Research Objective: Identify organizational, structural, workforce, and community level factors related to accreditation status of local health departments (LHDs) in the state of Missouri.

Data Sets and Sources: We used data from NACCHO’s 2010 National Profile of LHDs survey, American Community Survey, and the Missouri Department of Health and Senior Services 2012 Infrastructure Survey of Local Health Departments, which contained accreditation status of LHDs through Missouri’s Voluntary Accreditation Program (MOVAP) as well LHD structure, staffing, activities and programs.

Study Design: Our study design was observational and cross-sectional employing secondary data from multiple sources, with a sample size of 97 LHDs or 85% of 115 Missouri LHDs.

Analysis: We performed parametric and non-parametric bivariate analysis for predictors, including governance/funding, leadership/workforce, accreditation prerequisites, barriers to accreditation, and community characteristics. For the multivariate analysis of accreditation status, we performed binary logistic regression.

Principal Findings: Preliminary analyses show associations between accreditation status and multiple organizational, structural, workforce, and community level predictors, including funding, governance by a local board of health, administrator with at least a master’s degree, completion of accreditation prerequisites, utilization of performance management and improvement principles and tools, and multi-jurisdictional partnerships.

Conclusion: Accredited LHDs differed on many organizational, structural, workforce, and community level factors; many of these are amenable in nature. Interestingly, LHDs located near accredited LHDs are more likely to also be accredited.

Implications for the Field of PHSSR: Understanding the characteristics of non-accredited LHDs that differ from accredited LHDs in terms of leadership, structure, budget, and workforce has important implications for LHDs, local and national voluntary accreditation programs and their partners