Graduate Public Health Research Articles

Abstract A56: Sustainability and health education: Training public health students to deliver cancer information in Puerto Rico

Abstract Introduction: Cancer is the leading cause of death among Hispanics, currently the largest and fastest growing minority group in the US. Education plays an essential role in reducing cancer health disparities. Although community health workers (promotores) in Hispanic communities has been successful in health promotion and education initiatives, funding and training resource limitations may impact this model's sustainability and dissemination. In an effort to address these limitations, the NCI-funded U54 partnership between Moffitt Cancer Center and Ponce Health Sciences University (PSHU) developed a cancer education program to effectively deliver education in the community. The training program utilizes a culturally adapted version of “Cancer 101: A Cancer Education and Training Program” (Cancer 101) meeting the cultural needs and social context of Hispanics in Puerto Rico (PR). The purpose of this study was to train graduate public health students to disseminate cancer education to PR communities, Given that these students are likely to provide health education in a variety of community settings and contexts as part of their routine job responsibilities, to develop a sustainable cadre of public health professionals to deliver cancer education. Methods: Graduate students (n=32) from PHSU's Public Health program participated in a two-day Cancer 101 training, where they learned how to deliver nine cancer modules to the community: Cancer in PR, risk factors and prevention, early screening, diagnosis and stages, treatment, cancer and chronic illnesses, support for the survivor and the caregiver, biobanking, and cancer genetics. Participants also learned adult facilitation techniques and how to administer and analyze module pre- and post-tests. After each module was presented and discussed, cancer knowledge was assessed by using a total of 54 items to measure concepts discussed within each module, both before and after the training. At the end of the two-day training, participants completed a training evaluation, with items informed by the Social Cognitive Theory (SCT), which addresses the dynamics between communication and behavior change. Participants were asked to read each item and indicate if each statement was true, false, or if they were not sure. Items were recoded (1=correct, 0=incorrect or not sure) and scores added for total module scores, with higher scores meaning higher knowledge. Basic demographic frequencies were calculated and paired t-tests were conducted to measure students' gained knowledge. Lastly, means and standard deviations were calculated on evaluation items that assessed SCT constructs of self-efficacy, observational learning, facilitation, and outcome expectations. Results: Training participants were mainly female (78.1%), 26.7(+3.9) years old and enrolled in a Masters-level program (81.3%). The pre and post-test mean score (SD) were 38.25(4.00) and 49.63(2.65) out of the 54 questions with a 11.38 point increase in overall cancer knowledge [t(31)=14.88, p<.000], with all but one module (Module 3: Cancer Screening [t(31)=1.28, p=0.211]) showing statistically significant increases after receiving the two-day Cancer 101 training. Participants also evaluated the training favorably upon completion, reporting satisfactory comments in the open-ended responses and high levels on measured SCT constructs, which are important to ensure information is adequately delivered to community members. Conclusion: The Cancer 101 training allowed students to learn how to deliver cancer education to local communities. The availability of well-trained graduate students to serve as health educators is an innovative, sustainable way to deliver health education to local communities. These trained students will assist in efforts to disseminate cancer information and increase knowledge and attitudes about cancer prevention, early detection, treatment, and research in southern PR. Citation Format: Laura Moreno, Yonaira Rivera, Himilce Vélez, Julio Jiménez, Susan Vadaparampil, Teresita Muñoz-Antonia, José Torres, Gwendolyn Quinn. Sustainability and health education: Training public health students to deliver cancer information in Puerto Rico. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A56.

Using Social Media as a Pedagogical Tool in Graduate Public Health Education and Training

Public health is a complex field where current information and evidence available to inform best practices are constantly changing. With the rise of social media influencing public health actions, it is becoming more important for those working in the sector to have a proficient understanding of this form of communication. Social media use amongst public health organizations is also on the rise. Twitter, Facebook, and YouTube have been used to disseminate timely information as well as for public health education. We argue that formally integrating social media as a pedagogical tool in public health graduate programs would benefit both, educators and students as well as the public health field in which students will work. Communication skills have been included in core competencies for public health professionals as an essential skill. Critical in that skill is the ability to work with new methods of communication, such as social media. We bring forward the idea that social media should both be used in teaching and taught as an essential skill. Using social media as an educational tool is an opportunity to ensure that graduate public health programs train students with the competencies to work in public health.

Occupational health training in India: Need for a competency-driven approach.

Background:In order to cater to the changing business scenario, employment and education profiles of labor, newer occupations, and emerging occupational health challenges, it is time to improve the performance of occupational health professionals by adapting core professional competencies while drawing on global knowledge.Objective:To delineate the competencies required for medical graduates, medical postgraduates, and Masters in Public Health (MPH) graduates practicing occupational health in India.Materials and Methods:First, offline and online literature searches were carried out to enlist the core competencies for occupational health. A draft template was prepared for the identified competencies and stakeholders were asked to rank the listed competencies on a three-point scale stating must, desirable, and not required for each of the three categories of professionals, i.e., medical graduates, medical postgraduates, and MPH graduates.Results:Through the extensive literature search, 23 competencies were identified for occupational health practitioners. According to stakeholders, five competencies were a must, nine were desirable, and nine were not required by a medical graduate. Similarly for a medical postgraduate, except the ability to judge the ergonomic design of the workplace and working tools, which is considered desirable, all other competencies were considered a must while for an MPH graduate all the enlisted 23 competencies were considered a must by the stakeholders.Conclusion:The framework of occupational health competencies developed through this research can be used to strengthen the training of occupational health professionals in India.

A Citizen-Science Study Documents Environmental Exposures and Asthma Prevalence in Two Communities.

A citizen-science study was conducted in two low-income, flood-prone communities in Atlanta, Georgia, in order to document environmental exposures and the prevalence of occupant asthma. Teams consisting of a public-health graduate student and a resident from one of the two communities administered a questionnaire, inspected residences for mold growth, and collected a dust sample for quantifying mold contamination. The dust samples were analyzed for the 36 molds that make up the Environmental Relative Moldiness Index (ERMI). Most residents (76%) were renters. The median duration of residence was 2.5 years. Although only 12% of occupants reported a history of flooding, 46% reported at least one water leak. Homes with visible mold (35%) had significantly (P < 0.05) higher mean ERMI values compared to homes without (14.0 versus 9.6). The prevalence of self-reported, current asthma among participants was 14%. In logistic regression models controlling for indoor smoking, among participants residing at their current residence for two years or less, a positive association was observed between asthma and the homes' ERMI values (adjusted odds ratio per unit increase in ERMI = 1.12, 95% confidence intervals (CI): 1.01–1.25; two-tailed P = 0.04). Documentation of the exposures and asthma prevalence has been presented to the communities and public officials. Community-based organizations have taken responsibility for planning and implementing activities in response to the study findings.

Service-Learning in Undergraduate Global Health Education: The Effect of Team Dynamics on Civic Attitudes and Skills

Social justice is most effectively taught through experiential learning, including practicums, internships, and service-learning (SL). Service-learning provides solid conceptualizations, with the potential for improving civic attitudes (i.e., social responsibility and participation). Graduate public health programs have traditionally required SL internships designed to enhance civic attitudes and skills, which has led to the recent incorporation of SL courses into undergraduate curricula. The authors assessed the benefits of SL in undergraduate public health education using the Civic Attitudes and Skills Questionnaire administered to enrollees (n = 43) in a global health SL course at the University of Alabama at Birmingham. Variability among student groups by major, gender, academic year, partner type, honors college status, team dynamics, and previous SL experience was determined. Overall, students reported increases in their civic attitudes and skills. However, team dynamics emerged as the most important associated factor. Individuals reporting poor team dynamics consistently reported lower levels of improvement than those reporting great team dynamics.

Graduate public health training in healthcare of refugee asylum seekers and clinical human rights: evaluation of an innovative curriculum.

An innovative curriculum was developed to equip public health students with appropriate attitude and skills to address healthcare of asylum seekers. Implemented in 2005 the curriculum included: (1) didactic sessions covering epidemiology and health sequelae of torture, asylum laws, and approaches to identify survivors' healthcare needs; (2) panel discussions with survivors and advocates; and (3) participating in medico-legal process of asylum seeking. Complementary mixed methods evaluations included pre- and post-curriculum questionnaires, formal curriculum evaluations, final papers and oral presentations. 125 students participated. Students showed improved knowledge regrading sequelae of abuse and survivors' healthcare needs (P<0.01), improved attitudes towards working with survivors (P<0.05) and self-efficacy in identifying at-risk populations and addressing healthcare of survivors (P<0.05). Students reported increased desire to pursue global health and human rights careers. As an advocacy and cultural competency training in public health practice addressing healthcare of refugees domestically, this curriculum was well received and effective, and will also help students better serve other similar populations. Population case-based domestic opportunities to teach global health and health and human rights should be effectively utilized to develop a well-equipped global health corps.

Training in Infectious Disease Epidemiology through the Emerging Infections Program Sites.

One objective of the Emerging Infections Program (EIP) of the US Centers for Disease Control and Prevention is to provide training opportunities in infectious disease epidemiology. To determine the extent of training performed since the program's inception in 1995, we reviewed training efforts at the 10 EIP sites. By 2015, all sites hosted trainees (most were graduate public health students and physicians) who worked on a variety of infectious disease surveillance and epidemiologic projects. Trainee projects at all sites were used for graduate student theses or practicums. Numerous projects resulted in conference presentations and publications in peer-reviewed journals. Local public health and health care partners have also benefitted from EIP presentations and training. Consideration should be given to standardizing and documenting EIP training and to sharing useful training initiatives with other state and local health departments and academic institutions.

Enumeration of the Schools and Students of Public Health in Canada

Canada has experienced a growing trend in university public health education since the severe acute respiratory syndrome outbreak of 2003. However, the number of universities offering undergraduate and graduate public health degrees has not been accurately enumerated. Our study objectives were to quantify the university public health programs in Canada, examine the number of students graduating from these programs, and identify any trends and gaps. Websites of Canadian universities were reviewed to identify public health degree programs. We examined their academic units, degrees offered, year of establishment, references to public health core competencies, offerings of continuing education, and accreditation status. The faculties were contacted via survey, email, and/or phone to obtain the number of students issued a degree. We identified 36 faculties in 32 universities in Canada offering public health–related programs (four faculties offered programs accredited by a public health association). At present, 17 universities offer Master of Public Health degrees, representing over a threefold increase since 2003. We observed a twofold increase in the number of undergraduate and graduate public health students in the past 5 years. About two thirds of the universities stated a competencies-based learning curriculum, and less than half of the faculties offered continuing education opportunities for public health professionals. In little over a decade, public health education in Canada has changed from a subspecialty of medicine to distinct academic and research institutions. Further study is needed to determine the influences of the increase in public health academic programs and their graduates on Canada’s public health workforce.

Defining and Developing a Global Public Health Course for Public Health Graduates.

Global public health is increasingly being seen as a speciality field within the university education of public health. However, the exact meaning of global public health is still unclear, resulting in varied curricula and teaching units among universities. The contextual differences between high- and low- and middle-income countries, and the process of globalization need to be taken into account while developing any global public health course. Global public health and public health are not separable and global public health often appears as an extension of public health in the era of globalization and interdependence. Though global public health is readily understood as health of global population, it is mainly practiced as health problems and their solutions set within low- and middle-income countries. Additional specialist competencies relevant to the context of low- and middle-income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalization and its impact on health; disease burden; culture, society, and politics; and management are important.

A Pilot Study of Short Computing Video Tutorials in a Graduate Public Health Biostatistics Course

Traditional lecture-centered classrooms are being challenged by active learning hybrid curricula. In small graduate programs with limited resources and primarily non-traditional students, exploring how to use online technology to optimize the role of the professor in the classroom is imperative. However, very little research exists in this area. In this study, the use of short statistical computing video tutorials was explored using a pilot study in a small Public Health Program at the University of New Mexico. The videos were implemented in two Master's-level biostatistics courses and student perception of the videos was assessed using quantitative surveys and qualitative focus groups. The results from 16 survey respondents and 12 focus group participants are presented across the two courses. Viewing rates for the videos were high, with 15 out of 16 respondents reporting usually or always viewing the videos. Overall perception of the videos as a learning tool was positive, with 14 out of 16 respondents agreeing that the videos offer advantages to them. Two prominent themes emerged in our analysis: (1) the usability and convenience of the videos and (2) the deeper learning facilitated by having the videos available. We conclude that the short video tutorials were a useful learning tool in our study population.

A needs assessment survey of dental public health graduate education in Saudi Arabia.

ObjectivesThe Faculty of Dentistry at King Abdulaziz University (KAU) is planning to develop a master’s program in dental public health (DPH). To develop a curriculum for this program, a needs assessment was conducted in order to identify the level of DPH expertise that currently exists in Saudi Arabia, to identify gaps in knowledge, and to explore current perceptions regarding this type of program.MethodsA competency-based survey instrument was administered to private and government affiliated dental practitioners in Jeddah, Saudi Arabia. Participants’ knowledge, attitudes, and competencies in DPH were assessed. In addition, questions were submitted that addressed preferred strategies of teaching, curriculum delivery methods, course content, and prerequisites for DPH. These data were combined with data previously collected from dentists holding academic positions at KAU (n = 146) and were analyzed using Statistical Analysis System version 9.3 software. Mean values and frequencies were calculated for the study variables. Proportional odds ratios and 95% confidence intervals were estimated to assess differences in educational preferences and DPH competencies according to age, gender, and qualification.ResultsMost of the participants (95%) reported a need for a DPH graduate program. The respondents had a basic knowledge of DPH and moderate experience in DPH competencies. A variety of preferred educational strategies and methods were identified and differences in educational preferences according to age, gender, and qualification of the respondents were identified. The responses obtained also acknowledged skills and competencies that the participants considered most important for a DPH practice and that would be important for students accepted into a DPH graduate program.ConclusionsThis needs assessment survey represents a preliminary step in establishing a DPH graduate program that addresses current gaps in knowledge and in the practice of public health dentistry. This survey also provided valuable feedback regarding the development of course content for a graduate education program in DPH.

Türkiye’de Halk Sağlığı Uzmanları İçin İnsangücü Planlaması (2013-2023)

Abstract Objective: We aim to make a manpower planning forpublic health specialists between the years 2013-2023 in Turkey. Methods: Manpower planning of public health specialists is calculated on the basis of population and institutional necessities. Data is supplied from the databases of HASUDER, OSYM, Turkish MoH, YOK and the Departments of Public Health’s. Results: There are 520 public health specialists and 286 public health specialization students in Turkey in 2013. Specialization training is supplied at the 57 departments of public health. Nearly half of the public health specialists’ work for Ministry of Health (51%), while 47% of public health specialists works for universities. Totally 2014 specialists are required for Turkey in 2013. This number will be increased to 2365 in 2023. In this situation there is one specialist per 145.000 people in Turkey in 2013, while it had to be one specialist for per 37.537 people. According to our findings there will be a serious lack of public health specialists in 2018. However if public health specialization students quota is increased to 200 per year, public health specialist requirement will be almost completed in the institutions of Ministry of Health in 2023. Conclusions: However, if additional public health specialist requirements of other ministries, international organizations and municipalities are considered not only specialists, public health graduates in MPH and PhD should also definitely be used for manpower planning. Key Words: Public Health Specialist, health manpower planning

A Web-Based Platform for Educating Researchers About Bioethics and Biobanking.

Participation in biobanking among individuals with familial risk for hereditary cancer (IFRs) and underserved/minority populations is vital for biobanking research. To address gaps in researcher knowledge regarding ethical concerns of these populations, we developed a web-based curriculum. Based on formative research and expert panel assessments, a curriculum and website was developed in an integrative, systematic manner. Researchers were recruited to evaluate the curriculum. Public health graduate students were recruited to pilot test the curriculum. All 14 researchers agreed the curriculum was easy to understand, adequately addressed the domains, and contained appropriate post-test questions. The majority evaluated the dialgoue animations as interesting and valuable. Twenty-two graduate students completed the curriculum, and 77% improved their overall test score. A web-based curriculum is an acceptable and effective way to provide information to researchers about vulnerable populations' biobanking concerns. Future goals are to incorporate the curriculum with larger organizations.

Integrating journalism and public health to promote training and education on global health reporting

Abstract Background As the Ebola epidemic and other emerging diseases have shown, global health journalism has an influential role in public health action and inaction. Practical experience is important in preparing young people in ethical and technically accurate global health reporting. However, such training has not traditionally been incorporated into global public health education. The Center for Global Public Health at the University of California (UC), Berkeley, USA, was created in 2008 to foster global health research and education across the entire campus. Part of its aim is to foster transdisciplinary public health research and learning through global public health opportunities for students. Methods In 2013, the UC Berkeley Center for Global Public Health and the UC Berkeley Graduate School of Journalism partnered to create a new global health reporting internship that enables both public health and journalism graduate students the opportunity to investigate issues related to health disparities and/or health equity in low-to-middle-income countries. The programme seeks to provide faculty mentoring and guidance for interns who want to gain on-the-ground experience in reporting on important global health issues in developing countries. The fellowship is offered annually via a competitive application process, and the first two recipients completed their internships in the summer of 2014. Findings One Master of Public Health student explored migrant health and repatriation in Burundi, and a Master of Journalism student studied family planning in Burkina Faso. Their stories were printed or broadcasted through radio, print, and web media. They have also presented their work and talked about their experience at academic symposia and various media and online platforms. The students are now better prepared in their careers to share public health narratives on important global health issues. With the internship, they have also enriched their public health and journalism learning in their existing degree programmes. Interpretation The positive response to the internship programme by all involved indicates a need to further the programme both at UC Berkeley and beyond. Such transdisciplinary internships and opportunities should be supported by not only traditional public health disciplines but also journalism programmes, especially as the numbers of global health centres and programmes flourish across the USA and elsewhere. Funding UC Berkeley Center for Global Public Health/UC Berkeley School of Journalism

Bridging graduate education in public health and the liberal arts.

The University of Massachusetts Amherst is part of Five-Colleges Inc, a consortium that includes the university and four liberal arts colleges. Consortium faculty from the School of Public Health and Health Sciences at the university and from the colleges are working to bridge liberal arts with public health graduate education. We outline four key themes guiding this effort and exemplary curricular tools for innovative community-based and multidisciplinary academic and research programs. The structure of the consortium has created a novel trajectory for student learning and engagement, with important ramifications for pedagogy and professional practice in public health. We show how graduate public health education and liberal arts can, and must, work in tandem to transform public health practice in the 21st century.

Innovations in graduate public health education: the Instituto Nacional de Salud Pública.

During the past 10 years, the Instituto Nacional de Salud Pública (National Institute of Public Health) in Mexico has meticulously revised its educational model. This analysis resulted in the transformation of its educational model by tracing a new path in the pedagogical structure and faculty development to meet current challenges and students' needs. The first stage dealt with the national and international accreditation standards that came with the 21st century. The second stage responded to evidence of cognitive research showing that students are better prepared when they are engaged, active, and responsible for their own learning. This transformation was grounded on the use of information and communication technologies and on a competency-based educational approach that has led the expansion and innovation of educational practice.

Redefining leadership education in graduate public health programs: prioritization, focus, and guiding principles.

Public health program graduates need leadership skills to be effective in the complex, changing public health environment. We propose a new paradigm for schools of public health in which technical and leadership skills have equal priority as core competencies for graduate students. Leadership education should focus on the foundational skills necessary to effect change independent of formal authority, with activities offered at varying levels of intensity to engage different students. Leadership development initiatives should be practice based, process focused, interdisciplinary, diversity based, adaptive, experimental, innovative, and empowering, and they should encourage authenticity. Leadership training in graduate programs will help lay the groundwork for public health professionals to have an immediate impact in the workforce and to prioritize continuous leadership development throughout their careers.

Progress in the articulation of undergraduate and graduate public health?

Historically, in the absence of baccalaureate education in the public health, entry level education was offered at the graduate level in the Master of Public Health (MPH) degree. As MPH education was not preceded by baccalaureate education in the discipline, there are not typically prerequisite requirements for MPH admission, and introductory coursework in public health has always been offered at the graduate level. Other disciplines including business and nursing offer joint and dual degree programs; however, these programs are typically designed to accelerate completion of baccalaureate and graduate degrees (1–4) rather than supplement graduate with undergraduate education. While the developers of new undergraduate public health programs may look at the experience in other disciplines, public health presents the atypical characteristic that well-established graduate education preceded undergraduate education. In addition, review of a variety of accelerated programs at different universities demonstrates that they tend to be unique to individual universities rather than of a standard design.

Teaching Note—Educating Public Health Social Work Professionals: Results From an MSW/MPH Program Outcomes Study

Dual-degree programs in public health and social work continue to proliferate, yet there has been little research on master’s of social work (MSW)/master’s of public health (MPH) graduates. The purpose of this study was to describe and better understand the self-reported professional experiences, identities, roles, and outcomes associated with 1 group of graduates from an established MSW/MPH program. A 57-question electronic survey was administered to 214 alumni in 2010; the response rate was 71.4% (n = 153). Findings provide a snapshot of public health social work alumni experiences, including diverse employment opportunities, high career satisfaction, and a strong sense of reported public health and social work integration in the workplace.

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference