Methods
In 2014, a secondary analysis was conducted of data collected
between 2007 and 2011 from 2,734 employees in 19 LHDs located
in seven states: Arizona (one); Arkansas (three); Florida (nine);
Ohio (one); Montana (one); New Jersey (one); and New York
(three). The original studies were conducted under protocols
approved by the Columbia University IRB. The average LHD size
was 128 full-time equivalents (FTEs) and ranged from 35 to 565
FTEs. Data were collected via an organizational survey developed
in prior research, which was customized for each LHD to include