, USA. afhowa3@uky.edu
authors.forename: Alex F
authors.initials: AF
authors.lastname: Howard
authors.forename: Heather M
authors.initials: HM
authors.lastname: Bush
authors.forename: Robert M
authors.initials: RM
authors.lastname: Shapiro
authors.forename: Angela
authors.initials: A
authors.lastname: Dearinger
mesh_terms: D000288:Administrative Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D003195:Computer Communication Networks / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000517:prevention & control*; D033181:Information Dissemination; D007256:Information Systems; D033183:Interdisciplinary Communication; D007373:Interinstitutional Relations; D007629:Kentucky; D009111:Local Government; D010595:Pharmacists / Q000523:psychology / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D011635:Public Health Administration; D012308:Risk Management; D012932:Social Facilitation; D011795:Surveys and Questionnaires; D000078329:Workforce