Melissa Alperin

The MACH Model: From Competencies to Instruction and Performance of the Public Health Workforce

In A National Public Health Strategy for Terrorism Preparedness and Response 2003–2008, the Centers for Disease Control and Prevention (CDC) outlined the 11 imperatives for preventing death, disability, disease, and injury associated with urgent health threats.1 Imperative five, Competent and Sustainable Workforce, identifies four critical objectives: (1) increase the number and type of professionals who comprise a preparedness and response workforce; (2) deliver certification and competency-based training and education; (3) recruit and retain the highest quality workforce; and (4) evaluate the impact of training to ensure learning has occurred. The plan states: “Challenges that exist … include defining the role of certification, practicing quality assurance and performance measurement, developing customized standard competencies …”1 The MACH (Miner, Alperin, Cioffi, and Hunt) Model, developed at the Rollins School of Public Health, serves as a logic map that describes the associations among the objectives and challenges within this imperative. The MACH Model places into context the organizational and instructional theories that underpin workforce preparation and practice. It also accounts for the two general types of needs within public health: those of the employee with skill deficits for specific tasks, which can be met through training or other expert systems; and those of the institution with deficiencies in the work environment, which can be met through management practices and organizational priorities.

Can summits lead to curricula change? An evaluation of emergency preparedness summits for schools of nursing in Georgia.

The Emory University Center for Public Health Preparedness held two summits for nurses that were evaluated by survey. Participants cited multiple deficiencies and challenges with integrating emergency preparedness into nursing curricula. The summits and the related materials were reported as highly useful by survey respondents. More than three fourths of respondents reported incorporating emergency preparedness education into their curricula after summit attendance. Nursing professionals could use summits to encourage active practitioners to pursue continuing education and to initiate efforts to incorporate emergency preparedness and related health care issues into the curricula of schools of nursing.

A Drive Through Web 2.0: An Exploration of Driving Safety Promotion on Facebook™

This study explored Facebook™ to capture the prevalence of driving safety promotion user groups, obtain user demographic information, to understand if Facebook™ user groups influence reported driving behaviors, and to gather a sense of perceived effectiveness of Facebook™ for driving safety promotion targeted to young adults. In total, 96 driving safety Facebook™ groups (DSFGs) were identified with a total of 33,368 members, 168 administrators, 156 officers, 1,598 wall posts representing 12 countries. A total of 85 individuals participated in the survey. Demographic findings of this study suggest that driving safety promotion can be targeted to young and older adults. Respondents’ ages ranged from 18 to 66 years. A total of 62% of respondents aged ≤24 years and 57.8% of respondents aged ≥25 years reported changing their driving-related behaviors as a result of reading information on the DSFGs to which they belonged. A higher proportion of respondents ≥25 years were significantly more likely to report Facebook™ and YouTube™ as an effective technology for driving safety promotion. This preliminary study indicates that DSFGs may be effective tools for driving safety promotion among young adults. More research is needed to understand the cognition of Facebook™ users as it relates to adopting safe driving behavior. The findings from this study present descriptive data to guide public health practitioners for future health promotion activities on Facebook™.

Professional Relevance: Meeting the Contemporary Public Health Agenda

Abstract Recent publications that outline the community health agenda for the 1990s describe processes that are designed to assist local communities in the diagnosis of health problems and development and evaluation of interventions. These documents include: Assessment Protocol for Excellence in Public Health (APEXPH), Planned Approach to Community Health (PATCH), Healthy People 2000: National Health Promotion and Disease Prevention Objectives, and Healthy Communities 2000: Model Standards. A close examination of these sentinel documents indicates that the skills called for in these community processes are the same skills outlined in A Framework for the Development of Competency-Based Curricula for Entry-Level Health Educators. It is thereby important for employers and health education practitioners to realize that those individuals prepared in the competencies of health education are well suited to assume a leadership role in the public health agenda of the future.

Public Health Training Center Evaluation A Framework for Using Logic Models to Improve Practice and Educate the Public Health Workforce

The nation’s 37 public health training centers (PHTCs) provide competency-based trainings and practice-based opportunities to advance the current and future public health workforces. The Emory PHTC, based in Atlanta, Georgia, has developed a comprehensive evaluation plan to address the many evaluation-related questions that must be answered to inform decisions that improve practice. This plan, based on the center’s logic model, includes formative assessment, outcome evaluation, process evaluation, and programmatic evaluation. Rigorous evaluation has been used to (a) assess what is working, what is not working, and why; (b) guide decision making about program improvement; and (c) ensure efficient use of resources, such as time and money. This article describes how the Emory PHTC uses its logic model to guide development of a comprehensive evaluation plan and to create specific data collection tools. It also explains the process used to analyze data and make decisions to maximize effectiveness and ensure the best use of resources. Simply conducting trainings and providing opportunities for real-world application are not enough; it is critical to assess whether or not these educational opportunities are, in fact, educating.

Strategic Approach to Assess Training Needs Across a Diverse Region

The mission of the Region IV (R-IV) Public Health Training Center (PHTC), headquartered at the Rollins School of Public Health at Emory University in Atlanta, GA, is to develop and implement programming to train and educate public health professionals in U.S. Department of Health and Human Services Region IV. To identify public health workforce development needs, the R-IV PHTC created a systematic process that included the implementation of a variety of strategies, to gain insights from each state within the diverse region. Conducting regular needs assessments is an integral step to ensure trainings are relevant and meet the needs of public health professionals. To this end, the PHTC employed a mixed methods approach to gather information on both competency-based and non–competency-based training needs, as well as training needs within R-IV’s content focus area of infectious disease. In R-IV there is great variability between the structures of the state and local health departments (e.g., some centralized, some decentralized), each of which faces different funding challenges and works with different service delivery models and regulatory authorities. Moreover, states have diverse populations (e.g., races, urban/rural, migrant/refugees, tribal, Appalachian) and face a wide range of public health priority concerns. Health departments were found to be at different stages of readiness to undertake a training needs assessment due to a number of issues, including their stage of pursuing Public Health Accreditation Board accreditation and recent participation in other needs assessment efforts. The R-IV PHTC approach to assessing training needs within this challenging environment is described.

Distance Education And Learning: An Innovative Approach to Extending Workforce Training Capacity:

The mission of the Region IV (R-IV) Public Health Training Center (PHTC), headquartered at the Rollins School of Public Health at Emory University in Atlanta, Georgia, is to develop and implement programming to train public health professionals in the U.S. Department of Health and Human Services Region IV. The emphasis on public health accreditation, as well as the reality of high personnel turnover and a workforce with little formal training, point to the need for PHTCs that provide workforce training. PHTCs use distance-based education to reach those in need of training by minimizing or eliminating cost and travel barriers. However, many experienced public health trainers who are able to provide effective and engaging trainings in person lack the knowledge and skills necessary to adapt existing curricula to a distance format. Distance Education And Learning (DEAL) is an online course designed by the R-IV PHTC to increase the capacity of public health trainers to teach in the distance learning environment. The course includes four 3-hour synchronous online sessions with additional asynchronous presession and intersession activity requirements. This article describes the development and implementation of the DEAL course, including how it is used by the R-IV PHTC to increase the number of public health trainers with the skills needed to develop and implement distance-based training, which thereby builds the training capacity within the region and addresses issues of sustainability.

Enhancing Public Health Practice Through a Regional Student Field Placement Program

Experiential learning links knowledge to real practice through seasoned mentor support, professional reflection, and hands-on experience in authentic work environments. While academic public health programs seek to train the future workforce, the current workforce has a critical need for training as well. The Region IV Public Health Training Center’s Pathways to Practice Scholar program gives public health students the opportunity to apply knowledge to competency-based experiences while fulfilling the current workforce’s short- and long-term human resource needs. Placements are offered in all eight states of the region to broaden opportunities for both agencies and student scholars. On completion of the program, scholars are required to submit an executive summary, reflection statement, photos of the experience, and a draft abstract suitable for submission to a professional conference. Since 2015, 36 scholars have been placed in positions across Region IV, 11 in states other than those of their home universities. Students were placed at state, local, and tribal health departments; area health education centers (AHECs); and other agencies (e.g., primary care settings), and the most common work plan domains selected by scholars were analytic/assessment, policy development/program planning, and leadership/systems thinking skills. Scholars’ perceived confidence increased across all domains with the highest increases in financial planning/management and cultural competency. Program implementation and evaluation findings are described, including types of projects, differences in confidence in performing competency domains, and confidence and interest in working with underserved populations. Evaluation findings indicate that the Region IV Public Health Training Center scholars increased their confidence in performing practice competencies while providing support for public health agencies serving underserved populations.

The Role of the U.S. Public Health Learning Network in Strengthening the Current and Future Public Health Workforce

The public health workforce plays a critical role in ensuring the health and well-being of our communities, yet lack of formal training in public health and high turnover impede the ability of the workforce to do its job. The U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) estimates that only 20% of the nation’s public health workforce has the formal education and training necessary to do their jobs effectively (HRSA, 2004, as cited in Kennedy & Baker, 2005). When surveyed as part of the Association of State and Territorial Health Official’s Public Health Workforce Interests and Needs Survey (PH WINS), 79% of respondents stated they were somewhat or very satisfied with their job, yet 42% were still planning to retire before 2020 or leave their organization within the next year (Sellers et al., 2015). Additionally, the Association of Schools and Programs of Public Health estimates that 250,000 more public health workers will be needed by 2020 to maintain capacity (Association of Schools of Public Health, 2008). Established in 1999, the Public Health Training Centers (PHTC), funded by the HRSA, are partnerships between accredited public health degree programs and schools of public health, related academic institutions, public health agencies, and other community organizations. In 2014, the original PHTC model was updated by HRSA to the current regional model, which is composed of 10 regional PHTCs (one located in each U.S. Department of Health and Human Services region), 40 local performance sites, and the National Coordinating Center for Public Health Training (Bigley, 2016; HRSA, 2014). Collectively, these entities are known as the Public Health Learning Network (PHLN). The PHLN is designed to improve the U.S. public health system by strengthening the technical, scientific, managerial, and leadership competence of current and future public health professionals (Bigley, 2016; HRSA, 2014). Using the competencies developed by the Council on Linkages Between Academia and Public Health Practice, the regional PHTCs assess workforce training needs and provide competency-based education and training programs with an emphasis on improving the infrastructure of the public health system and helping achieve the Healthy People objectives (HRSA, 2014). The 2014 PHTC program also has an emphasis on distance-based programming. Additionally, the regional PHTCs are tasked with establishing and/or strengthening field placements for public health students as well as involving faculty and public health students in collaborative projects that enhance public health services to medically underserved communities and populations (HRSA, 2014). This supplement of Pedagogy in Health Promotion is dedicated to the work of the PHLN. Collectively these 15 articles (3 commentaries, 1 reflective piece, 10 descriptive best practices, and 1 original research piece) describe the work of the regional PHTCs, local performance sites, and National Coordinating Center for Public Health Training, which comprise the PHLN. Specific activities include training needs assessment, workforce development training, technical assistance for the public health workforce, and field placement activities. By reading these articles, readers will understand the importance of the PHLN’s work in strengthening both the current and future public health workforce. The supplement begins with three commentaries that set the context for subsequent articles, which discuss specific activities of the PHLN. The commentary by DeSalvo and Wang (2017) discusses five recommendations for the successful implementation of Public Health 3.0 and suggests that PHTCs have a role in developing trainings that incorporate Public Health 3.0 principles. In the next commentary, Dreyzehner, Williams, and Harkness (2017) talk about the important role that practice-based experiences such as internships and field placements have on public health students. They then describe the Commissioner’s Fellowship in Public Health, 701473 PHPXXX10.1177/2373379917701473Pedagogy in Health PromotionAlperin et al. research-article2017