title: Evidence-based public health practice among program managers in local public health departments.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Public Health, University of Tennessee, Knoxville, Tennessee (Dr Erwin); Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri (Drs Harris and Brownson); Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri (Ms Smith, Ms Duggan, and Dr Brownson); and National Association of County & City Health Officials, Washington, District of Columbia (Ms Leep).
authors.forename: Paul Campbell
authors.initials: PC
authors.lastname: Erwin
authors.forename: Jenine K
authors.initials: JK
authors.lastname: Harris
authors.forename: Carson
authors.initials: C
authors.lastname: Smith
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Leep
authors.forename: Kathleen
authors.initials: K
authors.lastname: Duggan
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
mesh_terms: D002908:Chronic Disease; D003141:Communicable Diseases; D004522:Educational Status; D004782:Environmental Health; D055317:Evidence-Based Practice; D006801:Humans; D015279:Organizational Culture; D011361:Professional Competence; D015980:Public Health Practice; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D014481:United States