Marshaling the Evidence: The Prioritized Public Health Accreditation Research Agenda

Abstract

A national public health department accreditation program was recently developed and implemented by the Public Health Accreditation Board (PHAB) to improve the quality and performance of public health departments. Because of its potential to transform public health, it is critical that the evidence base around accreditation be strong. With input from public health practitioners and researchers, PHAB developed a research agenda that highlights priority questions related to barriers and facilitators to seeking and obtaining accreditation, the PHAB standards and review process, metrics to determine the impact of accreditation, and benefits and outcomes associated with accreditation for the departments that undergo the process. We present that agenda, discuss the potential challenges of conducting accreditation research, and call on researchers to build a greater base of evidence related to accreditation.

Evidence-Based Public Health Provided Through Local Health Departments: Importance of Academic–Practice Partnerships

“…The logic model approach used by Joly et al in developing a research agenda regarding voluntary health department accreditation is a good example of both the utility of a logic model as a framework for research, as well as a basis for establishing the temporal sequence between inputs, outputs, and outcomes in creating evidence of what works. [23][24][25][26] Similar approaches have been used in a range of disciplines and topics, from health systems development in post-conflict societies, 27 to exploring the association between nurse staffing levels and skill mix with patient safety and outcome, 28 and to enhancing the methodological quality of primary health-care interventions. 29 As more research is conducted on AHDs, we anticipate that our existing logic model can be further adapted, improved, and tested.…”

Age-Adjusted All-Cause Mortality in Counties Served by PHAB-Accredited Local Health Departments Compared With Counties Served by Nonaccredited Local Health Departments: 1999 to 2020

“…Higher performing health departments may be better equipped to act on the multiple determinants of health and ultimately improve population health status 2. Most research on PHAB accreditation has focused on performance improvement and perceived value, as emphasized by the accreditation logic model and research agendas 2–4. However, research on the impact of PHAB accreditation on population health status is limited, and PHAB has recently called for further study on accreditation's impact on health outcomes and health equity 5…”

The Relationship Between Health Department Accreditation and Workforce Satisfaction, Retention, and Training Needs

“…For more than 10 years, the Public Health Accreditation Board (PHAB) has been working with national public health leaders and agencies to develop and execute a national voluntary accreditation process. These efforts arose in response to a call to improve the quality and performance of the public health system and its workforce 1–3. Accreditation is a multiyear process that requires health departments to demonstrate participation in core public health activities as well as engagement with their workforce in assessing training needs and providing training in response 2.…”

“…Another 9 SHAs and 184 LHDs are formally involved in the process 4. While much progress has been made (69% of the US population is covered by an accredited SHA and/or LHD), questions about the value and impact of accreditation are the current focus of attention and may be factors for agencies not yet involved in accreditation 3…”