Health Education Specialist Practice Analysis (HESPA) Study: Executive Summary



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Health Education Specialist Practice Analysis (HESPA) Study: Executive Summary The Health Education Specialist Practice Analysis (HESPA 2015 was undertaken to validate the contemporary practice of entry- and advanced-level health education specialists, provide guidance for the development of the Certified Health Education Specialist (CHES) and Master Certified Health Education Specialist (MCHES) examinations, report on changes in health education practice since the last major practice analysis study commissioned by the sponsoring agencies (the Health Educator Job Analysis 2010 [the HEJA-2010 study]) (Doyle et al., 2012), and inform professional preparation and continuing education initiatives. Through this study, a systematic and defensible update of the 2010 health education framework was provided. Results of the research study were used to identify similarities and differences between the practice patterns of entry-level and more experienced health education specialists, CHES and MCHES credentialed health education specialists, and certified and non-certified health education specialists. Results from the study also will be useful for evaluating and updating the content of professional preparation and professional development programs. The knowledge bases underlying health education practice has been updated, organized into a conceptual structure, and validated. The study was guided by a project steering committee (HESPA 2015-SC) consisting of the chief staff officers of the National Commission for Health Education Credentialing (NCHEC), the Society for Public Health Education, Inc. (SOPHE), the chair of the HEJA-2010 Task Force, and the appointed cochairs of the HESPA 2015 Task Force (HESPA 2015-TF). The SC drew on prior research and incorporated recommendations and lessons learned during the conduct of those studies. Best practices in job analyses from the Institute for Credentialing Excellence (ICE) also were implemented. Sixty-six volunteer health education specialists were selected by the HESPA 2015-SC from a pool of more than 460 volunteer nominees to serve in various capacities throughout the study. Of the 66 nominees invited to participate, 65 ultimately did so. This number included the additional 10 member HESPA 2015-TF (the two co-chairs, who also served on the HESPA 2015-SC, had been appointed earlier and were not selected via the nomination process), 11 subject-matter experts (SMEs) who participated in structured telephone interviews, 20 independent reviewers who provided guidance during the refinement of the framework, and 24 pilot survey participants. These volunteers were chosen to represent the diversity of work settings, educational backgrounds and experience levels of health education specialists, and to ensure demographic, gender, racial/ethnic and geographical diversity. During the 18-month project (February 2013 to August 2014), ProExam representatives worked with the HESPA 2015-SC and HESPA 2015-TF to update the current framework of health education specialist practice; review and approve the survey instrument and sampling plan for a large-scale survey of health education specialists to validate the framework; review the survey results; and develop recommendations regarding the framework and professional certification. A combination of structured interviews, focus groups, and modified Delphi techniques was used in the preliminary work of the systematic update of the description of health education practice and the knowledge supporting this practice; this process was followed by a large-scale validation survey of practicing health education specialists.

The process by which the framework of practice was developed consisted of the following major phases: Preliminary planning by the HESPA 2015-SC (February April 2013) Selection of the HESPA-TF and other volunteer health education specialists who would contribute to instrument development (April May 2013) Preliminary telephone interviews with 11 SMEs (June 2013) Preliminary work by the HESPA 2015-TF to update the description of health education practice through a face-to-face meeting and follow-up activities (July August 2013) A series of five web-based HESPA 2015-TF meetings to review and further refine the framework (September October 2013) An independent review process (IR) with 20 independent health education specialist reviewers representing diverse work settings (October November 2013) A face-to-face meeting of the HESPA 2015-TF to review and reconcile the IR results, create a pre-survey iteration of the framework, and develop validation survey rating scales (November 2013) Development of sampling plan for the validation survey by ProExam, and outreach to the profession for volunteer survey participants by HESPA 2015-SC and HESPA 2015-TF members (November 2013 April 2014) Data collection initiative regarding terminology related to incorporating the concept of health promotion throughout the framework with HESPA-TF, telephone interview panel, independent review panel, and NCHEC and SOPHE Boards of Trustees (December 2013) Institutional Review Board approval of the study received from Baylor University (January 2014) Pilot testing of the online survey instrument for comprehensiveness, clarity, and technical ease of use (January 2014) HESPA 2015-SC subcommittee review and reconciliation of pilot test findings (February 2014) Validation survey of the Sub-competencies and knowledge used by health education specialists conducted with a sample of 10,871 health education specialists (February April 2014) HESPA 2015-TF review of validation survey results in a face-to-face meeting and development of recommendations to the HESPA 2015-SC (May 2014) HESPA 2015-SC review of task force recommendations and finalization of the framework (June July 2014) A framework illustrating the practice of health education specialists was updated, refined and validated through these processes. In addition, the knowledge base supporting the work of health education specialists was organized into a conceptual structure and validated. The final framework consisted of 258 Sub-competencies, organized into 36 Competencies within seven major Areas of Responsibility. Of the Sub-competencies, 141 (54.7%) were validated as entry level, 76 (29.5%) were validated as Advanced-1, and 41 (15.9%) were validated as Advanced-2. The knowledge base needed by health education specialists was organized into 10 conceptual topic areas, and 131 knowledge topics were validated as being used health education specialists. Test specifications for the CHES and MCHES were empirically derived based on the validation survey data. Test specifications are the recommended percentages of the CHES and MCHES examinations that should be comprised of questions from each Area of Responsibility and for each Competency within the Areas of Responsibility. Information on the use of the validated knowledge also may be used in the construction of examination questions. Findings of this report should be shared widely with the health education profession and other stakeholders in efforts to promote continuous quality improvement of professional preparation, professional development, and certification of health education specialists.

Illustration of HESPA information related to the Areas of Responsibility, Competencies and subcompetencies: Sub-competencies NEW (HESPA) CURRENT (HEJA) Entry 141 162 Advanced 1 76 42 Advanced 2 41 19 Total 258 223 Areas, Competencies, and Sub-competencies at each level Area of Responsibility Competencies Total Subcompetencies Entrylevel Advanced 1 Advanced 2 Area I 7 33 30 3 0 Area II 5 34 28 6 0 Area III 4 29 21 8 0 Area IV 7 57 9 10 38 Area V 6 51 18 33 0 Area VI 3 16 5 11 0 Area VII 4 38 30 5 3 Total 36 258 141 76 41 Areas of Responsibility I. Assess Needs, Resources, and Capacity for Health Education/Promotion CHES % of exam MCHES % of exam 15% (25) 10% (17) II. Plan Health Education/Promotion 18% (29) 16% (26) III. Implement Health Education/Promotion 25% (41) 15% (25) IV. Conduct Evaluation and Research Related to Health Education/Promotion 9% (15) 20% (33) V. Administer and Manage Health Education/Promotion 12% (20) 18% (29) VI. Serve as a Health Education/Promotion Resource Person 9% (15) 12% (20) VII. Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession 12% (20) 9% (15) Total 100% (165) 100% (165)

Health Education Specialist Practice Analysis 2015 (HESPA - 2015) Recommendations to the Profession The Society for Public Health Education, Inc (SOPHE) and the National Commission for Health Education Credentialing, Inc. (NCHEC) commissioned the Health Education Specialist Practice Analysis (HESPA) to verify and update the health education competencies on behalf of the health education profession. In August 2014, the NCHEC and SOPHE boards accepted the final HESPA report. As the copyright holders of the health education competencies, the boards make the following seven recommendations to the health education profession regarding the use of the HESPA 2015 hierarchical model for Health Education Specialists. 1. Baccalaureate degree programs with a health education emphasis should prepare graduates to perform all Entrylevel Competencies and Sub-competencies within the Areas of Responsibility. Additionally, curriculum should incorporate the verified knowledge items. 2. NCHEC should use all Entry-level Competencies and Sub-competencies within the Areas of Responsibility as the basis for the Certified Health Education Specialist (CHES) examination. Additionally, exam questions should incorporate the verified knowledge items. 3. Master and doctoral programs with a health education emphasis should prepare graduates to perform all Entryand Advanced-level Competencies and Sub-competencies within the Areas of Responsibility. Curricula should incorporate the verified knowledge items. Additionally, doctoral programs should prepare graduates to demonstrate a high level of competency and complexity in all Advanced 2-level Sub-competencies. 4. NCHEC should use all Entry- and Advanced-level Competencies and Sub-competencies within the Areas of Responsibility as the basis for the advanced-level Master Certified Health Education Specialist (MCHES) examination. Additionally, exam questions should incorporate the verified knowledge items. 5. All Entry- and Advanced-level Competencies and Sub-competencies within the Areas of Responsibility and the verified knowledge items should serve as the basis for professional development and continuing education for the health education profession. 6. Accrediting agencies and approval bodies should be encouraged to recognize the Areas of Responsibility, Competencies, and Sub-competencies as the basis for quality assurance for health education professional preparation programs. 7. The HESPA hierarchical model should be used as the basis for communicating about the responsibilities and competencies of the health education profession to public and private employers, national/state/local policymakers, health insurers, health professionals, and other stakeholders. HESPA 2015 Hierarchical Framework Summary Areas of Responsibility 7 Competencies 36 Entry-level Competencies 29 Advanced-level Competencies 7 Sub-competencies 258 Entry-level Sub-competencies 141 Advanced-1 Sub-competencies 76 Advanced-2 Sub-competencies 41 Verified Knowledge List 131

Founded in 1988, the National Commission for Health Education Credentialing, Inc. (NCHEC) enhances the professional practice of Health Education by promoting and sustaining a credentialed body of Health Education Specialists. Therefore the, purpose of NCHEC is to certify health education specialists, promote professional development, strengthen professional preparation and practice, and support and promote the health education profession. (See www.nchec.org). Founded in 1950, the Society for Public Health Education (SOPHE) provides global leadership to the profession of health education and health promotion and promotes the health of society through advances in health education theory and research; excellence in professional preparation and practice; advocacy for public polices conducive to health; and the achievement of health equity for all.(www.sophe.org). ####