North Carolina Department of Health and Human Services (NC DHHS) received over $62 million for American Rescue Plan Act (ARPA) COVID-19 Public Health Workforce development. NCDHHS distributed a portion of these funds to local health departments (LHDs) to strengthen their workforce using a regional funding model, including hiring 10 Regional Workforce Development Directors. Region 5 serves ~1.5 million people, with 1,100 public health staff members. The ARPA work brings staff together in workshops, retreats and communities of practice (CoP) to share ideas, resources and network in order to strengthen relationships and remove siloes to enable collaboration.

Methods: In addition to a state-wide gaps analysis, Region 5 conducted staff interviews (n=112), focus groups (n=18), and LHD observations (n=18) to assess staff training, development and resource needs. Evaluation from trainings and workshops (n_sessions=172; n_attendees=2,000) collected demographics, confidence, competence, usefulness, likelihood to recommend, and qualitative data via surveys.

Results:

Trainings (n=172), retreats (n=7), CoP’s, (n= 25), and resources (n=200) provided in communications (i.e. emotional intelligence, active listening, conflict resolution), leadership (i.e. team effectiveness, performance management), and organizational development (i.e. culture change, strategy, and quality improvement). Competence and confidence in each skill area improved. More than 95% of participants recommend these trainings to others on their staff and all agreed or strongly agreed the content was useful for their roles. Qualitative data revealed learnings, specific applications to public health work and intention to share learnings with other staff.

Conclusions:

Skill and needs assessments provide necessary information to understand gaps in staff skills and to tailor trainings to those needs. Tailored trainings led to increased confidence and improved skills. The use of evaluation throughout the process enabled further intentionality in designing trainings and delivering resources, which ultimately will improve the infrastructure of local public health departments to serve the communities’ health needs.

Methods: Region 4 focused on core elements that impact every public health department: digitization, communications, and assessment. In addition to a state-wide gaps analysis, Region 4 staff conducted in-person interviews with public health staff to determine an action plan. A marketing firm was contracted to create 10 videos and launch a social media campaign intended to improve the public’s trust in public health and to recruit new public health staff. Using Quality Improvement tools and systems thinking, the region brought counties together on the same Community Health Needs Assessment (CHA) timeline.

Results: Over the past 24-months, 2.2 million pieces of paper have been digitized in Region 4, leading to a more efficient workflow. This increased perceived competence and customer service, leading to increased public trust. Ten videos were branded in eleven customized ways (one for each county) and shared over 1,000 times. The unique regional CHA model removed siloes across divisions and improved collaboration with community partners. Communities now see hospital systems and public health working together towards common health improvement goals.

Conclusions: Health Directors across NC have similar challenges, opportunities, and goals no matter how many people live in their geographic boundaries, and how many staff they employ. Improving connectivity and collaboration between LHD’s allow for peer support and resource sharing that is critical in serving our communities and improving LHD infrastructure. Improving communication and standardizing systems increased staff efficiency and the public’s trust in LHD’s.

Methods: NC DPH created a Foundational Capabilities Task Force (FCTF) that convenes quarterly consisting of local, regional, and state health leaders. The FCTF compared data from 10 regional and 1 statewide Foundational Capabilities Gap Analysis Reports in 2022 and 2023, respectively. The data was collected through an online survey (35% of local workforce and 53% of NC DPH represented), individual interviews with leadership (n=39) and focus groups (n=16). The purpose of the FCTF is to align on common needs and implement specific interventions to improve performance across North Carolina’s public health workforce.

Results: In January 2024, the FCTF aligned on prioritizing four foundational capabilities: Communications, Organizational Administrative Competencies, Accountability and Performance Management, and Policy Development and Support. Planning is now underway to choose specific workforce interventions affecting both local and state public health staff.

Conclusions: Consistent assessment, dedicated space for collaboration, and a common agenda has increased trust among public health leaders in North Carolina. Strategic investment, the creation of the FCTF, and alignment in the foundational capabilities sustains the public health workforce and the health of North Carolinians at the forefront of NC DPH’s workforce agenda.

Methods: UNCW conducted an assessment about individual staff confidence in performing foundational capabilities in the summer of 2022, which amplified needs for training in areas like understanding and interpreting data, communication skills, leadership development, and peer learning in Region 8. Through regular meetings with health department leadership, UNCW also identified need for communications strategies to address workforce recruitment and retention and access to public health services. Additionally, leadership shared needs for quality improvement of EHR/EMR systems to capture data more efficiently.

Results: UNCW hosted and developed trainings such as Data Use and Visualization, Introduction to Communication Styles, and Leadership Enrichment and Administrative Development Training. UNCW also facilitated a community of practice for health educators, offering peer networking and additional training opportunities. In total, 1,269 health department staff have participated in trainings within the identified areas. Additionally, UNCW is coordinating efforts to address communications and quality improvement needs.

Conclusions: There is agreement and consensus on county, regional, and state needs by health department leadership in Region 8. Leadership and staff at public health departments are motivated to engage in innovative problem solving and professional development, and the ARPA funds, coupled by partnership with UNCW, has provided opportunities for strategic planning and additional resources to support workforce needs.