1. P UERTO R ICO -F LORIDA P UBLIC H EALTH T RAINING C ENTER R ESULTS OF 2011 P UERTO R ICO N EEDS A SSESSMENT (P UERTO R ICO H EALTH D EPARTMENT W ORKFORCE ) José A. Capriles – Quirós, MD, MPH, MHSA

2. Introduction A competent and well-trained public health workforce is essential to address emerging and major public health challenges facing Puerto Rico and the United States. Maintaining a highly trained, culturally sensitive public health workforce must include on-going assessment of training needs and agile development of public health training opportunities.

3. Aim The first aim of the PRF-PHTC states as follows: To assess the public health workforce and training needs in Puerto Rico and Florida, especially among Spanish speakers.

4. Methodology All subjects who consented to participate in the study were included in the study. The inclusion criteria were as follows: study participants included Puerto Rico Department of Health active personnel at three different levels: entry level public health professionals, to individuals with management and/or supervisory responsibilities; and senior managers and/or leaders of public health organizations. Department of Health’s clerical and maintenance staff will be excluded from the survey.

5. Methodology A total of 2,676 questionnaires were distributed. From these: – 1,755 were collected in a month – 1,414 agreed to participate – 341 did not want to participate – Response rate of 58.0%.

6. PERCENTAGE DISTRIBUTION OF DEMOGRAPHIC AND PROFESSIONAL CHARACTERISTICS OF PUBLIC HEALTH TRAINING NEED ASSESSMENT’S SURVEY PARTICIPANTS RESULTS

7. Gender

8. Age

9. Highest Academic Degree

10. Employment Setting

11. Years in current employment Percent

12. PERCENTAGE DISTRIBUTION OF EXPERIENCE IN PUBLIC HEALTH OF PUBLIC HEALTH TRAINING NEED ASSESSMENT’S SURVEY PARTICIPANTS RESULTS

13. Total of years working in the field of Public Health

14. Source of Public Health Training Percent Distribution of Survey Participants by the Source of Public Health Training Source of Public Health Training * Frequency (n) Percentage (%) Formal Education (College degree)1599.1 Online/ Distance Learning Courses804.6 Seminars/ Workshops55631.7 Work Experience74042.2 None27215.5 * Categories are not mutually exclusive; Respondents could have chosen more than one category.

15. Public Health Field Specialty Percentage Distribution of Training Need Assessment’s Survey Participants by Their Public Health Field Specialty Public Health Field Frequency (n) Percentage (%) General Public Health40523.1 Environmental Health21112.0 Public Health Education1076.1 Health Services Administration935.3 Epidemiology925.2 Developmental Disabilities422.4 Health Systems Evaluation331.9 Gerontology291.7 Biostatistics181.0 Demography12.7 Other26815.3

16. PROFESSIONAL DEVELOPMENT ACTIVITIES

17. Main Reasons to Participate in Professional Development or Continuing Education Activities Percentage Distribution of Survey Participants According to Their Main Reasons to Participate in Professional Development or Continuing Education Activities Reasons Frequency (n) Percentage (%) Career advancement100957.5 It is a requirement in order to maintain license or certification94053.6 Need to update information and knowledge93853.4 Need to develop new skills and competencies regarding clinical care70039.9 It is required by employer62435.6 Need to develop new skills and competencies regarding interaction with the community 54931.3 Need to develop new skills and competencies regarding organizational development and management 42424.2 Interest to discuss common issues with colleagues35620.3 Other422.4

18. Barriers to Participate in Training or Professional Development Activities Percent Distribution of Survey Participants According to Perceived Barriers to Participate in Training or Professional Development Activities in Public Health Barriers FrequentlySometimesNever Mean (n)(%)(n)(%)(n)(%) a) Lack of time to attend educational seminars or other training that is offered outside the workplace. 26221.373559.823218.91.98 b) Lack of time to attend educational seminars or other training offered at their workplace. 25720.773259.125020.21.99 a)Barriers out of their control25221.958350.731627.52.06 a)Range of activities19921.142545.131833.82.13 a)Lack of financial support (payment or reimbursement of expenses to attend such activities). 34728.543635.843635.82.07 a)Lack of financial travel support to attend such activities in or out the island. 39532.729124.152343.32.11

19. Percent Distribution of Survey Participants According to How Much Time in the Average Week They Have Available to Participate in Professional Development Training or Knowledge Update Activities

20. PUBLIC HEALTH KNOWLEDGE AND COMPETENCIES

21. PERCENT DISTRIBUTION OF SURVEY PARTICIPANTS BY THEIR SELF-PERCEIVED NEED FOR TRAINING ON CORE FUNCTIONS OF PUBLIC HEALTH RESULTS

22. CORE FUNCTIONS OF PUBLIC HEALTH I do not need training Need Introductory course Need refresher course Need advanced training Mean n%n%n%n% A. Need Assessment 1. Health risks research.(165)12.5(378)28.7(577)43.8(198)15.0 2.61 2. Determination of Health Skills.(146)11.4(402)31.3(571)44.4(167)13.0 2.59 B. Advocacy 3. Create collaborative links with the community. (236)18.3(470)36.5(376)29.2(205)15.9 2.43 4. Setting priorities for health needs.(257)19.8(405)31.2(462)35.6(172)13.3 2.42 5. Develop plans / policies to address health priorities. (186)14.5(495)38.6(348)27.1(254)19.8 2.52 C. Evaluation 6. Managing resources.(202)15.9(481)37.8(354)27.8(235)18.5 2.49 7. Develop organizational structure.(189)14.8(500)39.2(327)25.6(259)20.3 2.51 8. Implement programs identified as priority. (203)15.9(480)37.7(339)26.6(251)19.7 2.50 9. Evaluate programs.(197)15.5(496)38.9(316)24.8(265)20.8 2.51 10. Report concerns / health concerns of the community. (236)18.4(456)35.6(386)30.1(204)15.9 2.44

23. Self-Perceived Knowledge or Skills on Council of Linkages Public Health Competencies Percent Distribution of Survey Participants by Self-Perceived Knowledge or Skills on Council of Linkages Public Health Competencies Dimensions Num. Items MeanMedian Chronbach’s alpha Analytical/ Assessment Skills46.88.0.920 Policy Development/ Program Planning 46.57.0.931 Communication47.58.0.903 Cultural Competency47.58.0.944 Community Dimensions of Practice47.78.0.921 Public Health Sciences46.58.0.953 Managerial and Financial Planning45.66.0.921 Leadership and Systems Thinking46.57.0.942

24. Council of Linkages Competencies Identified as Priorities in Need for Training Ranked According to Mean and Median Values Scale:  0= N/A This skill does not apply to my position.  1= I have no knowledge or skills.  2= I have awareness level knowledge or skills:  3= I have practical knowledge or skills.  4= I have advanced knowledge or skills.

25. Council of Linkages Competencies Identified as Priorities in Need for Training Ranked According to Mean and Median Values Rank How capable are you to effectively... COMPETENCIES ITEMS MEANMEDIAN 1Contribute to the preparation of proposals to obtain financing from external sources. 1.191.00 2Participate in the development of a program budget1.221.00 3 Describe the impact of changes in the public health system and broader social, political environment, economic impact on organizational practices. 1.502.00 4Describe how data are used to address scientific, political, ethical, and public health.1.532.00 4Translating assessment information into action steps to improve program implementation.1.532.00 5 Relate the public health science skills to the essential functions of public health and the ten essential services of public health. 1.572.00 6 Incorporate ethical standards of practice as the basis of all interactions with organizations, communities and individuals. 1.582.00 7Participate in program planning. 1.592.00 8Describe the scientific evidence related to issues, concerns or public health interventions. 1.592.00 8 Identify mechanisms to monitor and evaluate programs according to their effectiveness and quality. 1.602.00 9Participate in the assessment of cultural competence of public health organizations. 1.642.00 10 Engaging with stakeholders to identify key public health values and a shared public health vision and the principles that guide community action. 1.652.00 LEGEND COMPETENCIES DOMAINS Analytical/Assessment SkillsCommunity Dimensions of Practice Policy Development/Program PlanningPublic Health Sciences CommunicationManagerial, Financial Planning and Human Resources Cultural CompetencyLeadership and Systems Thinking

26. PERCENTAGE DISTRIBUTION OF TRAINING PREFERENCES AND TECHNOLOGICAL CAPACITY OF PUBLIC HEALTH TRAINING NEED ASSESSMENT’S SURVEY PARTICIPANTS RESULTS

27. Percent Distribution of Survey Participants by Perception of Self-Competence on Council of Linkages Public Health Professionals Competencies

28. Skills Level in Computer Literacy

29. Type and Place of Computer Service Access Percent Distribution of Survey Participants by Type and Place of Computer Service Access Have access to: WorkplaceHome n%n% Computer for my exclusive use 31821.870540.2 Computer that I share with others 51929.631317.8 Internet/World Wide Web 27615.779945.5 Intranet 1257.100 Electronic mail ( e-mail ) personal 001227.0 Electronic mail ( e-mail ) work 29917.070640.2 None of the above 45125.730317.3

30. Computer Services Use and Type Percent Distribution of Survey Participants by the Frequency of Computer Services Use and Type Does your computer allow you…? AlwaysUsuallyRarelyNeverNever tried Mean n%n%n%n%n% a. View online videos(312)33.9(140)15.2(91)9.9(221)24.0(156)17.02.95 b. Participate in interactive programs (online conferences with audio and Power Point, "Audience Response System", etc.) (193)21.1(89)9.7(95)10.4(256)27.9(283)30.93.71 c. Take online courses(198)21.9(70)7.7(89)9.8(260)28.7(289)31.93.78 d. Respond to electronic surveys online(252)28.0(97)10.8(111)12.3(235)26.1(205)22.83.28 e. Archiving or storing materials in the computer memory (542)58.5(151)16.3(65)7.0(101)10.9(67)7.22.80 f. Print materials(531)56.6(164)17.5(73)7.8(115)12.3(55)5.92.65 g. Connect to social networks(382)41.4(98)10.6(93)10.1(233)13.3(117)12.72.70

31. Computer Software That They Have Working Knowledge Percent Distribution of Survey Participants by the Computer Software That They Have Working Knowledge Computer Softwaren% Microsoft Word 81846.6 Microsoft PowerPoint 58733.4 Microsoft Excel 40723.2 Microsoft Access 1066.0 Epi Info 301.7 SPSS 341.9 SAS6.3 STATA 3.2 All of them 6.3 None 35120.0 Other 482.7

32. Interest in Receive Training

33. Top Five Topics Percent Distribution of Survey Participants by the Five Topics Preferred for Further training Computer Softwaren% Epidemics and Outbreak Effects in the Health System 38131.1 Health Promotion and Disease Prevention29323.9 Mental Health29223.8 Global Public Health25821.1 Health Law and Public Policy25420.7

34. Conclusion The PR/F PHTC Training Needs Assessment of the Puerto Rico Department of Health employees included a sample of 1,414. The survey provided information on these professionals public health-related experience, self-perceived competencies, barriers for training, technical capacity, and training preferences. In general, most respondents have acquired their public health knowledge by experience and not by academic formation or continued activities. They perceived a great need for introductory courses in the competencies assessed. Face-to-face methods were the training modality of preference.

35. Conclusion Results from their self-assessed technical capacity provide an idea of why Internet/Web-based training is their third choice for training modality. Respondents informed limited access to computer and online resources, in addition to poor level to none of computer literacy by a significant group (42.4%). Promisingly, the great majority of respondents are interested in receiving training in Public health as part of a capacity program over the next three years.