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    Pérez, Anna Rodríguez, Tània López, Maria José Continente, Xavier and Nebot, Manel 2016. Adoption of Preventive Measures and Attitudes Toward the H1N1 Influenza Pandemic in Schools. Journal of School Health, Vol. 86, Issue. 7, p. 534.


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)
  • DOI:
  • Published online: 07 November 2013

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
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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

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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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