Journal of Public Health Management and Practice最新文献

Context: Large local health departments (LHDs) serve diverse, high-need communities and are uniquely positioned to influence public health policy and practice locally, regionally, and nationally.

Objective: The purpose of this study is to investigate policy engagement as a reported training need in the 2024 Public Health Workforce Interests and Needs Survey within large LHDs, highlighting gaps and opportunities to strengthen policy capacity.

Design: Cross-sectional analysis of 2024 Public Health Workforce Interests and Needs Survey data using descriptive statistics and weighted logistic regression.

Setting: Large LHDs, serving populations of 250 000 or more, across the US.

Participants: Study sample included 24 121 responses from individuals working in large LHDs.

Main outcome measures: Descriptive and regression-based statistics for training needs, self-identified skill-building interests, and predictors of reporting a policy engagement training need.

Results: Nearly 40% of staff at large LHDs reported a training need in policy engagement, the only domain to show an increase in need since 2021. Women had significantly higher odds of reporting a policy training need (odds ratios [OR] = 1.67; P < .001), as did supervisors (OR = 2.09; P < .001) and managers (OR = 1.78; P < .001) compared to nonsupervisors, while those with master's (OR = 0.64; P < .001) or doctoral degrees (OR = 0.40; P < .001) had lower odds compared to bachelor's-level staff.

Conclusions: Large LHDs are well positioned to advance public health policy given their scale and connection to local communities. Targeting policy engagement training to workforce segments with the highest reported need offers a strategic opportunity to strengthen policy capacity across the US public health workforce.

Context: This report shares findings from a race and ethnicity questionnaire that aligns with recent updates to federal reporting standards under the US Office of Management and Budget's Statistical Policy Directive Number 15 (SPD 15). The questionnaire was included in a broader health survey and given to attendees of a community-engaged, health department-led COVID-19 health education and health literacy programs.

Objectives: The aim of this report to examine survey attributes and attendee characteristics that are associated with disaggregated race and ethnicity response, a new reporting requirement under the revised SPD 15.

Design: The race and ethnicity questionnaire consolidated race and ethnicity questions, added a Middle Eastern or North African category and included disaggregated race and ethnicity response options based on ancestries commonly reported among the local population in the American Community Survey.

Setting: The program was implemented between March 1, 2022, and March 31, 2023, in community settings in the New York City metropolitan area and online via videoconferencing systems.

Participants: Voluntary pre-surveys in English and Spanish were offered to attendees of virtual and in-person health information sessions.

Outcome measures: The primary outcome of interest was disaggregated race and ethnicity response rates by primary race and ethnicity, age, education, gender, and language.

Results: We collected 984 paper surveys and 335 online surveys in English and Spanish. Black or African American respondents were least likely to specify a more granular racial or ethnic identity when given the choice. Younger adults and Spanish speakers were more likely to select from the disaggregated race and ethnicity response options, although the extent of the differences appeared to differ between paper and online surveys.

Conclusions: Findings highlight the importance of inclusive survey designs for more precise health data and inform data instrument designs that are SPD 15-compliant and conducted in communities experiencing medical and government mistrust.

Context: The Applied Epidemiology Competencies (AECs) were first created in 2008 and have not been updated since to reflect the skills and advancements of the current epidemiology workforce.

Objectives: Starting in 2022, the Council of State and Territorial Epidemiologists (CSTE) revised the AECs to redefine the role and responsibilities of applied epidemiologists in state, tribal, local, and territorial health departments.

Design: The AECs were revised through a comprehensive literature review, input from a 17-member expert panel, and virtual town halls with applied epidemiologists in the field.

Intervention: CSTE grouped the data gathered from town halls, an online assessment, and the expert panel using grounded theory to make recommendations for revisions based on common themes. The revisions were reviewed again by the expert panel prior to finalization.

Results: The revised set includes integration of health equity throughout all domains, a revised tier structure, and alignment with the Core Competencies for Public Health Professionals.

Conclusions: These materials serve as instrumental tools for creating job descriptions, career portfolios, training plans, and other professional development tools to grow and enhance the applied epidemiology workforce.

Context: Partnership engagement in the development and adaptation of health interventions offers multiple benefits. A design workgroup is a collective of partners coming together to participate in interactive sessions to address a public health problem. Our paper offers a step-by-step guide to forming and implementing a design workgroup, using an example from a project to develop and adapt tobacco control resources and strategies for Connect to Wellness, an evidence-based workplace wellness program.

Program: Workgroup activities were informed by principles of codesign and previous implementation intervention studies. Meetings were cofacilitated by the research team and a consulting and communications firm. We recruited employers, employees, and health department staff to participate in the workgroup. The design workgroup consisted of 5 monthly, 2-hour virtual meetings.

Implementation: Meeting content included identifying barriers and facilitators affecting tobacco control EBI success; identifying strategies and resources to improve workplace tobacco control; identifying, developing, and reviewing changes to Connect to Wellness tobacco cessation resources to increase their appeal to employers and employees at small workplaces; and conducting an evaluation of the workgroup, including gathering feedback on successes and opportunities for improvement.

Evaluation: Members felt that their feedback was valued and reflected in changes made to the tobacco cessation resources. Members enjoyed engaging with each other and thought the meetings were productive with clear goals and objectives. Opportunities for improvement described included having meetings closer together, having fewer materials to review prior to each meeting, and streamlining content to avoid repetition across meetings.

Discussion: We provide detailed information on workgroup member recruitment, meeting content and facilitation, planning and evaluation, and lessons learned. This manuscript can serve as a useful tool for others who are interested in implementing their own design workgroups to adapt and improve implementation of health promotion evidence-based interventions across a wide variety of health topics and settings.

Objective: The National Association of Chronic Disease Directors (NACDD) is a nonprofit organization that supports state and territorial chronic disease prevention and health promotion efforts through capacity building and technical assistance. Each year, NACDD surveys health department leaders who oversee chronic disease prevention and health promotion work (hereafter, Chronic Disease Directors). In this paper, we report on the 2024 survey outcomes and place those findings into the broader public health policy context.

Design: Fifty-one Chronic Disease Directors completed the organizational capacity and development needs survey. Responses were summarized in aggregate and by jurisdiction size.

Results: State and territorial chronic disease units have varied responsibilities, but most address diabetes, cardiovascular diseases, and cancer screening and prevention. Chronic Disease Directors reported strong or improving capacity in most practice areas but ranked workforce development lower than other areas. Staffing decreased slightly during 2024 compared with 2023 (median of 1.1 and 1.3 employees per 100 000 jurisdiction population, respectively). Many Chronic Disease Directors expressed ongoing concerns about staff turnover and workforce development, funding limitations and stability, and the effects of the political climate on public health work. Despite these challenges, many respondents also conveyed success stories about program achievements, obtaining new funding, and building partnerships and collaborations. Looking forward to 2025, many Chronic Disease Directors expressed intentions to focus on leadership, policy, and technical training; on making structural and staffing changes within their units; and on continuing to build cross-sector relationships and collaborations.

Conclusions: Continued concerns about staff turnover and workforce development underscore the need to better understand and remove barriers to capacity building in this area to support job satisfaction and employee retention. Changes to federal infrastructure are likely to have substantial impacts and may increase reliance on cross-sector partnerships to continue advancing chronic disease prevention and health promotion.