Life expectancy and overall health have improved in recent years for most Americans, thanks in part to an increased focus on preventive medicine and dynamic new advances in medical technology. However, not all Americans are benefiting equally. This suggests a level of urgency for need to assist our public health professionals in obtaining specific skills sets that will assist them in working better with ethnic and racial minority populations. The overall goal of the research was to assess cultural competence knowledge and programmatic skill sets of individuals employed by an urban department of health located in the southwest region of the US. The Theory of Planned Behavior (TPB) guided the research design to effectively evaluate the correlation between behavior and beliefs, attitudes and intention, of an individual, as well as their level of perceived control. Within the program design, 90 participants were identified using convenience sampling. In order to effectively evaluate these constructs, a quantitative research approach was employed to assess attitudes, beliefs, knowledge and competencies of the subject matter. Participants completed the Cultural Competence Assessment (CCA), which is designed to explore individual knowledge, feelings and actions of respondents when interacting with others in health service environments (Schim, 2009). The instrument is based on the cultural competence model, and measures cultural awareness and sensitivity; cultural competence behaviors and cultural diversity experience on a 49 item scale. It seeks to assess actual behaviors through a self report, rather than self-efficacy of performing behaviors. In addition, information was obtained to assess participant perception of organizational promotion of culturally competent care and; availability of opportunities to participate in professional development training. The analysis suggested healthcare professionals who are more knowledgeable and possess attitudes which reflect increased cultural sensitivity, are more likely to engage in culturally competent behaviors. In addition, positive attitudes and increased knowledge were associated with diversity training participation. Respondents reported high levels of interaction with patients from ethnic and racial minorities. Observing the clinical and non-clinical respondents, approximately 47% and 57% respectively, stated their cultural diversity training was an employer sponsored program.

Critical thinking is crucial in public health due to the increasingly complex challenges faced by this field, including disease prevention, illness management, economic forces, and changes in the health system. Although there is a lack of consensus about how practitioners and educators view critical thinking, such skills are essential to the functions of applying theories and scientific research to public health interventions (Rabinowitz, 2012). The purpose of this research was to examine the relationship between critical thinking skills used by public health practitioners and critical thinking skills taught to graduate students in schools/programs of public health. Through interviews with public health practitioners and instructors twelve distinct critical thinking skills were identified. Findings of this study indicate that many critical thinking skills used by practitioners are aligned with those taught in courses, such as analysis, identification and assessment of a problem, information seeking, questioning, and reflection. This study also identified conceptualizing, evaluating, interpreting, predicting, reasoning, and synthesizing as critical thinking skills that may not be receiving the explicit attention deserved in both the workplace and the classroom. A high percentage of practitioners identified explaining as a critical thinking skill often used in the field, while few instructors reported teaching this skill. The results of this study have important implications for informing public health curricula and workforce development programs about critical thinking. Further, this research serves as a model for other professions to explore the relationship between critical thinking skills used by practitioners and those taught in higher education.

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.

As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, we explored reasons for the (lack of) interest in working in the PHS by conducting two cross-sectional surveys among 3019 medical students (MS), public health students, and students from other PHS-relevant fields (PH&ONM) in Germany right before (wave 1, 2019/2020) and during the COVID-19 pandemic (wave 2, 2021). While interest in working in the PHS among MS was low, it was considerably higher among PH&ONM. The prevalent underestimation of the importance of public health and low levels of knowledge about the PHS were identified as potential barriers. Although core activities of the PHS were often considered attractive, they were repeatedly not attributed to the PHS. A negative perception of the PHS (e.g., it being too bureaucratic) was prevalent among students with and without PHS interest, indicating that both a negative image and potentially structural deficits need to be overcome to increase attractiveness. Based on the findings, we propose approaches on how to sustainably attract and retain qualified personnel.

The Public Health Service (PHS) in Germany has had difficulties in recruiting enough qualified staff for years, but there is limited research on what factors drive decisions to (not) join the PHS workforce. We explored reasons for this perceived (lack of) attractiveness. We conducted two cross-sectional surveys among medical students (MS), public health students and students from other PHS-relevant fields (PH&ONM) in Germany before (2019/2020) and during the COVID-19 pandemic (2021). Both waves surveyed self-reported reasons for why students did (not) consider working in the PHS as attractive and how this could be improved, using open-question items. Qual- itative and quantitative content analyses were conducted according to Mayring. In total, 948 MS and 445 PH&ONM provided valid written responses. Reasons for considering the PHS as attractive were, among others, the perception of a good work-life balance, high impact, population health focus, and generally interesting occupations. Suggestions to increase attractiveness included reducing bureaucracy, modernization/digitalization, and more acknowledgement of non-medical profession- als. Among MS, reasons against were too little clinical/patient-related activities, low salary, and occupations regarded as boring. Our findings indicate areas for improvement for image, working conditions in, and institutional structures of the PHS in Germany to increase its attractiveness as an employer among young professionals.