Differences in Health Education Competencies Among Obesity Prevention and Nutrition Education Professionals.

The study purpose was to examine perceived health education competencies among those responsible for planning, implementing, and evaluating health education programs. A total of 172 obesity prevention and nutrition education professionals in the United States completed a survey measuring their perceived competency to plan, implement, and evaluate nutrition education/obesity prevention education programs based on the National Commission for Health Education Credentialing health education competencies and their endorsement of various health education approaches. Using a series of multiple hierarchical regression models, we found that those trained in health education had greater perceived competency in assessing needs (B = 1.19, t = 2.11, p = .03), planning health education programs (B = 1.63, t = 2.96, p = .004), implementing health education programs (B = 1.00, t = 2.22, p = .03), evaluating health education programs (B = 4.85, t = 3.54, p = .001), and managing health education programs (B = 1.70, t = 2.21, p = .03) than those trained in nutrition or dietetics. Additionally, those trained in health education were more likely to endorse the use of a skill-based approach to obesity prevention (B = 0.25, t = 2.53, p = .01) and less likely to endorse teaching facts and information (B = 0.24, t = 1.99, p = .05) than those trained in nutrition or dietetics. These results have implications for improving the effectiveness of health education and promotion programs and the professional preparation of health educators and dietitians alike.

Advocacy and Public Policy Perceptions and Involvement of College Health Promotion Students.

Understanding the advocacy and public policy training needs of our future health promotion workforce is crucial if we are to prepare them to meet their professional responsibilities. The purpose of this study was to examine health promotion students' advocacy/public policy involvement, training, and perceptions. Electronic surveys were disseminated nationwide to college students in health education and closely related programs. Of 477 student respondents, the most frequently indicated advocacy/public policy activity engaged in was voting (56%). The greatest benefit to advocacy was indicated as creating public awareness, while the most prevalent barrier reported was lack of familiarity with the legislation process. Less than one third of students reported receiving any training; however, training and the number of training sources were associated with greater involvement (p < .05). Comparisons by academic classification indicated that graduate students participated in more advocacy activities and reported significantly more benefits, barriers, knowledge, and self-efficacy compared with undergraduates. Regression analysis indicated that knowledge, self-efficacy, perceived benefits, and total number of training sources were significant predictors of advocacy involvement in both graduate and undergraduate student models, with age also contributing significantly to the graduate student model. Findings emphasize the need for increased training at earlier education levels to increase knowledge, self-efficacy, and advocacy/public policy involvement.

Mobilizing the Next Generation of Health Advocates: Building Our Collective Capacity to Advocate for Health Education and Health Equity Through SOPHE Advocacy Summits.

In this Career Development commentary, the author highlights the benefits of attending the Society for Public Health Education Advocacy Summit in Washington, D.C. Advocacy is an increasingly necessary skill that allows health educators to advance both the field of public health and their own career development as professionals. Students and practitioners from diverse health education settings get to connect with other professionals, attend skill-building workshops, and increase their ability to influence health policy. From a career development perspective, the Summit provides opportunities to develop professional networks, gain experience and continuing education in several areas of responsibility for health education specialists, and share lessons learned with colleagues in health education and public health.

Development and evaluation of a genomics training program for community health workers in Texas.

PURPOSE: Genomics services have the potential to reduce incidence and mortality of diseases by providing individualized, family health history (FHH)-based prevention strategies to clients. These services may benefit from the involvement of community health workers (CHWs) in the provision of FHH-based genomics education and services, as CHWs are frontline public health workers and lay health educators, who share similar ethnicities, languages, socioeconomic statuses, and life experiences with the communities they serve. We developed, implemented, and evaluated the FHH-based genomics training program for CHWs. METHODS: This theory- and evidence-based FHH-focused genomics curriculum was developed by an interdisciplinary team. Full-day workshops in English and Spanish were delivered to 145 Texas CHWs (91.6% were Hispanic/black). Preworkshop, postworkshop, and 3-month follow-up data were collected. RESULTS: CHWs significantly improved their attitudes, intention, self-efficacy, and knowledge regarding adopting FHH-based genomics into their practice after the workshops. At 3-month follow-up, these scores remained higher, and there was a significant increase in CHWs' genomics practices. CONCLUSION: This FHH-based genomics training successfully educated Texas CHWs, and the outcomes were promising. Dissemination of training to CHWs in and outside of Texas is needed to promote better access to and delivery of personalized genomics services for the lay and underserved communities.

Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: a cluster randomized trial.

BACKGROUND: US unintended pregnancy rates remain high, and contraceptive providers are not universally trained to offer intrauterine devices and implants to women who wish to use these methods. OBJECTIVE: We sought to measure the impact of a provider training intervention on integration of intrauterine devices and implants into contraceptive care. STUDY DESIGN: We measured the impact of a continuing medical education-accredited provider training intervention on provider attitudes, knowledge, and practices in a cluster randomized trial in 40 US health centers from 2011 through 2013. Twenty clinics were randomly assigned to the intervention arm; 20 offered routine care. Clinic staff participated in baseline and 1-year surveys assessing intrauterine device and implant knowledge, attitudes, and practices. We used a difference-in-differences approach to compare changes that occurred in the intervention sites to changes in the control sites 1 year later. Prespecified outcome measures included: knowledge of patient eligibility for intrauterine devices and implants; attitudes about method safety; and counseling practices. We used multivariable regression with generalized estimating equations to account for clustering by clinic to examine intervention effects on provider outcomes 1 year later. RESULTS: Overall, we surveyed 576 clinic staff (314 intervention, 262 control) at baseline and/or 1-year follow-up. The change in proportion of providers who believed that the intrauterine device was safe was greater in intervention (60% at baseline to 76% at follow-up) than control sites (66% at both times) (adjusted odds ratio, 2.48; 95% confidence interval, 1.13-5.4). Likewise, for the implant, the proportion increased from 57-77% in intervention, compared to 61-65% in control sites (adjusted odds ratio, 2.57; 95% confidence interval, 1.44-4.59). The proportion of providers who believed they were experienced to counsel on intrauterine devices also increased in intervention (53-67%) and remained the same in control sites (60%) (adjusted odds ratio, 1.89; 95% confidence interval, 1.04-3.44), and for the implant increased more in intervention (41-62%) compared to control sites (48-50%) (adjusted odds ratio, 2.30; 95% confidence interval, 1.28-4.12). Knowledge scores of patient eligibility for intrauterine devices increased at intervention sites (from 0.77-0.86) 6% more over time compared to control sites (from 0.78-0.80) (adjusted coefficient, 0.058; 95% confidence interval, 0.003-0.113). Knowledge scores of eligibility for intrauterine device and implant use with common medical conditions increased 15% more in intervention (0.65-0.79) compared to control sites (0.67-0.66) (adjusted coefficient, 0.15; 95% confidence interval, 0.09-0.21). Routine discussion of intrauterine devices and implants by providers in intervention sites increased significantly, 71-87%, compared to in control sites, 76-82% (adjusted odds ratio, 1.97; 95% confidence interval, 1.02-3.80). CONCLUSION: Professional guidelines encourage intrauterine device and implant competency for all contraceptive care providers. Integrating these methods into routine care is important for access. This replicable training intervention translating evidence into care had a sustained impact on provider attitudes, knowledge, and counseling practices, demonstrating significant changes in clinical care a full year after the training intervention.

Pediatric diabetes training for healthcare professionals in Europe: Time for change.

BACKGROUND: Training for healthcare professionals (HCPs) in Europe who care for children and young people (CYP) with type 1 diabetes and their families is variable depending on the country. Building on the work of SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) and using the German Certified Diabetes Educators (CDEs) curriculum, a European collaboration of pediatric diabetes experts aimed to (1) establish current core elements that should be included in a pediatric diabetes education training course and (2) create a template for a European CDE's training curriculum. METHODS: A qualitative methodology incorporating a survey questionnaire, focus group discussions, individual semi-structured interviews and workshops was employed to explore participants' experiences and opinions. HCPs-pediatric consultants, diabetes nurses, dietitians and psychologists, national and local diabetes leads, academic and education leads and children, and young people with diabetes and families took part in the study. The total number of participants equaled 186. RESULTS: A template for a European Certified Diabetes Educator Curriculum (EU-CDEC) was developed based on the themes that emerged from the participants' expertise and experiences. This provides a model for HCPs' pediatric diabetes training provision. CONCLUSIONS: There is a severe shortage of high quality, standardized training for HCPs across the majority of European countries. Lack of trained HCPs for CYP with diabetes will result in the delivery of suboptimal care and impact on health, wellbeing and clinical and psychological outcomes. The EU-CDEC template can be used to increase access to high quality training provision for all HCPs across Europe and worldwide.

Preparing Student Nurses as Parent-based Adolescent Sexual Health Educators: Results of a Pilot Study.

OBJECTIVES: While health promotion and patient education are central to the scope of practice of professional nurses, they often feel ill-equipped to assume the role of sexual health educator and lack adequate knowledge and skills to effectively engage parents in adolescent sexual and reproductive health efforts. DESIGN AND SAMPLE: Employing a mixed-methods study consisting of both pre- and post-test survey and exit interviews, a pilot study was conducted to assess the impact of implementing a parent-based adolescent sexual health intervention on baccalaureate nursing student outcomes (N = 31). RESULTS: We found statistically significant improvements in student outcome expectancies of parenting strategies, barriers to sexual health communication, self-efficacy, and sexual health counseling experience. Using thematic content analysis of exit interview content, emerging themes were (1) need for increased sexual and reproductive health (SRH) preparation, (2) wanting greater experience and opportunity for involvement in nursing research, and (3) educational gaps in family-focused community public health. CONCLUSIONS: Incorporating adolescent sexual health education into public health nursing clinical training can prepare nurses as parent-based adolescent sexual health educators, a core competency for nurses working with families in communities and across all health care delivery settings.

Advocacy and Public Policy Perceptions and Involvement of Master Certified Health Education Specialists.

Master Certified Health Education Specialists (MCHES; n = 186) participated in a mail survey on advocacy and public policy. Over half of participants reported that they had contacted a public official or provided policy-related information to consumers or other professionals. Participants identified barriers and benefits to influencing public policy. The greatest benefit was identified as improving the health or welfare of the public while the greatest barrier was that they were busy with other priorities. Participants also described their level of involvement, knowledge, training in advocacy, and their self-efficacy in performing various advocacy activities. Most MCHES reported voting and other basic advocacy functions while far fewer had participated in more advanced advocacy activities. Although nearly 73% had formal training on advocacy and policy, only 26% received it through college coursework. Factors predictive of advocacy and policy involvement were determined through a stepwise regression analysis. Five independent variables predicted the total number of advocacy activities and when combined accounted for nearly 61% of the variance. Government-level health educators' misconception that they cannot participate in advocacy and public policy issues should be dispelled. Health education specialists with the MCHES credential need coursework and additional training on how to effectively influence public health policy.

Health Education Careers in a Post-Health Reform Era.

Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law's provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

Promoting Health Through Policy and Systems Change: Public Health Students and Mentors on the Value of Policy Advocacy Experience in Academic Internships.

Emerging professionals and new Certified Health Education Specialists often lack academic training in and actual experience in National Commission for Health Education Credentialing Area of Responsibility VII: Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession. For undergraduate and graduate students who have an opportunity to complete an internship or practicum experience, gaining experience in Competencies 7.2: Engage in advocacy for health and health education/promotion and 7.3: Influence policy and/or systems change to promote health and health education can have a profound impact on their career development and their ability to advocate for policies that promote health and health equity. Compelling evidence suggests that interventions that address social determinants of health such as poverty and education and those that change the context through improved policy or healthier environments have the greatest impact on public health, making it vital for emerging public health professionals to gain experience in policy advocacy and systems change. In this commentary, students and faculty from two large universities in the U.S.-Mexico border region reflect on the value of policy advocacy in academic internship/fieldwork experiences. Based on their experiences, they highly recommend that students seek out internship opportunities where they can participate in policy advocacy, and they encourage university faculty and practicum preceptors to provide more opportunities for policy advocacy in both classroom and fieldwork settings.

Educating teenagers about hearing health by training them to educate children.

OBJECTIVE: We investigated the change in hearing-health behaviour amongst teenagers trained to deliver the Dangerous Decibels programme to younger children. DESIGN: The Dangerous Decibels programme uses a two-stage process to train 8-12 year-old children to protect their hearing from noise: (1) a team of experts train 'Educators' who (2) give classroom training to children in schools. Training teenagers as Educators may add a second level of benefit if teenagers internalize the hearing-health messages that they present and thus protect their own hearing better. They were assessed before training, immediately after, and three months later (after all had presented the classroom training) using a questionnaire. In addition, a focus group was conducted with a subgroup of the Educators to assess their subjective experience. STUDY SAMPLE: We trained 44 Educators aged 14-17 years. RESULTS: Results were generally positive: there were significant and sustained improvements in knowledge, self-reported behaviour, and perceived supports towards protecting hearing, and trends but not significant changes in attitudes or perceived barriers to hearing protection. CONCLUSIONS: Providing training to teenagers had benefits beyond the delivery of training to younger children, but improvements in the delivery model may increase the uptake and impact on the teenagers.

From Classroom to Capitol: Building Advocacy Capacity Through State-Level Advocacy Experiences.

This commentary provides insight from Community Health Education and Master of Public Health students on the benefits of participating in a state-level Advocacy Experience and provides a theoretical framework for increased advocacy intention among students as a result of participating in a state-level Advocacy Experience. Providing students the opportunity to translate what they learn about advocacy in the classroom into advocacy in action with policy makers is vital to the career development of our future health education professionals and is key to increasing advocacy capacity within our profession. This article builds on previous work from emerging public health professionals highlighting the role of policy advocacy in professional development and provides additional perspectives from the next generation of health education specialists.

Promoting Health and Wellness in Congregations Through Lay Health Educators: A Case Study of Two Churches.

Religious institutions are in regular contact with people who need education about and support with health issues. Creating lay health educators to serve in these communities can promote health initiatives centered on education and accessing resources. This paper is a prospective observational report of the impact of trained lay health community congregation members in two faith communities based on an urban setting. We describe health efforts made in an African-American Methodist church and in a Latino Spanish-speaking Catholic church. We review the intricacies in establishing trust with the community, the training of lay health educators, and the implementation strategies and outcomes of health initiatives for these communities.

Health Promotion in the Community: Impact of Faith-Based Lay Health Educators in Urban Neighborhoods.

Promoting wellness and providing reliable health information in the community present serious challenges. Lay health educators, also known as community health workers, may offer a cost-effective solution to such challenges. This is a retrospective observational study of graduates from the Lay Health Educator Program (LHEP) at Johns Hopkins Bayview Medical Center from 2013 to 2014. Students were enrolled from the surrounding community congregations and from the hospital's accredited clinical pastoral education program. There were 50 events implemented by the lay health educators during the 2014-2015 time period, reaching a total of 2004 individuals. The mean time from date of graduation from the LHEP to implementation of their first health promotional event was 196 ± 76 days. A significant number of lay health educators implemented events within the first year after completing their training. Ongoing monitoring of their community activity and the clinical impact of their efforts should be a priority for future studies.

A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women.

Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with sexual violence. A systematic review was applied. Inclusion criteria were English language published between 2003 and 2013; reporting on delivery and/or evaluation; focusing on any form of sexual violence; delivered to professionals, affected or at-risk women; targeting migrant, at-risk women or domestic workers. Data were extracted on the setting, content, evaluation process and target population. Four studies which focused on prevention or responding to sexual violence were included. One study provided sexual violence training to vulnerable female and one provided a HIV prevention intervention to marginalized women. Learning objectives included increasing knowledge around issues of sexual violence and/or gender and human rights, prevention and response strategies. Two studies aimed to train trainers. All studies conducted an outcome evaluation and two a process evaluation. It seems there is a gap on participatory empowerment training for marginalized women. Community train-the-trainer interventions are imperative to protect themselves and deal with the risk of sexual violence.

Needs assessment in genomic education: a survey of health educators in the United States.

The knowledge of genomic discoveries has been expanding daily, holding enormous potential to improve population health. Nevertheless, the training of health educators about genomics is lagging behind. To facilitate the movement of genomics into health promotion practice, as the first step, we conducted the first national survey to examine genomic education needs among health educators in the United States. A total of 980 health educators holding the Certified Health Education Specialist designation completed our web-based survey. The majority of participants reported that they had limited knowledge and training in genomics and were interested in seeking genomic education. Their first three preferred educational topics included genomic disorders/diseases (68.2%), family health history or genetic risk assessments (55.5%), and how to link genomics to health promotion (51.0%). A few contents, including basic genomic concepts, communication skills, and how to integrate genomics into routine professional tasks, were important to health educators' practice in genomics, but respondents seemed to be less favorable toward learning these contents. Continuing education (89.4%), web-based training (85.9%), and professional conferences (76.7%) were participants' top three desired delivery methods. This study will help guide the development, implementation, and evaluation of future genomic training programs for U.S. health educators.

Experience preferred: insights from our newest public health professionals on how internships/practicums promote career development.

Universities offering undergraduate degrees in health promotion or health education and/or graduate degrees in public health typically require an internship, practicum, or fieldwork experience. This type of mentored experience is an important aspect of career development for the next generation of public health professionals and benefits not only the students but also the profession and the communities in which they work. This article provides perspectives from four public health professionals who have recently graduated from designated minority-serving institutions and highlights the ways in which internship, practicum, or fieldwork experiences have contributed to their career development. From a career development perspective, internships provide unique opportunities to develop professional networks, practice competencies learned in the classroom, gain experience in different environments, and share lessons learned with others in our field. The diversification of the public health research and practice workforce is increasingly recognized as crucial in building health equity. Internship programs that focus specifically on the academic and professional development of students underrepresented in public health provide experiences that meet or supplement academic requirements, and provide students with real-world experience and an expanded network of mentors and role models.

Genomics education training needs of U.S. health educators: a (qualitative) pilot study.

As genomic advances have turned the promise of personalized prevention and health promotion into a concrete possibility in the near future, scholars and the Centers for Disease Control and Prevention have begun to call for U.S. health educators to develop their genomic competencies. This advocacy, however, begs the question whether health educators feel the need for further genomic training. Using an emergent design, the authors analyze qualitative data obtained from in-depth interviews with 24 health educators in the United States. Data are searched for salient, emergent themes (salience is determined by the frequency of a theme's occurrence across interviews). Findings indicate that although the majority (78.3%) of health educators have received minimal or no genomic education, 81.0% acknowledge the importance of adding some type of training to their future professional development. Participants suggest conference presentations, workshops, and symposia (54.5%) as the most preferable approach for delivering such training. The four most frequently desired training topics include applied genetics/genomics (85.7%), basic genetics/genomics (42.9%), current and future developments in genetics/genomics (28.6%), and genetic testing and screening (19.0%). Findings from this qualitative study can become catalysts for future examinations of this topic and provide the conceptual basis for developing genomics training materials specifically for health educators.

Evolution and growth of the ECHO (Enriching Communication skills for Health professionals in Oncofertility) program: a 5-year study in the training of oncofertility professionals.

PURPOSE: AYAs with cancer have unique psychosocial needs, with reproductive health being a primary concern. The ECHO training program provides reproductive health communication training to individuals providing care for AYAs with cancer. The purpose of this project is to describe the growth of ECHO and evaluate changes in learner engagement over a 5-year period. METHODS: ECHO is an 8-week online training program offered annually, with the program including learning modules, discussion topics and reflections, and synchronous discussions. Reflection quality scores and number of words were compared between the 5 cohorts using ANOVA with a p < .05 level of significance. Descriptive statistics summarized module topics, reflections, and synchronous discussions. RESULTS: The average number of reflections per unique learner increased each year (1.4 in cohort 1 vs 4.1 in cohort 5), as did average length and quality of reflections (72.1 words in cohort 1 vs 203.4 words in cohort 5, p < .0001; score of 1.21 in cohort 1 vs 4.46 in cohort 5, p < .0001). The percentage of learners in attendance at synchronous discussions increased between cohorts 4 and 5 (4.8% of learners in cohort 4 vs 18.8% of learners cohort 5). CONCLUSIONS: The ECHO program has seen significant growth and improvement in learner engagement over a 5-year period. This is particularly important given that student learning outcomes in online courses can be predicted by the level of engagement with online content. IMPLICATIONS FOR CANCER SURVIVORS: As fertility and reproductive health remain a top life goal and discussion priority for AYAs surviving cancer, increasing clinical competencies of AHPs in oncofertility is essential.