First-Destination Outcomes for 2015-2018 Public Health Graduates: Focus on Employment.

Objectives. To improve understanding of the future public health workforce by analyzing first-destination employment outcomes of public health graduates.Methods. We assessed graduate outcomes for those graduating in 2015-2018 using descriptive statistics and the Pearson χ2 test.Results. In our analysis of data on 53 463 graduates, we found that 73% were employed; 15% enrolled in further education; 5% entered a fellowship, internship, residency, volunteer, or service program; and 6% were not employed. Employed graduates went to work in health care (27%), corporations (24%), academia (19%), government (17%), nonprofit (12%), and other sectors (1%). In 2018, 9% of bachelor's, 4% of master's, and 2% of doctoral graduates were not employed but seeking employment.Conclusions. Today's public health graduates are successful in finding employment in various sectors. This new workforce may expand public health's reach and lead to healthier communities overall.Public Health Implications. With predicted shortages in the governmental public health workforce and expanding hiring because of COVID-19, policymakers need to work to ensure the supply of public health graduates meets the demands of the workforce.

Precision Health Analytics With Predictive Analytics and Implementation Research: JACC State-of-the-Art Review.

Emerging data science techniques of predictive analytics expand the quality and quantity of complex data relevant to human health and provide opportunities for understanding and control of conditions such as heart, lung, blood, and sleep disorders. To realize these opportunities, the information sources, the data science tools that use the information, and the application of resulting analytics to health and health care issues will require implementation research methods to define benefits, harms, reach, and sustainability; and to understand related resource utilization implications to inform policymakers. This JACC State-of-the-Art Review is based on a workshop convened by the National Heart, Lung, and Blood Institute to explore predictive analytics in the context of implementation science. It highlights precision medicine and precision public health as complementary and compelling applications of predictive analytics, and addresses future research and training endeavors that might further foster the application of predictive analytics in clinical medicine and public health.

Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

Considerations for increasing the competences and capacities of the public health workforce: assessing the training needs of public health workers in Texas.

BACKGROUND: Over the last two decades, concern has been expressed about the readiness of the public health workforce to adequately address the scientific, technological, social, political and economic challenges facing the field. A 1988 report from the Institute of Medicine (IOM) served as a catalyst for the re-examination of the public health workforce. The IOM's call to increase the relevance of public health education and training prompted a renewed effort to identify competences needed by public health personnel and the organizations that employ them. METHODS: A recent evaluation sought to address the role of the 10 essential public health services in job services among the Texas public health workforce. Additionally, the evaluation examined the Texas public health workforce's need for training in the 10 essential public health services. RESULTS AND CONCLUSION: Overall, the level of perceived training needs varied dramatically by job category and health department type. When comparing aggregate training needs, public health workers with greater day-to-day contact (nurses, health educators) indicated a greater need for training than their peers who did not, such as those working in administrative positions. When prioritizing and designing future training modules regarding the 10 essential public health services, trainers should consider the effects of job function, location and contact with the public.

Environmental and contextual influences on school violence and its prevention.

School violence has received unprecedented attention in recent years, particularly since the infamous events unfolded in Littleton, Colorado at Columbine High School. For many Americans, such events were not imagined possible while for others, they confirmed the need for urgent and careful examination of the nature and scope of school violence. It appears, however, that school violence research has been relegated to the individual level of analysis. In this introduction to the special issue about the environmental and contextual factors related to school violence, the authors examine what we know about school violence, how school violence has been addressed, and argue that environmental factors must be part of research and intervention in this area. Finally, the contributions of the articles included in this special issue are discussed.

An ESID case study at the federal level.

The D (dissemination) phase of the ESID model has been often overlooked in our efforts to create innovative and widespread social change. The process of replicating successful social innovations is both a prerequisite for dissemination (in order to assess the consistency of effects) and an obvious outcome of a successful dissemination effort. Fidelity, the extent to which a replicated program is implemented in a manner consistent with the original program model, is an important dimension of replication. This study was designed to provide empirical data related to three questions. Can complex social programs be implemented with fidelity? How much fidelity is appropriate or desired? What are the organizational dynamics of adoption with fidelity? Data were collected from grantees of a national replication initiative funded by the Center for Substance Abuse Prevention. Data suggest that high fidelity can be achieved, at least in the context in which programs are mandated to do so as part of the funding agreement and are given technical assistance in achieving fidelity. Secondly, programs perceived high fidelity as having positive effects on the program and its participants, a finding consistent with a limited assessment of the relationship of program outcomes and fidelity. Finally, much was learned about the human and organizational dynamics of replicating with fidelity. Implications for policy and direction regarding replication are discussed.

ESID, dissemination, and community psychology: a case of partial implementation?

Dissemination, the second stage of Experimental Social Innovation and Dissemination (ESID) is a critical, if not defining, element of this social change model. This paper attempts to assess the extent to which community psychology has adopted and implemented ESID's dissemination focus in its training and publications. We identify four levels of commitment to dissemination: dissemination advocate, dissemination activist, dissemination researcher, and experimental dissemination researcher. Content analyses of textbooks, journal publications, and conference papers and a brief survey of doctoral training in the field were conducted. Findings suggest that the dissemination aspects of ESID have been modestly and partially implemented within the field. That is, although there is some evidence of a commitment to dissemination practice (advocate, activist), there is much less evidence of a commitment to dissemination research. The implications of these findings for the effectiveness of the ESID model and for training and practice in community psychology are discussed.

Peripartum cocaine use and adverse pregnancy outcome.

The objective of the study was to analyze possible adverse effects of peripartum cocaine use on maternal and fetal outcomes. Informed consent was given by 720 (97%) of 740 women who delivered consecutively at a large urban public hospital to test an umbilical cord blood sample for the presence of non-medically administered drugs of abuse and alcohol and to be interviewed for the study. Samples were tested for the presence of a cocaine metabolite (benzoylecgonine-BZE) by radioimmunoassay. The presence of other substances of abuse (alcohol, methamphetamine, opiates) resulted in exclusion from the sample of 143 subjects. Thus, in this cohort analysis, drug-free controls (N = 469) were compared to those positive for cocaine only (N = 108). Peripartum exposure to cocaine only, and no other substances of abuse, was associated with an increased frequency of abruptio placentae (1.9% vs 0% for control, P < 0.004), thick meconium stained amniotic fluid (3.9% vs 0.7% for controls, P < 0.006), premature rupture of membranes (P < 0.02), genitourinary anomalies (OR = 3.6, P < 0.05), abdominal wall defects (OR = 4.4, P < 0.01) and increased frequency of low birth weight (OR = 2.0, P < 0.02). These are important findings because previous studies have been complicated by the confounding effects of other substances of abuse. Am. J. Hum. Biol. 11:598-602, 1999. Copyright 1999 Wiley-Liss, Inc.