Scaling Up and Tailoring the "Putting Public Health in Action" Training Curriculum.

Despite access to a growing menu of evidence-based interventions, public health practitioners continue to underuse them, in part because practitioners may require new knowledge, skills, and resources to do so. Numerous foundations, universities, governmental agencies, and consultants are providing trainings to address the gaps in practitioners' capacity. To most significantly affect population health, these trainings need to reach practitioners who may have limited access to on-site trainings. Despite the number of organizations offering trainings, little is known about how to scale up trainings to efficiently extend their reach or how to tailor trainings to the needs of different intervention. The Cancer Prevention and Control Research Network and its collaborating centers have developed a training curriculum and delivered it in both in-person and distance formats to a range of audiences. The purpose of this article is to describe the training curriculum and findings from the Network's evaluation of approaches used to scale up delivery of the "Putting Public Health Evidence in Action" curriculum and tailor content for specific evidence-based interventions.

Capacity building for evidence-based decision making in local health departments: scaling up an effective training approach.

BACKGROUND: There are few studies describing how to scale up effective capacity-building approaches for public health practitioners. This study tested local-level evidence-based decision making (EBDM) capacity-building efforts in four U.S. states (Michigan, North Carolina, Ohio, and Washington) with a quasi-experimental design. METHODS: Partners within the four states delivered a previously established Evidence-Based Public Health (EBPH) training curriculum to local health department (LHD) staff. They worked with the research team to modify the curriculum with local data and examples while remaining attentive to course fidelity. Pre- and post-assessments of course participants (n=82) and an external control group (n=214) measured importance, availability (i.e., how available a skill is when needed, either within the skillset of the respondent or among others in the agency), and gaps in ten EBDM competencies. Simple and multiple linear regression models assessed the differences between pre- and post-assessment scores. Course participants also assessed the impact of the course on their work. RESULTS: Course participants reported greater increases in the availability, and decreases in the gaps, in EBDM competencies at post-test, relative to the control group. In adjusted models, significant differences (p<0.05) were found in 'action planning,' 'evaluation design,' 'communicating research to policymakers,' 'quantifying issues (using descriptive epidemiology),' and 'economic evaluation.' Nearly 45% of participants indicated that EBDM increased within their agency since the training. Course benefits included becoming better leaders and making scientifically informed decisions. CONCLUSIONS: This study demonstrates the potential for improving EBDM capacity among LHD practitioners using a train-the-trainer approach involving diverse partners. This approach allowed for local tailoring of strategies and extended the reach of the EBPH course.

A systematic approach to evaluating public health training: the obesity prevention in public health course.

OBJECTIVE: Public health practitioners require new knowledge and skills to address the multilevel factors contributing to obesity. This article presents the systematic approach the Center of Excellence for Training and Research Translation (Center TRT) used both to assess practitioners' competencies to lead public health obesity prevention initiatives and to evaluate its annual, competency-based obesity prevention course. DESIGN: In 2006, Center TRT identified priority public health competencies for obesity prevention and then planned 7 annual courses to address the priority competencies progressively over time. Each year, a longitudinal evaluation based on Kirkpatrick's training evaluation framework was administered to course participants (n = 243) to assess perceptions of the course (daily), changes in self-reported competency (immediately pre- and postcourse), and course impact on practice over time (at 6 months). RESULTS: Participants rated the course highly for quality and relevance. Although many participants reported low levels of confidence prior to the course, following the course, at least 70% reported feeling confident to perform almost all competencies. At 6-month follow-up, the majority of participants reported completing at least 1 activity identified during course action planning. CONCLUSIONS: We identified practitioners' high-priority competency needs and then designed 7 annual courses to progressively address those needs and new needs as they arose. This approach resulted in trainings valued by practitioners and effective in increasing their sense of competence to lead public health obesity prevention initiatives. The course's continuing impact was evidenced by participants' high level of completion of their action plans at 6-month follow-up. Competency-based training is important to develop a skilled public health workforce.

Using the Program Sustainability Assessment Tool to assess and plan for sustainability.

Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program's sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning.