ADVANCEMENT OF THE SCIENCE
months to 6 months (Figure 1). Observed e ect sizes when comparing LHDs that par- ticipated in the Mentorship Program or RPS CAP with others were not large (Supplemen- tal Table A1 and A2).
TABLE 5
Proportion of Local Health Departments That Submitted Self- Assessment Updates
Objective 2
Cycle 1 Cycle 2 Cycle 3 Cycle 4 Total
Grant participation
Self-Assessment Updates Multiple updates to any given SA cycle can be submitted by an LHD in a 5-year cycle if the agency achieves conformance with a new standard during the period and wants to move toward verifying conformance via VA. Table 5 shows that, on average, jurisdictions that par- ticipated in grant programs were more likely to submit SA updates than those that did not. More mentorship participants (39%), RPS CAP grantees (48%), and jurisdictions that participated in both programs (50%) submit- ted SA updates than jurisdictions that did not participate in grant programs (19%). Number of Standards Met During a Self- Assessment Cycle We examined both self-reported confor- mance in SAs and verified conformance in VAs and found that LHDs achieved confor- mance with fewer standards in Cycle 1 than in subsequent cycles (Table 6). On average, Mentorship Program participants and RPS CAP grantees self-reported conformance with more standards (2.5 and 3.1, respectively) than LHDs that did not participate in either grant program (1.6). This finding was true even when comparing conformance verified by VA. In VAs, RPS CAP grantees achieved conformance with more standards than Men- torship Program participants (2.3 versus 1.8) or those who did not participate in either grant program (1.0).
Mentorship Program
0.45 0.25 1.00 0.13 0.16 0.15 0.13 0.16
0.37 0.50 0.29 0.32 0.31 0.30 0.35 0.33
0.20 0.56 0.67 0.25
0 – – 0 – 0 0 0
0.39 0.48 0.50 0.19 0.18 0.20 0.23 0.21
RPS CAP
Mentorship Program and RPS CAP
Neither
Jurisdiction population size * Small (<50,000)
0
Mid-sized (50,000–500,000)
0.29 0.39 0.31
Large >500,000
Overall
* Population size was determined using NACCHO member profiles. Missing jurisdictions did not have a current NACCHO profile. Note. RPS CAP = Retail Program Standards Cooperative Agreement Program; NACCHO = National Association of County and City Health Officials.
TABLE 6
Mean Number of Standards Achieved via Self-Assessment (SA) and Third-Party Verification Audit (VA)
Mean # of Standards Achieved via SA Cycle 1 Cycle 2 Cycle 3 Cycle 4 Total
Grant participation
Mentorship Program
2.0 1.0 2.0 1.3 1.3
3.6 3.4 3.9 2.6 2.7
3.6 4.2 5.0 2.6 3.0
1.0
2.5 3.1 3.8 1.6 1.7
RPS CAP
– –
Mentorship Program and RPS CAP
Neither
2.2 1.9
Overall
Mean # of Standards Achieved via VA Cycle 1 Cycle 2 Cycle 3 Cycle 4 Total
Estimated Impacts of Grant Program Participation
Grant participation
Mentorship Program
1.6 0.3 1.5 0.7 0.7
2.4 2.4 3.7 1.9 2.0
2.0 3.8 4.7 1.8 2.2
1.0
1.8 2.3 3.6 1.0 1.1
Multiple logistic regression was used to esti- mate the e ect of grant program participation on the odds of submitting an SA update, suc- cessful SA, or VA verifying conformance with at least one standard. As shown in Figure 2, participation in both the Mentorship Program and RPS CAP was associated with increased odds of achieving all three of the outcomes. Mentorship Program participation was sig- nificantly associated with odds of positive SA ( OR = 3.4, 95% confidence interval (CI) [1.7,
RPS CAP
– –
Mentorship Program and RPS CAP
Neither
1.2 1.1
Overall
Note. RPS CAP = Retail Program Standards Cooperative Agreement Program.
6.8]), achieving conformance with at least one standard via VA ( OR = 3.5, 95% CI [1.9, 6.3]), and submission of an SA update during
a cycle ( OR = 1.9, CI [1.0, 3.5]) compared with jurisdictions that did not participate in the Mentorship Program (Supplemental
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Volume 86 • Number 4
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