Health Districts as Quality Improvement Collaboratives and Multi-Jurisdictional Entities

Research Objective: The Georgia Public Health PBRN assessed the utility of the Multi-county Health District as a structured Quality Improvement Collaborative (QIC), and as multi jurisdictional entities for purposes of meeting standards for accreditation by the Public Health Accreditation Board. Data Sets and Sources: Data were collected from online surveys followed up with phone interviews or paper surveys to maximize participation. A newly developed clinical care QIC instrument (Schouten et al, 2010) was modified to collect data with a revised focus on QICs for public health. We retained QI culture constructs in the instrument while shifting the focus from healthcare to public health essential services related to accreditation standards. Study Design: Data was collected from a purposeful sample of local public health key informants in Georgia who were identified by the District Directors’ office as local key informants. Invitations Key informants included county and district staff and county board of health members. Analysis: Psychometric testing of the QIC assessment instrument included tests for validity and reliability. Census-based and self-reported demographic characteristics were used to compare responses. Principal Findings: Strong consensus emerged across various constituencies that Districts were critical for local public health to provide essential services. Key opinion leaders from both the rural and non-rural counties agreed that the Districts were important. Conclusion: Regionalization using Georgia Districts has major potential for supporting QI and meeting quality assurance standards associated with accreditation. Implications for Field of PHSSR: Accreditation has the potential to substantially clarify and enhance the role of public health in the 21st century. But local public health agencies, based on small municipality or county populations, are unlikely to possess and sustain capacity to meet the challenges of comprehensive essential services. Regionalization of local public health capacity is a critical emerging issue with the launching of public health accreditation

Effects of a Weight Training Personalized System of Instruction Course on Self-Efficacy, Behavioral Intent, Fitness Levels and Knowledge

Previous research shows the numerous benefits of physical activity, however historical trends demonstrate that physical activity decreases with age (American College of Sport Medicine, 2000; Kesanieme, Riddoch, Reeder, Blair, & Sorensen, 2010; National Association for Sport and Physical Education, 2007).Currently, 50.6% of college students are meeting the aerobic exercise guidelines, 38.6% are meeting strength training guidelines, and 50% reported no participation in strength training exercises (American College Health Association, 2012). Within higher learning institutions there is not a current graduation requirement involving the completion of physical activity courses or requirements of whom and how these courses should be taught to maximize learning. The purpose of this study was to compare the effects of a PSI weight training course and a direct instruction (DI) weight training course on college students’ fitness levels, knowledge of weight training, self-efficacy toward weight training, outcome expectancy of weight training, task value efficacy of weight training and expectancy related beliefs of weight training. Methods: Participants (PSI n = 41 and DI n = 30) enrolled in college weight training courses were assessed with a weight training cognitive test, weight training questionnaire and FITNESSGRAM fitness test before and after the completion of the 15 week course. Two (group) × two (time) repeated measures Analysis of Variances (ANOVAs) with Bonferroni corrections along with descriptive statistics were used to determine effectiveness. Results: No statistically significant differences in curl-ups, push-ups, and body composition were observed; however, significant differences were found in the back saver sit and reach test. Weight training knowledge test scores were statistically significantly higher for PSI when compared to DI. No statistically significant differences were observed for task value, outcome expectancy, and expectancy related beliefs scores. Weight training questionnaire scores for behavioral intent and self-efficacy were found to be statistically significant for the main effect of time. Overall this study found teaching weight training using the PSI model to be more effective in increasing cognitive knowledge about weight training

Effects of a Weight Training Personalized System of Instruction Course on Fitness Levels and Knowledge

Effective instruction in a university physical activity program is essential if the program desires to meet the National Association for Sport and Physical Education (NASPE, 1998) guidelines for an appropriate college/university physical activity instructional program. To meet these guidelines, an instructor can use the Personalized System of Instruction (PSI) model. The purpose of this study was to measure the effectiveness of using the PSI model in a university physical activity weight training course. Participants (n = 22) enrolled in a beginner weight training course were administered the FITNESSGRAM fitness test and a 50-question knowledge test before and after the 15-week PSI weight training course. Paired-samples t tests with Bonferroni correction revealed no significant difference in the Progressive Aerobic Cardiovascular Endurance Run (PACER) test, back saver sit and reach test, and trunk lift test, but did reveal a significant difference for curl-up test, t(21) = -4.335, p less than 0.007; push-up test, t(21) = -5.080, p less than 0.007; percentage body fat, t(21) = 5.722, p less than 0.007; and knowledge test, t(21) = -7.247, p less than 0.007. If a goal of the beginning weight training physical activity course was to promote student learning, the PSI weight training course was effective. (Contains 4 tables.

A Method to Identify Quality Improvement Initiatives in Georgia’s Multijurisdictional Public Health System

This presentation was given during the Academy Health Annual Research Meeting

Health Districts as Quality Improvement Collaboratives and Multi-Jurisdictional Entities

Research Objective: The Georgia Public Health PBRN assessed the utility of the Multi-county Health District as a structured Quality Improvement Collaborative (QIC), and as multi jurisdictional entities for purposes of meeting standards for accreditation by the Public Health Accreditation Board. Data Sets and Sources: Data were collected from online surveys followed up with phone interviews or paper surveys to maximize participation. A newly developed clinical care QIC instrument (Schouten et al, 2010) was modified to collect data with a revised focus on QICs for public health. We retained QI culture constructs in the instrument while shifting the focus from healthcare to public health essential services related to accreditation standards. Study Design: Data was collected from a purposeful sample of local public health key informants in Georgia who were identified by the District Directors’ office as local key informants. Invitations Key informants included county and district staff and county board of health members. Analysis: Psychometric testing of the QIC assessment instrument included tests for validity and reliability. Census-based and self-reported demographic characteristics were used to compare responses. Principal Findings: Strong consensus emerged across various constituencies that Districts were critical for local public health to provide essential services. Key opinion leaders from both the rural and non-rural counties agreed that the Districts were important. Conclusion: Regionalization using Georgia Districts has major potential for supporting QI and meeting quality assurance standards associated with accreditation. Implications for Field of Phssr: Accreditation has the potential to substantially clarify and enhance the role of public health in the 21st century. But local public health agencies, based on small municipality or county populations, are unlikely to possess and sustain capacity to meet the challenges of comprehensive essential services. Regionalization of local public health capacity is a critical emerging issue with the launching of public health accreditation

Evaluating Quality Improvement to Improve HIV Reporting

The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts

Building Capacity to Support and Study QI in Local Georgia Public Health Systems

The study of quality improvement within Georgia’s local public health systems provides important insight into the use of regional bodies as quality improvement (QI) collaboratives and multijurisdictional entities. This report describes QI initiatives following a RWJF funded quick strike research grant to assess health district capacity to conduct QI in Georgia’s local public health systems. These QI initiatives use QI to improve public health outcomes including: Adolescent pregnancy and Sexually Transmitted Infection prevention, HIV prevention and control, and HIV Management