Skip to main content
    • Aa
    • Aa

State, Territorial, and Local Health Departments’ Reporting of Partnership Strength Before and After the H1N1 Response

  • Karen E. Kun (a1), John Zimmerman (a2), Dale A. Rose (a1) and Stephanie Rubel (a1)

Research has shown that partnerships between public health agencies, service providers, and other key stakeholders can expand resources and facilitate focus on community health issues more effectively than can any agency or organization acting alone. There is, however, little empirical evidence drawn from actual public health emergency responses to support this claim. The US response to novel influenza A (H1N1) virus provided the Centers for Disease Control and Prevention (CDC) the opportunity to explore whether, and the extent to which, state, local and territorial health departments strengthened partnerships with key partner agencies and sectors.


Participants included the CDC Public Health Emergency Response (PHER) grantees comprised of 62 state, territorial and local health departments. PHER grantees completed an assessment instrument in May 2011, including questions asking them to rate their partnership strength (on a four-point ordinal scale) with six types of partners before and after the H1N1 response. Grantees additionally reported if and how PHER funding contributed to enhancing the strength of these partnerships.


Sixty-one PHER grantees (61/62, 98%) completed the assessment instrument's partnerships section. PHER grantees reported that their partnerships with retail pharmacies were most strengthened (mean increase = 1.11 (on a four-point ordinal scale), SD = .82). This was followed by schools (K-12) (mean increase = .90, SD = .58); private medical providers (mean increase = .81, SD = .68); immunization authorities (mean increase = .80, SD = .61); main education authorities (mean increase = .75, SD = .68); and businesses (mean increase = .74, SD = .61). Mean PHER grantee increases in the strength of each partner type were statistically significant for all partner types (P < .01). Grantees reported that PHER funding contributed to enhancing the strength of their partnerships with schools most frequently (46/46, 100%), and businesses least frequently (31/37, 83.8%).


This inquiry provides evidence that state, territorial, and local health department partnerships with key sectors, agencies, and programs were strengthened after the H1N1 response. It further demonstrates that the CDC's PHER funding contributed to the health departments’ reports of increased partnership strength.

KunK, ZimmermanJ, RoseD, RubelS. State, Territorial, and Local Health Departments’ Reporting of Partnership Strength Before and After the H1N1 Response. Prehosp Disaster Med. 2013;28(6):1-6.

Corresponding author
Correspondence: Dale A. Rose, PhD Office of Public Health Preparedness and Response Centers for Disease Control and Prevention 1600 Clifton Road, NE, Mailstop D18, Atlanta, GA 30333 USA E-mail
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

9. FH Norris , SP Stevens , B Pfefferbaum , et al. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol. 2008;41(1-2):127-150.

12. C Elrod , J Hamblen , F Norris . Challenges in implementing disaster mental health programs: State program directors’ perspectives. Annals of the American Academy of Political and Social Science. 2006;604:152-170.

13. F Norris , P Watson , J Hamblen , B Pfefferbaum . Provider perspectives on disaster mental health services in Oklahoma City. J Aggress Maltreat Trauma. 2005;10(1-2):649-661.

15. LA Rosenfeld , P Etkind , A Grasso , et al. Extending the reach: local health department collaboration with community pharmacies in Palm Beach County, Florida for H1N1 influenza pandemic response. J Public Health Manag Pract. 2011;17(5):439-448.

17. PG Foster-Fishman , SL Berkowitz , DW Lounsbury , et al. Building collaborative capacity in community coalitions: A review and integrative framework. Am J Community Psychol. 2001;29(2):241-261.

24. CC Pratt , WM McGuigan , AR Katzev . Measuring program outcomes: Using retrospective pretest methodology. American Journal of Evaluation. 2000;21(3):341-350.

25. L Griner Hill , DL Betz . Revisiting the Retrospective Pretest. American Journal of Evaluation. 2005;26:501-517.

K Kun , J Zimmerman , D Rose , S Rubel . State, territorial, and local health departments’ reporting of partnership strength before and after the H1N1 response. Prehosp Disaster Med. 2013;28(6):1-6

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 3
Total number of PDF views: 7 *
Loading metrics...

Abstract views

Total abstract views: 151 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 29th May 2017. This data will be updated every 24 hours.