title: National Voluntary Public Health Accreditation: Are More Local Health Departments Intending to Take Part?
abstract: OBJECTIVE
  This article examines local health department (LHD) participation and intentions to participate in national voluntary accreditation and reasons for not seeking accreditation. Specifically, it compares the results of national surveys among LHDs in 2010, 2013, and 2014.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  United States.
  
  
  METHODS
  LHDs that responded to the 2014 Forces of Change Survey and the 2010 and 2013 National Association of County and City Health Officials Profile studies.
  
  
  METHODS
  LHD level of engagement in Public Health Accreditation Board (PHAB) accreditation.
  
  
  RESULTS
  Data of 2014 indicated that 1% of LHDs achieved accreditation and 11% had submitted an application or a statement of intent, compared with 6% of LHDs that submitted an application or a statement of intent in 2013. The percent of LHDs that indicated they planned to apply for accreditation but had not submitted a statement of intent declined from 27% in 2013 to 22% in 2014. In multivariate models, controlling for governance category and jurisdiction population size, LHDs in states where the state health department (SHD) participated in e-PHAB had higher odds of being favorably inclined toward accreditation than those located in states where the SHD was not in the e-PHAB system (odds ratio = 2.82, 95% confidence interval: 1.81-4.41). Across 2013 and 2014, and across small and large LHDs, the top 2 reasons for deciding not to apply for accreditation were the time/effort required exceeded the benefits (67%) and fees were too high (46%).
  
  
  CONCLUSIONS
  SHDs are powerful mediators of LHDs' perceptions of the PHAB accreditation program. Health department governance structure and jurisdiction population size are associated with LHD accreditation participation decisions. With the launch of PHAB's program, fewer LHDs are undecided about accreditation participation and many have taken affirmative steps to become accredited. The top 2 reasons LHDs indicated for not proceeding with accreditation were time/effort exceed benefit and fees perceived as too high.
authors: Department of Global Health Systems and Development, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana (Dr Yeager); National Association of County and City Health Officials, Washington, District of Columbia (Dr Ye and Mss Robin and Leep); Public Health Accreditation Board, Alexandria, Virginia (Ms Kronstadt); and Department Behavioral Sciences and Social Medicine, Florida State University, College of Medicine, Tallahassee (Dr Beitsch).
authors: Valerie A
authors: VA
authors: Yeager
authors: Jiali
authors: J
authors: Ye
authors: Jessica
authors: J
authors: Kronstadt
authors: Nathalie
authors: N
authors: Robin
authors: Carolyn J
authors: CJ
authors: Leep
authors: Leslie M
authors: LM
authors: Beitsch
mesh_terms: D000068:Accreditation / Q000379:methods* / Q000592:standards; D006801:Humans; D009111:Local Government; D015999:Multivariate Analysis; D011634:Public Health / Q000295:instrumentation / Q000379:methods*; D014481:United States; D035141:Voluntary Programs / Q000639:trends