Journal of Public Health Management and Practice最新文献

Public health data and tools have proliferated, yet practical guidance for community-engaged data-driven decision making is limited. The HEALing Communities Study (HCS) was a randomized, wait-list controlled trial to assess the impact of an intervention to reduce fatal opioid overdoses in 67 highly affected communities across 4 sites (Kentucky, Massachusetts, New York, and Ohio). HCS researchers implemented the Communities That HEAL intervention, a phased approach which included a coalition-engaged, data-driven approach to selection of evidence-based practice strategies to reduce fatal opioid overdoses. Core steps to the data-driven approach included data selection, access, display, and engagement. Staff selected metrics that aligned with study goals, accessed data from numerous sources, created visualizations, and engaged coalition members to assess resource gaps and intervention opportunities. At the intervention conclusion, all 4 sites' staff collectively workshopped best practices and barriers encountered to data-driven decision making. This article explains the data-driven decision-making approach implemented, assessment results, alterations for subsequent implementation, and guidance for future implementations.

We analyzed a nationally representative sample of local public health professionals (LPHPs) from varying jurisdiction sizes across the United States who responded to the 2024 Public Health Workforce Interests and Needs Survey (PH WINS). Our goal was to explore experiences of burnout; perceived belonging within an agency; self-rated mental and emotional well-being; and intentions to leave an organization. Results showed that burnout was negatively associated with and perceived belonging within an agency was positively associated with ratings of mental and emotional health. Each of these 3 variables were associated with an intent to leave an organization in the next year. We discuss implications to-and recommendations for mitigating-attrition of the nation's local public health workforce after the size of the LPHP workforce rebounded following over a decade of decline.

Objective: This analysis examines the alignment of the Public Health Accreditation Board (PHAB) standards, the Mobilizing for Action through Planning and Partnerships (MAPP) model, and the Pennel evaluation tool. Despite the growing use of Community Health Assessments (CHAs) and Community Health Improvement Plans (CHIPs), variation in quality and evaluation persists. The analysis identifies convergence, divergence, and integration opportunities to inform more cohesive and sustainable public health improvement strategies.

Design: An alignment analysis was conducted through a document review of the PHAB Standards (v2022, initial accreditation), the MAPP model, and the 17-item Pennel evaluation tool. A structured matrix categorized alignment as full, partial, or absent, supported by thematic coding and expert validation for consistency and reliability.

Setting: The present analysis focuses on the approaches used by US local health departments conducting CHA/CHIP development and accreditation activities.

Participants: The unit of analysis was not individuals but rather the core components of each approach as articulated in public documentation, handbooks, and peer-reviewed sources.

Main outcome measures: Alignment was evaluated across three themes: Community Engagement & Governance, Data and Health Equity, and Strategy Development & Implementation.

Results: The analysis revealed strong alignment across the approaches in stakeholder engagement, data-informed decision-making, and goal setting. Divergence was observed in implementation specificity and sustainability planning. PHAB emphasized compliance documentation; MAPP prioritized participatory planning; and the Pennel tool provided guidance on evaluation and accountability.

Conclusions: A complementary approach that integrates the evaluative rigor of the Pennel tool, the procedural depth of MAPP, and the accountability of PHAB could foster a more equitable, responsive, and sustainable public health improvement. Findings underscore the need for public health agencies to support this integration by developing implementation guidance, training, and resources for evaluation. This integration has the potential to bridge accreditation compliance and meaningful health outcomes, advancing toward Public Health 3.0.

Context: Governmental public health workers age 35 or younger have been shown to experience lower retention rates than older workers. Salaries are often a factor in retention, but because health departments sometimes face restrictions in improving salaries, health departments might explore offering nontraditional benefits to attract and retain workers.

Objective: We sought to analyze data from the 2024 Public Health Workforce Interests and Needs Survey (PH WINS) to determine whether nontraditional benefits are more highly valued by younger workers than older workers.

Design: We selected respondents of 2024 PH WINS who were permanent, full-time health department employees, then created 2 subgroups of these respondents, one age 35 and younger, and the other over age 35, and compared their responses to survey questions regarding nontraditional benefits, reasons to stay in their jobs, and, for those 35 and younger, the factors which attracted them to governmental public health.

Results: Younger PH WINS respondents were significantly more likely to value nontraditional benefits than older workers. The findings were generally consistent with the literature.

Conclusions: Health departments could improve retention of younger workers by offering nontraditional benefits.

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.