Public health leadership "Transformation of dreams to reality".

This oration examines the multifaceted nature and skills of leadership in the field of public health from the eyes of public health practitioner. Through diverse examples from personal and professional experiences, the oration debunks common misconceptions surrounding leadership and underscores its capacity to motivate and steer individuals or groups towards a shared vision. It challenges the notion that leaders must possess all-encompassing knowledge, instead emphasizing the significance of traits such as courage, confidence, strategic thinking, and collaboration. Moreover, the oration also delves into the question of whether leadership is an innate quality or one that can be acquired through experience and training, recognizing that while some individuals exhibit inherent leadership qualities, others develop them over time. Throughout the article, the author shares his personal and professional journey in public health leadership, recounting formative experiences ranging from serving as a class representative to working in rural areas and marginalized communities. These encounters at various levels, encompassing departmental, institutional, national, and international, enabled the author to apply leadership attributes such as empathy, effective communication, teamwork, and change management to affect positive transformations in healthcare utilisation. The article summarises the fact that leadership is a continuous (not abstract) variable which is present in everyone, albeit, in different proportions and that, it can be acquired by persistence and perseverance.

Crisis leadership: a case for inclusion in accredited Master of Public Health program curricula.

OBJECTIVES: To evaluate the exposure to crisis leadership theory already present in Council on Education for Public Health (CEPH) accredited Master of Public Health (MPH) programs in the United States and provide a compelling case for its future inclusion. STUDY DESIGN: This was a narrative review. METHODS: We compiled a comprehensive list of 179 CEPH schools that offered an MPH program. During January through March 2021, we examined 179 websites for the core courses and elective courses offered in the MPH degree program to determine if any courses covered the topics of leadership, crisis leadership, or crisis management in either the course title or description. RESULTS: Leadership courses were available in only 55.31% of CEPH-accredited schools. Only a single program (0.56%) offers a crisis leadership course. CONCLUSIONS: The current global COVID-19 pandemic and reality of climate-induced disasters have brought crises to the forefront for health systems. Successful leadership for the future requires public health leaders to have training in crisis leadership. The evaluation and revision of public health curricula must focus on leadership competency development to prepare graduates to lead complex multiple crisis events and system shocks simultaneously.

Public health competences through the lens of the COVID-19 pandemic: what matters for health workforce preparedness for global health emergencies.

The COVID-19 pandemic is raising new questions on public health competences and leadership and on health workforce preparedness for global public health emergencies. The present commentary aims to highlight demand and opportunities for innovation through the disruptions caused by the COVID-19 crisis. We review the public health competency framework recently launched by WHO and ASPHER through the lens of COVID-19. The framework provides guidance for aligning public health and global health competences across sectors and professional groups. Five critical competency areas can be identified in relation to public health emergencies: (1) flexibility, adaptation, motivation, communication, (2) research, analytical sensitivity, ethics, diversity, (3) epidemiology, (4) preparedness and (5) employability. However, this may not be enough. New models of public health leadership and changes in the health workforce are needed, which transform the silos of professions and policy. Such transformations would include learning, working, leading and governing differently and must stretch far beyond the public health workforce. To achieve transformative capacity, critical public health competences must be considered for all healthcare workers on all levels of policymaking, thus becoming the 'heart' of health workforce resilience and pandemic preparedness.

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.

Emerging Health Care Leaders: Lessons From a Novel Leadership and Community-Building Program.

Background: Although there are guidelines and ideas on how to improve public health education, translating innovative approaches into actual training programs remains challenging. In this article, we provide an overview of some initiatives that tried to put this into action in different parts of the world, and present the Emerging Health Care Leader (EHCL), a novel training program developed in Switzerland. Policy Options and Recommendations: Looking at the experience of the EHCL, we propose policymakers and other interested stakeholders who wish to help reform public health education to support these initiatives not only through funding, but by valuing them through the integration of early career healthcare leaders in projects where their developing expertise can be practically applied. Conclusion: By openly sharing the experiences, strengths, weaknesses, and lessons learned with the EHCL program, we aim to foster a transparent debate on how novel training programs in public health can be organised.

Exploring communication by public health leaders and organizations during the pandemic: a content analysis of COVID-related tweets.

OBJECTIVES: Health communication is an essential competency in public health practice. The increasing use of social media and the connectivity between the general public and public health leaders present a unique opportunity to explore how digital communications tools were leveraged in the COVID-19 pandemic. This study explores Twitter-based communications from public health leaders and organizations across Canada and compares them with those from the World Health Organization (WHO). This research aimed to understand Twitter communications strategies to address the COVID-19 pandemic, other public health emergencies, and non-emergency public health issues. METHODS: A content analysis of COVID-related Twitter content during the first wave of the pandemic (January 1-August 31, 2020) was performed. The Canadian Institute for Health Information (CIHI) Policy Intervention Scan was used as a framework to analyze messaging from public health leaders and the WHO. RESULTS: Findings demonstrate that most tweets from public health leaders and organizations in Canada and the WHO focused on case management and public information. Gaps and areas of weakness identified include the lack of Twitter participation by some public health leaders and a narrow range of policy intervention topics, limiting the breadth and depth of public health messages. CONCLUSION: Strengthening communications can serve to improve information sharing in future pandemics or public health crises. Further research should assess how public health leaders and organizations applied communication best practices on all social media platforms and across different policy interventions.

RéSUMé: OBJECTIFS: La communication de messages sur la santé est une compétence essentielle de la pratique en santé publique. L'utilisation accrue des médias sociaux et de la connectivité entre le grand public et les responsables de la santé publique présente une occasion unique d'explorer comment les outils de communication numériques ont été exploités pendant la pandémie de COVID-19. Notre étude porte sur les messages publiés sur Twitter par les responsables et les organismes de la santé publique du Canada et les compare à ceux de l'Organisation mondiale de la santé (OMS). Notre but était de comprendre les stratégies de communication sur Twitter employées pour lutter contre la pandémie de COVID-19, les autres urgences sanitaires et les problèmes de santé publique non urgents. MéTHODE: Nous avons analysé les contenus liés à la COVID-19 publiés sur Twitter au cours du premier cycle de la pandémie (1er janvier au 31 août 2020). L'outil d'analyse des interventions de l'Institut canadien d'information sur la santé (ICIS) a servi de cadre à l'analyse des messages des responsables de la santé publique et de l'OMS. RéSULTATS: Selon nos constats, la plupart des messages des responsables et des organismes de la santé publique du Canada et de l'OMS ont porté sur la gestion des cas et l'information publique. Les lacunes et les points faibles cernés ont été l'absence de certains responsables de la santé publique sur Twitter et l'éventail limité de sujets abordés; ces deux éléments ont limité l'envergure et la profondeur des messages de santé publique. CONCLUSION: Le renforcement des communications pourrait améliorer la communication d'informations lors de futures pandémies ou crises sanitaires. Il faudrait pousser la recherche pour déterminer si les responsables et les organismes de la santé publique ont utilisé des pratiques de communication exemplaires sur toutes les plateformes de médias sociaux et pour différentes interventions.

Navigating misinformation and political polarization of COVID-19: interviews with Milwaukee, Wisconsin county public health officials.

Introduction: The spread of misinformation combined with the political polarization of the COVID-19 vaccine created major challenges for public health officials responding to the COVID pandemic and vaccine roll-out. The challenges public health officials faced when making safety recommendations and promoting the vaccine only exacerbated the already exhausting work conditions they experienced since the start of the pandemic. Combating misinformation while receiving inadequate political support led to burnout for many public health officials. As such, they had to adapt and develop new strategies for increasing vaccine acceptance and decreasing vaccine hesitancies. Method: This study was conducted through qualitative interviews with seven Milwaukee County public health officials. This study aimed to determine how public health officials perceived misinformation and political polarization during the pandemic. Additionally, the study aimed to learn more about strategies county health officials used to combat misinformation while increasing vaccine uptake in their communities. Results: Thematic analysis of the interviews identified three major challenges faced by public health officials in promoting vaccination: dissemination of misinformation in media, political polarization of COVID and its contribution to vaccine acceptance and COVID fatigue, and assessment of the risks associated with disease severity versus vaccine safety considering limited public health resources. Discussion: Learning from public health officials allows us to better understand their perceptions of the extent of local vaccine hesitancies and their advice on how to counteract fears and misinformation and to promote COVID vaccine uptake. Political polarization of COVID and misinformation affected community vaccine acceptance and challenged local public health leadership.

Trend and Correlates of Leadership Competencies Among Female Health Professionals in Albania.

Aim: Our aim was to assess the trends and correlates of the leadership competency level of female health professionals in Albania, a transitional country in the Western Balkans, based on a standardized international instrument. Methods: Two nationwide cross-sectional studies were conducted in Albania in 2014 (first wave; n = 105 women) and subsequently in 2018 (second wave; n = 121 women). A structured questionnaire was administered to all female participants aiming at self-assessing the current level of leadership competencies and the required (desirable) level of leadership competencies for their current job position. The questionnaire consisted of 52 items pertinent to eight domains. Answers for each item of the instrument ranged from 1 ("minimal competency level") to 5 ("maximal competency level"). Overall summary scores (range: 52-260) were calculated for both the current and the required leadership competency levels in both survey rounds, based on which the gap in leadership competency level was also computed (required minus current competency level). Binary logistic regression was used to assess the correlates of the gap in leadership competency level among study participants. Results: In multivariable-adjusted logistic regression models, there was evidence of a positive association between the gap in leadership competency level and: workplace in urban areas (OR = 3.2, 95%CI = 1.6-6.6); work experience (OR[for 1 year increment] = 1.1, 95%CI = 1.0-1.2); first round of the survey conducted in 2014 (OR = 2.1, 95%CI = 1.0-4.3); and, particularly, a high managerial job position/level (OR = 3.8, 95%CI = 1.6-9.3). Conversely, there was an inverse relationship with the age of women (OR[for 1 year increment] = 0.9, 95%CI = 0.8-1.0). Conclusion: Our study provides useful evidence about trends over time and selected correlates of the gap in leadership competencies among female health professionals in Albania. Policymakers and decision-makers in Albania and other countries should be aware of the unmet need for leadership training of female health professionals at all levels.

The New Harvard Doctor of Public Health: Lessons From the Design and Implementation of an Innovative Program in Advanced Professional Leadership.

We documented lessons learned in the initial design and development of the new Harvard doctor of public health (DrPH) degree, an innovative professional public health doctorate designed to provide advanced education in the field of public health. Using data from program documents, personal participation in the development and administration of the degree, and initial students' results, we present key learnings from this experience and describe the program's goals and processes. Now entering its fifth year, the new Harvard DrPH program has enrolled about 70 students and graduated its first 2 classes in a program that combines advanced public health study with leadership development and field engagement. Development of this transformational innovation in advanced public health education required creative approaches to competency development and curriculum design, engagement of faculty to become supportive stakeholders, and substantial support for educational administration. Demand for a program of this type is strong. Continuous improvement is ongoing.

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders.

BACKGROUND: The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public's Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health. MATERIALS AND METHODS: The study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1-10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person. DATA: Data were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS. RESULTS: The competency of most relevance to the highest executive function category was that of "interaction with interrelated systems." For sub-agency level officers the competency of most relevance was "advocating for the role of public health." The competency of most relevance to Program Directors/Managers or Administrators was "ensuring continuous quality improvement." The variation between competencies by job category suggests there are distinct underlying relationships between the competencies by job category.