Enumeration of the Public Health Workforce in New York State: Workforce Changes in the Wake of COVID-19.

The governmental public health workforce in the United States has faced staffing shortages for over a decade that have been exacerbated by the COVID-19 pandemic. To assess this critical issue, the Region 2 Public Health Training Center collaborated with the New York State Association of County Health Officials to enumerate the city and county public health workforce in New York State. The organizations used an online survey to: (1) count employees and full-time equivalent (FTEs) staff in local health departments in 2021; (2) assess workforce trends since the COVID-19 pandemic; and, (3) identify challenges local health departments encounter in recruiting and retaining qualified public health workers. To assess trends, findings were compared with secondary data from 2019. Despite playing a central role in COVID-19 mitigation, local health departments experienced no overall increase in staffing in 2021 compared to 2019, with many health departments experiencing large increases in vacant positions. Recruitment challenges include noncompetitive salaries, difficulties finding qualified candidates, and lengthy hiring processes. This study complements accumulating evidence indicating that long-term investment in local public health infrastructure is needed to bolster the workforce and ensure that communities are protected from current and future health threats.

Incorporating Systems Thinking Approaches Into Practice-Based Training to Strengthen Policy-Making Skills.

To be successful in advancing public health goals, public health practitioners need to develop competencies associated with policy engagement, a core function of public health work. Theoretical public health policy-making frameworks help practitioners understand steps in the policy process but often fail to reflect on-the-ground realities. Systems thinking approaches are relevant in addressing these complex realities, but training that breaks down seemingly complex concepts and that is useful for practical application is limited. This article discusses how the Region 2 Public Health Training Center developed online practice-based training modules that integrate systems thinking strategies into public health policy making.

Factors affecting evidence-based decision making in local health departments.

BACKGROUND: Data indicating the extent to which evidence-based decision making (EBDM) is used in local health departments (LHDs) are limited. PURPOSE: This study aims to determine use of decision-making processes by New York State LHD leaders and upper-level staff and identify facilitators and barriers to the use of EBDM in LHDs. METHODS: The New York Public Health Practice-Based Research Network implemented a mixed-methods study in 31 LHDs. There were 20 individual interviews; five small-group interviews (two or three participants each); and two focus groups (eight participants each) conducted with people who had decision-making authority. Information was obtained about each person's background and position, decision-making responsibilities, how decisions are made within their LHD, knowledge and experience with EBDM, use of each step of the EBDM process, and barriers and facilitators to EBDM implementation. Data were collected from June to November 2010 and analyzed in 2011. RESULTS: Overall, participants supported EBDM and expressed a desire to increase their department's use of it. Although most people understood the concept, a relatively small number had substantial expertise and experience with its practice. Many indicated that they applied EBDM unevenly. Factors associated with use of EBDM included strong leadership; workforce capacity (number and skills); resources; funding and program mandates; political support; and access to data and program models suitable to community conditions. CONCLUSIONS: EBDM is used inconsistently in LHDs in New York. Despite knowledge and interest among LHD leadership, the LHD capacity, resources, appropriate programming, and other issues serve as impediments to EBDM and optimal implementation of evidence-based strategies.

The Turning Point Social Marketing National Excellence Collaborative: integrating social marketing into routine public health practice.

Social marketing can be an effective tool for achieving public health goals. Social marketing uses concepts from commercial marketing to plan and implement programs designed to bring about behavior change that will benefit individuals and society. Although social marketing principles have been used to address public health problems, efforts have been dominated by message-based, promotion-only strategies, and effective implementation has been hampered by both lack of understanding of and use of all of the components of a social marketing approach and lack of training. The Turning Point initiative's Social Marketing National Excellence Collaborative (SMNEC) was established to promote social marketing principles and practices to improve public health across the nation. After 4 years, the Collaborative's work has resulted in improved understanding of social marketing among participating members and the development of new tools to strengthen the social marketing skills among public health practitioners. The Collaborative has also made advances in incorporating and institutionalizing the practice of social marketing within public health in participating states.

The process to develop a meaningful community health assessment in New York State.

Conducting and producing a meaningful Community Health Assessment (CHA) is an important and essential public health service and a mandatory biennial activity for New York State's (NYS) Local Health Departments. The Assessment Initiative project has allowed the NYS Department of Health to better understand and identify strategies to strengthen CHAs and to develop training, education, and technical assistance programs. The Assessment Initiative project has benefited from participation, coordination, and sharing of resources and expertise with other community health improvement initiatives in NYS, including those that emphasize collaborative approaches to health improvement, workforce development, and expanding access to data.