Based on the priorities determined by the deputy directors, the health department will use the PHF TRAIN tool to provide online trainings to health department employees. The Allegheny County Health Department has become a Course Provider, and will upload trainings and use existing training to improve workforce competencies. See Appendix E for a screen shot of the TRAIN tool. Upon determination of the training recommendations for the workforce, Tiers 2 and 3 will be surveyed to determine additional training needs for higher-level staff. A workforce development plan will then be completed for the accreditation process.
RECOMMENDATIONS
The self-assessment helped to determine the staff’s competencies and training needs. This section provides guidance on potential trainings for Allegheny County Health Department employees. However, training recommendations are not solely based on the wants and needs of the staff, but also dependent on the strategic direction of the health department. The deputy directors have their own opinions and recommendations for trainings. In this section, recommendations will be provided solely based on the self-assessment.
The eight domains were ranked from one to eight based on the average self-assessment score.
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Public Health Science Skills: 2.41
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Community Dimensions of Practice Skills: 2.48
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Financial Planning and Management Skills: 2.50
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Analytical/Assessment Skills: 2.54
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Leadership and Systems Thinking Skills: 2.62
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Communication Skills: 2.72
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Policy Development/Program Planning Skills: 2.73
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Cultural Competency Skills: 2.77
The narrow range of average scores indicates that individual questions should be analyzed to determine priorities. Determination of priorities were based on the following findings when data were analyzed (Table 4):
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While staff have an awareness of how policy can influence public health, their ability to apply it to their work is limited.
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Overall the department has a limited ability to describe the role of governmental and non-governmental organizations in the delivery of public health services.
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As a department we are aware of the importance of communicating clearly and with cultural understanding, but we report limited ability to apply this skill.
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There is awareness of the importance of identifying stakeholders and assets; the ability to incorporate them into their work is limited.
Although there are eight domains that the training needs assessment addressed, the three priorities recommended for training are:
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Public Health Policy (both within government organizations and non-government organizations)
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Cultural Competency (both within the organization and when working with the community)
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Identification of Stakeholders
These three priorities can be addressed and offered department wide and are not trainings specific to a bureau or program, although examples may vary depending on audience of training.
Public health policy Reason to Address
The Centers for Disease Control and Prevention define a policy “as a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions” (The Centers for Disease Control and Prevention , 2013). According to the World Health Organization, health policy “refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society (World Health Organization, 2014).” Policies within the context of public health aim to:
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“define a vision for the future which in turn helps to establish targets and points of reference for the short and medium term” (World Health Organization , 2014)
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improve health, through limiting unhealthy behaviors and promoting healthy behaviors
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create sustainable change
It is important that individuals within a health department not only understand organization policy, but also public health policy within the county, state, and at the federal level. This includes an understanding of public health law and the precedents that allow the staff to perform their everyday duties. In addition to understanding how policy impacts their jobs, it is necessary that employees understand how implementing policy within the county can improve the health of its residents. With budget constraints and limits to program resources available to health department employees, policy change (if feasible) to promote health and behavior change is viewed as an intervention that will not only be sustainable, but impact a large number of individuals.
Recommended Trainings
The following trainings are currently available on the TRAIN website as options for staff of the health department to participate in (under the search term “policy”) (Public Health Foundation, n.d.b):
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Public Health Policy and Advocacy
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Applying Performance Measurement to Policy Activities
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Engaging Communities in Public Health Research, Practice and Policy
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The Intersections of Cultural Diversity, Health Policy Development and Policy Analysis
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Making Data, Policy and Politics Work for Public Health
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The Role and Use of Evidence in Policy
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Using Evidence-Based Health Framework to Move Policy Forward
Cultural competency Reason to Address
The goal of cultural competence is “to create a health care system and workforce that are capable of delivering the highest-quality care to every patient regardless of race, ethnicity, culture, or language proficiency” (Betancourt et al., 2005). According to the National Institutes of Health, “cultural competency is critical to reducing health disparities and improving access to high-quality health care, health care that is respectful of and responsive to the needs of diverse patients” (National Institutes of Health, 2014). Understanding cultural competency is important because individuals have a broad range of knowledge and opinions regarding health, which is influenced “by their social or cultural backgrounds (Betancourt et al., 2005).
Through trainings in cultural competency, staff are able to better understand their co-workers as well as the needs of the population they serve. Understanding differences among a diverse set of community members, the health department will better serve the community and more effectively implement programs. The Commonwealth Fund identify the following as barriers to culturally competent care (Betancourt, 2002):
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“Lack of diversity in health care’s leadership and workforce.
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Systems of care poorly designed to meet the needs of diverse patient populations.
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Poor communication between providers and patients of different racial, ethnic, or cultural backgrounds.”
Current programs that address diverse populations include:
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Women, Infants, and Children
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Maternal Child Health
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Dental
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TB
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Infectious Disease
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STD
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Housing
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Preparedness
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AmeriCorps
Recommended Trainings
The following trainings are currently available on the TRAIN website as options for staff of the health department to participate in (under the search term “cultural competency”) (Public Health Foundation, n.d.a):
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Cultural Competency and Disaster Mental Health
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Introduction to Cultural Competency and Title VI
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Cultural Competency for Community Management of Special Needs Patients in Disaster
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Diversity and Cultural Competency in Public Health Settings- Basic Level
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Cultural Diversity, Health Disparities and Public Health
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Exploring Cross Cultural Communication
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Practicing Cross Cultural Communication- Community Health Worker Program
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Public Health Accreditation & Competency Based Learning: A Model Based on the TRAIN Learning Management System
Alternatives to a required online module for health department staff is an in person cultural competency training during a staff meeting. An expert within the field of cultural competency from the county, The University of Pittsburgh, or another organization within Allegheny County, can be contracted to provide cultural competency training and workshops to help staff better understand and work with diverse populations within Allegheny County. Supplemental cultural competency trainings can be offered to staff in individual programs that work with specific populations on a regular basis, such as WIC or maternal child health program staff.
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