Use of local health department websites: A study of e-government adoption and diffusion

Pamela Massie Aaltonen, Purdue University

Abstract

Two distinct but converging activities have the potential to alter the way local public health departments conduct business. These activities are the emergence of e-government and the addition of preparedness as a basic function of the public health system. Preparedness implies timely collaboration with government entities, community partners and the public; e-government provides a mechanism for these timely interactions. The aspect of e-government explored in this study is the adoption and diffusion of local health department websites. To discern the status of local e-government activities, 527 local health department websites were evaluated with regard to the level of website diffusion, functions that are supported on websites, the extent to which websites are being employed as a means of preparedness activities, and how well local health department websites meet quality measures. Local health department websites were viewed twice, at a two year interval, to determine changes made. While health departments modified site attributes and additional department websites were developed, there were only modest changes in the level of sophistication with 85 (16%) and 87 (16%) departments having the ability to do two-way transactions in 2008 and 2011 respectively. More commonly, websites incorporated a less sophisticated option of downloadable forms that expand access to materials but do not allow a remote electronic transaction. The growing numbers of departments posting health alerts were doing so primarily for foodborne illnesses or food recalls, but they could use this capacity to provide alerts when needed for preparedness. Yet, a considerable number, 30% in 2008 and 23% in 2011, of local health departments were not exploiting their websites as a strategic resource for preparedness. In 2008, 16% of local health departments were without a website, improving to 13% in 2011; the majority of these local health departments served smaller jurisdictions. Consistent with innovation and diffusion research, size is important in understanding differences in local health department websites, with those serving populations in excess of 500,000 people being substantially different than those serving jurisdictions of less than 50,000 people in level of sophistication, comprehensiveness of information, and incorporated features. Differences in these measures also exist among the states represented in the study. In conclusion, study results suggest a slow, incremental rather than transformational change in local e-government when measured by local health department website development. Findings suggest the need for guidelines similar to those available for the federal and state governments that incorporate best practices and benchmarks to improve website diffusion and level of sophistication. A condition critical to facilitating progress is a deliberate allocation of resources specifically for expansion of local e-government, particularly among small and medium health departments. In addition, preparedness should have more of a focus in local health department website creation and development.

Degree

Ph.D.

Advisors

McInerney, Purdue University.

Subject Area

Information Technology|Public health|Web Studies

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