Are we measuring what we think we are measuring? the validity and reliability of the astho profile of state public health survey instrument

The Association of State and Territorial Health Officials (ASTHO) Profile of State Public Health survey is one of the few sources of data available on state public health agencies and the state public health system. As such, it has played and plays a critical role in past and ongoing attempts to answer research questions regarding areas such as the optimal structure, funding patterns and workforce characteristics for state health agencies, and, perhaps more importantly, the implications of variations in these areas on the delivery of services to the public, and the impact of variations on health status. While the Profile is a widely used and important tool, the validity and reliability of key areas of the Profile have not been investigated. Thus, it is possible that the data used to answer research questions like the ones mentioned above, and, perhaps more importantly, the recommendations made to practitioners based upon the results of that research, are based on data that may not adequately reflect the reality of public health practice in the United States. Given the primary role of the Profile in research on state public health organizations, it is vital to determine the validity and reliability of the instrument. This project uses a combination of methods to determine the validity and reliability of three areas of the survey used most often in research: the finaicial characteristics of agencies, agency workforce makeup, and the services provided by agencies. This work, when completed, will allow ASTHO to modify the Profile if necessary, and, perhaps more importnatly, will assure that the research conducted and practice recommendations made using data from the Profile are sound, and can be used to improve practice. While the work for this project is ongoing, we expect that it will be completed in time to present at the conference.