Although the completion of the Human Genome Project helps develop efficient treatment/prevention programs, it will raise new and non-trivial public health issues. Many of these issues fall under the professional purview of health educators. Yet, no studies have evaluated if health educators (HEs) are ready to adopt genomic competencies into health promotion. This dissertation addresses this issue by examining three research questions in three separate studies: 1) Why must HEs develop genomic competencies? 2) What are HEs’ knowledge of, and attitudes toward genomic competencies? And 3) what is HEs’ likelihood of adopting genomic competencies into health promotion? The first theoretical study proposed five arguments supporting the need for HEs to develop their genomic competencies and integrate public health genomics into health promotion. These arguments touched on various dimensions of HEs’ professional goals and ranged from professional responsibilities and competencies, to the availability of funding for genomic-related research or interventions and opportunities for future employment. For the second study, a web-based survey was developed and distributed to all members of four major health education organizations. A total of 1,925 HEs’ completed the survey and 1,607 responses were utilized in the final analysis. This study indicated that participants had deficient knowledge and unfavorable attitudes toward the CDCproposed genomic competencies. In the third study, a theoretical model was developed to predict HEs’ likelihood to incorporate genomic competencies into their practice. Using techniques from Structural Equation Modeling (SEM), the model was tested with the same data of the second study. Findings supported the proposed theoretical model. While genomic knowledge, attitudes, and self-efficacy were significantly associated with HEs’ likelihood to incorporate genomic competencies into their practice, attitudes was the strongest predictor of likelihood. In summary, these studies indicated that participating HEs had deficient genomic knowledge, unfavorable attitudes toward a set of CDC-proposed genomic competencies, and low likelihood to adopt genomic competencies into health promotion. Relevant training should be developed and advocated. As the SEM analysis results indicated the survey findings supported the proposed theoretical model, which can be utilized to steer future training for HEs.

The Annual Wellness Visit (AWV) is a benefit available to Medicare beneficiaries. This benefit has the potential to address many areas of prevention in one focused visit to the primary care clinic, yet it is currently being provided to only 19% of Medicare beneficiaries. This research attempted to examine the extent to which certified health education specialists (CHES) have provided and perceive themselves to be prepared to provide the preventive health services (PHS) within the AWV, along with seven additional preventive counseling services (PCS). A web-based survey assessed the perceived preparedness of health educators, specifically CHES (N=998), to deliver these PHS. The results of these surveys include the development of a single factor internally consistent scale to measure perceived preparedness for the PHS within the AWV. They reveal health educators were least prepared to assist with end-of-life-planning and conduct a basic hearing test. No association was found for education level and perceived preparedness; however, prior experience did account for a significant amount of the variance in perceived preparedness to provide AWV services. Lastly, when compared to historical data regarding physician’s perceived preparedness to provide PCS, health educators were more prepared to counsel on diet and exercise and less prepared to counsel on six other PCS. These results may aid in the understanding of whether CHES perceive they are prepared to provide (PHS) and demonstrate the experience CHES have with each of these PHS.

Public health educators serve as a vital interface between medical and public health authorities and community members for the dissemination of important information related to disease prevention and health promotion. Public health educators deliver packaged educational programs, develop their own original programs, field impromptu health questions, and conduct community health assessments. This dissertation research employed a survey in January 2011 to illuminate the information-related attitudes and activities of health educators working in public health departments in Appalachia. The research questions explored how these health educators find and use information, how they perceive their information needs and their abilities to find and evaluate information related to their work, their satisfaction with the information resources available to them, and the impact of the economic and health status of their county or region on their information behavior. Key findings include that respondents are frequent information seekers with high-speed Internet access, but they need better access to information and data related to their work. Respondents use the web heavily but have concerns about evaluating online information. Information literacy training must accommodate their workflows and budgets. Library resource use is currently low but has the greatest potential for meeting their complex needs. Suggestions include multi-dimensional collaborations between health educators and information professionals and a new, more information-centric role for health educators.