title: Understanding administrative evidence-based practices: findings from a survey of local health department leaders.
abstract: BACKGROUND
  There are sparse data showing the extent to which evidence-based public health is occurring among local health departments.
  
  
  OBJECTIVE
  The purpose of the study was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance measures) in a representative sample of local health departments in the U.S.
  
  
  METHODS
  A cross-sectional study of 517 local health department directors was conducted from October through December 2012 (analysis in January-March 2013). The questions on administrative evidence-based practices included 19 items based on a recent literature review (five broad domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, financial processes).
  
  
  RESULTS
  There was a wide range in performance among the 19 individual administrative evidence-based practices, ranging from 35% for providing access to current information on evidence-based practices to 96% for funding via a variety of sources Among the five domains, values were generally lowest for organizational climate and culture (mean for the domain=49.9%) and highest for relationships and partnerships (mean for the domain=77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted ORs [aORs] ranging from 4.4 to 7.5) and state governance structure (aOR=3.1).
  
  
  CONCLUSIONS
  This research on the patterns and predictors of administrative evidence-based practices in health departments provides information on gaps and areas for improvement that can be linked with ongoing quality improvement processes.
authors.affiliation: Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri. Electronic address: rbrownson@wustl.edu.
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
authors.affiliation: Pontifical Catholic University of Parana, School of Health and Biosciencesand the Federal University of Parana, Department of Physical Education, Curitiba, Brazil.
authors.forename: Rodrigo S
authors.initials: RS
authors.lastname: Reis
authors.affiliation: Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri.
authors.forename: Peg
authors.initials: P
authors.lastname: Allen
authors.affiliation: Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Duggan
authors.affiliation: Prevention Research Center in St. Louis, Brown School, St. Louis, Missouri.
authors.forename: Robert
authors.initials: R
authors.lastname: Fields
authors.affiliation: College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Stamatakis
authors.affiliation: Department of Public Health, University of Tennessee, Knoxville, Tennessee.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Erwin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055317:Evidence-Based Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D009111:Local Government; D008297:Male; D008875:Middle Aged; D011635:Public Health Administration / Q000706:statistics & numerical data*; D014481:United States