The Leadership Style of "The People's Doctor": A Contemporary Look Back at New York State Commissioner of Health David Axelrod, MD.

David Axelrod, MD, New York State's commissioner of health from 1979 to 1991, had a panoramic view of public health and a legendary track record of tackling complex issues ranging from the Love Canal environmental disaster to HIV/AIDS and end-of-life ethics. Many raved about Axelrod's leadership, whereas others criticized his response and style. Two decades later, we describe his leadership attributes. Our retrospective review incorporates interviews with former staff and coworkers and information from historical archives. Axelrod's leadership style mirrored that of business leaders, goal driven and focused on execution, as opposed to the typical style of public health leaders, more sympathetic to needs of the team. He framed his mission within the context of social justice and data-driven science. His story, one in which leadership inspired passion and loyalty to science, is driven by a laser-sharp focus on the public good. In today's resource-deprived, politically charged environment, Axelrod's methods for achieving positive community health outcomes warrant close scrutiny. (Am J Public Health. 2019;109:85-91. doi:10.2105/AJPH.2018.304710).

Undergraduate Public Health Capstone Course: Teaching Evidence-Based Public Health.

The University at Albany School of Public Health has offered a Bachelor of Science in Public Health (BSPH) degree for the past 7 years. The final requirement of the BSPH degree is a capstone evidence-based public health class designed to culminate the degree program. This capstone course is framed by identifying a public health problem and creating a literature review based on this problem. The issues are selected through collaboration between the students and instructors. Developmental and analytical tools necessary to complete the literature review are provided throughout the semester. By the end of the course, students achieve the necessary competencies and skills to identify a public health problem, analyze information from peer-reviewed literature, and synthesize the relationship between a health issue and its correlated outcome. Successes were measured through achievement of core BSPH competencies, quality of final paper and presentation, and qualitative data gleaned from end of semester self-reported student surveys.

Screening, brief intervention, and referral to treatment for adolescents: Attitudes, perceptions, and practice of New York school-based health center providers.

BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) has been endorsed by the American Academy of Pediatrics as an evidence-based strategy to address risky substance use among adolescents in primary care. However, less than half of pediatricians even screen adolescents for substance use. The purpose of this study was to identify variation in SBIRT practice and explore how program directors' and clinicians' attitudes and perceptions of effectiveness, role responsibility, and self-efficacy impact SBIRT adoption, implementation, and practice in school-based health centers (SBHCs). METHODS: All 162 New York State SBHC program directors and clinicians serving middle and high school students were surveyed between May and June of 2013 (40% response rate). RESULTS: Only 22% of participants reported practicing the SBIRT model. Of the individual SBIRT model components, using a standardized tool to screen students for risky substance use, referring students with substance use problems to specialty treatment, and assessing students' readiness to change were practiced least frequently. Less than 30% of participants felt they could be effective at helping students reduce substance use, 63% did not believe it was their role to use a standardized screening tool, and 20-30% did not feel confident performing specific aspects of intervention and management. Each of these factors was correlated with SBIRT practice frequency (P < .05). CONCLUSIONS: Findings from this study identify an important gap between an evidence-based SBIRT model and its adoption into practice within SBHCs, indicating a need for dissemination strategies targeting role responsibility, self-efficacy, and clinicians' perceptions of SBIRT effectiveness.