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Perry IA. Assessment, Policy Development, and Assurance: Evolving the Core Functions of Public Health to Address Health Threats. AJPM FOCUS 2024; 3:100172. [PMID: 38249788 PMCID: PMC10797537 DOI: 10.1016/j.focus.2023.100172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Ijeoma A. Perry
- Administration for Strategic Preparedness and Response, HHS, Washington, District of Columbia
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Nganga-Good C, Chayhitz M, McLaine P. Overcoming barriers and improving public health nursing practice. Public Health Nurs 2023; 40:114-123. [PMID: 36285363 DOI: 10.1111/phn.13139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 01/14/2023]
Abstract
Public health nurses (PHN) are critical to ensuring the health of communities. Absent the most basic information on the PHN workforce in our state, we conducted interviews with 21 PHN and school health nurse (SHN) leaders and an online survey of PHNs and SHNs practicing in Maryland (N = 491). Our study identified an older, very experienced, and well-educated workforce. Both the interviews and survey identified similar barriers: low salaries, recruitment and hiring challenges, limited funding for public health programs, and no opportunities for education or career advancement. Survey participants also identified barriers of inadequate leadership, recognition, and communication including PHNs not being represented at decision-making tables or at the state leadership level. Strategies to promote public health nursing from leaders and survey participants were similar: increasing awareness about what public health and PHNs do and their value; improving advocacy and stakeholder engagement; improving access and availability of services; improving PHN leadership representation at the state level; a improving PHN salaries and benefits including tuition reimbursement. Although results were similar to national studies, comprehensive, granular workforce data is critical to ensure the public health workforce can meet current and emerging public health needs and that public health infrastructure and services are appropriately funded.
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Affiliation(s)
- Carolyn Nganga-Good
- Maryland Robert Wood Johnson Foundation Public Health Nurse Leader, 2015-2017, Princeton, New Jersey
| | - Mattison Chayhitz
- Former Graduate Research Assistant at University of Maryland School of Nursing, Baltimore, Maryland
| | - Pat McLaine
- Retired Specialty Director, Community Public Health Nursing Master's Program, University of Maryland School of Nursing, Baltimore, Maryland
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Gotsadze G, Mirzikashvili N, Kekelidze D, Kalandarishvili S, Kalandadze I, Abiatari I, Zoidze A. The State of Public Health Education and Science During and After the Fall of the Soviet Union: Achievements, Remaining Challenges, and Future Priorities. Front Public Health 2022; 10:871108. [PMID: 35784230 PMCID: PMC9240624 DOI: 10.3389/fpubh.2022.871108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesIn the post–COVID-19 world, when the adequacy of public health workforce education is being critically re-evaluated, this study undertakes a historical analysis of how the educational and scientific field of public health developed during and after the fall of the Soviet Union in 1991. The study intends to historically contextualize public health education and science development in former Soviet Republics. It attempts to document achievements after gaining independence and identify remaining challenges that need to be addressed for advancing public health science and education in Former Soviet Union countries to better prepare them for future pandemics and address current health challenges of the nations.MethodsThe study used a mixed-methods review approach combining both a literature review, information collection from the school's websites, and secondary analysis of the quantitative data available about scientific outputs—peer-reviewed articles.ResultsDuring communist rule and after the fall of the Soviet Union, the main historical events seem to have shaped the public health field of former Soviet countries, which also determined its eventual evolution. The international efforts post-1991 were instrumental in shifting medically oriented conceptualization of public health toward Western approaches, albeit with variable progress. Also, while scientific output has been growing from 1996 to 2019, sub-regional differences remain prominent.ConclusionThe region seems to have matured enough that it might be time to start and facilitate regional cooperation of public health schools to advance the field of public health and research. Regional and country variabilities feature prominently in the volume and quality of scientific output and call for the immediate attention of national governments and international partners.
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Affiliation(s)
- George Gotsadze
- Curatio International Foundation, Tbilisi, Georgia
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi, Georgia
| | - Nino Mirzikashvili
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi, Georgia
- *Correspondence: Nino Mirzikashvili
| | - Dali Kekelidze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Iagor Kalandadze
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi, Georgia
| | - Ivane Abiatari
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi, Georgia
| | - Akaki Zoidze
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi, Georgia
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Glynn MK, Paek M, Radkey C, Arvelo W, Greene E, Hardwick I, Neri A. Strategic Development of the Public Health Workforce: A Unified Logic Model for a Multifaceted Program at the Centers for Disease Control and Prevention. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:62-69. [PMID: 31592980 DOI: 10.1097/phh.0000000000000983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Public health has a responsibility to ensure the ability of its workforce to deliver essential services, including mastering the core public health competencies. PROGRAM The Division of Scientific Education and Professional Development (DSEPD) of the Centers for Disease Control and Prevention has a mission to improve health outcomes through a competent, sustainable, and empowered public health workforce. The DSEPD programs offer fellowships and other training opportunities, develop and disseminate quality public health training, and advance public health workforce development science. EVALUATION The DSEPD developed a unified division logic model to describe the combined activities and intended outcomes of all DSEPD programs and their intended contribution to a robust public health workforce and to support ongoing program planning and evaluation. The logic model has 4 streams of work that include (1) producing and disseminating quality learning products; (2) implementing and managing fellowship programs that support learning; (3) providing public health service through fellows; and (4) advancing workforce development science through collaboration with other public health leaders.The underlying program theory is that a robust workforce has sufficient workforce, organizational, and systems capacity to deliver public health essential services and, therefore, to protect the public's health. Three scientific theories support the program theory: the quality of learning; the accepted practice of competency-based programs and the service-learning model; and use of evidence-guided decision making in workforce development programs. DISCUSSION A unified division logic model allows DSEPD to describe its combined approaches to workforce development as a coherent portfolio with well-defined goals and measureable outcomes. The logic model effectively communicates the relationship among division programs, their shared outcomes, and their combined contributions to developing and maintaining a robust public health workforce. A unified logic model can serve as effective frame of reference for division evaluation and as evidence in public health workforce development science.
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Affiliation(s)
- M Kathleen Glynn
- Centers for Disease Control and Prevention, Office of Public Health Scientific Services, Center for Surveillance, Epidemiology, and Laboratory Services, Division of Scientific Education and Professional Development, Atlanta, Georgia
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Glynn MK, Jenkins ML, Ramsey C, Simone PM. Public Health Workforce 3.0: Recent Progress and What's on the Horizon to Achieve the 21st-Century Workforce. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S6-S9. [PMID: 30720611 PMCID: PMC6519880 DOI: 10.1097/phh.0000000000000971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M Kathleen Glynn
- Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Glynn and Simone); Behavioral and Public Health Branch, Division of Nursing and Public Health, Bureau of Health Workforce, Health Resources and Services Administration, Rockville, Maryland (Mr Jenkins and Ms Ramsey)
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Changes in the State Governmental Public Health Workforce: Demographics and Perceptions, 2014-2017. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S58-S66. [PMID: 30720618 PMCID: PMC6519782 DOI: 10.1097/phh.0000000000000933] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Context: Workforce is a critical cog in the governmental public health enterprise in the United States. Until 2014, workforce research was largely conducted at the organizational level. However, the fieldings of the Public Health Workforce Interests and Needs Survey allow for nationally representative comparisons with individual respondents. Objective: Using data from agencies that participated in 2014 and 2017, we conducted multi–cross-sectional comparisons of the Public Health Workforce Interests and Needs Survey data. Design: The Public Health Workforce Interests and Needs Survey participants at the State Health Agency Central Offices were surveyed using a Web-based platform. Balanced repeated replication weights were used to account for differential designs between 2014 and 2017. Setting: Thirty-three state health agency central offices that participated in both 2014 and 2017. Participants: Permanently employed governmental public health staff. Main Outcome Measures: We examined changes in perceptions of the workplace environment, job and pay satisfaction, intent to leave, awareness of emerging concepts in public health, and demographic/worker characteristics. Pearson and Rao-Scott–adjusted χ2 analyses were used to compare changes between 2014 and 2017. Results: The percentage of staff who are people of color increased from 29% (95% confidence interval, 28%-30%) to 37% (95% confidence interval, 36%-38%) from 2014 to 2017 across 33 states. Approximately 26% of staff were younger than 40 years in 2014 compared with 29% in 2017 (P < .001). Job satisfaction increased in 17 states overall (P < .05, n = 5) and decreased in 16 states (P < .05, n = 5) but did not change in aggregate. Overall, the percentage of staff considering leaving the organization in the next year or retiring within 5 years is up from 44% to 48% (P < .001). Conclusions: Global measures of satisfaction are relatively high and consistent between 2014 and 2017. Demographics are shifting toward a marginally younger workforce as many retire, and a significant portion of staff indicates that they are considering leaving their organization or planning to retire.
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The Public Health Workforce Interests and Needs Survey (PH WINS 2017): An Expanded Perspective on the State Health Agency Workforce. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S16-S25. [PMID: 30720614 PMCID: PMC6519868 DOI: 10.1097/phh.0000000000000932] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Context: Workforce surveillance efforts have long been called for in public health: the Public Health Workforce Interests and Needs Survey (PH WINS) answers that call. Objective: To characterize the state of the governmental public health workforce among State Health Agency-Central Office (SHA-CO) staff across the United States. Design: The SHA leadership were contacted and invited to have their agency participate in PH WINS 2017 as a census-based fielding. Participating agencies provided staff lists, and staff were then directly invited by e-mail to participate in a Web-based survey. Pearson and Rao-Scott χ2 analyses are employed in descriptive analyses. Balanced repeated replication weights account for design and nonresponse. Setting and Participants: SHA-CO staff. Main Outcome Measures: The PH WINS focuses on 4 primary domains: perceptions of workplace environment and job satisfaction, training needs, national trends, and demographics. In addition, measures of intent to leave and employee burnout are analyzed. Results: The state governmental public health workforce is primarily female (72%), non-Hispanic white (64%), and 46 years of age or older (59%). Nearly one-third (31%) of the workforce is older than 55 years, with 9% aged 30 years or younger. Overall, 74% of respondents indicated that they had at least a bachelor's degree, and 19% indicated having a public health degree of some kind. Seventy-nine percent of the respondents indicated that they were somewhat/very satisfied with their jobs. Approximately 47% of SHA-CO staff say that they are considering leaving or are planning to retire. With respect to training needs, the largest overall gaps for the state health agency workforce were observed in budget and financial management, systems and strategic thinking, and developing a vision for a healthy community. Conclusions: PH WINS represents the first nationally representative survey of governmental public health staff in the United States. It holds potential for wide usage from novel workforce research to identifying and helping address practice-based needs.
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Beatty K, Heffernan M, Hale N, Meit M. Funding and Service Delivery in Rural and Urban Local US Health Departments in 2010 and 2016. Am J Public Health 2020; 110:1293-1299. [PMID: 32673110 DOI: 10.2105/ajph.2020.305757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States.Methods. In this repeated cross-sectional study, we examined rural-urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data.Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P < .05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P < .05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P < .05).Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs' reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them.Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy.
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Affiliation(s)
- Kate Beatty
- Kate Beatty is with Health Services Management and Policy and Center for Rural Health Research, East Tennessee State University, Johnson City. Megan Heffernan is with Public Health Research, NORC at the University of Chicago, Bethesda, MD. Nathan Hale is with Health Services Management and Policy, College of Public Health, East Tennessee State University. Michael Meit is with Public Health Research Department, NORC Walsh Center for Rural Health Analysis, and Opioid and Substance Use Research Program, NORC at the University of Chicago, Bethesda
| | - Megan Heffernan
- Kate Beatty is with Health Services Management and Policy and Center for Rural Health Research, East Tennessee State University, Johnson City. Megan Heffernan is with Public Health Research, NORC at the University of Chicago, Bethesda, MD. Nathan Hale is with Health Services Management and Policy, College of Public Health, East Tennessee State University. Michael Meit is with Public Health Research Department, NORC Walsh Center for Rural Health Analysis, and Opioid and Substance Use Research Program, NORC at the University of Chicago, Bethesda
| | - Nathan Hale
- Kate Beatty is with Health Services Management and Policy and Center for Rural Health Research, East Tennessee State University, Johnson City. Megan Heffernan is with Public Health Research, NORC at the University of Chicago, Bethesda, MD. Nathan Hale is with Health Services Management and Policy, College of Public Health, East Tennessee State University. Michael Meit is with Public Health Research Department, NORC Walsh Center for Rural Health Analysis, and Opioid and Substance Use Research Program, NORC at the University of Chicago, Bethesda
| | - Michael Meit
- Kate Beatty is with Health Services Management and Policy and Center for Rural Health Research, East Tennessee State University, Johnson City. Megan Heffernan is with Public Health Research, NORC at the University of Chicago, Bethesda, MD. Nathan Hale is with Health Services Management and Policy, College of Public Health, East Tennessee State University. Michael Meit is with Public Health Research Department, NORC Walsh Center for Rural Health Analysis, and Opioid and Substance Use Research Program, NORC at the University of Chicago, Bethesda
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Undergraduate and graduate public health programs need changes to teach the public health workforce of the future. Dela J Public Health 2020; 6:24-26. [PMID: 34467089 PMCID: PMC8389124 DOI: 10.32481/djph.2020.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kerr D, Blavos A, Hancher-Rauch H, Brookins-Fisher J, Thompson A. CHES, MCHES, and/or CPH? Selecting the Best Credential for You. Health Promot Pract 2019; 20:167-172. [PMID: 30678505 DOI: 10.1177/1524839918825132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The health education profession within the broader context of public health has chosen certification to grant recognition to individuals meeting certain standards, as well as optional accreditation of academic programs. Regarding certification options for health education professionals, those who qualify may sit for the exams to achieve one of the following certifications: Certified Health Education Specialist (CHES), Master Certified Health Education Specialist (MCHES), or Certified in Public Health (CPH). Some health education and other professionals may be familiar with the concept of certification but may not be aware of the value of certification for the profession, their options for certification, or the processes of certification. This article provides information on CHES, MCHES, and CPH certifications and compares and contrasts their requirements. While many professionals may choose one credential over another, others may decide to pursue CHES/MCHES and the CPH. Credentialing continues to be an important part of advancing the health education profession and ensuring that those practicing in the field are highly qualified.
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Jackson JR, Holmes AM, Golembiewski E, Brown-Podgorski BL, Menachemi N. Graduation and Academic Placement of Underrepresented Racial/Ethnic Minority Doctoral Recipients in Public Health Disciplines, United States, 2003-2015. Public Health Rep 2018; 134:63-71. [PMID: 30500307 DOI: 10.1177/0033354918814259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Given public health's emphasis on health disparities in underrepresented racial/ethnic minority communities, having a racially and ethnically diverse faculty is important to ensure adequate public health training. We examined trends in the number of underrepresented racial/ethnic minority (ie, non-Hispanic black, Hispanic, American Indian/Alaska Native, Native Hawaiian, and Pacific Islander) doctoral graduates from public health fields and determined the proportion of persons from underrepresented racial/ethnic minority groups who entered academia. METHODS We analyzed repeated cross-sectional data from restricted files collected by the National Science Foundation on doctoral graduates from US institutions during 2003-2015. Our dependent variables were the number of all underrepresented racial/ethnic minority public health doctoral recipients and underrepresented racial/ethnic minority graduates who had accepted academic positions. Using logistic regression models and adjusted odds ratios (aORs), we examined correlates of these variables over time, controlling for all independent variables (eg, gender, age, relationship status, number of dependents). RESULTS The percentage of underrepresented racial/ethnic minority doctoral graduates increased from 15.4% (91 of 592) in 2003 to 23.4% (296 of 1264) in 2015, with the largest increase occurring among black graduates (from 6.6% in 2003 to 14.1% in 2015). Black graduates (310 of 1241, 25.0%) were significantly less likely than white graduates (2258 of 5913, 38.2%) and, frequently, less likely than graduates from other underrepresented racial/ethnic minority groups to indicate having accepted an academic position (all P < .001). CONCLUSIONS Stakeholders should consider targeted programs to increase the number of racial/ethnic minority faculty members in academic public health fields.
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Affiliation(s)
- Joanna R Jackson
- 1 Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Ann M Holmes
- 1 Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Elizabeth Golembiewski
- 1 Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | | | - Nir Menachemi
- 1 Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
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Sherrer KJ, Prelip ML. A Multifaceted Approach to Public Health Career and Professional Development Training. Health Promot Pract 2018; 20:932-940. [PMID: 29938535 DOI: 10.1177/1524839918783744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this article is to describe how a multifaceted approach to career and professional development training, focused on core competencies, student-driven programming, inter and multidisciplinary collaboration, and cultivating a community of insight and support, is being implemented by a university Public Health Career Services office with limited staff and resources and to share these practices for other public health programs to scale this approach to their own students' needs. The design of the career and professional development training program comprised five main approaches: (1) one-on-one career counseling, (2) peer-to-peer learning workshops, (3) community partnerships and experiential opportunities, (4) student-driven programming, and (5) accessible training and digital resources. All programs were tracked to gauge participation and to assess effectiveness. Noteworthy findings from program evaluations include (1) a large increase in student confidence levels in professionalism topics, from all of the school's departments; (2) benefits of student-driven programming and peer-to-peer learning, and (3) importance of employer and alumni engagement. Rather than use an optional participation model, it is recommended that a cohort model or mandatory participation be implemented as the opportunity to build on curriculum is vital.
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Drevdahl DJ, Canales MK. Public health nurses' graduate education decision making processes. J Prof Nurs 2017; 34:300-307. [PMID: 30055684 DOI: 10.1016/j.profnurs.2017.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 11/15/2017] [Accepted: 11/21/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION A well-educated public health workforce is needed to improve population health. Although nurses constitute the largest number of U.S. public health professionals, those holding graduate degrees remain low. This study describes public health nurses' (PHNs) perspectives on graduate school decision-making processes. METHODS Using a qualitative descriptive design, semi-structured, qualitative telephone interviews with PHNs (n=30) were conducted June 2014-January 2015. Study participants included PHNs from 17 states employed in a variety of positions within government health agencies, academe, and business. Interview transcripts were coded and thematically analyzed. RESULTS PHNs' pursuit of a graduate degree varied, often depending on work setting and/or availability of degree programs. Many study participants were unaware of the public health nursing graduate degree option, with only 9 of 26 participants obtaining an advanced degree in public health nursing. The MPH degree however, was well-known and particularly valued. CONCLUSION Opportunities for graduate public health nursing are limited; as such, marketing of existing programs need to be nationally coordinated and new collaborative efforts between schools of nursing and schools of public health developed. These efforts are required if graduate-prepared public health nurses are to be part of the future workforce, prepared to tackle increasingly complex population health issues.
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Affiliation(s)
- Denise J Drevdahl
- University of Washington Tacoma, 1900 Commerce Street, Campus Box 358421, Tacoma, WA 98402, United States.
| | - Mary K Canales
- University of Wisconsin, Eau Claire, College of Nursing & Health Sciences, 105 Garfield Avenue, Eau Claire, WI 54702, United States.
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McKay VR, Dolcini MM, Catania JA. Impact of Human Resources on Implementing an Evidence-Based HIV Prevention Intervention. AIDS Behav 2017; 21:1394-1406. [PMID: 27150896 PMCID: PMC5097686 DOI: 10.1007/s10461-016-1425-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Evidence-based interventions (EBIs) often require competent staff, or human resources (HR), for implementation. The empirical evidence characterizing the influence of HR fluctuations on EBI delivery is limited and conflicting. Using the Interactive Systems Framework, we explored staff fluctuation and the subsequent influence on RESPECT, an HIV prevention EBI. We conducted interviews with staff in two waves (n = 53, Wave I; n = 37, Wave II) in a national sample of organizations delivering RESPECT (N = 29). We analyzed interviews qualitatively to describe changes among RESPECT staff and explore the subsequent influences on RESPECT implementation. Organizations reported downsizing, turnover, and expansion of staff positions. Staff changes had multiple influences on RESPECT implementation including clients reached, fidelity to specific RESPECT protocols, and overall sustainability of RESPECT over time. HR fluctuations are common, and our analyses provide an initial characterization of the relationship between HR fluctuation and EBI implementation. Given the prominent influence of HR on EBI implementation, the Interactive Systems Framework is a useful guiding tool for future examinations.
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Affiliation(s)
- Virginia R McKay
- Hallie E. Ford Center for Healthy Children and Families, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, 2631 SW Campus Way, Oregon State University, Corvallis, OR, 97330, USA.
| | - M Margaret Dolcini
- Hallie E. Ford Center for Healthy Children and Families, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, 2631 SW Campus Way, Oregon State University, Corvallis, OR, 97330, USA
| | - Joseph A Catania
- Hallie E. Ford Center for Healthy Children and Families, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, 2631 SW Campus Way, Oregon State University, Corvallis, OR, 97330, USA
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Educational Attainment of the Public Health Workforce and Its Implications for Workforce Development. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 21 Suppl 6:S56-68. [PMID: 26422495 PMCID: PMC4590526 DOI: 10.1097/phh.0000000000000306] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study ascertains the levels of educational attainment among state health agency employees as well as the correlates of attainment. Educational attainment is a critical issue in public health workforce development. However, relatively little is known about the actual attainment of staff in state health agencies (SHAs).
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An Evaluation of a Competency-Based Public Health Training Program for Public Health Professionals in Kansas. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 23:447-453. [PMID: 28079642 DOI: 10.1097/phh.0000000000000513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Less than one-third of the US public health workforce has formal training in public health. Academic-public health agency partnerships aimed at addressing the nation's workforce challenges have shown great promise. OBJECTIVE To evaluate the effectiveness of a piloted competency-based public health training program formed out of an academic-public health agency partnership. DESIGN Mixed-methods design using pre- and postworkshop surveys and quizzes, open-ended questions, and document review. SETTING Large, urban local health department located in south central Kansas. MAIN OUTCOME MEASURES Participant satisfaction with training, knowledge change, self-report application of new knowledge, and organizational change. RESULTS Participants reported high satisfaction with the training program and valued the hands-on, practical approach used. Participation increased knowledge and confidence in public health competency areas covered in the program. At 3-month follow-up, 90% of participants reported applying new knowledge and skills in their primary job duties. At the organizational level, 3 major policy changes aimed at sustaining the program were implemented following its launch. CONCLUSION Incorporating tailored, theory-driven approaches to trainings and collaborating with health department leadership to identify policy opportunities that help sustain the training program within the agency is recommended. Findings from this evaluation demonstrate the success of an academic-agency partnership's effort to develop and implement at a large, urban local health department.
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Abstract
In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated education outcomes. First, for context, I briefly portray the nature of our related political and public health systems. I then frame this retrospective by illustrating how my serial employment within other public health system organizations led to, and then resulted from, my work within these two federal public health agencies. To represent the many talented individuals in each organization with whom I had the good fortune to work, I name only one in each organization. I then characterize how these individuals and organizations progressively shaped my work and career. I conclude by speculating about prospects for academic institutions to more purposefully prepare students and faculty to work within federal government public health agencies.
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Affiliation(s)
- Lloyd J Kolbe
- Indiana University School of Public Health-Bloomington, IN, USA
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Leider JP, Harper E, Shon JW, Sellers K, Castrucci BC. Job Satisfaction and Expected Turnover Among Federal, State, and Local Public Health Practitioners. Am J Public Health 2016; 106:1782-8. [PMID: 27552269 DOI: 10.2105/ajph.2016.303305] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To use data on the governmental public health workforce to examine demographics and elucidate drivers of job satisfaction and intent to leave one's organization. METHODS Using microdata from the 2014 Federal Employee Viewpoint Survey and 2014 Public Health Workforce Interests and Needs Survey, we drew comparisons between federal, state, and local public health staff. We fitted logistic regressions to examine correlates of both job satisfaction and intent to leave one's organization within the coming year. RESULTS Correlates of job satisfaction included pay satisfaction, organizational support, and employee involvement. Approximately 40% of federal, state, and local staff said they were either considering leaving their organization in the next year or were planning to retire by 2020. CONCLUSIONS Public health practitioners largely like their jobs, but many are dissatisfied with their pay and are considering working elsewhere. More should be done to understand the determinants of job satisfaction and how to successfully retain high-quality staff. PUBLIC HEALTH IMPLICATIONS Public health is at a crossroads. Significant turnover is expected in the coming years. Retention efforts should engage staff across all levels of public health.
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Affiliation(s)
- Jonathon P Leider
- At the time of the study, Jonathon P. Leider and Brian C. Castrucci were with the de Beaumont Foundation, Bethesda MD. Elizabeth Harper and Katie Sellers were with the Association of State and Territorial Health Officials, Arlington, VA. Ji Won Shon was with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Elizabeth Harper
- At the time of the study, Jonathon P. Leider and Brian C. Castrucci were with the de Beaumont Foundation, Bethesda MD. Elizabeth Harper and Katie Sellers were with the Association of State and Territorial Health Officials, Arlington, VA. Ji Won Shon was with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Ji Won Shon
- At the time of the study, Jonathon P. Leider and Brian C. Castrucci were with the de Beaumont Foundation, Bethesda MD. Elizabeth Harper and Katie Sellers were with the Association of State and Territorial Health Officials, Arlington, VA. Ji Won Shon was with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Katie Sellers
- At the time of the study, Jonathon P. Leider and Brian C. Castrucci were with the de Beaumont Foundation, Bethesda MD. Elizabeth Harper and Katie Sellers were with the Association of State and Territorial Health Officials, Arlington, VA. Ji Won Shon was with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Brian C Castrucci
- At the time of the study, Jonathon P. Leider and Brian C. Castrucci were with the de Beaumont Foundation, Bethesda MD. Elizabeth Harper and Katie Sellers were with the Association of State and Territorial Health Officials, Arlington, VA. Ji Won Shon was with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Klaiman T, Pantazis A, Chainani A, Bekemeier B. Using a positive deviance framework to identify Local Health Departments in Communities with exceptional maternal and child health outcomes: a cross sectional study. BMC Public Health 2016; 16:602. [PMID: 27435170 PMCID: PMC4952145 DOI: 10.1186/s12889-016-3259-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 07/01/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The United States spends more than most other countries per capita on maternal and child health (MCH), and yet lags behind other countries in MCH outcomes. Local health departments (LHDs) are responsible for administering various maternal and child health programs and interventions, especially to vulnerable populations. The goal of this study was to identify local health department jurisdictions (LHDs) that had exceptional maternal and child health outcomes compared to their in-state peers - positive deviants (PDs) - in Washington, Florida and New York in order to support the identification of strategies that can improve community health outcomes. METHODS We used MCH expenditure data for all LHDs in FL (n = 67), and WA (n = 35), and most LHDs in NY (n = 48) for 2009-2010 from the Public Health Activities and Services Tracking (PHAST) database. We conducted our analysis in 2014-2015. Data were linked with variables depicting local context and LHD structure. We used a cross-sectional study design to identify communities with better than expected MCH outcomes and multiple regression analysis to control for factors outside of and within LHD control. RESULTS We identified 50 positive deviant LHD jurisdictions across 3 states: WA = 10 (29 %); FL = 24 (36 %); NY = 16 (33 %). Overall, internal factor variables improved model fit for identifying PD LHD jurisdictions, but individual variables were not significant. CONCLUSIONS We empirically identified LHD jurisdictions with better MCH outcomes compared to their peers. Research is needed to assess what factors contributed to these exceptional MCH outcomes and over which LHDs have control. The positive deviance method we used to identify high performing local health jurisdictions in the area of maternal and child health outcomes can assist in better understanding what practices work to improve health outcomes. We found that funding may not be the only predictor of exceptional outcomes, but rather, there may be activities that positive deviant LHDs are conducting that lead to improved outcomes, even during difficult financial circumstances. This method can be applied to other outcomes, communities, and/or services.
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Affiliation(s)
- Tamar Klaiman
- />AccessMatters, 1700 Market St., Suite 15th Fl., Philadelphia, PA 19103 USA
| | - Athena Pantazis
- />University of Washington School of Nursing, Psychosocial & Community Health, Box 357263, Seattle, WA USA
| | - Anjali Chainani
- />University of the Sciences, 4101 Woodland Ave., Box 22, Philadelphia, PA 19104 USA
| | - Betty Bekemeier
- />University of Washington School of Nursing, Psychosocial & Community Health, Box 357263, Seattle, WA USA
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