The Need for Responsive Workforce Development During the Pandemic and Beyond: A Case Study of the Regional Public Health Training Centers.

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.

Creating a Vision for a Healthier Workforce Using a Systems-Based Approach.

CONTEXT: The public health system faces unprecedented challenges due to the pandemic, racism, health inequity, and the politicization of public health. At all levels of the system, the workforce is experiencing distress, burnout, safety issues, and attrition. Public health is being challenged to demonstrate and justify its impact and value, while also leveraging opportunities for learning and system strengthening. PROGRAM: To explore the current state and identify opportunities to strengthen the public health system, the Region 7 Midwestern Public Health Training Center (MPHTC), with support from Engaging Inquiry, embarked on a distinctive type of systems analysis, called "dynamic systems mapping." IMPLEMENTATION: This approach brought together diverse sectors of public health partners in the region to develop a rich contextual narrative and system-level understanding to highlight and align existing and emergent strengths, areas for growth, and tangible goals for the immediate- and long-term sustainability of local and regional health. EVALUATION: Focus groups and workshops were conducted with diverse practitioners to identify upstream causes and downstream effects of 11 key forces driving system behavior. These focus groups resulted in the development of a visual map that MPHTC is utilizing to identify opportunities for leverage, develop strategies to maximize the potential impact of these leverage points, as well as facilitate continuous learning. DISCUSSION: Public health utilization of systems mapping is a valuable approach to strengthening local and national system responses to current and future public health needs. Outcomes and lessons learned from the systems mapping process are discussed.

Capacity Building for Public Health: Participant-Guided Training.

Growth in the demand for public health services, along with limited funding, makes workforce collaboration and capacity building imperative. The faculty and staff of the Midwestern Public Health Training Center, with two Robert Wood Johnson Public Health Nurse Leaders, postulated that training could be more effective, and public health workers more effective in the field, if workers contributed to training format and content. The learning paradigm was tested on diabetes prevention and self-management programs. Public health professionals were surveyed on infrastructure, practices, roles, and gaps in diabetes-related services. Responses influenced the format and content of a one-day diabetes summit training program. Participants submitted evaluations immediately afterward. Eight months postsummit, participants were surveyed to self-assess behavioral changes attributed to the training. Using the Kirkpatrick model for evaluation, participants (n = 112) stated that the training met their expectations and that knowledge gained was consistent with stated training objectives. Qualitative postsummit survey results indicated that improvements in participants' delivery of diabetes prevention services to the public could be attributed to the training they received at the summit. Results suggest that training about specific programs and practices, as well as facilitated sessions of collaboration, can yield individual and organizational change.

Using a digital story format: a contemporary approach to meeting the workforce needs of public health laboratories.

INTRODUCTION: Public health laboratories are an integral partner in preparedness and emergency response. The Upper Midwest Preparedness and Emergency Response Learning Center (UMPERLC) and the State Hygienic Laboratory at the University of Iowa have a long history of working together to identify and meet the preparedness training needs of the laboratory workforce. The training, Anatomy of a Foodborne Outbreak, which uses a digital story format, provides an example of this partnership. BACKGROUND/RATIONALE: The State Hygienic Laboratory expressed the need for training programs targeted at enhancing early detection and investigation of outbreaks. Clinical laboratory staff play a significant role in identifying patient samples that may represent the effects of foodborne illness. Given that foodborne illnesses are on the increase nationally, it is critical that laboratory staff be prepared to deal with these outbreaks. METHODS/ACTIVITY: UMPERLC collaborated with State Hygienic Laboratory content experts in the design and development of a digital story, using a foodborne outbreak that focuses on testing to detect Shiga toxin-producing Escherichia coli. This narrative format was selected because seeing and hearing a story about the training content provide the learner with a deeper interaction and richer learning experience, allowing the learner to better see the bigger picture. RESULTS/OUTCOMES: Anatomy of a Foodborne Outbreak is available on UMPERLC's Learning Management System, Training Source (http://training-source.org). Evaluation data indicate positive learning experiences overall. DISCUSSION: The digital story format, which is a video that uses a blend of images, text, and audio narration, was an appropriate method for the content and learning outcomes of the Anatomy of a Foodborne Outbreak training. This format requires more active learning, which increases retention and transfer of knowledge. Training that is easily accessed and user-friendly is an important resource for laboratory staff. LESSONS LEARNED/NEXT STEPS: When reviewing the course completion data, the highest enrollment occurred immediately after the training program was released. To increase visibility, Anatomy of a Foodborne Outbreak is housed on both the State Hygienic Laboratory Web site and UMPERLC's Learning Management System. The course has also been added to national learning databases such as the Centers for Disease Control and Prevention TrainingFinder Real-time Affiliate Integrated Network (CDC TRAIN) and Certified in Public Health Recertification & Reporting System.

Adaptive scenarios: a training model for today's public health workforce.

INTRODUCTION: With the current economic climate, money for training is scarce. In addition, time is a major barrier to participation in trainings. To meet the public health workforce's rising demand for training, while struggling with less time and fewer resources, the Upper Midwest Preparedness and Emergency Response Learning Center has developed a model of online training that provides the public health workforce with individually customized, needs-based training experiences. BACKGROUND/RATIONALE: Adaptive scenarios are rooted in case-based reasoning, a learning approach that focuses on the specific knowledge needed to solve a problem. Proponents of case-based reasoning argue that learners benefit from being able to remember previous similar situations and reusing information and knowledge from that situation. Adaptive scenarios based on true-to-life job performance provide an opportunity to assess skills by presenting the user with choices to make in a problem-solving context. METHODS/ACTIVITIES: A team approach was used to develop the adaptive scenarios. Storylines were developed that incorporated situations aligning with the knowledge, skills, and attitudes outlined in the Public Health Preparedness and Response Core Competency Model. This article examines 2 adaptive scenarios: "Ready or Not? A Family Preparedness Scenario" and "Responding to a Crisis: Managing Emotions and Stress Scenario." RESULTS/OUTCOMES: The scenarios are available on Upper Midwest Preparedness and Emergency Response Learning Center's Learning Management System, the Training Source (http://training-source.org). Evaluation data indicate that users' experiences have been positive. DISCUSSION: Integrating the assessment and training elements of the scenarios so that the training experience is uniquely adaptive to each user is one of the most efficient ways to provide training. The opportunity to provide individualized, needs-based training without having to administer separate assessments has the potential to save time and resources. LESSONS LEARNED/NEXT STEPS: These adaptive scenarios continue to be marketed to target audiences through partner organizations, various Web sites, electronic newsletters, and social media. Next steps include the implementation of a 6-month follow-up evaluation, using Kirkpatrick level III. Kirkpatrick level III evaluation measures whether there was actual transfer of learning to the work setting.

Partnering for preparedness: the project public health ready experience.

Effective partnerships between local and state public health agencies and schools of public health have tremendous potential to improve the health of communities nationwide. This article highlights successful collaboration between local public health agencies (LPHA), state health departments, and Academic Centers for Public Health Preparedness (ACPHP) in schools of public health developed through participation in Project Public Health Ready, a program to recognize LPHA emergency preparedness. The project's pilot phase illustrated that LPHAs, state health departments, and ACPHP can effectively work together to improve individual public health worker competency and organizational response capacity in local public health agencies nationwide.

Matching documented training needs with practical capacity: lessons learned from Project Public Health Ready.

The Upper Midwest offers a distinct environment for identifying and addressing threat and preparedness scenarios. The population is often scattered, with residents using urban centers periodically. This has also led to the challenge of providing specific skills and cross-disciplinary awareness and coordination to the public health community. The Upper Midwest Center for Public Health Preparedness was established by a grant from the Centers for Disease Control and Prevention to assist in meeting the challenge of adding capacity to develop the preparedness workforce in the Upper Midwest. Project Public Health Ready (PPHR) provides an example of the role academic preparedness centers can play in partnering with local public health agencies to strengthen the public health workforce. The purpose of this article is to present the Iowa Systems Model for Workforce Development being utilized for workforce training and education, describe how the model has been applied in the example of PPHR, and discuss lessons learned from the PPHR experience.