Maternal and Child Health Graduate and Continuing Education Needs: A National Assessment

Objectives: The purpose of this report is to describe the methodology and results of a recent national assessment of long-term graduate and short-term continuing education needs of public health and health care professionals who serve or are administratively responsible for the U.S. maternal and child health population and also to offer recommendations for future training initiatives. Methods: The target of this needs assessment was all directors of state MCH, CSHCN and Medicaid agencies, as well as a 20% random sample of local public health departments. A 7-page needs assessment form was used to assess the importance of and need for supporting graduate and continuing education training in specific skill and content areas. The needs assessment also addressed barriers to pursuing graduate and continuing education. Respondents (n = 274) were asked to indicate the capacity of their agency for providing continuing education as well as their preferred modalities for training. Results: Regardless of agency type, i.e., state MCH, CSHCN, Medicaid or local health department, having employees with a graduate education in MCH was perceived to be of benefit by more than 70% of the respondents. Leadership, systems development, management, administration, analytic, policy and advocacy skills, as well as genetics, dentistry, nutrition and nursing, were all identified as critical unmet needs areas for professionals with graduate training. Education costs, loss of income, and time constraints were the identified barriers to graduate education. More than 90% of respondents from each agency viewed continuing education as a benefit for their staff, although the respondents indicated that their agencies have limited capacity to either provide such training or to assess their staff's need for continuing education. Program managers and staff were perceived in greatest need of continuing education and core public health skills, leadership, and administration were among the most frequently listed topics to receive continuing education training support dollars. Time away from work, lack of staff to cover functions, and cost were the top barriers to receiving continuing education. While attending on-site, in-state, small conferences was the continuing education modality of first preference, there was also considerable interest expressed in web-based training. Conclusions: Six recommendations were developed on the basis of the findings and address the following areas: the ongoing need for continued support of both graduate and continuing education efforts; the development of a national MCH training policy analysis center; the incorporation of routine assessments of training needs by states as part of their annual needs assessments; the promotion of alternative modalities for training, i.e., web-based; and, the sponsorship of academic/practice partnerships for cross-training.     

Public health educators' participation in teams: implications for preparation and practice

Collaboration among public health organizations is essential to ensuring the health of the public. Much of the day-to-day work of public health educators is done in groups or teams or in consultation with others. This study examined the extent of health educators' work in teams as a proxy for collaboration. Health educators participated in an average of four teams per individual; three of these were interorganizational teams. Moreover, 40% of the respondents participated in five or more teams. Health educators supervised by other health educators were more likely to work in interorganizational teams than were those supervised by other professionals. Certified Health Education Specialists were more likely to participate in intraorganizational teams. Curricula in academic programs should reflect the extensive teamwork in which health educators are involved. Employers need to provide health educators with grounding in organizational priorities and support to carry out their collaborative work.     

Occupational Stress in Special Education: A Challenge for School Health Professionals

Results of this study support the hypothesis that the majority of special educators, their support personnel, and general education administrators do not experience more job dissatisfaction than comparable occupational groups. However, they do report lower levels of subjective well-being when compared with normal populations. Furthermore, 18% of the educators in the study perceived themselves as failing to cope with their job, experienced more frequent symptoms of poor physical health, and reported significantly poorer subjective well-being. Health promotion programs for public school personnel should initiate prevention-oriented health education programs for all employees. For those identified as more vulnerable to stress-related mental and physical health problems, therapeutic approaches may be necessary. However, self-help and mutual support groups may offer both groups a social support system to help meet human needs in addition to offering the potential for reducing perceived occupational stress. School health personnel may be in the best position to influence policies, procedures, and practices in schools that would support the work-related needs of all employees.     

Peer Reviewed: Assessing the Professional Development Needs of Public Health Educators in Light of Changing Competencies

Introduction

Because of the need for a well-trained public health workforce, professional competencies have been recently revised by the Institute of Medicine and the National Health Educator Competencies Update Project. This study compared the self-identified training needs of public health educators with the updated competencies and assessed employer support for continuing education.

Methods

A convenience sample of public health educators was recruited from an e-mail list of San Jose State University master of public health alumni. Respondents completed a Web-based survey that elicited information on emerging trends in public health education, training needs, and employer support for continuing education.

Results

Concerns about funding cuts and privatization of resources emerged as a theme. Key trends reported were an increase in information technology, the need for policy advocacy skills, and the importance of a lifespan approach to health issues. Primary areas for training were organization development, evaluation, and management. Although most employers were reported to support continuing education, less than two-thirds of respondents were reimbursed for expenses.

Conclusion

These findings have implications for both research and practice. Innovative technologies should be developed to address health education professionals'' training needs, and emerging themes should be incorporated into curricula for students.     

Are Health Educators Being Prepared to Provide HIV/AIDS Education?: A Survey of Selected Health Education Professional Preparation Programs

Health education professional preparation programs were surveyed to determine the extent of HIV/AIDS education health educators are receiving. The survey also addressed content areas, skills being developed or enhanced, areas of deficiency in preparation programs, and areas in which national professional associations may assist in the preparation of AIDS educators. One hundred eight-three surveys were mailed; 114 (68%) were completed and returned. Twenty-one institutions reported planning a separate course on HIV/AIDS. Most were designing general service courses to reach a broad cross-section of students. Twenty-five institutions (23.8%) reported previously offering or currently offering a specific course on AIDS. One hundred two (89.5%) respondents reported HIV/AIDS warranted the attention and funding it had received. Thirty-seven (35.2%) respondents reported AIDS education was of sufficient importance to influence hiring of faculty members in their departments. Survey findings demonstrate that current AIDS education courses targeted to the general student population may not be adequate in meeting the professional preparation needs of health educators charged to provide AIDS education.     

Perceived needs of Canadian dietitians for continuing education in management.

The purpose of this research was to assess the perceived needs of Canadian dietitians for continuing education in management both currently and as they plan for advancement, career change and development. A self-assessment questionnaire was mailed in January 1985 to 1000 members of the Canadian Dietetic Association (CDA) selected by a systematic randomized technique. Analysis of 450 anonymous questionnaires from employed CDA members showed that 77% were employed full-time and 23% part time. The analysis indicated a profession with a young membership of an eight-year mean and a six-year median in full time practice. A ranked ordering of the types of positions to which dietitians aspired was chief administrative dietitian, consultant, positions in other administration, and then private practice. Personnel and financial management were very important areas for current positions and were expected to be even more so in future. Respondents cited salient factors regarding continuing education programs and prioritized their need for several management topics. These topics were further analyzed according to the present positions of the respondents. This research supports the need for high quality continuing education programs in management for practising dietitians.     

Undergraduate public health education: a workforce perspective

OBJECTIVE: To describe the career paths of students who majored in public health at the undergraduate level and to assess the skills and knowledge these graduates believed were most useful to them in the public health workforce. METHOD: A telephone survey was conducted of all graduates from Adelaide University's Bachelor of Health Sciences degree from 1992-99 who had majored in public health (124 graduates). RESULTS: The response rate to the graduate survey was 71%. Using the definition of public health functions from the National Delphi Study on Public Health Functions to delineate the public health workforce, 59% of respondents were employed in public health. Graduates working in public health valued generic skills such as communication and collaboration more highly than more specific public health skills and knowledge areas. However, they also believed their undergraduate course would have been improved by a more practical orientation. CONCLUSIONS: A high proportion of graduates from this generalist degree who major in public health find employment in the public health workforce. They greatly value the generic skills associated with their undergraduate public health education and believe their entry into the workforce would have been further facilitated by stronger links between their academic program and the working environment of public health professionals. Implications: Studies of workforce training programs in public health must differentiate between the educational needs of undergraduate and postgraduate students. In particular, strategies need to be developed to provide stronger links between undergraduate students and the public health workforce.     

Public Policy Involvement by Health Commissioners

The purpose of this national study was to determine advocacy activities and level of involvement of health commissioners regarding public policy. Benefits, barriers, and perceived outcomes of advocacy efforts were also explored. A previously validated (Holtrop et al., Am J Health Behav 24(2):132–142, 2000) four-page survey was mailed to 700 health commissioners, who were randomly selected from the National Association of County and City Health Officials (NACCHO) database. A three-wave mailing was performed which yielded a 50% response rate. Of these respondents, the majority (70%) were female and (88%) Caucasian. Overall, 31% of health commissioners reported being involved in influencing public policy in the last 4 years. The most common reported activities engaged in by health commissioners included voting (84%), and providing policy information to consumers or other professionals (77%). Perceived barriers to influencing policy were time, (64%), and other priorities (46%). Perceived benefits to influencing policy included improving the health of the public (94%) and making a difference in others’ lives (87%). Only 15% perceived their knowledge regarding the process of changing public policy was excellent. Although health commissioners are often spokespersons for health agencies and communities, their public policy involvement is marginal. Professional preparation programs and continuing education opportunities should focus on advocacy, public policy development, and removing barriers to action.     

A longitudinal evaluation of graduate programs in allied health education and administration

A longitudinal follow-up study was conducted of 196 graduates of allied health education and administration programs in Texas. The study assessed the graduates' continued presence as educators and their career patterns, experiences related to teaching, research, service, administrative leadership, job satisfaction, and perceived continuing education needs. The conclusions drawn from the results of the study were that the graduates are instructional and administrative resources for colleges, universities, and hospitals located in Texas and 23 other states; have exemplary records related to teaching, research, service, and other faculty activities; and are generally satisfied with their current employment. Application of computer technology was the most frequently cited continuing education need of the graduates.     

Smoking Cessation Counseling Practices of Texas Pharmacists

A cross-sectional study was conducted to determine pharmacists’ awareness and education about smoking cessation and their communication with patients about smoking cessation. A survey was mailed to East Texas pharmacists practicing in the areas of hospital or clinical, retail or community, managed care, consultant, or academic pharmacy. Outcome measurements included: measures of the awareness of the 5 A’s and 5 R’s of smoking cessation, training received in smoking cessation, and communication practices regarding smoking cessation. There were 320 respondents. Approximately 10% of the respondents indicated they had received tobacco cessation counseling education during their formal educational training, 36% during continuing education programs, and 9% during both formal training and continuing education. About 44% reported they had received no tobacco cessation counseling training. Among pharmacists surveyed, 5% responded that they usually or always ask their patients if they smoke cigarettes, pipe, or cigars, 43% reported they sometimes or half of the time ask, and 45% said they never ask. There is a clear relationship between pharmacists awareness and education of smoking cessation techniques and their communication with patients about them. Pharmacy education leaders must continue their movement to include public health in the pharmacy curricula to produce pharmacists who are prepared to better serve the community. This project was funded by a grant from the Texas Department of State Health Services.     

Assessing the Learning Needs of Maternal and Child Health Professionals to Teach Health Promotion

OBJECTIVE: To assess skills and preferred learning formats in teaching health promotion (HP). METHODS: A self-administered needs assessment of Maternal and Child Health (MCH) educators from multiple disciplines was conducted on a convenience sample taken nationally via e-mail using Dillman's method. Respondents rated ability to use, and desire to improve skills in, different teaching strategies (brainstorming, case method, collaborative learning, mini-presentation, reflective exercise, role play) and health concepts (partnership, communication, HP/illness prevention, time management, education, advocacy). Preferred learning formats were assessed with 5-point Likert scale and were analyzed using ANOVA. RESULTS: Fifty-seven percent of respondents (n = 180) taught in an urban setting, 26% suburban, and 17% rural. Most taught at academic health centers (35%), public health clinics (25%), or hospitals (17%). Seventy-five percent were female; average age was 42 years (SD--9.1 years). Specific disciplines showed no major difference in mean responses compared with others. The greatest barriers to integrating HP into teaching were time (82%) and budget (58%). Although a majority of all respondents felt comfortable in their abilities to use the teaching strategies and concepts, an equal percentage still wanted to improve these skills. One-third of respondents had experience using web-based study: 64% of them indicated web-based study as their preferred method of continuing education. CONCLUSIONS: While a majority of MCH educators felt confident using various teaching strategies to teach the integration of HP into practice, most still wished to improve their personal skills. Use of an inexpensive, time-efficient modality to access and learn to teach HP was appealing to respondents across disciplines.     

Assessment of training needs and preferences for geographic information systems (GIS) mapping in state comprehensive cancer-control programs

Geographic information systems (GIS) mapping technologies have potential to advance public health promotion by mapping regional differences in attributes (e.g., disease burden, environmental exposures, access to health care services) to suggest priorities for public health interventions. Training in GIS for comprehensive cancer control (CCC) has been overlooked. State CCC programs' GIS training needs were assessed by interviewing 49 state CCC directors. A majority perceived a need for GIS training, slightly more than half of state CCC programs had access to geocoded data, and the majority of programs did not require continuing education credits of their staff. CCC directors perceived judging maps and realizing their limitations as important skills and identified epidemiologists, CCC staff, public health officials, policy makers, and cancer coalition members as training audiences. They preferred in-class training sessions that last a few hours to a day. Lessons learned are shared to develop training programs with translatable GIS skills for CCC.     

Application of the Role Delineation Project "Framework" to a Professional Preparation Program

Using the Framework for the Development of Competency-based Curricula for Entry Level Health Educators, the health education faculty at the University of Alabama at Birmingham reviewed and modified their undergraduate health education professional preparation program. Efforts focused on the five steps of preparation and study, review and organization of Framework subcompetencies, organization of Framework subcompetencies into potential courses, placement of objectives for courses, and revision of schedule and sequence for professional preparation courses. The process produced seven core courses to be required of all health education majors. A master list of subcompetencies and objectives also was developed. Faculty perceived several benefits from participating in the project.     

Application of the Role Delineation Project "Framework" to a Professional Preparation Program

ABSTRACT: Using the Framework for the Development of Competency-based Curricula for Entry Level Health Educators, the health education faculty at the University of Alabama at Birmingham reviewed and modified their under-graduate health education professional preparation program. Efforts focused on the five steps of preparation and study, review and organization of Framework subcompetencies, organization of Framework subcompetencies into potential courses, placement of objectives for courses, and revision of schedule and sequence for professional preparation courses. The process produced seven core courses to be required of all health education majors. A master list of subcompetencies and objectives also was developed. Faculty perceived several benefits from participating in the project. (J Sch Health 1987;57(4):147–149)     

Perceptions of part-time faculty by chairpersons of undergraduate health education programs

In recent years, it has become commonplace for universities to hire part-time and non-tenure track faculty to save money. This study examined how commonly part-time faculty are used in health education and how they are used to meet program needs. The American Association of Health Education's 2009 "Directory of Institutions Offering Undergraduate and Graduate Degree Programs in Health Education" was used to send a three-wave mailing to programs that were not schools of public health (n = 215). Of the 125 departments (58%) that responded, those that used part-time faculty averaged 7.5 part-time faculty in the previous academic year, teaching on average a total of 10 classes per year. A plurality of departments (38%) were currently using more part-time faculty than 10 years ago and 33% perceived that the number of part-time faculty has resulted in decreases in the number of full-time positions. Although 77% of department chairs claimed they would prefer to replace all of their part-time faculty with one full-time tenure track faculty member. As colleges downsize, many health education programs are using more part-time faculty. Those faculty members who take part-time positions will likely be less involved in academic activities than their full-time peers. Thus, further research is needed on the effects of these changes on the quality of health education training and department productivity.     

Needs assessment for patient education for people with HIV/AIDS

This study examines the need for a comprehensive patient educationprogram that emphasizes self-help for adults living with HIV/AIDS.Data were collected using a self-administered, written questionnaire.Participants were recruited from agencies in northern California.This study revealed that 59 of 70 respondents were relativelysatisfied with the services, including patient education, availablein their community. Of the 70 respondents, 69 felt there wasa need for a comprehensive patient education program. The study'sfindings illustrate both distinct differences and commonaltiesbetween the experiences, perceived needs and priorities of maleand female respondents. These findings will help HIV/AIDS serviceagencies re-structure their health education programs and assistin patient education program development. Future research inthis area needs to address the perceived needs and prioritiesof different subgroups living with HIV/AIDS.     

A descriptive analysis of patient education courses in undergraduate and graduate health education programs

Patient education is a necessary component of quality health care, yet little attention has been given to the preparation of health educators to work in that setting. This study seeks to determine the status of and content in patient education courses offered in professional preparation programs. Results show that 9% of respondents offered a patient education course in their academic unit, whereas 18% indicated that such a course was offered in another unit on campus. It appears there is not agreement between university faculty members and practicing patient educators on what should be taught in such a course. In addition, no significant relationship is found between (a) programs with accreditation or approval and offering a patient education course and (b) programs that prepared students for the Certified Health Education Specialist examination and offering a patient education course. Recommendations are offered for improving the preparation of health educators for the medical care setting.     

Evaluation of a community health representative program among the Cree of northern Quebec

The James Bay Cree Community Health Representative (CHR) program was implemented in 1984 to train persons from the Cree population of northern Quebec to act as health care advocates and educators, as intermediaries between the Cree population, health services and local organizations, and as participants in assessing health needs. A formative evaluation was initiated which included quantitative analysis of the daily tasks of CHRs and a qualitative component based on documentary research, observation and semi-structured interviews. The evaluation revealed that CHRs actively participated in the ongoing community health programs mainly through health education; the people interviewed showed a high level of satisfaction. However, direct supervision, sufficient continuing education for the CHRs and better integration into health care teams are long-term goals which need to be emphasized in the program.     

Community colleges and public health: making the connections

Community colleges, in collaboration with public health agencies, can advance public health education by reaching a diverse student body, integrating public health into general education, and providing specialized associate degrees that serve workforce needs. Career ladders that include transferability of coursework to 4-year institutions and continuing education, including certificate programs, are key to success of these efforts. Community, or 2-year, colleges are well positioned to connect components of the Healthy People Curriculum Task Force's Education for Health framework by providing general education core courses in public health, epidemiology, and global health compatible with the educated citizen and public health movement. To serve specific workforce needs, associate degree programs are proposed, including environmental health, public health preparedness, public health informatics, and pre-health education. A generalist option designed for transfer to public health and related majors at 4-year institutions is also recommended.