Investigating improvements in premature death in two rural, majority-minority counties in the south

Lyn, Rodney; Heath, Erica; Torres, Andrea; Andrews, Christina M.

doi:10.1016/j.ssmph.2020.100618

Cited by 2 publications

(4 citation statements)

References 27 publications

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“…Having a high network density and prioritizing equity distinguished these local public health systems. Our results are in line with limited research that used positive deviance analysis of local public health systems to identify that they place a high value on partnerships and cross-sector collaboration in areas with exceptional outcomes 16,34,35. A 2016 study found that public health jurisdictions with exceptionally good maternal-child health outcomes had local health departments that placed a primary focus on partnerships to outsource services for at-risk populations 16.…”

Section: Discussionsupporting

confidence: 85%

“…Our study found that characteristics related to exceptional tribal organization participation were fundamentally different for rural and nonrural local public health jurisdictions. A 2020 study found that rural counties with exceptional prevention of premature deaths credited their success to collaboration among health organizations 35. However, these organizations did not exist in other rural counties with nonexceptional outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Our results are in line with limited research that used positive deviance analysis of local public health systems to identify that they place a high value on partnerships and cross-sector collaboration in areas with exceptional outcomes. 16 , 34 , 35 A 2016 study found that public health jurisdictions with exceptionally good maternal-child health outcomes had local health departments that placed a primary focus on partnerships to outsource services for at-risk populations. 16 It is notable that these local health departments chose to outsource services out of financial necessity when their budgets were cut, which may explain why public health partnerships are still possible regardless of differences in local health department revenue or employee support.…”

Section: Discussionmentioning

confidence: 99%

“…A 2020 study found that rural counties with exceptional prevention of premature deaths credited their success to collaboration among health organizations. 35 However, these organizations did not exist in other rural counties with nonexceptional outcomes. Underlying resource differences between rural and urban public health systems have been growing since the Great Recession.…”

Section: Discussionmentioning

confidence: 99%

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Examining Characteristics of Local Public Health Systems With Exceptional Tribal Organization Participation

Bauer,

Mitchell,

Mays

2023

Journal of Public Health Management and Practice

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Objective: To learn feasible ways to increase multisector community partnership with tribal organizations, meaning tribal health authorities or American Indian and Alaska Native (AI/AN)–serving organizations, by examining characteristics of local public health systems with exceptional tribal organization participation. Design, Setting, and Participants: In total, 728 local public health departments were surveyed in 2018 to generate a nationally representative sample of local public health systems in the United States. A positive deviance approach using logistic regression helped identify local public health systems that had tribal organization participation despite characteristics that make such participation statistically unlikely. Local public health systems with exceptional tribal organization participation were compared with systems with conventional participation, examining measures known to impact the formation of public health partnerships. Main Outcome Measure: This study used an exploratory logistic regression approach to identify unique characteristics of local public health systems with exceptional tribal organization participation. Results: Of 728 health systems surveyed, 21 were identified as having exceptional tribal organization participation. Across varying thresholds to identify exceptional participation, having a higher network density and prioritizing equity in public health activities were found to consistently distinguish exceptional tribal organization participation in both nonrural and rural areas. Conclusions: Public health partnerships with tribal organizations are possible even in circumstances that make them unlikely. Efforts to build denser networks of collaborating organizations and prioritize equity may help public health systems achieve success with tribal organization partnerships.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Examining Characteristics of Local Public Health Systems With Exceptional Tribal Organization Participation

Bauer,

Mitchell,

Mays

2023

Journal of Public Health Management and Practice

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The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

Kassie,

Eakin,

Abate

et al. 2024

BMC Health Serv Res

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Background Quality has been a persistent challenge in the healthcare system, particularly in resource-limited settings. As a result, the utilization of innovative approaches is required to help countries in their efforts to enhance the quality of healthcare. The positive deviance (PD) approach is an innovative approach that can be utilized to improve healthcare quality. The approach assumes that solutions to problems are already available within the community and identifying and sharing those solutions can help others to resolve existing issues. Therefore, this scoping review aimed to synthesize the evidence regarding the use of the PD approach in healthcare system service delivery and quality improvement programs. Methods Articles were retrieved from six international databases. The last date for article search was June 02, 2023, and no date restriction was applied. All articles were assessed for inclusion through a title and/or abstract read. Then, articles that passed the title and abstract review were screened by reading their full texts. In case of duplication, only the full-text published articles were retained. A descriptive mapping and evidence synthesis was done to present data with the guide of the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist and the results are presented in text, table, and figure formats. Results A total of 125 articles were included in this scoping review. More than half, 66 (52.8%), of the articles were from the United States, 11(8.8%) from multinational studies, 10 (8%) from Canada, 8 (6.4%) from the United Kingdom and the remaining, 30 (24%) are from other nations around the world. The scoping review indicates that several types of study designs can be applied in utilizing the PD approach for healthcare service and quality improvement programs. However, although validated performance measures are utilized to identify positive deviants (PDs) in many of the articles, some of the selection criteria utilized by authors lack clarity and are subject to potential bias. In addition, several limitations have been mentioned in the articles including issues in operationalizing PD, focus on leaders and senior managers and limited staff involvement, bias, lack of comparison, limited setting, and issues in generalizability/transferability of results from prospects perspective. Nevertheless, the limitations identified are potentially manageable and can be contextually resolved depending on the nature of the study. Furthermore, PD has been successfully employed in healthcare service and quality improvement programs including in increasing surgical care quality, hand hygiene practice, and reducing healthcare-associated infections. Conclusion The scoping review findings have indicated that healthcare systems have been able to enhance quality, reduce errors, and improve patient outcomes by identifying lessons from those who exhibit exceptional practices and implementing successful strategies in their practice. All the outcomes of PD-based research, however, are dependent on the first step of identifying true PDs. Hence, it is critical that PDs are identified using objective and validated measures of performance as failure to identify true PDs can subsequently lead to failure in identifying best practices for learning and dissemination to other contextually similar settings.

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Investigating improvements in premature death in two rural, majority-minority counties in the south

Cited by 2 publications

References 27 publications

Examining Characteristics of Local Public Health Systems With Exceptional Tribal Organization Participation

Examining Characteristics of Local Public Health Systems With Exceptional Tribal Organization Participation

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

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