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.

Rural women's perceptions of community prenatal care systems: an empowerment strategy.

Rural U.S. women often experience many barriers to prenatal care involving health care provider shortages, distance to health care, and less health insurance coverage as compared to urban women. Fewer community planning and consumer resources as well as less transportation also often decrease opportunities for rural women to participate in community health planning and assessment. The purpose of this article is to describe social work strategies for empowering rural women in their assessment of community prenatal care systems. A case study of a rural demonstration project addressing prenatal care barriers is presented as well as implications for social work practice.

Social work practice in a rural community collaborative to improve perinatal care.

U.S. rural women encounter many logistical and psychosocial barriers to prenatal care, including high poverty rates, high rates of inadequate health insurance, health care provider shortages, transportation problems and health care systems that may be inadequate or unresponsive to the needs of poor women. The purpose of this article is to describe the role of the social worker in rural communities in the development, implementation and evaluation of a community effort that sought to improve prenatal care through a collaborative of health and human services organizations. The nature of social work participation and the implications for social work are discussed.

Communication about sexual behavior among adolescent women, their family, and peers.

PIP: Adolescent pregnancy and sexually transmitted disease rates in the US are among the highest of developed nations. Findings are reported from a study conducted to determine which reproductive health topics adolescents and their parents discuss, which immediate and extended family members discuss reproductive health topics with their female adolescent relatives, which family members and peers encourage female adolescents to use family planning services, and how adolescent age, pregnancy history, or parental encouragement of the use of family planning relates to the discussion of reproductive health topics. All females of maximum age 19 years registering for an appointment at 1 of 3 family planning clinics in Allegheny County, Pennsylvania, were consecutively recruited to participate in the study. A survey of 249 female adolescent family planning clients found that women aged 13-16 years were more likely than women aged 17-19 years to discuss sexual behavior with adult, nonparental relatives (p = .007). Teens with a prior pregnancy were more likely than never-pregnant teens to report parental discussion of contraception choices (p = .004) and of sites for contraceptive care (p = .0023). Adolescents discuss sexuality with a complex network of family and peers. Social work clinical and community skills facilitate family-centered reproductive health training and counseling for the improved reproductive health of US adolescents.^ieng