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      Extent and patterns of community collaboration in local health departments: An exploratory survey

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          Abstract

          Background

          Local public health departments (LHDs) in the United States have been encouraged to collaborate with various other community organizations and individuals. Current research suggests that many forms of active partnering are ongoing, and there are numerous examples of LHD collaboration with a specific organization for a specific purpose or program. However, no existing research has attempted to characterize collaboration, for the defined purpose of setting community health status priorities, between a defined population of local officials and a defined group of alternative partnering organizations. The specific aims of this study were to 1) determine the range of collaborative involvement exhibited by a study population of local public health officials, and, 2) characterize the patterns of the selection of organizations/individuals involved with LHDs in the process of setting community health status priorities.

          Methods

          Local health department officials in North Carolina (n = 53) responded to an exploratory survey about their levels of involvement with eight types of possible collaborator organizations and individuals. Descriptive statistics and the stochastic clustering technique of Self-Organizing Maps (SOM) were used to characterize their collaboration.

          Results

          Local health officials vary extensively in their level of collaboration with external collaborators. While the range of total involvement varies, the patterns of involvement for this specific function are relatively uniform. That is, regardless of the total level of involvement (low, medium or high), officials maintain similar hierarchical preference rankings with Community Advisory Boards and Local Boards of Health most involved and Experts and Elected Officials least involved.

          Conclusion

          The extent and patterns of collaboration among LHDs with other community stakeholders for a specific function can be described and ultimately related to outcome measures of LHD performance.

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          Most cited references29

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          Public participation in health care priority setting: A scoping review.

          While much literature has debated public engagement in health care decision-making, there is no consensus on when public engagement should be sought and how it should be obtained. We conducted a scoping review to examine public engagement in one specific area: priority setting and resource allocation. The review drew upon a broad range of health and non-health literature in an attempt to elicit what is known and not known on this topic, and through this to outline any guidance to assist decision-makers and identify where efforts for future research should be directed. Governments appear to recognize benefits in consulting multiple publics using a range of methods, though more traditional approaches to engagement continue to predominate. There appears to be growing interest in deliberative approaches to public engagement, which are more commonly on-going rather than one-off and more apt to involve face-to-face contact. However, formal evaluation of public engagement efforts is rare. Also absent is any real effort to demonstrate how public views might be integrated with other decision inputs when allocating social resources. While some strands can be taken to inform current priority setting activity, this scoping review identified many gaps and highlights numerous areas for further research.
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            Of pride and prejudice: the role of sociology and social networks in integrating the health sciences.

            Calls have been issued for understanding the "contexts" or "environment" shaping the causes and consequences of health and health care. Existing efforts raise concerns about how a panorama of influences can be considered simultaneously. Sociology's view of contexts as social network structures that shape and are shaped in social interaction offers one key to resolving this dilemma. Because social networks have become central in the social, natural, and physical sciences, this perspective provides a common platform for bringing in sociology's rich theoretical and methodological insights. Yet, to do this well, three conditions must shape our response. First, all levels relevant to health and health care must be considered, separated out, and linked by network mechanisms. The genetic-biological level, perhaps the most foreign level to sociologists, represents the greatest need and best prospect for advancing a sociologically based solution. Second, room must be made to tailor models to populations, whether defined socially or medically. Third, sociologists must find a voice within "big science " to address problems from social construction to social causation that contribute to basic social processes as well as health. I trace developments in the Network-Episode Model as one theoretical starting point.
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              Institutional and economic determinants of public health system performance.

              Although a growing body of evidence demonstrates that availability and quality of essential public health services vary widely across communities, relatively little is known about the factors that give rise to these variations. We examined the association of institutional, financial, and community characteristics of local public health delivery systems and the performance of essential services. Performance measures were collected from local public health systems in 7 states and combined with secondary data sources. Multivariate, linear, and nonlinear regression models were used to estimate associations between system characteristics and the performance of essential services. Performance varied significantly with the size, financial resources, and organizational structure of local public health systems, with some public health services appearing more sensitive to these characteristics than others. Staffing levels and community characteristics also appeared to be related to the performance of selected services. Reconfiguring the organization and financing of public health systems in some communities-such as through consolidation and enhanced intergovernmental coordination-may hold promise for improving the performance of essential services.
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                Author and article information

                Journal
                BMC Res Notes
                BMC Research Notes
                BioMed Central
                1756-0500
                2011
                7 October 2011
                : 4
                : 387
                Affiliations
                [1 ]Department of Public Health Sciences, College of Health and Human Services, University of North Carolina, Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
                [2 ]College of Computing and Informatics, University of North Carolina, Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
                Article
                1756-0500-4-387
                10.1186/1756-0500-4-387
                3197510
                21981793
                d6b8f6ca-2bce-4817-8c95-0f1e03468eaf
                Copyright ©2011 Platonova et al; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 August 2011
                : 7 October 2011
                Categories
                Research Article

                Medicine
                Medicine

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