Articulation of undergraduate and graduate education in public health

The rapid growth of individual undergraduate courses, minors, and baccalaureate degrees in public health presents a new issue for graduate public health education: how does a graduate or professional program address previously completed undergraduate public health course work? A review of college directories found listings for 154 North American baccalaureate degrees in public health, public health education, and public health nursing. This article addresses the purposes of public health undergraduate education as (1) general liberal arts education, (2) education complementary to other non-public health graduate degrees, (3) preprofessional education, and (4) professional education preparing undergraduates for entry-level careers. Following a discussion of reasons to consider articulation of undergraduate and graduate degrees, as well as barriers to articulation, the article presents potential strategies for articulation and future issues to consider in addressing admission of undergraduate public health students to master of public health programs.     

Mentoring in epidemiology and public health training

In the past, mentoring was the job of one senior researcher in which the mentor molded the mentee in his/her own image. With public health being a very multidisciplinary field, mentoring may need to evolve to facilitate the needs of emerging scientists—including epidemiologists. The mentoring relationship can begin at many education stages, including high school. Involving students at all education levels acts as a way to recruit and nurture interest in public health. On the basis of the experience in the medical sciences, mentoring programs also can be used to recruit and retain high-quality professionals in our discipline. Mentoring functions nurture a young mentee with the bonus of greater workplace satisfaction for the mentor. Nevertheless, more understanding of what constitutes successful mentoring and how to develop programs that create great mentors is needed.     

The health agency training program: continuing education courses in biostatistics and epidemiology

The authors describe the development and evaluation of a continuing education program in biostatistics and epidemiology. Short courses were presented to public health and mental health professionals using teaching strategies that included lecture, discussion, practice-oriented examples, and interactive problem-solving. A total of 1723 health professionals attended one or more of the 120 courses presented from 1992 to 1996 in seven US states. Most course participants were female: the highest education level for 40% was a bachelor's degree, while 42% had advanced degrees. Approximately 66% of participants signed up for continuing education credits. The program represents a successful partnership between an academic institution and health agencies in a seven-state region.     

Immunization coalitions that work: training for public health professionals.

Coalition development is a major strategy to increase immunization rates. However, if local and state coalitions are to succeed, their staffs need training and technical assistance in coalition development, community planning, and program implementation. The National Coalition Training Institute trains key health agency staff in 87 state, territorial, and urban sites to perform needs assessments, use data to guide planning, plan comprehensive strategies, and evaluate their coalitions. The curriculum is based on training needs that are identified by a national survey of immunization coalitions, effective approaches, and participant evaluation. According to evaluations conducted during its first year, the National Coalition Training Institute is meeting the needs of participants.     

Nationwide satellite training for public health professionals: Web-based follow-up

INTRODUCTION: Few studies have rigorously evaluated the effectiveness of health-related continuing education using satellite distribution. This study assessed participants' professional characteristics and their changes in knowledge, attitudes, and actions taken after viewing a public health preparedness training course on mass vaccination broadcast nationally by satellite. METHODS: A three-part survey design was used to evaluate training effectiveness. Paper-based questionnaires were distributed at a stratified sample of downlink facilities to collect knowledge and attitude responses before and after the broadcast. Six weeks later, willing participants were invited by e-mail to complete a Web-based follow-up questionnaire to assess actions taken as a result of viewing the broadcast. Paired t-tests and McNemar's chi-square were used to compare changes in attitude from before to after the broadcast, after the broadcast to follow-up, and before the broadcast to follow-up. RESULTS: A total of 544 paper-based questionnaires were received from 59 of 70 sampled sites. The pre- and post assessments administered the day of the broadcast demonstrated statistically significant knowledge gain (p < .001) and an increased belief immediately following the broadcast that mass vaccination clinics are important to their organizations' public health activities (p < .001). Of the 291 respondents who completed the follow-up online questionnaire, 44% (n = 128) reported they implemented or planned some form of action after the broadcast. Reported actions were higher among public health workers most likely to be directly involved in preparedness and immunization activities. DISCUSSION: This evaluation assessed (1) participants' professional characteristics, (2) knowledge gain, (3) self-reported actions taken following the broadcast, (4) program satisfaction, and (5) suggested improvements for future satellite broadcast programs. The study's methodology of using a Web-based survey for follow-up is a relatively economical tool for assessing longer-term continuing education program objectives.     

Assessing the competencies and training needs for public health professionals managing chronic disease prevention programs.

The purpose of this study was to assess the competencies and training needs for public health professionals managing chronic disease prevention programs. Focus groups were conducted among representatives from 12 state health departments across the United States, and data from the interviews were analyzed. The findings support additional training to enhance specific competencies for management/leadership, epidemiology/biostatistics, chronic disease prevention/policy development, and evaluation. Commonly reported competencies were knowledge of public health and chronic diseases, communication, and diversity. The findings can be used to design future competency-based training programs to build the capacity for chronic disease programs in state and territorial health departments.     

Clinical governance for public health professionals

This paper examines the issues specific to clinical governance for public health professionals. It highlights three levels at which public health is capable of promoting clinical governance: within the specialty of public health, across other National Health Service (NHS) organizations and as part of the public health responsibilities of health authorities. Current work is reviewed, and its focus on hospital and community NHS Trusts is noted. Current thinking on the introduction of clinical governance into clinical practice is interpreted to provide a framework for its development in public health professional practice.     

Traditional epidemiology, modern epidemiology, and public health.

There have been significant developments in epidemiologic methodology during the past century, including changes in basic concepts, methods of data analysis, and methods of exposure measurement. However, the rise of modern epidemiology has been a mixed blessing, and the new paradigm has major shortcomings, both in public health and in scientific terms. The changes in the paradigm have not been neutral but have rather helped change--and have reflected changes in--the way in which epidemiologists think about health and disease. The key issue has been the shift in the level of analysis from the population to the individual. Epidemiology has largely ceased to function as part of a multidisciplinary approach to understanding the causation of disease in populations and has become a set of generic methods for measuring associations of exposure and disease in individuals. This reductionist approach focuses on the individual, blames the victim, and produces interventions that can be harmful. We seem to be using more and more advanced technology to study more and more trivial issues, while the major causes of disease are ignored. Epidemiology must reintegrate itself into public health and must rediscover the population perspective.     

Breast-feeding training for health professionals and resultant institutional changes.

Assessed is a breast-feeding training course that was attended by health professionals at the Santos Lactation Center (SLC), Santos, São Paulo, Brazil, as well as its impact on the implementation of breast-feeding programmes in maternity hospitals. Eight maternity hospitals were studied--four were randomly allocated to the experimental group and sent three health professionals to attend an 18-day course at SLC; the remaining four institutions constituted the control group. The compliance of all eight hospitals with WHO/UNICEF''s "Ten steps for successful breast-feeding" was determined using scores obtained before and 6 months after the training course. Institutions in the experimental group had an improved score, but those in the control group did not. The SLC training course was efficient since it enabled the participants to promote breast-feeding practices. However, in order to succeed in implementing breast-feeding programmes, health professionals require also to develop skills to apply the knowledge they acquire in the course, as well as to involve the whole maternity unit team in the activities.     

Strengthening public health practice content in public health training.

U.S. schools of public health have recognized the imperative to strengthen the public health practice content of training for future public health practitioners. Five strategies to develop administrative and curriculum programs within schools of public health to address this need are described: (1) institution of centers for public health program evaluation; (2) creation of automated field placement and apprenticeship programs; (3) formalization of linkages with professional management training programs to create a track for future senior managers of community health agencies; (4) establishment of cross-departmental applied public health faculty tracks; and (5) offering applied public health evaluation scholarships for students. These initiatives may provide incentives for the institution of a public health practice focus within schools of public health.     

An overview of multicentric training workshops for public health professionals on reproductive and child health programme in India

The major emphasis of Reproductive and Child Health (RCH) programme in India is delivery of client-oriented, demand driven and broader ranges of high quality, safe and effective services for children, adolescents, mothers and reproductive age group population at large. Increased client satisfaction is considered as main determinant for improved acceptance of the services. Thus, well trained and motivated health personnel are necessary to deal with highly sensitive, personal health issues of the clients, like contraception, abortion, infertility services etc. The Indian Public Health Association organized total 10 workshops in several places of India (A total 322 members, composed of Medical Administrators (54.7%), Faculty members of Medical Colleges (24.5%), Sociologist and Nutritionists (13.9%) and also public health personnel (6.9%) participated in the workshop). Learning objectives and lesson plans etc. were formulated. Accordingly the contents were incorporated in a module, validated and pretested. The training sessions were conducted by briefing, discussion, group exercise and VIPP method and were evaluated by semi structured. The pre/post assessment schedule and scored scale of feedback from participantsAE were used for evaluation. The pre-post assessment scores revealed wide variations of mean score among the participants of several places. Significant post workshop improvement of knowledge was quite evident, with few exceptions. The group variants of pre and post score of results was considered to be due to heterogeneous groups of participants. Review of objectivity and quality of the questionnaire were felt as necessary.     

Innovation and motivation in public health professionals

OBJECTIVES: Innovations in public health services promote increases in the health status of the population. Therefore, it is a major concern for health policy makers to understand the drivers of innovation processes. This paper focuses on the differences in behaviour of managers and front-line employees in the pro-innovative provision of public health services. METHODS: We utilize a survey conducted on front-line employees and managers in public health institutions across six European countries. The survey covers topics related to satisfaction, or attitude towards innovation or their institution. We undertake principal components analysis and analysis of variance, and estimate a multinomial ordered probit model to analyse the existence of different behaviour in managers and front-line employees with respect to innovation. RESULTS: Perception of innovation is different for managers and front-line employees in public health institutions. While front-line employees' attitude depends mostly on the overall performance of the institution, managers feel more involved and motivated, and their behaviour depends more on individual and organisational innovative profiles. CONCLUSION: It becomes crucial to make both managers and front-line employees at public health institutions feel participative and motivated in order to maximise the benefits of technical or organisational innovative process in the health services provision.     

Contributions of public health to genetics education for health care professionals.

With growing knowledge about the role of genetics in health, genetics education for health care professionals has taken on increasing importance. Many efforts are under way to develop new genetics curricula. Although such efforts are primarily the responsibility of health professional schools and professional societies, the public health system is an important stakeholder, and different sectors of public health have opportunities to enhance educational efforts. These include the development of authoritative information sources about the clinical utility of genetic susceptibility and pharmacogenetic tests, creation of networks that link professionals in underserved regions to educational materials and consultative backup, and sponsorship of forums for multidisciplinary discussion of controversial issues. Public health input can help to ensure an appropriate emphasis on health outcomes as new genomic tests and technologies come into use, thus helping to protect society from the social and medical costs of genetic tests with limited clinical value.