Survey of accredited master of public health (MPH) programs with health education concentrations: a resource for strengthening the public health workforce

The authors designed survey research to assess accredited master of public health (MPH) programs with health education concentrations. A Web-based survey was distributed to program directors and was used to collect characteristics of program faculty, students, graduates, internships, employment, and competency development. Results indicate that students and graduates are diverse; 72% of students complete internships and 61% of graduates work in government or community public health-related agencies; 98% of faculty hold a doctoral degree and 67% have at least one degree from an accredited public health school or program; and 85% of programs build competencies in most of the Institute of Medicine-suggested areas. The authors conclude that accredited MPH programs with a concentration in health education train diverse public health practitioners highly likely to work in a government or community public health agency with competencies to enhance public health.     

Identification and evaluation of competencies of public health nutritionists.

The Delphi Technique was used to elicit a number of essential competencies expected of the "entry-level" public health nutritionist from members of Graduate Faculties of Programs in Public Health Nutrition. Questionnaires composed of "competency statements" were constructed from these responses and sent to practitioners in public health nutrition. The questionnaire requested evaluation of the "necessity" of each competency. Responses served as the basis for "factor analysis" procedures, employed to obtain clusters of competency functions expected of the nutritionist. From the 109 competency items originally identified, 17 competency scales were derived from the factor analysis. A ranking from both faculties and practitioners revealed that both groups highly rated competencies to communicate, to counsel and deal with clients/patients, and to interpret scientific data in "lay language." Less important in the ranking were competencies which dealt with administrative abilities, program planning, legislative activism, and consumer advocacy. These findings have cimplications for the practitioner in public health nutrition as well as for academic groups who must plan and evaluate curricula in public health nutrition and in other fields of public health.     

Peer Reviewed: Designing Competencies for Chronic Disease Practice

Introduction

Competencies are the cornerstone of effective public health practice, and practice specialties require competencies specific to their work. Although more than 30 specialty competency sets have been developed, a particular need remained to define competencies required of professionals who practice chronic disease prevention and control. To that end, the National Association of Chronic Disease Directors (NACDD) engaged a group of stakeholders in developing competencies for chronic disease practice.

Methods

Concept mapping was blended with document analysis of existing competencies in public health to develop a unique framework. Public health experts reviewed the results, providing extensive and richer understanding of the issues.

Results

The final product presents an integrated picture that highlights interrelationships among the specific skills and knowledge required for leading and managing state chronic disease programs. Those competencies fall into 7 clusters: 1) lead strategically, 2) manage people, 3) manage programs and resources, 4) design and evaluate programs, 5) use public health science, 6) influence policies and systems change, and 7) build support.

Conclusion

The project yielded a framework with a categorization scheme and language that reflects how chronic disease practitioners view their work, including integrating communications and cultural competency skills into relevant job functions. Influencing policies and systems change has distinct relevance to chronic disease practice. We suggest uses of the competencies in the field.     

Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces,China

Problem

The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance.

Approach

To understand village doctors’ perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention.

Local setting

The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province.

Relevant changes

Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts.

Lessons learnt

Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.     

Effectiveness of an emergency preparedness training program for public health nurses in New York City

A public health workforce that is competent to respond to emergencies is extremely important. We report on the impact of a training program designed to prepare public health nurses to respond appropriately to emergencies. The program focused on the basic public health emergency preparedness competencies and the emergency response role of public health workers employed by the New York City School Department of Health and Mental Hygiene School Health Program. The evaluation methods included pre/post-testing followed by a repeat post-test one month after the program. The program resulted in positive shifts in both knowledge and emergency response attitudes.     

丹东市2006-2015年突发公共卫生事件流行特征分析

目的 分析丹东市2006-2015年突发公共卫生事件特征,为制定卫生应急管理策略,建立良好卫生应急管理运行机制提供科学参考依据。方法 利用国家突发公共卫生事件管理信息系统报告的事件信息,应用描述性流行病学方法,对丹东市2006-2015年突发公共卫生事件进行分析。结果 2006-2015年丹东市突发公共卫生事件报告19起,发病603例,死亡4例;2006-2007年突发公共卫生事件呈高发态势;2009年以后事件报告整体呈低发态势;无特别重大和重大事件,一般事件为主,占事件报告总数78.95%;各县区均有事件报告,沿海（江）及内陆山区报告事件较多;除5、6月外,其他月份均有事件报告,以4、8、9和12月多发;报告事件以食物中毒为主,占事件报告总数的68.42%,且发病数、死亡数均以食物中毒事件为主;学校事件占事件报告总数47.37%,高中及职业中等学校报告事件占学校事件报告总数83.33%;平均每起事件处置经费3.51万元,造成经济损失5.07万元。结论 丹东市卫生应急管理运行机制逐步完善,管理措施实施有效,应进一步落实应急保障措施,注重在事前预防、健康教育、综合培训、基层能力建设方面提供保障。     

Developing public health competencies through building a problem-based learning project

Aim  

In order to tackle the major challenges faced by public health over recent decades, there is a pressing need for an appropriately competent work force. Therefore, investment is required in the development of the necessary pedagogical strategies to deliver such competencies and thereby enable public health professionals to effectively perform their core functions. Drawing primarily upon on the work and experiences of the EC-funded PHETICE (Public Health Education and Training in the Context of an Enlarging Europe) and EUMAHP (European Masters in Health Promotion) projects, in this article an appropriate training method that integrates several public health models is introduced and discussed in order to deliver key public health competencies.     

Predictors of effectiveness among public health nutritionists

This study investigated how public health nutrition directors and practitioners each rated the effectiveness of their professional performance. We examined the specific factors which were predictive of each set of effectiveness ratings. Eleven directors supplied the names and addresses of 226 practitioners, each of whom was mailed a questionnaire. The response rate to the mailing was 84 per cent. Director ratings of practitioners were not significantly related to the self-ratings. Results of multiple regression analysis revealed that the directors had based their evaluation on more "external" criteria, such as age, being a Registered Dietitian, and possessing an extroverted personality. In contrast, the nutritionists' self-ratings were based on more introspective qualities, including self-perceived innovativeness, and the number of competencies which they felt they were currently performing well. The roles of work environment, nature of supervision, and type of educational preparation need to be assessed in future research.     

论如何做好卫生领域突发公共事件的风险沟通工作

近年来,随着社会经济的发展,卫生领域突发公共事件时有发生。卫生领域突发公共事件是指突然发生,造成或者可能造成严重社会危害,需要采取应急新闻处置措施予以应对的公共卫生事件和其他与卫生工作有关的公共事件、舆情事件等。本文总结了近年来卫生部门突发公共事件风险沟通工作情况,分析风险沟通工作的成效及存在的问题,并从日常工作、突发公共卫生事件、舆情事件三个层面提出做好突发公共事件风险沟通工作的措施建议,以期更好地防止突发公共事件的发生或降低甚至消除事件的负面影响,同时提升卫生部门的公信力,塑造卫生行业良好的声誉和形象。     

Identifying core competencies for public health epidemiologists

BACKGROUND: Public health authorities have prioritized the identification of competencies, yet little empirical data exist to support decisions on competency selection among particular disciplines. We sought perspectives on important competencies among epidemiologists familiar with or practicing in public health settings (local to national). METHODS: Using a sequential, qualitative-quantitative mixed method design, we conducted key informant interviews with 12 public health practitioners familiar with front-line epidemiologists' practice, followed by a web-based survey of members of a provincial association of public health epidemiologists (90 respondents of 155 eligible) and a consensus workshop. Competency statements were drawn from existing core competency lists and those identified by key informants, and ranked by extent of agreement in importance for entry-level practitioners. RESULTS: Competencies in quantitative methods and analysis, critical appraisal of scientific evidence and knowledge transfer of scientific data to other members of the public health team were all regarded as very important for public health epidemiologists. Epidemiologist competencies focused on the provision, interpretation and 'translation' of evidence to inform decision-making by other public health professionals. Considerable tension existed around some potential competency items, particularly in the areas of more advanced database and data-analytic skills. INTERPRETATION: Empirical data can inform discussions of discipline-specific competencies as one input to decisions about competencies appropriate for epidemiologists in the public health workforce.     

Sustainability of the impact of a public health intervention: lessons learned from the laval walking clubs experience

To inform health promotion practice regarding the sustainability of public health interventions, the authors interviewed the directors of 13 new community-based organizations created through a practitioner-initiated public health intervention designed to promote physical activity at the community level. The purpose of the interviews was to uncover the factors that lead organization directors to become involved in the initiative and to maintain their involvement across an extended period of time. Results showed that there were 3 categories of positive outcomes associated with leading a walking club: maintaining and improving health, personal satisfaction, and group motivation. Difficulties associated with directing the club included high participant turnover rates, isolation of club directors, and lack of support from community organizations. Club directors indicated that sustainability would be enhanced through developing individual competencies, becoming more proficient at leading group dynamics, and developing better rootedness in the community. This information is interpreted in light of the six factors associated with sustainability.     

Assessing the capacity of health departments to engage in community-based participatory public health

OBJECTIVES: We created indicators of local public health agency capacity to engage in community-based participatory public health. METHODS: We sent a survey of 27 items reflecting aspects of community-based participatory public health to 429 employees in 4 local health departments. Two thirds (n = 282) responded. We performed a factor analysis to identify components of community-based participatory practice. RESULTS: We identified 4 factors: (1) the agency's and (2) the individual employee's skills in working with community groups and minority populations, (3) the extent and frequency of agency networking, and (4) community participation in health department planning. CONCLUSIONS: Our findings suggest that it is possible to measure the competencies needed by health department staff to engage in community-based participatory public health.     

突发公共卫生事件社会影响评估内容的探讨

依据突发公共卫生事件特征,分析和探讨突发公共卫生事件社会影响的内涵和评估内容,探讨建立社会影响评估的理论框架,为突发公共卫生事件的社会影响评估提供科学可行的参考依据,为我国开展突发公共卫生事件社会影响评估研究和突发公共卫生事件应急管理工作提供理论支持。     

US health educators' likelihood of adopting genomic competencies into health promotion

Objectives. We examined US health educators’ likelihood of adopting genomic competencies—specific skills and knowledge in public health genomics—into health promotion and the factors influencing such likelihood.Methods. We developed and tested a model to assess likelihood to adopt genomic competencies. Data from 1607 health educators nationwide were collected through a Web-based survey. The model was tested through structural equation modeling.Results. Although participants in our study were not very likely to adopt genomic competencies into their practice, the data supported the proposed model. Awareness, attitudes, and self-efficacy significantly affected health educators’ likelihood to incorporate genomic competencies. The model explained 60.3% of the variance in likelihood to incorporate genomic competencies. Participants’ perceived compatibility between public health genomics and their professional and personal roles, their perceptions of genomics as complex, and the communication channels used to learn about public health genomics significantly related to genomic knowledge and attitudes.Conclusions. Because US health educators in our sample do not appear ready for their professional role in genomics, future research and public health work-force training are needed.The Human Genome Project has motivated extensive research and technological developments regarding genetics and genomics. Because most diseases can be associated either with single genes, with multiple genetic variations, or with interactions between genes and environment, advancements in genomic knowledge stand to affect public health—in its quest to improve the biological, environmental, social, and educational conditions fostering health promotion—in unprecedented ways.1^,2An emerging field, public health genomics, focuses on “the study and application of knowledge about the elements of the human genome and their functions, including interactions with the environment, in relation to health and disease in populations.”3 This focus signals important “changes in the landscape” of public health2^,4 and requires that public health workers develop new professional skills. Health promotion scholars,5^,6 alongside many professional organizations and agencies such as the American Public Health Association (APHA),7 the Institute of Medicine,1 the National Coalition for Health Professional Education in Genetics,8 and the Centers for Disease Control and Prevention (CDC),9 have advocated the adoption of specific genomic competencies by the public health workforce. What Caumartin, Baker, and Marrs affirmed of public health students applies invariably to all public health professionals:

Students of Public Health do not need to be geneticists. They should, however, be public health specialists who possess an understanding of how the application of human genetic information and technology is creating a paradigm shift in public health and prevention strategies.10^(p569)

The term “genomic competencies” refers to specific skills and knowledge in public health genomics.5^,9 According to the CDC,9 as members of the public health workforce, health educators should develop 7 specific genomic competencies (Table 1

Needs assessment and a model agenda for training the public health workforce

OBJECTIVES: A training needs assessment project tested the use of "universal" competencies for establishing a model training agenda for the public health workforce. METHODS: Agency supervisors selected competencies for training priorities. Regional and national public health leaders used these selections to design the model training agenda. RESULTS: The competencies given high priority by supervisors varied among state and local agencies and included some not within the universal set. The model training agenda reflected supervisors' priorities as well as leaders' perspectives. CONCLUSIONS: The universal competencies provide a useful starting point, but not necessarily an exclusive framework, for assessing and meeting the training needs of the public health workforce.     

天津市2008和2010年突发公共卫生事件信息监测及分析

目的分析2008和2010两年天津市突发公共卫生事件的流行病学特点,探讨事件发生原因,为突发公共卫生事件的监测和预警提供技术支撑。方法采用回顾性调查和突发公共卫生事件网络信息管理系统,收集2008和2010两年发生在天津市的突发公共卫生事件相关资料并进行统计分析。结果 2008和2010两年间,通过突发公共卫生事件网络信息系统及相关信息监测到各类事件117起。其中Ⅲ级事件3起,占2.56%;Ⅳ级事件92起,占78.63%;未分级事件22起,占18.80%。其中传染病事件92起,占78.63%;食物中毒事件14起,占11.97%;环境因素事件5起,占4.27%,职业中毒1起,占0.85%,其他事件5起,占4.27%。发生场所以中小学校为主,占事件总数的44.44%;其次是幼儿园,占事件总数的21.37%。发生高峰主要是在第2季度,占整个事件的38.46%;其他3个季度发生起数基本相同,分别占19.66%、23.93%和17.95%。117起事件中发病3 884例,死亡13例。市区发生47起,滨海新区22起,乡镇19起,农村29起。结论天津市主要突发公共卫生事件是传染病和食物中毒,事件发生地主要是学校和幼托机构。     

重大突发公共卫生事件下学龄儿童心理健康研究进展

儿童是重大突发公共卫生事件中的脆弱易感人群,2020年新型冠状病毒肺炎疫情在世界范围内大规模流行,学龄儿童心理健康成为全世界关注的问题。研究通过对新冠肺炎疫情对一般儿童以及心理问题本身高发的特殊儿童群体心理健康问题的影响进行综述,重点阐述了新冠肺炎疫情期间不同国家和地区学龄儿童焦虑、抑郁和创伤后应激障碍问题的患病情况,考虑到个体间的易感性与社会资源可及性,研究进一步探究了影响学龄儿童心理健康的儿童、家庭及社会相关因素,最后从国家、学校-家庭-社区和个人层面对重大突发公共卫生事件中儿童心理健康服务体系建设提出了建议,为构筑一个安全、可靠的儿童心理健康防护网络需要社会各方的共同努力。     

Minimum competencies for public health personnel

The public health discipline is receiving increased attention in the United States under initiatives for health care reforms. It is realized that community-wide interventions to prevent disease and promote health are more cost-effective than medical interventions to cure injury and illness. Internationally, these same realizations were embedded in the Alma Ata movement for increased primary care. To improve respect for public health professionalism, a national effort is now underway in the United States to establish minimum competencies for public health practice, and to assure that these competencies are addressed as part of professional graduate studies. Using nationally recommended competencies detailed across nine public health and a separate cross-cutting list of universal competencies, the University of Hawaii School of Public Health assessed all their courses to determine the degree each competency is addressed by each course. A four-point scale was used. Lead faculty for each course assessed the depth of coverage. For the Hawaii School of Public Health, this study identified important gaps in instruction, and possible areas of over-instruction. This information will assist the School to revise course offerings and academic/clinical posts. This approach to curriculum reform and the establishment of minimum competencies for academic public health should also prove useful to other schools in the US and elsewhere. By standardizing professional competencies, the public health profession with increase in stature and impact.     

Comprehensive effective and efficient global public health surveillance

At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources.Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR[2005]); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers.To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners.We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it's needed, where it's needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship of public health information; and second, the right of individuals to access real-time public health information that might impact their lives.The vision can be accomplished through an interoperable, global public health grid. Adopting guiding principles, the global community should circumscribe the overlapping interest, shared vision, and mutual benefit between the security and public health communities and define the boundaries. A global forum needs to be established to guide the consensus governance required for public health information sharing in the 21st century.     

Privatization and the scope of public health: a national survey of local health department directors

OBJECTIVES: This study sought to obtain and analyze nationally representative data on (1) privatization of local health department services, (2) local health department directors' beliefs and perspectives on the desirable role and focus of health departments, and (3) the influence of these views on privatization practices. METHODS: A stratified representative national sample of 380 local health department directors was drawn, and 347 directors were interviewed by telephone. Logistic regression established the independent effects of various factors on decisions to privatize. RESULTS: Almost three quarters (73%) of the local health departments privatized public health services of some type. The 12% of the directors who believed that local health departments should be restricted to the core public health functions and move entirely out of direct provision of personal health care were more likely to privatize services. The 77% of the directors who believed that local health departments should be involved in an increasing array of social problems were more likely to privatize. CONCLUSIONS: Privatization has quietly and quickly become commonplace in public health, and privatization practices are intimately related to divergent conceptions of public health and the role of local health departments.