Assessment of Public Health Education Practice: Health Educator Responsibilities

This study presents a method for better understanding how practicing health educators in local health departments spend their time. The purpose of this study was to document the daily practice of health educators in the 10 areas of responsibility as defined by a competency-based framework for graduate-level health educators. The results of the current study present the average percentage of time health educators spent carrying out each area of responsibility and the percentage of health educators that did not carry out activities related to a specific area of responsibility. For example, the greatest percentage of time was spent implementing programs (21.2%), and approximately 60% of the health educators in the sample did not conduct research nor did they participate in activities to advance the profession. These findings have implications for the professional preparation of health educators and for their continuing education. The current study contains several suggestions for future research in this area

All---hazards preparedness in an era of bioterrorism funding.

Objectives: All-hazards preparedness was evaluated in North Carolina's 85 local health departments (LHDs). Methods: In regional meetings, data were collected from LHD teams from North Carolina's LHDs using an instrument constructed from Centers for Disease Control and Prevention's preparedness indicators and from the Local Public Health Preparedness and Response Capacity Inventory. Results and Conclusions: Levels of preparedness differ widely by disaster types. LHDs reported higher levels of preparedness for natural disasters, outbreaks, and bioterrorist events than for chemical, radiation, or mass trauma disasters. LHDs face challenges to achieving all-hazards preparedness since preparation for one type of disaster does not lead to preparedness for all types of disasters. LHDs in this survey were more prepared for disasters for which they were funded (bioterrorism) and for events they faced regularly (natural disasters, outbreaks) than they were for other types of disasters

A Profile of Public Health Educators in North Carolina's Local Health Departments.

The purpose of this study was to provide a profile of the public health education workforce in North Carolina. A survey was administered to all practicing health educators at local health departments (LHDs) in North Carolina. The study specifically attempted to answer four questions: (1) Who functions as health educators in LHDs in North Carolina? (2) What is the educational background and professional training of North Carolina LHD health educators? (3) What are the characteristics of health educators' positions in North Carolina? and (4) How do these characteristics of health educators (demographics and education) as well as their titles, job responsibilities, and supervisory relationships differ according to the size of the LHD? The study showed that most public health educators in North Carolina are white females; most do not have Certified Health Education Specialist certification; that younger health educators are more likely to have health education degrees; and that almost two thirds of public health educators have administrative responsibilities

Public Health Educators' Participation in Teams: Implications for Preparation and Practice.

Collaboration among public health organizations is essential to ensuring the health of the public. Much of the day-to-day work of public health educators is done in groups or teams or in consultation with others. This study examined the extent of health educators' work in teams as a proxy for collaboration. Health educators participated in an average of four teams per individual; three of these were interorganizational teams. Moreover, 40% of the respondents participated in five or more teams. Health educators supervised by other health educators were more likely to work in interorganizational teams than were those supervised by other professionals. Certified Health Education Specialists were more likely to participate in intraorganizational teams. Curricula in academic programs should reflect the extensive teamwork in which health educators are involved. Employers need to provide health educators with grounding in organizational priorities and support to carry out their collaborative work

The Influence of Neighborhood Poverty on Blood Glucose Levels: Findings from the Community Initiative to Eliminate Stroke (CITIES) program

Objectives:  To examine the relationship between both individual and neighborhood level characteristics and non-fasting blood glucose levels.Study design: This study used a cross sectional design using data from the Community Initiative to Eliminate Stroke Program in NC (2004-2008).  A total of 12,809 adults nested within 550 census block groups from two adjacent urban counties were included in the analysis.Methods:   Participants completed a cardiovascular risk factor assessment with self-reported demographics, stroke-risk behaviors, and biometric measurements.  Neighborhood level characteristics were based upon census data.  Three multilevel models were constructed for data analysis.Results:  Mean blood glucose level of this sample population was 103.61mg/dL.  The unconditional model 1 suggested a variation in mean blood glucose levels among the neighborhoods (τ00 = 13.39; P < .001).  Both models 2 and 3 suggested that the neighborhood composite deprivation index had a significant prediction on each neighborhood’s mean blood glucose level (¡01= .69; P < 0.001,¡01= .36; P = .004).  Model 3 also suggested that across all the neighborhoods, on average, after controlling for individual level risk factors, deprivation remained a significant predictor of blood glucose levels.Conclusions:  The findings provide evidence that neighborhood disadvantage is a significant predictor of neighborhood and individual level blood glucose levels.  One approach to diabetes prevention could be for policymakers to address the problems associated with environmental determinants of health

Privatization of local health department services: Effects on the practice of health education.

Local health departments (LHDs) are changing service delivery mechanisms to accommodate changes in health care financing and decreased public support for governmental services. This study examined the extent to which North Carolina LHDs privatized and contracted out services and the effects on the time spent on core functions of public health and activities of health educators. Questionnaires were mailed to the senior health educators in all LHDs. Sixty-nine responded, and 68% of LHDs had not privatized any services other than laboratory and home health. Clinical services were more commonly privatized than nonclinical services. Respondents perceived that privatization produces more time for LHDs to address the core public health functions and for health educators to engage in appropriate professional activities. Health educators in LHDs that had not privatized were more likely to be concerned about potential negative effects. This study suggests that privatization has generally had a positive effect on the roles of health educators in North Carolina LHDs

Delivering a Post-Partum Weight Loss Intervention via Facebook or In-Person Groups: Protocol for a Randomized Feasibility Pilot Trial

BACKGROUND: Postpartum weight retention contributes to long-term weight gain and obesity for many women. Lifestyle interventions with numerous visits are logistically challenging for many postpartum women. Delivering a lifestyle intervention via social media may overcome logistic challenges to participation in in-person weight loss programs. OBJECTIVE: The objective of this study is to conduct a randomized feasibility pilot trial of a 6-month postpartum weight loss intervention delivered via Facebook or in-person groups with 72 postpartum women with overweight or obesity. METHODS: Women with overweight or obesity who are 8 weeks to 12 months postpartum (N=72) will be recruited from the Hartford, Connecticut community. Eligible participants must also own an iPhone or Android smartphone and be an active Facebook user. Participants will receive a 6-month postpartum weight loss intervention based on the Diabetes Prevention Program lifestyle intervention and adapted for postpartum women. Participants will be randomized to receive the intervention via a private Facebook group or in-person group meetings. Assessments will occur at baseline, weekly during the intervention, at 6 months (at the end of the intervention), and at 12 months. Primary feasibility outcomes are recruitment, sustained participation, contamination, retention, and feasibility of assessment procedures including measurement of costs to deliver and receive the intervention. We will describe 6- and 12-month weight loss as an exploratory outcome. RESULTS: Recruitment began in September 2018. The first wave of the intervention began in February 2019, and the second wave of the intervention is expected to begin in fall 2019. We anticipate completing follow-up assessments in fall 2020, and results will be analyzed at that time. CONCLUSIONS: Results will inform the design of a large randomized controlled trial to assess whether delivering a postpartum weight loss intervention via Facebook is noninferior for weight loss and more cost-effective than delivering the intervention via traditional in-person groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15530