Thinking beyond the silos: emerging priorities in workforce development for state and local government public health agencies.

CONTEXT: Discipline-specific workforce development initiatives have been a focus in recent years. This is due, in part, to competency-based training standards and funding sources that reinforce programmatic silos within state and local health departments. OBJECTIVE: National leadership groups representing the specific disciplines within public health were asked to look beyond their discipline-specific priorities and collectively assess the priorities, needs, and characteristics of the governmental public health workforce. DESIGN: The challenges and opportunities facing the public health workforce and crosscutting priority training needs of the public health workforce as a whole were evaluated. Key informant interviews were conducted with 31 representatives from public health member organizations and federal agencies. Interviews were coded and analyzed for major themes. Next, 10 content briefs were created on the basis of priority areas within workforce development. Finally, an in-person priority setting meeting was held to identify top workforce development needs and priorities across all disciplines within public health. PARTICIPANTS: Representatives from 31 of 37 invited public health organizations participated, including representatives from discipline-specific member organizations, from national organizations and from federal agencies. RESULTS: Systems thinking, communicating persuasively, change management, information and analytics, problem solving, and working with diverse populations were the major crosscutting areas prioritized. CONCLUSIONS: Decades of categorical funding created a highly specialized and knowledgeable workforce that lacks many of the foundational skills now most in demand. The balance between core and specialty training should be reconsidered.

Disparity of physicians' utilization of tobacco treatment services.

OBJECTIVES: To evaluate the familiarity with and utilization of tobacco treatment resources among physicians. METHODS: The NJ State Physician Census was mailed to 30,639 physicians with 8150 responding (26.6%). Data from 4598 direct patient-care physicians were analyzed. RESULTS: Pulmonologists, cardiologists, and family physicians had the highest levels of familiarity and referral, whereas psychiatrists, neurologists, ophthalmologists, and surgeons had the lowest. Physicians who were younger, female, who had more teaching hours, and who accepted fewer new patients all had higher familiarity. CONCLUSIONS: Familiarity with tobacco dependence treatment resources varies by physician characteristics. Increasing physicians' utilization of these resources is an important research priority.

Defining cigarette smoking status in young adults: a comparison of adolescent vs adult measures.

OBJECTIVE: To determine the agreement between 2 measures (adult vs adolescent) of current cigarette smoking among young adults. METHODS: We examined data from 1007 young adults from the New Jersey Adult Tobacco Survey. The adult measure incorporates lifetime and present use, whereas the adolescent measure assesses past 30-day use. The kappa coefficient was used to determine agreement between the 2 current cigarette smoking measures. RESULTS: Agreement between the measures was high, but not ideal. The percent reporting smoking in the past 30 days but not 100 cigarettes in their lifetime was notably higher, and therefore agreement was lower, for black females, Hispanic males, and college students living on campus. CONCLUSIONS: Sole use of the adult or adolescent measure of current cigarette smoking is insufficient to document progression to regular smoking in young adults.