Overview of the National Health Educator Competencies Update Project, 1998-2004

Health Education Specialist Practice Analysis 2015 (HESPA 2015)

The Health Education Specialist Practice Analysis 2015 (HESPA 2015) was conducted to update and validate the Areas of Responsibilities, Competencies, and Sub-competencies for Entry- and Advanced-Level Health Education Specialists. Two data collection instruments were developed—one was focused on Sub-competencies and the other on knowledge items related to the practice of health education. Instruments were administered to health education specialists ( N = 3,152) using online survey methods. A total of 2,508 survey participants used 4-point ordinal scales to rank Sub-competencies by frequency of use and importance. The other 644 participants used the same 4-point frequency scale to rank related knowledge items. Composite scores for Sub-competencies were calculated and subgroup comparisons were conducted that resulted in the validation of 7 Areas of Responsibilities, 36 Competencies, and 258 Sub-competencies. Of the Sub-competencies, 141 were identified as Entry-level, 76 Advanced 1–level, and 41 Advanced 2–level. In addition, 131 knowledge items were verified. The HESPA 2015 findings are compared with the results of the Health Education Job Analysis 2010 and will be useful to those involved in professional preparation, continuing education, and employment of health education specialists.

A Qualitative Analysis of Health Education Practice in Applied Work Settings

Job analysis projects play a critical role in the health education profession by validating what is constant in the profession and identifying emerging patterns of effective practice. In this regard, the Role Delineation Project, Competencies Update Project (CUP), and Health Educator Job Analysis Project (HEJA) have provided frameworks for the accreditation of professional preparation programs, credentialing, and continuing education of health education specialists. To date, projects (CUP, HEJA, and Health Education Specialist Practice Analysis) have revalidated the framework to help describe the contemporary practice of health education specialists. Evidence is lacking regarding exactly how the frameworks have been integrated into applied practice and what guides the practice of health educators. In context of the Areas of Responsibility for health education specialists, the purpose of this qualitative study was to examine the gap between the "state of the art" and the "state of the practice" among health education practitioners in a range of workplace settings. Data were collected through structured interviews and analyzed for emergent themes. Major themes included the use of formal and informal assessment methods, program-specific planning materials and implementation strategies, supplemental materials for planning and conveying information, and the influence and work with organizations. Based on the emergent themes, the gaps between the "state of the art" and the "state of the practice" were described, with suggestions for advancing the profession.

Knowledge, instruction and behavioural change: building a framework for effective eczema education in clinical practice

AIMS

A discussion on the reasons educational interventions about eczema, by nurses, are successful, with the subsequent development of a theoretical framework to guide nurses to become effective patient educators.

BACKGROUND

Effective child and parent education is the key to successful self-management of eczema. When diagnosed, children and parents should learn to understand the condition through clear explanations, seeing treatment demonstrations and have ongoing support to learn practical skills to control eczema. Dermatology nurses provide these services, but no one has proposed a framework of the concepts underpinning their successful eczema educational interventions.

DESIGN

A discussion paper.

DATA SOURCES

A literature search of online databases was undertaken utilizing terms 'eczema OR atopic dermatitis', 'education', 'parent', 'nurs*', 'framework', 'knowledge', motivation', in Scopus, CINAHL, Web of Science, Medline and Pubmed. Limits were English language and 2003-2013.

IMPLICATIONS FOR NURSING

The framework can inform discussion on child and parent education, provide a scaffold for future research and guide non-specialist nurses, internationally, in providing consistent patient education about eczema.

CONCLUSION

Founded on an understanding of knowledge, the framework utilizes essential elements of cognitive psychology and social cognitive theory leading to successful self-management of eczema. This framework may prove useful as a basis for future research in child and parent education, globally, in the healthcare community. A framework has been created to help nurses understand the essential elements of the learning processes at the foundation of effective child and parent education. The framework serves to explain the improved outcomes reported in previous nurse-led eczema educational interventions.

Accreditation of Professional Preparation Programs for School Health Educators: The Changing Landscape

The health education profession is committed to maintaining the highest standards of quality assurance, including accreditation of professional preparation programs in both school and community/public health education. Since 2001, the Society for Public Health Education (SOPHE) has increased attention to strengthening accreditation processes for preservice programs. This article focuses on the preparation of school health educators and the evolving philosophies and approaches concerning quality assurance, with particular attention to recent changes in teacher education and national professional accreditation entities. The unification of the National Council for Accreditation of Teacher Education (NCATE) and the Teacher Education Accreditation Council (TEAC) to form the Council for the Accreditation of Educator Preparation (CAEP) as the single voice for teacher accreditation presents an opportunity to create a model unified accreditation system. Such a system can improve and enhance the stature of the teaching profession, raise expectations and the performance standards for teacher education candidates, and strengthen the standards for the evidence used to support claims of quality. During this transition period from NCATE and TEAC to CAEP, a School Health Education Accreditation Working Group convened by SOPHE recommended to the SOPHE Board of Trustees that SOPHE urge health education professionals to monitor and provide input into the emerging standards and processes for school health educator program accreditation. The Working Group also recommended that both health education professionals and the stakeholder professional organizations advocate for strong quality assurance standards for school health educator professional preparation programs. The Working Group anticipates future changes in quality assurance processes and curricula to keep pace with new accreditation requirements and the results from the latest role delineation research for health education specialists.

New developments in undergraduate education in public health: implications for health education and health promotion

The article provides an overview of efforts to improve public health and health education training and on the potential use of Critical Component Elements (CCEs) for undergraduate health education programs toward more consistent quality assurance across programs. Considered in the context of the Galway Consensus Conference, the authors discuss the need for consistency in health education and public health quality assurance and curricular development. They discuss emerging quality assurance trends in relation to newly approved CCEs by the Association of Schools of Public Health after being developed by the Framing the Future Task Force: The Second 100 Years for Public Health. The CCE development process is discussed including its consideration as a tool program, which can be used to develop or refine undergraduate health education professional preparation programs. The authors suggest that CCEs should be "cross-walked" against existing health education undergraduate-level competencies. The authors conclude that CCEs may serve the long-term health education goal of accreditation for undergraduate health education and promote the tradition of strong undergraduate health education within a broader framework of public health and health promotion.

The National Health Educator Job Analysis 2010: process and outcomes

The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience levels in a seven-step instrument development process. An online survey was then completed by 1,022 practicing health educators. Survey participants used 4-point ordinal scales to rank subcompetencies by frequency of use and importance and related knowledge items by cognitive levels based on the Revised Bloom's Taxonomy. Composite scores were calculated and subgroup comparisons conducted to validate 223 subcompetencies at entry (162), advanced-1 (42), and advanced-2 (19) levels of practice, along with 113 knowledge items. Advanced-level versus entry-level competencies and a comparison with the Competency Update Project model of 2006 are discussed. Implications and recommendations for the profession are provided.

Steps for Strengthening the Health Education Profession

Since its founding in 1950, the Society for Public Health Education (SOPHE) has evolved in response to the changing needs of both the public and the profession. This SOPHE Presidential Address provides a brief review of SOPHE’s history and the legacy of its achievements over some 60 years. It also describes how new challenges being created by the pending organizational realignment between SOPHE and the American Association for Health Education, which promises to further unify the profession, along with changing American community demographics, can provide an opportunity for SOPHE to strengthen the health education profession by becoming more inclusive and further redefining Dorothy Nyswander’s concept of the “Open Society” and the role health educators play as agents of change.

A summative report of applications submitted for the experience documentation opportunity for the master certified health education specialist credential

The purpose of this article is to provide a summative report of the applications submitted for the Experience Documentation Opportunity (EDO), implemented by the National Commission for Health Education Credentialing, Inc. (NCHEC). The EDO was a one-time, 6-month opportunity for health education specialists holding the entry-level certification (Certified Health Education Specialist or CHES) for 5 or more continuous years, with active status, to submit documentation to verify practice at the advanced level to become a Master Certified Health Education Specialist (MCHES), the new advanced certification. The EDO process was rigorous and effective in verifying a professional's level of practice. A total of 862 applications were submitted to NCHEC; 819 were approved, 36 denied, and 7 withdrew. Frequency distributions indicate which advanced-level subcompetencies were used the most and least for applications. Results of the EDO process provide valuable information regarding characteristics of the first cohort of MCHES, as well as a direct assessment of advanced-level practice in the field of health education.

Key questions for conducting role delineation research

Role delineation research for the verification of professional competencies is essential in many professions to promote quality assurance and support capacity building and workforce development. In this article, guidance is provided about key aspects of role delineation research. The information contained in this article focuses on 13 key questions within three selected research phases when attempting to identify and verify the roles that are inherent within any given profession. The major sections in the paper include planning the research, collecting and analyzing the data, interpreting findings, and considering the future. Recommendations and examples related to each of the important questions are provided to assist others undertaking role delineation research.

Why a coordinated accreditation system benefits school health education programs: a response to Clark's commentary

BACKGROUND

Concerns about a coordinated accreditation system for professional preparation programs in school health education were raised by Clark in a commentary published in the October 2009 issue of the Journal of School Health. The purpose of this article is to clarify information presented by Clark as well as offer alternative views to some of his opinions.

METHODS

To provide context, an overview is provided about efforts to strengthen quality assurance systems for school and community health education. Additional topics address the Dallas II conference, generic competencies, unification of the profession, National Council on Accreditation of Teacher Education/Teacher Education Accreditation Council, competency-based vs settings approach, and CUP implications.

RESULTS

In the discussion, the authors address several key points raised by Clark and note areas of agreement, alternative views, and clarification of facts.

CONCLUSIONS

The conclusion summarizes the benefits of accreditation for school health education and the health education profession.

Workforce development: using role delineation research findings for policy-making and professional practice

For the health education profession in the United States, role delineation research has been ongoing to identify valid professional competencies as the basis for workforce development. During 1998—2004, a multi-phase national research study, the National Health Educator Competencies Update Project (CUP), was designed to re-verify the role of the entry-level health educator, and further define and verify the role of advanced level health educators. The CUP findings are the evidence that has influenced the professional preparation, credentialing, and professional development of health educators. The lessons learned include the importance of employing role delineation research with a discipline-specific representative sample to appropriately affect workforce development and sustainability through an empirically-based model.

Marketing Health Educators to Employers: Survey Findings, Interpretations, and Considerations for the Profession

In July 2007, a market research report was produced by Hezel Associates on behalf of five sponsoring health education profession member organizations and the National Commission for Health Education Credentialing. The purpose of the survey was to learn about current or potential employers’ knowledge, attitudes, and behaviors toward health educators and the health education profession and their future hiring practices. This article presents the background leading up to the production of this report, the major findings of the survey of employers, recommendations from the market research group regarding core messages, and implications for the profession having discovered for the first time information about employers’ understanding of professionally prepared health educators. The article discusses the umbrella and key messages that may be incorporated into a marketing plan and other recommendations by the firm that should assist health educators in marketing the profession. Furthermore, this article presents reactions by leaders in this field to these messages and recommendations and concludes with next steps in this project and a call for the overall need to market the profession of health education.

The Galway Consensus Conference: international collaboration on the development of core competencies for health promotion and health education

Developing a competent health promotion workforce is a key component of capacity building for the future and is critical to delivering on the vision, values and commitments of global health promotion. This paper reports on an international consensus meeting to identify core competencies, jointly organized by the International Union for Health Promotion and Education (IUHPE), the Society for Public Health Education (SOPHE) and the US Centers for Disease Control (CDC), with participation from international leaders in the field, that took place at the National University of Ireland, Galway, in June 2008. The purpose of the meeting is outlined and the outcomes in terms of strengthening global exchange, collaboration and common approaches to capacity building and workforce development are discussed. The Consensus Statement, based on the proceedings of the meeting, outlines core values and principles, a common definition and eight domains of core competency that are required to engage in effective health promotion practice. The core domains of competency agreed to at the meeting are: catalysing change, leadership, assessment, planning, impementation, evaluation, advocacy and partnerships. A summary of the Consensus Statement is presented and further dialogue and discussion are invited in order to continue the process of building international consensus with regard to health promotion core competencies. (Global Health Promotion, 2009; 16 (2): pp. 5—11)

Building Health Promotion Capacity in Developing Countries: Strategies From 60 Years of Experience in the United States

The Galway Consensus Conference articulated key definitions, principles, values, and core domains of practice as the foundation for the diffusion of health promotion across the globe. The conference occurred in the context of an urgent need for large numbers of trained health workers in developing countries, which face multiple severe threats to the health of their people. In this article, the authors draw on the experience acquired by the health promotion profession in the United States to illustrate what might be done to build health promotion capacity in developing countries. They examine the profession's experience in the areas of accreditation and certification, research and publications, advocating for the profession, and advocating for public health policy. Finally, the authors direct a challenge to the profession in the United States to extend a hand to developing countries to assist them in expanding their capacity to prepare health promotion professionals and deliver health promotion services.

Current developments in accreditation and certification for health promotion and health education: a perspective on systems of quality assurance in the United States

The health education profession in the United States employs parallel, and overlapping, systems of voluntary credentialing to ensure quality in professional preparation. The U.S. approach to quality assurance comprises credentialing at the individual level, including certification, and at the institutional level, including regional and program-specific accreditation or approval of professional preparation degree programs. These multiple systems and levels of quality assurance have evolved during a half century but have not been uniformly available or universally embraced by the field, employers, or those in the institutional settings in which health educators now receive their professional preparation. This article reviews the current scope of credentialing systems in the United States and explains whom they serve and how they function. Recent developments that are now reshaping the landscape of quality assurance in health education and health promotion are also discussed.

Perspectives on health promotion competencies and accreditation in Europe

There is a growing and diverse health promotion workforce in Europe; however, no overall body has responsibility for quality assuring standards of training and professional practice at the European level. This paper provides an overview of recent developments in Europe, including initiatives led by the International Union for Health Promotion and Education, in the context of developing a pan-European accreditation system. Specific developments on establishing national-level accreditation processes in the UK, Estonia and The Netherlands are examined. While there is limited experience in this field across Europe, lessons can be learned from those countries with established systems. This paper focuses on those countries which have developed competencies, standards and accreditation systems, and the implications for developing a pan-European accreditation system are discussed. Differences between countries in the formats, content and processes of developing accreditation, coupled with the different educational, practice, political and resource situations, reflect the complexity of developing a pan-European system that is flexible, relevant and comprehensive. The development of competencies, standards and accreditation is not intended to be directed at health promotion specialists alone but aims to assure quality in performance of all those who contribute to health promotion, from whatever background or area of professional practice. It is likely that there will be a need to develop a robust system that will accommodate different levels of accreditation for different levels and fields of practice. Developing a pan-European accreditation system poses a significant challenge but also presents a unique opportunity to form a solid basis for building capacity and assuring quality for health promotion practice, research and training across the European region.

Toward International Collaboration on Credentialing in Health Promotion and Health Education: The Galway Consensus Conference

The interest in competencies, standards, and quality assurance in the professional preparation of public health professionals whose work involves health promotion and health education dates back several decades. In Australia, Europe, and North America, where the interest in credentialing has gained momentum, there have been rapidly evolving efforts to codify competencies and standards of practice as well as the processes by which quality and accountability can be ensured in academic professional preparation programs. The Galway Consensus Conference was conceived as a first step in an effort to explore the development of an international consensus regarding the core competencies of health education specialists and professionals in health promotion and the commonalities and differences in establishing uniform standards for the accreditation of academic professional preparation programs around the world. This article describes the purposes, objectives, and process of the Galway Consensus Conference and the background to the meeting that was convened.

Perspectives on Terminology and Conceptual and Professional Issues in Health Education and Health Promotion Credentialing

This article was prepared to inform the deliberations of the Galway Consensus Conference by providing a common and global reference point for the discussion of terminology and key conceptual and professional issues in the credentialing of health education and health promotion specialists. The article provides a review of the terminology that is currently employed across different countries in defining health education and health promotion as well as health educator and health promotion specialist. The terminology used to describe concepts in professional credentialing of health education and health promotion specialists and the scope of professional responsibilities of such specialists, including the terms professional competencies, professional standards, and accreditation, are also reviewed. Finally, key unresolved issues are identified and discussed from a global perspective. The article concludes that despite differences in terminology in the definitions of roles and responsibilities, health education and health promotion are conceptually more similar than different across countries.

A review of the international literature on health promotion competencies: identifying frameworks and core competencies

Building a competent health promotion workforce with the necessary knowledge and skills to develop, implement and evaluate health promotion policies and practice is fundamental to mainstreaming and sustaining health promotion action. This paper reviews the international literature on competencies in health promotion, examines the competencies developed to date, identifies the methods used in their development and considers what can be learned from the experience of others when establishing international core competencies. The paper considers the advantages and disadvantages of employing a competency approach and the extent to which the competencies identified to date can enhance the quality of practice and update the skill set required to work within changing social, cultural and political contexts.

Strengthening Quality Assurance in Health Education: Recent Milestones and Future Directions

The health education profession has a lengthy history of efforts to assure the quality of health education professional preparation and practice. These initiatives to improve the value and accountability of health education are not only beneficial to current practitioners and faculty but also to consumers, students, employers, other professional colleagues, and numerous other stakeholders. This article describes the movement during the last decade to further strengthen quality assurance in health education, including current credentialing mechanisms for individuals and academic programs, the efforts of three national accreditation task forces, and the 2006 Third National Congress for Institutions Preparing Health Educators (Dallas II). Post—Dallas II activities related to program accreditation and approval and individual certification are presented as well as future directions for the health education workforce.

A role delineation study of health educators in the United States: methodological innovations

This paper focuses on methodological innovations used in the National Health Educator Competencies Update Project (CUP) in the United States. The CUP was a six-year research study designed to delineate the role of the health educator in the USA. Individuals who self-identified as health educators were included in the study. To provide context, the background for the research is presented, followed by a brief overview of the research process. Some of the key methodological innovations discussed are: selecting a representative sample when the total population of those working as health educators was not easily identified or readily accessible; assessing response methodology preferences through pilot studies; enhancing the response rate through accurate, up-to-date mailing lists and incentives; and exploring new approaches to large-scale data analyses. Insights gained are included for other researchers who may wish to undertake similar studies or draw from the CUP dataset for secondary analyses.

Public health educators' participation in teams: implications for preparation and practice

Collaboration among public health organizations is essential to ensuring the health of the public. Much of the day-to-day work of public health educators is done in groups or teams or in consultation with others. This study examined the extent of health educators' work in teams as a proxy for collaboration. Health educators participated in an average of four teams per individual; three of these were interorganizational teams. Moreover, 40% of the respondents participated in five or more teams. Health educators supervised by other health educators were more likely to work in interorganizational teams than were those supervised by other professionals. Certified Health Education Specialists were more likely to participate in intraorganizational teams. Curricula in academic programs should reflect the extensive teamwork in which health educators are involved. Employers need to provide health educators with grounding in organizational priorities and support to carry out their collaborative work.