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Information Needs and Uses of the Public Health Workforce -- Washington, 1997-1998

Substantial efforts have been made to ensure that state and local public health agencies have the information technology and training needed for public health communications, information access, and data exchange (1,2). Numerous public health-related data and information resources are available on the World-Wide Web (e.g., MEDLINE, MMWR, CDC Prevention Guidelines Database, and Emerging Infectious Diseases); however, little systematic work has been done to understand the information needs of the public health workforce. To identify these needs and patterns of use and to set priorities for developing new online public health information resources, the University of Washington School of Public Health and Community Medicine (UW SPHCM) and the Washington State Department of Health (WSDoH) held structured and facilitated discussions with segments of the local public health workforce in Washington during 1997-1998. This report summarizes the results of those discussions, which indicate that different segments of the public health workforce have different information needs.

Five subgroups of the local public health workforce were selected for inclusion in the investigation on the basis of input from state and local public health leaders: 1) local health officers and public health agency directors, 2) environmental health directors, 3) directors of public health nursing, 4) health assessment coordinators and epidemiologists, and 5) a group comprising public health officials from small local health departments in which staff typically have responsibilities in multiple areas (e.g., nursing and disease investigation). Open-ended questions about information acquisition and use were developed in consultation with UW SPHCM faculty, WSDoH leaders, and staff from the Eastern and Western Washington Area Health Education Centers (AHECs). AHEC directors served as facilitators at each discussion.

Eight sessions were held from June 1997 through April 1998. A total of 70 persons participated; the smallest group had four and the largest had 14 participants. Persons in each group were from a cross section of local health jurisdictions representing metropolitan and rural areas, large and small agencies, and eastern and western Washington. The participants included 22 environmental health directors (in two sessions in different parts of the state), 10 public health nursing directors, 13 health assessment coordinators and epidemiologists (in two sessions in different parts of the state), four health officers/agency directors, and 21 staff members (mixed segments) from two small county health departments.

Seven information needs were identified by all four workforce segments (Table 1): 1) better tools and resources for contacting experts; 2) updates on pertinent legislative issues and events; 3) structured information ("metadata") characterizing the contents of data sets; 4) outcome measures and "best practice" resources; 5) better scheduling software and event calendars; 6) standard templates for frequently used applications; and 7) synthesized, knowledge-based information from external databases. Five needs were identified by more than one group and another 15 needs were identified by a single group (Table 1).

Interest in the use of information resources and technology also varied across groups (e.g., nursing directors expressed more interest in using videoconferencing technology than did other groups [Table 1]). Some groups expressed readiness to incorporate online resources (e.g., contact lists, statistical databases, and Web-accessible knowledge resources) into their work.

Reported by N Rambo, Health Sciences Library, Univ of Washington, Seattle, Washington, and Pacific Northwest Region, National Network of Libraries of Medicine; P Dunham, School of Public Health and Community Medicine, Univ of Washington, Seattle, Washington. Office of the Director, Public Health Practice Program Office, CDC.

Editorial Note:

Public health practice spans numerous health, environmental, and social science disciplines; therefore, public health practitioners need access to diverse and complex information and data from multiple sources. Electronic access to peer-reviewed biomedical literature is available through MEDLINE (3); however, this resource meets only a portion of the public health practitioner s information needs (4). The variety in the types of information needed is matched by the diversity of the public health workforce itself that includes agency directors, environmental health scientists, epidemiologists and health assessment specialists, health educators, health officers, laboratorians, nurses, nutritionists, sanitarians, social workers, and outreach workers. Ideally, the development of online public health information resources should reflect this complexity and diversity.

Approximately one fourth of the information needs identified in this study was shared by all segments of the Washington public health workforce, but nearly half of the information needs was not shared by more than one segment. Also, readiness to incorporate the use of online information resources into public health practice varied across segments. In addition to diverse information needs, these findings may reflect differences in training, experience, and professional culture.

This study is subject to at least two limitations. First, these data are based on interviews with public health professionals in Washington only and may not represent the information needs in other states. Second, some public health workforce groups were not interviewed (e.g., health educators, nutritionists, social workers, and other outreach workers); therefore, the study probably underestimates the range and diversity of information needs among public health workers.

CDC s Information Network for Public Health Officials (1), the Health Alert Network (2), and the National Library of Medicine's Partnership in Information Access for Public Health Officials (5) are designed to strengthen the information infrastructure of state and local public health agencies. The success of these initiatives will depend not only on technology but also on the information content being delivered and used and on a workforce trained to use effectively these new tools and resources. Further research is needed to determine optimal development, structure, delivery, and marketing of public health information to specific public health workforce segments.

References

  1. Baker EL, Friede AM, Moulton AD, Ross DA. A framework for integrated public health information and practice. Journal of Public Health Management Practice 1995;1:43-7.
  2. Rotz LD, Koo D, O'Carroll PW, Kellogg RB, Sage MJ, Lillibridge SR. Bioterrorism preparedness: planning for the future. Journal of Public Health Management Practice 2000 (in press).
  3. Lindberg DAB, Siegel ER, Rapp BA, Wallingford KT, Wilson SR. Use of MEDLINE by physicians for clinical problem solving. JAMA 1993;269:3124-9.
  4. Friede A, Blum HL, McDonald M. Public health informatics: how information-age technology can strengthen public health. Annu Rev Public Health 1995;16:239-52.
  5. Humphreys B, Ruffin A, Cahn M, Rambo N. Resources for strengthening the public health infrastructure: the National Library of Medicine and the National Network of Libraries of Medicine. Am J Public Health 1999;89:1633-6.


Table 1

Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.

TABLE 1. Data and information resource needs of four local public health workforce segments -- Washington, 1997-1998

Needs

Assessment coordinators and epidemiologists

Nursing directors

Environmental health directors

Health officers and agency directors

Access to academic/state experts

X

X

X

X

Administrative/budget data

     

X

Notification of continuing education opportunities

   

X

 

Criminal justice data

X

     

Disease incidence data (county/state/national)

X

X

   

Disease/condition information*

X

     

Geographically coded health-related data

   

X

 

Health education information for the public

   

X

 

Health education program information

 

X

   

Health insurance billing data

X

     

Vaccination guidelines

 

X

   

Industrial effluent data

   

X

 

Laboratory data (online)

   

X

 

Laws and regulations (county/state)

   

X

X

Legislative issues updates

X

X

X

X

Local/small area data

X

     

Metadata on data sets

X

X

X

X

Outcome measurement resources

X

X

X

X

Group-specific electronic discussion lists

X

 

X

 

Remote access to office systems and meetings

 

X

   

Scheduling software/resources

X

X

X

X

Socioeconomic data

X

     

Standard templates§

X

X

X

X

State agency data/resources/publications

X

X

   

Synthesized, knowledge-based information

X

X

X

X

Treatment data**

X

X

   

U.S. census data

X

     

* Includes fact sheets, nursing protocols, treatment for contacts, epidemiologic summaries, and prevention guidelines.
† Include information on scope, coverage, location, how to access, and strengths and weaknesses of the data.
§ E.g., reporting forms, surveys, assessment instruments, and management tools.
¶ Include custom synthesized information and access to online bibliographic and factual databases (e.g., MEDLINE and CDC Prevention Guidelines Database).
** Include hospital-based and clinic-based ambulatory, emergency, and inpatient care.


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