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Objective: The Pandemic and All-Hazards Preparedness Act calls for establishing a competency-based training program to train public health practitioners. To inform such training, the Centers for Disease Control and Prevention and the Association of Schools of Public Health managed groups of experts to produce a competency model which could function as a national standard of behaviorally based, observable skills for the public health workforce to prevent, protect against, respond to, and recover from all hazards., Design: A systematic review of existing competency models generated a competency model of proposed domains and competencies., Participants: National stakeholders were engaged to obtain consensus through a three-stage Delphi-like process., Results: The Delphi-like process achieved 84 percent, 82 percent, and 79 percent response rates in its three stages. Three hundred sixty six unique individuals responded to the three-round process, with 45 percent (n = 166) responding to all three rounds. The resulting competency model features 18 competencies within four core learning domains targeted at midlevel public health workers., Conclusions: Practitioners and academics have adopted the Public Health Preparedness and Response Core Competency Model, some of whom have formed workgroups to develop curricula based on the model. Efforts will be needed to develop evaluation materials for training and education programs to refine the model as well as for future training and education initiatives.

Although global health is a recommended content area for the future of education in public health, no standardized global health competency model existed for master-level public health students. Without such a competency model, academic institutions are challenged to ensure that students are able to demonstrate the knowledge, skills, and attitudes (KSAs) needed for successful performance in today's global health workforce. The Association of Schools of Public Health (ASPH) sought to address this need by facilitating the development of a global health competency model through a multistage modified-Delphi process. Practitioners and academic global health experts provided leadership and guidance throughout the competency development process. The resulting product, the Global Health Competency Model 1.1, includes seven domains and 36 competencies. The Global Health Competency Model 1.1 provides a platform for engaging educators, students, and global health employers in discussion of the KSAs needed to improve human health on a global scale.

Objective: The Pandemic and All-Hazards Preparedness Act calls for establishing a competency-based training program to train public health practitioners. To inform such training, the Centers for Disease Control and Prevention and the Association of Schools of Public Health managed groups of experts to produce a competency model which could function as a national standard of behaviorally based, observable skills for the public health workforce to prevent, protect against, respond to, and recover from all hazards., Design: A systematic review of existing competency models generated a competency model of proposed domains and competencies., Participants: National stakeholders were engaged to obtain consensus through a three-stage Delphi-like process., Results: The Delphi-like process achieved 84 percent, 82 percent, and 79 percent response rates in its three stages. Three hundred sixty six unique individuals responded to the three-round process, with 45 percent (n = 166) responding to all three rounds. The resulting competency model features 18 competencies within four core learning domains targeted at midlevel public health workers., Conclusions: Practitioners and academics have adopted the Public Health Preparedness and Response Core Competency Model, some of whom have formed workgroups to develop curricula based on the model. Efforts will be needed to develop evaluation materials for training and education programs to refine the model as well as for future training and education initiatives.

A 10-year retrospective analysis was done using training records for 869 trainees who had attended a 40-hour course for hazardous waste site work. The course is intended for professional site workers, but had been attended by a demographically diverse audience. Analysis of test, demographic, and course data revealed some spurious effects but also indicated that trainees were not disadvantaged in their learning gains based on their own background or that of the class overall. Moreover, a large class appears to present some advantages, and a diverse class appears to present advantages in training material applied across work duties (hands-on skills, decontamination, etc.). Logistics encountered in the study raise doubts that a definition of professional/nonprofessional can be achieved or applied. Overall, the routine practice of providing separate training to professionals and nonprofessionals requires revisiting.

A mail survey was conducted among emergency responders who received training at the New Jersey/New York Hazardous Materials Worker Training Center. Responses indicate that technical topics are extremely important (i.e., decontamination, personal protection); that the vast preponderance of trainees felt confident in their ability to recall specific critical concepts in a crisis; and that 42% of respondents (75) had experienced an incident that would have resulted in injury or death without training. Phone surveys for details of specific incidents reported by 43 of the 75 mail survey respondents revealed that anecdotal data provide powerful evidence of the value of training; that extensive and uniform training is needed across jurisdictions; that training should emphasize the technical aspects of health and safety, and should include demonstration and hands-on techniques; and that integrated organizational support for implementation of health and safety practices is critical.

Health promotion and disease prevention must be addressed in medical education, and the assessment of future physicians' health preventive perceptions and behaviors is a critical step in the process. We conducted a cross-sectional survey of 512 medical students enrolled during the 1992-1993 academic year. Outcome measures were self-reported health behaviors and ratings of the importance of prevention. Overall, results indicated that the preponderance of respondents are engaging in healthy behaviors; however, some high-risk behaviors, such as drinking and driving and possible binge drinking, were reported by at least 15% of the respondents. Significant differences were detected regarding students' perceptions; a linear decreasing trend was noted with first-year students rating the importance of prevention the highest and fourth-year students rating it the lowest. Additionally, this study attempted to correlate health behaviors with perceptions. The results show significant relationships between student-reported behaviors and corresponding perceptions. Even though this cohort is healthy overall, some students are engaging in behaviors that are not conducive to maintaining a healthy lifestyle. It is important to identify and address negative health behaviors in this population, not only in terms of personal health, but also in its effect on their interaction with future patient populations. The attrition of interest in prevention during undergraduate medical training is cause for concern; future clinical practice will be strongly motivated by their perceptions. Medical schools should identify health issues and assess preventive health perceptions among students in order to facilitate the adoption of preventive practices by future physicians. Medical Subject Headings (MeSH): health promotion, prevention, medical students, health behavior.

Given the occupational risks of hazardous waste workers, this study was conducted to explore possible differences in medical surveillance practices among blue and white collar workers. Demographic and medical surveillance data were collected from 636 white collar and 206 blue collar trainees, enrolled in health and safety training courses. Overall, 4.5% of the trainees reported being ill or injured because of hazardous substances. Significant differences (P < .0001) were noted between groups; blue collar trainees were more likely to have been ill or injured. Differences also existed for medical surveillance enrollment; 32% of the white collar trainees report enrollment compared to 19% of the blue collar trainees (P = .004). This study indicates that blue collar trainees are more likely to be injured and less likely to be enrolled in medical surveillance programs. Issues of illness and injury, as well as medical surveillance enrollment, must be addressed; ensuring that all workers receive medical surveillance needed to prevent occupational illness in the hazardous waste field.

This chapter has provided examples of practical and theoretical considerations that should be made when developing evaluation activities concomitant to training. Evaluation choices have been described based on considerations and experiences from others in the training field, sound rationale for program and policy research, and realistic constraints and demands of training. The discussion has presented some of the basic technical issues associated with the collection and analysis of trainee, program, and test data. It also has presented some basic considerations in optimizing procedures and in interfacing within and beyond programs for data collection. Finally, it has presented options available for data analysis from other models and methods in the training field. Whenever possible, select standard variables should be used to facilitate the advancement of training and reporting. Many variables and procedures will differ between programs based on training objectives; others should be part of basic activities. The authors conclude that use of demographic, program, and tests and nontest effectiveness measures are all important in assessing the quality of training efforts and the instruments themselves. When possible, such efforts should expand to include behavior assessment at the worksite, as occurs with behavior-based training developed and provided at the work-site. Most issues relating to evaluation in general are amenable to modification. Indeed, by responding to the issues cited, both in support of and in opposition to various methods, it is possible to address valid technical concerns and maximize data strength. The value of program evaluation will ultimately be based on the selection of critical variables and the use of data collection and analysis activities that maximize their potential. The value of program evaluation to policy development will largely be dependent upon the quality of program evaluation and the extent to which similar programs collaborate and report their outcomes.

This pilot project was conducted to measure the effectiveness of patient package inserts (PPIs) when controlled interventions by pharmacists are increased. The PPIs were designed to be easily understood by patients and included information on possible side effects, interactions, compliance and instructions on how to take the medication. PPIs for penicillin and ampicillin were evaluated. Data analysis yielded the following results for respondents receiving PPIs as compared with those who did not: satisfaction with the amount of drug information received; increase in knowledge concerning the drug's proper use; higher rates of compliance; high rating given to the "helpfullness" of the PPI information; interest in receiving PPIs routinely, particularly with new prescriptions. The PPIs developed for this study were found to be valuable tools to respondents for understanding how to take their medications, both in terms of knowledge and behavior. Verbal reinforcement of the PPI by the pharmacist was also found to be helpful.