1 Supplemental Digital Content
Appendix Table 2. Strategic Skill Gaps among the Region V Public Health Workforce Strategic Skill
Domain with
Training Need Theme Illustrative Quote
Resource
Management Managing financial
resources “...how you’re securing and sustaining funding over time is important, and I think that comes with not everybody’s comfortable writing grants or even knowing where to look for supplemental funding. It’s also about how to manage funding that has specific parameters...how they report and evaluate is another component of resource management.”
Resource
Management Managing financial
resources “There is a dynamic to this boom and bust cycle, where federal dollars are flying in. How do you get them out the door as fast as you can in a way that's as effective and efficient as possible?...if I thought there was a skill that is lacking, it might be how to clearly and effectively advocate for long term infrastructure, support of public health.”
Resource
Management Developing and managing human resources
“You have a lot of...promotion from within, of individuals who are subject matter experts...but might not necessarily be promoted with the right competencies to be effective at management and supervision.”
Resource
Management Developing and managing human resources
“Our general public health workforce is not diverse...of our local health departments, we maybe have one health officer that is not white in our whole state...other than our tribes….What does it mean to change policies that might have an opportunity to bring in a more diverse workforce?”
Resource
Management Developing and managing human resources
“...where do you fit, you know, sort of newly onboarded people into the public health system.
Like, maybe there’s people who are contact tracers who do have expertise in other areas. And maybe that’s not an area that a public health department has looked at before….I think it’d be kind of a shame if you introduce people to a role in a local health department setting and then it just becomes temporary and then they go on to the next thing.”
Change
Management Assessing and
addressing change “So when we begin thinking about change management, you need to understand clearly who the leadership is, where is their head around change management. Because if their head is in a place that says, “change is bad”… or “we don’t need change,” then trying to have discussions around change management is going to be really difficult. The problem that gets created then is that as
2 new folks, young folks come into the arena and they are ready for change, you see that tension gets created there.”
Change
Management Strengthening adaptive leadership skills
“One thing we’ve learned about ourselves and was very valuable to our operation here is we learned real quick you have to be flexible. Don’t fall in love with a plan because the plan is gonna change...We had to be aware of [changing COVID-19 messaging] and realize that we have to remain flexible and when things change, we have to change with it.”
Change
Management Forming and
maintaining effective partnerships
“For us in public health, we’re so used to working with partners and we do such a great job there but sometimes, you know, we have conversation upon conversation but the movement and the action to something, that’s the activity that sometimes seems lacking…How you go from strategy thinking to implementation and ultimately, evaluation, is something that is lacking, especially when it comes to partners.”
Justice, Equity, Diversity, and Inclusion
Implementing general
JEDI principles “Talking about these issues can be really challenging in some of our rural areas of the state. In some cases, it’s maybe a perception of a lack of readiness for communities to engage in that conversation. Maybe it’s even having the courage and support to engage in those conversations.
How to engage in those conversations. How do we look at data? How do we collect the data that show some of those inequities? And how do we share that with our community with also a mind to not re-traumatize the communities that are already most impacted by the issue? When I think about skills needed to support justice, equity, diversity, and inclusion—whether it’s within the workplace or within the broader community—how to talk about these issues... how to present the information… how to elevate equity in a community [are needed].”
Justice, Equity, Diversity, and Inclusion
Implementing general
JEDI principles “I think we have a lot of work to do at all levels of the agency, frankly, in terms of having conversations around race and how that impacts equity...We’re gonna have leaders coming from below that really are gonna need the space to be able to teach those that may be in those named leadership positions…I think we’re going to have to be open to a different way of learning about equity and race because I don’t think it’s going to be top-down.”
Justice, Equity, Diversity, and Inclusion
Implementing general
JEDI principles “[Our training] talks about the history of tribes, it talks about how tribes were formed and they're how they're governed…[We’ve provided it] to our staff...we've also provided it to like state health department staff [and] ...other partners that we work with…I think everyone gets off on a good start that way.”
3 Justice, Equity,
Diversity, and Inclusion
Strengthening JEDI performance management
“We can declare racism is a public health crisis and then what?...There are plenty of people out there who want to see an equitable world, they just don’t know how…Part of [the issue] is that the approach to addressing our own implicit biases hasn’t been done very well.… We have to get better at describing what the actual benefit is. ‘So what? Why do we have to do this?’ is a response that I think we’re going to get. We really have to craft ways to get people to understand what a difference it makes.”
Effective
Communication Strengthen external- facing communication efforts
“If you can’t communicate well with people or communities, you really don’t have much as far as an impact…How do we reach out to communities that are relatively different from us? How do we resonate with them?… How can we communicate and work with communities and give them what they need...[even if] it may not be directly related to public health?...if you think about social determinants of health, how can we make the connection, how can we come in and be viewed, how can we be accepted into their inner circle?”
Effective
Communication Strengthen external- facing communication efforts
“Well, COVID was made way too political the whole time we’ve been dealing with it. So politics, unfortunately, have taken away from the importance of you having a well-respected, hard-working health department that has done their research, has some data- and science- based guidelines, and wants to provide education, not only to the wider community, but maybe possibly a particular business owner, a particular company, a particular bar or restaurant where we might be concerned that we have potential risk. So because politics has been the underlying factor in, unfortunately, a lot of missteps along the way, it has made it increasingly challenging to take facts and data and science and present it in a way that is well received by the community, depending on the political makeup of your public...Meeting people where they are at [is needed]. So if you have a community that very much doesn’t believe in masking because their political tendencies are leaning towards candidates or individuals that are campaigning on a platform that masking doesn’t work, then you have a whole lot of work ahead of you. As opposed to a community next door to ours where possibly it’s a little more socially-normed, it may be a few more steps ahead of us. Navigating that is tricky too.”
Effective
Communication Strengthening internal
communications “Telework’s been a challenge, adjusting to that. I like the interaction with my team and…I know we’re better when we’re working as a group so I’ve been looking at ways to bring teams together through supervisor calls, through all-staff calls, and then even breaking it down to one-on-ones.
What is the reporting back and forth from teams to managers? That was a challenge.
Communication was difficult at first. A lack of interaction with teams and what that meant for professional development, and to some extent, even mental health for some.”
