Workforce-Staffing Changes
Room: Thoroughbred 3
Wednesday, April 9, 2014, 2-3:15 pm
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AUDIO
KC14 Session 4C on Workforce: Staffing Changes by NCC for PHSSR
MODERATOR
Angela Beck, Ph.D., M.P.H.
PRESENTERS
Patrick Bernet, Ph.D.
Determinants of local public health department staffing changes 2008-2010
Co-Investigators: None Listed
Background: The Great Recession precipitated many public health spending and staffing reductions. That same event has increased demand for public health services, compounding the challenge of dealing with staffing reductions..
Research Objective: The goal of this study is to better understand local health department (LHD) organizational and demographic characteristics associated with staffing changes between 2008 and 2010.
Data Sets and Sources: This study starts with 2008 and 2010 profile studies of LHDs conducted by the National Association of County and City Health Officials (NACCHO). These surveys contain information on the funding, staffing, governance, and activities of LHDs across the United States. LHD characteristics were paired with population demographics from the US Census and community health status indicators.
Study Design: In the first phase, staffing changes between 2008 and 2010 are computed and LHDs are classified by degree of resilience based on whether 2010 staffing staff levels were greater or less than expected. In the second phase, the change in staffing levels was modeled using multivariate regression to gauge the impact of independent variables across all levels of resilience. In the third phase, models were then re-run just among LHDs with greater-than-expected changes to determine if certain characteristics were more strongly associated with increases or decreases in staffing.
Analysis: Staffing change is modeled as a function of organizational characteristics (such as governance, administrator credentials, and structure), and demographic characteristics (such as population, poverty, age and race). We then add staffing characteristics (such as average salary levels and percent full-time) to determine if those add to our understanding.
Principal Findings: Resilient LHDs were more likely to have a physician or nurse administrator, smaller populations, fewer non-whites, poor and elderly. Resilient LHDs used more part time workers and had higher average spending per employee.
Conclusions: LHD staffing changes between 2008 and 2010 were significantly associated with a variety of organizational, demographic and staffing characteristics.
Implications for Public Health Practice and Policy: Understanding determinants of staffing changes can help LHDs prepare for resource allocation changes.
JP Leider, Ph.D.
Undergraduate public health conferrals in the US, 1992-2012
Co-Investigators: Brian Castrucci, M.P.H., Christine Pleppys, M.S., Emily Burke, M.P.H., Craig Blakely, Ph.D., James Sprague, M.D.
Background: Baccalaureates trained in public health could prove an important new input into the public health workforce, Since the early 2000s, several national initiatives and considerable national interest has made undergraduate public health a focal point in public health education.
Research Objective: Despite considerable interest in undergraduate public health, no enumeration exists as to how many undergraduate degrees have been conferred nationally. This presentation will address that gap.
Data Sources: The National Center for Education Statistics’ (NCES) Integrated Postsecondary Dataset, which tracks graduation trends for colleges and universities in the US.
Study Design and Analysis: Twenty-one years of NCES data were cleaned and records for public health undergraduates were extracted. Next, classifications from the Association of Schools and Programs of Public Health (ASPPH) were incorporated. The final dataset comprises all undergraduate degree conferrals in the United States for 1992-2012, by gender and program specialization. Data on graduation trends by race were available between 2003 and 2012.
Principal Findings: In 2012, just under 6,500 students received undergraduate degrees in public health. NCES data show a significant yearly increase in conferrals beginning in 2005 (approximately 3,000 conferrals) and up from 1992 (750 conferrals). In 2012, the most common undergraduate specializations in public health were Public Health Education and Promotion (1,887 conferrals), Public Health-General (1,397 conferrals) and Community Health and Preventive Medicine (1,088 conferrals). In 2012, non-Hispanic white students received 53% of all undergraduate public health degrees, followed by non-Hispanic black students (18%), Asian students (12%), and Hispanic/Latino students (10%). Since 2003, non-Hispanic white students have decreased as a relative share of total conferrals. In 1992, women received 61% of all undergraduate public health degrees. This percentage increased to 78% of all undergraduate public health degrees in 2012.
Conclusions and Implications for Public Health Practice and Policy: Little information exists on the 6,500+ students graduating yearly in undergraduate public health. An important point for future research includes investigating whether these graduates end up in public health practice. If so, they could represent an important new source of relatively low-cost, skilled workers for governmental public health.
Virginia Mckay, M.A., B.S.
"My job was already two jobs": The impact of personnel changes on implementation of an evidence-based HIV prevention program
Co-Investigators: None Listed
Background: Evidence-based interventions (EBIs) often require competent, trained staff for successful implementation. However, staff inevitably fluctuate over time, potentially influencing program implementation and ultimately program outcomes. The influences of staff changes on EBI implementation are relatively unexplored.
Research Objective: The current study qualitatively explored the impact of staff changes on implementation of RESPECT, an evidence-based HIV prevention program.
Data Sets and Sources: Data were collected as part of a longitudinal mixed-methods investigation, the Translation into Practice (TIP) study, a national survey of community-based organizations and public health departments delivering RESPECT (N=30).
Study Design: Semi-structured interviews were conducted with executive directors and supervisors at two time points (n=53, wave I; n=37, wave II) on topics such as implementation, adaptation, and program maintenance. Agencies with multiple staff dedicated to RESPECT were included in the current study (n=29).
Analysis: Interview questions related to staff changes were identified. Using Nvivo 8.0, questions were categorically coded to describe the kinds of staff changes that occurred and thematically coded to describe the impact of staff changes on RESPECT implementation.
Principal Findings: Agencies experienced increases, decreases, and turnover among staff. Staff changes impacted the number of clients receiving RESPECT, the skill and knowledge related to the program at the agency, workload for remaining employees, and created gaps in replacement and training. The majority of agencies experienced decreases and turnover among staff, leading to challenges in program implementation.
Conclusions: Staffing changes were common and highlight factors that may negatively impact program implementation. Lack of skill and knowledge, work overload, and limited ability to serve clients may influence priority EBI outcomes (e.g., fidelity, reach).
Implications for Public Health Policy and Practice: Although staff changes are common in public health agencies, successful implementation of EBIs will benefit from a focus on increasing staff retention. Additionally, policies that emphasize training throughout implementation have potential to address gaps that occur when inevitable staff turnover occurs.