[Interpreting the evidence. Reducing subjectivity in appraising the evidence calls for a return to teaching evidence-based medicine.] / L'interpretazione delle evidenze. Per ridurre la soggettività nella lettura delle prove serve tornare a insegnare l'evidence-based medicine.

The interpretation of clinical research evidence is still characterized by wide subjectivity. This subjectivity is also visible when comparing guidelines and recommendations developed by institutions and learned societies. It is often due to bias and conflicts of interest experienced by the members of guideline panels: thus, the role of editors and publishers of journals and scientific media becomes increasingly important, and they should return to careful oversight of the content of what is published. To address the problem, however, it is necessary to return to teaching evidence-based medicine in order to restore its function as a "North star" in clinical practice and public health decision-making.

Public health communication professional development opportunities and alignment with core competencies: an environmental scan and content analysis. / Offres de perfectionnement professionnel en communication en santé publique et correspondance avec les compétences essentielles : analyse contextuelle et analyse de contenu.

INTRODUCTION: Communication is vital for effective and precise public health practice. The limited formal educational opportunities in health communication render professional development opportunities especially important. Competencies for public health communication describe the integrated knowledge, values, skills and behaviours required for practitioner and organizational performance. Many countries consider communication a core public health competency and use communication competencies in workforce planning and development. METHODS: We conducted an environmental scan and content analysis to determine the availability of public health communication professional development opportunities in Canada and the extent to which they support communication-related core competencies. Three relevant competency frameworks were used to assess the degree to which professional development offerings supported communication competency development. RESULTS: Overall, 45 professional development offerings were included: 16 "formalized offerings" (training opportunities such as courses, webinars, certificate programs) and 29 "materials and tools" (resources such as toolkits, guidebooks). The formalized offerings addressed 25% to 100% of the communication competencies, and the materials and tools addressed 67% to 100%. Addressing misinformation and disinformation, using current technology and communicating with diverse populations are areas in need of improved professional development. CONCLUSION: There is a significant gap in public health communication formalized offerings in Canada and many of the materials and tools are outdated. Public health communication professional development offerings lack coordination and do not provide comprehensive coverage across the communication competencies, limiting their utility to strengthen the public health workforce. More, and more comprehensive, professional development offerings are needed.

Exploring the gaps between training and expected job skills of public health graduates to identify: A way forward.

Objectives: To explore the non-alignment between what is taught in academic programmes for public health and what is actually needed or expected in the field. METHODS: The qualitative phenomenological study was conducted from October 2020 to April 2021 in Karachi after approval from the institutional ethics review board of Jinnah Sindh Medical University, Karachi. The sample comprised major stakeholders including representatives of public health institutions and organisations involved in the implementation of public health programmes. Data was collected through in-depth interviews and focus group discussions using a guide after content validation by an expert. Data was analysed using both inductive and deductive approaches. RESULTS: A total of 13 in-depth interviews and 5 focus group discussions were conducted. Regarding gaps in the process of curriculum development, 2 major concerns emerged; lack of comprehensive involvement of experts in different fields of public health in designing the curriculum, and the lack of incorporation of the feedback provided by students in revising the curriculum. Regarding the content of curriculum, three main themes emerged; theoretical nature of courses, lack of uniformity in all programmes, and poor local contextualisation. The casual approach of students and barriers faced by them in joining public health programmes also affected the quality of such programmes. CONCLUSIONS: Three broad areas of improvement were identified, which included improvement in curriculum, methods of learning, and improving students' approach.

Supporting the Development of Grassroots Maternal and Childhood Health Leaders through a Public-Health-Informed Training Program.

The purpose of this research was to assess leadership growth (i.e., changes in personal capacity and social capital) among women living in high-risk infant mortality zip codes who completed a grassroots maternal and childhood health leadership (GMCHL) training program. We used semi-structured qualitative interviews and thematic analysis. Three major themes associated with the training program experience were identified: (1) building personal capacity and becoming community brokers; (2) linking and leveraging through formal organizations; and (3) how individual change becomes community change. Although many of the grassroots leaders were already brokers (i.e., connecting individuals to information/services), they were able to become community brokers by gaining new skills and knowledge about strategies to reduce adverse birth outcomes in their community. In particular, joining and participation in formal organizations aimed at improving community health led to the development of linking or vertical ties (e.g., "people in high places"). The grassroots leaders gained access to people in power, such as policymakers, which enabled leaders to access more resources and opportunities for themselves and their social networks. We outline the building blocks for supporting potential grassroots leaders by enhancing personal capacity and social capital, thus leading to increases in collective efficacy and collective action.

History of development of undergraduate public health education in Bulgaria.

OBJECTIVE: The study aims to present a historical review and analysis of the establishment and development of undergraduate public health (PH) education in Bulgaria from 1878 until 2019. METHODS: А search and selection of historical documents was performed, including laws, rules, regulations, government plans, programmes, scientific publications from periodical medical press, journals, specialized monographs, and books. A retrospective analysis of the normative documents related to the organization of the sanitation and public health activities, and to the provision of professional undergraduate education of the public health workforce in Bulgaria has been carried out. The required competences and tasks of the specialists exercising public health control services were extracted. RESULTS: The development in the public health educational activities were followed in three consecutive periods: the newly independent state (1878-1944); the socialist state (1945-1990); the democratizing state (1990-2019). The development of organized PH activities began after the liberation of Bulgaria in 1878. The historical analysis reveals a direct link between the major socioeconomic changes in the country and the organization of PH undergraduate education which passed through dynamic transformations. The professional education in the sphere of PH started with the training of feldshers, followed by sanitary feldsher and sanitary health inspectors performed in secondary vocational medical schools during the socialist period, reaching the stage of undergraduate university PH education provided by medical colleges associated with universities in the third period. CONCLUSION: Despite the continuous development in the organization of undergraduate PH education in Bulgaria, its content is still not fully compatible with the basic European PH services and actions. There is a growing need for wider standardization and integration of undergraduate PH education in the EU so that the specialty can reach the status of a regulated health profession similar to medicine, nursing, and others.

Universidad de las Ciencias de la Salud "Hugo Chávez Frías"

Universidad Nacional Experimental especializada, con personalidad jurídica y patrimonio propio, como parte del Sistema Público Nacional de Salud (SPNS), sujeta a las políticas y lineamientos del Ministerio del Poder Popular para la Salud (MPPS) y del Ministerio del Poder Popular para Educación Universitaria, Ciencia y Tecnología (MPPEUCT), siendo su naturaleza la formación de profesionales y técnicos en el área de la salud, cuya preparación científico-técnica, capacidades y actitudes permitan potenciar la atención integral de la salud, orientados a la promoción de la salud, protección de la vida y la prevención, diagnóstico, tratamiento y rehabilitación de la enfermedad, contribuyendo al desarrollo integral y sustentable de las comunidades para la construcción del Socialismo Bolivariano del siglo XXI.

Servicio Autónomo Instituto de Altos Estudios "Dr. Arnoldo Gabaldon"

Ente adscrito al Ministerio del Poder Popular para la Salud que ofrece programas de formación de posgrado, formación permanente y de interacción social para dar respuesta a las necesidades del Sistema Público Nacional de Salud, eventos edición de publicaciones, incluyendo el Boletin de Malariología y Salud Ambiental.

Developing competencies in public health: a scoping review of the literature on developing competency frameworks and student and workforce development.

Effective and precise public health practice relies on a skilled and interdisciplinary workforce equipped with integrated knowledge, values, skills, and behaviors as defined by competency frameworks. Competency frameworks inform academic and professional development training, support performance evaluation, and identify professional development needs. The aim of this research was to systematically identify and examine trends in the extent, nature, and range of the literature related to developing competencies in public health. This includes developing public health competency frameworks, and how competencies are developed and maintained in students and practitioners. We used a scoping review methodology to systematically identify and report on trends in the literature. Two independent reviewers conducted title and abstract and full-text screening to assess the literature for relevance. Articles were included if they were original primary research or gray literature and published in English. No date or geographic restrictions were applied. Articles were included if they focused on developing competency statements or frameworks for public health and/or training public health students or practitioners to develop competencies. The review encompassed a range of methods and target populations, with an emphasis on building competencies through student and professional development. Foundational competency development was a primary focus, and we found a gap in discipline-specific competency research, especially within developing discipline-specific competency statements and frameworks. Several evidence-based practices for competency development were highlighted, including the importance of governance and resources to oversee competency framework development and implementation, and workforce planning. Experiential learning and competency-based training were commonly identified as best practices for building competencies. A comprehensive understanding of public health competency development-through developing and incorporating foundational and discipline-specific competencies, mapping student and practitioner training to competency frameworks, and incorporating best practices-will enable public health to create skills and an adaptable workforce capable of addressing complex public health issues.

A New Model for Ranking Schools of Public Health: The Public Health Academic Ranking.

Objectives: As there is no ranking designed for schools of Public Health, the aim of this project was to create one. Methods: To design the Public Health Academic Ranking (PHAR), we used the InCites Benchmarking and Analytics™ software and the Web Of Science™ Core Collection database. We collected bibliometric data on 26 schools of Public Health from each continent, between August and September 2022. We included 11 research indicators/scores, covering four criteria (productivity, quality, accessibility for readers, international collaboration), for the period 2017-2021. For the Swiss School of Public Health (SSPH+), a network gathering faculties across different universities, a specific methodology was used, with member-specific research queries. Results: The five top schools of the PHAR were: London School of Hygiene and Tropical Medicine, Public Health Foundation of India, Harvard T.H. Chan School of Public Health, SSPH+, Johns Hopkins Bloomberg School of Public Health. Conclusion: The PHAR allows worldwide bibliometric ordering of schools of Public Health. As this is a pilot project, the results must be taken with caution. This article aims to critically discuss its methodology and future improvements.

Charting the Advocacy Landscape: A Qualitative Content Analysis of Syllabi in Public Health Graduate Education.

CONTEXT: Addressing public health challenges necessitates policy approaches, but concerns persist about public health graduates' preparedness to advocate. OBJECTIVE: This qualitative study sought to assess advocacy content and skills taught to Master of Public Health students enrolled in US accredited schools and programs of public health (SPPHs) by analyzing 98 course syllabi submitted to the Council on Education for Public Health (CEPH) between 2019 and 2021. Syllabi were submitted by SPPHs during their (re)accreditation process to demonstrate compliance with CEPH's advocacy competency requirement. DESIGN: Qualitative content analysis study. Syllabi were analyzed using MAXQDA Qualitative Data Analysis Software using a 2-coder approach. SETTING: SPPHs accredited by CEPH. PARTICIPANTS: Ninety-eight syllabi submitted to CEPH by 22 schools of public health and 54 programs of public health. MAIN OUTCOME MEASURES: Exemplary language from advocacy courses and assignments and aggregate frequency of syllabi advocacy content and skills. RESULTS: Most advocacy courses (61%) were survey, health policy, or health care delivery courses, covering policy (66%), policy communication (46%), coalition-building (45%), lobbying (36%), community organizing (33%), and media advocacy (24%) skills. Only 7% prioritized advocacy skill instruction, and 10% addressed how to advocate in an equitable way. CONCLUSIONS: Defining public health advocacy and essential skills is crucial. Issuing competency guidelines, supporting advocacy faculty, offering standardized training, and expanding experiential learning are important first steps. More research is needed on how academic institutions are incorporating equity skill training into courses, whether separate from or combined with advocacy skills.

The role of the Field Epidemiology Training Program in the public health emergency response: Sudan armed conflict 2023.

Background: On April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation's public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region. Methods: Employing a blend of quantitative and qualitative methodologies, we investigated the SFETP's contributions to the public health response during the initial 4 months of the conflict (April-July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires. Results: A total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response. Conclusion: The study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.

Curricula and resources related to social entrepreneurship and public health innovation within schools of public health in the United States.

This paper examines the current state of social innovation and entrepreneurship programming, courses, and centers within schools of public health through a survey data analysis. This report presents a cross-sectional survey conducted among faculty members of public health schools in the United States. The survey aims to determine the availability and current state of student-centered programs and courses centered around social innovation and entrepreneurship within schools of public health. Insights were drawn from 19 professionals across 15 schools of public health. Uncertainties surround the sustainability of current programs, with insufficient funding, human resources, and the need to teach more pressing topics identified as the most significant obstacles. Key areas identified as opportunities for growth were faculty engagement, expertise, and funding to expand more structured programming.

The key role of public health in renovating Italian biomedical doctoral programs.

Background: A key renovation of doctoral programs is currently ongoing in Italy. Public health and its competencies may play a pivotal role in high-level training to scientific research, including interdisciplinary and methodological abilities. Methods: As a case study, we used the ongoing renovation of the Clinical and Experimental Medicine doctoral program at the University of Modena and Reggio Emilia. We focused on how the program is designed to meet national requirements as well as students' needs, thus improving educational standards for scientific research in the biomedical field, and on the specific contribution of public health and epidemiology in such an effort. Results: The renovation process of doctoral programs in Italy, with specific reference to the biomedical field, focuses on epidemiologic-statistical methodology, ethics, language and communication skills, and open science from an interdisciplinary and international perspective. In the specific context of the doctoral program assessed in the study and from a broader perspective, public health appears to play a key role, taking advantage of most recent methodological advancements, and contributing to the renovation of the learning process and its systematic quality monitoring. Conclusions: From a comparative assessment of this case study and Italian legislation, the key role of public health has emerged in the renovation process of doctoral programs in the biomedical field.