NEHA November 2023 Journal of Environmental Health

ADVANCEMENT OF THE SCIENCE

many success stories and other anecdotal evi- dence from mentorship participants, but this study is the first time the program’s relation- ship with conformance to the Retail Program Standards has been assessed and reported. The relationship of jurisdiction size with timeliness of submission was unexpected. Generally, larger LHDs have increased capacity, perhaps due in part to greater sta - ing resources. In our study, small LHDs sub- mitted SAs much sooner than mid-sized and large LHDs. While this result did not sup- port our hypothesis, it is noteworthy that NACCHO’s National Profile of Local Health Departments also reported that the number of FTEs per capita decreased with jurisdic- tion size. This finding provides an interest- ing case when evaluating the Retail Program Standards, as small LHDs might be more likely to have a dedicated sta member who can focus primarily on the standards. This association was reversed when comparing the impact of jurisdiction size on confor- mance. Thus, while smaller jurisdictions may hit administrative deadlines at a higher rate, larger jurisdictions still appear to be outperforming their smaller counterparts in conformance. It is important to continue to

engage individuals at small LHDs to ensure that their passion for advancing confor- mance remains constant, but it is also neces- sary to improve support for mid-sized and large LHDs whose sta might be involved with the standards while working on several projects simultaneously. Limitations Due to the exploratory nature of our study, a significant number of comparisons are made. For this reason, we report e ect sizes in lieu of reporting p -values. In addition, caution should be taken when considering compari- sons—including Cycle 3 and Cycle 4—due to the small number of observations in those cycles. Future research assessing the longi- tudinal trends of grant program participants could provide more insight into how con- formance to the Retail Program Standards improves during and after being awarded the RPS CAP and Mentorship Program grants. Conclusion The findings of our study suggest that continu- ing to expand and provide funding opportuni- ties for LHDs is key to advancing conformance with the Retail Program Standards. The e orts

undertaken by FDA to promote enrollment and active participation in the Retail Program Standards since its inception have significantly increased the capacity of LHDs to meet dead- lines and achieve conformance at the local level. FDA and its association partners should continue to promote enrollment in the Retail Program Standards and provide opportunities for participating LHDs to collaborate on their e orts toward conformance. To better understand the impact of grant funding and mentorship participation, addi- tional longitudinal analysis of conformance in participating SLTT regulatory programs should be completed, which would allow for a better characterization of changes in confor- mance before and after grant funding or Men- torship Program participation. Furthermore, this type of analysis would provide stronger evidence for expanding funding streams to include more opportunities for cooperative agreements and peer-to-peer mentorship. Corresponding Author: Nicholas Adams, Senior Program Analyst, National Asso- ciation of County and City Health Ocials, 1201 Eye Street NW, Fourth Floor, Washing- ton, DC 20005. Email: nadams@naccho.org.

References

Centers for Disease Control and Prevention. (2018). Estimates of foodborne illness in the United States . https://www.cdc.gov/food borneburden/index.html Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates. Food and Drug Administration. (2023a). Voluntary National Retail Food Regulatory Program Standards . https://www.fda.gov/ food/retail-food-protection/voluntary-national-retail-food- regulatory-program-standards Food and Drug Administration. (2023b). Retail Food Program Standards enrollments (as of 6/30/2023) . https://www.fda.gov/ media/129524/download

National Association of County and City Health Ocials. (2019). National profile of local health departments . https://www.naccho. org/uploads/downloadable-resources/Programs/Public-Health- Infrastructure/NACCHO_2019_Profile_final.pdf National Association of County and City Health Ocials. (2022). An evaluation of existing Retail Program Standards networks [Issue brief]. https://www.naccho.org/uploads/downloadable- resources/RPS-Issue-Brief_FINAL_June-2022.pdf Sawilowsky, S.S. (2009). New e ect size rules of thumb. Journal of Modern Applied Statistical Methods , 8 (2), Article 26. https://doi. org/10.22237/jmasm/1257035100

Did You Know?

When you donate to the NEHA Endowment Foundation, you can give your gift in honor of a loved one. What a wonderful way to demonstrate your appreciation for a fellow colleague, past professor, or environmental health leader who inspired you. Donate today at www.neha.org/donate.

Volume 86 • Number 4