摘要：We identified, described, and defined models of academic institution–public health agency partnerships in Florida. The study involved a mixed-method research design using data collected from a survey of 67 county health department (CHD) administrators and directors in Florida, in-depth interviews of key informants, and reviews of relevant Florida statutes and other archival data providing context for the partnerships. Fifty-one of the CHDs (76%) participated in the survey. Most reported formal agreements involving 50 different academic institutions. The partnerships were perceived to enhance the local public health system’s capacity. Recommendations focus on the need for a multitiered system for recognition of the partnerships and expansion of federal support for partnership beyond existing approaches. Following the Institute of Medicine’s recognition of the importance of collaboration to the future of public health, 1 , 2 partnerships between public health agencies and academic institutions have received increased attention. Most of the partnerships described, however, have been collaborations related to single specific issues or services. Although these collaborative activities are wide-ranging (emergency preparedness, 3 , 4 disease prevention and control, 5 – 8 reducing health disparities, 9 hospices, 10 minority health, 11 minority workforce recruitment, 12 , 13 rural health, 14 , 15 maternal and child health, 16 environmental health, 17 , 18 education, research, and service, 19 – 23 and so on), they do not provide a holistic or systems view of academic institution–public health agency (academic–agency) partnerships. Most assessments of these relationships have been conducted by public health academic institutions and primarily reflect the faculties’ own reports of success, 24 – 35 as do recent assessments involving schools of nursing 36 – 44 and medicine. 45 – 47 Third-party evaluation is rare, and little is known of what the leaders of health agencies think about the value of these partnerships to their organizations and to the health and well-being of the communities they serve. The growing interest of schools of public health in these partnerships can be traced to the 1988 Institute of Medicine report The Future of Public Health , which concluded that “schools of public health have in recent years become somewhat isolated from the field of public health practice.” 1 (p128) Schools of public health responded by focusing more on practice, 48 – 50 but the notable academic partnerships that emerged have been with state health departments. 51 , 52 Third-party assessment of academic institutions’ progress in forming partnerships with local public health agencies has not been optimistic. According to a recent study by the Health Resources and Services Administration on the public health workforce, “While there are a few examples of successful collaborations between schools of public health and public health agencies at the local level, schools of public health, in general, have done a poor job of partnering with these agencies.” 53 (p4) The “academic health department” concept, 54 a robust model for collaborations between public health agencies and academic institutions, has reinvigorated interest and enthusiasm for expanded academic–agency partnerships. 55 These collaborations are similar to the relationship between teaching hospitals and medical schools in academic medical centers. Teaching hospitals are well established in American society, with volumes of literature discussing their relationships with communities and academic institutions (see, for example, Meyer et al. 56 and Naughton and Vana 57 ). Applying the academic medical center model to public health, a health department would become a center for advanced public health practice where university faculty would serve as both public health agency staff and university teaching and research faculty. This model is well developed at the state level in New York and Arkansas by affiliations between the state departments of health and schools of public health, but its status at the local level is not as well defined. Keck’s 54 description of partnerships that provide for joint appointment of faculty or staff appears to be fundamental to the emergence of this model for public health, but a paucity of literature limits insights into best practices, characteristics, or definitions of what constitutes an “academic health department.” In view of the increasing interest in academic health departments, and the scant data related to their development, we implemented this study in 2005 to define the current status of collaboration between academic institutions and local health departments. The study was catalyzed in part by the need for the Florida Association of County Health Officials (FACHO) to respond to questions from the Florida Department of Health (DOH) about the importance and legitimacy of these relationships. We attempted to (1) identify and describe models for academic–agency partnerships throughout the state, (2) assess health department directors’ perceptions of the impact of these partnerships on core public health functions, and (3) identify guiding principles or best practices for their development. The study involved a survey of all county health department (CHD) administrators and directors in Florida’s 67 counties, in-depth interviews of key informants on academic–agency partnerships, and a review of Florida statutes and other archival source material that define and govern the agencies and institutions involved in these partnerships.
