title: Collaboration among Missouri nonprofit hospitals and local health departments: content analysis of community health needs assessments.
abstract: OBJECTIVE
  We identified the levels of joint action that led to collaboration between hospitals and local health departments (LHDs) using the hospital's community health needs assessments (CHNAs).
  
  
  METHODS
  In 2014, we conducted a content analysis of Missouri nonprofit hospitals (n = 34) CHNAs, and identified hospitals based on previously reported collaboration with LHDs. We coded the content according to the level of joint action. A comparison sample (n = 50) of Missouri nonprofit hospitals provided the basic comparative information on hospital characteristics.
  
  
  RESULTS
  Among the hospitals identified by LHDs, 20.6% were "networking," 20.6% were "coordinating," 38.2% were "cooperating," and 2.9% were "collaborating." Almost 18% of study hospitals had no identifiable level of joint action with LHDs based on their CHNAs. In addition, comparison hospitals were more often part of a larger system (74%) compared with study hospitals (52.9%).
  
  
  CONCLUSIONS
  The results of our study helped develop a better understanding of levels of joint action from a hospital perspective. Our results might assist hospitals and LHDs in making more informed decisions about efficient deployment of resources for assessment processes and implementation plans.
authors.affiliation: Kate E. Beatty is with the Department of Health Services Management & Policy, College of Public Health, East Tennessee State University, Johnson City. Kristin D. Wilson is with the Health Management and Policy Masters in Public Health Program, Department of Health Management and Policy, Saint Louis University College for Public Health and Social Justice, St. Louis, MO. Amanda Ciecior is with the Department of Vermont Health Access, Vermont Agency of Human Services, Winooski. Lisa Stringer is with the Department of Health Management and Policy, Saint Louis University College for Public Health and Social Justice, St. Louis.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Beatty
authors.forename: Kristin D
authors.initials: KD
authors.lastname: Wilson
authors.forename: Amanda
authors.initials: A
authors.lastname: Ciecior
authors.forename: Lisa
authors.initials: L
authors.lastname: Stringer
mesh_terms: D003299:Cooperative Behavior; D006739:Hospital Administration; D006801:Humans; D007373:Interinstitutional Relations; D009111:Local Government; D008923:Missouri; D020380:Needs Assessment; D009939:Organizations, Nonprofit / Q000458:organization & administration*; D011635:Public Health Administration; D013597:Systems Analysis