PUERTO RICO-FLORIDA PUBLIC HEALTH TRAINING CENTER

RESULTS OF 2011 PUERTO RICO NEEDS ASSESSMENT

(PUERTO RICO HEALTH DEPARTMENT WORKFORCE)

José A. Capriles – Quirós, MD, MPH, MHSA

Introduction

• A competent and well-trained public health workforce is essential to address emerging and major public health challenges facing Puerto Rico and the United States.

• Maintaining a highly trained, culturally sensitive public health workforce must include on-going assessment of training needs and agile development of public health training opportunities.

Aim

• The first aim of the PRF-PHTC states as follows:• To assess the public health workforce and training needs

in Puerto Rico and Florida, especially among Spanish speakers.

Methodology • All subjects who consented to participate in the study were

included in the study. • The inclusion criteria were as follows: study participants

included Puerto Rico Department of Health active personnel at three different levels: entry level public health professionals, to individuals with management and/or supervisory responsibilities; and senior managers and/or leaders of public health organizations. Department of Health’s clerical and maintenance staff will be excluded from the survey.

Methodology

• A total of 2,676 questionnaires were distributed. From these:– 1,755 were collected in a month– 1,414 agreed to participate– 341 did not want to participate– Response rate of 58.0%.

PERCENTAGE DISTRIBUTION OF DEMOGRAPHIC AND PROFESSIONAL CHARACTERISTICS OF PUBLIC HEALTH TRAINING NEED ASSESSMENT’S SURVEY PARTICIPANTS

RESULTS

Gender

22%

78% Male

Female

Age

0.1%

4.7%

15.4%

36.1%

36.3%

7.4%

0 10 20 30 40

20 or less

21-29

30-39

40-49

50-59

60 or more

Year

s

Highest Academic Degree

11.8%

24.3%

48.1%

10.9%

4.8%

High school diploma or equivalent

Associate degree / technical

Baccalaureate

Master's degree

Doctorate

Employment Setting

32%

44%

23%

1% Central LevelRegionLocalPrivate Office

Years in current employment

5.37.3

23

13

17.1

34.3

0

5

10

15

20

25

30

35

40

Less than 1 1 a 3 4 a 10 11 a 15 16 a 20 More than 20

Years

Perc

ent

PERCENTAGE DISTRIBUTION OF EXPERIENCE IN PUBLIC HEALTH OF PUBLIC HEALTH TRAINING NEED ASSESSMENT’S SURVEY PARTICIPANTS

RESULTS

Total of years working in the field of Public Health

6.4%

5.7%

20.6%

11%

19.2%

37.1%

Less than one year

1 to 5 years

6 to 10 years

11 to 15 years

16 to 20 years

More than 20 years

Source of Public Health Training

Percent Distribution of Survey Participants by the Source of Public Health Training

Source of Public Health Training * Frequency(n)

Percentage(%)

Formal Education (College degree) 159 9.1

Online/ Distance Learning Courses 80 4.6

Seminars/ Workshops 556 31.7

Work Experience 740 42.2

None 272 15.5*Categories are not mutually exclusive; Respondents could have chosen more than one category.

Public Health Field SpecialtyPercentage Distribution of Training Need Assessment’s Survey Participants

by Their Public Health Field Specialty

Public Health Field Frequency(n)

Percentage(%)

General Public Health 405 23.1

Environmental Health 211 12.0

Public Health Education 107 6.1

Health Services Administration 93 5.3

Epidemiology 92 5.2

Developmental Disabilities 42 2.4

Health Systems Evaluation 33 1.9

Gerontology 29 1.7

Biostatistics 18 1.0

Demography 12 .7

Other 268 15.3

PROFESSIONAL DEVELOPMENT ACTIVITIES

2.7%

69.7%

21.5%

3.7%

2.4%

0 20 40 60 80

Never participated in professional development or continuing education

Less than one year

1 to 3 years

4 to 10 years

More than 10 years

Percent

Percentage Distribution of Respondents According to the Time Since Their Last Training Professional Development Activity or

Continuing Education Related to Their Work Area

Main Reasons to Participate in Professional Development or Continuing Education Activities

Percentage Distribution of Survey Participants According to Their Main Reasons to Participate in Professional Development or Continuing Education Activities

Reasons Frequency(n)

Percentage(%)

Career advancement 1009 57.5

It is a requirement in order to maintain license or certification 940 53.6

Need to update information and knowledge 938 53.4

Need to develop new skills and competencies regarding clinical care 700 39.9

It is required by employer 624 35.6

Need to develop new skills and competencies regarding interaction with the community 549 31.3

Need to develop new skills and competencies regarding organizational development and management 424 24.2

Interest to discuss common issues with colleagues 356 20.3

Other 42 2.4

Barriers to Participate in Training or Professional Development Activities

Percent Distribution of Survey Participants According to Perceived Barriers to Participate in Training or Professional Development Activities in Public Health

Barriers Frequently Sometimes Never

Mean(n) (%) (n) (%) (n) (%)

a) Lack of time to attend educational seminars or other training that is offered outside the workplace.

262 21.3 735 59.8 232 18.9 1.98

b) Lack of time to attend educational seminars or other training offered at their workplace. 257 20.7 732 59.1 250 20.2 1.99

a) Barriers out of their control 252 21.9 583 50.7 316 27.5 2.06

a) Range of activities 199 21.1 425 45.1 318 33.8 2.13

a) Lack of financial support (payment or reimbursement of expenses to attend such activities).

347 28.5 436 35.8 436 35.8 2.07

a) Lack of financial travel support to attend such activities in or out the island. 395 32.7 291 24.1 523 43.3 2.11

Percent Distribution of Survey Participants According to How Much Time in the Average Week They Have Available to Participate in

Professional Development Training or Knowledge Update Activities

31.3

38.7

16.813.2

28.1

37.0

19.615.3

0

5

10

15

20

25

30

35

40

45

No time (0 hours)

1-2 hours 3-4 hours 5 or more hours

Workplace

Home

PUBLIC HEALTH KNOWLEDGE AND COMPETENCIES

3.4%

24.8%

53.0%

18.9%

0 10 20 30 40 50 60

I have no knowledge or skills

I have awareness level

I have practical knowledge

I have advanced knowledge or skills

Percentage distribution of survey participants rated knowledge of the Public Health

PERCENT DISTRIBUTION OF SURVEY PARTICIPANTS BY THEIR SELF-PERCEIVED NEED FOR TRAINING ON CORE FUNCTIONS OF PUBLIC HEALTH

RESULTS

CORE FUNCTIONS OF PUBLIC HEALTH

CORE FUNCTIONS OF PUBLIC HEALTHI do not need

training

Need Introductory

course

Need refresher course

Needadvanced training

Mean

n % n % n % n %

A. Need Assessment1. Health risks research. (165) 12.5 (378) 28.7 (577) 43.8 (198) 15.0 2.612. Determination of Health Skills. (146) 11.4 (402) 31.3 (571) 44.4 (167) 13.0 2.59B. Advocacy 3. Create collaborative links with the

community. (236) 18.3 (470) 36.5 (376) 29.2 (205) 15.9 2.43

4. Setting priorities for health needs. (257) 19.8 (405) 31.2 (462) 35.6 (172) 13.3 2.425. Develop plans / policies to address

health priorities. (186) 14.5 (495) 38.6 (348) 27.1 (254) 19.8 2.52

C. Evaluation6. Managing resources. (202) 15.9 (481) 37.8 (354) 27.8 (235) 18.5 2.497. Develop organizational structure. (189) 14.8 (500) 39.2 (327) 25.6 (259) 20.3 2.518. Implement programs identified as

priority. (203) 15.9 (480) 37.7 (339) 26.6 (251) 19.7 2.50

9. Evaluate programs. (197) 15.5 (496) 38.9 (316) 24.8 (265) 20.8 2.5110. Report concerns / health concerns

of the community. (236) 18.4 (456) 35.6 (386) 30.1 (204) 15.9 2.44

Self-Perceived Knowledge or Skills on Council of Linkages Public Health Competencies

Percent Distribution of Survey Participants by Self-Perceived Knowledge or Skills on Council of Linkages Public Health Competencies

DimensionsNum. Items

Mean MedianChronbach’s

alphaAnalytical/ Assessment Skills 4 6.8 8.0 .920

Policy Development/ Program Planning 4 6.5 7.0 .931

Communication 4 7.5 8.0 .903

Cultural Competency 4 7.5 8.0 .944

Community Dimensions of Practice 4 7.7 8.0 .921

Public Health Sciences 4 6.5 8.0 .953

Managerial and Financial Planning 4 5.6 6.0 .921

Leadership and Systems Thinking 4 6.5 7.0 .942

Council of Linkages Competencies Identified as Priorities in Need for Training Ranked According

to Mean and Median Values• Scale:

0= N/A This skill does not apply to my position. 1= I have no knowledge or skills. 2= I have awareness level knowledge or skills: 3= I have practical knowledge or skills. 4= I have advanced knowledge or skills.

Council of Linkages Competencies Identified as Priorities in Need for Training Ranked According to Mean and Median Values

RankHow capable are you to effectively ...COMPETENCIES ITEMS

MEAN MEDIAN

1 Contribute to the preparation of proposals to obtain financing from external sources. 1.19 1.00

2 Participate in the development of a program budget 1.22 1.00

3Describe the impact of changes in the public health system and broader social, political environment, economic impact on organizational practices.

1.50 2.00

4 Describe how data are used to address scientific, political, ethical, and public health. 1.53 2.00

4 Translating assessment information into action steps to improve program implementation. 1.53 2.00

5Relate the public health science skills to the essential functions of public health and the ten essential services of public health.

1.57 2.00

6Incorporate ethical standards of practice as the basis of all interactions with organizations, communities and individuals.

1.58 2.00

7 Participate in program planning. 1.59 2.00

8 Describe the scientific evidence related to issues, concerns or public health interventions. 1.59 2.00

8Identify mechanisms to monitor and evaluate programs according to their effectiveness and quality.

1.60 2.00

9 Participate in the assessment of cultural competence of public health organizations. 1.64 2.00

10Engaging with stakeholders to identify key public health values and a shared public health vision and the principles that guide community action.

1.65 2.00

LEGENDCOMPETENCIES DOMAINS

Analytical/Assessment Skills Community Dimensions of PracticePolicy Development/Program Planning

Public Health Sciences

Communication Managerial, Financial Planning and Human ResourcesCultural Competency Leadership and Systems Thinking

PERCENTAGE DISTRIBUTION OF TRAINING PREFERENCES AND TECHNOLOGICAL CAPACITY OF PUBLIC HEALTH TRAINING NEED ASSESSMENT’S SURVEY PARTICIPANTS

RESULTS

Percent Distribution of Survey Participants by Perception of Self-Competence on

Council of Linkages Public Health Professionals Competencies

60.7

17.6

6.1

19.9

3.6

0.9

Face to face (eg conferences, workshops, group classes, etc.).

Internet

Interactive Teleconference

Auto modules - instructional

Conference Calls

Other

Skills Level in Computer Literacy

11.8%

45.8%

32.9%

9.5%

Percent Distribution of Survey Participants by Self-Reported Skills Level in Computers Literacy

Excellent

Good

Poor

Terrible / None

Type and Place of Computer Service Access

Percent Distribution of Survey Participants by Type and Place of Computer Service Access

Have access to: Workplace Home

n % n %

Computer for my exclusive use 318 21.8 705 40.2

Computer that I share with others 519 29.6 313 17.8

Internet/World Wide Web 276 15.7 799 45.5

Intranet 125 7.1 0 0

Electronic mail (e-mail) personal 0 0 122 7.0

Electronic mail (e-mail) work 299 17.0 706 40.2

None of the above 451 25.7 303 17.3

Computer Services Use and Type Percent Distribution of Survey Participants by the Frequency of Computer Services Use and Type

Does your computer allow you…?Always Usually Rarely Never Never tried

Mean

n % n % n % n % n %

a. View online videos (312) 33.9 (140) 15.2 (91) 9.9 (221) 24.0 (156) 17.0 2.95

b. Participate in interactive programs (online conferences with audio and Power Point, "Audience Response System", etc.)

(193) 21.1 (89) 9.7 (95) 10.4 (256) 27.9 (283) 30.9 3.71

c. Take online courses (198) 21.9 (70) 7.7 (89) 9.8 (260) 28.7 (289) 31.9 3.78

d. Respond to electronic surveys online (252) 28.0 (97) 10.8 (111) 12.3 (235) 26.1 (205) 22.8 3.28

e. Archiving or storing materials in the computer memory (542) 58.5 (151) 16.3 (65) 7.0 (101) 10.9 (67) 7.2 2.80

f. Print materials (531) 56.6 (164) 17.5 (73) 7.8 (115) 12.3 (55) 5.9 2.65

g. Connect to social networks (382) 41.4 (98) 10.6 (93) 10.1 (233) 13.3 (117) 12.7 2.70

Computer Software That They Have Working Knowledge

Percent Distribution of Survey Participants by the Computer Software That They Have Working Knowledge

Computer Software n %

Microsoft Word 818 46.6

Microsoft PowerPoint 587 33.4

Microsoft Excel 407 23.2

Microsoft Access 106 6.0

Epi Info 30 1.7

SPSS 34 1.9

SAS 6 .3

STATA 3 .2

All of them 6 .3

None 351 20.0

Other 48 2.7

Interest in Receive Training

90.6 %

9.4%

Percent distribution of Survey Participants by Whether or not They Are Interested in Receiving Training in Public Health

Over the Next Three Years

Yes No

Figure 7

Top Five TopicsPercent Distribution of Survey Participants by the Five Topics Preferred for Further training

Computer Software n %

Epidemics and Outbreak Effects in the Health System 381 31.1

Health Promotion and Disease Prevention 293 23.9

Mental Health 292 23.8

Global Public Health 258 21.1

Health Law and Public Policy 254 20.7

Conclusion

• The PR/F PHTC Training Needs Assessment of the Puerto Rico Department of Health employees included a sample of 1,414.

• The survey provided information on these professionals public health-related experience, self-perceived competencies, barriers for training, technical capacity, and training preferences.

• In general, most respondents have acquired their public health knowledge by experience and not by academic formation or continued activities. They perceived a great need for introductory courses in the competencies assessed.

• Face-to-face methods were the training modality of preference.

Conclusion

• Results from their self-assessed technical capacity provide an idea of why Internet/Web-based training is their third choice for training modality.

• Respondents informed limited access to computer and online resources, in addition to poor level to none of computer literacy by a significant group (42.4%).

• Promisingly, the great majority of respondents are interested in receiving training in Public health as part of a capacity program over the next three years.