ArticleBMC public health2016
Using a positive deviance framework to identify Local Health Departments in Communities with exceptional maternal and child health outcomes: a cross sectional study.
Article in BMC public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Using positive deviance to enhance HIV care retention in South Africa: development of a compassion-focused program to improve the staff and patient experience.BMC global and public health · 2025Article
- [Effect of positive deviation on the diagnosis and treatment of gestational syphilis, and the prevention of congenital syphilis: A cohort study].Revista colombiana de obstetricia y ginecologia · 2024Article
- Using Positive Deviance to Enhance HIV Care Retention in South Africa: Development of a Compassion-Focused Programme to Improve the Staff and Patient Experience.Research square · 2024Article
- The use of positive deviance approach to improve health service delivery and quality of care: a scoping review.BMC health services research · 2024Article
- Investigating improvements in premature death in two rural, majority-minority counties in the south.SSM - population health · 2020Article
- Racial Equality in Infant Outcomes: A Call to Action.American journal of public health · 2019Article
- A county-level cross-sectional analysis of positive deviance to assess multiple population health outcomes in Indiana.BMJ open · 2017Article
- State-Level Progress in Reducing the Black-White Infant Mortality Gap, United States, 1999-2013.American journal of public health · 2017Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe United States spends more than most other countries per capita on maternal and child health (MCH), and yet lags behind other countries in MCH outcomes. Local health departments (LHDs) are responsible for administering various maternal and child health programs and interventions, especially to vulnerable populations. The goal of this study was to identify local health department jurisdictions (LHDs) that had exceptional maternal and child health outcomes compared to their in-state peers - positive deviants (PDs) - in Washington, Florida and New York in order to support the identification of strategies that can improve community health outcomes.
methodsWe used MCH expenditure data for all LHDs in FL (n = 67), and WA (n = 35), and most LHDs in NY (n = 48) for 2009-2010 from the Public Health Activities and Services Tracking (PHAST) database. We conducted our analysis in 2014-2015. Data were linked with variables depicting local context and LHD structure. We used a cross-sectional study design to identify communities with better than expected MCH outcomes and multiple regression analysis to control for factors outside of and within LHD control.
resultsWe identified 50 positive deviant LHD jurisdictions across 3 states: WA = 10 (29 %); FL = 24 (36 %); NY = 16 (33 %). Overall, internal factor variables improved model fit for identifying PD LHD jurisdictions, but individual variables were not significant.
conclusionsWe empirically identified LHD jurisdictions with better MCH outcomes compared to their peers. Research is needed to assess what factors contributed to these exceptional MCH outcomes and over which LHDs have control. The positive deviance method we used to identify high performing local health jurisdictions in the area of maternal and child health outcomes can assist in better understanding what practices work to improve health outcomes. We found that funding may not be the only predictor of exceptional outcomes, but rather, there may be activities that positive deviant LHDs are conducting that lead to improved outcomes, even during difficult financial circumstances. This method can be applied to other outcomes, communities, and/or services.
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