Pre-Pandemic Landscape of the Oklahoma Public Health Workforce: A Case Study From the Region 6 Training Needs Assessment Survey, 2019.

CONTEXT: The COVID-19 pandemic highlighted the need for a well-trained public health workforce prior to the public health crisis. Public health training centers regularly assess workforce needs and their pre-pandemic data play vital roles in guiding public health workforce development beyond the crisis. PROGRAM: In 2019, Oklahoma partners of the Region 6 South Central Public Health Training Center (R6SCPHTC) co-conducted an online survey of the public health workforce located in the Health Resources & Services Administration Region 6. IMPLEMENTATION: Between March and April, the R6SCPHTC collected 503 surveys, including 201 surveys from Oklahoma. Questions inquired about demographic and workforce characteristics, work contexts, training needs and interests, training access and logistics, and knowledge of R6SCPHTC online resources. EVALUATION: Key findings included that two-thirds of the pre-pandemic Oklahoma public health workforce consisted of employees age 40 or older with few holding public health or medical degrees. The majority of respondents worked for health departments and Tribes, and almost half were frontline workers. Although at least half of the participants interested in training on public health activities and topics were familiar with them, confidence in their abilities related to these activities and topics was expressed by less than half. Qualitative data provided details on training needs addressed quantitatively and described new training areas. Survey participants expressed interest in diverse training delivery methods and technological devices. Most respondents were not familiar with the free trainings available through the R6SCPHTC. DISCUSSION: Similar to the regional and national public health workforce, Oklahoma's workforce needed training and support already before COVID-19. Time and resources need to be invested into the current and future workforce. While addressing priority public health skills and topics remains important, training on current and emerging topics is needed. Providing accessible trainings with expanded content will prepare Oklahoma's public health workforce for the future.

A Snapshot of Oklahoma's CHR/CHW Workforce: Results from the Region 6 Training Needs Assessment Survey, 2019.

Background ­: The Region 6 South Central Public Health Training Center conducts needs assessments to inform the development of online trainings tailored to the HRSA Region 6 health and public health workforce. The purpose of this study was to assess Oklahoma's Community Health Representative (CHR) / Community Health Worker (CHW) workforce characteristics, current trainings, and training needs to guide the development of online trainings. Methods ­: This survey-based needs assessment for health and public health workforce training needs asked about alternative job titles, top three health issues addressed, roles played, skills used, current trainings, and training needs. Descriptive statistical analysis provided insights about CHRs/CHWs. The Fisher's exact test was used to compare frequency of responses between CHRs and CHWs, with p-values <0.05 considered significant. We analyzed qualitative data by using a modified content analysis. Results ­: Fifty-one self-identified CHRs/CHWs in Oklahoma participated in the 2019 regional health and public health training needs assessment. Most CHRs/CHWs were female and identified as "frontline public health workers." Respondents reported a range of educational attainment and diverse job titles. CHRs worked at tribal health or public health organizations primarily in rural areas. Most CHWs worked in urban areas and were employed by state and local health departments or community-based organizations. CHRs/CHWs had a broad spectrum of roles and skills, with required trainings reflecting various organizational needs. CHRs/CHWs expressed strong interest in receiving additional trainings via multiple delivery formats. Discussion and Conclusions ­: Oklahoma's CHRs/CHWs would benefit from and utilize workforce development, including trainings on a broad spectrum of roles and skills in multiple delivery formats. Potential employers and funders across the state would benefit from education on CHRs/CHWs as a workforce, team-integration, and sustainable funding.

Obesogenic Behaviors and Depressive Symptoms' Influence on Cardiometabolic Risk Factors in American Indian Children.

BACKGROUND: American Indian (AI) populations suffer disproportionately from cardiovascular disease and depression as compared to other racial/ethnic groups. Behaviors that contribute to obesity are considered obesogenic and include poor diet, low physical activity, and high screen time. This study examined the relationship between depressive symptoms and obesogenic behaviors on cardiometabolic risk factors in AI youth. METHODS: Participants (n=121) were evaluated for depressive symptoms, obesogenic behaviors, weight, blood pressure, lipids, and glucose levels. RESULTS: All participants failed to meet guidelines for intake of sugar-sweetened beverages and fruits/vegetables, 74% did not meet physical activity guidelines, and 85% did not meet screen time guidelines. Lower physical activity was associated with higher body fat percentage (b=-4.20 ± 1.82, p=0.022). Elevated depressive symptoms and presence of at-risk cardiometabolic risk factors were found. Higher depressive symptoms were associated with higher blood glucose (random, fasting, and hemoglobin A1c). CONCLUSIONS: Low physical activity, high screen time, and the presence of depressive symptomology heighten cardiometabolic risk factors in AI children. Associations between depressive symptoms and blood glucose underscore the impact of emotional health on cardiometabolic disease and emphasize need for proper depression assessment in chronic disease prevention efforts.

Obesogenic Behaviors, Self-Efficacy, and Depressive Symptoms in American Indian Children.

BACKGROUND: American Indian (AI) children suffer from high rates of obesity, obesity-related disease, obesogenic behaviors, and depressive symptoms. OBJECTIVE: Study was designed to determine the associations between depressive symptoms and obesogenic behaviors in school-aged AI children in Oklahoma. METHODS: Study design was cross-sectional. Depressive symptoms, beverage intake, fruit and vegetable intake, meal frequency, physical activity, and screen time were self-reported. RESULTS: Mean participant age was 10.5 ± 1.6 years (n = 121); 64% were overweight/obese. Depressive symptoms were associated with dieting and screen time. CONCLUSION: AI chronic disease prevention efforts will benefit by including measures for depression and associations of obesogenic behaviors and depressive symptoms in treatment planning.