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The need for a robust public health system in the United States is critical for safeguarding population health. However, current data suggest an insufficient number of individuals entering or staying in the governmental public health workforce. Expanding the public health pipeline requires creative thinking about recruitment and training activities. To attract students to public health and other health-related fields, including medicine, one institution in the Southeast recently initiated the Public Health Influencers Summer Institute (PHISI), a program that addresses the beginning of the career development continuum: recruitment of high school students. For this investigation, we reviewed evaluation data of the PHISI and provided descriptive analyses and selected quotes to reflect student learning. Participants reported increased familiarity with all public health topics after participating in the program, with the greatest increases in public health policy and social determinants of health. In addition, all participants reported increased or significantly increased understanding of public health after participating in the program. While interest in the field of public health increased due to the COVID-19 pandemic, there are not enough individuals entering or staying in the public health workforce, leaving a critical shortfall. Introducing high school students to the field of public health may increase their interest in entering the public health workforce in the future, thereby strengthening the overall public health infrastructure. We propose that the PHISI may be an innovative strategy for increasing both the number and diversity of students interested in pursuing a career in public health.
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OBJECTIVE: Maintaining a skilled public health workforce is essential but challenging given high turnover and that few staff hold a public health degree. Situating workforce development within existing structures leverages the strengths of different organizations and can build relationships to address public health challenges and health equity. We implemented and evaluated an innovative, sustainable model to deliver an established evidence-based public health (EBPH) training collaboratively among Prevention Research Centers (PRC), local and state health departments, and Public Health Training Centers (PHTC). DESIGN: Quantitative data: quasi-experimental, 1-group pre-post. Qualitative data: cross-sectional. Data were collected between December 2021 and August 2022. SETTING: Four US sites, each a partnership between a PRC, local or state health department, and a PHTC. PARTICIPANTS: Governmental public health staff and representatives from other organizations that implement public health programs in practice settings. MAIN OUTCOME MEASURES: Course participants completed a pre- and postcourse survey self-rating 14 skills on a 5-point Likert scale. Differences were analyzed using mixed effects linear models. In-depth interviews (n = 15) were conducted with course faculty and partners to understand: (1) resources contributed, (2) barriers and facilitators, (3) benefits and challenges, and (4) resources needed to sustain this model. Interviews were transcribed verbatim, and a thematic analysis identified themes. RESULTS: Statistically significant increases in all skills were observed from pre- to postcourse (n = 241 at post, 90% response). The skills with the largest increases were understanding economic evaluation enough to inform decision-making (mean change = 1.22, standard error [SE] = 0.05) and developing an action plan (mean change = 1.07, SE = 0.07). Facilitators to delivering the course included having a shared goal of workforce development, existing course curricula, and dedicated funding for delivering the course. CONCLUSIONS: Collaborative delivery of the EBPH training can ameliorate the effects of high staff turnover, strengthen academic-practice relationships, and promote population-wide health and health equity.
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CONTEXT: The COVID-19 pandemic underscored the importance of a strong public health infrastructure for protecting and supporting the health of communities. This includes ensuring an adaptive workforce capable of leading through rapidly changing circumstances, communicating effectively, and applying systems thinking to leverage cross-sector partnerships that help promote health equity. The 10 Regional Public Health Training Centers (PHTCs) advance the capacity of the current and future public health workforce through skill development and technical assistance in these and other strategic areas. PROGRAM: This study examines activities through which the Regional PHTCs and their partners supported the public health workforce during the pandemic. Representatives of the 10 Regional PHTCs completed a survey in the spring of 2022. The survey included (1) pulling trends in training usage from 2018-2021 annual performance reports and (2) questions assessing the type, content, and reach of training needs assessments, training and technical assistance, student placements, and PHTC Network collaborative activities that occurred from January 1, 2020, to December 31, 2021. Respondents also reflected on trends in use, challenges, lessons learned, stories of impact, and future PHTC practice. EVALUATION: During the pandemic, the Regional PHTCs engaged in numerous efforts to assess needs, provide training and technical assistance to the practice community, facilitate projects that built student competency to support public health agency efforts, and collaborate as the PHTC Network on national-level initiatives. Across these activities, the Regional PHTCs adjusted their approaches and learned from each other in order to meet regional needs. DISCUSSION: The Regional PHTCs provided student and professional development in foundational public health knowledge and skills within their regions and nationally while being flexible and responsive to the changing needs of the field during the pandemic. Our study highlights opportunities for collaboration and adaptive approaches to public health workforce development in a postpandemic environment.
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Pandemias , Saúde Pública , Humanos , Saúde Pública/educação , Pandemias/prevenção & controle , Promoção da Saúde , Recursos Humanos , Inquéritos e QuestionáriosRESUMO
Interest in and awareness of public health in the United States has grown due to COVID-19; however, state and local health departments have seen a mass exodus of leadership since the beginning of the pandemic. Based on the results of the de Beaumont Foundation's most recent Public Health Workforce Interests and Needs Survey (PH WINS), nearly one in three public health employees say they are considering leaving the profession due to stress, burnout, and low pay. One viable strategy for ensuring a diverse and competent public health workforce is the national network of Public Health Training Centers (PHTCs). This commentary describes the Public Health Training Center Network, with a specific focus on Region IV, and discusses challenges and opportunities for advancing the public health agenda in the United States. The national PHTC Network continues to provide invaluable services in terms of training, professional development, and experiential learning for the current and future public health workforce. However, increased funding would allow PHTCs to have a greater impact and reach through bridge programs for public health workers and others, additional field placement experiences, and expanded outreach to non-public health professionals in training activities. PHTCs have shown great adaptability over time and can once again pivot to meet the needs of a rapidly changing public health landscape demonstrating that PHTCs are truly more relevant than ever.
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Policy surveillance is becoming an increasingly powerful tool in public health to identify policies and programs that influence individual and community health. However, not many systems exist to track or facilitate greater understanding of policies at a city or county level. Furthermore, relatively little is known about which policies are being implemented and how they relate to population health goals. In 2019, the University of Alabama at Birmingham School of Public Health joined a consortium of universities to specifically track municipal policies in Birmingham, Alabama. Since its inception, the Birmingham Policy Surveillance Initiative has identified 443 policies and program initiatives related to 6 key areas of focus. The purpose of this article is to describe a policy surveillance system in Birmingham, Alabama. Results are intended to raise the profile of policy surveillance and inform policy makers of opportunities and gaps in policies that influence individual and community health.
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Saúde Pública , Instituições Acadêmicas , Humanos , Epidemiologia Legal , Universidades , Cidades , Política de SaúdeRESUMO
Site-based, in-person field placement experiences prepare students for real-world community practice through reflection; direct, hands-on experience; and the completion of a project or set of deliverables that add value to the organization. These practice experiences encourage students to integrate classroom learning with the knowledge and skills of a workplace environment. In the Southeast United States, the Region IV Public Health Training Center (R-IV PHTC) provides students with practice experiences through the Pathways to Practice Scholars Field Placement Program. Before COVID-19, these field placement experiences were limited to in-person assignments in which students worked and lived in the communities they served. However, student and mentor experiences during the COVID-19 pandemic demonstrated that remote work arrangements offer a viable alternative to the onsite-only field placement experience. In this article, we describe student experiences with remote and hybrid work arrangements, highlight issues regarding equity and inclusion, and discuss implications for future public health practice.
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COVID-19 , Pandemias , Humanos , Aprendizagem , Mentores , EstudantesRESUMO
This case study describes how one county health department in Alabama used the best available evidence to address the needs of its citizens during the first 6 months of the COVID-19 pandemic. The authors explore issues of scope of authority by government officials, individual freedom versus population health, and challenges of health communication during a disease outbreak. Despite the availability of vaccines, boosters, and access to vaccines by children as young as 5 years, COVID-19 cases are on the rise across the United States more than 2 years after the official news broke out of Wuhan, China. Health officials have expressed concerns that backlash against governmental public health during the pandemic will limit public health authorities from responding to the traditional challenges that were present pre-COVID-19 and will remain in a post-COVID-19 world.
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COVID-19 , COVID-19/epidemiologia , Criança , Surtos de Doenças , Humanos , Pandemias/prevenção & controle , Saúde Pública , SARS-CoV-2 , Estados UnidosRESUMO
There is an increasing demand for public health workers due to the unmet needs of the poor and underserved populations. However, through field placement experiences, students can actively engage in their own learning while also addressing critical needs of rural and medically underserved populations. In this mixed-methods evaluation, we explored experiences of emerging public health practitioners who participated in the Region IV Public Health Training Center's Pathways to Practice Scholars program between 2014 and 2018. Based on student confidence level ratings and descriptions of field placement experiences, scholars participated in meaningful and enriching field placement experiences in rural areas or on behalf of medically underserved populations. Across all eight Council on Linkages Core Competency Domains, students recorded increased pre- to post-confidence scores, and for many, the field placement experience appeared to affirm their interest in addressing the needs of these communities in the future.
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Equidade em Saúde , Capacitação em Serviço , Área Carente de Assistência Médica , Serviços de Saúde Rural , Estudantes de Saúde Pública , Humanos , População RuralRESUMO
Patients admitted to Level 1 trauma centers in the United States are rarely assessed for or educated about the potentially devastating effects of acute stress disorder (ASD) or posttraumatic stress disorder (PTSD). This descriptive research was conducted to describe current levels of assessment and education of ASD and PTSD in Level 1 trauma centers in the United States. The aims of this article are to (1) determine the extent to which Level 1 trauma centers in the United States assess and educate patients and providers about ASD and PTSD and (2) identify clinical staff who administer assessments and provide educational resources. A web-based survey was distributed to the trauma program managers and trauma medical directors of 209 adult and 70 pediatric Level 1 trauma centers in the United States. For PTSD, 26 (25.00%) adult and 17 (36.17%) pediatric centers had an assessment protocol for use with trauma patients. For ASD, 13 (12.50%) adult and 13 (27.66%) pediatric centers utilized an assessment protocol for use with trauma patients. For PTSD, 12 (12.37%) adult and 8 (20.00%) pediatric centers offered educational protocols for use with trauma patients. Seven (7.22%) adult and 7 (17.50%) pediatric centers maintain educational protocols for ASD in trauma patients. Fewer centers had assessment or educational protocols targeting formal and informal caregivers. This study was limited to Level 1 trauma centers in the United States. Results indicate that trauma patients are rarely assessed for or educated about the potential effects of PTSD or ASD. Formal and informal caregivers are also assessed and educated at low rates. Assessment, education, and incidence of PTSD and ASD should be included as universally measured health outcomes across trauma centers.
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Educação de Pacientes como Assunto , Padrões de Prática em Enfermagem , Transtornos de Estresse Pós-Traumáticos/psicologia , Ferimentos e Lesões/psicologia , Adulto , Criança , Feminino , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/enfermagem , Centros de Traumatologia , Estados Unidos , Ferimentos e Lesões/enfermagemRESUMO
OBJECTIVE: The purpose of this study was to identify factors that might impact a Medical Reserve Corps (MRC) volunteer's decision to respond to an emergency event. The 2 primary goals of this survey were to (1) establish realistic planning assumptions regarding the use of volunteers in health care emergency responses, and (2) determine whether barriers to volunteer participation could be addressed by MRC units to improve volunteer response rates. DESIGN: An anonymous online survey instrument was made available via Qualtrics through a customized URL. For the purpose of distribution, the Mississippi State Department of Health sent an electronic message that included the survey link to all MRC volunteers who were registered with the Mississippi Responder Management System (MRMS) as of September 2014. RESULTS: Approximately 15% of those surveyed indicated they would be available and able to deploy within 24 hours. The most common factors reported in terms of respondent decisions to deploy included risk to personal health (61.2%), length of deployment (58.8%), and the security of the deployment area (55.3%). In addition, 67% of respondents indicated that extended periods of deployment would have a negative financial impact on their lives. Respondents who have had training or previous deployment experience reported having greater knowledge of potential response roles, increased comfort in their ability to respond with the MRC, and increased confidence in responding to differing public health emergencies. CONCLUSIONS: Barriers to MRC volunteers being able to deploy should be addressed by each MRC unit. Issues such as risk to personal safety while on deployment, site security, and length of deployment should be considered by planners and those solutions communicated to MRC members during trainings. Emergency plans utilizing MRC volunteers will require significant evaluation to assess the risk of relying on an expected resource that could be severely limited during an actual emergency.
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Planejamento em Desastres/organização & administração , Desastres/prevenção & controle , Serviços Médicos de Emergência/organização & administração , Voluntários/educação , Voluntários/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , MississippiRESUMO
Beginning in 2010, the U.S. Department of Health and Human Services, Health Resources and Services Administration, made provisions in its Public Health Training Center cooperative agreements for field placements. This article describes best practices and lessons learned establishing and managing the South Central Public Health Partnership's Interns and Mentors Program for ACTion (IMPACT) Field Placement Program, which was initially funded through the Centers for Disease Control and Prevention's Centers for Public Health Preparedness Cooperative agreement in 2002. The IMPACT program is based on a six-step process that has been developed and refined over its 10-year history: (a) identifying field placement opportunities, (b) marketing field experience opportunities to students, (c) selecting students seeking field experience opportunities, (d) placing students with practice partners, students with practice partners, (e) evaluating student progress toward field experience objectives, and (f) evaluating the program. This article describes the program's structure and processes, delineates the roles of its academic and practice partners, discusses evidence of its effectiveness, and describes lessons learned from its decade-long history. Hopefully, this information will facilitate the establishment, management and evaluation of internship and field placement programs in other Public Health Training Centers and academic public health programs.
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Educação Profissional em Saúde Pública/organização & administração , Preceptoria , Desenvolvimento de Programas , Prática de Saúde Pública , Avaliação de Programas e Projetos de Saúde , Estados UnidosRESUMO
OBJECTIVE: The purpose of this study was to examine the effects of a tornado disaster on the personal preparedness of local residents to determine (1) to what extent the tornado outbreak experience had altered preparedness awareness, willingness to act, and levels of personal preparedness of residents as measured by possession of a preparedness kit; and (2) what effect this experience had on the variables associated with having a complete disaster preparedness kit. DESIGN: Two random digit-dialed surveys were completed following the Behavioral Risk Factor Surveillance System protocols. The pre-tornado survey was conducted between October and December 2010 and the post-tornado survey was conducted between January and March 2012. RESULTS: After the April 2011 tornado outbreak, 86.08% of the respondents (n = 1364) reported that they had thought more about personal or family preparedness and 59.65% (n = 907) reported that they had taken actions to increase their level of preparedness. Overall, general awareness of preparedness media campaigns increased significantly (almost 24%; P < .0001), as did the percentage of those having a complete disaster preparedness kit (a 66% increase, not quite doubled from 2010 to 2012; P < .0001). CONCLUSIONS: Findings of the study indicate that the disaster had a significant impact on the local residents' (1) awareness of preparedness campaigns, (2) awareness of the need to be prepared, (3) willingness to become better prepared, and (4) possession of a disaster and emergency preparedness kit and its associated items.
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Planejamento em Desastres , Desastres , Tornados , Adolescente , Adulto , Idoso , Alabama , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
INTRODUCTION: Increasingly, public health departments are designing and engaging in complex operations-based full-scale exercises to test multiple public health preparedness response functions. The Department of Homeland Security's Homeland Security Exercise and Evaluation Program (HSEEP) supplies benchmark guidelines that provide a framework for both the design and the evaluation of drills and exercises; however, the HSEEP framework does not seem to have been designed to manage the development and evaluation of multiple, operations-based, parallel exercises combined into 1 complex large-scale event. METHODS: Lessons learned from the planning of the Mississippi State Department of Health Emergency Support Function--8 involvement in National Level Exercise 2011 were used to develop an expanded exercise planning model that is HSEEP compliant but accounts for increased exercise complexity and is more functional for public health. RESULTS: The Expanded HSEEP (E-HSEEP) model was developed through changes in the HSEEP exercise planning process in areas of Exercise Plan, Controller/Evaluator Handbook, Evaluation Plan, and After Action Report and Improvement Plan development. The E-HSEEP model was tested and refined during the planning and evaluation of Mississippi's State-level Emergency Support Function-8 exercises in 2012 and 2013. DISCUSSION: As a result of using the E-HSEEP model, Mississippi State Department of Health was able to capture strengths, lessons learned, and areas for improvement, and identify microlevel issues that may have been missed using the traditional HSEEP framework. NEXT STEPS: The South Central Preparedness and Emergency Response Learning Center is working to create an Excel-based E-HSEEP tool that will allow practice partners to build a database to track corrective actions and conduct many different types of analyses and comparisons.
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Defesa Civil/educação , Planejamento em Desastres/organização & administração , Planejamento em Saúde/organização & administração , Desastres , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Mississippi , Modelos Educacionais , Modelos Organizacionais , Técnicas de Planejamento , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Prática de Saúde Pública , Controle de Qualidade , Estados UnidosRESUMO
The Alabama Long-Term Care Strike Team was established in 2022 to help long-term care facilities build and maintain infection prevention and control (IPC) systems. Infection preventionists use CDC's Infection Control Assessment and Response (ICAR) tools to provide IPC-specific recommendations. Analysis of ICAR recommendations identified the 3 greatest training needs in Alabama: source control, hand hygiene, and environmental cleaning. The ICAR provides a standardized and objective way to monitor and mitigate IPC risk.
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Controle de Infecções , Assistência de Longa Duração , Alabama , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Assistência de Longa Duração/normas , Infecção Hospitalar/prevenção & controle , Higiene das Mãos/normasRESUMO
CONTEXT: Recent disaster experiences in Alabama have highlighted the state's public health vulnerabilities to natural disasters. To respond to the need of building better prepared and more resilient communities, the Alabama Department of Public Health developed and launched a mass media campaign, Get10, to promote personal preparedness. This study evaluates the level of preparedness of the residents in Jefferson County, Alabama, using Get10 recommendations of Alabama Department of Public Health as a guideline. This study also examines the level of personal preparedness of the at-risk population including those older than 65 years and those younger than 65 years with diabetes, cardiovascular disease, poor perceived health status, and a physical, mental, or emotional activity limitation disability. OBJECTIVE: To assess (1) awareness of multimedia preparedness campaigns; (2) the levels of personal preparedness in Jefferson County residents; and (3) the levels of personal preparedness within different sectors of the vulnerable or "at-risk" populations. DESIGN: A random-digit-dialed survey was conducted following the Behavioral Risk Factor Surveillance System protocols in the fall of 2010. The survey included a subset of Behavioral Risk Factor Surveillance System questions and additional questions based on Get10 recommendations. RESULTS: More than 38% of the residents of Jefferson County have a complete disaster kit. Those representing the vulnerable (at-risk) populations are not more likely to have preparedness kits than the general population (P = .6646). Marital status was the only variable that was consistently significant in determining whether someone had a complete disaster kit (P = .0140); however, bivariate analysis indicated annual household income as significant (P = .0109). No association was found between having a complete preparedness kit and familiarity with general family preparedness campaigns (P = .0976) or Get10 campaign of Alabama Department of Public Health (P = .3227). CONCLUSIONS: Vulnerable populations were no more likely to have a complete disaster preparedness kit than the general population. Therefore, future marketing should target those at risk of adverse health effects following a disaster as well as the unmarried and those with household incomes under $25 000 per year. Future disaster preparedness campaigns should monitor and evaluate their efforts in reaching these populations and include strategies for acquiring and maintaining disaster kit items.
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Defesa Civil/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alabama , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Renda , Masculino , Estado Civil , Pessoa de Meia-Idade , Saúde Pública , Populações Vulneráveis/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: This paper: (1) explores the real and perceived threats to Emergency Departments (EDs) in addressing infectious disease cases in the US, like measles, and (2) identifies priorities for protecting employees, patients, and others stakeholders through hospital preparedness while streamlining processes and managing costs. METHODS: A case study approach was used to describe the events that triggered an infectious disease emergency response in 1 ED in the southeast. Development of the case study was informed by emergency preparedness literature on Homeland Security Exercise and Evaluation Program processes. RESULTS: Hospital staff and administrators identified a number of factors that either positively contributed to disease containment or exacerbated conditions for disease transmission. Successes included early recognition of the potential threat, development of a multidisciplinary taskforce, and implementation of a pre-incident response plan. Challenges comprised of patient flow in crisis response, lab turnaround time, and employee records. CONCLUSIONS: The threat of exposure challenged daily operations and raised situational awareness among administrators and providers to issues that might arise during an infectious disease exposure. Recording emergency preparedness successes, remediating challenges, and sharing information with others may help minimize the threat of communicable diseases within hospital settings in the future.
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Defesa Civil , Doenças Transmissíveis , Sarampo , Humanos , Surtos de Doenças/prevenção & controle , Hospitais , Sarampo/epidemiologia , Sarampo/prevenção & controle , Serviço Hospitalar de EmergênciaRESUMO
During the fall 2019 and spring 2020 semesters, 156 MPH students enrolled in the Integrative Learning Experience at the University of Alabama at Birmingham School of Public Health explored concepts of the built environment and health by auditing 2500 street segments in 4 urban neighborhoods in Birmingham, Alabama. In teams of 4 to 5, in-class and online students worked collaboratively to assess 63 built environment variables related to transportation, land use, advertisement, and neighborhood physical disorder. This type of "community assessment" is the first stage of the Evidence-based Public Health Framework and consistent with the applied nature of an MPH degree. Authors conducted secondary data analysis of final team assignments to demonstrate how students translated observations and ratings into practical recommendations for neighborhood improvements to promote physical activity. Students recommended improvements in neighborhood infrastructure and services, specifically: creating exercise space, providing outdoor exercise equipment, improving neighborhood safety, and cultivating a culture of health. The Integrative Learning Experience course encouraged students to use their knowledge and skills to prioritize recommendations to improve neighborhood conditions. Variable ratings and observations increased student awareness of the built environment and its potential to impact individual and community health. Moreover, the project helped students make connections between proximal outcomes, such as improving neighborhood walkability, and distal outcomes, such as improved health outcomes among residents. Finally, this project modeled for students the use of evidence-based strategies for making data-informed decisions, which are essential skills for new and emerging public health professionals.
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INTRODUCTION/OBJECTIVES: Across the United States, and particularly in the South, there is an urgent need to improve health outcomes for people with HIV. In response, the Southeast AIDS Education & Training Center (AETC) conducted a 4-year Practice Transformation (PT) initiative (2015-2018) in 12 mostly primary care clinics across 4 states in the region. Drawing on the leadership of PT facilitators ("coaches") from AETC partner sites throughout the region and specific clinic staff members ("champions"), clinics worked toward self-selected organizational goals to increase their HIV care capacity and improve HIV health outcomes. METHODS: To explore coaches' and champions' experiences and perspectives of PT, we conducted 2 focus group sessions, 1 tailored for coaches (n = 5) and another for champions (n = 9). RESULTS: Content analysis of qualitative data revealed 4 major themes around coaches' and champions' experiences and perspectives of PT. These themes include Challenges, Facilitators, Successes, and Suggestions for PT Improvement. CONCLUSION: Primary care and infectious diseases/HIV clinics can help improve HIV Care Continuum outcomes through increasing their capacity to serve the needs of their clients, as facilitated through coaches and clinic champions. Since no single clinic or clinic patient population is alike, it is important work within organizations to address specific needs and leverage unique skillsets. Future PT initiatives can learn from experiences of this PT program to optimize the effectiveness of their programs.