Public Health Workforce Development: Developing Genomic Competencies in Public Health
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The purpose of this activity is to present essential public health competencies that incorporate specific aspects of genomics and present the required core knowledge, skills, abilities, and crosscutting functions related to public health programs. This becomes increasingly important as genetics expands beyond its traditional role in newborn screening, maternal and children’s health, state genetic services, and public health laboratories into most public health activities. These competencies will consist of a core set for all public health staff, a set for public health professionals, and supplemental competencies corresponding to six functional areas of public health: Administration, Clinical, Epidemiology, Health Education, Laboratory, and Environmental Health.
Statement of Need:
In the year 1996, CDC began a long-range program to develop the capacity to integrate genomic and genetic discoveries into public health actions that will ensure the appropriate use of genetic information to promote health and prevent disease. As developments in genomics increasingly affect health policy and practice, the importance of preparing the public health workforce for meeting that challenge becomes evident.
Public health capacity depends upon the effective integration of new scientific knowledge about potential interventions with the practical experience of “what works.” The broad operations and services of public health can be ordered into three core functions—assessment, policy development, and assurance— and the related essential services that define the actions necessary for effective programs. The awareness, engagement, and eventual competence of public health staff in applying genomic knowledge throughout these operations and services are several of the foci of public health workforce development.
Since 1996, CDC has undertaken a wide range of projects to raise awareness about genetics within the public health community. As the relevance of genomics in adult chronic disease, environmental health, epidemiology, and policy areas has been recognized, public health leaders have emphasized the need for training and expertise. Although several general training programs on genetics and public health have been offered, a systematic approach to planning and developing relevant competencies in genomics for public health workers was lacking. Using the foundation of the essential public health services and prior core competencies efforts in both genomics and public health, CDC initiated a project to outline the needed competencies and to associate this project with existing crosscutting public health workforce development projects that offered a framework for implementation.
The report “Genomic Competencies in Public Health” is the principal reference for developing curriculum, planning training programs for public health staff, and setting priorities related to integrating these core competencies into crosscutting training strategies. CDC is producing this report through a working group of diverse state and local public health professionals, genetic professionals, and academic and industry representatives who reflect the multidisciplinary roles of genomics in public health. The six functional areas represented are State And Local Public Health Administrators, Laboratory Directors, Clinicians (i.e. physicians, physician assistants and nurses), Environmental Health Professionals and Specialists, Health Educators, and Epidemiologists / Data Management Specialists. Beginning with the core public health functions as a foundation, the report will promote practical genomic competencies, which are components of these discrete functional areas.
A wide range of formal courses, educational materials, on-line training programs, and other learning opportunities will be required to effectively disseminate the emerging genomic science to the approximately 460,000 people who constitute the public health community. Recommendations from the working group that drafted the report will be combined with input from genetic and public health professional organizations about priorities and options for achieving the identified competencies. Many existing training programs and materials that focus on either the general public health workforce, or specifically on one of the functional groups, are expected to immediately adapt the recommendations for training programs.
In March 2000, CDC began to develop a project designed to convene public health and genetic colleagues to produce a set of public health competencies that incorporated specific aspects of genomics. This was a joint effort of the Office of Genomics and Disease Prevention (OGDP) and the Public Health Practice Program Office (PHPPO) to consolidate existing OGDP genetics and public health capacity and training activities with the PHPPO-facilitated public health workforce development activities. CDC convened selected state and local public health representatives, and other academic and private sector professionals working in the major functional areas of health to assess the approach for creating the report. This group also considered the scope, format, and necessity as well as categories of participants. In May 2000, these Genomic Working Group leaders established six groups consistent with the broad functional areas of public health. Each of the six working groups was comprised of 5-6 members who represented experience and/or expertise in that functional area as well as interest in workforce development, genomics, genetics, or the practical concerns of public health workers. These groups reviewed background information on genomics, the status of the CDC Workforce Development project, existing competencies and training programs, and other relevant resources. A Web site was established for the Working Groups that provided easy access to references, provided a forum for interactions among groups, and supported document revision.
In August 2000, these Working Groups consisting of a total of approximately 50 state and local public health, academic and private sector colleagues met to begin development of the first draft of the report “Genomic Competencies in Public Health.” The group determined that a set of competencies for each of the six areas was in fact needed and that a composite set of core competencies was to be established from the crosscutting priorities that were identified. These competencies would provide the basis for planning, prioritizing, and developing curricula and training media and would be important for shaping formal educational programs as well as ongoing training projects. In addition, the competencies could be used to develop individual and public health agency performance standards. A target date for providing the final draft was set for May 2001.
CDC staff produced a composite working draft of the six sets of competencies to highlight the common cross-cutting elements as well as the unique competencies associated with specific functional areas. This working draft was organized by categories consistent with those promulgated by the CDC Workforce Development project. The Working Group leaders produced a three-tier working draft in March 2000. This draft includes a set of core competencies, a set of competencies for public health professionals, and a set of competencies for each of the six targeted functional areas/ professional specialties. After refinements by the Working Groups, the draft report will be circulated to colleagues in public health, training programs, and genetic services programs for critical review and input. Recommendations for the next steps will be developed to include completion, dissemination and implementation of the genomic working document.
Outcome and Impact:
The report “Genomic Competencies for Public Health” will be made available to national public health and professional organizations for further review and comment. The report will be widely distributed as a reference document for discussion by June/July 2001, while CDC and the Working Groups continue to work closely with these organizations to further refine and gain its acceptance. Through the discussions of the Genomic Working Group members with these organizations and the implementation of recommendations for the use of the report in training programs and performance standards development, the primary goal of integrating genomics into public health capacity will be promoted.
As the CDC Public Health Workforce Development program begins to prioritize investments in life long learning for public health workers, the importance of genomics will have been established as core and crosscutting competencies to be addressed at all levels. In each of the functional areas, the specific competencies will provide a foundation for strengthening academic programs, interactive media, and workforce training programs. Each of these efforts will further the goals of providing a competent public health workforce.