Public Health Curriculum Research Articles

Realigning the Master of Public Health (MPH) to Meet the Evolving Needs of the Workforce

Graduate public health education is evolving rapidly as a function of complex and interrelated factors including rising student debt, a changing economy and job market, varied perceptions of the value of higher education, and new educational technologies affecting how courses and programs are delivered. At the same time, employers are seeking more highly trained public health professionals across a broader range of industries including, but not limited to, government, health care, pharmaceutical, consulting, and education. We redesigned the Boston University Master of Public Health (BU MPH) curriculum to provide students with integrated foundational knowledge; specialized skills and training in key areas sought after by employers across industries and functions; and activities to build student’s professional capabilities and confidence. The BU MPH, detailed in this article, provides an illustration of an MPH that is interdisciplinary, flexible, and adaptable to meet the changing needs of the workforce.

The Healthy Fitness Zone Continuum Score as a Measure of Change in Body Mass Index of School-Aged Children and Adolescents, Georgia, 2012-2014

The FitnessGram Healthy Fitness Zone continuum (HFZc) score reflects the relative difference of a person's body mass index (BMI) from the established FitnessGram standard. As such, it may provide added utility for public health programming and research on obesity among school-aged children and adolescents. We used the standard BMI Z (BMIz) score and the alternative HFZc score to describe changes in BMI of school-aged children and adolescents in Georgia over time. We compiled 2012-2014 BMI data from the Georgia FitnessGram database. The sample included 162 992 boys and 141 711 girls enrolled in 239 schools from a large urban district in Georgia. We analyzed trends in BMIz and HFZc scores separately for normal-weight, overweight, and obese categories for school-aged children and adolescents using hierarchical linear models. From 2012 to 2014, the BMIz score shifted favorably in up to 40.7% (2052/5047) of normal-weight, 51.0% (758/1485) of overweight, and 52.8% (5430/10 279) of obese students. We also found favorable shifts in HFZc score in up to 69.8% (105 831/151 739) of normal-weight, 78.3% (3605/4603) of overweight, and 80.8% (8305/10 279) of obese students. Compared with the BMIz score, the HFZc score may be a better indicator of favorable changes in BMI over time among school-aged children and adolescents with different baseline BMI levels, making it potentially valuable for use in individualized assessments, school programs, obesity research, and public health curriculum and policy development.

Application of the Intervention Mapping Framework to Develop an Integrated Twenty-first Century Core Curriculum-Part Three: Curriculum Implementation and Evaluation.

Public health professionals have been challenged to radically reform public health training to meet evolving demands of twenty-first century public health. Such a transformation requires a systems thinking approach with an interdisciplinary focus on problem solving, leadership, management and teamwork, technology and information, budgeting and finance, and communication. This article presents processes for implementing and evaluating a revised public health curriculum and outlines lessons learned from this initiative. To date, more than 200 students have participated in the initial pilot testing of this program. A rigorous process and outcome evaluation plan was developed and employed. Results from the evaluation were used to enhance the resulting curriculum. Specifically, all instructional materials were evaluated by both the students who received the materials and the faculty who presented the materials. As each successive pilot is delivered, both enrollment and faculty involvement has increased. Through this process, the value of committed faculty, the importance of engaging learners in the evaluation of an education program, and the need to implement curriculum that has been carefully evaluated and evidence-informed in nature has emerged. We credit our successful transformation of the Masters in Public Health core to the challenge provided by the Framing the Future task force, the commitment of our College of Public Health leadership, the engagement of our faculty, and the time we allowed for the process to unfold. Ultimately, we believe this transformed curriculum will result in better trained public health professionals, interdisciplinary practitioners who can see public health challenges in new and different ways.

Global Health Teaching in India: A Curricular Landscape.

Today, health has transcended national boundaries and become more multifaceted. Global health has evolved as a new paradigm and is recently being identified as a thrust area now in India. Despite an existing need for a standardized global health curriculum, there is little information available on its education and curriculum in medical and health education space. In the Indian context, we are yet to have a fuller picture of the current status, including, content, structure, selection, teaching methods of global health, and how students are evaluated in India. The objective of this study was to map courses relating to studies on global health in India and analyze its mode of delivery. A detailed Internet search was carried out to identify global health courses and analyzed for: (i) whether global health is a part of the teaching curriculum, (ii) mode of teaching, (iii) broad contents, (iv) instructional formats, (v) assessment, and (vi) selection process. It was found that delivery of global health education in India was fragmented with limited focus at the undergraduate and postgraduate levels. Global health teaching was largely based on certificate courses or online courses, with hardly any institutions imparting a distinct global health education program. There is also no definite specification as to which institutes can impart teaching on global health education and what the specific eligibility requirements are. Our analysis suggests that efforts should be directed toward integrating global health education into broader public health curriculum. At the same time, the need for generation of global health leaders, creation of a common forum for addressing merits and demerits of global health issues, as well as creation of more opportunities for placements are recognized.

Student Involvement in Curriculum Development Enhances Medical Education

Background: During the 2014 annual review of the curriculum for first year medical students at the Medical College of Georgia, the public health module was noted as an area that needed improvement. To address this concern, a Public Health Curriculum Workgroup was formed for the purpose of identifying specific areas to improve and developing a more robust and integrative curriculum. A small cohort of medical students with public health backgrounds were invited to be members of this workgroup and participate in the development and delivery of public health content to the next cohort of first year medical students. We hypothesized that having this type of student participation results in a more clinically relevant and engaging curriculum.

Teach 100: Teaching Aggregate Education in Public Health Curriculum.

Teach 100: Teaching Aggregate Education in Public Health Curriculum.

Sexual and Gender Minority Health Curricula and Institutional Support Services at U.S. Schools of Public Health

ABSTRACTLimited research has examined the ways in which public health training programs equip students to address health disparities affecting the lesbian, gay, bisexual, and transgender (LGBT) community and other sexual and gender minority (SGM) populations. This study outlines the availability of public health curricula on SGM health topics, and the prevalence of LGBT and SGM-inclusive institutional support services across CEPH-accredited U.S. schools of public health. Content analysis of all course offerings related to gender and sexuality revealed a limited focus on sexual and gender minority health: just 4.7% of courses contained keywords indicating that LGBT or SGM health topics were covered. Similar analysis of institutional support services available at U.S. schools of public health found that only 25% of schools had LGBT student organizations, and just 19% had an office of diversity that specifically advertised LGBT or SGM-inclusive programming or services on the institution’s Web site. Finally, only two of 52 schools offered an educational certificate centered on LGBT health. These findings illustrate a significant need for enhanced curricular content and institutional support services that equip public health students to address SGM health disparities. Improvement in this area may encourage future health care professionals to work to reduce these disparities, to improve SGM persons’ experiences in health care settings, and to generate further research in this area.

Framing Undergraduate Public Health Education as Liberal Education: Who Are We Training Our Students To Be and How Do We Do That?

The rapid development of the undergraduate major in public health over the past 15 years has led to a debate about the most appropriate framing for the degree. Should it be viewed as a liberal education degree (akin to academic disciplines such as psychology and political science) or as a professional training degree (akin to disciplines such as nursing and management)? This paper presents an overview of both the liberal education and the professional training degree approaches to the undergraduate public health degree. The reality of public health work in the modern era and the constraints on undergraduate-level training lead to our conclusion that the liberal education framing is a more optimal way to design the degree program. Such a framework optimizes career opportunities, especially long-term opportunities, for graduates, acknowledges the reality of the complex and diverse career paths that one can take under the general umbrella of public health, and accounts for the important role of critical thinking skills in undergraduate education. Ultimately, the distinction between liberal education and professional training may be fuzzier than the debate often highlights—an intentional, well-designed, and thoughtfully implemented undergraduate public health curriculum can address the range of student needs underlying both the liberal education and professional training approaches to the degree, thus optimizing both learning goals and career outcomes for undergraduate public health students.

And Why So Great a "No?": The Donor and Academic Communities' Failure to Confront Global Chronic Disease.

Chronic diseases are the dominant issues for global public health in terms of mortality, morbidity, and cost, and they have been identified as such for >40 years. Despite their predominance, however, these diseases—cardiovascular disease (CVD), diabetes, cancer, pulmonary disease, mental health, and dementia—attract little attention in the public health curriculum and even less from the funding community. We explore the rationales that have perpetuated this inability or unwillingness to match need with effort. We examine 3 concepts that impede changing this relationship: 1) the traditional contextual view of public health that emerged, to be sure with great success, in the post–World War II era; 2) the failure of public health to transition to economic development as the goal of health assistance; and 3) the unwillingness of public health to confront social, political, and economic policies as the foci of upstream drivers of the public's health. We conclude with a discussion of the need for public health to expand its horizon and tear down the walls of the silos that inhibit the emergence of relevant global public health.

Policy Help Needed, Experience Required

There is a shift toward a "health in all policies" approach in public health; however, most practitioners are not equipped with the necessary knowledge or skills to engage in and practice policy. This study explores how public health professionals can become policy practitioners and better engage in the policy process. This article also provides recommendations for training programs on how to increase students' policy-related knowledge and skills. We conducted in-depth interviews with 10 public health policy experts in the United States spanning academic, governmental, advocacy, and practice settings. Key informants provided perspectives regarding strengths and skill sets that practitioners need to better position themselves to do policy-relevant work and opportunities for public health programs to improve training. The research team conducted thematic analyses to determine commonality among expert responses. Informants identified a number of strengths and skills that either support or impede practitioners' ability to conduct policy work and proposed recommendations for public health curricula to integrate policy-related coursework or practical experiences to prepare practitioners for policy careers. Public health professionals need to become more politically astute to practice and advance public health policy. To facilitate the development of such skills, public health training and pedagogy must integrate policy practice into traditional public health coursework, include new policy-focused courses, and provide opportunities for real-world policy experience.

Knowledge, attitudes and practices of prevention for cervical cancer and breast cancer among medical students.

Objective To assess the knowledge, attitudes and practices of medical students for health promotion, primary prevention and early detection of breast neoplasm and uterine cervical neoplasm, as well as to make recommendations for improving the Public Health curriculum at the Universidad de los Andes. Methodology This study utilized a survey of medical knowledge, attitudes and practices applied to fifth year Colombian medical students attending the Universidad de los Andes in the first semester of 2013. Results 64/76 students answered the surveys (response rate 84.2 % ): 62.5 % (40/64) and 37.5 % (24/64) response rates from students in their ninth and tenth semesters, respectively; and 64.1 % (41/64) and 35.9 % (23/64) response rates from female and male students, respectively. Knowledge: clinical breast exam (CBE), breast self-examination (BSE) and mammography were recommended by 95.3 % (61/64) of students, 96.9 % (62/64) of medical students and 90.7 % (58/64) of students, respectively. Attitude: the most effective tests to reduce mortality in women aged ≥ 50 years were the Papanicolaou test according to 90.6 % (58/64) of students and mammography according to 82.8 % (53/64) of students. Practice: 55.0 % (35/64) of students had received training in the guidelines and protocols for breast neoplasm and uterine cervical neoplasm screening. Discussion To promote early detection of cervical and breast cancer, knowledge, attitudes and practices must be improved to enhance clinical practices (e.g. Papanicolaou test) and medical student training guidelines or protocols for these two cancers. Overall, with induced demand and support from research communities and institutions seeking to make these improvements, we collaborate to decrease missed opportunities in medical research and Public Health.

Framing the Future: Exploring Inter-Professional Education and Practice in an Undergraduate Course

Framing the Future: Exploring Inter-Professional Education and Practice in an Undergraduate Course

An exploratory study of the need for curriculum review of Master of Public Health Degree at a Rural-based University in South Africa.

BackgroundMaster of Public Health (MPH) training programmes were developed worldwide in response to the crisis in human resources for health.AimTo determine whether the MPH programme at the selected rural-based university in South Africa enabled students to achieve the MPH core competencies relevant for Lower Middle Income Countries.SettingThe study was carried out at a rural-based University in South Africa. The target population was the 2011 first-year cohort of MPH students who by the beginning of 2014 had just completed their coursework.MethodologyA quantitative cross-sectional descriptive research design was adapted. Eighty-five students were randomly selected to participate in the study. A structured questionnaire comprising seven competency clusters was developed. The selected students completed a self-administered questionnaire. Only those students who signed consent forms participated in this study. The questionnaire was tested for construct validity and reliability using 10 students with similar characteristics to those sampled for the study. Microsoft Excel software was used to analyse the data descriptively in terms of frequency and percentages.ResultsThe students were confident of their competencies regarding public health science skills. Amongst these were analytical assessment, communication, community and inter-sectorial competencies as well as ethics. However, the students lacked confidence in context-sensitive issues, planning and management, research and development, and leadership competencies. Yet the latter is the backbone of public health practice.Conclusion and recommendationThere is a need for revamping public health curricula. In this respect, a follow-up study that builds a deeper understanding of the subject is needed.

Special Volume 2015: A Global Public Health Curriculum

Special Volume 2015: A Global Public Health Curriculum

Using popular education with health promotion students in the USA: Table 1:

Recent publications have called for new approaches to training the next generation of health promotion professionals, for whom effective practice depends on understanding how systemic inequities are created and function and how they can be dismantled. These approaches gain particular urgency in the context of recent trends toward commodification of knowledge at both the secondary and post-secondary levels. Popular education, a liberatory pedagogy, has been used in social movements around the world for decades. In a health promotion context, its use has been associated with increased empowerment and improved health. To explore the potential of popular education (PE) for helping health promotion students develop a systemic analysis of power and privilege and the concrete skills needed to address health and social inequities, we conducted a case study in the context of a community organizing class in a Master's in Public Health curriculum. Analysis of mixed methods data collected from students suggested that PE, with its focus on concrete practices and interactions, is a valid alternative to conventional pedagogy and a useful complement to liberatory pedagogies more common in university classrooms. Application of PE in higher education will require overcoming barriers, including student resistance and institutional pressures that discourage its use.

Using consensus methods to develop a country-specific Master of Public Health curriculum for the Republic of Maldives.

BackgroundOver the last four decades, the health status of Maldivian people improved considerably, as reflected in child and maternal mortality indicators and the eradication or control of many communicable diseases. However, changing disease patterns are now undermining these successes, so the local public health practitioners need new skills to perform effectively in this changing environment. To address these needs, in 2013 the Faculty of Health Sciences of the Maldives National University developed the country’s first Master of Public Health (MPH) program.MethodsThe process commenced with a wide scoping exercise and an analysis of the curricular structure of MPH programs of high-ranking universities. Thereafter, a stakeholder consultation using consensus methods reached agreement on overall course structure and the competencies required for local MPH graduates. Subsequently, a working group developed course descriptors and identified local public health research priorities, which could be addressed by MPH students.ResultsTen semistructured interviews explored specific training needs of prospective MPH students, key public health competencies required by local employers and preferred MPH training models. The recommendations informed a nominal group meeting, where participants agreed on MPH core competencies, overall curricular structure and core subjects. The 17 public health electives put forward by the group were prioritized using an online Delphi process. Participants ranked them by their propensity to address local public health needs and the locally available teaching expertise. The first student cohort commenced their MPH studies in January 2014.ConclusionConsensus methods allowed a broad stakeholder engagement with public health curriculum development and the creation of a country-specific curriculum, informed by local realities and needs.

Postdoctoral degree in humanistic medical science: The first development from a public health curriculum unit

Postdoctoral degree in humanistic medical science: The first development from a public health curriculum unit

Incorporating practical application in graduate introductory public health courses

Purpose – The purpose of this paper is to examine the utility of a redesigned course assessment in a required, introductory Master of Public Health (MPH) course to demonstrate competency achievement through practical application. School of public health curricula are informed by competency-based education (CBE) to prepare students for the field. This is a challenge in introductory courses as traditional assessments do not translate into practical application of knowledge. Design/methodology/approach – This retrospective post-test-only evaluation examined a practice-based, multi-disciplinary assessment utilized in Fall 2014 (n = 63 students). Web-based surveys were administered three months after the course to participating students (n = 33), the teaching team or teaching teams (n = 7) and organization representatives (n = 3) to evaluate the utility of the assessment. Questions were analyzed descriptively using chi-square tests, where applicable responses were compared across groups. Findings – Results indicate that a practice-based assessment in an introductory MPH course may enhance student learning by fostering deeper appreciation and application of course content while more closely reflecting the collaborative, multi-disciplinary and problem-solving nature of practice. The assessment may also increase the depth of competency achievement and career preparedness. Practical implications – Institutions that are guided by CBE, train students for multi-disciplinary practice and are impacted by the changing landscape of the field may want to consider course assessments that mimic practice to best prepare students. Originality/value – Course assessments should be evaluated to ensure they appropriately measure competency achievement. This evaluation provides multiple perspectives on the process and outcome of a practice-based course assessment.

Building Interdisciplinary Leadership Skills among Health Practitioners in the Twenty-First Century: An Innovative Training Model.

Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.

Pilot testing a predoctoral dental public health curriculum: reporting process and outcomes.

The purpose of this study was to pilot test the predoctoral dental public health (DPH) curriculum developed by the American Association of Public Health Dentistry (AAPHD) in various US dental schools and dental hygiene programs. Following the Lewy's theoretical framework, we used all three curriculum tryout methods (laboratory tryout, pilot tryout, and field tryout) for the pilot testing process. Open-ended questions on the structure, presentation, and content of the curriculum were sent to faculty pilot testing the DPH curriculum to obtain critical feedback and comments. Between Summer 2013 and Spring 2015, the curriculum was pilot tested in nine dental schools and seven dental hygiene programs with over 1,300 students. The majority of the comments from the faculty were favorable. Positive comments about the structure of the curriculum focused on the well-organized nature of the curriculum, the value of the instructor guide and speaker notes, rubrics, and the flow of the presentations. In terms of the content, faculty commented on the wide range of public health issues covered and the clarity of course and lecture objectives. Negative comments dealt with the level of detail, some confusing assignments, and outdated data. Problems identified in pilot testing were corrected in the final DPH curriculum. The curriculum was successfully utilized in varied formats and well received. Through AAPHD, this standardized DPH core curriculum is now available for widespread use at dental schools and dental hygiene programs.