On the other hand, in addition to the barriers identified by survey respondents that prevented their pursuit of a partnership with an educational institution, we speculate that organizational culture could also be a significant inhibitor of pursuing such relationships. Academic institution-health department partnerships are recommended as an advantageous collaboration that can address a capacityconstrained community and contribute to training the current and future public health workforce [19]. However, we argue that it can take significant time and effort to develop such a partnership and that both partners need to be willing to engage in the process and commit to the time it will take to develop mutual respect, trust, and open communication
[20]. These are working principles common to communitybased participatory research that is conducted between partners that traditionally operate in very different organizational cultures and environments [21]. Covich et al. [22] report similar working principles for their academichealth department partnership that worked to improve public health preparedness.