Assessment of National CLAS Standards in Rural and Urban Local Health Departments in Kentucky.

CONTEXT: Findings from the Centers for Disease Control and Prevention suggest that addressing persistent health disparities based on race and ethnicity must become a national priority. The field of cultural and linguistic competency has gained national attention by improving access to and quality of health care, patient-provider communication, health outcomes, and health equity for minority groups and other vulnerable or special needs populations. OBJECTIVES: (1) To measure how local health departments (LHDs) in Kentucky comply with the National Standards for Culturally and Linguistically Appropriate Services (CLAS); and (2) to provide policy recommendation based on the findings. This study is the first to assess a statewide public health system under the lens of CLAS. DESIGN: Analysis of cross-sectional survey. SETTING: Electronic surveys administered to LHD administrators in Kentucky. PARTICIPANTS: Public health directors, nurse leaders, and program managers. MAIN OUTCOME MEASURE: Levels of compliance with various CLAS standards were examined for rural and urban counties using a novel scoring method. RESULTS: A total of 159 LHD administrators received the survey. Response rate was 67% (106 participants). Rural and urban LHDs achieved moderate compliance on domains of plans and policies, quality monitoring and improvement for needs assessment, management information systems for clients, and staff training and development. Both geographic groups exhibited lesser compliance on domains of organizational governance, culturally inclusive health care environment for educational materials, and diversity of personnel recruitment. CONCLUSION: County and district LHDs in Kentucky have implemented activities and policies that comply with CLAS standards at levels that vary by domain. Areas requiring particular attention include organizational governance, culturally inclusive health care environment for educational materials, and diversity of personnel. Improvements in these areas may help LHDs better meet the needs of vulnerable populations, racial and ethnic minorities, and special needs groups. CLAS practices may allow organizations to adhere to national public health accreditation standards.

Factors associated with pharmacy student interest in international study.

OBJECTIVES. To examine the interest of pharmacy students in international study, the demographic factors and involvement characteristics associated with that interest, and the perceived advantages and barriers of engaging in international opportunities during pharmacy school. METHODS. A self-administered electronic survey instrument was distributed to first-, second-, and third-year pharmacy students at the University of Kentucky College of Pharmacy. RESULTS. There were 192 total respondents, for a response rate of 50.9%. Seventy-two percent reported interest in international study. Previous international study experience (p=0.001), previous international travel experience (p=0.002), year in pharmacy school (p=0.03), level of academic involvement (p<0.001), and level of diversity involvement (p<0.001) were associated with international study interest. Positive influences to international study included desire to travel and availability of scholarships. Perceived barriers included an inability to pay expenses and lack of foreign language knowledge. CONCLUSIONS. The needs and interests of pharmacy students should be considered in the development and expansion of internationalization programs in order to effectively optimize global partnerships and available international experiences. Colleges and schools of pharmacy should engage students early in the curriculum when interest in study-abroad opportunities is highest and seek to alleviate concerns about expenses as a primary influence on study-abroad decisions through provision of financial assistance.

The forgotten instrument: analysis of the national public health performance standards program governance instrument.

This study examines the use of, and results from, the National Public Health Performance Standards Program Local Governance Instrument. It includes a compilation and analysis of 173 local governance instruments completed by local boards of health from 2003 to 2006. Only 24 of the 173 scored instruments are used because of exclusion of data from New Jersey. The study compares results from the instruments based upon demographic data reported by the local boards of health, and data on performance compiled by the National Public Health Performance Standards Program Local Public Health System Instrument. Local boards of health perform well on Essential Public Health Services #6 (78.85%), #2 (71.41%), and #7 (70.75%). Performance is far from optimal on Essential Public Health Services #10 (45.42%) and #9 (41.30%). Comparing groups based on demographic data yielded deviations too large and power too low to form any significant conclusions about local boards of health performance. It is important to note that individuals with varying levels of knowledge may have completed the governance instruments, and this may affect the results of any comparison between individual boards of health. Local boards of health need encouragement from national and state associations of local boards of health to complete the local governance instrument. This would allow local boards of health to use these data to compare performance with other boards around the nation. Identification of weak performing areas may lead to changes to improve service to the community. This instrument could also prove a useful tool in health department accreditation.