Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders

BACKGROUND: During the 2008-2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders\u27 demographic and organizational characteristics and to characterize the underlying relationships. MATERIALS AND METHODS: The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ) and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal-Wallis non-parametric tests were used, and to adjust for potential confounding, linear regression analysis was performed. DATA: Local health department leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data were utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders\u27 observable attributes relating to age, gender, race, educational background, leadership experience, and openness to change. RESULTS: Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-2013 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply that there are underlying relationships between leader and LHD characteristics based on leader openness to change

Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders

BACKGROUND: During the 2008-2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders\u27 demographic and organizational characteristics and to characterize the underlying relationships. MATERIALS AND METHODS: The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ) and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal-Wallis non-parametric tests were used, and to adjust for potential confounding, linear regression analysis was performed. DATA: Local health department leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data were utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders\u27 observable attributes relating to age, gender, race, educational background, leadership experience, and openness to change. RESULTS: Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-2013 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply that there are underlying relationships between leader and LHD characteristics based on leader openness to change

Editorial: Leading People - Managing Organizations: Contemporary Public Health Leadership

Effectively leading people engaged in the practice of public health has never been more critical than in the early years of the twenty-first century. Likewise, effectively managing the organizations in which these individuals practice the various professional disciplines of public health has become increasing important and difficult. Taken together, leading the people and managing public health organizations requires well educated and appropriately trained public health leaders and managers. Although leadership is often viewed as one of the key attributes of management, not every great manager will be a great leader and vice versa. While some leaders may be born with the inherent skills to lead, most effective leaders develop the requisite skills through education, additional training, and practice. Our aim is to focus the attention of public health practitioners on the importance of effectively leading public health organizations. Public health managers should recognize that their most valuable resource is the people they lead. The articles comprising the eBook on Leading People – Managing Organizations is composed of articles expressing the opinion of their authors of the need for effective public health leaders; perspective articles establishing their authors’ understanding of how leadership may be applied in various situations; methods articles that demonstrate how public health leadership may be applied, and original research articles that establish the role of public health leadership research studies

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

Background: The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health. Materials and methods: The study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1–10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person. Data: Data were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS. Results: The competency of most relevance to the highest executive function category was that of “interaction with interrelated systems.” For sub-agency level officers the competency of most relevance was “advocating for the role of public health.” The competency of most relevance to Program Directors/Managers or Administrators was “ensuring continuous quality improvement.” The variation between competencies by job category suggests there are distinct underlying relationships between the competencies by job category

Vaccination Perceptions of College Students: With and without Vaccination Waiver

IntroductionThe resurgence of vaccine preventable diseases occurs more often among intentionally unvaccinated individuals, placing at direct risk young adults not caught up on vaccinations. The objectives of this study were to characterize the sociodemographic characteristics of young adults with and without vaccination waivers and identify their perceived benefits, barriers, and influencers of vaccination.MethodsYoung adults (n = 964) from a Midwestern rural university responded to a survey (fall 2015—spring 2016) designed to identify their perception toward vaccination. Instrument consistency was measured using the Cronbach α-scores. The Chi-square test was used to test any sociodemographic differences and Mann–Whitney U-tests results for differences between exempt and non-exempt students. Analysis occurred in spring 2017.ResultsA little over one-third of young adults with a vaccination waiver were not up to date on their vaccinations, and think that vaccinations can cause autism. The biggest identifiable benefit was effective control against disease. The surveyed young adults ranked the out of pocket cost associated with vaccination as the most important barrier and safe and easy to use vaccines as the most important influencer of vaccination.ConclusionYoung adults who have had a vaccination waiver appear to not be up to date on their vaccinations. Vaccine administration programs, such as university campus clinics, would benefit from addressing perceptions unique to young adults with and without a vaccine waiver. This would subsequently better provide young adults a second shot for getting appropriately caught up on vaccinations

Leading people - managing organizations: Contemporary public health leadership

In this Research Topic, we provide a comprehensive overview of current public health leadership research, focusing on understanding the impact of leadership on the delivery of public health services. By bringing together ground-breaking research studies detailing the development and validation of leadership activities and resources that promote effective public health practice in a variety of settings, we seek to provide a basis for leading public health organizations. We encouraged contributions that assess the effectiveness of public health leaders, as well as critical discussions of methods for improving the leadership of public health organizations at all levels. Both ongoing and completed original research was welcome, as well as methods, hypothesis and theory, and opinion papers. The effective practice of public health leadership is a key concept for public health practitioners to clearly understand as the 21st century unfolds. Following the significant lapses of leadership in the for-profit world, leaders in governmental and not-for-profit agencies are required to learn by their failed examples. A major task facing all current and prospective public health practitioners is developing the required leadership skills in order to be effective twenty first century leaders. As a consequence of the rapidly evolving health of the public, as well as the development of the discipline and practice of public health, understanding the principles and attributes of leadership are now required of all public health practitioners. Leadership can be described in a variety of ways. Leadership in public health requires skillful individuals meeting the health challenges of communities and the population as a whole. Leadership may be defined as a process that occurs whenever an individual intentionally attempts to influence another individual or group, regardless of the reason, in an effort to achieve a common goal which may or may not contribute to the success of the organization. Thus leadership is a process involving two or more people. The nature of leadership is an important aspect of the concept as a whole. Submissions relating public health leadership to the management of public health organizations were welcomed. This Research Topic provided the opportunity for authors to consider the concept of leadership from a variety of approaches. Original research papers considering a variety of leadership theories provide methodological approaches to the topic. Hypothesis and theory papers provide the basis for application of leadership to public health practice. Opinion papers provide the opportunity to develop thinking concerning practice of public health leadership

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

BackgroundThe foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health.Materials and methodsThe study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1–10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person.DataData were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS.ResultsThe competency of most relevance to the highest executive function category was that of “interaction with interrelated systems.” For sub-agency level officers the competency of most relevance was “advocating for the role of public health.” The competency of most relevance to Program Directors/Managers or Administrators was “ensuring continuous quality improvement.” The variation between competencies by job category suggests there are distinct underlying relationships between the competencies by job category