Effectiveness of Public Health Quality Improvement Training Approaches: Application, Application, Application.

Document Type


Publication Date



Education, Education, Public Health Professional, Humans, Public Health Practice, Quality Improvement, Surveys and Questionnaires, United States

Publication Title

Journal of public health management and practice : JPHMP


CONTEXT: Quality improvement (QI) has been identified as a key strategy to improve the performance of state and local public health agencies. Quality improvement training effectiveness has received little attention in the literature.

OBJECTIVES: To evaluate the effectiveness of 3 QI training types: webinars, workshops, and demonstration site activities on improving participant knowledge, skill, and ability to conduct QI through a questionnaire conducted after training participation.

DESIGN: We used a natural experimental design hypothesizing that demonstration site participants would have the greatest gains on outcomes of interest compared with webinar and workshop participants. Bivariate and multivariate models were used to examine outcome differences between questionnaire respondents who participated in various training types.

PARTICIPANTS: Local health department employees who participated in the 3 training strategies.

MAIN OUTCOME MEASURES: Measures included knowledge and skill gain, skill application, QI receptivity, and ability to successfully participate in a QI project.

RESULTS: Two hundred eighty-four unique individuals who work in 143 health departments completed the questionnaire for a 59% response rate. The majority of these health departments serve midsize populations. Demonstration site respondents had significantly greater gains in knowledge and skills, skill application, and ability to successfully participate in a QI project. Webcast training participants had significantly higher QI receptivity in adjusted models. Respondents who participated in both webcast and demonstration site trainings had higher mean scores on all outcomes when compared with demonstration site single training participants, these differences were significant in unadjusted models.

CONCLUSION: Our findings suggest that QI training for public health agency employees should include both didactic training on QI content and opportunities for QI application. Future research should examine if this approach can effectively increase successful participation in QI projects for staff in LHDs of all sizes.