Tracking Success: Outputs Versus Outcomes—A Comparison of Accredited and Non-Accredited Public Health Agencies’ Community Health Improvement Plan objectives
With funding for public health initiatives declining, creating measurable objectives that are focused on tracking and changing population outcomes (i.e., knowledge, attitudes, or behaviors), instead of those that are focused on health agencies’ own outputs (e.g., promoting services, developing communication messages) have seen a renewed focus. This study analyzed 4094 objectives from the Community Health Improvement Plans (CHIPs) of 280 local PHAB-accredited and non-accredited public health agencies across the United States. Results revealed that accredited agencies were no more successful at creating outcomes-focused objectives (35% of those coded) compared to non-accredited agencies (33% of those coded; Z = 1.35, p = .18). The majority of objectives were focused on outputs (accredited: 61.2%; non-accredited: 63.3%; Z = 0.72, p = .47). Outcomes-focused objectives primarily sought to change behaviors (accredited: 85.43%; non-accredited: 80.6%), followed by changes in knowledge (accredited: 9.75%; non-accredited: 10.8%) and attitudes (accredited: 1.6%; non-accredited: 5.1%). Non-accredited agencies had more double-barreled objectives (49.9%) compared to accredited agencies (32%; Z = 11.43, p < .001). The authors recommend that accreditation procedures place a renewed focus on ensuring that public health agencies strive to achieve outcomes. It is also advocated that public health agencies work with interdisciplinary teams of Health Communicators who can help them develop procedures to effectively and efficiently measure outcomes of knowledge and attitudes that are influential drivers of behavioral changes.
KeywordsObjectives Outcomes Public health departments CHIP
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 6.Chudgar, R. B., Shirey, L. A., Sznycer-Taub, M., Read, R., Pearson, R. L., & Erwin, P. C. (2014). Local health department and academic institution linkages for community health assessment and improvement processes: A national overview and local case study. Journal of Public Health Management and Practice, 20(3), 349–355.CrossRefPubMedGoogle Scholar
- 12.Issel, L. M., & Rosenberg, D. (2014). Program objectives and setting targets. In L. M. Issel (Ed.), Health program planning and evaluation: A practical, systematic approach for community health (pp. 215–248). Burlington, MA: Jones & Bartlett Learning.Google Scholar
- 13.Kotler, P., & Lee, N. R. (2008). Social marketing: Influencing behaviors for good. Thousand Oaks, CA: Sage.Google Scholar
- 18.National Cancer Institute. (2005). Theory at a glance: A guide for health promotion practice. Bethesda, MD: U.S. Dept. of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Publication No. pp. 05–3896.Google Scholar
- 20.Pitman, B. (1994). Stop wasting training dollars: Train for outcomes, not outputs. Journal of Systems Management, 45(6), 25.Google Scholar
- 21.Public Health Accreditation Board. (2013). Standards & Measures: Version 1.5. Retrieved from: http://www.phaboard.org/wp-content/uploads/SM-Version-1.5-Board-adopted-FINAL-01-24-2014.docx.pdf.
- 22.Public Health Accreditation Board. (2016). What does it cost? Retrieved from: http://www.phaboard.org/accreditation-overview/what-does-it-cost/.
- 24.Rosner, B. (2006). Fundamentals of Biostatistics, 6th Edition. Belmont, CA: Thomson.Google Scholar
- 26.United Way. (1996). Measuring program outcomes: A practical approach. Alexandria, VA: United Way of America.Google Scholar
- 28.Wilson, L. J., & Ogden, J. D. (2008). Strategic communications planning for effective public relations and marketing. Dubuque, IA: Kendall.Google Scholar