Department of Epidemiology and Biostatistics Academia: Professional Training and Certification Implications of Health Literacy for Public Health Workshop November 21, 2013 Olivia Carter-Pokras, Ph.D.
Public Health Programs and Graduates Council on Education for Public Health (CEPH) is accrediting body for public health schools and programs Currently 51 schools, 102 programs, 30 applicants Accredited schools and programs graduated about 10,000 students in 2009; 6,700 graduated with an MPH degree 20 schools + 8 programs have undergraduate degrees; CEPH revised accreditation procedures in Fall 2013 SOURCE: http://ceph.org/assets/ceph_statistics_faq.pdf
Master of Public Health (MPH) Core Competency Model Diversity and Culture: A new graduate with an MPH can: Explain why cultural competence alone cannot address health disparity. Differentiate among linguistic competence, cultural competency, and health literacy in public health practice However, the study guide for the Certified in Public Health (CPH) exam includes definitions for Linguistic Competence, Cultural Competence, and Cultural and linguistic competence but not health literacy SOURCE: http://www.asph.org/document.cfm?page=1132; http://www.asph.org/cphstudyguide/terminologydiversityandculture.cfm
Johns Hopkins MPH Social and Behavioral Sciences competencies Formulate communication strategies for improving the health of communities and individuals and preventing disease and injury Health literacy is discussed briefly in 2 required courses: Tools of Public Health Practice and Decision Making (communication, cultural sensitivity, stakeholder involvement lectures; no readings) Problem Solving in Public Health (challenges of numeracy, literacy, public health literacy are discussed in communication lecture) Elective Health literacy course SOURCE: http://www.jhsph.edu/academics/degree-programs/master-of-publichealth/current-students/ft-mph-student-manual-2013-14.pdf
Undergraduate Public Health Education Skills Ability to communicate public health information, in both oral and written forms and through a variety of media, to diverse audiences Domains factors that impact human health and contribute to health disparities Basic concepts of public health-specific communication Cross-curricular Concepts Cultural contexts in which public health professionals work Diversity Commitment to diversity and evidence of ongoing practice of cultural competence in student learning Skills for working with diverse individuals and communities in ways that are appropriate and responsive to relevant cultural factors SOURCE: http://ceph.org/assets/sbp-criteria.pdf; http://ceph.org/constituents/programs-baccalaureate-level/
Temple University Undergraduate Public Health Competencies Differentiate among linguistic competence, cultural competency, and health literacy in public health practice Ethnicity, Culture and Health; Health Communication Administration and Marketing of Public Health Programs Professional Seminar International Health AIDS and Society SOURCE: http://www.asph.org/userfiles/templeundergradcomps.pdf
Status of Accreditation of Public Health Departments (11/12/13) SOURCE: http://www.phaboard.org/news-room/accredited-health-departments/
Accreditation of Public Health Agencies Standard 3.1: Provide health education and health promotion policies, programs, processes, and interventions to support prevention and wellness. Health literacy should be taken into account, and information should be provided in plain language with everyday examples. Standard 3.2: Provide information on public health issues and public health functions through multiple methods to a variety of audiences Materials that are culturally appropriate, in other languages, at low reading level, and/or address a specific population that may have difficulty with the receipt or understanding of public health communications Standard 7.2: Identify and implement strategies to improve access to health care services Lead or collaborate in culturally competent initiatives to increase access to health care services for those who may experience barriers due to cultural, language, or literacy differences Standard 11.1: Develop and maintain an operational infrastructure to support the performance of public health functions SOURCE: http://www.phaboard.org/wp-content/uploads/phab-standards-and-measures- Version-1.0.pdf
Core Competencies for Public Health Professionals Communication skills Tier 1 (entry level): identifies health literacy of populations served (e.g., ability to understand and use available health information) Tier 2 (program manager/supervisor): assess health literacy of populations served Tier 3 (senior manager/executive): ensures that the health literacy of populations served is considered throughout all communication strategies Cultural competency All Tiers: Incorporates strategies for interacting with persons from diverse backgrounds (e.g., cultural, socioeconomic, educational ) SOURCE: The Council on Linkages Between Academia and Public Health Practice
SOURCE: http://diadelamujerlatina.org/promotores/training/
NYC Health Literacy and Plain Language Workshops NYC Department of Health and Mental Hygiene conducted staff trainings for more effective communication of healthcare information with adults who are functionally illiterate at 2 different levels: basic (1day) and advanced (2 days) More than 800 staff took the trainings (including both basic and advanced). Covered cultural competencies, easy writing, language issues (interpretation and translation) and communication issues. Although most attendees felt this training was very helpful and useful for their tasks, the training was not continued after initial grant ended
Need for curricular integration and evaluation of new integrated curricula Cultural Competency and Health Literacy training share a common: goal of disparities reduction communication skill set Both aim for practice outcomes - high quality care Curricular time is limited Curricular integration mimics actual practice Designing core learning outcomes and competencies for both is a start
Free Online Training Example resource: HRSA Effective Communication Tools for Healthcare Professionals combines cultural competency and health literacy SOURCE: http://dhmh.maryland.gov/mhhd/cchlp/sitepages/home.aspx
Examples of Common research questions What are best practices in health literacy and cultural competency training? What are effective teaching methods? What faculty development is necessary? How can we include community stakeholders for health professional training? SOURCE: Lie D, Carter-Pokras O, Braun B, Coleman C. What do health literacy and cultural competence have in common? Calling for a collaborative health professional pedagogy. J Health Communication 2012;17-13-22
To summarize Many players Requirements for public health programs and schools are not in sync with workforce needs Health literacy education is variable in public health programs and schools Public health education in cultural competency or communication may cover aspects of health literacy
Acknowledgments Would like to acknowledge conference funding support by R13MD006056 (O. Carter-Pokras) from the National Institute on Minority Health and Health Disparities; and comments by participants of our conference grant funded dialogues in Maryland, Chicago (Third Annual Health Literacy Research Conference) and Irvine, California (DiversityRX). The views expressed do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.