Scaling Up Evidence-Based Public Health Training

Abstract

Evidence-based public health (EBPH) is the process of integrating science-based interventions with community preferences. Training in EBPH improves the knowledge and skills of public health practitioners. To reach a wider audience, we conducted scale-up efforts including a train-the-trainer version of the EBPH course to build states’ capacity to train additional staff. In this essay, we describe formats for course delivery and local adaptations to content, and we review success factors and barriers for state-based replication of the EBPH training course. Findings were based on our experiences and interviews. EBPH training was delivered in varied blended formats as well as in person and in distance courses, each with advantages and disadvantages. Adaptations were made to meet the needs of learners. Success factors included having committed and competent coordinators and trainers, organizational incentives, leadership support, funding, internal and external collaborators, the infrastructure to support training, and models to learn from. Barriers reported included insufficient staff or trainer capacity; time constraints for organizers, trainers, and participants; and lack of sustained funding. We hope our experience and findings will be a guide for states that are committed to building and sustaining capacity through continued EBPH training. Our lessons may also apply more generally to other workforce development training efforts.

Preferred modalities for delivering continuing education to the public health workforce: a scoping review

“…We identified public health training programs delivered in over 11 countries: Australia, 10,16,17 Bolivia, 18 Brazil, 19 Canada, [20][21][22] Greece, 23 the Islamic Republic of Iran, 24 Mexico, 25 Rwanda, 26,27 Uganda, 28 the United Kingdom 29 and the United States of America (USA). [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] One program offered trainings in over 77 countries, 46 and another trained participants in Austria, Lithuania and the Netherlands. 9 Within the past 7 years, 19 of these articles were published.…”

“…The objectives of and the methods used to gather evaluations varied across studies. Approaches to evaluation included surveys; 26,27,38,42,43 pre/post questionnaires; 30,31,33,41 participant completion statistics; 19 interviews; 28,45 and mixed methods (a combination of either focus groups or interviews and surveys or questionnaires with participants). 9,10,[16][17][18][20][21][22][23][24][25]29,32,[34][35][36]39,40,44 Evaluations after participation captured participants' demographic information, subject knowledge before and after training, satisfaction with and post-training use of their newly gained knowledge.…”

“…18,32,40,46 Participants also noted the convenience of online training 29 and onsite training, 17 with both decreasing travel time. Other factors that increased accessibility to public health professionals included content adapted to the context of the community in which the learners work 20,27,45 and when a variety of modalities was used to deliver the content. 9 One study noted participants' preference for a formally certified course.…”

“…24 Employer support, for instance by providing tools such as computers and designated time to complete the training, was an essential factor in facilitating program completion. 10,19,20,22,25,44,45 Barriers to completing public health training In the context of online training, technological challenges such as sound quality and network issues were cited as one of largest barriers to completing training, 18,20,32 especially in rural locations. 17,26 In one study, some training participants did not use computers in their daily work so they were not familiar with the technologies used for the course, which resulted in poor uptake.…”

“…17,26 In one study, some training participants did not use computers in their daily work so they were not familiar with the technologies used for the course, which resulted in poor uptake. 19 The lack of time to work on modules or assignments while working full-time was another commonly reported barrier, 18,20,39,41,45 especially when planning group work. 22 This concern cut across the literature.…”