A model for public health workforce development using the National Public Health Performance Standards Program.

Workforce development programs in public health should link improvements in workers' performance with improvements in their agencies' performance. The "ten essential services" of public health provide criteria for measuring both individual worker training (as in workforce competency standards) and agency performance (as in the Centers for Disease Control and Prevention's National Public Health Performance Standards Program). This shared foundation was the basis for a model strategic training program developed for use in a 500-employee urban county health department. Full implementation of this model as a foundation for assessment, curriculum development, and evaluation requires careful attention to management issues, confidentiality of employee records, and evaluation methodologies.     

Continuing-education needs of the currently employed public health education workforce

OBJECTIVES: This study examined the continuing-education needs of the currently employed public health education workforce. METHODS: A national consensus panel of leading health educators from public health agencies, academic institutions, and professional organizations was convened to examine the forces creating the context for the work of public health educators and the competencies they need to practice effectively. RESULTS: Advocacy; business management and finance; communication; community health planning and development, coalition building, and leadership; computing and technology; cultural competency; evaluation; and strategic planning were identified as areas of critical competence. CONCLUSIONS: Continuing education must strengthen a broad range of critical competencies and skills if we are to ensure the further development and effectiveness of the public health education workforce.     

Public housing, public health: health needs of public housing tenants

OBJECTIVES: To determine the health needs of public housing tenants, measured in terms of self-reported health status, health risk factors and expressed need for health risk reduction intervention. METHOD: Face-to-face interviews were conducted with a randomly selected sample of public housing tenants in the Hunter Region of New South Wales. RESULTS: Of 463 contactable tenants, 329 consented to participate in the study. Participants were 2.5 times more likely to rate their health as fair or poor relative to the community generally, and visited a doctor twice as often. The prevalence of smoking was more than twice that of the community generally, and the prevalence of falls was approximately three times greater. Risk of injury due to domestic violence was approximately six times greater, and the risk of injury due to violence in other locations was more than double that in the community. Between a quarter and a half of the participants requested support to reduce their health risks. CONCLUSIONS: The findings suggest that public housing tenants are one of the more severely health-compromised groups in the Australian community. IMPLICATIONS: An urgent need exists for public health initiatives that are directed at improving not only the current markedly poorer health status of public housing tenants, but also the greater prevalence of health risk factors that predict a likely continuation of such differentials into the future.     

The importance of the National Public Health Compass for public health

The National Public Health Compass provides an online overview of the current state of public health in the Netherlands. The Compass contains largely the same information as the Dutch Public Health Status and Forecasts Reports, the 2002 edition of which showed stagnation of public health improvement. This highlights the role of these overviews in the signalling of public health problems. The quality of the reporting on public health has been shown to be high and the reports are successful in providing information for Dutch health policy. However, if the Dutch are to regain their leading position in Europe, more policy efforts are required.     

The National Board of Public Health Examiners: credentialing public health graduates

The National Board of Public Health Examiners (NBPHE, the Board) is the result of many years of intense discussion about the importance of credentialing within the public health community. The Board is scheduled to begin credentialing graduates of programs and schools of public health accredited by the Council on Education for Public Health (CEPH) in 2008. Among the many activities currently underway to improve public health practice, the Board views credentialing as one pathway to heighten recognition of public health professionals and increase the overall effectiveness of public health practice. The process underway includes developing, preparing, administering, and evaluating a voluntary certification examination that tests whether graduates of CEPH-accredited schools and programs have mastered the core knowledge and skills relevant to contemporary public health practice. This credentialing initiative is occurring at a time of heightened interest in public health education, and an anticipated rapid turnover in the public health workforce. It is fully anticipated that active discussion about the credentialing process will continue as the Board considers the many aspects of this professional transition. The Board wishes to encourage these discussions and welcomes input on any aspects relating to implementation of the credentialing process.     

Health promotion and health education at the school of governance in health, National School of Public Health, Brazil

Schools of public health should define their teaching, research, and technical cooperative programs on the basis of epidemiological, epistemological, and health care parameters, which are heavily affected by the socioeconomic context of their countries. Brazil's demographic and epidemiological transition has been characterized by an increasing prevalence of diseases and risk factors associated with life styles, thus requiring an extensive and in-depth change in the country's health care model, with a greater supply of evidence-based services and preventive and health promotion measures, including new initiatives in information, education, and communications. This article approaches the recent experience at the Brazilian National School of Public Health, which has added to its long-standing academic tradition with a strategic reorientation known as the School of Governance in Health, including distance education as one of its main teaching options. Given Brazil's prevailing social and health situation, we conclude by highlighting the importance of training health professionals and promoting research and technological development in the fields of health promotion and education within the context of the School of Governance in Health at the National School of Public Health.     

Identifying training needs in the public health workforce: the public health prevention service as a case study.

The Public Health Prevention Service is a three-year training program committed to developing a workforce that is skilled in planning, managing, and evaluating prevention programs. In 2000, a questionnaire was administered to participants to assess their training needs. According to the resultant data, training is preferred in traditional formats (e.g., case studies and group discussion) and in short installments (one to three hours). Topics identified for future training included software application, prevention effectiveness (i.e., economic analysis), program evaluation, budgeting, and consensus building.     

Mapping the public health workforce I: a tool for classifying the public health workforce

We aimed to develop a tool to identify members of the public health workforce and classify them using categories developed for the Chief Medical Officer's project to strengthen the public health function. The tool was developed to gain a picture of London's public health workforce, and needed to be reliable and easy to use in many settings inside and outside the health service. We needed to be able to classify posts from brief information without interrogation of postholders, so that the entire workforces of large organisations could be classified from information provided by only a few key informants. Key questions and decision rules were defined by presenting interviewees in public health with brief information on nine jobs and discussing with them the process by which they determined whether each post was in the public health workforce, and if so, in which category. The questions and decision rules were refined into a classification tool which was presented as a flow diagram and a questionnaire. Application of the tool revealed that it was understood by key informants and resulted in classifications which were accepted by the researchers. The tool has now been applied extensively in London and yielded useful results. Many other applications in public health workforce planning and development are anticipated.     

Transforming a Master of Public Health program to address public health practice needs

The future of the constantly changing public health profession is tied to the development of practice skills through competency-based training. In this article, we describe a program change in the Master of Public Health program at East Stroudsburg University in northeastern Pennsylvania. The first goal of the program transition was to ensure that all program elements included the relevant vision, values, mission, goals, and objectives. The second goal was to use continuous data input and evaluation to incorporate opportunities for flexible assessments. The change process helped the university faculty define the program's vision and fostered an environment of community collaboration that guides training for public health professionals.     

The local public health agency workforce: research needs and practice realities.

There is a paucity of information about the nation's local governmental public health agency (LPHA) workforce. Without additional research, crucial questions about the individuals providing front-line public health services remain unanswered. Current national efforts to develop a public health workforce research agenda must include strategies for collecting basic data on local governmental public health workers. The work of enumerating and classifying LPHA staff is complicated, but not impossible. Projects to improve LPHA performance and discussions of the certification of public health workers are incomplete without current and accurate data on the individuals comprising our nation's public health system. The need to describe basic facets of the LPHA workforce is not trivial. As city and county budgets are cut and LPHAs are left scrambling to cover lost positions, data are needed to inform important decisions about what kinds of LPHA staff are needed to keep a community healthy.     

National Public Health Institutes: contributing to the public good

Donor and government funding for public health programs in low-resource countries - to increase immunizations or treat HIV/AIDS, for example - has risen dramatically. Rising less rapidly is the funding for public health functions that are not direct services or linked to programs for high-priority diseases and conditions. In many countries, these functions are housed in National Public Health Institutes (NPHIs). NPHIs are science-based agencies, usually within national governments, that include in their missions such public goods as assessing and monitoring the population's health and responding to outbreaks. Through a survey, we collected information from and about members of a new international organization for NPHIs. The responses illustrate the roles of NPHIs as purveyors of public goods. Data collected in the future on NPHI structures, practices, and challenges will be helpful to countries that are creating or restructuring NPHIs. The new knowledge will also help advocates for increasing budgetary support for the public goods functions of NPHIs.