Validation of a screening survey to assess local public health performance

The study seeks to validate an abbreviated protocol for measuring local public health performance. Primary data were collected during 1993 on a series of indicators keyed to defined public health core functions and their associated practices. The data were obtained from responses provided by local health department directors and were reviewed for accuracy by respective state health department personnel. All local public health jurisdictions (370) in six states were surveyed with a screening protocol. A sample of 36 of these jurisdictions was then resurveyed by means of a full-length protocol using 84 different indicators of public health performance. Correlations between scores obtained from the screening survey and those from the reference survey were high for overall public health performance, for each of the three functions, and for some of the ten practices. A group of only four queries was shown to predict reliably the overall scores. Findings support the conclusion that public health practice can be defined, measured, and monitored. A proposed surveillance system is feasible.