All ETDs from UAB

Advisory Committee Chair

Nir Menachemi

Advisory Committee Members

Leslie M Beitsch

Peter M Ginter

Grant T Savage

Biskha Sen

Document Type


Date of Award


Degree Name by School

Doctor of Public Health (DrPH) School of Public Health


This dissertation, comprised of three publishable manuscripts, addresses various identified gaps in the literature focused on public health systems and services research. Public health systems and services research includes studies that examine the organization, financing and delivery of public health services in communities, and the impact of these services on public health. Specifically, this dissertation focuses on three topics: (1) the measurement of the health care market environment of local public health departments, (2) community characteristics related to quality improvement strategies in local public health environments, and (3) the longitudinal changes in public health partnerships and how these partnerships relate to health outcomes. The first study presented in this dissertation is a systematic review of studies that examined the market environment of health care organizations. It summarizes the ways that the environmental constructs munificence, dynamism, and complexity have been operationalized for empirical studies. The second study of this dissertation examines the relationship between the market environment of local public health departments and the use of quality improvement within these organizations. It presents the first attempt at operationalizing characteristics of local public health markets into variables representing the level of resources and uncertainty within the market. The third study of this dissertation is a longitudinal examination of local public health partnerships over time and the relationships between partnerships and health outcomes.

Included in

Public Health Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.