No description available.

No description available.

No description available.

No description available.

No description available.

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration (HRSA)-funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an Academic Health Department (AHD) involving the East Tennessee State University (ETSU) College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessments and community-oriented practice. Similarly, the COPH recognized the need to expand field-based public health practice opportunities for students. Personnel from SCRHD, LIFEPATH, and COPH developed a formal AHD memorandum of understanding during the summer of 2012, launching the program in fall 2012. The COPH/SCRHD model addresses financial barriers experienced by other AHDs by competitively awarding the Coordinator position to a Doctor of Public Health (DrPH) student from the COPH, demonstrating investment in the model by the COPH. The DrPH student gains valuable leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. SCRHD benefits from formally trained graduate-level interns dedicated to long-term work within the community. This AHD offers a unique opportunity for doctoral-level students to develop practical leadership skills in a functioning health department, while enhancing the capacity of SCRHD and COPH to serve their community and stakeholders.

Maintaining the health of Tennesseans depends heavily on a well-trained, efficient public health workforce that can work effectively in a complex environment. In order to assess the training needs of this group, the Tennessee Public Health Training Center-LIFEPATH administered a survey to all governmental public health employees in Tennessee during the summer of 2012. This instrument was modeled after previous assessments conducted by health agencies outside of Tennessee which utilized as their rubric the Core Competencies for Public Health Professionals developed by the Council on Linkages between Academia and Public Health Practice. The goal of this research was to inform and streamline educational efforts of the Tennessee Department of Health (TDOH), LIFEPATH and their partners across the state by identifying specific competency driven training opportunities within the workforce. Participants were recruited via email and directed to SurveyMonkey, an online survey toolkit, where they could complete the questionnaire. Of the 5178 TDOH employees who received the recruitment email, 3086 individuals completed at least one of the competency questions for a response rate of 59.6%. The survey assigned questions pertinent to the eight core competency areas to respondents based on one of three Tiers – Tier 1: Entry Level, Tier 2: Management Level, Tier 3: Leadership Level. Once the data were collected, responses from all three tiers were dichotomized to generate a “Needs Score” which when summarized represented the percentage of responses indicating a lack of knowledge or proficiency in a competency area. Tier 1 respondents had an average needs score of 60.46% in each of the eight core competency areas. Tier 2 had an average needs score of 49.50%, and Tier 3 respondents had an average needs score of 28.91%. This trend shows that individuals in leadership positions within TDOH were more likely to be knowledgeable or proficient in the eight core competency areas. Prior to administering the survey, TDOH job classifications were submitted to an expert panel within the health department. This body was tasked with assigning tiers to specific job classifications. Previous needs assessments that used the eight core competencies had respondents self-select their tier. As a test of validity the LIFEPATH survey asked TDOH employees to select their job classification in addition to tier. A Kappa test of agreement between self-selection of tier and their actual tier determined by TDOH leadership showed moderate agreement (Kappa=0.5089), suggesting that while most respondents selected the correct tier; there remained some confusion regarding tier definitions. This must be considered when evaluating the results of previous studies that utilize only the self-selected tiers to drive their survey. This data has already begun to direct training goals at the state, regional and local levels across Tennessee and will serve as a baseline measure for future evaluations of educational programing’s impact on workforce competency.

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child. While a preponderance of the drug dependence research is adult-centric, a significant body of research demonstrates the importance of not only addressing the immediate well being of the children of drug dependent caregivers but preventing the continuing cycle of drug dependence. The present commentary demonstrates through a brief review of the US history of drug dependence crises and research from the 1980s and 1990s, a range of “tried and true” family, school, and community interventions centered on children. We already know that these children are at high risk of maladjustment and early onset of drug dependence; early intervention is critical; multiple risk factors are likely to occur simultaneously; comprehensive strategies are optimal; and multiple risk-focused strategies are most protective. Where we need now to turn our efforts is on how to effectively implement and disseminate best practices, many of which we learned in the 1980s and 1990s. The greatest opportunity in both changing the nature of the opioid epidemic at scale and influencing rapid translation of existing research findings into policy and practice is not in asking what to do, but in asking how to do the right things well, and quickly.

The Safe and Drug-Free Schools and Communities Act of 2002, which operates under the No Child Left Behind Act of 2001, requires school districts to implement substance abuse and violence prevention programs to prevent or reduce substance use/abuse and violence and to decrease risk factors and increase protective factors that contribute to healthy child development without providing adequate funding to implement the mandate. The inadequacy of funding does not support the most effective strand of programs: community and family-based or environmental programs. An on-line survey of 43 elementary school principals was conducted to establish their knowledge and perceptions of the implementation of science-based substance abuse and violence prevention programs. The responses produced mixed results. The participants reported generally positive experiences with the implementation process of research-base prevention programs, but they admitted a lack of skill regarding implementation of community and family-focused research-based prevention programs due to their inexperience with the environmental programs. The participating principals also stated that they experienced frustration with the lack of time and the lack of funds to properly implement the research-based prevention programs. The administrators indicated they were knowledgeable about these research-based substance abuse and violence prevention programs; however, some of their responses revealed their lack of knowledge in distinguishing the difference between actual research-based programs that are on the State Board of Education's approved list and other prevention programs that are marketed. The elementary school principals in this study generally reported positive perceptions of the implementation of research-based substance abuse and violence prevention programs, including the following advantages that were supported by the literature: science-based substance abuse and violence prevention programs prevent or reduce substance use/abuse and violence and student discipline problems, and these programs increase protective factors and decrease risk factors in the lives of students and/or their families. Stated disadvantages about the amount of time required to implement the research-based prevention programs, the lack of training, and the inadequacy of funding yielded some negative perceptions. Recommendations for educational administrators include providing extensive training for site principals and teachers in prevention science and in identifying at-risk students and their needs for prevention services. In addition, administrators were encouraged to collaborate more with their communities in an effort to provide the more meaningful and effective environmental strand: community and family-oriented research-based substance abuse and violence prevention programs.

The effectiveness of a shor-term prevention program to increase drug refusal behavior in elementary school children was assessed. Fifty-seven third grade children were randomly assigned to one of three groups: rehearsal-plus, traditional, and control. Children in the rehearsal-plus group were taught drug knowledge, assertiveness skills, decision making skills, and specific drug refusal techniques in the context of a skills-based strategy. This procedure included behavioral training and elaborative rehearsal. The traditional group targeted the same components, drug knowledge, assertiveness skills, decision making skills, and drug refusal skills, and employed a general educational-based approach to enhance children's functioning. Training occurred in three socially validated situations corresponding to settings where children are likely to be offered drugs. Assessment was carried out at pre- and post-test phases. It was hypothesized that children in the rehearsal-plus group would outperform those in the traditional and control groups on targeted responses. The results suggest that the rehearsal-plus procedure was most effective in enhancing desired behavior. / Master of Science