State Health Official Career Advancement and Sustainability Evaluation-Description of the Methods Used in the SHO-CASE Study.

State health officials (SHOs) lead state governmental public health agencies, playing an important role in their states. However, little comprehensive research has examined SHOs or characteristics of these leaders, limiting evidence about ways to improve SHO selection and subsequent performance. This brief describes the methods of the SHO-CASE study focused on current and former SHOs in state public health agencies. Methods used include qualitative components that informed the development of survey questions, survey administration, and survey response. A total of 147 SHOs responded to the SHO survey representing every state and Washington, District of Columbia. The SHO-CASE study survey database represents the most comprehensive database of its kind regarding a range of attributes of current and former SHOs. These data can be used to explore factors contributing to SHO success including valuable insights into effectively working with the states' elected officials.

Public Health Senior Deputy's Perceptions of State Health Officials' Success Factors: Professional Characteristics, Personal Attributes, and Signs of Derailment.

CONTEXT: Senior deputies work closely with state health officials (SHOs) in state public health agencies and are a valuable resource for understanding their roles, responsibilities, and characteristics. OBJECTIVE: Examine senior deputies' perceptions of SHO success factors. DESIGN: Qualitative study including nominal group technique focus groups, a small expert focus group, and interviews. SETTING: US state public health agencies. PARTICIPANTS: Senior deputies in state public health agencies 2016/2017. MAIN OUTCOME MEASURES: Perceptions of SHO success factors. RESULTS: The most commonly perceived professional characteristics of a successful SHO included the following: credible trusted voice with internal respect/external credibility; improves public health prominence/visibility with an evidence-based agenda; and grows the agency/leaves it stronger. Perceptions of the most common personal attributes for success included excellent listening skills; credibility/honesty/trustworthiness; and public health experience/knowledge. The most commonly perceived signs of SHO derailment included when SHOs have a visible lack of support of elected officials (eg, governor/legislators) and when the SHO is "bypassed" by elected officials. CONCLUSIONS: A key finding of this study centers on the relationship between the SHO and the governor; meeting the expectations of the governor was identified as a significant professional characteristic of success. Findings highlight the expectation that SHOs have a clear understanding of the governor's priorities and how to relate to the governor's office early in their tenure. This goal should be a priority for transition teams that aid new SHOs as they begin in their new roles. Study insights can help better prepare for orientation/onboarding of new SHOs. Development of key transition documents and tools for rapid onboarding should be considered. Transition teams should assist new SHOs in establishing an understanding of the governor's priorities and how to best communicate with to the governor's office early in their tenure. Strong senior management teams should be prioritized and fostered.

High Turnover Among State Health Officials/Public Health Directors: Implications for the Public's Health.

CONTEXT: State health officials (SHOs) serve a critical role as the leaders of state public health systems. Despite their many responsibilities, there is no formal process for preparation to become an SHO, and few requirements influence the selection of an SHO. Furthermore, to date, no studies have examined SHO tenure or their experiences. OBJECTIVE: This study examines SHO tenure over time and the relationship between SHO tenure and organizational and state attributes. DESIGN: This longitudinal study employed primary data on SHOs and secondary data from the Association of State and Territorial Health Officials on organizational attributes of state public health agencies. SETTING: This study examines SHOs within the United States. PARTICIPANTS: SHOs who served in years 1980-2017. MAIN OUTCOME MEASURES: Annual average SHO tenure; average SHO tenure by state. RESULTS: In the 38 years of this study, 508 individuals served as SHOs in the 50 states and the District of Columbia. The average tenure over this period was 4.1 years, with a median tenure of 2.9 years. During the study period, almost 20% of SHOs served terms of 1 year or less. A total of 32 SHOs (32/508 or 6.3%) served for 10 years or longer. Excluding SHOs who served 10 years or longer (n = 32 SHOs who had a collective 478 years of tenure) reduces the average term in office to 3.5 years. The average number of new SHOs per year is 12.3. SHOs appointed by a board of health averaged more than 8 years in office compared with averages just under 4 years for those appointed by governors or secretaries of state agencies. CONCLUSIONS: There are notable differences in SHO tenure across states. Future research is needed to further examine SHO tenure, effectiveness, job satisfaction, transitions, and the relationship between SHOs and state health. It may be valuable to expand on opportunities for new SHOs to learn from peers who have moderate to long tenures as well as SHO alumni. Given that average SHO tenure is approximately 4 years and that an SHO could be thrust into the national spotlight at a moment's notice, governors may want to consider experience over partisanship as they appoint new SHOs.

Creating a mentoring partnership model: a university-department of health experience.

The purpose of this project was to increase the number of students participating in public health nursing experiences at Vermont Department of Health through creation of a mentoring partnership model. The model targeted preceptor needs, including roles and responsibilities when working with students; educational needs of faculty, particularly related to evolving roles of public health nurses; and creation of additional clinical opportunities for students. Outcomes included improved working relationships among students, faculty, and public health mentors as measured by narrative evaluative comments of project participants; a 150% increase in the number of students participating in public health nursing clinical experiences; expanded involvement of Vermont Department of Health district offices and central office, with the addition of two new clinical sites and increased numbers of students in sites used prior to this project. Guidelines for preceptors working with students were also developed.