Council on Linkages Between Academia and Public Health Practice

Meeting Minutes
Wednesday, March 17, 1999
9:00 a.m. – 3:00 p.m.
Crystal City, VA

I. Opening Business

Dr. C. William Keck, chair, opened the meeting and welcomed all participants.  A special welcome was extended to new members: Society for Public Health Education (SOPHE) and the National Environmental Health Association (NEHA).  Special thanks were given to Prevention ’99 for providing the meeting room.  The minutes from the last Council meeting on November 19, 1998 were unanimously approved without comment.

 

II. Council on Education for Public Health (CEPH)

A. Presentation of CEPH’s Accreditation Process
Ms. Patricia Evans, Executive Director, presented a summary of CEPH and its accreditation process.  CEPH was formed in 1974 to assist graduate schools of public health, including graduate programs in community health education and community health/preventive medicine, in evaluating content and quality of their programs, CEPH grants accreditation to those school(s) and programs which meet its published criteria.  Its board of directors is composed of representatives from both academia and public health practice.  CEPH has set accreditation criteria for graduate schools of public health, graduate community health education programs and graduate community health/preventive medicine programs.  The criteria create a relative standard for graduate and post-graduate level public health students.  CEPH is interested in a set of criteria that will place emphasis on practice related activities.  During its current revision process, CEPH is looking to refine criteria and does not expect to make major changes.   Criteria are to be specific enough to provide guidance and hold schools accountable, but also flexible enough to accommodate schools with different mission statements.

Ms. Evans explained that the accreditation process for schools of public health involves the following steps:

• Schools complete a self-evaluation
• 5 member team visit by CEPH
• CEPH staff and members meet with faculty, students and alumni
• Evaluation and accreditation decision by the accreditation board

Dr. Keck related this topic of discussion to Council Objective 2.  "Enhance the quality of public health education by encouraging the incorporation of competencies in the curriculum and accreditation of all public health programs."

B. Council Discussion and Recommendations
The Council expressed concern that the linkage to federal, state and local agencies was not clear in the accreditation process.  Field experience is where most linkages come from, but field experience is not required.  It is considered an "important" component.  The criteria for waiving practical experience are to be determined on a case-by-case basis.  There is also a criterion that requires some type of career counseling and advising be in place.  It was suggested job fairs be required for schools of public health to provide networking opportunities for the students and additionally, that students may want access to faculty members as job mentors.

Dr. Keck re-visited the issues of accredited verse non-accredited programs - we simply do not know anything about the non-accredited programs.  Ms. Evans explained that there are 60 plus accredited programs and 9 that are in applicant status.  The Council agreed increasing the importance of accreditation is a Council role.

Dr. Sue Hassmiller of the Robert Wood Johnson Foundation asked about the movement towards outcomes based criteria.  Ms. Evans explained that schools are responsible for developing measurable learning objectives around the competencies.  They are also responsible for identifying these outcome measures and documenting the processes and procedures that accomplish them.  It was suggested that documentation criteria on how research is applied should be enhanced.

Discussion turned to the public health competencies that will be needed 5 to 10 years from now.  Dr. Keck explained that the 10 Essential Public Health Services are currently included in curriculum design at many institutions, but not all.  The profession pushes the CEPH objectives and the CEPH criteria provide a framework for the schools.  It was suggested that schools of public health should be required to have a process to determine competency needs of the current and future work force.  In response, Dr. Charles Mahan described the University of South Florida’s survey process - every two years, students, alumni and employers are surveyed about their needs and successes as public health professionals.   Dr. Mahan also stressed the importance of pushing the accreditation process to make linkages happen.  He suggested leadership groups for doctoral students that focus on the future of public health.

Ms. Elaine Auld, SOPHE, suggested looking to the criteria to get more faculty involved in the practice realm and to establish incentives for such involvement.  Council members suggested encouraging schools of public health to reward linkages as part of their tenure track evaluation.  There needs to be a real collaboration between the community and schools of public health to help break down the wall.  Mr. Mike Gemmell, Association of Schools of Public Health, reminded Council members that many schools of public health have adopted promotion criteria that reward faculty for their practice and service activities.

Dr. Hugh Tilson brought forth a motion that the Council commends CEPH and Patricia Evans for their leadership in this area of public health.  The motion was unanimously passed.

Ms. Evans invited comments particularly focusing on how to monitor the quality of continuing education credits, distance learning programs and certificate programs and what these mean to the degree structure.  In the past CEPH tended to treat these as part of the school’s services.  Many schools are now offering them as academic credits towards a degree.

Dr. Keck summarized the four recommendations for CEPH from the Council:

• Encourage CEPH to enhance a practice component for schools of public health.
• Ensure that faculty are rewarded for linkage work in the community.
• Encourage schools of public health to perform a needs assessment with students, alumni, faculty and employers to forecast competency needs.
• Enhance criteria for documentation of applied research.

It was agreed that Council members would e-mail staff within one week, any additional comments or recommendations.  Staff will draft a letter to CEPH and transmit it within two to three weeks.

 

III. National Public Health Practice Research Agenda

Dr. Keck related this item of business to Council Objective 1. ("Encourage all accredited public health educational programs to engage in collaborative research and to create public health practice offices/programs dedicated to building public health capacity at the state and local levels and throughout the organized health services delivery system.")

Dr. Tilson summarized his recent presentation to the Public Health Functions Working Group Workgroup (PHFWG) about the public health practice research agenda.  The PHFWG is in support of this initiative and encouraged progress with the research agenda. It also suggested changing the concept of a "pilot project" to a "feasibility study."

The discussion focused on other research initiatives and future action for the Council.  The Centers for Disease Control and Prevention (CDC) may be developing its own research agendas with a trickle-up effect.  It was suggested that the Council model its protocol after the National Occupational Research Agenda for the National Institute for Occupational Safety and Health.  Collaboration with the Partnership for Prevention was also suggested.

The participants were encouraged to share the progress to date with the CDC and receive approval for the Council to move this forward.  The need for the research to translate into practice was addressed.   Mr. Randy Schwartz felt that SOPHE would be able to look at ways to operationalize a research agenda.  He was enthusiastic about bringing the SOPHE research committee into this and having them participate during the feasibility phase.  The issue of keeping technology transfer separate from the research was stressed.  There is a difference between researching what we already know and learning something new.

The Council felt it would be good to have a sense of "ownership" during the feasibility phase and then turn full implementation over to other organizations.  Dr. Tilson recommended the Council actively seek funding for the feasibility study, with CDC support.  Dr. Keck proposed that the Council move forward with a draft proposal for the research agenda.  There was consensus among the members to move forward.  Dr. Wasserman and Mr. Schwartz expressed interest in being a part of a sub-group that continues with the research agenda.

 

IV. Academic Public Health Agencies

Dr. Keck related this item of business to Council Objectives 1 and 7. (Objective 7 – "Work with public health practice associations to promote training and educational initiatives with academic organizations.  Identify initiatives of these associations in the areas of education and training.")

Dr. Keck opened the discussion by explaining that the Council is trying to raise awareness of the importance and benefits of academic/practice linkages and assure the right ideas are addressed.  Participants expressed concern over the following:

• The use of the word "agency," because it gives the impression of an entity in and of itself as opposed to a partnership trying to join academics with public health departments

• The discussion about academic public health agencies was centering on one end of the spectrum, and the concept needed to be somewhere in the middle.  There is a need for a wide variety of models and broader framing would be more helpful.

• The need for funding for "teaching health departments" comparable to teaching hospitals.  There is a lack of funding to join agencies and schools.  One possibility would be to reimburse faculty for teaching in a department of health.

The Council suggested finding a way to define and express the different types of relationships schools of public health have with health departments.  Dr. Keck, Mr. Bialek, Mr. Milne and Dr. Wasserman volunteered to assist in developing questions, as an initial step in characterizing the different types of relationships.  There was a motion to move forward with this.  The survey will be sent out via the NACCHO Membership Monthly.

Dr. Keck requested Council members read and provide comments on the draft academic health agency concept paper.

 

V. State Association of County Health Officials (SACHO) Demonstration Project

Dr. Keck related this piece of business to Council Objective 7.

The SACHO demonstration project proposes to work in one state with the state association of county health officials, the state’s public health academic institutions, and the state health department.  The Council will facilitate a one-day meeting that brings together the practice and academic communities so they can explore mutually beneficial opportunities involving/requiring collaboration.  The Council will continue to pursue the potential linkages through conference calls and by providing technical assistance.

Dr. Mahan moved that the Council move ahead with the SACHO demonstration project and suggested implementing it in Ohio, as recommended.  The motion was unanimously passed.

 

VI. Healthy People 2010 Infrastructure Objectives

Ms. Carol Roddy of Health Resources and Services Administration presented information on Chapter 14 of Healthy People 2010 – Infrastructure.  The two overarching suggestions received via the public comment period were: 1) make Chapter 14 Chapter 1; and 2) expand the phrase "federal, state and local agencies" to "federal, state, tribal and local agencies."   The Healthy People Steering Committee debated whether or not there should be a separate chapter on data as a result of the public comments received, and concluded that data should remain part of the infrastructure chapter.  The Council was also informed that the research objectives were suggested for elimination because they were seen as not measurable.

The Council agreed that objectives on data information systems should be kept under the Infrastructure chapter.  It was motioned that the Council go on record as a group recommending the Chapter on Infrastructure be moved to Chapter 1 and the research objectives be maintained.  This was seconded and approved.  The Council staff will draft a letter conveying these recommendations to Surgeon General David Satcher and Secretary Donna E. Shalala, to be sent before the Secretary’s Council meeting in April.

 

VII. Public Health Workforce Training

Dr. Mahan presented on the action steps resulting from the meeting:

• Develop a leadership system around the workforce development efforts to sustain and coordinate these efforts.
• Make workforce training a priority issue for all public health organizations and agencies.
• Re-examine funding streams.  Bring in other groups to see how to do this quickly and inexpensively.
• Create a clearinghouse for development information.
• Assess the need and capacity for workforce training.

The following points were made following Dr. Mahan’s presentation:

• Schools of public health are not the only place for workforce training.
• Assessing the barriers to staff participation in training programs is necessary.
• ASTHO was developing a paper on training barriers.
• There are data available from Environmental Health training efforts that may be helpful.
• ASPH is already moving on the needs assessment piece.
• Public Health Foundation (PHF) is developing the clearinghouse.
• Maggie Potter from the University of Pittsburgh has received a grant for HRSA to start researching workforce training.

 

VIII. Potential Activities with National Center for Health Statistics (NCHS)

Dr. Edward Sondik, Director, National Center for Health Statistics, provided meeting participants a brief overview of NCHS.   Dr. Sondik is attempting to foster greater community collaboration and input.   In the spirit of collaboration, NCHS would like to call meetings and ask for guidance from the community.  NCHS would also like to provide the opportunity for people to work with NCHS staff through IPA’s and fellowships (3 months to 2 years).   Dr. Sondik suggested that this is a good opportunity for faculty and health department staff.  NCHS is also interested in university visitation programs and distance learning modules.  Additionally, NCHS is looking for opportunities for its staff to work in the community, through schools of public health, state and local agencies.

Dr. Sondik expressed interest in establishing a set of contacts with Council organizations.  It is anticipated that prevention research dollars can be used to perform research using NCHS data.  Another possibility is to collaborate on a data analysis workshop.  The workshop would focus on the analysis of state, regional and local data.  Dr. Sondik suggested that this collaboration will be a good way to share "best practices" and assess what needs to be done.  Dr. Sondik also stressed that the upcoming census will drive changes in many agendas due to racial, ethnic and socio-economic changes, making collaborative efforts even more important.

Dr. Keck stated that there was the potential for Council organizations to develop a relationship with NCHS and suggested the following action steps:

• Draft a one or two page article for The Link describing opportunities with NCHS.
• NCHS to provide set of slides on the SES Chartbook which can be listed as a reference in The Link.
• Initiate a Public Health Practice Committee to assist in developing a workshop for state and local data.

Dr. Brown suggested the Council help encourage the use of NCHS data.  It was suggested that the Council facilitate the distribution of information on NCHS resources in the academic and practice community.  The Council also stressed the need to be able to translate and use the data with local politicians, parents, media, etc.

 

IX. Member Presentations

A. CDC: Guide to Community Preventive Services
Dr. Moulton reported that the Public Health Practice Program Office (PHPPO) and the Epidemiology Program Office (EPO) staffed the task force.  A reorganization resulted in the guide going entirely to the EPO.  PHPPO currently is in the process of transitioning evaluation and field testing to the EPO.  Another significant change of the reorganization is that PHPPO was asked by Dr. Jeffrey Koplan to lead the development of a CDC-sponsored training/workforce development program.

B. NEHA
Dr. Gist distributed a handout on NEHA’s origin, mission, membership, governance and programs and services.  She gave a brief overview of the handout.  Dr. Moulton reported that the Agency for Toxic Substances and Disease Registry and the National Center for Environmental Health are developing training in environmental health issues and will do more organized training at the state and local levels.

C. SOPHE
Mr. Schwartz reported that SOPHE is putting out a new journal - Health Promotion Practice: A Journal of Health Promotion/Health Education Applications, Policy and Professional Issues.  There will be a column on the circle of research and practice.  Mr. Schwartz handed out a packet of information on SOPHE, including a paper on its research agenda committee and a paper on research and practice.  Mr. Schwartz stated that he would check with the publishers to see about using The Link articles in the new journal.

D. Management Academy of Public Health
Dr. Porter announced the new Management Academy for Public Health, a joint project between the University of North Carolina School of Public Health and the Business School.  CDC, HRSA, the W.K. Kellogg Foundation and the Robert Wood Johnson Foundation are joint funders.    The Academy will provide training to 600 individuals over 3 years in 4 states: Georgia, North Carolina, South Carolina and Virginia.  The goal is to assess if training makes a difference in the management of state and local health departments.  It is the largest joint effort ever between two UNC schools.  The focus of the Academy is to change organizational management skills, not just individuals’ skills, hence, only teams are accepted into the program.  The initiatives web site is www.maph.unc.edu.

 

X. Other Council Activities

A. Council Objectives and Strategies
Dr. Keck acknowledged that some of the Council’s written objectives have become a bit wordy.  He plans to work with staff to make revisions.  These revisions will be circulated to the members for approval at the next meeting.

B. Public Health Competencies
Mr. Bialek reported that there has been progress made in gaining funding for the Councils’ public health competencies.  Inquiries were made about the link between this and the work Kristine Gebbie is doing.  It was suggested that future Council work related to public health competencies be coordinated with other related efforts.

C. Report Card
Ms. Michon Béchamps reported that the Council report card is in draft form and will be published in the Fall issue of The Link.  The report card will look at how the Council has met its objectives, provide case studies of Council projects, and case studies of past Linkages Award winners.  A draft will be available for review and discussion at the next Council meeting.

D. Linkages Award
Ms. Béchamps informed Council members that the call for abstracts for the Linkages Award is currently out.  For the first time this year, the call was sent out to all Council member organizations.  The deadline for entry is May 4, 1999.  Anyone interested in serving on the review committee was encouraged to contact Ms. Béchamps.  The winners will be announced and display their projects during the NACCHO and ASTHO annual meetings this summer.  Council members are encouraged to think about the current criteria for the Linkages Award and to suggest updates.

E. The Link
Ms. Béchamps reported that the current issue of The Link is going to the printer this week.  The focus is on research.  The next issue will focus on the ways linkages support leadership programs.  It was also suggested that an article about the University of North Carolina’s Management Academy of Public Health be included in the next issue.  Other suggestions are also welcome.  Council members are encouraged to think about suggestions for articles for the Fall issue of The Link.

F. The Council Web Site
Ms. Béchamps brought attention to the web site material included in the meeting packet.  Staff is looking for feedback on the utility of the site and any suggestions for improvement.  The site continues to be updated on a regular basis.

 

XI. Administrative Business

• Next Council meeting at the NACCHO meeting in Dearborn, MI.  The meeting was moved to July 14, 1999, from 1 p.m. to 5 p.m.  The following meeting will be held in October in the Washington, D.C. area.

• Council members are encouraged to review current Council roster and note any corrections.

         The meeting was adjourned at 2:45 p.m.

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