Frontiers in Public Health Services and Systems Research is an open-access, rapid-response, peer-reviewed online journal offering brief, preliminary PHSSR findings from ongoing or recently completed empirical studies or quality improvement projects. Journal articles answer questions of importance regarding the organization, financing, and delivery of public health services; the structure, operation, and management of public health delivery systems; the application of quality improvement methods in public health settings; and/or the impact of these endeavors on population health. Findings must have the potential to guide future public health practice, health policy, and research. Frontiers is intended to provide quick access to actionable public health infrastructure research to improve public health practice at the state and local levels. It is of use to practitioners, policy makers and researchers.

September 10, 2015
Guthrie S. Birkhead et al.

Background: Public health surveillance has traditionally relied on manual processes including paper-based reporting by clinicians. The introduction of electronic laboratory reporting increased the efficiency and completeness of infectious disease surveillance but clinical and risk factor data are often still collected manually. The use of electronic health records (EHR) has significant promise to enrich surveillance by collecting these data automatically and by expanding surveillance to chronic diseases (e.g., diabetes, hypertension, obesity).

September 10, 2015
Nicolaas P. Pronk

Workforce fitness matters for the prevention of premature death, chronic diseases, productivity loss, excess medical care costs, loss of income or family earnings, and other social and economic concerns. Yet fitness levels appear to be relatively low and declining. Over the past half century obesity has doubled, physical activity levels are below par, and cardiorespiratory fitness often does not meet minimally acceptable job standards. During this time, daily occupational energy expenditure has decreased by more than 100 calories.

September 10, 2015
Michele Issel et al.

Background: Assessing the satisfaction of the “population-patient” requires conceptualizing the dimensions of satisfaction differently from that of individual patients.

Purpose: The focus of this study was to develop and pilot test a short questionnaire that can reliably assess satisfaction with the care provided by public health nurses (PHNs) carrying out population-level activities in their communities.

September 10, 2015
Simone Singh et al.

Background: A detailed understanding of the costs that local health departments (LHDs) incur in the provision of public health services plays an important role in their efforts to provide services in an effective and efficient manner. However, surprisingly little evidence exists about the key cost components that LHDs incur in the provision of services.

Purpose: The purpose of this report was to provide empirical estimates of LHDs’ cost structure.

September 10, 2015
Rakhi Trivedi et al.

Background: Recent research shows that social media offer unprecedented opportunities for communications with stakeholders in public health and other industries.

Purpose: This study examines the manner in which U.S. local health departments (LHDs) use Facebook. Public health program themes discussed on Facebook profiles of LHDs were analyzed and ranked by the frequency of mentions on Facebook.

August 11, 2015
Cezar Brian C. Mamaril

A general theme is identified from the papers featured in this Frontiers of PHSSR issue by relating it to the evaluation of local health department (LHD) disease surveillance and investigation activities.

August 9, 2015
Johnna S. Murphy et al.

Failure Modes and Effects Analysis (FMEA) is a structured process used to identify and prioritize risks by ranking them based on severity, occurrence, and detectability. Historically, FMEA has been used within industries, including automotive and health care. This project explored the adaption of the FMEA template to a small public health program designed to improve asthma outcomes. The Breathe Easy at Home (BEAH) program is a multi-sector partnership that uses a web-based system to link clinical sites with housing code inspections and enforcement for patients with asthma.

August 9, 2015
Kaja M. Abbas et al.

Background: The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.

August 9, 2015
Gulzar H. Shah et al.

Background: Electronic disease reporting systems (EDRSs) are imperative for local health departments (LHDs) operating in the post-H1N1 and evidence-based public health practice era. Studies regarding functionality and factors responsible for variation in implementation are important but rare.

Purpose: This primary objective for this study was to provide evidence regarding the level to which LHDs have implemented electronic disease reporting systems and factors associated with variation in implementation of electronic disease reporting systems.

August 9, 2015
Jason E. Orcena et al.

Introduction: Although several studies have linked population size to the cost of service delivery in local health departments, none have looked at the network position of the LHD. This study expands the understanding of how the position of an LHD in Ohio’s local health department network affects its expenditures in providing core, or nonclinical, services.