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Public Health Leadership, Interventions, and Best Practices

By: Edem Jongue

Table of Contents

The Public Health System in America

Core Functions and Essential Services of the Public Health System

My Public Health Niche

Public Health Intervention

Program Evaluation

Leadership in Public Health and Best Practices

Conclusion

Hello, my name is Edem Jongue and I am a graduate student of the Master of Public Health Degree Program. I am presently completing my Capstone and should be graduating shortly after finalizing this course. It has been a very intriguing and worthwhile education journey. My knowledge and skills in the field of public health have increased tremendously. I have had many great professors, a supportive and understanding education advisor, awesome school resources, and great classmates. As you embark on this education journey, I would like to encourage you to become critical thinkers, ask questions, do research, participate in the discussion boards, and keep your eyes on your ultimate education goals.

This presentation will serve as a welcome and introduction to a leadership career in the field of public health. I will present you with a brief overview of the public health system. I will talk about my public health niche. A health intervention within my public health niche, chronic diseases, will be discussed. The importance of program evaluation will be highlighted as I conclude the presentation with an outline of leadership skills and best practices.

Public Health in America

This Photo by Unknown Author is licensed under CC BY

The public health system in America is very complex. Do not let its complexity scare you but try to extract the benefits that result from its complex nature. There are numerous employment possibilities and opportunities to grow professionally within the public health field.

Some of the goals of the public health system are:

To prevent epidemics and the spread of diseases

Protect the population from environmental hazards

Prevent injuries

Promote and Encourage Healthy Behaviors

Respond to disasters and assist in community disaster recovery

Assure access to quality health services

(Turnock, 2016)

Core Functions and Essential Services of Public Health

The dimensions of the public health system include:

Capacity (system inputs): This includes workforce, funding, and facilities.

Outcomes/Results: These are the “fruits” of the combined efforts of the system inputs and processes of the public health system.

(Turnock, 2016)

(Centers for Disease Prevention and Control [CDC], 2011a)

In this slide, the graphic provides a brief overview of the core functions and the essential services of the public health system. I believe that it is important to provide you with this information as it will be an essential guide to you throughout this program. Its concepts will be applicable to many of the courses that you will take and their assignments. I also want to provide you with a brief overview of the structure of the public health system.

The dimensions of the public health system include:

Capacity (system inputs): This includes workforce, funding, and facilities (Turnock, 2016). It constitutes of all the necessary resources and relationships needed to ensure that the core functions and the essential services of the public health system are fulfilled.

Process (practices and outputs): This component of the public health system refers to all the practices and processes needed to accomplish the core functions and essential services of the public health system (Turnock, 2016). This section highlights the undeniably important role of best practices by public health leaders.

Outcomes/Results: These are the “fruits” of the combined efforts of the system inputs and processes of the public health system. Outcomes may include improved organizational performance and improved program performance. They indicate the health status of specific communities and can also highlight the results of risk reduction efforts (Turnock, 2016).

My Public Health Niche

Chronic

Diseases

Applied

Epidemiology

One of the final steps that you would have to take in the Master of Public Health Program is to clearly demonstrate that you know what your public health niche or area of specialty will be. Pay particular attention to your public health interests as they may become more evident to your during the completion of specific courses. It is an added bonus, I believe, to contemplate on how one could play a more significant role in fulfilling the core functions and essential services of the public health system.

My future public health career is one that would enable me to make a significant contribution in the area of chronic diseases. My public health niche is going to be centered around chronic diseases and the implementation of preventative disease strategies, such as healthy diets and regular physical exercise, within the field of applied epidemiology.

I have developed a love for researching chronic diseases such as obesity and diabetes. I have also enjoyed preparing health education campaigns and communications that highlight the goal of curbing the growing incident rates of these chronic diseases. Applied epidemiology will allow me to do in depth research in the area of chronic diseases.

Leadership

Skills

Best Practices

As mentioned earlier, I have a keen interest in the area of chronic diseases. The health intervention that I am going to share with you is based on high blood pressure control and prevention. It is entitled, “ Barber-Based Monitoring, Education, and Referral Support Improve Treatment Rates and Blood Pressure Control in African-American Men.”

Public Health Intervention— “ Barber-Based Monitoring, Education, and Referral Support Improve Treatment Rates and Blood Pressure Control in African-American Men.”

The target risk factor—High blood pressure.

The target population—A racial/ethnic minority community—African American men.

The target outcome or indicator—High blood pressure control.

The intervention setting/location—Local barber shops in the African American community.

The intervention types—Access to high blood pressure care and disease management.

Assets used in this health intervention included residents/community health workers and the physical space of the barber shops.

Health Intervention

Trained barbers in African-American-owned barber shops provided ongoing monitoring of blood pressure to African-American male patrons during the time of their haircut. In addition to monitoring their blood pressure, they also provided high blood pressure health education and provided feedback that helped persuade patrons with abnormal readings to visit the doctor. Those barbers received incentives for recording blood pressure, assisting patrons with no regular doctor with referral, and getting patrons to visit their physician for treatment.

This health intervention was successful.

Public Health Intervention

The results of this health intervention showed that treatment rates and blood pressure control in patrons with high blood pressure significantly improved. In the cluster randomized trial, the average systolic blood pressure among participants fell during the 10-month program (Agency for Healthcare Research and Quality, 2014).

Program Evaluation and Its Importance

Evaluations should be planned from the earliest stages of a health intervention development.

It is an ongoing process.

There are different types of evaluations.

A formative evaluation also known as a process evaluation, is usually done during the program planning process.

A summative evaluation determines if the implementation of a program was successful.

An impact evaluation highlights what happened because of the health intervention/program

An outcome evaluation assesses the final results of a health program.

(Watson, 2010)

When a public health professional undertakes a health intervention and needs to determine whether or not his/her health initiative efforts were successful, he/she completes a process called program evaluation. A public health leader must know how to effectively oversee program evaluations. This is another important component of best practices.

Program Evaluation and Leadership Best Practices

The CDC (2011b) highlights important steps that should take place in an evaluation process. Please note that these steps may overlap each other.

Engage stakeholders, including those involved in program operations; those served or affected by the program; and primary users of the evaluation.

Describe the program, including the need, expected effects, activities, resources, stage, context and logic model.

Focus the evaluation design to assess the issues of greatest concern to stakeholders while using time and resources as efficiently as possible.

Gather credible evidence to strengthen evaluation judgments and the recommendations that follow.

Justify conclusions by linking them to the evidence gathered and judging them against agreed-upon values or standards set by the stakeholders.

Ensure use and share lessons learned.

Leadership in Public Health—Best Practices

Public health professionals must possess the skills and abilities outlined in the Core Competencies for Tier 1 (Entry-Level) Public Health Workers (Turnock, 2016). These include:

Analytic/Assessment Skills

Policy Development/Program Planning Skills

Communication Skills

Cultural Competency Skills

Public Health Sciences Skills

Financial Planning and Management Skills

Leadership and Systems Thinking Skills

Public healthcare leaders understand that they work within a complex and dynamic health system. They should not only be good team leaders, but they should be good team players. They should be aware of the changes that take place within the micro and macro environments of their health organization. Flexibility and willingness to apply concepts from various leadership theories and models are traits that a public health leader, I believe, should possess. These theories and models equip a public health leader with the abilities to become better communicators. They help empower him/her to make wise decisions that will improve the efficacy and efficiency of the health outputs of a health institute.

Leadership Best Practices and Success

I am going to expound a little on leadership success and skills. When you study leadership theories and leadership phases, you will understand more clearly that leadership success involves a combination of elements from all the phases of leadership.

Leader success = Individual (Nature + Nurture) x

Situational adaptation x

Organizational culture x personal + subordinate accountability

(Ledlow & Stephens, 2018)

Leadership Competencies and Best Practices

Some leadership competencies and best practices that I would use to lead a public health program or intervention include:

Adhering to legal and regulatory standards

Anticipating and planning strategies for overcoming obstacles

Championing solutions and encouraging decision making

Creating an organizational climate that encourages teamwork

Facilitating individual motivation

Developing external relationships

Promoting and managing change

Promoting continuous organizational learning

Job performance = ability x motivation x organizational support

(Adhish, Deshmukh, & Kumar, 2014)

Leadership skills and domains are many, but for the purpose of this presentation I will highlight a few. A public health professional should be able to incorporate ethical standards of practice within his/her daily activities. A Public healthcare leader should possess conflict resolution, team building, and coaching and mentoring skills.

Conclusion

In conclusion, I would like to highlight the fact that public healthcare leaders build and lead teams. There should be a clear understanding of what a team, team work, collaboration, and collaborative practices entail. It is vital to remember that conflict resolution skills become a very essential component of promoting collaboration and achieving team member satisfaction and effectiveness.

I believe that in order to be a successful public health leader, one should appropriately and adequately apply skills in leadership, administration, and communication. These skills are used in combination, to plan, organize, administer, and evaluate public health interventions.

Thank you for your attention!

The public healthcare leader is a team leader that understands that best practices will secure a high standard of job performance from team members.

The use of best practices by a public healthcare leader will ensure that team members are empowered to do their best, feel motivated, and receive organizational support.

References

Adhish, V.S., Deshmukh, V., & Kumar, S. (2014). Building and leading teams. Indian Journal of

Community Medicine, Vol 39, Iss 4, Pp 208-213 (2014), (4), 208.

https://doi.org/10.4103/0970-

0218.143020

Agency for Healthcare Research and Quality. (2014). Barber-based monitoring, education, and

referral support improve treatment rates and blood pressure control in African-American

men. Retrieved from https://innovations.ahrq.gov/profiles/barber-based-monitoring-

education-and-referral-support-improve-treatment-rates-and-blood

Centers for Disease Prevention and Control. (2011a). Core functions of public health and how they relate to the 10 essential services. Retrieved from https://www.cdc.gov/nceh/ehs/ephli/core_ess.htm

Centers for Disease Prevention and Control. (2011b). Program Performance and Evaluation

Office (PPEO).

Evaluation steps. Retrieved from https://www.cdc.gov/EVAL/steps/index.htm

Centers for Disease Prevention and Control. (2018). CDC community health improvement

navigator. Database of interventions. Retrieved from https://wwwn.cdc.gov/chidatabase

Ledlow, G.R., Stephens, J.H. (2018). Leadership for Health Professionals: Theory, Skills, and

Applications (3rd ed). Burlington, MA: Jones and Bartlett

Turnock, B.J. (2016). Public Health: What it is and how it works (6th ed). Burlington, MA:

Jones and Bartlett

Victor, R. G., Ravenell, J. E., Freeman, A., Leonard, D., Bhat, D. G., Shafiq, M., … Haley, R.

W. (2011). Effectiveness of a barber-based intervention for improving hypertension

control in black men: the BARBER-1 study: a cluster randomized trial. Archives Of

Internal Medicine, 171(4), 342–350. https://doi.org/10.1001/archinternmed.2010.390

Watson, M.E. (2010). Systems approach workbook for health education and program planning (1st ed). Burlington, MA: Jones and Bartlett.

The End

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