A Win for Workforce Development: The Value of PH WINS for ASTHO Affiliates.

Affiliate membership groups, such as the 21 legally independent professional associations representing state public health workers that are members of the standing Affiliate Council of the Association of State and Territorial Health Officials (ASTHO), play a critical role in developing the public health workforce's skills, including by contributing to workforce trainings, credentialing programs, and mentorship and leadership development programs. Data from the Public Health Workforce Interests and Needs Survey (PH WINS) are a valuable input that help identify priority challenges and potential solutions. Although many affiliate groups face similar, crosscutting issues, there are nuances that call for a tailored, evidence-informed approach. This commentary details how 3 affiliate groups are each using PH WINS data to inform workforce development programs and initiatives that best meet the needs of their constituencies.

Scott J. Becker, MS

Executive Director, Association of Public Health Laboratories

The Association of Public Health Laboratories (APHL) works to strengthen public health laboratory systems across the nation and the world, in part, through the development of the laboratorian workforce in state and local health departments through trainings and leadership development, among other activities. APHL supports the fielding of PH WINS, and data from the most recent fielding in 2017 significantly contribute to and complement our own workforce assessment and understanding of our member workforce.

Data from the most recent PH WINS revealed key trends and information about the laboratory staff nationwide that can assist us in shaping our workforce development efforts and verify our own data collected on the workforce. One key finding from PH WINS was that most laboratorians are satisfied with their job (77%) while far fewer are satisfied with their pay (44%), which was consistent with findings from our own workforce report. Despite the high levels of job satisfaction, PH WINS data also revealed that 27% of laboratorian respondents indicated that they were considering leaving their agency in the next year. Of those, most cited lack of opportunities for advancement, pay, workplace environment and lack of acknowledgement or support, stress and burnout, and job satisfaction. These data, which reflect and affirm findings from APHL's own workforce assessment in 2016, provide insight into targeting critical workforce development opportunities for our members around succession planning and potentially recruitment efforts, as well as a clear directive to provide members with opportunities to identify stretch assignments and acknowledgement and support opportunities, and address staff stress and burnout.

While PH WINS data complement our own workforce data, much of the value in PH WINS data for APHL is that they provide an essential baseline for understanding the workforce trends for laboratorians relative to the public health workforce nationally. In most areas explored in the survey, laboratorians were very similar to the broader workforce including demographics and workforce attitudes, workplace perceptions, and intentions to leave or retire. However, there were significant differences in the tenure in the agency, higher levels of education, less agreement recommending their organization as a good place to work, and satisfaction with pay, job, and organization. This additional perspective supports a broader context of the strengths, challenges, and opportunities of public health laboratories, based on their unique population characteristics.

Claire Hannan, MPH

Executive Director, Association of Immunization Managers

Workforce development, training, and assisting the public health immunization workforce to succeed in its job of preventing vaccine-preventable disease are major priorities of the Association of Immunization Managers (AIM). To improve workforce performance, AIM has implemented a number of initiatives targeting public health immunization employees and managers. Since 2013, AIM has established the AIM Leadership Institute, held 4 annual Leadership in Action conferences, and developed a joint new immunization program manager orientation with the Centers for Disease Control and Prevention. As a comparatively small membership association, AIM utilizes the data results generated by PH WINS to develop data-driven programs and initiatives that are needed for professional development.

PH WINS findings help guide professional development programs such as the AIM Leadership Institute. Eighty-five percent of immunization supervisors/managers and 100% of immunization executives considered the ability to communicate ideas and information in a way that different audiences can understand of “high importance.” These skills and competencies are included in the AIM Leadership Institute's immunization program management curriculum, which continues to be developed and tested while providing guidance to the annual Leadership in Action Conference, new program manager orientation, and educational webinars for AIM members.

PH WINS data both corroborate what AIM is doing and provide direction to build training curriculum and member activities. Forty-four percent of supervisors/managers cited high importance but low skill for identifying funding methods to develop sustainable funding models. AIM recently launched an Immunization Information Systems (IIS) sustainability project to help program managers address the complex challenge of establishing sustainable funding models for IIS. Information technology (IT) and immunization coverage data are central to immunization program activities and provide the data and evidence-based support for quality improvement, outbreak control, and focused disease prevention. The strategic direction of immunization programs depends heavily on the ability of programs to provide stable funding to sustain and enhance IIS technology that grows with program needs and provides the data and evidence necessary to direct program activities.

The areas of financial analysis and implementation of a business plan also ranked near the top of skills viewed as highly important but with low current skill level (45% and 49% of supervisors and managers, respectively). Forty-six percent of supervisors/managers cited the ability to integrate current and projected trends and 40% the ability to assess drivers in the environment that may influence public health programs, important components to position immunization programs on the forefront of IT and other programmatic advancement. AIM has built strategic planning into its training curriculum and partners with both the private sector and broader immunization community to identify trends and provide forward-thinking leadership strategies. This type of training is applicable to both leadership and workforce, as 100% of immunization executives responding to PH WINS viewed integration of current and projected trends, creating a culture of quality improvement at the agency, and ensuring use of appropriate sources of data of high importance but with low skill.

Just over half of immunization employees and executives are motivated by the availability of training opportunities, highlighting the importance of the AIM Leadership Institute and its expansion to online training modules. AIM will continue to grow and market these opportunities to the immunization workforce, as only 52% of employees were motivated by the availability of in-person training opportunities and only 55% were motivated by availability of online training opportunities.

The culture and training needs of the immunization workforce mirror that of the overall public health community. As AIM and other public health membership associations work to build the skills of their members, working in collaboration and measuring progress are critical to success. ASTHO and the Affiliate Council play key leadership roles here, and PH WINS is the primary tool of engagement. AIM is pleased to participate on the Affiliate Council and will continue to prioritize the development of the immunization workforce with the guidance of PH WINS.

John W. Robitscher, MPH

Chief Executive Officer, National Association of Chronic Disease Directors

Public health practitioners often are drawn to this work through their passion and commitment to population health improvement. Therefore, it is not at all surprising that PH WINS found that 94% of chronic disease prevention practitioners surveyed indicated their determination to perform at the highest level every day. Yet, almost a third of respondents acknowledged they were considering leaving their agency within the next year (29%). There were varied reasons for staff planning their departures, but a lack of opportunity for growth within a position was the most prevalent (51%). A clear picture is emerging of our association's members—they want to keep doing great work in their communities but feel stuck professionally in their current roles.

As the only professional association representing chronic disease directors in every US state, jurisdiction, and territory, we are very focused on attrition within chronic disease units. In particular, we have been working to help address the impending wave of retirements of senior levels within the workforce—as many as 45% of public health professionals could retire during the next 5 years, taking with them years of expertise and historical knowledge that are critical to the long-tail process of chronic disease prevention, control, and health promotion. Some of these professionals will move on to other sectors. Others may wish to remain involved in public health but need an opportunity and an outlet to do so.

The National Association of Chronic Disease Directors is working to address these issues on multiple levels. We have dedicated significant resources to improving chronic disease prevention competencies to help the next generation of frontline public health staff and leadership meet the growing needs of their communities, and we are harnessing the skills of retired leaders to do so. For example, by leveraging former state health department leaders as subject matter experts and consultants, we have developed multiple competency assessment tools and complementary trainings that are available online for our members. We host an annual Chronic Disease Academy and provide scholarships to directors and their staff to attend and learn about emerging best practices in the field. And we offer a State Activation and Response (STAR) assessment of chronic disease units to help states build organizational capacity for chronic disease prevention and health promotion through quick-cycle quality improvement strategies. We also work closely with Washington University expert Ross Brownson to assess and support the adoption of evidence-based public health and administrative practices within departments.

It is a true public health win that we have amassed a comprehensive response to support our chronic disease professionals as they navigate these challenging times. As we prepare to celebrate our 30th anniversary this spring, we look forward to the opportunities that these and other programs will offer to support a skilled and integrated next generation of chronic disease work.