Welter Christina, Davis Sarah, Elnicki Jill, Kulik Phoebe K G, Lloyd Laura M, Tenney Martha, Todd Barrett Karla, Rose Barbara, Walter Cassidy
Division of Health Policy and Administration, Policy, Practice and Prevention Research Center, School of Public Health, University of Illinois Chicago, Chicago, Illinois (Dr Welter); Rocky Mountain Public Health Training Center, Center for Public Health Practice at the Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado (Mss Davis, Walter, and Elnicki); Region V Public Health Training Center, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik); Region IV Public Health Training Center, Rollins School of Public Health, Emory University, Atlanta, Georgia (Ms Lloyd); Mined Insights Consulting, LLC, Denver, Colorado (Ms Tenney); New England Public Health Training Center, Department of Community Health Sciences, Boston University School of Public Health (BUSPH), Boston, Massachusetts (Ms. Todd Barrett); and HRSA Region X, Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rose).
J Public Health Manag Pract. 2023;29(2):202-209. doi: 10.1097/PHH.0000000000001654. Epub 2022 Oct 9.
There have been multiple calls in the United States for public health workforce development approaches that expand practitioner skill sets to respond to profound inequities and improve population health more effectively. However, most workforce models address individual competencies that instead focus on collective approaches to systems change.
In response to this opportunity, the HRSA-funded Regional Public Health Training Centers (PHTCs) and the University of Illinois Chicago Policy, Practice, and Prevention Research Center (P3RC) released Creating a Learning Agenda for Systems Change: A Toolkit for Building an Adaptive Public Health Workforce (the Toolkit) in December 2020. We later supplemented the Toolkit with additional learning activities to launch the Learning Agenda Toolkit Pilot Test (Toolkit Pilot).
From June to August 2021, 24 diverse teams piloted the Toolkit. Teams completed a multistep process simulating the development of a learning agenda aimed at addressing community health issues and impacting systems change.
We conducted an evaluation process to assess the usability and impact of the Toolkit Pilot to inform its improvement and future implementation. An evaluation subcommittee analyzed worksheets completed by the Pilot Teams that are aligned to the Learning Agenda steps and conducted and analyzed 12 key informant interviews using concepts from the Toolkit Pilot Logic Model.
Evaluation results suggest that most Pilot Teams found that the Toolkit Pilot offered a step-by-step process toward a clear vision that produced a concrete product on how to address community challenges through learning and systems change. Pilot Teams noted that the Toolkit Pilot provided exposure to and a unique focus on systems thinking; however, prior knowledge of systems thinking and systems change was important. Building readiness for systems change and having more time, resources, and technical assistance would be needed for future versions of the Learning Agenda Toolkit.
在美国，有多项呼吁要求采用公共卫生劳动力发展方法，以扩大从业者的技能组合，应对严重的不平等现象，并更有效地改善人群健康。然而，大多数劳动力模式关注的是个人能力，而非侧重于系统变革的集体方法。
为抓住这一机遇，由卫生资源与服务管理局（HRSA）资助的区域公共卫生培训中心（PHTC）和伊利诺伊大学芝加哥分校政策、实践与预防研究中心（P3RC）于2020年12月发布了《创建系统变革学习议程：构建适应性公共卫生劳动力的工具包》（以下简称《工具包》）。后来，我们又为《工具包》补充了其他学习活动，以启动学习议程工具包试点测试（工具包试点）。
2021年6月至8月，24个不同的团队对《工具包》进行了试点。各团队完成了一个多步骤流程，模拟制定旨在解决社区健康问题并影响系统变革的学习议程。
我们开展了一个评估过程，以评估工具包试点的可用性和影响，为其改进及未来实施提供参考。一个评估小组委员会分析了试点团队填写的与学习议程步骤一致的工作表，并运用工具包试点逻辑模型中的概念进行了12次关键信息人访谈并进行分析。
评估结果表明，大多数试点团队发现，工具包试点提供了一个朝着清晰愿景逐步推进的过程，产生了一个关于如何通过学习和系统变革应对社区挑战的具体成果。试点团队指出，工具包试点让他们接触到了系统思维，并对其给予了独特关注；然而，对系统思维和系统变革的先验知识很重要。未来版本的学习议程工具包需要为系统变革做好准备，并需要更多时间、资源和技术援助。
