James Anthony Ransom is a 2013 graduate of the PhD Program in Leadership and Change.

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Organizational culture is defined as a system of shared meaning held by members of an organization that distinguishes it from other organizations. How organizational culture is experienced in the public sector, particularly local health departments (LHDs), is not well understood. The purpose of this study was to determine whether LHD organizational culture impacts childhood immunization coverage rates. I used a modified organizational culture survey tool, the Organizational Management Survey, to quantify organizational culture and determine whether an LHD's organizational culture helps explain variations in childhood immunization coverage rates. In addition, qualitative data from an earlier study of LHD immunization staff were used to enhance the quantitative results. I used factor analysis and hierarchical regression analyses to explore organizational and demographic factors associated with variations in community childhood immunization coverage rates. The factors included organizational culture, organizational leadership, type of LHD, agency size, jurisdiction type, and participation in an immunization coalition. Among the LHD immunization programs in the study sample, organizational culture and type of LHD were significant predictors of immunization rate variation. This two-item model explained 6% of the variation in vaccination coverage levels among the respondents. The other variables did not contribute significantly. This study identified key issues for better understanding how organizational culture functions in LHDs. This research provides information on the impact that organizational culture has on work method and outcomes. Some specific changes can take place or be implemented once this is understood. The electronic version of this Dissertation is at OhioLink ETD Center,