The 2009 H1N1 influenza A virus vaccination campaign focused on use of school-located vaccination (SLV) clinics because of the ability of SLV to reach targeted populations. Large numbers of children are found in schools, and schools are conveniently located throughout communities. Communities are generally familiar with and trust schools, and school facilities can generally accommodate mass vaccination clinics. School nurses are familiar with the health of individual students and may be available to assist in vaccination activities. In addition, schools have access to parental contact information, which can facilitate communications. Challenges faced by local health departments (LHDs) and schools in implementing 2009 H1N1 SLV clinics, including disruption of educational activities, locating adequate staff, tailoring immunization activities to meet the needs of each school district, and transportation and administration of vaccine, are explored.

The 2009 H1N1 influenza virus presented a major challenge to health departments, schools, and other community partners to effectively vaccinate large numbers of Americans, primarily children. The use of school-located vaccination (SLV) programs to address this challenge led health departments and schools to become creative in developing models for successful SLV implementation. Successful models are explored in this article.

Background The COVID-19 pandemic has highlighted the need for nurse leaders who “embrace the interconnection” between medicine and public health. The inequitable impact of COVID-19 on people of color demonstrates the importance of applying expertise from nursing practice and public health systems to work with communities and other professions on complex health issues. Yet, despite a clear need for improved population health, educational programs designed to produce Advanced Public Health Nurses, with skills to address complex system changes, have become increasingly scarce. Purpose We put forward the perspective that the nation needs more advanced practice nurses prepared for leadership roles focused on the health of whole populations, marginalized communities, and the systems and policies that promote their health. Discussion We argue that opportunities should be expanded for nurses to attain education for these roles through increased investments in the Doctor of Nursing Practice model to prepare nurses for advanced public health specialty practice.

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Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB.

The Interactive and Organizational Model of Community as Client is presented as a conceptual framework for the specialty of public health nursing. A descriptive study was undertaken that explored a construct of the model, community-focused nursing. The study used a survey mailed to a stratified, random sample of directors of public health nursing (n = 145) in local health departments in an eight-state region of the midwestern United States. Seventy-nine percent (n = 115) of the directors responded. The vast majority reported performance of community-focused nursing functions. Implications for nursing-model development, education and practice are discussed.

Despite the fact that community assessment has been identified as a core function of public health for more than 2 decades, evaluations of the impact of the practice of community health assessment are few in number and have only recently been published. This article describes an evaluation of a 2011-2012 community health needs assessment (CHNA) of Kane County, Illinois. The evaluation customized and used a reliable and valid Web-based survey, the New York State Community Health Assessment Usefulness Survey, to measure Kane County CHNA user perceptions of content, format, and impact utility of the assessment. Survey respondents were community leaders and members from a diverse set of professional backgrounds and were nearly evenly divided between those who had actively participated in the CHNA and those that had not. Respondents were overwhelmingly positive in their evaluation of the Kane CHNA, with an average per item score of greater than 3 on a 4-point Likert scale, although respondents who were not involved in the CHNA process were less positive than those directly involved. Implications for public health practitioners and researchers are discussed.

Objectives: Estimate the number of full-time equivalents (FTEs) needed to fully implement Foundational Public Health Services (FPHS) at the state and local levels in the United States. Methods: Current and full implementation cost estimation data from 168 local health departments (LHDs), as well as data from the Association of State and Territorial Health Officials and the National Association of County and City Health Officials, were utilized to estimate current and "full implementation" staffing modes to estimate the workforce gap. Results: The US state and local governmental public health workforce needs at least 80 000 additional FTEs to deliver core FPHS in a post-COVID-19 landscape. LHDs require approximately 54 000 more FTEs, and states health agency central offices require approximately 26 000 more.Conclusions: Governmental public health needs tens of thousands of more FTEs, on top of replacements for those leaving or retiring, to fully implement core FPHS. Implications for Policy and Practice: Transitioning a COVID-related surge in staffing to a permanent workforce requires substantial and sustained investment from federal and state governments to deliver even the bare minimum of public health services.