Building Public Health Workforce Capacity: Longer-Term Effectiveness of a Capacity Building Intervention to Improve Community-Based Public Health Prevention Work.

Introduction: There is an urgent need to build capacity among existing and incoming public health workers to enhance community-based work focused on prevention and health promotion. Public Health Essentials, a cohort-based facilitated asynchronous online capacity building intervention, was designed to build public health workers' strategic skills and professional confidence. Earlier research reported on the short-term learning outcomes of the intervention; in this paper, the authors report on results from a longer-term outcomes evaluation, including skill retention, skill application, and possible indicators of workforce retention and community health improvement. Methods: A sequential mixed-methods research design was used to assess and explore longer-term outcomes among a sample of Public Health Essentials graduates working in community public health roles. Results: Some 46% of eligible Public Health Essentials graduates (n=70) completed a skills survey at 3 time points: before Public Health Essentials completion, after Public Health Essentials completion, and 3-6 months after Public Health Essentials completion. Longitudinal analysis of responses showed statistically significant skill gains over baseline (beginner → proficient, p<0.005), despite a slight drop in self-perceived ability 3-6 months after Public Health Essentials completion. Qualitative interviews with respondents and focus groups with their supervisors suggest that Public Health Essentials completion benefits participants' everyday work by developing strategic skills and grounding their work in shared public health language, paradigms, and values. Broader reported benefits include the ability to apply new skills to community public health prevention projects and expressed motivation to continue to work in public health. Conclusions: Successful completion of Public Health Essentials provides learners with durable skills applicable to public health work and may spur interest in continuing to work in the field of public health. The importance of developing and retaining a competent community-focused public health workforce cannot be overstated. Comprehensive-facilitated, online asynchronous capacity building programs may be an effective tool.

Facilitated Asynchronous Online Learning to Build Public Health Strategic Skills.

CONTEXT: The COVID-19 pandemic spurred significant government investments for hiring public health workers. There are clear opportunities to help build capacities among both current and incoming public health workers, closing well-elucidated skill gaps. OBJECTIVE: To report on the development process, methods used, and outcomes seen from a point-in-time public health workforce capacity-building initiative, Public Health Essentials (PHE) . DESIGN: Capacity-building outcomes evaluation using pre/postintervention measures. SETTING: The United States. PARTICIPANTS: A total of 512 learners working in roles (government or adjacent to) that support public health. INTERVENTION: PHE, a cohort-based facilitated asynchronous online course comprising 5 units, 18 modules, 54 learning outcomes, and 266 teaching and applied assessment elements designed to build public health strategic skills. MAIN OUTCOME MEASURES: Two outputs and 3 outcomes were used to assess and improve progress in achieving our goal of building generalizable and transferrable public health ability and confidence among diverse public health workers: Use of PHE , PHE completion rate , Learner competence , Change in self-assessed ability , and Benefits of PHE. RESULTS: From September 2021 to December 2022, 4 agencies used PHE for fellowship training or employee capacity building. Some 79% (n = 512) of learners completed the training, demonstrating competence in all 54 areas assessed by expert course facilitators. Of those, 79% (n = 321) completed both optional pre- and post-PHE surveys, reporting statistically significant gains in all strategic skill domains assessed (n = 9), regardless of demographics and public health experience. Learners gained new skills and knowledge (92%), developed a better understanding of public health (86%), and broadened their public health skill base (84%). A majority can apply the knowledge and skills gained directly to their work (94%), which benefits their team (92%), and have increased their confidence as public health practitioners (49%). CONCLUSIONS: PHE can significantly improve learners' ability across 9 strategic skill areas in as few as 15 weeks, regardless of their demographics, training, or experience.

Pandemic Response Officers: Integration Between Medical, Public Health, and Higher Education Systems to Expedite Prevention and Response.

CONTEXT: Research and policy studies alike have enumerated population and community health benefits of system integration between medical, public health, and social entities. The emergence of the COVID-19 pandemic revealed the necessity of a well-trained and adequately staffed public health and medical workforce in order to process SARS-CoV-2 cases and prevent subsequent transmission. Higher education systems, in particular, represented defined populations of exposure and transmission. Opportunities existed for collaboration and task sharing between institutions of higher education and local public health departments to limit spread and impacts. PROGRAM: This article describes the Pandemic Response Officer (PRO) program at Cornell University, a team of staff and students created during the intensity of the pandemic to benefit the Tompkins County and Cornell University communities. IMPLEMENTATION: The PRO program was formed in January 2021, with an original team of 8 individuals, working iteratively to investigate and support employee cases and exposures. Implementation was motivated by Cornell University's dual responsibility as a large employer that also possessed SARS-CoV-2 test results of employees. PROs loaded case information into a shared HIPPA-compliant electronic record that collected information for case notification, case investigation, isolation support, contact tracing, contact notification, and quarantine support. Over time, the PROs grew to a team of 25, gaining responsibilities as university and public health systems shared roles to maximize resources. EVALUATION: From January 1 to December 31, 2021, PROs managed 773 employee and 2943 student cases. During the Omicron surge (November 28-December 31, 2021), PROs saved the public health department an estimated 2797 hours of effort, equating to more than 10 professionals working full-time, evenings and weekends, to process cases and contacts during this interval. DISCUSSION: By integrating efforts between a university and public health agency, this intervention minimized SARS-CoV-2 transmission via expedient case support and alleviated strain on public health systems by expanding the public health workforce.

Social determinants of health and the Affordable Care Act.

Healthy living is mainly seen as a product of good genetics and holistic healthcare in the United States, but a growing field of research is also attributing well-being to social determinants of health (SDH), which are the compounded effects that arise from the concentration or lack of social capital. The Affordable Care Act (ACA) was enacted to promote the overall health of the country and its clauses are calling to attention the health disparities that come from social inequalities, the main sources for SDH. The ACA acknowledges that SDH affects marginalized communities in different ways, and to mitigate their effects, it localizes funding in hopes of empowering individuals and communities, but there is no integrated, multi-prong system for addressing SDH.