A conceptual model for leadership development.

Collaboration among schools of public health and national, state, and local health agencies has resulted in creation of comprehensive public health workforce education and training initiatives that offer integrated, sequential, and accessible professional development programs, including a nation-wide network of public health leadership institutes. A conceptual model for leadership development is presented. It contains seven elements considered critical for design of leadership programs in public health: capacity/competence needs; program target; area served; program content; training level; learning approach; and implementation methods. This model can be used to design leadership as well as public health workforce education and training programs.     

Does leadership training make a difference? The CDC/UC Public Health Leadership Institute: 1991-1999.

Public health leadership development programs have proliferated since the release of the Institute of Medicine's call for strengthened public health leadership. Little has been documented, however, about the impact of these programs. This article presents results of an eight-year retrospective evaluation of the Centers for Disease Control and Prevention/University of California Public Health Leadership Institute, the nation's first year-long leadership development program serving senior public health leaders. Results show that this program has had a positive impact on participants' leadership effectiveness at the personal, organizational, and community levels as well as on the field of public health.     

Competency identification and modeling in healthcare leadership

In line with the current interest in leadership development across many industries today, a number of competency-based educational programming initiatives have been launched in professional education. As well, the National Summit on the Future of Education and Practice in Health Management and Policy in 2001 called for the documentation of learning outcomes for continual educational improvement in health management and policy. The National Center for Healthcare Leadership (NCHL) subsequently launched a comprehensive, multi-stage process for identifying the competencies salient to distinguishing outstanding leadership performance in health management. This article describes the plan and the processes associated with NCHL's specification of a preliminary model of core competencies for leadership in health management, as well as the continued methods for refinement and validation of the model with both educators and practitioners in the field. The initial version of the NCHL Competency Model has facilitated field-wide dialogue regarding outcomes-based learning and assessment for both educational and professional development program planning. Subsequent development of the model will continue to stimulate open exchanges regarding pedagogical practice, as well as facilitate the design of leadership assessments for individuals, programs, organizations, and the field at large.     

Competency development in public health leadership

The professional development of public health leaders requires competency-based instruction to increase their ability to address complex and changing demands for critical services. This article reviews the development of the Leadership Competency Framework by the National Public Health Leadership Development Network and discusses its significance. After reviewing pertinent literature and existing practice-based competency frameworks, network members developed the framework through sequential use of workgroup assignments and nominal group process. The framework is being used by network members to develop and refine program competency lists and content; to compare programs; to develop needs assessments, baseline measures, and performance standards; and to evaluate educational outcomes. It is a working document, to be continually refined and evaluated to ensure its continued relevance to performance in practice. Understanding both the applications and the limits of competency frameworks is important in individual, program, and organizational assessment. Benefits of using defined competencies in designing leadership programs include the integrated and sustained development of leadership capacity and the use of technology for increased access and quality control.     

Connecting for health literacy: health information partners

This article describes a community-based health information partnership to address health literacy and health information inequalities in marginalized communities. Public health, medical, literacy, and library practitioners promote health literacy through outreach, training, and professional development activities in community settings. They create learning environments for people to develop the necessary knowledge and skills to better understand health information and health policy so they can make decisions concerning personal and community health. Outreach activities focus on visits to neighborhood health centers, health fairs, health exhibits at union meetings and conferences; training programs involve hands-on, peer-led computer classes for people living with HIV and for the general public; and professional development programs connect librarians, health providers, public health workers, and literacy teachers in joint planning and learning. Several learners currently participate in and lead community health education programs and HIV advocacy. The coalition's strength develops from strongly shared objectives, an absence of territoriality, and a core active leadership group.     

Equipping clinical leaders for system and service improvements in quality and safety: an Australian experience

Objective : To develop clinical leadership among health professionals working in public sector organisations to improve their skills in ensuring high quality and safe health services. Methods : A longitudinal pre‐post‐intervention mixed methods study that included 60 health professionals working in one state in Australia. Results : The program was successful in the development of clinical leaders. Conclusions : An interdisciplinary, inter‐sectoral leadership development program involving health professionals from metropolitan, regional and rural areas can be successful in developing knowledge, skills and competencies among these health professionals in health service quality and safety. Implications : Health professionals can participate in a development program to enhance their clinical leadership skills. While this was a post‐qualification course, targeting experienced health professionals, the learnings could be applied to pre‐qualification education of health professionals.     

Developing leaders in public health: the role of executive training programs

The growing complexity of the nation's health care system is creating new challenges and opportunities for public health officials, and a renewed concern for leadership training among these officials. A focus group conducted with public health officials at local, state, and national levels reveals perceptions about the predominant trends effecting public health practice, the leadership skills required for effective public health practice, and the strategies that are needed for providing appropriate leadership training to public health executives. Officials indicate that public health practice is undergoing substantial changes in response to the growth of managed care and integrated delivery systems, changes in public health funding sources and levels, and efforts to privatize the delivery of public health services. The skills identified as critical for effective leadership in this environment include the ability to guide organizational behavior and cultivate interorganizational relationships; apply scientific knowledge to public health problems, and build and sustain community coalitions. In light of these skills, public health officials identify four essential components of an optimally effective executive training program in public health leadership: exposure to the core scientific disciplines within public health; exposure to organization theory and management science; training in community development and empowerment; and training in ethics and social justice. All of the officials agree with the need for distance learning programs for executives in public health leadership, and most officials also support the need for doctoral-level training in public health practice.     

Mentorship and competencies for applied chronic disease epidemiology.

To understand the potential and establish a framework for mentoring as a method to develop professional competencies of state-level applied chronic disease epidemiologists, model mentorship programs were reviewed, specific competencies were identified, and competencies were then matched to essential public health services. Although few existing mentorship programs in public health were identified, common themes in other professional mentorship programs support the potential of mentoring as an effective means to develop capacity for applied chronic disease epidemiology. Proposed competencies for chronic disease epidemiologists in a mentorship program include planning, analysis, communication, basic public health, informatics and computer knowledge, and cultural diversity. Mentoring may constitute a viable strategy to build chronic disease epidemiology capacity, especially in public health agencies where resource and personnel system constraints limit opportunities to recruit and hire new staff.     

Social inequalities in health. A partnership of research and education

The Chair on Health Inequality is one of the 12 Chairs created by the CHSRF. Resulting from a partnership between l'Université de Montréal, together with the Direction de la santé publique of the Régie régionale de la santé et des services sociaux Montréal-centre, the Chair will create a research program that will document and assess the role of public health programs based on social development in urban districts, in reducing social health inequality. This research infrastructure will support two training programs: 1) a post-doctoral training program that will introduce newly minted social science PhDs to collaborative research in public health; and 2) a professional doctorate program for public health professionals. The decision-makers and policy-makers targeted by the Chair's knowledge diffusion program are Directors of public health organizations.     

An interdisciplinary MPH via distance learning: meeting the educational needs of practitioners.

This article describes a distance learning master of public health program that prepares students to lead programs and organizations. Evaluation showed that the curriculum, format, and teaching methods were accessible, affordable, acceptable, and appropriate for the working professional, and equivalent to residential master's programs aimed at experienced professionals. Students interacted with professors and other learners using the World Wide Web, weekly videoconferences, and face-to-face meetings. Students, whose main motivations for enrolling included improving job performance in leadership and career advancement, reported strengthening of knowledge, perspective, skill, technical facility, confidence, and job performance. Learner satisfaction was high, with 100% agreeing they would recommend the program to others.     

Developing practitioner leaders in a distance education doctoral program: challenges and opportunities

The nation's first executive doctoral program in health leadership was launched at the University of North Carolina School of Public Health in August 2005. The program confers a DrPH in health administration. This paper describes the program goals, admissions criteria, program structure and content, use of technology and results of initial program evaluations. Lessons learned during the planning and first three years of operation may assist others as they evaluate the feasibility and desirability of creating similar doctoral-level distance education programs. A critical need exists for additional programs able to attract and prepare top health leaders. This distance DrPH leadership program is one model for what may be the beginning of a promising new era in health leadership education.     

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.     

The Pipeline Training Program in Maternal and Child Health: Interdisciplinary Preparation of Undergraduate Students from Underrepresented Groups

The Preparing Academically Successful Students in Maternal and Child Health (MCH PASS) training program provided financial support and specialized training to occupational therapy (OT) and speech-language pathology (SLP) undergraduate students from underrepresented groups in maternal and child health. The project assisted undergraduate trainees to matriculate into graduate programs in their respective fields and facilitated application into long-term maternal and child health training programs. Sixteen trainees (8 OT and 8 SLP) participated in an undergraduate training program with an emphasis on interdisciplinary teaming, family mentoring, leadership development, public health and population-based research. Instruction occurred in community and classroom settings through didactic instruction and small group discussions. Fifteen of the trainees applied to and were accepted in graduate programs in their respective fields. Two trainees applied to a long-term MCH training program. Students reported increased knowledge about programs that serve women and children, the effects of poverty on health, interdisciplinary teaming and the daily routines of families who have a child with a special health care need. The MCH PASS program provided a unique opportunity for undergraduate students in OT and SLP to learn about public health with an emphasis on maternal and child health. The specialized preparation enabled students to understand better the health concerns of underserved families whose children have special health care needs.     

The MCH Certificate Program: A New Path to Graduate Education in Public Health

Objective: The purpose of the MCH Certificate Program was threefold: to develop a new educational initiative in response to national and local demands for increased MCH workforce capacity, to eliminate key financial and nonfinancial barriers to advanced MCH academic preparation, and to improve rates of recruitment and retention of students from minority communities, thus enhancing the quality of MCH services available to the region. Methods: An MCH Certificate Program, designed for clinicians (e.g., nurses, occupational therapists and nutritionists) and public health practitioners as a bridge to graduate programs in public health, combined a competency based curriculum with skills workshops, leadership seminars, mentoring, small group activities, and an interactive teaching format. Results: Students from the first two cohorts (n = 45) report an expansion of core public health knowledge (issues, policies, and strategies), enhanced self-confidence, and efficacy. Half have experienced job changes that represent increased responsibility, leadership, and professional advancement. A third are enrolled in or have completed a formal program of graduate study in MCH. Conclusions: This innovative MCH Certificate Program, now in its fourth year, is a new approach to increasing workforce capacity and a successful model of instruction for adult learners. It has the potential for adaptation to a variety of educational settings and MCH populations, and helps to expand the continuum of MCH training experiences in schools of public health.     

Physical fitness programming for health promotion at the worksite

Exercise enthusiasts and health professionals have recommended that physical fitness programs be implemented in the occupational setting. Such programs are promoted on the basis of expected benefits to both the employee and employer. The potential for benefit to the employee seems substantial, since a sizable body of knowledge links regular exercise to improved functional capacity and reduced risk for development of certain chronic diseases. The available literature provides some direct evidence that exercise programs can improve the health status of employee groups. Specifically, programs may generate improvements in cardiorespiratory fitness and cardiovascular health and promote long-term adherence to exercise. The physiological goals can be attained with programs that provide 20–30 min of moderately intense “aerobic” activity 3 or more days per week. Several factors are known to affect adherence of employees to company-sponsored fitness programs. Of particular importance are program leadership, motivational schema, program activities, convenience of participation, and social support. It is recommended that, where feasible, supervisors of employee fitness programs (a) secure professional leadership, (b) provide on-site or other facilities that maximize convenience, (c) allow participation across the widest possible time span, (d) provide programs offering a wide range of activities, (e) attend carefully to evaluation, recognition, and other motivational concerns, and (f) incorporate a comprehensive health promotion perspective.     

Achieving consensus on leadership competencies and outcome measures: The Pediatric Pulmonary Centers' experience

Pediatric Pulmonary Centers (PPCs) are federally funded interdisciplinary leadership training programs aiming to improve the health of families and children. This article describes the process PPCs used to efficiently and effectively achieve consensus on leadership training competencies and outcome measures among a large and diverse group of health professionals. Phase 1 used a modified Delphi technique to develop an initial set of competencies and outcome measures. Phase 2 used the nominal group technique and modified focus group strategies to refine and prioritize the competencies and outcomes measures. Participants reported being highly satisfied with the process and outcomes. In Phase 3, a formal program evaluation instrument was implemented, designed to measure the competency and describe the career paths and leadership accomplishments of previous trainees. The consensus process adopted can serve as a model for academic and public health entities seeking to achieve consensus on program goals, strategies, methods, priorities, and outcomes.     

MPH Program Adaptability in a Competitive Marketplace: The Case for Continued Assessment

In the last several years, the number of Master of Public Health (MPH) programs has increased rapidly in the US. As such, MPH programs, particularly smaller-sized ones, need to critically examine how their programs are meeting the needs and preferences of local public health practitioners. To assist in this necessity, the University of New Hampshire conducted a comprehensive educational assessment of its effectiveness as a smaller-sized, accredited MPH program. The aim of the assessment was to review the MPH program from the perspective of all stakeholders and then to agree on changes that would contribute to the fulfillment of the program’s mission, as well as improve program quality and reach. The program’s stakeholders examined the following components: policy development and implementation; target audience; marketing strategies; marketplace position; delivery model; curriculum design; and continuing education. Though assessment activities explored a wide array of program attributes, target audience, curriculum design, and delivery strategy presented significant challenges and opportunities for our smaller MPH Program to remain competitive. The effort put forth into conducting an in-depth assessment of the core components of our program also allowed for a comparison to the increasing number of MPH programs developing regionally. Since public health practice is changing and the education of public health practitioners must be adaptable, we propose that a routine assessment of an institution’s MPH program could not only meet this need but also assist with keeping smaller, unbranded MPH programs competitive in a burgeoning marketplace.