May 2013

New structure enhances Institute efficiency


NCIPH's management team. L-R, Carol Gunther-Mohr, Sarah Strunk, Jen Horney, Anna Schenck, Kathryn Cheek, and Rachel Wilfert

The North Carolina Institute for Public Health’s new organizational structure is designed to support the Institute’s mission to be a bridge between the UNC Gillings School of Global Public Health and the public health practice community, including government agencies and community organizations.

“Research and practice go hand-in-hand, each informing and supporting the other,” said Anna Schenck, PhD, MSPH associate dean for public health practice. “We believe our new structure will enhance that back-and-forth exchange of knowledge.”

The new structure includes four functional areas:

The new leadership team is led by Schenck, and also includes operations and quality improvement manager Carol Gunther-Mohr, and senior investigators with expertise in key areas of public health research and practice such as Dorothy Cilenti, John Graham, Gene Matthews and Mary Davis.

"Our environment is changing, and we need ensure we continue to use all our resources in the most efficient ways,” Schenck said. “This new structure allows us to build on the strong foundation and accomplishments of our past. By realigning with our key focus areas, we can develop more unified strategies for delivering training, providing technical assistance to public health practice partners, and conducting research to solve practice-based problems.”

Some things won’t change, she said: our continuing education services  our work with communities and organizations around preparedness, healthy communities, accreditation, , evaluation and other areas will continue.

Details about the functional areas can be found here.

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Impact

ALBD at 10 – still growing strong

Active Living By Design (ALBD) celebrated its 10th anniversary in 2012, but there were no cakes with gooey icing. Instead, the group reflected on all it has accomplished to create environments and policies that get people moving, encourage healthier eating and improve overall well-being. They’re building on all the lessons learned as they start their second decade.

“Ten years ago, it was simply a vision,” says Sarah Strunk, director of ALBD.  “Ten years later, it is a movement.”

The November 2012 issue of the American Journal of Preventive Medicine includes a supplement that focuses on evaluation of ALBD and features commentaries, an in-depth assessment of the 5P Community Action Model, cross-site analysis and results from a number of grantee communities. See the complete supplement here.

It’s a movement that creates community-led change by working with local and national partners to build a culture of active living and healthy eating.

Part of the NC Institute for Public Health at the UNC Gillings School of Global Public Health, ALBD was launched in 2002 as a five-year, $15.5 million national program of the Robert Wood Johnson Foundation (RWJF). The focus was on increasing physical activity through changes in policy and the built environment - a significant departure from the more traditional focus on education and awareness as primary influencers of behavior change. The premise was relatively simple: To see what could be accomplished by engaging 25 multidisciplinary partnerships representing a diverse array of communities across the country, and offering small amounts of grant funding combined with technical assistance and consultation from an experienced group of project officers and a peer learning network.

To commemorate and reflect on the program’s success, ALBD produced a brochure, available online, that highlights amazing accomplishments by community partners across the country, the impact that students and staff associated with ALBD have had on the world, tools and publications that have come from more than a decade of work, and reflections from grantees and partners.

And of course, they consider lessons learned, including:

LEADERSHIP COUNTS: Leaders can come from anywhere, and should be distributed and cultivated.

BE OPEN TO OTHER OUTCOMES: Healthy community change initiatives can and should be about more than obesity.

PROGRESS MEANS SHIFTING POWER: Authentic community engagement is an intentional, ongoing process that should create pathways for leadership development, full participation in decision-making processes and ultimately shift the balance of initiative, control and power toward the community.

SUSTAIN AND DEFEND POLICIES: Policy victories are great accomplishments, but the work is not nearly over when a policy is adopted.

NO SHORTCUTS TO HEALTH EQUITY: While scaling policy change initiatives can be appealing, it can also be fraught with tempting shortcuts and challenges to health equity.

UTILIZE LEARNING NETWORKS: Learning networks can be powerful at various levels.

CULTIVATE READINESS: Readiness is a strong predictor of success in achieving community-level policy, systems and environmental changes.

STAY FLEXIBLE: Flexibility is a key success indicator.

REMEMBER THE SOCIAL ENVIRONMENTS: Supporting and sustaining behavior change requires changing both the physical and social environments.

BUILD FROM THE GROUND UP: Equity movements and culture change are more likely to succeed if they’re built from the ground up, not top down.

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Impact

Practice Pathways Seminar orients students to state, local public health


Panelists, L-R, Chris Hoke, Danny Staley, and Laura Gerald

There’s always a transition from the classroom to what’s often called “the real world.” Public health is no exception, and because the field is so diverse, that transition may be one of the most complicated within the university.

On Jan. 17, three top leaders from the N.C. Division of Public Health came to the School to help new students understand how public health practitioners in North Carolina work together and with the School. Laura Gerald, MD, MPH, State Health Director; Danny Staley, Deputy Director and Chief Operating Officer; and Chris Hoke, Chief of the Office of Regulatory and Legal Affairs, were panelists at the Practice Pathways Seminar

Practice Pathways is a program offered through the Southeast Public Health Training Center in NCIPH. A highlight is the annual “Phield Trip” to a local public health office (see 2011 and 2012 coverage). January’s seminar oriented students to the state public health system and to trends these practitioners see in public health across the state.


Laura Gerald and public health students

“Many of the School’s programs require students to complete a practicum,” explains Janet Place, MPH, Co-PI and director of the Southeast Public Health Training Center, funded by the U.S. Health Resources and Services Administration (HRSA). “The number of practicum hours varies, depending on the department. Maternal and Child Health, Health Policy and Administration, Health Behavior and others require students to spend significant time in the field. Even if their path doesn’t lead them eventually to a career in state or local health departments, they benefit from understanding how these programs are run and what they have to offer.”

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Impact

Taking time to celebrate Public Health


L-R, Anna Schenck, Laura Gerald, and Dr. Sandra Greene, Professor of the Practice of Health Policy

Sometimes, public health practice is a little like the electrical grid or the landing gear on an airplane – people don’t think much about it until it’s not there. They take for granted that water will be clean and abundant, that school lunches will be nutritious, that the sources of disease and infection will be identified and destroyed, that public officials will be prepared to take care of us in an emergency.

But practitioners across the state know how much effort goes into protecting and improving the public’s health. And in April, for the past 35 years, the state has recognized the importance of public health programs and services, and the effect they have on the quality of life. On April 17, State Health Director Laura Gerald and other state and local public health leaders joined Gillings School faculty, students and staff to celebrate Public Health Month with a reception at the Carolina Club, the university’s alumni center.


Tom Bridges, Henderson County health director, and Dorothy Cilenti, NCIPH senior investigator

“This month of recognition give us all the opportunity to remind everyone how important public health programs are to our quality of life and how urgently we need to continue support for them,” said Anna Schenck, PhD, Associate Dean for Public Health Practice. “Our event also was a celebration of the collaboration between state, local and academic partners and the amazing work of public health practitioners in our state, who inspire our students, faculty and staff.”

The annual recognition of public health began 35 years ago through the efforts of a private group – many of whom are alumni of our School – called N.C. Citizens for Public Health. The designation of April as “Public Health Month” enables and encourages local and state health departments to sponsor events promoting public health and healthy living.

And although it wasn’t an official part of Public Health Month, three graduate student teams from the School participated in the UNC Science Expo. The expo allowed students to highlight practice-related projects that can have a positive impact on public health. Teams from the Public Health Leadership Program (project management strategy and application course), presented exhibits on nutrition, sexual health and recycling.

Healthy Carolina Kids provided information on nutrition and physical activity benefits. Let’s Talk About It! addressed the lack of free teen-friendly mobile apps with clear, concise and accurate information about pregnancy prevention and STD prevention and protection.  ReThink: Reduce, Reuse, and Recycle provided information that highlights recyclability of common key recycling facts and the science behind recycling.

Participating students were: Jon Brolund, Marie Callahan, Suja Davis, Zinaida Mahmutefendic, Kaitlin McCormick, Emily Nicholson, Lauren Synder and Janeen Williams.

 

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Impact

Hospitals, public health departments join forces to uncover local health needs

In Wake County, some of the state’s leading medical centers--WakeMed Health and Hospitals, Duke Raleigh Hospital and UNC Rex Healthcare--are teaming up with other health agencies and organizations to identify the health priorities of people in Raleigh and the surrounding urban and rural areas.

“This is an amazing collaboration, not just of hospitals and local health departments, but also non-profits like United Way and Wake County’s FQHC (Federally Qualified Health Center),” said Rachel Wilfert, MD, MPH, Manager of Training and Technical Assistance at the North Carolina Institute for Public Health. “This type of broad collaboration is a model for how these types of assessments can be conducted.”

The new federal Affordable Care Act requires hospitals to conduct community health assessment every three years, proving (among other things) that they are meeting the community’s needs. Their tax status as a not-for-profit institution is tied to the assessment.

Hospitals aren’t the only ones required to complete community health assessments. North Carolina state law requires county health departments to conduct them, too. The purpose, according to the N.C. Division of Public Health, is “to identify priority health issues and to plan interventions to build healthier communities with the ultimate goal of making North Carolina one of the healthiest states in the nation.”

NCIPH is a critical link to help all these health care providers work together to understand community health care needs and priorities. NCIPH experts provide unique quantitative and qualitative methodology to reach out to citizens, officials, health care practitioners and others.

NCIPH has a long history of assisting with community health assessments, participating in assessments of 39 out of 100 counties. In addition, since 2009, NCIPH has participated in 11 community health assessments in multiple NC counties using a widely validated cluster sampling methodology to conduct primary data collection. In more recent years, NCIPH has helped to convene the NC Public Health Hospital Collaborative (PHHC), a partnership of local and state public health leaders, hospital leaders, and community-based stakeholders which was created to lead collaborative efforts to measurably improve the health of North Carolinians. The PHHC has a particular focus on community health assessments with a goal of promoting collaboration and developing models of effective community collaboration.   

The Wake County assessment started in January and is scheduled to be completed by June 30.

“That’s an incredibly fast turnaround,” said Jen Horney, PhD, MPH, Manager of NCIPH’s Research and Evaluation Unit. “But we’ve had an engaged team of funding partners as well as an active and diverse steering committee of community stakeholders working with us to ensure this assessment meets state and federal requirements. Everyone participating in the assessment process – including participating community members and volunteers – knows the importance of identifying Wake County’s community health and health care priorities. Yes, there are more resources there than in many places in the state, but they still need to be used wisely. Wake can be a model for other hospitals, health departments and community organizations across the state wishing to do this kind of collaboration.”

More information is available here.

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Impact

Study launched to explore new methods and measures to assess the impact of the economic recession on public health outcomes

The Robert Wood Johnson Foundation has funded the University of North Carolina at Chapel Hill (UNC), along with 6 other institutions, to examine the impact of system changes on public health through the lens of a natural experiment. For UNC’s research, the economic recession is the natural experiment which will be used to estimate the effect of public health spending and programs on population health. 

The two-year research study, Exploring new methods and measures to assess the impact of the economic recession on public health outcomes, led by Anna Schenck, PhD, director of the North Carolina Institute for Public Health at the UNC Gillings School of Global Public Health and Dr. Anne Marie Meyer, PhD, facility director for the Integrated Cancer Information and Surveillance System (ICISS) at UNC Lineberger Comprehensive Cancer Center, will employ existing sources of data to test a new method to understand public health departments’ impact on population health.

Using a retrospective cohort design, and creating linkages to population-based datasets, this project will follow all local health departments (LHDs) in North Carolina (NC) from 2003 - 2008. Data from the National Association of County and City Health Officials (NACCHO) health department 2005 and 2008 profiles will be used to measure LHD spending, staffing and services in the time periods prior to, and during, the recession. These LHD metrics will be linked with rates based on aggregated public and private insurance data to explore variations in county-level morbidity and mortality rates for selected outcomes (infant mortality, heart disease, cancer, diabetes and influenza). Data from time periods (2003-2005, and 2006-2008) will be examined using generalized estimating equations and geo-spatial approaches to adjust for spatial correlation.  This project will combine a novel insurance claims data resource with NACCHO data to develop and test new methods and metrics for public health systems research.

In addition to the research goals, this project will collaborate with partners to translate and disseminate the research findings. The newly formed Academic/Practice-Based Research Section of the North Carolina Public Health Association will serve as the advisory committee for this project.

For additional information:

Anna P. Schenck, PhD, MSPH
Associate Dean for Practice and Professor of the Practice
Director of the Public Health Leadership Program and the North Carolina Institute for Public Health
UNC Gillings School of Global Public Health
Campus Box 7469, Chapel Hill, NC 27599-7469
Email: anna.schenck@unc.edu  Phone:  919.843.8580

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Impact

Providing opportunities for students and practitioners to learn and share

Bringing people together to share ideas and gain new insights is one of the Institute’s most valued missions. Two recent examples are the 34th UNC Minority Health Conference and the 33rd Annual Occupational Safety and Health Winter Institute, both held in February, both facilitated by NCIPH.

“It’s an honor to work with groups like the UNC Minority Student Caucus and the North Carolina Occupational Safety and Health Education Research Center,” said Kathy Cheek, NCIPH Administration Manager. “The caucus is led by students, and the center is led by practitioners, so we have a wide range of people to work with. That reflects the nature of public health, though. It’s a broad field with perspectives.”

More than 550 people registered for the 34th UNC Minority Health Conference and hundreds more watched from 60 broadcast sites in 26 states, and one in Canada. This year’s theme was “Constructing the Foundation for Health Equity.” The event is held annually at the UNC William and Ida Friday Center for Continuing Education in Chapel Hill. A highlight of each conference is the William T. Small, Jr. Keynote Lecture, presented this year by Brian D. Smedley, PhD, Vice President and Director of the Health Policy Institute, Center for Political and Economic Studies. His lecture was titled, Taking Action to Achieve Health Equity: Beyond the Affordable Care Act.

The 33rd Annual Occupational Safety and Health Winter Institute was held Feb. 3-8 in Orlando, Fla., with 90 professionals attending. The conference is sponsored by the North Carolina Occupational Safety and Health Education Research Center (ERC), one of 18 regional education and research centers for occupational safety and health. The centers were established by the National Institute for Occupational Safety and Health (NIOSH) to ensure that occupational safety and health professionals were well-trained and available to support the public health programs that rely on them. The NC ERC shares responsibility for training professionals in eight southeastern states, including North Carolina, South Carolina, Georgia, Florida, Alabama, Mississippi, Tennessee and Kentucky. Institutes are held each winter and summer to provide continuing education to professionals including industrial hygienists, safety personnel, occupational physicians, occupational health nurses, managers, supervisors, personnel specialists, union health and safety professionals and others with responsibility for providing a safe and healthy work environment. Approximately 30 courses, last about five days each, are offered at each institute.

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