Managing public health in the Army through a standard community health promotion council model.

Public health processes in the US Army remain uncoordinated due to competing lines of command, funding streams and multiple subject matter experts in overlapping public health concerns. The US Army Public Health Command (USAPHC) has identified a standard model for community health promotion councils (CHPCs) as an effective framework for synchronizing and integrating these overlapping systems to ensure a coordinated approach to managing the public health process.The purpose of this study is to test a foundational assumption of the CHPC effectiveness theory: the 3 features of a standard CHPC model - a CHPC chaired by a strong leader, ie, the senior commander; a full time health promotion team dedicated to the process; and centralized management through the USAPHC - will lead to high quality health promotion councils capable of providing a coordinated approach to addressing public health on Army installations.The study employed 2 evaluation questions: (1) Do CHPCs with centralized management through the USAPHC, alignment with the senior commander, and a health promotion operations team adhere more closely to the evidence-based CHPC program framework than CHPCs without these 3 features? (2) Do members of standard CHPCs report that participation in the CHPC leads to a well-coordinated approach to public health at the installation?The results revealed that both time (F(5,76)=25.02, P<.0001) and the 3 critical features of the standard CHPC model (F(1,76)=28.40, P<.0001) independently predicted program adherence. Evaluation evidence supports the USAPHC's approach to CHPC implementation as part of public health management on Army installations. Preliminary evidence suggests that the standard CHPC model may lead to a more coordinated approach to public health and may assure that CHPCs follow an evidence-informed design. This is consistent with past research demonstrating that community coalitions and public health systems that have strong leadership; dedicated staff time and expertise; influence over policy, governance and oversight; and formalized rules and regulations function more effectively than those without. It also demonstrates the feasibility of implementing an evidence-informed approach to community coalitions in an Army environment.