RESUMEN
CONTEXT: The public health workforce encountered challenges during the COVID-19 pandemic that exposed areas for improvement in preparation for future public health threats. Key among these is well-trained public health leaders equipped with an array of crisis leadership skills. OBJECTIVES: To examine the training background, assess the perceived preparedness, and garner recommendations for training of the future public health workforce from public health leaders who navigated the COVID-19 pandemic. DESIGN: This exploratory research gleaned information by utilizing an online questionnaire and interviews to provide lessons learned regarding improvements needed for public health leader preparedness. SETTING: Three California public health departments representing urban, suburban, and rural populations. PARTICIPANTS: Thirty public health leaders who were directly involved in public health work for ≥3 years in a leadership/management role and involved in COVID-19-related work for at least 6 months participated. RESULTS: Questionnaire findings revealed gaps in crisis leadership, communication, and collaboration training. Interview results supported and expanded upon the quantitative findings, including the value of various competencies and recommendations to improve the preparedness of future public health leaders. CONCLUSIONS: The findings suggested that although many of the skills needed are competencies for accredited public health training programs, effective leadership during public health emergencies may require additional training beyond what is generally provided. Recommendations include integrating study findings into public health training programs to address competency gaps, leveraging results to enhance leadership skills, and promoting collaboration between public health departments and academic institutions to develop evidence-informed crisis leadership training. These findings inform strategies to ensure the preparedness of the public health workforce for future crises.
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COVID-19 , Liderazgo , Pandemias , Salud Pública , SARS-CoV-2 , Humanos , COVID-19/epidemiología , Encuestas y Cuestionarios , Salud Pública/métodos , California , Masculino , Femenino , Adulto , Administración en Salud Pública/métodosRESUMEN
A panel of 24 international experts met in July 2022 to discuss challenges associated with pertussis detection, monitoring, and vaccination in adults; conclusions from this meeting are presented. There has been a shift in the epidemiology of pertussis toward older children and adults. This shift has been attributed to the waning of infection- or vaccine-induced immunity, newer detection techniques causing detection bias, and possibly the replacement of whole-cell pertussis with acellular vaccines in high-income countries, which may lead to immunity waning more quickly. The burden of adult pertussis is still likely under-ascertained due to widespread under-recognition by healthcare professionals (HCPs), under-diagnosis, and under-reporting in this age group. Non-standardized testing guidance and varied case definitions have contributed to under-reporting. Key barriers to HCP engagement with the tetanus, diphtheria, and pertussis (Tdap) vaccine include low awareness, lack of time/funding, and lack of motivation due to low prioritization of Tdap.
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Vacunación , Tos Ferina , Humanos , Tos Ferina/prevención & control , Tos Ferina/epidemiología , Tos Ferina/diagnóstico , Adulto , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/inmunología , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Vacuna contra la Tos Ferina/inmunología , Vacuna contra la Tos Ferina/administración & dosificación , Administración en Salud Pública/métodos , Salud PúblicaRESUMEN
OBJECTIVES: The aim of this study was to review the role of public health emergency operations centers in recent public health emergencies and to identify the barriers and enablers influencing the effective use of a public health emergency operations center (PHEOC) in public health emergency management. METHODS: A systematic search was conducted in 5 databases and selected grey literature websites. RESULTS: Forty-two articles, consisting of 28 peer-reviewed studies and 14 grey literature sources matched the inclusion criteria. Results suggest that PHEOCs are used to prepare and respond to a range of public health emergencies, including coronavirus disease (COVID-19). Factors found to influence the use of a PHEOC include the adoption of an incident management system, internal and external communications, data management, workforce capacity, and physical infrastructure. CONCLUSIONS: PHEOCs play an important role in public health emergency management. This review identified several barriers and enablers to using a PHEOC in public health emergency management. Future research should focus on addressing the barriers to using a PHEOC and looking at ways to evaluate the impact of using a PHEOC on public health emergency outcomes.
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COVID-19 , Salud Pública , Humanos , Urgencias Médicas , COVID-19/epidemiología , Administración en Salud Pública/métodos , Recursos HumanosRESUMEN
OBJECTIVE: To compare nurse and non-nurse lead executives' relationship with organizational characteristics supporting performance and health equity in local health departments (LHD). DESIGN: This was a cross-sectional quantitative study. SAMPLE: The final national sample consisted of 1447 LHDs using the 2019 Profile of Local Health Departments survey. MEASUREMENTS: We used multivariable logistic and negative binomial regression analyses to explore the relationship between nurse versus non-nurse LHD lead executives and involvement in ten organizational characteristics including community health assessment (CHA) and community health improvement plan (CHIP) completion and policy activities related to the social determinants of health (SDOH). RESULTS: Multivariable logistic regression models showed that, for nurse lead executives, the odds of having completed a CHA is 1.49 times, and the odds of having completed a CHIP is 1.56 times, that of non-nurse lead executives. Negative binomial regression models predicted nurse lead executives, compared to non-nurses, to perform 1.18 times more SDOH-related policy activities. CONCLUSION: Results suggest that nurse lead executives are more likely than non-nurses to emphasize assessment in their work and engage in upstream-focused policy activities. As such, they are important partners in work to facilitate health equity.
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Equidad en Salud , Enfermeras Administradoras , Humanos , Gobierno Local , Estudios Transversales , Administración en Salud Pública/métodos , Salud Pública/métodosRESUMEN
Objectives. To describe the creation of an interactive dashboard to advance the understanding of the COVID-19 pandemic from an equity and urban health perspective across 30 large US cities that are members of the Big Cities Health Coalition (BCHC). Methods. We leveraged the DrexelâBCHC partnership to define the objectives and audience for the dashboard and developed an equity framework to conceptualize COVID-19 inequities across social groups, neighborhoods, and cities. We compiled data on COVID-19 trends and inequities by race/ethnicity, neighborhood, and city, along with neighborhood- and city-level demographic and socioeconomic characteristics, and built an interactive dashboard and Web platform to allow interactive comparisons of these inequities across cities. Results. We launched the dashboard on January 21, 2021, and conducted several dissemination activities. As of September 2021, the dashboard included data on COVID-19 trends for the 30 cities, on inequities by race/ethnicity in 21 cities, and on inequities by neighborhood in 15 cities. Conclusions. This dashboard allows public health practitioners to contextualize racial/ethnic and spatial inequities in COVID-19 across large US cities, providing valuable insights for policymakers. (Am J Public Health. 2022;112(6):904-912. https://doi.org/10.2105/AJPH.2021.306708).
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COVID-19 , COVID-19/epidemiología , Ciudades/epidemiología , Inequidades en Salud , Humanos , Pandemias , Administración en Salud Pública/métodosRESUMEN
Leadership in public health is necessary, relevant, and important as it enables the engagement, management, and transformation of complex public health challenges at a national level, as well as collaborating with internal stakeholders to address global public health threats. The research literature recommends exploring the journey of public health leaders and the factors influencing leadership development, especially in developing countries. Thus, we aimed to develop a grounded theory on individual leadership development in the Nepalese context. For this, we adopted constructivist grounded theory, and conducted 46 intensive interviews with 22 public health officials working under the Ministry of Health, Nepal. Data were analysed by adopting the principles of Charmaz's constructivist grounded theory. The theory developed from this study illustrates four phases of leadership development within an individual-initiation, identification, development, and expansion. The 'initial phase' is about an individual's wishes to be a leader without a formal role or acknowledgement, where family environment, social environment and individual characteristics play a role in influencing the actualisation of leadership behaviours. The 'identification phase' involves being identified as a public health official after having formal position in health-related organisations. The 'development' phase is about developing core leadership capabilities mostly through exposure and experiences. The 'expansion' phase describes expanding leadership capabilities and recognition mostly by continuous self-directed learning. The grounded theory provides insights into the meaning and actions of participants' professional experiences and highlighted the role of individual characteristics, family and socio-cultural environment, and workplace settings in the development of leadership capabilities. It has implications for academia to fulfill the absence of leadership theory in public health and is significant to fulfill the need of leadership models grounded in the local context of Asian countries.
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Liderazgo , Administración en Salud Pública/métodos , Salud Pública/tendencias , Adulto , Femenino , Teoría Fundamentada , Humanos , Masculino , Persona de Mediana Edad , Nepal , Lugar de TrabajoAsunto(s)
COVID-19/epidemiología , Regulación Gubernamental , Control de Infecciones , Salud Global/legislación & jurisprudencia , Prioridades en Salud/legislación & jurisprudencia , Prioridades en Salud/organización & administración , Humanos , Control de Infecciones/legislación & jurisprudencia , Control de Infecciones/organización & administración , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Administración en Salud Pública/legislación & jurisprudencia , Administración en Salud Pública/métodos , Investigación/legislación & jurisprudencia , Investigación/organización & administración , SARS-CoV-2/fisiología , Estados Unidos/epidemiología , United States Food and Drug Administration/legislación & jurisprudencia , United States Food and Drug Administration/organización & administraciónRESUMEN
In order to effectively control spread of coronavirus 2019 (COVID-19), it is essential that jurisdictions have the capacity to rapidly trace close contacts of each and every case. Best practice guidance on how to implement such programs is urgently needed. We describe the early experience in the City and County of San Francisco (CCSF), where the City's Department of Health expanded contact tracing capability in anticipation of changes in San Francisco's 'shelter in place' order between April and June 2020. Important prerequisites to successful scale-up included a rapid expansion of the COVID-19 response workforce, expansion of testing capability, and other containment resources. San Francisco's scale-up offers a model for how other jurisdictions can rapidly mobilize a workforce. We underscore the importance of an efficient digital case management system, effective training, and expansion of supportive service programs for those in quarantine or isolation, and metrics to ensure continuous performance improvement.
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COVID-19/epidemiología , COVID-19/prevención & control , Trazado de Contacto/métodos , Administración en Salud Pública/métodos , COVID-19/diagnóstico , Prueba de COVID-19/estadística & datos numéricos , Manejo de Datos/organización & administración , Eficiencia Organizacional , Humanos , Pandemias , Cuarentena/psicología , SARS-CoV-2 , San Francisco/epidemiología , Servicio Social/organización & administraciónRESUMEN
Population health expands the focus of health care from individual, in-person care to the proactive management of cohorts that can occur asynchronously from a clinical encounter. In its most successful form, the approach segments populations by defined characteristics and promotes outreach and engagement to deliver targeted interventions, even among those who have missed recent or routine care. The triple aim, supported by the Institutes for Health Care Improvement, emphasizes improving the health of populations, cost of care, and patient and care team experience and has influenced new approaches in primary care. In primary care settings such as community health centers, the goal of improving outcomes leverages technology to expand focus from point-of-care interventions to population-level approaches to deliver high-quality preventive services and chronic disease management that benefit entire families and communities. Developments in informatics have introduced technology tools for population management and underscored the need to align technology with effective processes and stakeholder engagement for success. Informed by a review of the literature and observations across multiple implementations of population health strategies in community health, in this conceptual paper, we describe the steps (process), domains of team expertise (people), and health information technology components (technology) that contribute to the success of a population health strategy. We also explore future opportunities to expand the reach and impact of population health through patient engagement, analytics, interventions to address social determinants of health, responses to emerging public health priorities, and prioritization-of-use cases by assessing community-specific needs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Administración en Salud Pública/instrumentación , Administración en Salud Pública/métodos , Salud Pública/métodos , Humanos , Atención Primaria de Salud/métodos , Atención Primaria de Salud/tendencias , Salud Pública/instrumentación , Salud Pública/tendencias , Administración en Salud Pública/tendenciasRESUMEN
BACKGROUND: The patient protection and Affordable Care Act (ACA) sought to improve population health by requiring nonprofit hospitals (NFPs) to conduct triennial community health needs assessments and address the identified needs. In this context, some states have encouraged collaboration between hospitals and local health department (LHD) to increase the focus of community benefit spending onto population health. OBJECTIVES: The aim was to examine whether a 2012 state law that required NFPs to collaborate with LHDs in local health planning influenced hospital population health improvement spending. RESEARCH DESIGN: We merged Internal Revenue Service data on NFP community benefit spending with data on hospital, county and state-level characteristics and estimated a difference-in-differences specification of hospital population health spending in 2009-2016 that compared the difference between hospitals that were required to collaborate with LHDs to those that were not, before and after the requirement. MEASURES: The primary outcome was population health spending divided by operating expenses. RESULTS: We found that the requirement for hospital-LHD collaboration was associated with increased mean population health spending of â¼$393,000-$786,000 (P=0.03). This association was significant in 2015-2016, perhaps reflecting the lag between assessments and implementation. Urban hospitals were responsible for most of the increased spending. CONCLUSIONS: Policymakers have sought to encourage hospitals to increase their investment in population health; however, overall community benefit spending on population health has remained flat. We found that requiring hospital-LHD collaboration was associated with increased hospital investment in population health. It may be that hospitals increase population health spending because collaboration improves expected effectiveness or increases hospital accountability.
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Administración Hospitalaria/economía , Organizaciones sin Fines de Lucro , Administración en Salud Pública/métodos , Prioridades en Salud , Humanos , Colaboración Intersectorial , New York , Patient Protection and Affordable Care Act , Salud PoblacionalRESUMEN
BACKGROUND: Leading Change is one of five Executive Core Qualifications (ECQs) used in developing leaders in the federal government. Leadership development programs that incorporate multirater feedback and executive coaching are valuable in developing competencies to lead change. METHODS: We examined the extent by which coaching influenced Leading Change competencies and identified effective tools and resources used to enhance the leadership capacity of first- and midlevel leaders at Centers for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention. Data included qualitative data collected via semi-structured interviews that focused on leadership changes made by leaders in the Coaching and Leadership Initiative (CaLI), a leadership development program for Team Leads and Branch Chiefs. FINDINGS: Ninety-six participants completed leadership coaching; 94 (98%) of whom completed one or more interviews. Of those 94 respondents, 74 (79%) reported improvements in their ability to lead change in 3 of 4 leading change competencies: creativity and innovation, flexibility, and resilience. All respondents indicated tools and resources that were effective in leading change: 49 (52%) participated in instructor-led activities during their CaLI experience; 33 (35%) experiential activities; 94 (100%) developmental relationships, assessment, and feedback; and 25 (27%) self-development. CONCLUSIONS/APPLICATION TO PRACTICE: First- and midlevel leaders in a public health agency benefitted from using leadership coaching in developing competencies to lead organizational change. Leadership development programs might benefit from examining Leading Change competencies and including instructor-led and experiential activities as an additional component of a comprehensive leadership development program.
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Retroalimentación , Liderazgo , Innovación Organizacional , Administración en Salud Pública/normas , Humanos , Tutoría/métodos , Tutoría/normas , Tutoría/estadística & datos numéricos , Administración en Salud Pública/métodos , Administración en Salud Pública/estadística & datos numéricosAsunto(s)
COVID-19/epidemiología , Salud Global , Pandemias , Salud Pública , COVID-19/historia , Predicción , Salud Global/historia , Salud Global/tendencias , Prioridades en Salud/economía , Prioridades en Salud/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Pandemias/economía , Pandemias/historia , Pandemias/prevención & control , Salud Pública/historia , Salud Pública/tendencias , Administración en Salud Pública/historia , Administración en Salud Pública/métodos , Administración en Salud Pública/tendencias , SARS-CoV-2RESUMEN
Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.
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COVID-19/epidemiología , Control de Enfermedades Transmisibles , Salud Global , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/tendencias , Salud Global/historia , Salud Global/tendencias , Gobierno , Historia del Siglo XXI , Humanos , Pandemias/historia , Salud Pública/historia , Salud Pública/métodos , Salud Pública/tendencias , Administración en Salud Pública/métodos , Administración en Salud Pública/normas , Administración en Salud Pública/tendencias , SARS-CoV-2/fisiologíaAsunto(s)
Antígenos Virales/análisis , Prueba Serológica para COVID-19 , COVID-19/diagnóstico , Salud Pública , SARS-CoV-2/inmunología , Antígenos Virales/aislamiento & purificación , COVID-19/epidemiología , COVID-19/inmunología , Prueba Serológica para COVID-19/economía , Prueba Serológica para COVID-19/métodos , Prueba Serológica para COVID-19/estadística & datos numéricos , Análisis Costo-Beneficio , Diagnóstico Precoz , Humanos , Nariz/virología , Pandemias , Salud Pública/economía , Salud Pública/métodos , Salud Pública/estadística & datos numéricos , Administración en Salud Pública/economía , Administración en Salud Pública/métodos , Administración en Salud Pública/estadística & datos numéricos , Sensibilidad y EspecificidadAsunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Control de Infecciones/organización & administración , Modelos Organizacionales , Pandemias , COVID-19/transmisión , Redes Comunitarias/organización & administración , Redes Comunitarias/normas , Atención a la Salud/métodos , Atención a la Salud/organización & administración , Brotes de Enfermedades/prevención & control , Asistencia Alimentaria/organización & administración , Asistencia Alimentaria/normas , Humanos , India/epidemiología , Control de Infecciones/métodos , Sistemas de Apoyo Psicosocial , Administración en Salud Pública/métodos , Administración en Salud Pública/normas , SARS-CoV-2/fisiología , MigrantesAsunto(s)
COVID-19/epidemiología , Planificación en Desastres/organización & administración , Urgencias Médicas/epidemiología , Promoción de la Salud/organización & administración , Administración en Salud Pública/métodos , Conducta Cooperativa , Humanos , Relaciones Interprofesionales , Vigilancia de la Población/métodos , Salud Pública , SARS-CoV-2 , SindémicoRESUMEN
BACKGROUND: Making the right decisions in the field of public health depends on the reliable recording of statistical data such as death and birth. There have been radical changes and innovations in the death registration since 2009 in Turkey to improve reporting. AIMS: To examine the distribution and the trend of causes of death between the years 2009 and 2017 in Turkey. STUDY DESIGN: Descriptive study. METHODS: In this study, the causes of death were evaluated in three groups used in the Global Burden of Disease study. Group I included infectious, maternal, perinatal, and nutritional conditions; group II included noncommunicable diseases; and group III included injuries. Age-standardized mortality rates were calculated per 100,000 according to age, sex, and cause of death. Joinpoint regression was used to evaluate the trend in mortality rates. In addition, the leading causes of death were also determined. RESULTS: In total, age-standardized mortality rates increased significantly on average annually (1.5% per year). When the trends of causes of death were examined according to gender, there was a significant increase in deaths from group I in both genders and a significant increase in deaths from group III in males, whereas there was no statistically significant change in deaths from group II between 2009 and 2017. CONCLUSION: A significant quantitative improvement in death registration was seen in Turkey between the years 2009 and 2017. This is due to the increase in the number of reported deaths. The change in the distribution of causes of death is noteworthy. This research can provide the basis for further researches that will examine the change in causes of death.