This dissertation attempts to provide an understanding of the relationship between emergency preparedness training and organizational performance in public health emergency preparedness at the local level. This is accomplished by the utilization of longitudinal data to examine the following: 1) what supply- and demand-side characteristics in a local health department's jurisdiction would influence whether any training will be undertaken; 2) does training have a direct on EP performance measures; and 3) do certain individual- and workplace-level characteristics influence the training – performance relationship?
This study has several major findings. The key finding is that once endogeneity was controlled for, training does appear to influence a LHD's performance, at least in PHEP for LHDs using the TRAIN system. Second, the supply-side characteristics of spending per capita and FTEs per capita have a negative relationship with the uptake of training, suggesting that larger LHDs may have other sources of training not related to TRAIN. This negative relationship was also present for the demand-side characteristic of geographic location; compared to rural LHDs, urban LHDs tended not to use TRAIN as much. Finally, scope of training was more susceptible to the moderating influences of certain individual- and workplace-level characteristics than intensity of training.
Several major policy implications are associated with these findings. The first relates to funding for training; specific funding sources for training may be necessary. For example, funding from the Prevention and Public Health Fund may be used for training as in the past. Second, some form of continuing education may be needed. These findings support PHAB's training requirements for accreditation.
These findings lead to additional research questions such as, do the same factors that influence a LHD's participation in EP training influence other types of public health training. In addition, a more in-depth analysis is needed to better understand the factors that moderate the training – performance relationship in public health. Finally, the comparative effectiveness of one-time training versus continuing training needs to be examined.
|Advisor:||Mays, Glen, Wayne, John|
|Commitee:||Curran, Geoffrey, Davis, Mary, Pulley, LeaVonne|
|School:||University of Arkansas for Medical Sciences|
|Department:||Health Systems Research|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 74/09(E), Dissertation Abstracts International|
|Subjects:||Public Health Education, Public health|
|Keywords:||Emergency preparedness, Organization performance, Public health, Training|
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