Background:

Home health aides (HHA) provide essential care services to support the health and daily functioning of Medicaid recipients with long-term health needs. However, resources supporting the training and advancement of HHAs have been limited. As part of the State's Medicaid redesign and transformation to value-based payment (VBP) healthcare delivery, New York State launched the “Workforce Investment Organization” (WIO) initiative in 2018 to train direct care workers serving Medicaid Managed Long-term Care (MLTC) members. This study sought to assess the health impact of 5 WIO training programs on 7 VBP outcomes of 13,320 MLTC members.

Methods:

A quasi-experimental design was used to examine the association between WIO training and the VBP outcomes. MLTC members’ VBP measures were matched with claim-paid HHA visit data, and the WIO training rosters from four licensed home care service agencies. We conducted multivariate generalized additive and generalized linear logistic regression models to analyze member VBP outcomes alongside their WIO-exposure, measured by service hours received from WIO-trained aides.

Results:

Regression results suggested statistically significant associations between WIO-exposure and 6 VBP measures; yet the strength and direction of associations varied across VBP measures, member service needs, and level of exposure. At study population level, WIO-exposure positively contributed to performance of receiving an influenza vaccination, not experiencing uncontrolled pain, remaining stable or demonstrating improvement in dyspnea, and not having an emergency room visit.

Conclusions:

These complex results we observed reflected differential opportunities for trained aides to impact client health within their scope of work and the complexity of the WIO intervention and its implementation.

Improving training of the public health workforce, particularly related to addressing equity, diversity, inclusion and community engagement, is a national priority. Associated competencies are critical to our nation’s capacity to achieve health equity. While there have been improvements in the overall health of the nation, little improvement has been made in eliminating racial and ethnic inequities. To address the gap in robust measures of workforce development needs and effectiveness, the Center for Public Health Practice, at the Colorado School of Public Health, collaborated with state public health department partners to create a comprehensive instrument to identify training needs and assess growth in essential public health competencies annually. Twelve domains served as the overall structure of the workforce development assessment (e.g., coalition management, community engagement, cultural humility, health equity, implementing environmental/systems changes). We mapped public health core competencies to each of these domains. Advisory Group members – a diverse group of stakeholders convened to provide input on grants designed to address health disparities in Colorado – reviewed and provided substantive input that made items more concrete, specific, and practice-oriented. When a respondent indicates that a domain is a high training priority, the associated competencies are displayed. The respondent is prompted to specify the “top three” competencies of greatest interest. This design makes it possible to identify needs related to a more differentiated set of skills, which enhances the information available to inform workforce development.

State health departments are encouraged to build capacity and social capital in communities using innovative funding methods to address chronic disease. This approach has been hampered by siloed funding sources with narrow foci. This presentation will describe the implementation and evaluation of a mini-grant initiative focused on chronic diseases by a state health department. Braided funding from federal and state sources was used to build and implement the initiative.

Mini-grants, facilitated by five different facilitating organizations, were funded to promote implementation of policy, systems and environmental (PSE) changes at the local level. Grant recipients represented a variety of sectors, including school, government, non -profit and private sectors.Primary (surveys) and secondary data (content analysis of final reports) sources were used to document PSE changes.

A total of $196,369 was dispersed to 65 organizations; 126 PSE changes in the areas of physical activity, nutrition and tobacco were reported by grantees. Challenges in implementing and evaluating mini-grants were identified, including the heterogeneity of the sectors/settings involved and associated variability of proposed activities, timelines, measurement and evaluation activities. COVID-19 also disrupted plans for many projects.

The success of this initiative can be attributed to three main elements: 1) a participatory evaluation process, combined with early and ongoing communication among all stakeholders, 2) a braided funding strategy, and 3) use of intermediary organizations to facilitate the mini-grants. The processes and outcomes, including challenges, can help inform other state health departments’ efforts in braiding funding to promote policy, systems and environmental changes at the local level.

Background:

Advances in HIV service delivery demand: 1) promoting visibility of workforce pathways, 2) enriching workforce skillsets, and 3) providing responsive HIV-specific training. Opportunities for public health training can help equip future leaders with training and support to carry out these essential roles within public health systems. The Public Health Boot Camp (PHBC) is an intensive one-week continuing education program hosted by the Institute of Public Health & Medicine (IPHAM) at Northwestern University (NU) and AIDS Foundation Chicago (AFC). The unique residential, cohort-learning model prepares HIV/AIDS organizational leaders in Chicagoland with foundational public health training to advance career enhancement in a peer-to-peer learning environment.

Methods:

Over the past thirteen years, the program has graduated 119 participants. The Community-University partnership team developed an outcome evaluation using the Kirkpatrick Four-Level Training Evaluation Model and key elements of Adult Education and Transformative Learning. The evaluation focused on evaluating the individual and organizational outcomes of the PHBC.

Results:

The survey was deployed in Spring of 2021. Key themes highlighting all four levels of the Kirkpatrick Training Evaluation Model (Reaction, Learning, Behavior, Results) will be discussed. Insights gathered from the application of the outcome evaluation model will be detailed.

Conclusions:

Community-University partnerships that incorporate topic-specific, adult educational theory-driven approaches to training programs benefit the careers of public health professionals. Opportunities for working professionals to learn in executive formats are useful. The novel use of the Kirkpatrick Training Evaluation Model provides a framework to understand individual and organizational level outcomes. Findings contribute to understandings of Community-University partnerships and aim to improve future HIV/AIDS non-clinical workforce development.