Abstract
Objectives A skilled workforce is essential to advancing maternal and child health (MCH) in a rapidly changing public health system. Little is known about the MCH workforce’s existing capacity to maximize opportunities afforded by ongoing change. We assessed MCH workforce capacity in three areas: Systems Integration, Evidence-Based Decision-Making, and Change Management/Adaptive Leadership. We then examined associations between workforce capacity and modifiable workforce development strategies/resources. Methods Data are from the Public Health Workforce Interests and Needs Survey (PH WINS). The present study was limited to employees working in MCH programs (weighted N = 3062). Workforce capacity was operationalized as self-reported awareness of public health trends and proficiency to perform related skills in the three areas. Survey-weighted generalized estimating equations were used to fit logistic regression models accounting for employee clustering within states. Results While awareness of public health trends was low, the majority of employees (> 70% in each area) reported proficiency to perform skills related to these trends. Capacity was lowest in Systems Integration. Employee engagement in academic partnerships and higher state contributions to MCH program budgets were the strategies/resources most consistently associated with higher capacity. Workplace support was the strongest correlate of capacity in Change Management/Adaptive Leadership. Conclusions for Practice Although employees lacked familiarity with specific public health trends, they were proficient in skills needed to engage in related work. Still, areas for improvement remain. Results provide a baseline against which future training efforts can be evaluated. Academic partnerships and MCH program funding may be useful to prioritize in the context of health transformation.
Highlights
The enactment of the Patient Protection and Affordable Care Act (ACA) in 2010, followed by transformation of the Title V Maternal and Child Health Services Block Grant in 2015, ushered in an era of change, innovation, and promise for the advancement of maternal and child health (MCH) in the United States
Within the Systems Integration core, only 11% reported awareness of Health in All Policies (HiAP), yet 74% reported proficiency to assess the broad array of factors that influence public health problems, and 72% reported proficiency to understand the relationship between a new policy and public health problems
Engaging in academic partnerships was the strongest correlate of workforce capacity in the Systems Integration and Evidence-Based Decision-Making core areas, supervisory support was the strongest correlate of skill proficiency in the Change Management/Adaptive Leadership core
Summary
The enactment of the Patient Protection and Affordable Care Act (ACA) in 2010, followed by transformation of the Title V Maternal and Child Health Services Block Grant in 2015, ushered in an era of change, innovation, and promise for the advancement of maternal and child health (MCH) in the United States. A comprehensive understanding of the MCH workforce’s existing capacity is critical for targeting training efforts, and evaluating their success. The Association of Maternal and Child Health Programs (AMCHP) routinely assesses workforce training, staffing, and development needs (Grason et al 2012). In the context of health systems transformation, it may be useful to examine how MCH workers rate their own knowledge of new trends in public health practice and their ability to perform related skills. Such information can support the development of relevant and responsive training efforts, and provide a baseline against which training impacts can be evaluated
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