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8. Academia
Pages 358-400

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From page 358...
... , several focused on needed improvements in academia regarding the education of public health professionals. The report called for the following changes: · Creating new linkages among public health schools and programs and public health agencies at the federal, state, and local levels; · Developing new relationships within universities between public health schools and programs and other professional schools and departments; · Formulating more extensive approaches to education that encompass the full scope of public health practice; · Strengthening the knowledge base in the areas of international health and the health of minority groups; · Conducting a wide range of research that includes basic and applied research, as well as research on program evaluation and implementation; and · Developing new training opportunities for professionals who are already practicing in public health.
From page 359...
... The Public Health Faculty/Agency Forum, convened by CDC and the Health Resources and Services Administration (HRSA) , illustrates one way in which nonacademic institutions convene and foster cooperation and coordination between academia and public health agencies in support of community health.
From page 360...
... convened the Committee on Educating Public Health Professionals for the 21st Century that, concurrent with the work of the Committee on Assuring the Health of the Public in the 21st Century, has conducted an in-depth examination of the future needs of public health professional education and developed a framework and recommendations for how, over the next 5 to 10 years, education, training, and research in programs and schools of public health can be strengthened to prepare future public health professionals to improve population health. Given the in-depth examination and analysis of public health education that was undertaken by the IOM Committee on Educating Public Health Professionals for the 21st Century, the present report will not go into detail about the future of public health education but, rather, will briefly describe the kinds of degree and professional development programs available, discusses the current workforce and its training needs, identifies problems and barriers to providing public health education, and makes recommendations for maximizing academia's contributions to the education of the current and future public health workforce.
From page 361...
... , in an 18-month study of the Texas public health workforce, counted nearly 17,700 professional public health workers in that state. Only one-third of the professional public health workforce identified in that study was employed in official public health agencies, and only an estimated 7 percent had formal education in public health.
From page 362...
... Thus, in the early l900s, the public health workforce was trained primarily in medicine, nursing, and the biological sciences (Brands and Gardner, 2000; Garrett, 2000; Mullan, 2000~. Basic public health training now requires an approach that incorporates understanding of the following: rations; · Health problems must be examined in the context of defined popu· Many problems of public health are deeply rooted in the behavior of individuals and in their social context; · Public health problems of the twenty-first century are rooted in the technologies of economic development; and · Public health problems continue to require the engagement of the body politic, in the form of government participation, for their solution (Fineberg et al., 1994~.
From page 363...
... For example, the Pew Health Professions Commission (O'Neil, 1998) has developed a set of 21 competencies for successful practice that apply to physicians, nurses, and allied health professionals.
From page 364...
... Preventive medicine certification and training is another example of integrated interdisciplinary learning. In preventive medicine training, the primary emphasis is on disease prevention and health promotion.
From page 365...
... For additional information about preparing nurses to enter the public health workforce, refer to Who Will Keep the Public Healthy?
From page 366...
... Additional discussion of the need to increase collaboration and education between public health and other health professions can be found in the report Who Will Keep the Public Healthy? , developed by the IOM Committee on Educating Public Health Professionals for the 21st Century (IOM, 2003~.
From page 367...
... They founci that communication was the area in which public health professionals require the most training, with the four most highly rated topics being interpersonal communication, cross-cultural and cross-age communication, electronic communication, and participatory teaching and training skills. The educational and training needs of the current public health workforce are enormous and multifacetecl.
From page 368...
... · Grants to assist accredited schools of public health and other public or nonprofit educational entities with accredited graduate programs in health administration, health planning, or health policy analysis and planning in meeting costs of special projects to develop new programs or expand existing ones in the same four public health disciplines mentioned above. · A requirement for the Secretary of Health and Human Services, in coordination with the National Center for Health Statistics, to continuously develop and disseminate statistics and other information on the supply of and need for different types of public and community health personnel.
From page 369...
... 89-109. Community Health Services Extension Amendments of 1965 Authorized a 3-year program of grants to public or other nonprofit institutions or to individuals for traineeship awards for graduate or specialized training in public health.
From page 370...
... Extended for 2 years (through FY 1971) authority for traineeship awards for professional public health personnel, with up to $14 million authorized for FY 1971, and extended through FY 1971 authority for project grants for graduate or specialized training in public health, with up to $12 million authorized for 1971.
From page 371...
... Each of the Public Health Training Centers for each respective state or region will work to · Assess the educational needs of and training materials and facilities available to local and state public health agencies; · Use distance-learning technology and other new educational approaches to provide both basic and specialized public health education; · Improve public health providers' ability to interpret and make informed decisions based on relevant data and information; · Establish on-site educational programs in underserved areas; · Develop field-based educational opportunities for students from traditional on-campus graduate public health programs; · Develop new curricula for public health practitioners on emerging public health issues such as bioterrorism, behavioral and mental health, domestic and societal violence, and environmental health issues; and · Train lay workers from local boards of health and community health offices. The centers are designed to offer training and continuing education programs to about 100,000 public health students and professionals each year.
From page 372...
... Core courses in epidemiology, health policy, health management, biostatistics, behavioral sciences, and health education were typically delivered in the first half of the program. In the later phase, students focused on one of the following specialty tracks: epidemiology and surveillance, health policy and management, or community health.
From page 373...
... Distance-learning programs and new information technologies are perceived to be a boon to meeting the educational needs of the public health workforce in the United States (Cannon et al., 2001~. Although this development builds on more than two decades of computer networking activities (e.g., e-mail and bulletin board systems)
From page 374...
... The committee recommends that Congress increase funding for HRSA programs that provide financial support for students enrolled in public health degree programs through mechanisms such as training grants, loan repayments, and service obligation grants. Funding should also be provided to strengthen the Public Health Training Center program to effectively meet the educational needs of the existing public health workforce and to facilitate public health worker access to the centers.
From page 375...
... He defines public health systems research as "a field of inquiry using quantitative or qualitative methodology to examine the impact of the organization, financing, staffing, and management of systems on the access to, delivery, cost, outcomes, and quality of population-based services." Turnock (2001) states that improving public health practice requires research that explicates the links and relationships of key processes, programs, and services or outputs.
From page 376...
... CDC defines prevention research as research directly applicable to public health practice (Doll et al., 2001~. Sattin (2001)
From page 377...
... Examples of well-known population-based research include the Framingham Heart Study, which continues to yield new insights, and the Woman's Health Initiative (see Box 8-1~. Although population-based studies are often used to generate hypotheses about the potential risk factors for disease, population studies can also test hypotheses developed in earlier studies.
From page 378...
... states that research needs a three-way partnership of academia, public health practice groups, and community-based organizations. A key factor in establishing successful partnerships is trust (Nelson et al., 1999~.
From page 379...
... The Process Phase During the process phase, potential intervention strategies and research instruments are designed and pilot tested among small community samples (Valente, 2002~. Agreement must be reached on the health promotion strategies, specific media and messages, and research instruments after repeated iterations.
From page 380...
... A specific example of community-based research in which academia has the potential to contribute in many ways is the Community Health Improvement Process discussed in Chapter 4 (see Figure 8-1~. Unfortunately, academic institutions have undervalued communitybased participatory research.
From page 381...
... Therefore, the committee recommends that federal funders of research and academic institutions recognize and reward faculty scholarship related to public health practice research. Funding of Prevention Research The Centers for Disease Control and Prevention CDC, in collaboration with local, state, and other federal health and education agencies, plays a major role in prevention activities in the United States.
From page 382...
... Funds for the projects are provided by the CIOs and are administered by CDC's Public Health Practice Program Office (PHPPO)
From page 383...
... They are intended to serve as bridges between science and practice and from academia to state and local health departments, health care providers and provider organizations, and community organizations, as well as CDC. Evaluation research is embedded in many of the PRC interventions; the centers also train public health professionals in applied prevention research (IOM, 1997a)
From page 384...
... een pregnancy prevention and youth development Risk reduction and early detection in AfricanAmerican and other minority communities Partnerships with Native American communities to improve health and wellbeing Improving community health through workplace health promotion
From page 385...
... Louis 1994 University of South Carolina, Columbia 1993 University of South Florida, Tampa 1998 University of Texas, Houston Health 19 8 6 Science Center Tulane Medical Center, New Orleans 1998 University of Washington, Seattle 19 8 6 West Virginia University, Morgantown 1994 Yale University, New Haven Promoting healthy behavior in Native American 1998 populations Chronic disease prevention in high-risk communities Promoting health through physical activity Community-based marketing for disease prevention and health promotion From healthy children to healthy adults Environmental agents and the health of communities Keeping older adults healthy and independent by using community partnerships Health promotion and disease prevention in rural Appalachia Public health initiatives across the prevention spectrum SOURCE: Doll et al.
From page 386...
... It has invested in largescale community trials (Green et al., 2001) , conducts research on risk factors for disease, and evaluates drugs for secondary prevention of disease.
From page 387...
... A Pew Health Professions Commission report (O 'Nell, 1998) stated, "The nation and its health professionals will be best served when public service is a significant part of the typical path to professional practice." The academic community provides three kinds of service: 1 ~7 .
From page 388...
... Collaboration As communities try to address their health issues in a comprehensive manner, all of the stakeholders will need to sort out their roles and responsibilities, which will vary from community to community. These interdependent sectors must address issues of shared responsibility for various aspects of community health and individual accountability for their actions.
From page 389...
... Additionally, governmental financial and programmatic constraints require health partnerships, coalitions, and shared resources to achieve public health objectives (Baker et al., 1994~. What makes for a successful collaboration?
From page 390...
... Each center will develop a regional hub of expertise for the use of genetic information to improve health and prevent disease. In addition to contributing to the knowledge base on genomics and public health and providing training for the public health workforce, the centers are to provide technical assistance to regional, state, and local public health organizations.
From page 391...
... The centers work in collaboration with partners across their regions to assure a well-trained and prepared public health workforce, informed health care providers, and an alert citizenry to protect against terrorism. In September 2000, CDC, the Association of Schools of Public Health, state and local public health agencies, and other academic communities entered into a partnership to begin development of a national system of Centers for Public Health Preparedness (DHHS, 2002~.
From page 392...
... National Center of Excellence for Environmental Management Local exemplar centers DeKalb County Health Department Denver Public Health Monroe County Health Department campuses across the United States that support and facilitate student and faculty work in communities; (2) the National Service-Learning Exchange, which provides training and technical assistance to service-learning programs; (3)
From page 393...
... A continuing barrier to scholarly service and one of great concern relates to faculty rewards, promotion, and tenure. Public health practice activities are not generally valued or rewarded by most academic institutions.
From page 394...
... This knowledge is applied as consultant, professional expert, or technical advisor to the university community, the public health practice community, or professional practice organizations. The dimension of scholarship distinguishes practice-based service from a form of service known traditionally as the general responsibilities of citizenship.
From page 395...
... Numerous activities have been undertaken to educate and train the current and future public health workforce through methods such as classroom-based instruction, distance-learning programs, and training and leadership institutes. Stagnant and shrinking resources allocated to public health training are, however, impeding the ability of academic institutions to address today's new and emerging health problems.
From page 396...
... A Global and National Implementation Plan for Public Health Workforce Development. Revision date: January 5, 2001.
From page 397...
... 2001. Survey of Graduate Programs in Public Health and Preventive Medicine and Community Health Education.
From page 398...
... 2000. A threat to the public health workforce: evidence from trends in preventive medicine certification and training.
From page 399...
... 1997. Assessing the Training and Education Needs of the Public Health Workforce in Five States.
From page 400...
... 2001. Survey of Graduate Programs in Public Health and Preventive Medicine and Community Health Education.


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