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PubMed2003

Assessing competencies of the public health workforce in a frontier state.

The purpose of this study was to determine the level of perceived proficiency of a public health workforce based on the Public Health Practice Core Competencies. The Public Health Profile and Training Needs Assessment questionnaire was mailed out to public health employees representing mostly public health nursing, environmental health, mental health, and public health management/administration (n = 696). Nearly three-quarters (74%) of participants were female and 96% reported being white. Eighty one percent of participants were currently employed full-time. The majority of participants were trained at the bachelors level (54%). The response rate was 63.9%. Findings from this study show that all disciplines reported higher perceived proficiency in the Communication skills domain compared to the other seven skills domains. Perceived low skills domains included "financial planning and management skills" and "policy development/program planning skills" among public health nurses, mental health professionals, and environmental health specialists. Management/administration level staff reported their lowest perceived proficiency in Basic Public Health Science skills. Each group had different strengths and weaknesses and the necessary level of skill needed differs among discipline groups, thus future trainings on the Public Health Core Competencies should be discipline specific.

Adult↗
PubMedDate not supplied

Best practices for assessing competence and performance of the behavioral health workforce.

The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed. A conceptual model of competence is presented, and practical applications of this model are reviewed. Finally, guidelines are proposed for building competency assessment protocols for behavioral health.

Behavioral Medicine↗
PubMed1999

Training for the mental health workforce: a review of developments in the United Kingdom.

OBJECTIVE: Implementation of the National Mental Health Strategy has important implications for education and training of the Australian mental health workforce. This paper discusses relevant developments in the United Kingdom that may provide some lessons for Australia. METHOD: A review was undertaken of a number of specific clinical education and training programs for mental health workers in the United Kingdom which have been subjected to published evaluation. RESULTS AND CONCLUSIONS: A finite mental health resource base dictates that education and training activity should: (i) be evaluated; (ii) target those clients most in need; (iii) include evidence-based approaches such as assertive community treatment, medication management, cognitive-behaviour therapy and family interventions; and (iv) prepare mental health workers in the core competencies needed to implement these approaches. Two programs, developed in the United Kingdom, which meet these criteria are presented as examples of best practice: the nurse therapy model established by Isaac Marks; and the Thorn initiative established in association with the Institute of Psychiatry, London and the University of Manchester.

Evidence-Based Medicine↗
PubMed1998

Changing supply and earning patterns of the mental health workforce.

The authors examine recent trends in the supply and earnings of various mental health providers from 1989 to 1995. The makeup of the mental health workforce is fundamentally different now than a decade ago. The number and earnings of psychiatrists have been relatively flat. The number of psychologists increased by 24%, with their earnings rising rapidly in the 1980s, and remaining level since 1990. The number of clinically trained social workers increased by 87% over the same period, and the number of advanced practice nurses certified in mental health specialties almost doubled, with the earnings of these master's-level providers increasing steadily over the period described. These trends are discussed in the context of major changes in the financing and delivery of mental health care.

Humans↗
PubMed2005

Development and implementation of a public health workforce training needs assessment survey in North Carolina.

Assessing the training needs of local public health workers is an important step toward providing appropriate training programs in emergency preparedness and core public health competencies. The North Carolina Public Health Workforce Training Needs Assessment survey was implemented through the collaboration of several organizations, including the North Carolina Center for Public Health Preparedness at the North Carolina Institute for Public Health, the outreach and service unit of the University of North Carolina School of Public Health, the Office of Public Health Preparedness and Response in the North Carolina Division of Public Health Epidemiology Section, and local health departments across the state.

Data Collection↗
PubMedDate not supplied

Self-assessment in the measurement of public health workforce preparedness for bioterrorism or other public health disasters.

OBJECTIVE: The purpose of this study was to examine effective ways to evaluate public health workers' competence for preparedness. METHODS: The Public Health Ready project, developed by the National Association of County and City Public Health Officials and the Centers for Disease Control and Prevention, is a pilot program designed to prepare local public health agencies to respond to emergency events. Workers at a Public Health Ready site (N=265) rated their need for training and their competence in meeting generic emergency response goals. Cluster analysis of cases was conducted on the self-assessed need for training. RESULTS: Three groups of workers emerged, differing in their overall ratings of need for training. A given worker tended to report similar needs for training across all training goals. CONCLUSIONS: In this study, workers' ratings of need for training may reflect an overall interest in training rather than need for training in a particular area. Caution should be exercised in interpretation when generic goals and self-assessment are used to measure need for training. Future assessments of training needs may be more effective if they use objective measures of specific local plans.

Attitude of Health Personnel↗
PubMed2005

A conceptual model for recruitment and retention: allied health workforce enhancement in Western Victoria, Australia.

Attracting and retaining allied health professionals in rural areas is a recognised problem in both Australia and overseas. Predicted increases in health needs will require strategic actions to enhance the rural workforce and its ability to deliver the required services. A range of factors in different domains has been associated with recruitment and retention in the allied health workforce. For example, factors can be related to the nature of the work, the personal needs, or the way an organisation is led. Some factors cannot be changed (eg geographical location of extended family) whereas others can be influenced (eg education, support, management styles). Recruitment and retention of allied health professionals is a challenging problem that deserves attention in all domains and preparedness to actively change established work practices, both individually as well as collectively, in order to cater for current and predicted health needs. Changes to enhance workforce outcomes can be implemented and evaluated using a cyclic model. The Allied Health Workforce Enhancement Project of the Greater Green Triangle University Department of Rural Health (GGT UDRH) is working towards increasing the number of allied health professionals in the south west of Victoria. Based on themes identified in the literature, an interactive model is being developed that addresses recruitment and retention factors in three domains: (1) personal or individual; (2) organisation; and (3) community.

Adult↗
PubMed2004

Innovation in behavioral health workforce education.

This article describes an effort to promote improvement in the quality and relevance of behavioral health workforce education by identifying and disseminating information on innovative training efforts. A national call for nominations was issued, seeking innovations in the education of behavioral health providers, consumers, and family members. A review committee evaluated each nomination on four dimensions: novelty, significance, transferability, and effectiveness. Nineteen innovations were selected for recognition, all of which are briefly described.

Adult↗
PubMedDate not supplied

Public health workforce enumeration: beware the "quick fix".

The most common source of information on workforce in the United States is the Bureau of Labor Statistics (BLS), a branch of the Department of Labor. In 1998, 14 public health workforce titles were added to the BLS Standard Occupational Classification (SOC) system. While this was a constructive step, it is not a "quick fix," because these additional titles do not solve the longstanding problems inherent in capturing accurate PH workforce data. As is true for all currently available sources, BLS statistics capture a limited segment of public health's broadly defined and multidisciplinary workforce. A standard system of data collection is needed to guide planning to sustain the present and future workforce. Revision of the 1998 SOC in preparation for the 2010 Census is now underway. This presents an opportunity for the public health community to act on prior recommendations regarding workforce data and advocate for more inclusive enumeration of public health occupations that can inform policies and planning for the current and future workforce.

Employment↗
PubMed2000

Strategic management and health workforce policy.

Among the many consequences of health care restructuring is the impact such changes have on the training requirements for the health professions. Since workforce planning has been difficult and sometimes controversial in relatively stable times, it is likely to be even more problematic amid the turbulent changes ahead as the U.S. health care system restructures for the 21 century. Strategic management models emphasizing stakeholder involvement offer a middle ground between the extremes of government mandates and free markets by engaging a variety of participants with a stake in the planning outcome. The following report on the New Jersey effort to engage a variety of health care stakeholders in a participatory management process to shape the state physician workforce may provide useful insights for both managers and policy-makers.

Delivery of Health Care↗
PubMed2005

Improving health among culturally diverse sulbgroups: an exploration of trade-offs and viewpoints annong a regional population health workforce.

ISSUES ADDRESSED: This article addresses availability and implications of evidence about culturally diverse subgroups in population. OBJECTIVES: To determine implications of evidence about culturally and linguistically diverse (CALD) communities for decision-makers and practitioners in population health. METHODS: Self-administered questionnaire of a regional population health workforce. One hundred and four population health staff of the Division of Population Health in South Western Sydney Area Health Service (SWSAHS) were invited to participate (response rate 73%). RESULTS: The majority of respondents were positive about applying culturally appropriate approaches in population health practice in south-western Sydney, a region well known for its cultural diversity. Respondents' levels of uncertainty increased when considering more strident statements, for example deciding exactly what to do when evidence generalisable to specific CALD communities was limited. CONCLUSIONS: Culturally appropriate approaches to population health are needed. As there is uncertainty in the workforce about how to deal with the paucity of ethno-specific evidence, a concerted effort is needed to study population-based interventions in order to increase the evidence base.

Adult↗
PubMed2002

Planning for Canada's health workforce: looking back, looking forward.

"Are there enough health professionals in Canada, and will they be there when I need them? " Answers to these two seemingly simple questions cover a variety of complex and interrelated factors that are not fully understood, as the report about Canada's Healthcare Providers (CIHI 2001) makes clear. The report appears at a time when Canadian political leaders, healthcare organizations, caregivers and others involved with the healthcare system are looking for creative solutions to the human resources challenges facing the health system. Many of the issues are not new; over the last 50 years they have been raised by various groups and government commissions. But there is a sense of urgency today as options for renewing and sustaining Canada's health system are actively being explored. This essay offers highlights from the report, providing a portrait of what is known (and not known) about the people who work in healthcare across the country. It makes clear that whether there are (or are not) enough healthcare providers is not simply a question of numbers of health professionals. From changes in health and healthcare to shifts in the worklife and practice patterns of professionals, a better understanding of the wide range of factors affecting healthcare providers is essential to further the important debates taking place.

Canada↗
PubMed2002

Variation in routine psychiatric workload: the role of financing source, managed care participation, and mental health workforce competition.

This study was conducted to examine the association between psychiatrists' demographic characteristics, payment source, and managed care participation and psychiatrists' practice workload, and between the supply of other mental health providers in a psychiatrist's county of practice and psychiatrists' practice workload. Data from the 1996 American Psychiatric Association National Survey of Psychiatric Practice were merged with national countywide measures of mental health workforce and environmental data from the 1996 Area Resource File. In comparison to male psychiatrists, female psychiatrists treat fewer patients per week, provide less total hours of weekly patient care, and obtain fewer new monthly referrals. An increase in psychiatrists' managed care participation was associated with only minor increases in the number of patients per week, weekly time spent in clinical care, and number of new monthly referrals. The supply of other mental health providers was not associated with variation in practice workload. Once psychiatrists participate in managed care plans, an increase in their participation rate does not significantly expand clinical practice workload. The supply of other mental health providers was not significantly associated with variation in psychiatrists' workload, which suggests that substitution effects may not be evident with this aspect of psychiatric practice.

Adult↗
PubMed1996

From piety to platitudes to pork: the changing politics of health workforce policy.

Policy to subsidize the education of health professionals in the United States has become contentious and uncertain. This article examines the politics of workforce policy in the twentieth century, emphasizing the years since World War II. From early in the century until the 1970s, most decision makers viewed policy to subsidize the education of health professionals as self-evidently correct. As consensus eroded, proponents insisted to increasingly skeptical audiences that these subsidies created benefits for the public. Recently, decision makers outside health care institutions have come to regard workforce policy as serving particular rather than general interests. Thus health workforce policy, like other policies outside of health affairs, may be said, perhaps oversimply but not inaccurately, to have gone through three stages: from piety to platitudes to pork.

Academic Medical Centers↗
PubMed2006

Diversity of the allied health workforce: the unmet challenge.

Although black and Hispanic people together constitute 25% of the American population, they represent only 18% of students enrolled in 4-year colleges and universities. The educational divide further widens within the health professions programs, where < 10% of enrolled students in the allied health professions are black or Hispanic. Health agencies have begun referring to the underrepresentation of minorities in the health professions as a public health crisis. Despite the increased focus that the national government is placing on underrepresented minorities, there has been little to no increase in the number of minorities enrolled in health professions programs. This report examines the roles of educational institutions, accrediting organizations, and the government in addressing diversification of the health workforce. The authors challenge stereotypes that reinforce the belief that the predominant reason for low enrollment by underrepresented minorities is inadequate numbers of qualified minorities.

Accreditation↗
PubMed2001

A systems approach to public health workforce development.

During the 1990s, several distinct but interrelated efforts to strengthen the public health infrastructure were launched. Defining public health work in terms of core functions and essential services, these efforts focused on the competence of the workforce and the performance of public health agencies. The systems approach offered here highlights the relationships and interdependencies among these three components of public health practice: (1) the work, (2) the worker, and (3) the work setting. The model suggests that advances in public health workforce development may require major public health organizational development efforts.

Competency-Based Education↗