Graduate Public Health Research Articles

Recruitment in Qualitative Public Health Research: Lessons Learned During Dissertation Sample Recruitment

The purpose of this article is to describe the recruitment challenges faced by eight public health graduate students when conducting qualitative dissertation research. The authors summarize their dissertation studies, describe recruitment challenges, and provide strategies and recommendations used to address challenges. The authors identified twelve recruitment issues which they grouped into three major categories: (a) obtaining consent; (b) working with gatekeepers; and (c) accessing participants. The authors propose three recommendations to consider in participant recruitment, which are: (a) collaborate with gatekeepers; (b) use additional recruitment tools; and (c) understand your target population. The compilation of experiences from multiple graduate students from a diverse selection of topics provides valuable insight and resources when planning a qualitative research study in the field of public health.

Exploring Opportunities for Public Health Graduates in Government Health System in Nepal

Nepal has a history of nearly three decades of public health education. Public health graduates are working under different capacities at governmental and non governmental organizations. If the health system can utilize this human resource, this will contribute to health system strengthening in Nepal. The objective of this paper is to explore the opportunities for public health graduates in government health system in Nepal. MoHP needs to expand opportunities for public health graduates in different areas within government system. Recruiting district level supervisors from bachelor in public health background would enhance performance because of their knowledge and skills on areas like district health management, research, public health administration, health economics and medical sociology as compared to those with certificate level education on General medicine currently being recruited. In the meantime this will create hundreds of job placements in district health system for job aspirants. Role of community health inspectors needs to be made clear and sanctioned at the district and peripheral level. Also, there is necessity of environmental health technicians, health educators, health economists and other types of health personnel. It is equally necessary to establish environmental health, occupational health, urban health, health care waste management, mental health and oral health units at district level. The other areas where public health graduates can work as health officers are District Development committee, Municipality, Women and Child office and Water and Sanitation Division Office. The public health community including its professional organization Nepal Public Health Association should advocate for the professional rights and contribute to create opportunities for public health graduates.DOI: http://dx.doi.org/10.3126/hprospect.v13i1.11292 Health Prospect Vol.13(1) 2014: 7-11

Future directions for public health education reforms in India.

Health systems globally are experiencing a shortage of competent public health professionals. Public health education across developing countries is stretched by capacity generation and maintaining an adequate ‘standard’ and ‘quality’ of their graduate product. We analyzed the Indian public health education scenario using the institutional and instructional reforms framework advanced by the Lancet Commission report on Education of Health Professionals. The emergence of a new century necessitates a re-visit on the institutional and instructional challenges surrounding public health education. Currently, there is neither an accreditation council nor a formal structure or system of collaboration between academic stakeholders. Health systems have little say in health professional training with limited dialogue between health systems and public health education institutions. Despite a recognized shortfall of public health professionals, there are limited job opportunities for public health graduates within the health system and absence of a structured career pathway for them. Public health institutions need to evolve strategies to prevent faculty attrition. A structured development program in teaching–learning methods and pedagogy is the need of the hour.

Using core competencies to build an evaluative framework: outcome assessment of the University of Guelph Master of Public Health program.

BackgroundMaster of Public Health programs have been developed across Canada in response to the need for graduate-level trained professionals to work in the public health sector. The University of Guelph recently conducted a five-year outcome assessment using the Core Competencies for Public Health in Canada as an evaluative framework to determine whether graduates are receiving adequate training, and identify areas for improvement.MethodsA curriculum map of core courses and an online survey of University of Guelph Master of Public Health graduates comprised the outcome assessment. The curriculum map was constructed by evaluating course outlines, assignments, and content to determine the extent to which the Core Competencies were covered in each course. Quantitative survey results were characterized using descriptive statistics. Qualitative survey results were analyzed to identify common themes and patterns in open-ended responses.ResultsThe University of Guelph Master of Public Health program provided a positive learning environment in which graduates gained proficiency across the Core Competencies through core and elective courses, meaningful practicums, and competent faculty. Practice-based learning environments, particularly in collaboration with public health organizations, were deemed to be beneficial to students’ learning experiences.ConclusionsThe Core Competencies and graduate surveys can be used to conduct a meaningful and informative outcome assessment. We encourage other Master of Public Health programs to conduct their own outcome assessments using a similar framework, and disseminate these results in order to identify best practices and strengthen the Canadian graduate public health education system.

Initial External Validation of REGRESS in Public Health Graduate Students

Linear regression is typically taught as a second and potentially last required (bio)statistics course for Public Health and Clinical and Translational Science students. There has been much research on the attitudes of students toward basic biostatistics, but there has not been much assessing students' understanding of critical regression topics. The REGRESS (REsearch on Global Regression Expectations in StatisticS) quiz developed at Mayo Clinic utilizes 27 questions to assess understanding for simple and multiple linear regression. We performed an initial external validation of this tool with 117 University of Michigan public health students. We compare the results of pre- and postcourse quiz scores from the Michigan cohort to scores of Mayo medical students and professional statisticians. University of Michigan students performed higher than Mayo students on the precourse quiz due to previous related coursework, but did not perform as high postcourse indicating the need for course modification. In the Michigan cohort, REGRESS scores improved by a mean (standard deviation) of 4.6 (3.4), p < 0.0001. Our results support the use of the REGRESS quiz as a learning tool for students and an evaluation tool to identify topics for curricular improvement for teachers, while we highlight future directions of research.

Making mapping matter: a case study for short project international partnerships by global public health students

Background A large number of global public health students seek international experience as part of their academic curriculum. These placements are often short, given the constraints of cost and time available within the academic calendar. In contrast to international electives for clinical students there are few published guidelines on practical, ethical or feasible projects. This paper describes a ten-day sanitation mapping project in Mumbai, India and explores the broader implications for global public health student electives. Methods Three graduate public health students conducted a geographic review of sanitation facilities in Cheeta Camp informal settlement, Mumbai. Forty-six toilet blocks with 701 individual seats were identified. The project was reviewed ethically, educationally and logistically as a possible model for other short-term international projects. Conclusions Clearer guidelines are needed to support non-clinical placements by global public health students. Projects that are feasible, relevant and meaningful should be foster maximise benefit for learners and host communities.

Into the deep end: Incorporating a global health governance and diplomacy experience in graduate public health training

Global health governance benefits from participants well-versed in the realities of international policy-making. Consequently, educational programmes must establish more opportunities for students to engage in global health policy development. This paper examines a unique global health governance and diplomacy practicum programme at the University of Southern California, designed for Master of Public Health candidates. Through the programme, students act as official non-governmental delegates to the World Health Assembly in Geneva, Switzerland through organisational partnerships. Students and collaborating organisations were asked to complete an online post-participation survey examining the perceived quality of the experience. Through the survey, students indicated reinforcement of classroom learning, continued or heightened interest in global health policy and enthusiasm in recommending the programme to other students. Organisations perceived students to be adequately prepared and indicated their continued desire to work with students in the programme. The data collected suggest that the programme was successful in providing students with a worthwhile experience that developed skills in global health diplomacy and promoted interest and critical thinking concerning international policy-making processes. A discussion of strengths and challenges serves as a blueprint for the creation of future practicum programmes.

Halk Sağlığı Araştırma Görevlilerinin Eğitim Süreçlerini "Mentor" Kavram Ve Yaklaşımı Kapsamında Değerlendirmeleri

In this study, we aimed to assess the knowledge and opinions of the public health residents recorded in the Society of Public Health Specialists’ inventory by August 2013 on mentoring related concepts, as well as to determine whether their training period is compatible with the requirements of mentoring idea. Materials and Methods: Two hundred and eighty three research assistants who were in the list of the Society of Public Health Specialists’ working at the 43 universities’ Public Health Departments was the universe of the study. Nevertheless, 160 residents participated in this study (participation rate=55.9%). Data was collected via electronic data collection method. Results: Mean age of the participants was 28.9±2.9. 60.8% of the research assistants started their thesis process and 69.2% of the research assistants had an advisor. The average time of determining the thesis content was9.4±10.5 months (median=2.0). 50.3% of the residents’ definition on academic advisor was found as “sufficient”. 72.0% of the residents declared that their academic plan had been completed at the beginning of their training period whereas 18.6% of them mentioned their un-satisfaction on that their expectations. 91.1% of the participants attended the internship education, 97.5% of them attended seminars, 91.1% of them attended literature classes, and 56.6% of them attended to the post graduate Public Health classes. Conclusion: In both under and post graduate medical education, the term of mentoring is need to be known accurately and to be practiced more effectively in resident training. It is recommended that the administrative bodies of Public Health departments with their academic members and the society of Public Health Specialists’ should collaboratively work to improve the current curricula and programs in this regard.

Do we develop public health leaders?- association between public health competencies and emotional intelligence: a cross-sectional study.

BackgroundProfessional development of public health leaders requires a form of instruction which is competency-based to help them develop the abilities to address complex and evolving demands of health care systems. Concurrently, emotional intelligence (EI) is a key to organisational success. Our aim was twofold: i) to assess the relationship between the level of self-assessed public health and EI competencies among Master of European Public Health (MEPH) students and graduates at Maastricht University, and; ii) to determine the relationship between different groups of public health competencies and specific EI skills.MethodsA cross-sectional study was conducted including all recent MEPH graduates and students from 2009–2012, out of 67 eligible candidates N = 51 were contacted and N = 33 responded (11 males and 22 females; overall response: 64.7%).Two validated tools were employed: i) public health competencies self-assessment questionnaire, and; ii) Assessing Emotions Scale.ResultsFemales scored higher than males in all seven domains of the self-assessed key public health competencies (NS) and emotional intelligence competences (P = 0.022). Overall, the mean value of public health competencies was the lowest in students with “staff” preferences and the highest among students with mixed job preferences (P < 0.001). There was evidence of a correlation between the overall public health competencies and the overall emotional intelligence competencies (r = 0.61, P < 0.001).ConclusionsThe study shows a positive correlation between public health specific competencies and EI attributes. It can contribute to the improvement of the educational content of PH curricula by rising awareness through self-assessment and supporting the identification of further educational needs related to leadership.

Huda Zurayk: advancing health and research in the Arab world

Huda Zurayk: advancing health and research in the Arab world

Notes from the Field: Planting, Nurturing, and Watching Things Grow

Editors' Note: We invited a sample of AJPM's Editorial Board, supplement guest editors, and longtime colleagues and contributors to share their experiences and impressions of the impact of AJPM on their respective domains. We were particularly fond of Ken Powell's analogy to being "tenders of the planted seed"--as planters, weeders, and harvesters--watching and nurturing the growth of AJPM, and have elected to lead with his commentary.

MPH Education for the 21st Century: Motivation, Rationale, and Key Principles for the New Columbia Public Health Curriculum

Public health is at a watershed moment. The world's health needs are changing, and complex problems require interdisciplinary approaches and systems-based solutions. Our longer lives and changing environments necessitate life-course and structural approaches to prevention. This argues strongly for public health graduate education that adequately prepares trainees to tackle emerging challenges and to lead now and in the future. Nearly a century of scholarship and scientific advances may offer a blueprint for training the next generation of public health leaders. We articulate a case for change; discuss some of the foundational principles that should guide public health education; and discuss what such a change might look like building on prior scholarship, on the examples set by other disciplines, and on our own experience.

Immersive Simulation Education: A Novel Approach to Pandemic Preparedness and Response

Pandemic management involves strategic and tactical concepts rarely experienced with other disasters. To comprehend the enormity of these tasks and experience the critical decision-making required, local public health and other stakeholders participate in tabletop and functional exercises. Students in Master of Public Health (MPH) programs not only rarely experience this educational format, but also are seldom afforded substantive time to appreciate the critical decision making that is unique to pandemics. An immersive semester-long simulation exercise was created to educate graduate public health students about pandemics. Students in a MPH course were divided into groups representing county health departments. During the semester, students collaborated and completed incident command training, received audio lectures, and materials concerning an imminent pandemic. The students then participated in the 2.5-hr facilitated tabletop exercises in the classroom. A survey was developed to assess their perceptions of the experience. Most students felt more knowledgeable afterward and thought that this training style was innovative, entertaining, educational, and recommended it to fellow students and colleagues. The students believed that delivering a tabletop exercise in this fashion was educational and entertaining. It gave the students a better appreciation of the role of public health in managing the complexities associated with pandemics.

Public Health in the Field and the Emergency Operations Center: Methods for Implementing Real-Time Onsite Syndromic Surveillance at Large Public Events

To develop an onsite syndromic surveillance system for the early detection of public health emergencies and outbreaks at large public events. As the third largest public health jurisdiction in the United States, Maricopa County Department of Public Health has worked with academic and first-response partners to create an event-targeted syndromic surveillance (EVENTSS) system. This system complements long-standing traditional emergency department-based surveillance and provides public health agencies with rapid reporting of possible clusters of illness. At 6 high profile events, 164 patient reports were collected. Gastrointestinal and neurological syndromes were most commonly reported, followed by multisyndromic reports. Neurological symptoms were significantly increased during hot weather events. The interview rate was 2 to 7 interviews per 50 000 people per hour, depending on the ambient temperature. Discussion Study data allowed an estimation of baseline values of illness occurring at large public events. As more data are collected, prediction models can be built to determine threshold levels for public health response. EVENTSS was conducted largely by volunteer public health graduate students, increasing the response capacity for the health department. Onsite epidemiology staff could make informed decisions and take actions quickly in the event of a public health emergency.

Fueling the Public Health Workforce Pipeline Through Student Surge Capacity Response Teams

In January 2003, the University of North Carolina Center for Public Health Preparedness established Team Epi-Aid to match graduate student volunteers with state and local health departments to assist with outbreaks and other applied public health projects. This study assessed whether Team Epi-Aid participation by full-time graduate students impacted post-graduation employment, particularly by influencing students to work in governmental public health upon graduation. In September 2010, 223 program alumni were contacted for an online survey and 10 selected for follow-up interviews. Eighty-three Team Epi-Aid alumni answered the survey (response rate=37%). Forty-one (49%) reported participating in at least one activity, with 12/41 (29%) indicating participation in Team Epi-Aid influenced their job choice following graduation. In 6months prior to enrolling at UNC, 30 (36%) reported employment in public health, with 16/30 (53%) employed in governmental public health. In 6months following graduation, 34 (41%) reported employment in public health, with 27 (80%) employed in governmental public health. Eight alumni completed telephone interviews (response rate=80%). Five credited Team Epi-Aid with influencing their post-graduation career. Experience in applied public health through a group such as Team Epi-Aid may influence job choice for public health graduates.

Public Health Workforce in Switzerland: are public health workers lacking?

As public health workers, our core mission is to develop appropriate responses to the health needs of the population. This includes not only the prevention of diseases and the promotion and protection of health, but also the organization of health services and their evaluation. We want to ensure a fair distribution of public health benefits across the population (WHO 2006). These are ambitious, but achievable aims. A first step in this direction and a condition for success is to organize the transfer of knowledge from the scientific research realm to best practice interventions in the workplace. Therefore, we believe that the health of a population can be greatly increased by a qualified workforce specifically trained in public health sciences (Beaglehole 2003). A public health education can provide knowledgeable, prepared practitioners at all levels, who can achieve improved health outcomes and contribute to large-scale changes in the overall health of our societies. Currently, there is no shortage of discussion on the public health workforce and its training needs, especially among public health practitioners working in the public or semi-public sectors, as well as in private companies. A report by the WHO (2006) states that our global workforce capacity (size, training, and competencies) is currently misaligned with the health needs of the population. Bjegovic-Mikanovic et al. assert in their article ‘‘Education and training of public health professionals in the European Region: variation and convergence’’ (2013, this issue) that public health education in Europe is vastly insufficient to prepare workers for the ‘‘real world’’ of changing health risks, increasing health disparities and newly developing health technologies, among other pressing challenges. This body of research suggests a critical gap exists between actual public health needs and the extent to which public health workers are trained in basic and continuing public health education. Yet, if we are to better understand the needs of the workers, and better prepare our educational institutions to meet these needs, we need a more cohesive understanding of where public health graduates are going when they enter the workforce, and what they are doing. There have been several attempts to map professional engagements and educational backgrounds of the public health workforce (Frank et al. 2013, http://www.ssphplus. ch/downloads). In order to better assess our domestic workforce, the Swiss School of Public Health (SSPH?) recently conducted a census and created a profile of those currently employed in public health positions (Frank et al. 2013). We found that overall, respondents were well-educated (2/3 had at least a Bologna masters degree). However, 69 % of respondents in the workforce had no specific public health degree, suggesting that current workers, at all levels, could benefit from further training in specific public health skills. This finding is supported by our data showing ‘‘public health sciences’’ as one of the top-reported competency needs by workers. F. Paccaud A. Weihofen (&) Swiss School of Public Health, Seilergraben 49, 8001 Zurich, Switzerland e-mail: aweihofen@ssphplus.ch URL: http://www.ssphplus.ch

Labour market outcomes of public health graduates: evidence from Australia

Little information is available on the public health workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in Public Health (MPH) graduates in Australia, using data from the 1999-2009 waves of the Graduate Destination Survey. It was found that public health graduates had a high amount of female representation and very low proportions of indigenous representation. Public health graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of public health graduates working in public health roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for public health professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for public health graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the public health workforce should be a priority. Mapping of public health graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential public health workers with more comprehensive career trajectories.

Formação pedagógica na pós-graduação stricto sensu em saúde coletiva

The scope of this research is to discuss the relevance and need for pedagogical training of university lecturers in the Public Health field. The contention is that college teaching is a practice that requires specific training, since it is characterized by complex elements that transcend the mastery of given content. Considering stricto sensu graduate studies as an important stage in the training of future university lecturers, an attempt was made to identify and analyze the subjects and practices of pedagogical training in academic masters and doctorate programs in Public Health. To achieve the research aim, this work was based on Pierre Bourdieu's field theory and on Tomaz Tadeu da Silva's curriculum theory. Results indicate that the programs do not consider the aspect of teacher training as a major issue. With regard to the Public Health field approximately 61% of masters and 38% of doctorate programs have pedagogical training subjects/practices. Furthermore, there is a tendency for technical-instrumental training, which is in line with the history of the Public Health field. The conclusion is that there is a need to develop a culture that values college and graduate Public Health teaching, considering the complexity of pedagogical practice in all its dimensions.

Assessment of graduate public health education in Nepal and perceived needs of faculty and students

BackgroundDespite the large body of evidence suggesting that effective public health infrastructure is vital to improving the health status of populations, many universities in developing countries offer minimal opportunities for graduate training in public health. In Nepal, for example, only two institutions currently offer a graduate public health degree. Both institutions confer only a general Masters in Public Health (MPH), and together produce 30 graduates per year. The objective of this assessment was to identify challenges in graduate public health education in Nepal, and explore ways to address these challenges.MethodsThe assessment included in-person school visits and data collection through semi-structured in-depth interviews with primary stakeholders of Nepal’s public health academic sector. The 72 participants included faculty, students, alumni, and leaders of institutions that offered MPH programs, and the leadership of one government-funded institution that is currently developing an MPH program. Data were analyzed through content analysis to identify major themes.ResultsSix themes characterizing the challenges of expanding and improving graduate public health training were identified: 1) a shortage of trained public health faculty, with consequent reliance on the internet to compensate for inadequate teaching resources; 2) teaching/learning cultures and bureaucratic traditions that are not optimal for graduate education; 3) within-institution dominance of clinical medicine over public health; 4) a desire for practice–oriented, contextually relevant training opportunities; 5) a demand for degree options in public health specialties (for example, epidemiology); and 6) a strong interest in international academic collaboration.ConclusionDespite an enormous need for trained public health professionals, Nepal’s educational institutions face barriers to developing effective graduate programs. Overcoming these barriers will require: 1) increasing the investment in public health education and 2) improving the academic environment of educational institutions. Long term, committed academic collaborations with international universities may be a realistic way to: 1) redress immediate inadequacies in resources, including teachers; 2) encourage learning environments that promote inquiry, creativity, problem-solving, and critical thinking; and 3) support development of the in-country capacity of local institutions to produce a cadre of competent, well-trained public health practitioners, researchers, teachers, and leaders.

Graduate Global Public Health Education: Activities and Outcomes in Relation to Student Prior Experience

The Dalla Lana School of Public Health uses an “add-on” or concentration model of global health education. Records of masters’ graduate cohorts across five disciplinary fields from 2006 to 2009 were classified as to prior experience at application and completion of global health concentration requirements. Alumni from the first two cohorts (2006-08 and 2007-09) were interviewed using a semi-structured interview guide. Prior experience was not linked consistently with the number of elective courses, location of practica or completion of requirements. Successful completion of the global health requirements depended more on the student’s base disciplinary program. Interviewed alumni with medium prior experience reported greater satisfaction with the concentration. Alumni with lower prior experience wanted more courses and support with practica. The pros and cons of a concentration model of global public health graduate education are discussed.