Survey respondents were requested to identify barriers that prevent their pursuit of a partnership with an educational institution (Table 3). LHD directors who reported an existing partnership with an educational institution, as well as LHD directors who did not report a partnership responded to this question. The content of the responses were coded and themes of barriers were identified: lack of time, lack of adequate funding, and a lack of adequate staffing. The LHDs without an academic partnership also identified a ‘‘lack of interest’’ on the part of LHD employees and on the part of the nearby educational institution. Other barriers included politics and an absence of policies to govern such partnerships. For those LHDs with an academic partnership, they most often classified their level of engagement as ‘‘moderate’’ and rated their partnership with academia as ‘‘very valuable’’ on a Likert scale.