Advancing MCH Interdisciplinary/Interprofessional Leadership Training and Practice Through a Learning Collaborative

The Critical Value of Maternal and Child Health (MCH) to Graduate Training in Public Health: A Framework to Guide Education, Research and Practice

Introduction

In light of persistent health inequities, this commentary describes the critical role of maternal and child health (MCH) graduate training in schools and programs of public health (SPPH) and illustrates linkages between key components of MCH pedagogy and practice to 2021 CEPH competencies.

Methods

In 2018, a small working group of faculty from the HRSA/MCHB-funded Centers of Excellence (COEs) was convened to define the unique contributions of MCH to SPPH and to develop a framework using an iterative and consensus-driven process. The working group met 5 times and feedback was integrated from the broader faculty across the 13 COEs. The framework was further revised based on input from the MCHB/HRSA-funded MCH Public Health Catalyst Programs and was presented to senior MCHB leaders in October 2019.

Results

We developed a framework that underscores the critical value of MCH to graduate training in public health and the alignment of core MCH training components with CEPH competencies, which are required of all SPPH for accreditation. This framework illustrates MCH contributions in education, research and evaluation, and practice, and underscores their collective foundation in the life course approach.

Conclusions

This new framework aims to enhance training for the next generation of public health leaders. It is intended to guide new, emerging, and expanding SPPH that may currently offer little or no MCH content. The framework invites further iteration, adaptation and customization to the range of diverse and emerging public health programs across the nation.

A cluster randomized controlled trial comparing Virtual Learning Collaborative and Technical Assistance strategies to implement an early palliative care program for patients with advanced cancer and their caregivers: a study protocol

BACKGROUND

Virtual Learning Collaboratives (VLC), learning communities focused on a common purpose, are used frequently in healthcare settings to implement best practices. Yet, there is limited research testing the effectiveness of this approach compared to other implementation strategies. This study evaluates the effectiveness of a VLC compared to Technical Assistance (TA) among community oncology practices implementing ENABLE (Educate, Nurture, Advise, Before Life Ends), an evidence-based, early palliative care telehealth, psycho-educational intervention for patients with newly diagnosed advanced cancer and their caregivers.

METHODS

Using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) and Proctor's Implementation Outcomes Frameworks, this two-arm hybrid type-III cluster-randomized controlled trial (RCT) will compare two implementation strategies, VLC versus TA, among the 48 National Cancer Institute Community Oncology Research Program (NCORP) practice clusters that have not historically provided palliative care to all patients with advanced cancer. Three cohorts of practice clusters will be randomized to the study arms. Each practice cluster will recruit 15-27 patients and a family caregiver to participate in ENABLE. The primary study outcome is ENABLE uptake (patient level), i.e., the proportion of eligible patients who complete the ENABLE program (receive a palliative care assessment and complete the six ENABLE sessions over 12 weeks). The secondary outcome is overall program implementation (practice cluster level), as measured by the General Organizational Index at baseline, 6, and 12 months. Exploratory aims assess patient and caregiver mood and quality of life outcomes at baseline, 12, and 24 weeks. Practice cluster randomization will seek to keep the proportion of rural practices, practice sizes, and minority patients seen within each practice balanced across the two study arms.

DISCUSSION

This study will advance the field of implementation science by evaluating VLC effectiveness, a commonly used but understudied, implementation strategy. The study will advance the field of palliative care by building the capacity and infrastructure to implement an early palliative care program in community oncology practices.

TRIAL REGISTRATION

Clinicaltrials.gov . NCT04062552; Pre-results. Registered: August 20, 2019. https://clinicaltrials.gov/ct2/show/NCT04062552?term=NCT04062552&draw=2&rank=1.

“Mommy and Me”: raising implicit followership theories

Purpose

The purpose of this paper is to examine the antecedents to implicit followership theories (IFTs) and make recommendations for developing positive IFTs. Female transformational parenting is highlighted, showing that although followership is typically associated with one’s role in an organization, its development is not relegated to that context. Accordingly, this paper encourages transformational-parenting training and features activities for current leader-training programs to enlighten trainees about their IFTs.

Design/methodology/approach

Through one online and one paper survey, participants self-defined “follower,” rated their female primary caregivers’ transformational leadership during adolescence, reported their IFTs and provided demographic information.

Findings

Qualitative and quantitative data analyses found that the degree to which female primary caregivers demonstrated transformational leadership related to children’s positive IFTs and positive definitions about followers in young adulthood.

Research limitations/implications

Future research should test female caregivers’ influence on IFTs at more advanced stages of one’s career, examine their influence over participants’ followership behavior and incorporate external ratings of leadership and followership.

Practical implications

Recommendations for embedding IFTs into transformational-leadership-training programs are provided, falling into the categories of feedback, reflection/introspection and mentoring/coaching. In the spirit of contemporary approaches to leadership, recommendations require trainees to recognize their biases/knowledge of followers and followership and use that knowledge to facilitate collaboration between leaders and followers.

Originality/value

Findings spotlight female leadership, an often-overlooked source of power in organizations, and go beyond leader/follower dichotomies by insisting on IFTs awareness and development for both parties.