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Leadership institutes help public health workers advance careers.

Public health professionals looking to build their careers can find an opportunity through the nation's many public health leadership institutes, which offer professional development to public health practitioners whose jobs are integral to the development of healthy communities. Across 43 states, a system of more than 30 state and regional public health leadership institutes are helping to increase the capacity of trained leaders who are ready to meet new public health challenges.

In the nation's schools and programs of public health, leadership skills are rarely addressed. For that reason, leadership institutes focused on the needs of public health professionals play a critical role in developing the personal, team, agency, community and professional leadership skills of the nation's public health work force.

"Getting an MPH does not necessarily confer on you the realities of practicing public health, just as medical schools do not necessarily train doctors to handle money or management issues," said Stephanie Coursey Bailey, MD, MHSA, chief of the Centers for Disease Control and Prevention's Office of Public Health Practice.

Practitioners who participate in public health leadership institutes hold jobs at the federal, state and local levels of public health. Some work in governmental organizations while others are associated with non-profit agencies, academic institutions or with private companies.

"Participants are as diverse as the public health work force," said Geoffrey Downie, MPA, program manager of the Mid-America Regional Public Health Leadership Institute.

Environmental health, public health nursing, infectious disease, epidemiology, preparedness and emergency response are among the public health fields represented in public health leadership development programs, Downie said. However, all institutes "share the belief that systems thinking is a key component to effective leadership, and that community health will improve if public health infrastructure is sustained and supported."

Since opening its doors in 1992, the Mid-America Regional Public Health Leadership Institute, which was the first state public health leadership institute, has graduated more than 750 scholars from Arkansas, Illinois, Indiana, Massachusetts, North Dakota, Wisconsin and Quebec. Downie said many graduates have ascended to positions of higher leadership, including the U.S. Congress and as senior executive staff in state and national organizations.

Across the public health leadership institute landscape, programs, curricula, tuition fees, scholar mix and models vary. Some institutes have more "carets" than others, "but each of these programs is really a jewel," said Edward L. Baker, MD, MPH, MSC, director of the North Carolina Institute for Public Health, which oversees the National Public Health Leadership Institute at the University of North Carolina at Chapel Hill's School of Public Health.

"They are all part of a system of leadership development and each plays an important role," said Baker, who is the former director of CDC's Public Health Practice Program Office and former assistant U.S. surgeon general. "These are proven programs. They are effective. They clearly benefit people, and there is a lot of evidence to support that."

APHA member Susan M. Allan, MD, JD, MPH, credits her participation in the National Public Health Leadership Institute's first class of scholars in 1991 with her decision to earn a graduate degree in public health.

"I had been working in public health for several years before I got the MPH," said Allan, public health director for the Oregon Department of Human Services in Portland. "I found it helped provide the theoretical and scientific framework for the work I had already been doing so that I was more confident and focused in addressing public health situations, and much clearer and more effective in explaining what we did and why."

Leadership institutes provide training and reinforce skills that are rarely learned as part of health professions training programs, Allan said, "such as policy development and advocacy, media training and understanding and working with your individual leadership and management skills."

As a participant in the National Public Health Leadership Institute's second class of scholars in 1992, David E. Rice, MPH, MA, who serves as health director for the New Hanover County Health Department in Wilmington, N.C., developed the Healthy Reno Sparks and Washoe County Community Assessment, which incorporated the goals and national objectives of Healthy People 2010.

"I developed a strong coalition based on that community assessment," Rice told The Nation's Health. "It equipped us to carry forth the public health agenda in that community."

In addition to his own participation with the National Public Health Leadership Institute, four members of Rice's current management team have attended the Southeast Public Health Leadership Institute, a year-long leadership development program within the University of North Carolina School of Public Health for mid- to senior-level public health administrators working in Arkansas, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. Rice's department has also sponsored eight teams to the University of North Carolina at Chapel Hill's Management Academy for Public Health, which prepares teams of health professionals for new management challenges in community health, including building skills in managing money, people, data and partnerships. Every team writes and presents a public health business plan designed to attack a key public health problem in the community.

Putting learning into public health practice

Public health leadership institutes embrace a concept known as "ecological leadership" because they are part of a system that helps develop leadership and management skills across a person's career, said Joyce R. Gaufin, executive director of the Great Basin Public Health Leadership Institute in Salt Lake City.

"One of the most important individual benefits of participation is an increased sense of confidence about their own abilities and the actions they take as a leader," said Gaufin, who also serves as chair of the National Public Health Leadership Development Network, a consortium of organizations and individuals dedicated to advancing the practice of public health leadership.

The network, established in 1994 through a cooperative agreement among CDC, the Association of Schools of Public Health and Saint Louis University, supports the growth of public health leadership institutes and works to improve access to them. The network's Web site, at www.heartland, also serves as a one-stop information clearinghouse for public health professionals seeking information about leadership development.

Most leadership institutes are one-year programs aimed at developing advanced leadership skills to support the work force needs of state, local and regional public health systems, Gaufin said. Most programs feature one or two weeks of on-site training and one off-site retreat, with the bulk of the learning conducted via self-study courses, online learning and video and teleconferencing events. Training is conducted by expert faculty members from leading schools of public health, business programs and the private sector. Instructors often represent experts in the fields of leadership and management. Over the course of the training year, participants, often referred to as "scholars," complete real-life learning projects and receive feedback on their leadership progress from their peers, direct reports and managers.

Funding for the programs comes from a variety of sources, including CDC, state and local health agencies, public health foundations, grants and tuition fees. Each public health leadership institute operates independently and receives policy direction from key sponsoring organizations that set standards for admission and set tuition fees, which can range from a fully funded program offered at no cost to the participant to about $3,000 for a one-year program.

Upon graduating, scholars can continue to strengthen their skills through alumni programs, including membership in the Public Health Leadership Society in New Orleans, an organization composed of alumni from national, state and regional public health leadership institutes. Moreover, many public health leadership institutes work through, or in partnership, with academic programs, and therefore are able to offer continuing education credits, often at the graduate level.

"If you combine these learning outcomes, it's easy to see why some scholars attribute their public health leadership institute experience to helping to advance their careers through promotions, enhanced job responsibilities or improved networking opportunities," Gaufin said.

The Great Basin Public Health Leadership Institute, which Gaufin facilitates, was created in 2004 to serve public health practitioners in Utah and Nevada. The institute's program is designed around three, three-and-a-half-day on-site workshops. Prior to the first workshop and in between, scholars participate in self-study and distance learning events.

Audrey Stevenson, a graduate of Great Basin's inaugural class, said scholars "get out of a leadership institute what they put in," because the process isn't passive.

"It is well worth the cost, time and effort if the scholar is sincere about learning and growing," said Stevenson, director of the family health services division of the Salt Lake Valley Health Department in Salt Lake City, Utah.

For Stevenson, the opportunity to complete a meaningful project, with input from a mentor, colleagues and instructors, was one of the greatest benefits of attending the Great Basin Public Health Leadership Institute. Stevenson's project, which provided training across divisions of the Salt Lake Valley Health Department, has since served to increase staff awareness of public health and has facilitated a greater understanding of public health and the various programs in place in other divisions of the Salt Lake Valley Health Department.

"As a PhD student, this was one more validation of the importance of such institutes in professional public health leadership development," Stevenson said.

Institutes building for public health's future

Nearly 20 years ago, a landmark Institute of Medicine public health report noted that "the need for leaders is too great to leave their emergence to chance."

Decrying the lack of focus on leadership development for the nation's public health practitioners, the report, "The Future of Public Health," challenged public health leaders to develop greater leadership effectiveness, and schools of public health to increase the number of leadership development opportunities available to public health practitioners.

The public health community accepted the challenge by creating the nation's first public health leadership institutes, which to this day serve as training grounds for U.S. public health professionals.

In 1991, CDC initiated the first national leadership development program--the National Public Health Leadership Institute--at the University of North Carolina at Chapel Hill. Recognizing the need to foster leadership skills throughout health organizations, CDC began providing funds for the establishment of state and regional leadership programs across the nation. With that, the first two state public health leadership institutes, the Illinois Public Health Leadership Institute, now called the Mid-America Regional Public Health Leadership Institute, and the Missouri Public Health Leadership Institute, came into existence in 1991 and 1992.

Gaufin estimates that since 1991, more than 5,000 public health practitioners have graduated from state, regional or national public health leadership programs.

One of the newest such institutes, the Satcher Health Leadership Institute, has plans to open at Atlanta's Morehouse School of Medicine. Though still in development, the new institute will be headed by former U.S. Surgeon General David Satcher, MD, PhD, director of the Center of Excellence on Health Disparities at Morehouse School of Medicine in Atlanta and the Poussaint-Satcher-Cosby chair in mental health. With a goal to eliminate health disparities, the institute will focus on three core areas: mental health, sexual health and the health of the black family.

Another such specialized leadership institute is offered through APHA. The Maternal and Child Health Community Leadership Institute assists state maternal and child health directors in meeting Healthy People 2010 objectives through a variety of evidence- and community-based approaches. Institute participants come together during the APHA Annual Meeting and work on projects throughout the year.

"The need for leadership in public health is well documented, and many would agree that at no time in this nation's history has the need been greater," said Kate Wright, director of the National Public Health Leadership Development Network.

CDC's funding of the network has been "critical throughout the years," Wright said, "and has helped to get additional support from other sources that also believe in the strength and need for the network of public health leadership institutes."

Each public health leadership institute operates autonomously, however leadership institutes share resources and best practices through the network, which does not charge for its services.

However, to increase the efficiency and effectiveness of the many programs, some public health work force experts feel that greater standardization is needed across national, state and regional public health leadership institutes.

There are some tried and true methods for leadership training, said Ron Bialek, MPP, president of the Washington, D.C.-based Public Health Foundation.

"If we had the resources there could be some standardization to meet the regional, state and local needs," he said. "Standardization could help us ensure that those tried and true methods are employed throughout the United States."

For more information, visit www.heartland
COPYRIGHT 2007 The Nation's Health
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Title Annotation:Thousands of scholars take part nationwide
Publication:The Nation's Health
Geographic Code:1USA
Date:Aug 1, 2007
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