Association between accreditation engagement and using the community guide for preventive services by local health departments

Background: Accreditation is one of the macro trends shaping the future of public health practice, and The Community Guide to Preventive Services is a decision-making tool used to select evidence-based interventions. Although local health departments (LHDs) seeking accreditation use The Community Guide, the relationship between the two remains unknown. The purpose of this study was to determine whether accreditation engagement is associated with the extent to which LHDs use The Community Guide. Methods: Data from the National Association of County and City Health Officials' 2016 Profile of LHDs were examined for associations between accreditation engagement and the use of The Community Guide. Results: Whereas 52.8% of LHDs used The Community Guide sometimes or consistently, only 21.5% were engaged in the accreditation process. Engaged LHDs were more likely to use The Community Guide consistently (adjusted odds ratios: 8.2; 95% confidence interval, 4.0-16.4) or sometimes (adjusted odds ratios: 3.6; 95% confidence interval, 2.4-5.3) than those not engaged at all. Local health departments serving a population of more than 50 000, organized with a county or mixed level of jurisdiction, and those having a top executive with a masters' or a doctoral degree, were more likely to report some use of The Community Guide. Conclusions: The extent that LHDs utilize The Community Guide is positively associated with the level of their accreditation engagement. Capacity building and policy measures could encourage LHDs to seek accreditation thereby increasing the use of The Community Guide for evidence-informed practice. Future studies should identify causal factors predicting the use of The Community Guide.