Linda Lysoby, MS, CHES, CAE Executive Director, NCHEC CHES and MCHES: Recent Developments and An Advanced-Level Health Education Certification Developing a Sustainable System of Quality Assurance for Professional Preparation and Practice of Health Education Specialist in the U.S. IUHPE Conference in Geneva July 12, 2010 Linda Lysoby, MS, CHES, CAE Executive Director, NCHEC © NCHEC, 2010

This presentation will cover U.S. Health Education: Certification Organization Structure and Processes Importance of Competencies in Certification Certified Health Education Specialist- Entry and Advanced Future Challenges of CHES/MCHES Certification This presentation about Health Education in the US will discuss: Certification Organization Structure and Processes Brief History of relating Competencies to certification Certified Health Education Specialist Credentials Future Challenges of CHES/MCHES Certification © NCHEC 2009

Vision Statement: To be the premier credentialing body for health education specialists Promote professional development Strengthen professional preparation and practice Support and promote the profession Strategic Plan Priority I Strategic Plan Priority II Strategic Plan Priority III Strategic Plan Priority IV education specialists Certify health Mission Statement: To enhance the professional practice of Health Education by promoting and sustaining a credentialed body of Health Education Specialists. To meet this Mission, NCHEC certifies health education specialists, promotes professional development, and strengthens professional preparation and practice. The National Commission for Health Education Credentialing has been in existence since 1988. The Mission is To enhance the professional practice of Health Education by promoting and sustaining a credentialed body of Health Education Specialists. To meet this Mission, NCHEC certifies health education specialists, promotes professional development, and strengthens professional preparation and practice. Additionally, we believe that NCHEC supports and promote the profession of health education.

NCHEC Structure Nonprofit, Certification Organization Board of Commissioners (11) Executive Director (1) __ Office Staff (6) Division Board for Certification of Health Education Specialists (13) Division Board for Professional Development (7) Division Board for Professional Preparation & Practice (7) NCHEC is governed by an eleven-member Board of Commissioners (BOC) and has 3 Division Boards: 13 directors on the Division Board for Certified Health Education Specialists (DBCHES), and 7 directors on the Division Board for Professional Development (DBPD), and Division Board for Professional Preparation and Practice (DBPPP).  Each division board addresses one of the three activities noted in NCHEC’s mission. Board commissioners and directors represent all areas of practice in health education (schools, worksite, health care), and are elected by the entire body of Certified Health Education Specialists (CHES). Each Division Board elects two directors to serve as Division Board representatives on the BOC. Four commissioners are elected directly to the BOC and a Public Member is appointed following a public call for nominations. © NCHEC 2010

History of NCHEC Credentialing of Health Educators 1978 - National Task Force Developed 1980 - Role Verification 1985 - Competencies Established 1988 - NCHEC Incorporated as a Nonprofit Organization 1989 - Charter Certification Initiated - Work History 1990 - First CHES Exam Given 2005 - Competency Update Project (CUP) Results Released (1998-2004 Study) 2006 - Revised Framework Published 2007 - CHES Exam Based on New Framework 2008 - NCAA Accreditation of CHES Program 2010 - Health Education Job Analysis (HEJA) Results Released (2008-2009 Study) NCHEC was established through the work, financial contributions and commitment of health education professionals, employers, health education organizations, and government agencies. Beginning in the mid 1970s, the health education profession began the process of developing the steps necessary to establish the credentialing of health educators. In 1978, the Workshop on Commonalities and Differences on the Preparation and Practice of Community, Patient and School Health Educators was conducted, which initiated a process for consensus building of data collection and discussions. The goal was to clarify the role of health educators and to establish standards of professional practice. This led to the agreement on the Competencies and Responsibilities of health educators. The 1978 Workshop on Commonalities and Differences recommended the formation of a planning committee, which became the National Task Force on the Preparation and Practice of Health Educators. The Task Force was charged with the responsibility of developing guidelines for professional preparation that would apply in all health education settings. This group formulated and enacted the Role Delineation study that determined the role of an entry-level health educator encompassed in the Seven Areas of Responsibility. Those Seven Areas comprised what is known as A Competency-Based Framework for the Professional Development of Certified Health Education Specialists (1986). By 1988, NCHEC was incorporated as a non profit, tax-exempt organization with an elected board. The Responsibilities and Competencies of Health Educators were re-verified in the Competencies Update Project (CUP) 1998-2004. The revised publication, A Competency Based Framework for Health Educators was released in 2006. The CHES exam adapted to the CUP competencies was first administered in Fall 2007. In 2008 , the CHES certification was accredited by NCCA. To keep with credentialing standards, NCHEC partnered with the two largest membership organizations, SOPHE & AAHE in the HEJA(2008-2009). © NCHEC 2010

Professional Credentialing Components Role delineation or job analysis Link exam to defined body of knowledge Reliability and validity based on psychometric methods Minimum pass score set Parallel forms of exam created According to the Institute for Credentialing Excellence, formally known at the National Organization for Competency Assurance, the following components are essential for a valid certification: Role Delineation or Job Analysis Conducted and Periodically Validated Link Exam to Defined Body of Knowledge Based on Role Delineation Reliability and Validity of Exam Based on Psychometric Methods Establish a Minimum Pass Score (not everyone passes the exam) Create Parallel Forms of Exam Source: Credentialing Concepts (2006). Institute for Credentialing Excellence. http://www.credentialingexcellence.org © NCHEC 2010

Area of Responsibility/ Domains US Korea Galway Consensus Conf. I. Assess Needs, Assets, and Capacity for Health Education II. Planning, Implementation and Evaluation of health education program I. Catalyzing change II. Plan Health Education II. Leadership III. Implement Health Education III. Development of health education methods and materials III. Assessment IV. Conduct Evaluation and Research Related to Health Education IV. Management of health education program IV. Planning V. Administer and Manage Health Education V. Environmental support for healthy life V. Implementation VI. Serve as a Health Education Resource Person VI. Management of health information VI. Evaluation VII. Communicate and Advocate for Health and Health Education IV. Research for health education and promotion VII. Advocacy VIII. Partnerships Internationally there has been much activity to determine the competencies and domains of health educators. This slide show a comparison of the competencies used in the US and the newly formed Korean certifications and the core domains identified in the Galway consensus conference in 2008 While the order of the domains differ, notice key words repeating of assess, plan, implement, evaluation , information (resource)and advocacy. Unique words were: Environmental support for healthy life Partnerships Catalyzing change © NCHEC 2010

Benefits of Certification Establishes national standard Attests to individual’s knowledge and skills Assists employers in identifying qualified practitioners Sense of pride and accomplishment Promotes continued professional development Benefits of certification: Establishes national standard Attests to individual’s knowledge and skills Assists employers in identifying qualified practitioners Sense of pride and accomplishment Promotes continued professional development

CHES Certification Three Components: Meet Academic Eligibility Standards Pass Written Examination Continuing Education Requirements -75 in 5 years Voluntary National in Scope Based on Generic Health Education Responsibilities and Competencies Verified through a Job Analysis Meets NCCA standards Over 9,000 Active CHES The Certified Health Education Specialist (CHES) credential as, awarded by the National Commission for Health Education Credentialing ,indicates that an individual has met three components: academic eligibility standards, passed a written exam, and then an ongoing commitment to continuing education. This certification is voluntary, meaning that one chooses to earn this credential which is national in scope. The certification is based on generic (meaning regardless of setting or topic) responsibilities and competencies that have been verified as necessary for practice in health education by a job analysis process. The CHES certification, with more than 9000 individuals nationwide, has met the rigorous standards of the National Commission of Certifying Agencies (NCCA). © NCHEC 2010

Certified Health Education Specialist (CHES) Credential Establishes Professional Identity Exam Eligibility: Minimum Bachelors Degree Major and/or Degree In Health Education Academic Transcript Reflecting 25 Semester Hrs Addressing the Seven Areas of Responsibility of Health Educators OR Exam Fees: $210-$330 Renewal/Recertification Annual Renewal Fee : $55.00 Continuing Education 75 Hours in 5 Years The CHES establishes professional identity in the health education profession. The CHES exam eligibility requires a minimum of a bachelors degree with either a specific health education major OR with 25 credits specific to the Health Education Areas of Responsibility. Exam fees range from $210 to $330 with the lowest prices for students and early registration. Every year, there is a $55 renewal fee. Within 5 years, the CHES must earn 75 continuing education hours. © NCHEC 2010

Why an Advanced Credential? Official recommendations of the National Task Force on Accreditation Findings of CUP and HEJA revealed advanced levels among health educators in their practice. 2006 Feasibility Study Survey: 2/3 of respondents indicated that an advanced level certification will benefit the profession Continuing comments from health educators that current CHES credential is “entry-level” and, therefore, not reflective of the scope of practice of many health education specialists. Now we will turn the focus of our discussion today to the specifics of the advanced- level credential. There are many reasons why NCHEC started to consider this additional credential. The National Task Force on Accreditation, convened by SOPHE and AAHE included a recommendation that there be distinction in levels of certification. The CUP study, released in 2005, revealed advanced levels among health educators in their practice. These findings were later confirmed by the Job Analysis Project. Survey respondents in a feasibility study indicated that an advanced level certification will benefit the profession. And a very important reason was continuing comments from health educators that the current CHES credential is “entry-level” and therefore not reflective of the scope of practice of many health education specialists. © NCHEC, 2010

Confirms Professional Development / Career Ladder Master Certified Health Education Specialist (MCHES) Credential (begins October 2011) Confirms Professional Development / Career Ladder Exam Eligibility: 5 Years Experience AND Master’s Degree or 5 year CHES Major and/or Degree In Health Education Academic Transcript Reflecting 25 Semester Hrs Addressing the Seven Areas of Responsibility of Health Educators OR Exam Fees: $250-390 Renewal/Recertification Annual Renewal Fee : $55.00 Continuing Education 75 Hours in 5 Years 30 CECH Must be Linked to Advanced-Level Sub-competencies The establishment of an advanced credential is to extend the relevance of the CHES credential. Care will be taken not to “devalue” the existing CHES credential and many will continue to hold the CHES credential. MCHES exam eligibility requires 5 years of experience and a minimum of a Master’s degree with either a specific health education major OR with 25 credits specific to the Health Education Areas of Responsibility. Individuals who hold the CHES credential for 5 years are also eligible with a Bachelor’s degree. MCHES exam fees range from $250 to $390. Every year, there is a $55 renewal fee. They must earn 75 continuing education hours in 5 years with 30 hours linked to advanced-level Sub-competencies. © NCHEC 2010

Percentage of 2011 CHES/MCHES Exam Questions by Area of Responsibility I. Assess Needs, Assets, and Capacity for Health Education 12% 10% II. Plan Health Education 15% III. Implement Health Education 24% 20% IV. Conduct Evaluation and Research Related to Health Education 16% V. Administer and Manage Health Education 11% VI. Serve as a Health Education Resource Person VII. Communicate and Advocate for Health and Health Education 7% 8% The CHES and MCHES Exams are constructed based on the results of the role delineation. The HEJA results will be incorporated into the Certifications in 2011. This chart indicates the 7 areas of responsibility and the percentage of test questions that apply for both the CHES and MCHES exam. Biggest differences_ MCHES had more i n Area 5 ( Administer) and less in Area 3 (implementation) © NCHEC 2010

MCHES Experience Documentation Opportunity (EDO) CHES ≥ 5 years continuous active status 6 month period (October 2010 to April 2011) only Document practice of advanced-level practice & testament of 2 recommenders If successful, applicants will not have to take the exam For 6 months only, beginning October 15, 2010, CHES who have held active status for the past five consecutive years will have the opportunity to elect an assessment mechanism of his/her experience. They can participate in the MCHES Experience Documentation Opportunity (EDO). If successful, CHES will not be required to take the exam to obtain the MCHES designation. Successful applicants will be notified within 30 days of the completed application and documentation. All MCHES certifications will be conferred effective April 2011. © NCHEC, 2010

Timeline for Job Analysis & MCHES Certification Feb 2010 Health Education Job Analysis Results Released by SOPHE, AAHE & NCHEC August 2010 Release of Revised Framework and Study Guide Publications Oct.‘10– Apr ‘11 MCHES Experience Documentation Opportunity (EDO) Period Oct. 2010 MCHES Exam Study Materials available April 2011 First MCHES Credential Conferred from EDO New CHES Exam administered on updated Competencies First MCHES Exam We are currently still communicating the HEJA results with the profession. The revised Framework and CompansionStudy Guide will be released by the end of summer. A 6-month window for current active CHES to submit an Experience Documentation Opportunity (EDO) will be available October 2010 to April 2011. The first MCHES credentials will be conferred in April 2011. The New CHES exam will be administered in April 2011 with the updated competencies. The first MCHES exam will be available in October 2011 and will be based on advanced-level competencies as outlined in the Job Analysis. © NCHEC 2010

Health Education Specialist Job Opportunities Web site Postings: http://www.nchec.org/news/docs/jobs.htm Free Job Listings: CHES Required or Preferred Postings Total Number of Ads in April 2010 = 51 NCHEC posts job opportunities on our Web site with no fee to post if the job requires or prefers the CHES credential. The total number of Ads in April 2010 were 51. © NCHEC 2010

Future Challenges & Lessons Learned Apply standards consistently Update competencies regularly Set and enforce minimum pass score Quality Standard My advice from the NCHEC experience is to apply standards consistently, update competencies regularly, set and enforce minimum pass score and your certification will be a true quality standard. The process is continuous and as soon as we finish this update , we need to start the next job analysis process. © NCHEC 2010

For More Information National Commission for Health Education Credentialing, Inc 1541 Alta Drive, Suite 303 Whitehall, PA 18052-5642 484-223-0770 www.nchec.org llysoby@nchec.org Please contact the NCHEC office for more information © NCHEC 2010 18