title: Describing the continuum of collaboration among local health departments with hospitals around the community health assessments.
abstract: BACKGROUND
  Hospitals and local health departments (LHDs) are under policy requirements from the Affordable Care Act and accreditation standards through the Public Health Accreditation Board. Tax exempt hospitals must perform a community health needs assessment (CHNA), similar to the community health assessment (CHA) required for LHDs. These efforts have led to a renewed interest in hospitals and LHDs working together to achieve common goals.
  
  
  OBJECTIVE
  The purpose of this study is to gain a better understanding of levels of joint action leading toward collaboration between LHDs and hospitals and describe collaboration around CHAs.
  
  
  METHODS
  Local health departments were selected on the basis of reporting collaboration (n = 26) or unsure about collaboration (n = 29) with local hospitals. Local health departments were surveyed regarding their relationship with local hospitals. For LHDs currently collaborating with a hospital, a collaboration continuum scale was calculated. Appropriate nonparametric tests, chi-squares, and Spearman's rank correlations were conducted to determine differences between groups.
  
  
  RESULTS
  A total of 44 LHDs responded to the survey (80.0%). Currently collaborating LHDs were more likely to be interested in accreditation and to refer to their CHA 5 or more times a year compared to the unsure LHDs. In the analysis, a collaboration continuum was created and is positively correlated with aspects of the CHA and CHA process.
  
  
  CONCLUSIONS
  This study is the first attempt to quantify the level of collaboration between LHDs and hospitals around CHAs. Better understanding of the levels of joint action required may assist LHDs in making informed decisions regarding deployment of resources on the path to accreditation.
authors.affiliation: Health Management and Policy MPH Program (Dr Wilson) and Department of Health Management and Policy (Drs Wilson, Mohr, and Beatty and Ms Ciecior), Saint Louis University College for Public Health and Social Justice, Saint Louis, Missouri.
authors.forename: Kristin D
authors.initials: KD
authors.lastname: Wilson
authors.forename: Lisa Buettner
authors.initials: LB
authors.lastname: Mohr
authors.forename: Kate E
authors.initials: KE
authors.lastname: Beatty
authors.forename: Amanda
authors.initials: A
authors.lastname: Ciecior
mesh_terms: D000068:Accreditation / Q000592:standards*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D005260:Female; D006292:Health Priorities / Q000592:standards*; D006764:Hospitals, Community / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009111:Local Government; D008297:Male; D008875:Middle Aged; D008923:Missouri; D020380:Needs Assessment / Q000592:standards*; D009937:Organizational Objectives; D011635:Public Health Administration / Q000592:standards*; D011795:Surveys and Questionnaires; D055815:Young Adult