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Martin S, Kalra A, Jenny A, Maher AD, Foreman A, Chavez A, Gagliano J, Reid MJA, Brickley DB. Rapid and sustained contact tracing training for COVID-19 in San Francisco: a training model for developing an emergency public health workforce. Front Public Health 2023; 11:1125927. [PMID: 37457246 PMCID: PMC10347383 DOI: 10.3389/fpubh.2023.1125927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
The City and County of San Francisco was the first municipality in the United States to institute a COVID-19 contact tracing program. The San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco (UCSF) created an outcome-based fully remote contact tracing curriculum using participatory learning methods to train non-public health emergency workers as contact tracers. Between April and December 2020, we trained over 300 individuals in contact tracing skills and procedures over three training phases. Using iterative curriculum design and Kirkpatrick's evaluation methodology, we aimed to ensure high quality and successful person-centered contact tracing. The resulting curriculum consisted of 24 learning outcomes taught with six participatory skills development activities, asynchronous materials, and one-on-one contact tracer support. We collected more than 700 responses from trainees using various evaluation tools across the training phases, and contact tracers interviewed more than 24,000 contacts after training in our program. Our evaluations showed that knowledge and skills improved for most trainees and demonstrated the utility of the training program in preparing trainees to perform person-centered contact tracing in San Francisco. Local health jurisdictions and state health agencies can use this model of curriculum development and evaluation to rapidly train a non-public health workforce to respond to future public health emergencies.
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Affiliation(s)
- Shayanne Martin
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Anika Kalra
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Alisa Jenny
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Andrew D. Maher
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Allison Foreman
- School of Medicine, University of California San Diego, San Diego, CA, United States
| | - Alejandro Chavez
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Jayne Gagliano
- Department of Public Health, COVID-19 Command Center, San Francisco, CA, United States
| | - Michael J. A. Reid
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Debbie Bain Brickley
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
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Kiernan B, Alonis A, Diala JA, Willard-Grace R, Welty S, White K, Dorian A, Dunn C, Peare A, Westfall M, Shodahl S, Brickley DB. Virtual Trainings Effectively Prepared the Public Health Workforce to Support Schools During the COVID-19 Pandemic in California in 2021. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:720-727. [PMID: 35703296 PMCID: PMC9555584 DOI: 10.1097/phh.0000000000001535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT School closures in California due to COVID-19 have had a negative impact on the learning advancement and social development of K-12 students. Since March 2020, the achievement gap has grown between high-income and low-income students and between White students and students of color. PROGRAM In November 2020, a team from the California Department of Public Health, University of California, San Francisco, and University of California, Los Angeles, developed the School Specialist training for local health department and state employee redirected staff to the COVID-19 response to equip them to support schools as they reopen. IMPLEMENTATION A pilot of the virtual School Specialist training was carried out in December 2020, which informed subsequent biweekly half-day virtual trainings. The training consisted of lectures from experts and skill development activities led by trained facilitators. EVALUATION The objectives of the evaluation of the training were to understand whether (1) knowledge of key concepts improved from pre- to posttraining; (2) confidence in skills central to the role of a School Specialist improved from pre- to posttraining; and (3) course learners who were activated to work as School Specialists felt the training adequately prepared them for the role. The School Specialist training team sent pre- and posttraining surveys to learners between February 8 and May 18, 2021. Of the 262 learners who responded, a significant improvement was seen in knowledge, with a mean score increase of 15.6%. Significant improvement was also observed for confidence, with a 20.1% score improvement seen posttraining. DISCUSSION Overall, the School Specialist training was shown to be effective in increasing knowledge and confidence in preparation for School Specialist deployment. Adequate training and partnerships for local health department and school staff are critical to keep K-12 students safe and to reduce the learning achievement gap during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Brianán Kiernan
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Amelia Alonis
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Jody A. Diala
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Rachel Willard-Grace
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Susie Welty
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Karen White
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Alina Dorian
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Caitlin Dunn
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Anna Peare
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Miranda Westfall
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Skye Shodahl
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
| | - Debbie Bain Brickley
- Pandemic Initiative for Equity and Action University of California, San Francisco, San Francisco, California (Mss Kiernan, Diala, Welty, White, and Dunn and Dr Brickley), Center for Excellence in Primary Care University of California, San Francisco, San Francisco, California (Ms Willard-Grace), and Curry International Turberculosis Center University of California, San Francisco, San Francisco, California (Ms Alonis); and University of California, Los Angeles, Los Angeles, California (Drs Dorian and Westfall and Mss Peare and Shodahl)
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Ruebush E, Dennison A, Lane J, Harper-Hardy P, Poulin A, Prather B, Wright S, Harvey D, Fraser MR. Implementation of a Nationwide Knowledge-Based COVID-19 Contact Tracing Training Program, 2020. Public Health Rep 2022; 137:11S-17S. [PMID: 35786097 PMCID: PMC9357820 DOI: 10.1177/00333549221101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In the United States, the public health response to control COVID-19 required rapid expansion of the contact tracing workforce from approximately 2200 personnel prepandemic to more than 100 000 during the pandemic. We describe the development and implementation of a free nationwide training course for COVID-19 contact tracers that launched April 28, 2020, and summarize participant characteristics and evaluation findings through December 31, 2020. Uptake of the online asynchronous training was substantial: 90 643 registrants completed the course during the first 8 months. In an analysis of a subset of course participants (n = 13 697), 7724 (56.4%) reported having no prepandemic public health experience and 7178 (52.4%) reported currently serving as case investigators, contact tracers, or both. Most participants who completed a course evaluation reported satisfaction with course utility (94.8%; 59 497 of 62 753) and improved understanding of contact tracing practice (93.0%; 66 107 of 71 048). These findings suggest that the course successfully reached the intended audience of new public health practitioners. Lessons learned from this implementation indicate that an introductory course level is appropriate for a national knowledge-based training that aims to complement jurisdiction-specific training. In addition, offering a range of implementation options can promote course uptake among public health agency staff. This course supported the emerging needs of the public health practice community by training a workforce to fill an important gap during the COVID-19 pandemic and could serve as a feasible model for enhancing workforce knowledge for future and ongoing public health threats.
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Affiliation(s)
- Elizabeth Ruebush
- Association of State and Territorial Health Officials, Arlington, VA, USA
| | | | - J.T. Lane
- Association of State and Territorial Health Officials, Arlington, VA, USA
| | - Paris Harper-Hardy
- Association of State and Territorial Health Officials, Arlington, VA, USA
| | - Amelia Poulin
- Association of State and Territorial Health Officials, Arlington, VA, USA
| | - Bill Prather
- Association of State and Territorial Health Officials, Arlington, VA, USA
| | - Shauntā Wright
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David Harvey
- National Coalition of STD Directors, Washington, DC, USA
| | - Michael R. Fraser
- Association of State and Territorial Health Officials, Arlington, VA, USA
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Westfall M, Forster M, Golston O, Taylor KD, White K, Reid MJA, Dorian A, Prelip ML, Shafir S. Real World Feedback: How Well Did the Virtual Training Academy Prepare California's COVID-19 Contact Tracing Workforce? Front Public Health 2022; 10:857674. [PMID: 35836992 PMCID: PMC9273764 DOI: 10.3389/fpubh.2022.857674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
To effectively respond to the COVID-19 pandemic, California had to quickly mobilize a substantial number of case investigators (CIs) and contact tracers (CTs). This workforce was comprised primarily of redirected civil servants with diverse educational and professional backgrounds. The purpose of this evaluation was to understand whether the weeklong, remote course developed to train California's CI/CT workforce (i.e., Virtual Training Academy) adequately prepared trainees for deployment. From May 2020 to February 2021, 8,141 individuals completed the training. A survey administered ~3 weeks post-course assessed two measures of overall preparedness: self-perceived interviewing proficiency and self-perceived job preparedness. Bivariate analyses were used to examine differences in preparedness scores by education level, career background, and whether trainees volunteered to join the COVID-19 workforce or were assigned by their employers. There were no significant differences in preparedness by education level. Compared to trainees from non-public health backgrounds, those from public health fields had higher self-perceived interviewing proficiency (25.1 vs. 23.3, p < 0.001) and job preparedness (25.7 vs. 24.0, p < 0.01). Compared to those who were assigned, those who volunteered to join the workforce had lower self-perceived job preparedness (23.8 vs. 24.9, p = 0.02). While there were some statistically significant differences by trainee characteristics, the practical significance was small (<2-point differences on 30-point composite scores), and it was notable that there were no differences by education level. Overall, this evaluation suggests that individuals without bachelor's degrees or health backgrounds can be rapidly trained and deployed to provide critical disease investigation capacity during public health emergencies.
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Affiliation(s)
- Miranda Westfall
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Maeve Forster
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Olivia Golston
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kelly D. Taylor
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Karen White
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Michael J. A. Reid
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Alina Dorian
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michael L. Prelip
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shira Shafir
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
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