Public Health Skills Research Articles

Are clinical leads clinical leaders? Optimising primary care-led commissioning and policy making

There is rising demand for general practitioners in the UK to fill leadership roles in clinical commissioning. Function can vary, from providing frontline insights, representing peers or patients, as well as adding credibility, or relationship-building for programme delivery. The term ‘clinical lead’ may, however, be misleading regarding responsibilities, which often lack the authority or strategic tenets defined in leadership. Much of the literature regarding medical managers focuses on single healthcare provider organisations that adopt shop-floor clinicians into a leadership structure. Population commissioning, however, demands additional technical skills in public health, statistical literacy, economics and even ethics, which, while learnable, are not innate to clinicians. Along with biases in the selection of leadership hierarchies, and limitations of traditional project management, further steps are necessary to nurture the competencies for coherent leadership that use implementation science and maximise opportunity for clinician-leaders to bridge the evidence-policy gap. Organisations need to learn to more effectively distribute authority across the political economy of healthcare to appropriate clinical-leaders in policy rather than continued concentrations of executive decision-making. This requires clinicians with the appropriate neutrality and minimum necessary competencies to be selected and developed for population commissioning.

Frameworks and guidance to support ethical public health practice.

This article reports and reflects on an element of a recent survey of UK public health professionals, specifically in relation to the Public Health Knowledge and Skills Framework (PHSKF) and the ethical requirements that underpin public health practice. Only 38.4% of respondents reported accessing the PHKSF and a mere 13.7% reported accessing the accompanying background paper on ethical public health practice. Given that ethical practice underpins the PHSKF, it is concerning that so few respondents are familiar with the PHSKF and one of the source documents. While issuing frameworks and guidance is one way to support public health practice, there is a further need for greater integration of skills and knowledge around ethical public health practice within education and training initiatives.

Competent with patients and populations: integrating public health into a medical program

BackgroundAs the global burden of chronic disease grows, and infectious disease threats loom large, the need for medical graduates with expertise in public health medicine (PHM) is growing. A recurrent challenge is integrating this broad knowledge into crowded medical curricula and making PHM relevant. This study describes the process of integrating public health content into an Australian graduate entry medical course.MethodsA redesign of the PHM curriculum at Deakin University School of Medicine was conducted in 2014 to make the curriculum practice-based and solution-oriented. Central to the redesign was the development of a curriculum map.ResultsPublic health is now taught from a practice-based framework adapted from the World Health Organization emphasizing skills aligned with the Australasian Faculty of Public Health Medicine domains that prepare students for specialisation. Learning outcomes are structured to build depth and application in student knowledge. Mapping the curriculum provided the ability to measure alignment of learning outcomes with course, university and accrediting body outcomes. Regular feedback from students indicates engagement has improved along with perceived relevance to future careers.ConclusionsDoctors with public health skills are increasingly sought after in Australia, particularly in rural areas. Deakin graduates are well placed to meet this demand.

STRATEGI MANAJEMEN KAS (CASH MANAGEMENT) DALAM RANGKA OPTIMALISASI DANA PADA YAYASAN INSAN MADANI SEJAHTERA (YIMS) TAHUN 2004-2009

cash management strategy (cash management) in order to optimize the foundation fund civil insan prosper (yims) year 2004-2009. Cash management strategy (cash management) in order to optimize the funds on Madani Insan Sejahtera Foundation (Yims) include: revenue from the year 2004 amounting to Rp. 18,250,500.00 until 2009 to Rp. 559,454,000.00 or 300 times increase. Similarly, expenditure in the form of compensation, public health services, skills training, caring teachers and preachers, the economic empowerment of the ummah, qurban from 2004 amounting to Rp. 17,787,500.00 until 2009 to Rp. 559 005 100 is almost 300%. The channeling of funds up to 98% - 102% from 2004 to 2009. The remaining funds are used for operational reserves the foundation. The Foundation expects an increase in revenue from activities that are funded in accordance mission of the foundation is: (1) to provide services to the community through empowerment programs that integrate educational programs, health, economy and skills. (2) Being a liaison between the haves with the community through the distribution of funds can not afford the social, charity, infaq, shodaqoh and humanitarian funds. (3) Establish partnerships with both private institutions, government or other social institutions in reducing social problems in the community. Keywords : cash management

An example of public health training in emergency medicine.

There is growing recognition of the vital roles that Emergency Physicians can play in public health. Accordingly, there is a need for emergency medicine trainees to have opportunities to acquire relevant public health skillsets. This article provides an example of such a possibility. It describes the experience of an emergency medicine trainee in undertaking a 6 month training rotation at a Public Health Unit. The example illustrates the feasibility and benefits of a public health rotation for interested trainees, and offers recommendations for establishing such rotations. There are challenges, including eligibility requirements and funding. However, possible approaches exist at the individual and college levels to facilitate such training opportunities so that emergency medicine trainees can acquire necessary and valuable public health skills.

Aloha Undergraduates: Development and Application of Local & Indigenous Topics into an Undergraduate Public Health Curriculum.

As public health education expands to include undergraduate students, it is important to include discussion of local public health topics and issues to provide a sense of place to the educational experience. Inclusion of Native Hawaiian and indigenous issues and perspectives is also an established priority of the University of Hawai‘i system. To address both needs, a required course was created during development of a new Bachelor of Arts (BA) public health program at the University of Hawai‘i at Mānoa to specifically focus on discussion of local and indigenous public health topics of interest. Public Health Issues in Hawai‘i is an introductory course included early in the recommended undergraduate curriculum and emphasizes the application of public health skills and principles to local issues (e.g., state-level legislative awareness and local sustainability topics). The Public Health Issues in Hawai‘i course further challenges students to recognize public health practice in their daily activities, and encourages them to become actively engaged in local community issues early in their public health educational careers. Among multiple advantages, improved awareness of local health challenges and early connections to community members and organizations have been instrumental in actively engaging local students in their education, and has also proved beneficial for students participating in required undergraduate applied learning capstone experiences and entry-level public health careers following graduation. Here we present insights into course development, articulation with broader program curricula, and successes and challenges in the past 4 years of implementation and instruction.

Role of naturopathy and yoga therapy on subjective well-being and prevention of non-communicable diseases

Background: National Health Policy 2017 recognizes the need to nurture Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) system of medicine through the development of infrastructural facilities of teaching institutions, improving quality control of drugs, capacity building of institutions and professionals. It also recognizes the need for building research and public health skills for preventive and promotive health care. Linking AYUSH systems with Accredited Social Health Activists and Village Health Sanitation and Nutrition Committee would be an important plank of this policy. Objectives: The objectives of the study were to determine patients’ subjective feeling of well-being and outcomes after naturopathy treatment. Materials and Methods: The study was conducted among inpatients (IP) of a naturopathy center in the field practice area of an Rural Health Training Centre attached to the Department of Community Medicine in a Medical College, Navi Mumbai. Questionnaires were distributed for 3 months to all the IP who were willing to participate and give their feedback at discharge. A total of 64 subjects responded. They were personally interviewed, their history and presenting complaints were listed, clinical examination was done, positive findings were noted, details of treatment and advice given were enumerated. Obtained data were tabulated in MS Excel and analyzed using SPSS software. Patients received normal care from the respective therapists and no intervention was done from our side. Permission from the Institutional Review Board for conducting the study was taken. Results: Systolic blood pressure before and after therapy was compared, there was a difference of mean reduction in 4 mmHg with P = 0.00. Significant reduction in weight was noticed among overweight and obese people taking the therapy. A strong positive correlation was seen when quantity of weight reduction was correlated with initial Body Mass Index (BMI). The correlation constant was 0.811 with a significance level of 0.00. Conclusion: Naturopathy therapy as well as yoga practice results in a broad range of outcomes from physical and emotional change through to wider benefits involving the patients’ lifestyle, outlook, and attitude toward their health.

Future of Public Health Training: What Are the Challenges? What Might the Solutions Look Like?

The Asia-Pacific region has rapidly changing health needs. This reshaping of health priorities is directly affecting current and future public health education. This brief review focuses on foundational public health skills including epidemiology, biostatistics, and health informatics. Epidemiological skills, in particular, are essential for policymakers and practitioners to identify the emergence of problems and to inform priority setting of public health efforts. Training needs to move beyond didactic, passive learning methods in class settings to approaches that engage and challenge students and academics in active, flexible learning and realistic problem-solving. We provide an overview of future trends in public health training in the Asia-Pacific region and illustrate the diversity of online training resources globally that can enrich staff and student skills and complement our active, class-based teaching.

Public health education and health system needs in Pakistan: a mixed methods study

Pakistan has recently observed a significant growth in public health education programmes. Little is known about the structure of these programmes nor whether they are adequately responsive to national health system needs. We reviewed existing public health degree programmes in Pakistan along with an exploration of the national public health market and health system needs. A mixed-methods study was conducted between January 2015 and March 2016. Seventeen public health degree programmes were reviewed for programmatic and instructional attributes. Thirteen key-informant interviews were conducted to explore health system needs and challenges related to public health workforce. We found substantial variation in public health academic programmes in terms of offered courses, credit hours, number of faculty and tuition costs. About 70% of public health degree programmes were generic (i.e. with no specific concentration track) and only 18% offered practicums. Overall median tuition cost in 2016 was US$ 10 350. During key-informant interviews, emerged themes for challenges included lack of practical public health skills, limited knowledge of latest theoretical principles, poor communication skills and insufficient IT orientation. Identified themes about knowledge and skills areas to address future public health challenges of Pakistan included system thinking mind set, healthcare IT skills, and leadership and management skills. Public health education in Pakistan falls short of meeting current national challenges. Pakistan needs a national public health accreditation body for regulating education, harmonizing global standards to local context and developing relevant career pathways.

Public Health Emergency Response Lessons Learned by Rapid Deployment Force 3, 2006-2016.

Following Hurricane Katrina, the uniformed US Public Health Service created an updated system through which its officers participated in emergency responses. The Rapid Deployment Force (RDF) concept, begun in 2006, involved five teams of officers with diverse clinical and public health skill sets organized into an incident command system led by a team commander. Each team can deploy within 12 hours, according to a defined but flexible schedule. The core RDF mission is to set up and provide care for up to 250 patients, primarily persons with chronic diseases or disabilities, in a temporary federal medical station. Between 2006 and 2016, the RDF 3 team deployed multiple times in response to natural disasters and public health emergencies. Notable responses included Hurricane Sandy in 2012, the unaccompanied children mission in 2014, and the Louisiana floods in 2016. Lessons learned from the RDF 3 experience include the need for both clinical and public health capacity, the value of having special mental health resources, the benefits of collaboration with other federal medical responders, and recognition of the large burden of chronic disease management issues following natural disasters.

A Framework for Practice-Based Teaching in Public Health.

To prepare master of public health graduates for successful application of public health competencies in their careers, accredited schools of public health must identify the knowledge, technical and professional skills needed for practice, and provide opportunities for application of these skills in public health settings. Practice-based teaching (PBT) is a pedagogical approach where students learn through course instruction while working on a real problem and producing implementable deliverables for a public health agency. Currently, no framework exists for designing, implementing, and evaluating the pedagogy. This article defines PBT for public health and presents a novel 5-step framework, PBT STEPS, to guide faculty in development of a practice-based curriculum for public health education, including (1) securing partnerships, (2) training and technology, (3) engagement and implementation, (4) presenting deliverables, and (5) sizing up the results. PBT has been implemented using PBT STEPS in both domestic and global courses, teaching a variety of technical competencies. Collaborating agencies for PBT courses have ranged from small community-based organizations to large departments of public health, to international nongovernmental organizations and to private hospitals. Each step is described and illustrated through a practical example from a past PBT course. The practical example was evaluated through a mixed-methods approach to assess outcomes for students and collaborating agencies. All students (n = 12) reported significant increases in ability with the technical and professional competencies addressed in the course, and all agencies (n = 3 representing 5 distinct projects) reported utility of the final deliverables to the agency and populations served. Evidence-informed, feasible, and innovative solutions created through PBT collaboration provide significant benefits to the agency and the communities they serve while successfully training students for the public health workforce. Utilizing the PBT STEPS framework allows for successful and productive academic and community collaborations.

Educating public health champions

Objective: This article describes a university course that aimed to create public health champions and its evaluation. The course attracted 92 participants, over three cohorts. Participants included healthcare professionals, fitness instructors, a belly dancer, housing officers, community workers and those who worked in public health policy. Design: The course evaluation aimed to provide a longitudinal understanding of the participants’ learning and the impact of the course in terms of developing the attributes of public health champions. Setting: A university setting in England. Methods: Evaluation methods included questionnaires, self-assessment against UK Public Health Skills and Knowledge Framework statements, ‘check out’ sentences post action learning set meetings, impact statements and unstructured interviews. Results: The evaluation illuminated the participants’ experience of their learning journey, which comprised cognitive, affective and conative learning, the development of public health competences and evidence of putting the learning into public health practice. Conclusion: In total, 76 participants achieved a university award. There was evidence of participants identifying the underlying causes of ill health and using an evidence-based approach to planning, partnership and influencing others. Some participants reported actions that indicated they had become transformative leaders and public health champions. The article discusses limitations to the evaluation and current challenges to public health workforce development in England.

The applicability of the UK Public Health Skills and Knowledge Framework to the practitioner workforce: lessons for competency framework development.

Many countries have developed competency frameworks for public health practice. While the number of competencies vary, frameworks cover similar knowledge and skills although they are not explicitly based on competency theory. A total of 15 qualitative group interviews (of up to six people), were conducted with 51 public health practitioners in 8 local authorities to assess the extent to which practitioners utilize competencies defined within the UK Public Health Skills and Knowledge Framework (PHSKF). Framework analysis was applied to the transcribed interviews. The overall framework was seen positively although no participants had previously read or utilized the PHSKF. Most could provide evidence, although some PHSKF competencies required creative thinking to fit expectations of practitioners and to reflect variation across the domains of practice which are impacted by job role and level of seniority. Evidence from previous NHS jobs or education may be needed as some competencies were not regularly utilized within their current local authority role. Further development of the PHSKF is required to provide guidance on how it should be used for practitioners and other members of the public health workforce. Empirical research can help benchmark knowledge/skills for workforce levels so improving the utility of competency frameworks.

Applying psychoeducational program on general health and communication skills in caregivers of patients with schizophrenia: A randomized controlled trial

Background and objectivesThrough the use of an experimental design with a baseline and post intervention, the aim of this study was to investigate the effectiveness of a psychological intervention in increasing public health and communication skills for caregivers. MethodsThis randomized controlled trial was designed in Razi Hospital in Tehran, Iran. A sample size of 90 participants was evenly divided into intervention and control groups. The intervention group was given routine treatments and also participated in planned educational sessions. The planned educational program was implemented in 10 group sessions over a period of 5 weeks. Each session lasted 45–60min. The outcome measures were: (1) improvement in the caregiver's general health as measured by the changes in their General Health Questionnaire (GHQ) scores taken at baseline and post intervention and (2) changes in the caregiver's communication skills, measured by the communication skills questionnaire taken at baseline and after 3 months. ResultsAn independent samples t-test revealed that there was a significant difference between the two groups in the mean scores of communication skill at baseline (P<0.001). To adjust for the effects of pre-intervention scores on the post-intervention results, a covariance analysis was used. Consequently, differences between the mean scores of post-intervention GHQ total, GHQ subcategories, and communication skills in the intervention group and the control group were statistically significant (P<0.001). ConclusionResults of our study confirm that providing education on effective communication skills can be an effective, cost-efficient, and convenient strategy to reduce the psychological complications for caregivers and improve the care of patients living with schizophrenia.

NFSHE in a nutshell

British Journal of School NursingVol. 13, No. 2 RepresentationNFSHE in a nutshellHelen KimbleHelen KimbleSearch for more papers by this authorHelen KimblePublished Online:4 Apr 2018https://doi.org/10.12968/bjsn.2018.13.2.98AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health. Healthy Child Programme, 5–19. 2009. www.gov.uk/government/publications/healthy-child-programme-5-to-19-years-old (accessed 28 February 2018) Google ScholarDepartment of Health. Getting it Right for Children, Young People and Families – Maximising the Contribution of the School Nurse Team: Vision and Call to Action. 2012. www.gov.uk/government/publications/getting-it-right-for-children-young-people-and-families (accessed 28 February 2018) Google ScholarNursing and Midwifery Council. Standards of Proficiency for Specialist Community Public Health Nurses. 2004. NMC, London Google ScholarPublic Health England (2016a) Best start in life and beyond: Improving public health outcomes for children, young people and families. 2016a. www.gov.uk/government/publications/commissioning-of-public-health-services-for-children (accessed 28 February 2018) Google ScholarPublic Health England. Healthy Child Programme: The 4-5-6 approach for health visiting and school nursing. 2016b. www.gov.uk/government/publications/commissioning-of-public-health-services-for-children (accessed 28 February 2018) Google ScholarPublic Health England. The Public Health Skills and Knowledge Framework. 2016c. www.gov.uk/government/publications/commissioning-of-public-health-services-for-children (accessed 28 February 2018) Google ScholarPublic Health England. Facing the Facts, Shaping the Future: A draft health and care workforce strategy for England to 2027. 2017. https://hee.nhs.uk/our-work/workforce-strategy (accessed 28 February 2018) Google Scholar FiguresReferencesRelatedDetails 2 March 2018Volume 13Issue 2ISSN (print): 1752-2803ISSN (online): 2052-2827 Metrics History Published online 4 April 2018 Published in print 2 March 2018 Information© MA Healthcare LimitedPDF download

Innovation and Entrepreneurship: Harnessing the Public Health Skill Set in a New Era of Health Reforms and Investment.

Innovation and Entrepreneurship: Harnessing the Public Health Skill Set in a New Era of Health Reforms and Investment.

Measures of Success: Exploring Student Approaches to Learning Public Health

The goal of public health education consists of equipping competent future public health professionals with the skills necessary to effectively convert knowledge to meet current and future public health challenges. Although great focus has been placed on topics and skills that are relevant to undergraduate degree curricula in public health, little effort has been directed at identifying student perceptions about metacognitive strategies that best help them learn and recall public health skills or ideas. There is also little investigation of factors that contribute to students’ success in the field of public health. The purpose of this article is threefold: first, to describe common themes and gaps pertaining to public health undergraduates’ awareness of potent learning strategies; second, to characterize students’ definition of success in the field of public health; and third, to provide instructors with valuable information that may be used to enhance the design of classroom learning environments, course content, content delivery methods, and course assessments.

Dual Master of Social Work / Master of Public Health Degrees: Perceptions of Graduates and Field Instructors

Despite growing interest in Master of Social Work/Master of Public Health (MSW/MPH) programs, limited research literature is available on MSW/MPH graduates and none has examined field instructors’ perceptions of MSW/MPH students. This study describes the perceptions and experiences of MSW/MPH alumni and field instructors from a recently implemented MSW/MPH program at the University of Georgia. Electronic surveys were administered to 32 alumni and 34 field instructors; response rates were 71.9% (n=23) and 70.6% (n=24), respectively. Alumni reported satisfaction with the dual degree and utilization of both social work and public health skills in the workplace. Field instructors underscored the complementary skill sets of dually-trained students and noted the added value of MSW/MPH professionals in their agencies. Dually-trained MSW/MPH practitioners are uniquely prepared to address the need for transdisciplinary and interprofessional collaborations to address long-standing social and health issues.

Transformational Learning in Undergraduate Public Health Education: Course Design for Generation Z

Community partnerships provide an invaluable and practical teaching opportunity for undergraduate public health education programs. This is especially true when working with Generation Z students who desire meaningful, effective learning experiences. The continued strong interest of Generation Z undergraduates in public health and health promotion, combined with their skills and learning preferences, provides a strong rationale for utilization of community-based learning strategies. It could be argued, however, that programs must go beyond providing service learning and reflection opportunities. Indeed, experiential learning has come under criticism for lack of engagement with community-based organizations served by students and a lack of evidence on the quality or utility of the “services” provided. In this light, we constructed a transformational model of learning, where students complete tangible, timely projects with community partner organizations. In this model, all parties benefit: The students experience an often-profound learning opportunity through project execution; the community partners benefit from the skills, insight, time, and talents of the students; and the undergraduate program is able to assess a novel marker of student achievement—evaluation of a real-world application of public health skills and knowledge.

Master or apprentice: rethinking entry points and training in Public Health.

The Public Health workforce needs to adapt to a policy environment in which the need to improve public health is not only a key challenge but also has to be delivered within financial constraints. A total of 14 qualitative individual interviews or focus groups (of up to 10 people), were conducted with senior Public Health staff in 12 local authorities and in Public Health England in the Yorkshire and the Humber region of England. Thematic analysis was applied to the transcribed interviews. Despite cuts in training budgets, junior staff were increasingly expected to deliver Public Health functions. There is also an absence of a career ladder for this core Public Health workforce. There were concerns that financial constraints would lead to reductions in Public Health skills with fewer staff to provide critical analysis. Formal qualifications were increasingly less valued. Instead staff were expected to have a broader skill set with an emphasis on experience. Entry points into Public Health careers need rethinking. There was an expectation that Public Health departments would 'grow their own'. Apprenticeship schemes could help maintain or enhance the professional status of Public Health and provide a training route for Public Health practitioners.