Download:
pdf |
pdfAttachment A: NCCDPHP Core Competencies
NCCDPHP
CORE COMPETENCIES
FOR
STATE HEALTH DEPARTMENTS
Submitted by ICF International
March 2015
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
TTASC | Training and Technical Assistance Support Center
TABLE OF CONTENTS
NCCDPHP Core Competencies for State Health Departments ................................................. 1
Executive Summary..................................................................................................................... 1
Background ................................................................................................................................. 4
Purpose ....................................................................................................................................... 4
Methods ...................................................................................................................................... 4
Results ......................................................................................................................................... 6
Recommended Next Steps.......................................................................................................... 8
Appendix
NCCDPHP Core Competencies Draft List Shared with Key Informants for Feedback
NCCDPHP Core Competencies for State Health Departments
i
NCCDPHP CORE COMPETENCIES FOR STATE HEALTH
DEPARTMENTS
Executive Summary
The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) at the
Centers for Disease Control and Prevention (CDC) has launched a center-wide initiative to
create a comprehensive training approach. As part of this initiative, NCCDPHP has contracted
with ICF International (hereafter ICF) to assist in identifying core competencies for State health
department chronic disease and health promotion staff working to support NCCDPHP’s mission
and goals. The competencies will provide a framework to help categorize and organize training
resources for grantees funded under the State Public Health Actions for 1305 (1305) and for all
other major State-based cooperative agreements focused on chronic disease prevention and
health promotion. These competencies will also serve as an important filter for prioritizing,
developing, and recommending training opportunities to NCCDPHP awardees and project
officers. This document provides a summary of ICF’s efforts in synthesizing existing public
health practice competencies into a comprehensive list for the NCCDPHP Core Competencies
for State health departments.
ICF reviewed seven existing competency lists developed by NCCDPHP stakeholder
organizations. After reviewing the existing competencies, ICF worked with NCCDPHP to
synthesize them into nine draft core competencies and developed accompanying descriptions
for each (the Appendix). Staff from CDC then identified a number of individuals external to CDC
with expertise in either developing or utilizing public health competencies. ICF contacted these
individuals to assess their willingness and availability to review and provide feedback on the
draft competencies. This feedback informed the revisions that resulted in the 11 competencies
noted in Table 1 below.
Table 1. NCCDPHP Core Competencies
NCCDPHP Core Competency
1.
Leadership and Systems Thinking
Competency Description
Articulates and promotes a vision for chronic disease
prevention and health promotion that serves as a catalyst for
change
Describes and influences the dynamic interactions between
political, financial, social, health, and environmental systems
and their impact on chronic disease
Advocates for the role of public health in the prevention and
management of chronic disease
Creates opportunities for coordination across chronic disease
programs and other major health initiatives for maximum
efficiency
NCCDPHP Core Competencies for State Health Departments
1
Table 1. NCCDPHP Core Competencies (continued)
NCCDPHP Core Competency
2.
Organizational and Financial
Management
Competency Description
Develops and sustains the necessary operational
infrastructure, workforce, and financial resources to prevent
and manage chronic disease in the population
Continuously engages in workforce development and
capacity building for managers and staff.
Negotiates, implements, and monitors contracts, with
particular emphasis on achieving outcomes
Uses available resources (e.g., financial data, budget
information, financial management concepts, information
systems, etc.) to increase program effectiveness by
conducting analysis and developing viable solutions to
complex program management issues
Identifies and engages, early on and continuously,
appropriate and relevant partners that can influence chronic
disease management and prevention
Reassesses partners along the way to ensure value and
effectiveness of partnerships
Communicates with other practitioners, partners, and the
public in a way and via various mediums that increases the
demand for a public health approach to chronic disease
prevention and control
Promotes policies and strategies for health improvement;
and leverages opportunities to further the chronic disease
prevention agenda statewide
Clearly communicates the impact of public health programs
and strategies on the health and wellness of the population
Identifies and uses the best available evidence for making
informed public health practice decisions in the prevention
and management of chronic disease
Promotes understanding and use of the current body of
research, evaluations, and evidence-based practices to assist
others with program planning and action plan development
Contributes to the public health evidence base
Effectively assesses and frames policy problems influenced
by the social, economic, and physical factors of the
environment
Uses policy analysis tools
Influences policy change processes
Implements enacted policies
Evaluates policy interventions to prevent and manage
chronic disease
3.
Partnership Engagement and Strategic
Communication
4.
Public Health Science and
Programming
5.
Policy-Related Skills
NCCDPHP Core Competencies for State Health Departments
2
Table 1. NCCDPHP Core Competencies (continued)
NCCDPHP Core Competency
6.
Sector-Wide and Systems Change
Competency Description
Interacts and collaborates effectively with major sectors
(including health care, transportation, extension services,
aging services, parks and recreation, education, private
sector) to implement evidence-based policies and programs
to prevent and control chronic disease
Increases opportunities to collaborate with large sectors and
systems to share data, promote access to services, and
ensure conditions that support healthy choices
Addresses root causes of poor health, historical and
contemporary injustices, and the elimination of health and
health care disparities in chronic disease
Incorporates diverse perspectives in developing,
implementing, and evaluating chronic disease programs and
policies
Considers the impact of decisions, programs, and policies on
health disparities, including unintended consequences
Collects and maintains data that provide essential
information on conditions of public health importance and
on the health status of the population
Utilizes these critical data to inform priority setting and
advance public health policy, processes, programs, or
interventions
Leverages new health information technology and big data
systems to improve the efficiency and timeliness of public
health surveillance and epidemiology
Understands a variety of evaluation designs (qualitative,
quantitative, and economic) and develops and implements
evaluation plans
Utilizes evaluation findings to monitor progress and
achievement, improve performance, and inform future plans
Integrates chronic disease prevention efforts across public
health, education, health care, social, and environmental
systems in such a way as to sustain desired population health
outcomes achieved
Plans sustainability into all chronic disease prevention efforts
from the beginning, and maintains it as an ongoing focus
Treats sustainability as more than a funding effort, instead as
a way of working with and through partners to achieve and
maintain long-term health impacts
7.
Health Equity
8.
Surveillance, Epidemiology, and
Strategic Use of Data/Information
9.
Evaluation
10. Sustainability
NCCDPHP Core Competencies for State Health Departments
3
Table 1. NCCDPHP Core Competencies (continued)
NCCDPHP Core Competency
11. Economic Analysis
Competency Description
Uses economics to identify, measure, value, and compare the
costs, benefits, and consequences of prevention strategies
Tracks costs of chronic diseases and conducts cost analyses
of intervention/program
Designs and utilizes economic evaluations for comparing two
or more interventions/programs in terms of costs or
benefits; evaluations include cost-effectiveness, cost-benefit,
and cost-utility analyses
Background
NCCDPHP’s initiative to create a comprehensive training approach is intended to coordinate
trainings across the center’s many divisions. The NCCDPHP Core Competencies for State Health
Departments is one component of several being developed in a larger effort that includes
awardee training needs assessments, 2015 Training Roadmaps, 5-year training plans for StateBased Cooperative Agreement Awardees (both NCCDPHP-wide and 1305-specific), and an
electronic Learning Management System (LMS) that will include an inventory of training
materials.
Purpose
The NCCDPHP core competencies will be used to organize future training needs assessments,
5-year training plans and the LMS, and to prioritize training events and materials aimed at
strengthening the capacity of State health departments to carry out the work of chronic disease
prevention and health promotion across categorical areas. In addition, the core competencies
will be used to assess, prioritize, and meet project officer training needs.
Methods
The NCCDPHP Core Competencies are not new. Instead, they are a distillation of existing public
health practice competencies developed in a range of efforts to support public health
professional development. The work to identify the core competencies can be categorized into
two phases: Phase 1) Review and Draft Competencies Development, and Phase 2) Validation
and Finalization. These phases are described below.
Phase 1: Review and Draft Competencies Development
ICF developed a matrix of the various existing competency lists. We used this matrix to conduct
a crosswalk of competencies and classify them according to similarities. A synthesized draft list
of competencies (see the Appendix) was developed using this matrix and included content
common across existing competencies. The competency lists included in this crosswalk are
noted in Table 2.
NCCDPHP Core Competencies for State Health Departments
4
Table 2. NCCDPHP Core Competencies Sources by Title, Author/Organization,
and Date Developed
Title
Core Competencies for Public Health Professionals
Author/Organization
Date
The Council on Linkages
Between Academia and
Public Health Practice
June 2014
Center for Training and Research
Translation Training Competencies
Center for Training and
Research Translation
October 2010
(revised)
Foundational Skills and Practice
CDC’s Division of
Community Health
2012
www.phf.org/corecompetencies
Title
National Association of Chronic Disease Directors (NACDD)
Domains and Competencies
Author/Organization
National Association of
Chronic Disease Directors
Retrieved from
Web site
November 22,
2014
Public Health
Accreditation Board
December 2013
Directors of Health
Promotion and Education
Funded by the
CDC/NCCDPHP through a
cooperative agreement
2006
http://www.chronicdisease.org/?page=DomainsCompetencies#
Public Health Accreditation Board Standards: An Overview
http://www.phaboard.org/wpcontent/uploads/StandardsOverview1.5_Brochure.pdf
Public Health Solutions Through Changes in Policies, Systems,
and the Built Environment: Specialized Competencies for the
Public Health Workforce
http://c.ymcdn.com/sites/dhpe.siteym.com/resource/resmgr/docs/hpec_comps_phase_final.pdf
Date
Emery J, Crump C. Public
health solutions through
changes in policies,
systems, and the built
environment: Specialized
competencies for the
public health workforce.
Directors of Health
Promotion and Education.
http://www.dhpe.org.
Published 2006
Training Needs and Supports for Evidence-Based Decision
Making Among the Public Health Workforce in the United
States
http://www.biomedcentral.com/content/pdf/s12913-0140564-7.pdf
NCCDPHP Core Competencies for State Health Departments
Jacob, et al. Training
needs and supports for
evidence-based decision
making among the public
health workforce in the
United States. BMC
Health Services Research.
2014;14: 564.
November 2014
5
Phase 2: Validation and Finalization
Brief descriptions of the draft core competencies were developed and provided to five key
informants that NCCDPHP identified. Key informants reviewed the draft competencies and
were then interviewed by telephone to validate the core competencies. All key informants
were public health professionals with expertise related to public health practice competencies
and the professional development needs of State-level public health practitioners. Following
are the key informants interviewed:
MaryCatherine Jones, MPH
Ross C. Brownson, PHD
Epidemiologist/Evaluator
Director, Prevention Research Center
Healthy Living through Environment Policy and Washington University in St. Louis
Improved Clinical Care Program (EPICC)
Utah Department of Health
Madeleine Solomon, MPH
Director of Policy and Community Programs
Tobacco Technical Assistance Consortium
Emory Centers for Training and Technical
Assistance
Ginny Furshong
Program Manager
Montana Comprehensive Cancer Control
Program
Amy Slonim
Senior Program Officer
Robert Wood Johnson Foundation Office
Results
Feedback provided by the five key informants was both thorough and thoughtful. Suggested
revisions varied from minor editorial changes (e.g., deletion or addition of a word or phrase) to
more substantive, conceptual modifications (e.g., splitting and reframing an existing
competency into multiple competencies). Key informants also suggested the addition of the
following new competencies to the list:
Sustainability
Collaboration
Learning by doing
Economics/cost
Root causes of poor health/high rates of chronic disease
Coordination/integration
NCCDPHP Core Competencies for State Health Departments
6
In considering the feedback provided, both sustainability and financial management/economics
were added to the final list of NCCDPHP competencies. In developing the financial
management/economics competency, we drew from Public Health Financial Management
Competencies developed by Honoré and Costich.1 Elements of the remaining competencies
suggested as additions were incorporated into the existing competencies.
Broader feedback provided by the key informants included the thought that, within the
competencies, chronic disease prevention-focused organizations should play a larger role in
data sharing across sectors and in exploring financial mechanisms to fund chronic disease
prevention efforts in other sectors, as well. This feedback was integrated into the Sector-Wide
and Systems Change competency in the final list.
Some key informants suggested additional sets of competencies and relevant journal
publications for future review.
Additional competencies:
•
Competencies for Applied Epidemiologists in Governmental Public Health Agencies,
developed by the Council of State and Territorial Epidemiologists (CSTE) (in conjunction with
CDC). Available from http://www.cdc.gov/AppliedEpiCompetencies/#1
Institute for Alternative Futures. Public Health 2030: A Scenario Exploration. Alexandria, VA.
May 2014. Available from www.altfutures.org/pubs/PH2030/IAFPublicHealth2030Scenarios.pdf
Additional relevant journal articles:
Allen P, Sequeira S, Best L, Jones E, Baker EA, Brownson RC. Perceived Benefits and
Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health
Departments. Prev Chronic Dis. 2014;11.
Brownson RC, Allen P, Duggan K, Stamatakis KA, Erwin PC. Fostering more-effective public
health by identifying administrative evidence-based practices: a review of the literature. Am
J Prev Med. 2012;43:309-319.
Brownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental
concept for public health practice. Annu Rev Public Health. 2009;30:175-201.
Elliott L, McBride TD, Allen P, et al. Health Care System Collaboration to Address Chronic
Diseases: A Nationwide Snapshot From State Public Health Practitioners. Prev Chronic Dis.
2014;11:140075.
The CSTE competencies were reviewed and considered in drafting the final list of competencies.
Finally, during the interviews, key informants were asked for their thoughts or suggestions on
ways that NCCDPHP could use these competencies, they responded with the following:
1
Honoré P, Costich J. Public health financial management competencies. JPHMP. 2009;15: 311-318.
NCCDPHP Core Competencies for State Health Departments
7
Utilize the competencies in onboarding new CDC and, possibly, State staff – NCCDPHP
could develop a 1-year onboarding schedule that breaks down expectations at period
intervals throughout the year (e.g., 1 month, 3 months, 6 months). Onboarding would be
the responsibility of each supervisor. A checklist of resources and competencies could be
provided for each interval of onboarding. Project officers also could have checklists and
schedules to follow as their State contacts turn over and new staff need to improve their
knowledge and skills.
Incorporate the competencies into grant announcements, performance tracking, capacity
building activities, and technical support –The competencies should serve as benchmarks
of progress and work.
Link the competencies more explicitly with the NCCDPHP domains–Make a visual
connection between each domain and where the competencies fit in to help make people
most effective in their work.
Align the competencies with CDC’s project officer program – Ensure that the competencies
are integrated into the skills of those that support State chronic disease programs. The
competencies should be used as a focal point in the work among project officers working
with States. The competencies could be a tool for those staff to think about States and
areas where they need to evolve and ways to support States around these core areas.
Other suggestions included integrating and/or applying the competencies in workforce
recruitment, hiring standards, performance evaluations, and professional development.
Recommended Next Steps
At the time of this report submission, the core competencies presented here are already
informing the organization of the 2015 NCCDPHP State Health Department Grantee Training
Roadmaps and the conceptualization of grantee and project officer needs assessments. The
competencies also will be used to inform a 5-year Training Plan for NCCDPHP Grantees later
this year. In addition to these applications already in progress, we recommend the following
next steps:
1. Dissemination: Now that the core competencies have been developed, it is time to
disseminate them to the NCCDPHP Training Workgroup, leadership across the NCCDPHP
divisions, project officers, State health departments, and NCCDPHP’s partner organizations
(e.g., NACDD). Dissemination may include sharing this report along with a brief PowerPoint
presentation or Webinar to discuss the intention, process, and next steps for applying the
core competencies to varied stakeholder groups. The plan also may include translation and
implementation plans, as well as a forum for stakeholder feedback to be integrated into
future versions of the competencies.
2. Translation and Implementation: The key informants engaged to validate these
competencies contributed several strategic suggestions that require translation to be
applicable to work at the national, State, and local levels (see Results section of this report).
The NCCDPHP leadership, Training Workgroup, NACDD, and others have varied
perspectives. Each should be engaged to translate these core competencies for public
NCCDPHP Core Competencies for State Health Departments
8
health professionals working across geographies to prevent chronic disease. Once
translated, plans to implement the core competencies, as suggested by key informants, can
be made for the following areas:
o Workforce:
Recruitment: The core competencies may inform job descriptions used to recruit for
chronic disease-focused staff positions.
Staff development: The core competencies may inform staff development
opportunities at the unit or individualized levels.
Ongoing performance monitoring: The core competencies may inform annual
performance reviews and goal development for staff.
o Grant opportunities:
Program development: The core competencies may inform program development at
the national, state, and local levels.
Guidance: The core competencies may inform grantee guidance.
Technical assistance: The core competencies may inform the technical assistance
offered to grantees.
3. Continued Refinement: Due to the dynamic nature of public health practice, these core
competencies will require regular examination for relevance and refinement to be of longterm use. Key informant feedback included a request for the competencies to be linked
more explicitly to the NCCDPHP domains. As the emergent work around Domains 3 and 4
(Health Care System Interventions and Community Programs Linked to Clinical Services)
especially, continues to evolve, operationalizing the competencies to achieve this work will
be an ongoing process, as well.
NCCDPHP Core Competencies for State Health Departments
9
APPENDIX. NCCDPHP CORE COMPETENCIES DRAFT LIST
SHARED WITH KEY INFORMANTS FOR FEEDBACK
Leadership and Systems Thinking: Articulates and promotes a vision for chronic disease
prevention and health promotion that serves as a catalyst for change; describes and influences
the dynamic interactions between political, financial, social, and environmental systems and
their impact on chronic disease, and advocates for the role of public health in the prevention
and management of chronic disease.
Organizational Management: Develops and sustains the necessary operational infrastructure,
workforce, and financial resources to prevent and manage chronic disease in the population;
creates opportunities for coordination across chronic disease programs for maximum efficiency.
Partnership Engagement and Strategic Communication: Identifies and engages appropriate
and relevant partners early on that can influence chronic disease management and prevention;
communicates with other practitioners, partners, and the public in a tailored way and in various
mediums; promotes policies and strategies for health improvement; and leverages
opportunities to further the chronic disease prevention agenda statewide.
Public Health Science and Programming: Identifies and uses the best available evidence for
making informed public health practice decisions in the prevention and management of chronic
disease; promotes understanding and use of the current body of research, evaluations, and
evidence-based practices to assist others with program planning and action plan development;
and contributes to the public health evidence base.1
Policy-Related Skills: Effectively assesses and frames policy problems, uses policy analysis tools,
influences the policy change process, implements enacted policies, and evaluates policy
interventions to prevent and manage chronic disease.2
Sector-wide change/Cross-sector change: Interacts effectively with other major sectors
(including health systems, transportation, parks and recreation, education, private sector) to
implement evidence-based policies and programs that provide data, promote access to
services, and support the prevention and management of chronic diseases.
1
Public Health Accreditation Standards
2
Emery J, Crump C. Public health solutions through changes in policies, systems, and the built environment: Specialized competencies for the public
health workforce. Directors of Health Promotion and Education. Available at http://www.dhpe.org.
3
Bauer, U, et al. Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the
USA. Lancet. 2004;384:45-52.
NCCDPHP Core Competencies for State Health Departments ● Appendix
1
Health equity: Addresses avoidable inequities, historical and contemporary injustices, and the
elimination of health and healthcare disparities in chronic disease; incorporates diverse
perspectives in developing, implementing, and evaluating chronic disease programs and
policies; and considers the impact of decisions, programs, and policies on health disparities,
including unintended consequences.
Surveillance, Epidemiology, and Strategic Use of Data/Information: Collects and maintains
data that provide essential information on conditions of public health importance and on the
health status of the population; utilizes these critical data to inform priority setting and advance
public health policy, processes, programs, or interventions.1, 3
Evaluation: Understands a variety of evaluation designs (qualitative, quantitative, and
economic) and develops and implements evaluation plans; utilizes evaluation findings to
monitor progress and achievement, improve performance, and inform future plans.
NCCDPHP Core Competencies for State Health Departments ● Appendix
2
| File Type | application/pdf |
| File Modified | 2015-08-21 |
| File Created | 2015-03-26 |