Undergraduate Public Health Education Research Articles

History of development of undergraduate public health education in Bulgaria.

The study aims to present a historical review and analysis of the establishment and development of undergraduate public health (PH) education in Bulgaria from 1878 until 2019. А search and selection of historical documents was performed, including laws, rules, regulations, government plans, programmes, scientific publications from periodical medical press, journals, specialized monographs, and books. A retrospective analysis of the normative documents related to the organization of the sanitation and public health activities, and to the provision of professional undergraduate education of the public health workforce in Bulgaria has been carried out. The required competences and tasks of the specialists exercising public health control services were extracted. The development in the public health educational activities were followed in three consecutive periods: the newly independent state (1878-1944); the socialist state (1945-1990); the democratizing state (1990-2019). The development of organized PH activities began after the liberation of Bulgaria in 1878. The historical analysis reveals a direct link between the major socioeconomic changes in the country and the organization of PH undergraduate education which passed through dynamic transformations. The professional education in the sphere of PH started with the training of feldshers, followed by sanitary feldsher and sanitary health inspectors performed in secondary vocational medical schools during the socialist period, reaching the stage of undergraduate university PH education provided by medical colleges associated with universities in the third period. Despite the continuous development in the organization of undergraduate PH education in Bulgaria, its content is still not fully compatible with the basic European PH services and actions. There is a growing need for wider standardization and integration of undergraduate PH education in the EU so that the specialty can reach the status of a regulated health profession similar to medicine, nursing, and others.

Shaping undergraduate public health education through critical race theory: a case study.

In 2020, the American Public Health Association declared structural racism a public health crisis acknowledging the long-lasting and harmful effects of prejudice, including relatively high rates of morbidity and mortality in many communities of color. Critical Race Theory (CRT) has become an essential lens to view and reconsider education's role in perpetuating racial and ethnic discrimination. Debates over integrating CRT in higher education with the intent to acknowledge and address racial equality and justice are more present than ever, and the discussions held in public health classrooms are no different. We present a case study of CRT integration into the Bachelor of Arts in Public Health (BAPH) program at the University of Hawai'i at Mānoa. In line with Solorzano's framework of CRT in education, initial goals of integrating CRT in instruction and advising included fostering discussions of race and racism, using a social justice framework to highlight opportunities to reduce health inequities, and validating the experiential knowledge of people of color. By engaging in active discussions with community leaders and participating in experiential learning throughout the program, students develop empathy and many underrepresented and marginalized students engage actively in their home communities. Specific examples of CRT integrated in the curriculum and examples of student projects that integrate a CRT lens are provided for educators and researchers.

Engagement of Online Biobehavioral Health Students in Ethics Education Through Virtual Immersive Experiences

In public health, ethics is a core competency. Accordingly, ethical decision-making should be part of the curriculum for all students seeking to enter the profession. Evidence suggests simulation may positively impact student learning of ethics. Yet, engaging in a traditional simulative or immersive experience is inaccessible to many students. Instead, could participation in virtual immersive experiences serve as a proxy for promoting student outcomes for ethical decision-making in public health? This quasi-experimental mixed methods study examined whether the integration of 360° videos in an undergraduate online health ethics course enhanced intended ethical decision-making. Undergraduate students ( n = 26) provided access to two assignments or artifacts. These artifacts were analyzed in accordance with a tailored rubric to explore differences in five constructs of ethical reasoning when writing assignments were completed with ( n = 13), or without ( n = 13), an integrated 360° video component. The results show the 360° videos enhanced the students’ ability to engage in ethical reasoning, with significant differences in rater scores being noted across multiple constructs. The data were also analyzed qualitatively. Students in the intervention group engaged in a process of “compassionate calculus,” integrating various elements of empathy, compassion, and self-awareness toward a clinical outcome. Together these findings demonstrate the capacity of virtual immersive experience to support students in the enhancement of intended ethical decision-making through the development of greater compassion or empathic concern. This study provides evidence to guide the continued integration of virtual immersive experiences into undergraduate public health education.

Biology in Public Health: Course-Based Experiential Learning Strategies to Promote Active Experimentation Among Undergraduate Public Health Students

Experiential learning is a critical aspect of undergraduate public health education. However, there is limited literature on the implementation of experiential learning in undergraduate public health programs. The course “Biology in Public Health” was developed to better link population-level public health concepts with the biological sciences through multiple experiential learning opportunities. The course provides students opportunities to apply concepts of population health and biological sciences to their own lives and the lives of others. The course includes several experiential learning components and over its tenure has been adapted to increase the emphasis on experiential learning. Three core experiential components that have been the basis for the class since its inception are: (1) weekly mindfulness and meditation practice, (2) guest presentations by individuals living with the week’s health condition, and (3) participation in an optional 10-day whole-food plant-based diet intervention. Data from course evaluations and surveys of diet intervention participants show impacts on students’ health behaviors and attitudes. Thirty-eight percent of students self-reported utilizing meditation outside of class to manage stress at the end of the semester, and all participants in the diet intervention stated that they would decrease their animal protein and dairy intake at the end of the intervention. This article provides an overview of the course structure and details the experiential learning strategies utilized to promote students’ active experimentation with health behaviors, improve student comprehension of the impact of stress and diet on health outcomes, and foster the utilization of this knowledge in their future public health careers.

Cultivating Health Policy Analysis and Communication Skills in Undergraduate Public Health Education: An Active Learning Approach

Public health programs are increasingly offering health policy content to meet workforce demand for public health professionals with health policy analysis and communication skills. Undergraduate public health education in health policy and related curriculum is lacking. Existing work describes service- and experiential learning approaches, which may not be feasible in large courses or public health programs with limited administrative or financial resources. This article describes health policy curriculum, learning objectives, and course activities (i.e., individual writing assignment, mock policy debate, and policy analysis exercise) that integrate an active learning approach and use simulation to develop policy analysis and communication skills in an undergraduate classroom setting. An active learning approach can increase teaching effectiveness, critical thinking, peer interaction, and student engagement to cultivate these applied skills. The described curriculum has been used in various modalities (in-person, hybrid, and remote) with positive reception in a public research university with a high percentage of first-generation college students. Student course evaluations and an independent assessment of the policy analysis exercise reflect high student interest, engagement, problem solving, satisfaction, perceived benefits, and application of policy analysis and communication skills, providing support for teaching health policy curriculum to undergraduate students using an active learning approach. The discussion includes strategies to address resistance by public health instructors and students to using active learning techniques.

What Elephant? Pedagogical Approaches to Addressing Stigma Toward Mental Disorders in Undergraduate Public Health Education

In the past decade, the number of undergraduate public health programs has increased exponentially. This growth provides a unique opportunity to explore concepts and issues relevant to understanding the determinants of health at a population level using new pedagogical approaches. One of these issues is stigma toward mental disorders. Stigma is a concept that refers to a feature or characteristic that reduces, devalues, and disempowers a person. Given the prevalence of mental and substance use disorders among college students, undergraduate education is an important setting for attempting to address stigmatizing attitudes both for society at large and for faculty, staff, and students, including those experiencing mental health problems. This article describes an effort to develop an undergraduate course in public mental health that explicitly addresses the ways stigma shapes student understanding of this topic and discusses lessons learned from this experience.

Undergraduate public health degree courses in India: selected overview

Background: Building the public health workforce in India along with strengthening the public health systems across the Nation are essential components necessary to achieve the sustainable development goals for India. In the Indian context, there is limited information available for undergraduate public health education. The central aim of this brief study is to elucidate the undergraduate public health education landscape at selected institutions in India.Methods: A mixed methods approach was used in this brief study. First, cross-sectional, scoping review was used. Then, to describe student perceptions and attitude towards undergraduate public health curriculum, primary data were collected by using a questionnaire. A self-administered questionnaire was developed after extensive literature search. Descriptive statistics were used to summarize questionnaire results. Chi-square tests were used to help identify factors that may influence student perceptions and attitudes.Results: Through scoping rapid review and internet search, eight institutions were identified that are offering undergraduate public health courses in India. Most institutes in India have 3 years duration for the undergraduate public health degree courses. Most of students (89%) believed that the undergraduate public health course increased their knowledge in the field of public health. We found an association between student perceptions about community benefits from trained undergraduate public health workforce.Conclusions: The undergraduate public health education initiatives should be promoted and envisioned as a new strategy for public health capacity-building in public health in India.

Opportunities and Challenges for Undergraduate Public Health Education in Australia and New Zealand

The international emergence of undergraduate education in public health has transformed the public health education landscape. While this shift is clearest and most widely evaluated in the United States, efforts in other parts of the world—such as Australasia—have not kept pace. This article aims to redress the evidence gap by identifying and discussing the different approaches through which Australian and New Zealand universities deliver public health education at the undergraduate level. A content analysis was conducted of online handbook information published by 47 universities across Australia and New Zealand, to gauge the various ways in which these universities implement undergraduate public health education. Each offering identified was assigned to one of four predetermined categories. Of the 47 universities, 45 were found to offer some form of undergraduate coursework in public health. Offerings took primarily the form of single subjects. Less commonly implemented were specializations ( n = 20), stand-alone undergraduate degrees ( n = 11), and double degree combinations ( n = 6). This breadth of activity highlights the need for renewed efforts in evaluating undergraduate public health education across the region. Further research is recommended into three areas: (1) emerging best practices in curriculum development and implementation, (2) explorations of public health accreditation in the region, and (3) the outcomes achieved by students and graduates of undergraduate public health degrees across Australia and New Zealand. These efforts will ultimately strengthen the operationalization and contribution of this education in helping shape the future public health workforce in Australasia.

Congratulations to Dr Elahe Nezami for Winning the 2019 Riegelman Award for Excellence in Undergraduate Public Health Education.

Congratulations to Dr Elahe Nezami for Winning the 2019 Riegelman Award for Excellence in Undergraduate Public Health Education.

A Cohort Model and High Impact Practices in Undergraduate Public Health Education.

Developing curriculum that is more than a collection of courses necessitates articulating philosophy and principles that undergird curricular decisions. While faculty are accustomed to expressing ideas within their realms of content expertise, building consensus around educational philosophy and pedagogy may be less common but equally important to assure coherent curriculum. Such discussions lead to intentional curriculum. When attuned to intent and combined with high impact practices, curriculum is likelier to result in student success and engagement. Since public health by nature entails community interaction, opportunities to think and work in a variety of communities reflects the work in the public health arena. Building a community of learners in the context of a highly diverse urban campus requires very deliberate curriculum planning and design. The likelihood that learning communities will emerge spontaneously is reduced when only a small proportion of students live on or near campus, and most spend considerable time commuting. Virtually all undergraduate public health students have responsibilities beyond academics, including employment, family caregiving, religious obligations, etc. Since most undergraduate students in this setting are first generation to higher education, learning communities and other high impact practices become even more important to provide meaningful baccalaureate education. Such communities evolve most efficiently when integrated into the curriculum design. By implementing a cohort model, not only can faculty participate and facilitate the evolution of a community of learners, they can employ other high impact practices designed to enhance and compound public health content and processes. Undergraduate public health students in this setting take all of their core courses (32 semester hours) together in a prescribed sequence. Faculty have clear understanding about what preceded a course and what follows. Every course entails both individual work and group collaboration. Students come to understand each other's strengths and needs, and with rare exception, they support each other on the journey and share some mutual successes. Both expected and unintended outcomes of this approach are conveyed in this article along with a few cautions for those considering these strategies for undergraduate public health education.

Integrative Learning in US Undergraduate Public Health Education: A Review of Student Perceptions of Effective High-Impact Educational Practices at Georgia State University.

In 2003, the United States (US) Institute of Medicine of the National Academies recommended that all undergraduate students have access to an education in public health to assist with diversifying the public health workforce and ensuring an educated citizenry on public health issues. In line with this recommendation, and that of the Consensus Conference on Undergraduate Public Health Education, Georgia State University established a Bachelor of Science in Public Health (BSPH) program in 2016, with the mission of advancing health through leadership, scholarship, research, and service, to better the human condition and to promote the common good, especially for urban communities in the US and for global populations. Using integrative approaches that encourage student empowerment, self-development, integrative thinking, and reflective learning, the Georgia State University BSPH program currently offers a range of generalist introductory public health courses to over 400 students. This review seeks to examine student perceptions of integrative practices utilized by Georgia State University faculty in the BSPH program and to investigate the extent to which student perceive these integrative educational practices as preparing them to use insights gained in the classroom and from the field, to question, modify, connect, and integrate material learned in the academic setting, to real-life public health challenges. It also seeks to identify which of the integrative educational practices have the highest impact of helping students integrate the knowledge and skills gained to public health issues.

Promoting and strengthening public health through undergraduate education.

There are widely divergent views as to what constitutes "public health" and "public health research". But regardless of these views, readers of this journal would likely agree that public health matters; we assert that so does the educational programming that prepares its workforce. Our voiced perspectives as authors are influenced by our respective training, occupations, and academic locales, and we believe that undergraduate public and population health education (UGPPHE) across many disciplines is crucial to strengthening public health in Canada. Existing literature and discourse related to UGPPHE in Canada tends to be concentrated around its ancillary positioning within clinical health disciplines such as medicine, nursing, and dentistry, rather than on the evolution of undergraduate degree programs. While UGPPHE programming has the important function of preparing undergraduates to enter into practice as public health professionals, it has added virtue in its capacity to improve public health literacy and produce a more robust body of informed and engaged citizens. The intent of this commentary is to draw increased attention towards the other disciplines less well known for bringing awareness to UGPPHE in Canada and to commence what will hopefully be a cascade of dialogue from stakeholders across the nation.

The State of the US Governmental Public Health Workforce, 2014-2017.

Public health workforce development efforts during the past 50 years have evolved from a focus on enumerating workers to comprehensive strategies that address workforce size and composition, training, recruitment and retention, effectiveness, and expected competencies in public health practice. We provide new perspectives on the public health workforce, using data from the Public Health Workforce Interests and Needs Survey, the largest nationally representative survey of the governmental public health workforce in the United States. Five major thematic areas are explored: workforce diversity in a changing demographic environment; challenges of an aging workforce, including impending retirements and the need for succession planning; workers' salaries and challenges of recruiting new staff; the growth of undergraduate public health education and what this means for the future public health workforce; and workers' awareness and perceptions of national trends in the field. We discussed implications for policy and practice.

High School Epidemiology: Helping Students Practice Science Through Guided Inquiry and Authentic Learning Strategies

A call has been made over the last decade for the expansion of epidemiology coursework into high schools in the United States. Epidemiology instruction has been shown to increase student scientific and health literacy, promote critical thinking skills, enhance students’ perception of public health as both practical and relevant, and empower students as independent, lifelong learners. Epidemiology is also a flexible science with relevance to students from diverse backgrounds, skill levels, and interests. While there has been tremendous growth in undergraduate public health education, we have yet to witness the mainstream adoption of epidemiology into high school coursework. In this article, I propose the formal integration of epidemiology into high school curricula to help students practice science as it relates to public health. I posit that epidemiology is a flexible science discipline with real-world significance to students from diverse backgrounds, skill levels, and interests. Also, teaching epidemiology through guided inquiry and authentic learning strategies can intrinsically motivate and empower students to address health-related problems in their local communities. Moreover, epidemiology instruction at the high school level can meet student learning needs, teacher instructional objectives, administrative mandates, and community interests. In essence, epidemiology instruction at the high school level can hone fundamental skills in preparation for health and science careers and promote important public health awareness and interest among adolescents.

The Landscape of US Undergraduate Public Health Education.

The Landscape of US Undergraduate Public Health Education.

Developing an Undergraduate Public Health Introductory Core Course Series.

The number of undergraduate public health education programs is increasing, but few publications provide examples of introductory public health courses that provide foundational knowledge and meet 2016 Council on Education in Public Health (CEPH) accreditation standards. This article presents the development and testing of a three-course, introductory series in public health at the University of Hawai‘i at Mānoa (UHM). Development was informed by best pedagogical practices in education, web review of existing programs, literature review, key informant interviews, and accreditation standards. Student mastery of required concepts, domains, and competencies is assessed through testing and class assignments. Data from course evaluations, students' exit questionnaires at graduation, and faculty feedback were used to continuously evolve and adapt the curriculum. The three-course series—including Introduction to Public Health, Public Health Issues in Hawai‘i, and Introduction to Global Health—was designed to provide incoming undergraduate public health students with a foundation in local, national, and global public health concepts and domains, while improving their skills in public health communication and information literacy. Data from class assignments, examinations, and later coursework suggest students are mastering the course materials and gaining required competencies. Data from course evaluation and exit questionnaires suggest that the students appreciate the series' approach and the challenge to apply course concepts locally and globally in subsequent courses. This foundational public health series provides a model for an introductory course series that can be implemented with existing resources by most programs, meets the new CEPH requirements, is well-received by students, and prepares students well for upper-division public health courses.

Teaching Epidemiology at the Undergraduate Level: Considerations and Approaches.

The rapid growth in undergraduate public health education has offered training in epidemiology to an increasing number of undergraduate students. Epidemiology courses introduce undergraduate students to a population health perspective and provide opportunities for these students to build essential skills and competencies such as ethical reasoning, teamwork, comprehension of scientific methods, critical thinking, quantitative and information literacy, ability to analyze public health information, and effective writing and oral communication. Taking a varied approach and incorporating active learning and assessment strategies can help engage students in the material, improve comprehension of key concepts, and further develop key competencies. In this commentary, we present examples of how epidemiology may be taught in the undergraduate setting. Evaluation of these approaches and others would be a valuable next step.

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.

Student and Faculty Perspectives on the Use of Movies in Public Health Pedagogy

Introduction. Movies can be used in public health pedagogy to illustrate concepts and build students’ connection to the material. This study describes the perspectives of undergraduates and faculty on effective strategies for using movies to achieve key public health learning outcomes. Method. In this cross-sectional study, a survey was administered to undergraduate majors in health studies ( n = 109) and faculty who teach health-related courses ( n = 27). The survey included measures of usage and attitudes toward pedagogical applications of movies, which were informed by Bloom’s Taxonomy and the Core Competencies for Public Health Professionals. Results. Students and faculty expressed favorable attitudes toward the use of movies in undergraduate public health education. Additionally, both groups endorsed the usefulness of movies for affective and cognitive learning outcomes, with appraisals of affective learning being significantly higher. Movies were most frequently applied to building the core public health competencies of analyzing public health issues, communicating effectively, relationship building, and cultural competency. Among students, 74% stated that watching health-related movies reinforced their current career trajectory, encouraged them to consider other careers, or changed their choice of career. Discussion. Preparation of the future public health workforce requires students to develop both cognitive skills and an emotional connection to efforts that address health-related challenges. The findings of this study indicate that movies support both types of learning outcomes and therefore deserve further investigation as pedagogical tool in population health instruction.

Establishing undergraduate public health education: process, challenges, and achievements in a case study in Israel

BackgroundIn this paper, we describe the development process of the first undergraduate public health baccalaureate program, in the Ashkelon Academic College in Israel. Expansion of degree-granting colleges in Israel is part of the democratization of higher education providing access to and increasing educational opportunities for groups underrepresented in universities. The main objectives of the program at Ashkelon Academic College have been to open accessible and affordable career opportunities for current workers in the health system and for new entries to health careers for academic advancement in a peripheral and relatively poor region of the country.Case PresentationThe program focuses on well-established and literature-based learning goals of public health education but also includes basic medical sciences, incorporation of arts and sciences into public health, development of critical thinking and quantitative skills, experiential field learning, and integrative learning for facing global health challenges. The curricula of the program is composed of seven modules including introductory courses, methodology courses, health organization courses, epidemiology courses, courses related to core content of public health, elective courses and practicum. The first class will graduate in 2017; this will allow for final approval of the Council of Higher Education of Israel and possible revision of curriculum. A second BA program is now seeking approval in Israel and cooperation with post-graduate schools of public health is developing.ConclusionsOur program is in keeping with trends in Europe and the USA to broaden public health education, to reduce inequality of career opportunity, to expand the workforce, and to promote public health.