title: Factors Driving Local Health Departments' Partnerships With Other Organizations in Maternal and Child Health, Communicable Disease Prevention, and Chronic Disease Control.
abstract: To describe levels of partnership between local health departments (LHDs) and other community organizations in maternal and child health (MCH), communicable disease prevention, and chronic disease control and to assess LHD organizational characteristics and community factors that contribute to partnerships.
  
  
  
  Data were drawn from the National Association of County & City Health Officials' 2013 National Profile Study (Profile Study) and the Area Health Resources File. LHDs that received module 1 of the Profile Study were asked to describe the level of partnership in MCH, communicable disease prevention, and chronic disease control. Levels of partnership included "not involved," "networking," "coordinating," "cooperating," and "collaborating," with "collaborating" as the highest level of partnership. Covariates included both LHD organizational and community factors. Data analyses were conducted using Stata 13 SVY procedures to account for the Profile Study's survey design.
  
  
  
  About 82%, 92%, and 80% of LHDs partnered with other organizations in MCH, communicable disease prevention, and chronic disease control programs, respectively. LHDs having a public health physician on staff were more likely to partner in chronic disease control programs (adjusted odds ratio [AOR] = 2.33; 95% confidence interval [CI], 1.03-5.25). Larger per capita expenditure was also associated with partnerships in MCH (AOR = 2.43; 95% CI, 1.22-4.86) and chronic disease prevention programs (AOR = 1.76; 95% CI, 1.09-2.86). Completion of a community health assessment was associated with partnership in MCH (AOR = 7.26; 95% CI, 2.90-18.18), and chronic disease prevention (AOR = 5.10; 95% CI, 2.28-11.39).
  
  
  
  About 1 in 5 LHDs did not have any partnerships in chronic disease control. LHD partnerships should be promoted to improve care coordination and utilization of limited health care resources. Factors that might promote LHDs' partnerships include having a public health physician on staff, higher per capita expenditure, and completion of a community health assessment. Community context likely influences types and levels of partnerships. A better understanding of these contextual factors may lead to more complete and effective LHD partnerships.
authors.affiliation: Department of Public Health, Brody School of Medicine (Drs Luo and Winterbauer and Ms Tucker), and Department of Health Education and Promotion, College of Health and Human Performance (Dr Xu), East Carolina University, Greenville, North Carolina; and Department of Health Policy & Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah).
authors.forename: Huabin
authors.initials: H
authors.lastname: Luo
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Winterbauer
authors.forename: Gulzar
authors.initials: G
authors.lastname: Shah
authors.forename: Ashley
authors.initials: A
authors.lastname: Tucker
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
mesh_terms: D002908:Chronic Disease / Q000517:prevention & control / Q000628:therapy; D003141:Communicable Diseases / Q000628:therapy; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000379:methods; D006801:Humans; D016015:Logistic Models; D000068101:Maternal-Child Health Services / Q000191:economics / Q000706:statistics & numerical data / Q000600:supply & distribution; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011322:Primary Prevention / Q000379:methods* / Q000458:organization & administration; D011634:Public Health / Q000379:methods*; D055818:Public-Private Sector Partnerships / Q000592:standards*; D055502:Secondary Prevention / Q000379:methods* / Q000458:organization & administration; D014481:United States