Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health


Health Promotion

First Committee Member

Marisa Rosen

Second Committee Member

Celeste Ehrenberg

Third Committee Member

Nicole Kolm-Valdivia


The Division of Public Health (DPH) within the Nebraska Department of Health and Human Services (DHHS) is redesigning its State Health Assessment (SHA) and State Health Improvement Plan (SHIP) procedures. This study aimed to support the Nebraska DPH SHA/SHIP redesign evaluation plan by determining the local health department (LHD) health priority determination processes, Tribal and LHDs’ (T/LHD) CHA/CHIP methodology, and if any differences exist between rural & urban and small, medium, and large jurisdictional size health departments in Nebraska. The results show that most health departments utilize the MAPP process to conduct their CHA/CHIP, one tribal entity utilizes a different evidence-based practice that originated from an out-of-state tribal entity, and 88% of LHDs selected mental health as a priority. Urban health departments were able to complete the CHA/CHIP process in a shorter time frame and utilized more secondary data sources than rural health departments. But multiple T/LHD representatives detailed data access barriers throughout the CHA/CHIP process. Additionally, this project showed that both rural and urban health departments in Nebraska have approximately 40% fewer Full-Time Equivalents (FTEs) than the national average of LHDs with similar population sizes. Finally, this project revealed that many LHDs say that the usefulness of Nebraska’s SHA/SHIP would be greatly enhanced by improving the allocation and alignment of funding and resources with local health priorities, aligning the timing of local CHA/CHIP processes with the state’s SHA/SHIP, and encouraging greater transparency and communication between DPH and LHDs. The discussion summarizes the key findings of this research report and details recommendations to improve the local CHA/CHIP and Nebraska’s SHA/SHIP processes.

Included in

Public Health Commons