These are publications authored by MPHTC partners. To read the full article, click on the publication title.

The Need for Responsive Workforce Development During the Pandemic and Beyond: A Case Study of the Regional Public Health Training Centers

January/February 2024

Authors: Phoebe Kulik, Melissa Alperin, Karla Todd Barrett, Betty Bekemeier, Patricia Documet, Kimberly Francis, Christian Gloria, Erich Healy, Roger Hileman, Hope Kenefick, Alyssa Lederer, Jonathon Leider, Lisa McCormick, Laura Prechter, Kelly Reynolds, Megan Rogers, Barbara Rose, Elaine Scallan Walter, Laurie Walkner, Danielle Zemmel, Laura Power

Context: The COVID-19 pandemic underscored the importance of a strong public health infrastructure for protecting and supporting the health of communities. This includes ensuring an adaptive workforce capable of leading through rapidly changing circumstances, communicating effectively, and applying systems thinking to leverage cross-sector partnerships that help promote health equity. The 10 Regional Public Health Training Centers (PHTCs) advance the capacity of the current and future public health workforce through skill development and technical assistance in these and other strategic areas.
Program: This study examines activities through which the Regional PHTCs and their partners supported the public health workforce during the pandemic. Representatives of the 10 Regional PHTCs completed a survey in the spring of 2022. The survey included (1) pulling trends in training usage from 2018-2021 annual performance reports and (2) questions assessing the type, content, and reach of training needs assessments, training and technical assistance, student placements, and PHTC Network collaborative activities that occurred from January 1, 2020, to December 31, 2021. Respondents also reflected on trends in use, challenges, lessons learned, stories of impact, and future PHTC practice.
Evaluation: During the pandemic, the Regional PHTCs engaged in numerous efforts to assess needs, provide training and technical assistance to the practice community, facilitate projects that built student competency to support public health agency efforts, and collaborate as the PHTC Network on national-level initiatives. Across these activities, the Regional PHTCs adjusted their approaches and learned from each other in order to meet regional needs.
Discussion: The Regional PHTCs provided student and professional development in foundational public health knowledge and skills within their regions and nationally while being flexible and responsive to the changing needs of the field during the pandemic. Our study highlights opportunities for collaboration and adaptive approaches to public health workforce development in a postpandemic environment.

Creating a Vision for a Healthier Workforce Using a Systems-Based Approach

September/October 2022

Authors: Laurie Walkner, Kathleen May, Bailey Goldman, Hannah Shultz, Sonja Armbruster, Brandon Grimm, Suzanne Hawley, Abigail Menke, Shirley Orr, Kristin Wilson, Jeneane Moody, Tanya Uden-Holman, Kaci Ginn

Context: The public health system faces unprecedented challenges due to the pandemic, racism, health inequity, and the politicization of public health. At all levels of the system, the workforce is experiencing distress, burnout, safety issues, and attrition. Public health is being challenged to demonstrate and justify its impact and value, while also leveraging opportunities for learning and system strengthening.
Program: To explore the current state and identify opportunities to strengthen the public health system, the Region 7 Midwestern Public Health Training Center (MPHTC), with support from Engaging Inquiry, embarked on a distinctive type of systems analysis, called “dynamic systems mapping.”
Implementation: This approach brought together diverse sectors of public health partners in the region to develop a rich contextual narrative and system-level understanding to highlight and align existing and emergent strengths, areas for growth, and tangible goals for the immediate- and long-term sustainability of local and regional health.
Evaluation: Focus groups and workshops were conducted with diverse practitioners to identify upstream causes and downstream effects of 11 key forces driving system behavior. These focus groups resulted in the development of a visual map that MPHTC is utilizing to identify opportunities for leverage, develop strategies to maximize the potential impact of these leverage points, as well as facilitate continuous learning.
Discussion: Public health utilization of systems mapping is a valuable approach to strengthening local and national system responses to current and future public health needs. Outcomes and lessons learned from the systems mapping process are discussed.


September 2021

Authors: Mayela Arana, Dena Fife, Dany Zemmel, Nicole Dettmar, Tamira Moon

Intentionally focusing on justice is crucial to achieving health and racial equity. Many professionals in the field of public health are familiar with health and racial equity principles; they often lack the knowledge or skills to connect theory to action and measurable impact. Public health practitioners need to be able to challenge organizational policies and equity initiatives that uphold institutional and structural racism. Having a tool that enables this examination and provides accountability is vital to addressing health disparities and bringing about true racial justice. To address this imperative, the HRSA-funded Public Health Training Centers (PHTCs) in partnership with the National Coordinating Center for Public Health Training began holding monthly conversations around racism and the role of PHTCs. As a result of these conversations, the PHTCs developed the Racial Justice Workgroup to formalize their racial justice work. The workgroup also creates a unified framework that all the PHTCs, their partners, and the public health agencies in each region can use to provide racial justice education and training. The goal is to establish clear, specific, consensus-based recommendations and produce a Racial Justice Competency Model (RJCM).


July 2019

Authors: Brandon Grimm, Christine Arcari, Athena Ramos, Tricia LeVan, Kathleen Brandert, Keyonna King, Mohammad Siahpush, Tzeyu Michaud, Patrik Johansson, Charlotte Burke, Liene Topko

Objectives: The objectives of our study were to (1) illustrate a public health workforce assessment process in a medium-sized city or county health department and (2) demonstrate the insights gained by moving from the use of aggregate department-level and competency domain-level training needs results to more granular division-level and skills-level results when creating a workforce development plan. Methods: We used a 130-question needs assessment to guide the creation of a workforce development plan for the Lincoln Lancaster County Health Department (LLCHD) in Nebraska and its 7 divisions. Using SurveyMonkey, we administered the survey to 128 (of the 129) LLCHD public health staff members in June 2015. Using a Likert scale, respondents indicated (1) the importance of the skill to their work and (2) their capacity to carry out 57 skills in 8 domains of the core competencies for public health professionals. We identified training needs as those for which the percentage of respondents who perceived moderate-to-high importance was at least 15 percentage points higher than the percentage of respondents who perceived moderate-to-high capacity. Results: LLCHD as a department had training needs in only 2 competency domains: financial planning and management (importance-capacity difference, 15 percentage points) and policy development and program planning (importance-capacity difference, 19 percentage points). The Health Promotion and Outreach division had training needs in all 8 domains (importance-capacity difference range, 15-45 percentage points). Of the 57 skills, 41 were identified by at least 1 of the LLCHD divisions as having training needs. In 24 instances, a division did not qualify as having training needs in the overall domain yet did have training needs for specific skills within a domain. Conclusions: When performing public health workforce assessments, medium-to-large public health departments can obtain detailed workforce training needs results that pertain to individual skills and that are tailored to each of their divisions. These results may help customize and improve workforce development plans, ensuring that the workforce has the necessary skills to do its job.


April 2019

Authors: Suzanne Hawley, Karen Crimmings, Ivonne Rivera-Newberry, Shirley Orr, Laurie Walkner

Growth in the demand for public health services, along with limited funding, makes workforce collaboration and capacity building imperative. The faculty and staff of the Midwestern Public Health Training Center, with two Robert Wood Johnson Public Health Nurse Leaders, postulated that training could be more effective, and public health workers more effective in the field, if workers contributed to training format and content. The learning paradigm was tested on diabetes prevention and self-management programs. Public health professionals were surveyed on infrastructure, practices, roles, and gaps in diabetes-related services. Responses influenced the format and content of a one-day diabetes summit training program. Participants submitted evaluations immediately afterward. Eight months postsummit, participants were surveyed to self-assess behavioral changes attributed to the training. Using the Kirkpatrick model for evaluation, participants (n = 112) stated that the training met their expectations and that knowledge gained was consistent with stated training objectives. Qualitative postsummit survey results indicated that improvements in participants’ delivery of diabetes prevention services to the public could be attributed to the training they received at the summit. Results suggest that training about specific programs and practices, as well as facilitated sessions of collaboration, can yield individual and organizational change.


June 2017

Authors: Laurie Walkner, Tanya Uden-Holman, Jeneane Moody, Joy Harris

In the past few years, the drive for public health department accreditation has continued to build momentum. As the Centers for Disease Control and Prevention notes, “Engaging in accreditation catalyzes quality and performance improvement within all public health programs and can help health departments be better prepared to proactively respond to emerging and reemerging health challenges”. Many organizations support accreditation efforts, including the Public Health Training Centers (PHTCs), which have been providing workforce development support since 1999. This article describes how one PHTC, the Midwestern Public Health Training Center, has supported capacity building for accreditation in partnership with other state-based organizations through the development of three major accreditation readiness activities: accreditation workshops, informational videos on Public Health Accreditation Board standards and measures, and competency-based workforce development assessments. Given the current and emerging public health challenges, the need for a well-prepared workforce is more important than ever to strengthen the public health system, and by engaging in activities to meet the accreditation standards, public health departments will be better positioned to respond to these challenges. PHTCs will continue to have a critical role in capacity building for accreditation.

The Public Health Learning Network is the nation’s most comprehensive system of educators, public health experts, and thought leaders whose mission is to advance public health practice and improve population health in the United States. One of 10 regional centers in the Public Health Learning Network, the Midwestern Public Health Training Center Regional Coordinating Center has developed expertise in the development of competency-based eLearning to meet the training needs of the public health and health care workforce. eLearning has become a widely used method for providing online training to strengthen a learner’s knowledge, skills, and attitudes. This article discusses the use of the analysis, design, development, implement, and evaluate model as a standard for instructional design and best practice elements of eLearning. Two examples of eLearning programs are provided, along with data on level of interactivity and Kirkpatrick Level 1 and 2 evaluation results. Evaluation data indicate that users’ experiences have been positive.


September 2017

Authors: Brandon Grimm, Kathleen Brandert, David Palm, Colleen Svoboda

In 2013, the Nebraska Department of Health & Human Services, Division of Public Health (Nebraska’s State Health Department); and the University of Nebraska Medical Center, College of Public Health developed a comprehensive approach to assess workforce training needs. This article outlines the method used to assess the education and training needs of Division staff, and develop comprehensive workforce development plans to address those needs. The EDIC method (Engage, Develop, Identify, and Create) includes the following four phases: (1) Engage Stakeholders, (2) Develop Assessment, (3) Identify Training Needs, and (4) Create Development Plans. The EDIC method provided a process grounded in science and practice, allowed input, and produced buy-in from staff at all levels throughout the Division of Public Health. This type of process provides greater assurance that the most important gaps in skills and competencies will be identified. Although it is a comprehensive approach, it can be replicated at the state or local level across the country.


December 2016

Authors: Brandon Grimm, Shinobu Watanabe-Galloway, Denise Britigan, Alice Schumaker

Leadership programs in public health have been declining in numbers since 2012. The decline in training programs could be due to the lack of outcome-based results and the lack of a manageable set of standardized skills needed for public health leadership. A comprehensive study was completed in two phases to determine if the current model of public health leadership institutes is effective at generating outcome-based results. The following paper will focus on the first phase of the study. The first phase included a qualitative analysis to determine the domains, definitions, and skills needed to lead. An analysis of the skills, domains, definitions, and traits included in five established and commonly used leadership models/theories in public health leadership development (Transformational, Servant, Appreciative, Collaborative, and Emotional Intelligence leadership) plus the National Public Health Leadership Development Network (NLN) Leadership for Community Health, Safety & Resilience Competency Framework was completed. Of the 161 different skills, definitions, traits, and/or competencies from the five leadership models and the NLN competency framework, 123 were determined to be related to one of six domains needed for leadership and were defined into 21 skills. The findings could lead to more uniformity in public health leadership development and evaluation.


June 2015

Authors: Brandon Grimm, Patrik Johansson, Preethy Nayar, Bettye Apenteng, Samuel Opoku, Anh Nguyen

Introduction: In 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821) conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments, and urban Indian clinic) public health workforce across three professional levels. The objectives of the needs assessment were to determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health training interests, needs, and preferences, and to determine the barriers and motivators to participate in public health training.
Methods: The assessment was developed using the Council on Linkages Between Academia and Public Health Practice, Core Competencies for Public Health Professionals survey (1). The final assessment was created and piloted by numerous individuals representing practice and academia.
Results: Respondents identified cultural competency and communication skills as the two most important public health competency domains. Although the public health professionals perceived that they were least proficient in the area of policy development and program planning, participants identified the greatest needs for training in financial planning and management skills and analytical/assessment skills. In general, respondents preferred instructor-led interactive training sessions offered as onsite multi-day workshops or computer-based courses. Respondents identified obesity, health disparities, physical activity, chronic diseases, and diabetes as the top five public health topical areas.
Conclusion: These priorities align with State and National public health plans. The findings of the needs assessment were used to tailor educational opportunities to build the capacity of Nebraska’s public health system. Additionally, the results were used to develop workforce development plans for numerous local health departments throughout Nebraska.


September 2014

Authors: Laurie Walkner, Dena Fife, Jennifer Bedet, Mary DeMartino

Public health laboratories are an integral partner in preparedness and emergency response. The Upper Midwest Preparedness and Emergency Response Learning Center (UMPERLC)* and the State Hygienic Laboratory at the University of Iowa have a long history of working together to identify and meet the preparedness training needs of the laboratory workforce. The training, Anatomy of a Foodborne Outbreak, which uses a digital story format, provides an example of this partnership.


May 2014

Authors: Kathleen Brandert, Claudine McCarthy, Brandon Grimm, Colleen Svoboda, David Palm, Jim P. Stimpson

There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska’s state and local public health staff and their community partners to use public health policy and law as a public health tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state’s public health workforce. Challenges and lessons learned when offering workforce development on public health policy efforts are discussed.


November 2005

Authors: Tanya Uden-Holman, Laurie Walkner, Dan Huse, Barry Greene, Dawn Gentsch, Christopher Atchinson

The Upper Midwest offers a distinct environment for identifying and addressing threat and preparedness scenarios. The population is often scattered, with residents using urban centers periodically. This has also led to the challenge of providing specific skills and cross-disciplinary awareness and coordination to the public health community. The Upper Midwest Center for Public Health Preparedness was established by a grant from the Centers for Disease Control and Prevention to assist in meeting the challenge of adding capacity to develop the preparedness workforce in the Upper Midwest. Project Public Health Ready (PPHR) provides an example of the role academic preparedness centers can play in partnering with local public health agencies to strengthen the public health workforce. The purpose of this article is to present the Iowa Systems Model for Workforce Development being utilized for workforce training and education, describe how the model has been applied in the example of PPHR, and discuss lessons learned from the PPHR experience.