BACKGROUND Public health resources are limited and best used for effective programs. This study explores associations of mis-implementation in public health (ending effective programs or continuing ineffective programs) with organizational supports for evidence-based decision making among U.S. local health departments. METHODS The national U.S. sample for this cross-sectional study was stratified by local health department jurisdiction population size. One person was invited from each randomly selected local health department: the leader in chronic disease, or the director. Of 600 selected, 579 had valid email addresses; 376 completed the survey (64.9% response). Survey items assessed frequency of and reasons for mis-implementation. Participants indicated agreement with statements on organizational supports for evidence-based decision making (7-point Likert). RESULTS Thirty percent (30.0%) reported programs often or always ended that should have continued (inappropriate termination); organizational supports for evidence-based decision making were not associated with the frequency of programs ending. The main reason given for inappropriate termination was grant funding ended (86.0%). Fewer (16.4%) reported programs often or always continued that should have ended (inappropriate continuation). Higher perceived organizational supports for evidence-based decision making were associated with less frequent inappropriate continuation (odds ratio = 0.86, 95% confidence interval 0.79, 0.94). All organizational support factors were negatively associated with inappropriate continuation. Top reasons were sustained funding (55.6%) and support from policymakers (34.0%). CONCLUSIONS Organizational supports for evidence-based decision making may help local health departments avoid continuing programs that should end. Creative mechanisms of support are needed to avoid inappropriate termination. Understanding what influences mis-implementation can help identify supports for de-implementation of ineffective programs so resources can go towards evidence-based programs.

中文翻译：

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对美国地方公共卫生部门计划执行不当的看法。


背景技术公共卫生资源是有限的，最好用于有效的计划。本研究探讨了公共卫生领域的错误实施（终止有效计划或继续无效计划）与美国地方卫生部门循证决策的组织支持之间的关系。方法 这项横断面研究的美国全国样本按当地卫生部门管辖范围内的人口规模进行分层。每个随机抽取的当地卫生部门都会邀请一名人员：慢性病科的领导或主任。在 600 名入选者中，579 名拥有有效的电子邮件地址； 376 人完成了调查（回复率为 64.9%）。调查项目评估了错误执行的频率和原因。参与者表示同意组织支持循证决策的声明（7 点李克特）。结果 百分之三十 (30.0%) 报告的项目经常或总是结束，而本应继续进行（不适当的终止）；组织对循证决策的支持与项目结束的频率无关。不当终止的主要原因是赠款资助终止（86.0%）。较少的人（16.4%）报告经常或总是继续本应结束的项目（不适当的继续）。较高的组织对循证决策支持的感知与不适当延续的频率较低相关（优势比 = 0.86，95% 置信区间 0.79、0.94）。所有组织支持因素都与不适当的延续负相关。主要原因是持续的资金（55.6%）和政策制定者的支持（34.0%）。 结论 对循证决策的组织支持可能有助于当地卫生部门避免继续实施本应结束的项目。需要创造性的支持机制来避免不当终止。了解影响错误实施的因素有助于确定对无效计划的取消实施的支持，以便资源可以用于基于证据的计划。