Background: Accreditation is one of the macro trends shaping the future of public health practice and the Community Guide is a decision-making tool used to select evidence-based interventions. Although Local Health Departments (LHDs) seeking accreditation use The Community Guide, the association between the two remains unknown. The purpose of this study was to determine whether accreditation engagement influences the extent to which LHDs use The Community Guide.

Methods: Data from the National Association of County and City Health Officials’ 2016 Profile of LHDs were examined for associations between accreditation engagement with the use of The Community Guide.

Results: While 52.8% of LHDs used The Community Guide sometimes or consistently, only 21.5% were engaged in the accreditation process. Engaged LHDs had a higher odds of using The Community Guide at a greater extent than those not involved (Odds Ratio (OR) 3.8 [95% CI:2.7-5.0]). LDHs having a top executive with a doctoral degree (OR: 2.8 [1.6-5.0]), serving a population of over 500,000 (OR: 3.13 [1.9-5.3], and having a county level jurisdiction (OR:1.9 [1.4-2.6]) were more likely to use the Community Guide.

Conclusions: The extent LHDs utilize the Community Guide is positively associated with the level of their accreditation engagement. Training and policy measures could encourage LDHs to seek accreditation and use the community guide for evidence-informed practice thereby improving population health. Future studies need to clarify the causal nature of factors predicting community guide usage.