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Fieldwork Handbook CUNY SCHOOL OF PUBLIC HEALTH at HUNTER COLLEGE Fall 2012 Revised 1/27/2012 Contents Contents 2 Introduction 3 Fieldwork Site 5 The Major Players 6 Relationship Between Fieldwork & Capstone 8 Fieldwork Timeline 8 Guidance on Deliverables 11 (Fieldwork Contract, Literature Review and Reflections on Fieldwork) CUNY Policy for Student Research with Human Subjects 12 Fieldwork Waiver 12 Forms 14 A. Prospective Fieldwork Student Information Form 15 B. IRB Research Determination Form 17 C. Preceptor’s Evaluation of Fieldwork Student 20 D. Student‘s Evaluation of Fieldwork Experience 29 E. Fieldwork Log [required by selected programs] 31 F. Request to Waive Fieldwork 32 Appendix 33 A. Sample Field Contract 34 B. Sample Literature Review 37 C. Sample ‘Reflections on Fieldwork’ 40 CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 2 of 43 1. Introduction The Council on Education for Public Health (CEPH) is the accrediting body for public health programs and schools in the United States The CUNY School of Public Health at Hunter College (SPH) is CEPH-accredited as of June 2011, and this includes the MPH and MS degree programs in each of the SPH consortial campuses -- Brooklyn College (GPH and HCPA), Lehman College (CBPH) and Hunter College (BIOS/EPI, COMHE, EOHS, HPM & NUTR) and the DPH program at The Graduate Center. CEPH requires that all MPH students in its accredited programs demonstrate the application of basic public health concepts through a practice experience that is relevant to the students’ areas of specialization. In the SPH, fieldwork experience provides MPH and MS students with the opportunity to demonstrate their ability to use the knowledge gained during their graduate coursework. Each MPH and EOHS-MS student completes a supervised practice experience while signed up for a fieldwork course. The table on the next page provides a summary of these courses by campus and degree program. The goal is to match students to field organizations appropriate to their specialization and on the basis of their individual interests, professional goals and needs. The supervised practice experience strives to increase students’ understanding of public health organizations while improving their professional self-confidence through involvement in developing, planning, organizing, executing and evaluating public health activities. Fieldwork placements may involve program planning, implementation or operation, applied public health research, community health education and outreach, health advocacy or other appropriate public health-related work. During the fieldwork period, students are required to follow the policies, rules and regulations of the field organization, as well as seek and accept the field preceptor’s guidance and appraisal of performance throughout the placement. Students should share with the field preceptor any questions and concerns regarding the progress of the fieldwork and secure approval of the field preceptor for plans how to best use, disseminate or publish information gleaned from the project. Fieldwork faculty are responsible for developing and implementing policies regarding the approval of preceptors and placement sites and for supervising students in the selection and evaluation of their field placements. This packet presents the policies and procedures for selection, approval, execution, completion and evaluation of the fieldwork experience and provides the forms that must be submitted as part of the fieldwork course. Prerequisite: Completion of 18 credits toward the master's degree, including at least 3 required core courses (biostatistics, epidemiology, and the course most relevant to your specialization) and at least 2 courses in students' specialization. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 3 of 43 Practice Experience in the MPH and EOHS-MS Degree Programs Degree Campus Program Course Course name Practice Credits no. hours Master in Lehman Community-Based PHE 790 Public Health 180 3 Public Public Health (CBPH) Internship Health (MPH) Brooklyn General Public Health HNSC Internship in 150 3 (GPH) 7920 Public Health optional optional Health Care Policy & optional optional 150 3 Administration HNSC Internship in (HCPA) 7921 Public Health II 1 Hunter Biostatistics (BIOS) PH 737 Supervised 210 3 Community Health Fieldwork (COMHE-MPH) Environmental & Occupational Health Science (EOHS-MPH) Epidemiology (EPI) Health Policy & Management (HPM) Hunter Public Health Nutrition PH 737 Supervised 210 (NUTR-MPH) or Fieldwork or 3 NUTR or 300 703 Pre-Professional Practice in Dietetics- Community Master of Hunter Community/Public NURS Community/Public 334 6 Science / Health Nursing/Urban 771 Health Nursing I Master in Public Health NURS & II Public 772 Health (MS/MPH) Master of Hunter EOHS-MS PH 737 Supervised 210 3 Science Fieldwork (MS) 1 Elective field course for students requiring or desiring additional field experience CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 4 of 43 2. Fieldwork Site Options Depending on opportunities available and scheduling demands, students generally have two kinds of options for their fieldwork, either working with: 1) Government or private organizations: the student works with a fieldwork preceptor at that organization to define a research or practice project., or 2) CUNY or other academic institutions: the student works with a faculty member on a public health-related project. A wide range of organizations and agencies can provide a valuable field practicum experience for the student. In general, any organization that researches, provides, plans for, coordinates, organizes, pays for, or regulates public health services is a valid training site. Participating agencies and organizations agree to provide the student with a suitable field experience for a designated period of time and agree to assist in the professional development of that student by identifying an appropriate preceptor. The agency agrees to provide the student with all materials, equipment, and space needed to conduct the work in a professional work environment. The agency submits a written and signed letter of a confirmation that identifies the student, the agreed upon scope of the fieldwork project, and expected deliverables from the student. Examples of types of sites include: Federal agencies, such as the USDHHS, Veterans Administration, CDC, USDA, OSHA State, county or city health departments Other state and local health and social service agencies Managed care organizations Neighborhood health centers and community clinics Hospitals (public, nonprofit, for profit) Extended care facilities Community mental health centers Environmental health consulting companies Industrial settings Multi-specialty medical practices Head Start, public schools, private schools, nursery schools Academic or other non-governmental research institute Criteria for site selection The site is able to provide appropriate public health experience as it relates to the student’s career goals and area of concentration. The site is able to provide support and space for the student appropriate for the student’s experience. The environment of the site is safe for the student’s field practicum experience. The site has an available preceptor who is qualified and able to spend time with the student and provide guidance. The preceptor has an understanding of the educational needs of public health students, including the need to increase responsibility and independence gradually. If fieldwork is to be performed in a student’s own current job setting, the student must identify a different supervisor and engage in substantially different assignment outside the scope of his or her usual activities. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 5 of 43 3. Major Players and Their Responsibilities Close cooperation is essential between the following players: Student (the masters degree student) Academic advisor (student’s program advisor, also referred to as ‘advisor’) Fieldwork faculty member -- the faculty member from the student’s program assigned to the fieldwork course for the semester during which the student is registered for the course (also referred to as the ‘fieldwork faculty’). Fieldwork Preceptor (also known as ‘fieldwork supervisor,’ or ‘preceptor’) Student Students are primarily responsible for developing a scope of work for the fieldwork, in consultation with their preceptor and the faculty fieldwork member, and for carrying out that scope of work. Students are also responsible for submitting appropriate paperwork at the beginning and end of the enrolled Fieldwork semester. During the course of the fieldwork project, students are expected to meet regularly with the preceptor to discuss progress and raise any questions or problems regarding the work. Students are expected to treat the fieldwork as they would any job and follow organizational policies and meet all commitments to the agency. Responsibilities of the student for the fieldwork experience include: Identifying and organizing the fieldwork project Submitting appropriate paperwork Following the policies, rules, and regulations of the field agency or organization. Maintaining the agreed upon working hours. Maintaining a professional attitude and conduct. Seeking and accepting the field preceptor’s guidance and appraisal of performance throughout the work period. Sharing with the field preceptor any questions and concerns regarding the progress of the field work. Planning for conferences with the fieldwork preceptor. Attending requested meetings and workshops. For some programs, maintaining a weekly Fieldwork log & submitting all logs to the fieldwork faculty member at the end of the course. Submitting to the host agency all agreed upon deliverables within the time frames indicated by the preceptor. Providing the host agency with a copy of the student’s final capstone project if that project is based on the fieldwork experience. For further information, please contact the fieldwork faculty member in your area of concentration. Academic Advisor By the time students’ complete 12-15 credits of coursework, academic advisors should start discussing with advisees possible fieldwork experiences that would help the student achieve his or her professional CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 6 of 43 goals and objectives. While students take primary responsibility for identifying fieldwork opportunities and making initial contact, academic advisors may assist students in prioritizing their fieldwork goals, and provide assistance with brainstorming and networking. An optional Prospective Fieldwork Student Information Form (see ‘Forms’ section of Handbook) can be completed and shared with Academic Advisors and Fieldwork Faculty to help a student identify fieldwork placement if needed. Fieldwork Faculty Member Within each degree program, the designated fieldwork faculty member approves fieldwork contracts, tracks required fieldwork paperwork, provides guidance and support to the student and site supervisor during the semester, and determines the student’s grade for the course (pass or fail), based on a review of the fieldwork supervisor’s evaluation and additional fieldwork requirements. All fieldwork faculty members must maintain a valid human subjects training certificate, even if they are not currently conducting research with human subjects. The fieldwork faculty member guides and tracks the development of fieldwork contracts, submission of IRB determination forms, and evaluation forms. The fieldwork faculty member assists students and preceptors in resolving problems that arise during fieldwork placement. The fieldwork faculty member assists students in finalizing the conceptualization of Capstone projects, either in relation to the fieldwork project or independent of it. Preceptor The preceptor is the key to a successful fieldwork experience. The preceptor serves as both supervisor and mentor. Preceptors are expected to provide students with an orientation to the organization and project, meet with students regularly, and provide guidance and feedback. The preceptor is expected to have expertise in the area of the student’s project so proper guidance can be provided. Preceptors help students develop a written fieldwork contract specifying the expectations for the fieldwork. Preceptors also complete an evaluation of the student’s performance at the end of the work experience, as the preceptor has the primary responsibility for supervising and guiding the student in the development and implementation of the fieldwork project. The role of the preceptor includes the following activities: CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 7 of 43 Assist the fieldwork student in determining specific, mutually- agreeable, written fieldwork objectives & deliverables to the agency. Orient the student to the field organization’s mission, programs, policies, protocols. Commit time for instructional interaction & dialogue w/ student. Provide supervision of the student’s activities. If indicated, resolve conflicts w/ agency or organization policy. Prepare an evaluation of the student, and discuss it with the student prior to sending it to the fieldwork faculty member. Transmit the student’s final evaluation to the student’s fieldwork faculty member. Share any comments and/or suggestions about the field experience with the course fieldwork faculty. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 8 of 43 4. The Relationship Between Fieldwork and Capstone Fieldwork is a prerequisite for Capstone. In other words, students may start the Capstone course only when they have completed their fieldwork. During the fieldwork semester, students compose a short essay summarizing reflections on their fieldwork experience. This short essay will be incorporated in the student final portfolio, which is submitted during the Capstone semester. The Capstone paper may or may not be developed based on the fieldwork experience. o Practice papers must be based on fieldwork. o Research papers may or may not be based on fieldwork. o Master’s essays and theses may or may not be based on fieldwork 5. Fieldwork Timeline When? Activity One or Two Notify your program advisor of intention to register for fieldwork. Discuss semesters eligibility. If searching for fieldwork opportunities or potential fieldwork before the sites, complete the Prospective Fieldwork Student Information Form planned and share with both your academic advisor and your program’s fieldwork fieldwork faculty member. experience. Register for the next semester’s Fieldwork course once a fieldwork opportunity has been identified. Within the first Students have 2 key deliverables prior to or at the start of the fieldwork two weeks of semester: the semester students are Develop a written Fieldwork Contract which includes the planned work registered for schedule, your learning objectives and a description in general terms of the fieldwork what will be done to achieve the goals of the research. Secure feedback course. from fieldwork faculty member and preceptor. This plan should document plans for regularly scheduled meetings with the fieldwork faculty. Fieldwork student and preceptor should sign the final approved version of the Fieldwork Contract. This signed document should be submitted to the Fieldwork Faculty member. If your fieldwork is going to play a role in your Capstone project, complete an IRB determination form (http://cuny.edu/site/sph/hunter- college/campus-resources/fieldwork.html ) and submit to the IRB office via IRBNet (irbnet.org). PLEASE NOTE: You will have to register as a new user on this site in order to submit the form. If you have questions about the submission process, please direct them to Sarah Leon of the Hunter IRB Office at email@example.com. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 9 of 43 On-going Undertake the fieldwork experience. Meet with fieldwork faculty member throughout the as arranged. It is recommended that you keep a daily/routine log of supervised activities so you can recall how your time was spent, and when you were fieldwork constrained by problems (government, private organizations, investigators; experience. data, methodological, and other problems.) For some programs, this log is a required deliverable. Share your progress routinely with your fieldwork supervisor, fieldwork faculty member and track advisor. End of the All fieldwork students have 3 deliverables towards the end of the semester semester: (1) Submit two relevant evaluation forms: your Student’s Evaluation of Fieldwork Experience Form, and the Preceptor’s Evaluation of your performance. (2) Submit a Literature review: conduct a brief literature review during fieldwork to help guide capstone proposal. If fieldwork is unrelated to capstone proposal topic, then the student should submit a literature review on their capstone topic. See below for guidance on literature review. (3)Complete the Reflections on Fieldwork section of your portfolio. Incorporate your reflections on the fieldwork experience in your portfolio, which is submitted at the end of the capstone semester. th Program-specific 4 requirement: If your program requires submission of a Field Log, submit this also. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 10 of 43 6. Guidance on Deliverables (Fieldwork Contract, Literature Review and Reflections on Fieldwork) All fieldwork students must submit a mutually agreed upon contract on the letterhead of the fieldwork site that is signed by the preceptor. The contract includes the information outlined below. We recognize some of the information may change, but including it in the contract obliges you to think through your project, goals, and expectations a priori with your preceptor. 1. State the competencies the student seeks to accomplish. Look at the list of core and program - specific competencies and incorporate several into your contract. 2. Provide a brief description of work activities you expect to perform. 3. State the total number of hours you will work, including the start & completion dates. 4. Provide a 1-page detailed description of the project in which you will participate. If you cannot provide this information now, provide it as soon as you can, certainly within the first few weeks of your Fieldwork. For a project Identify the type of data sources that will inform the process Identify the kind of process you will use to develop your project Describe what the project will involve List your expected outcomes For research List the tools to be used for obtaining data (description of what will go into survey, type of monitor used, method for locating information, etc.) Provide the number of samples or subjects to be obtained or analyzed Explain where samples or subjects will come from Describe the kind of analysis you anticipate using Literature Review Students are required to review of scientific, professional and public health literature relevant to the fieldwork project early in the fieldwork process and turn-in, upon completion of fieldwork, a brief written literature review (1-4 pages of text) that includes references. For students who write their capstone paper on their fieldwork project, this literature review can later easily be incorporated into the capstone paper or master’s essay proposal, and then expanded into an introduction and/or discussion section of the capstone paper/master’s essay during the capstone class. Students who write their capstone paper or master’s essay on a topic other than their fieldwork project can either submit a literature review on their capstone topic or their fieldwork topic. If the latter, they will have to repeat this process for the new topic, but the experience gained during fieldwork should make the process easier this second time. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 11 of 43 Reflections on Fieldwork (required Portfolio section) Students are required to think about their fieldwork experience and provide written reflections that will become part of section 9 of your portfolio, submitted at the end of the capstone course. This section asks you to provide the following: Reflections on the extent to which your graduate course work prepared you for the fieldwork experience. Reflections on the quality of on-site supervision you received during your fieldwork. Was someone generally available to answer your questions and provide feedback? Discuss the usefulness and value of the feedback you received. Reflections on challenges or problems you encountered during the fieldwork and how they were addressed. What technical or human obstacles did you encounter? Were there any deviations from your original plan or expectations for the fieldwork (for better or worse!). Reflections on the overall quality of the fieldwork. Were there particular skills, knowledge or lessons that you acquired unexpectedly? Explain. Was the fieldwork a good educational experience – why or why not? How did it provide you with a better sense of the skills needed for employment in the profession? Discuss recommendations for improving your fieldwork experience. Explain why you would or would not recommend that other students conduct fieldwork with the same department or agency. 7. CUNY Policy for Student Research with Human Subjects and IRB All students are required to submit an Institutional Review Board (IRB) Research Determination Form at the point they have a general sense of their capstone paper topic and how it will be addressed (sources of information or data). For many students, this will occur before or during their fieldwork project. This brief form describes the project, as well as any human subject involvement, and institutions/individuals involved. The appropriate CUNY campus IRB office (e.g. Hunter IRB Office) will review this document to assess whether a full IRB proposal must be submitted, or if the project is exempt from human subject issues. Research in CUNY Research conducted in the City University of New York (CUNY) is subject to federal regulations, which require that all research protocols involving human subjects be reviewed by an IRB office. However, these regulations allow many types of course-related studies to be exempted from IRB review, depending on potential risks to participants. Definitions Research: Research involves “a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge.” (Citiprogram.org) Human subject: "A human subject is a living individual about whom an investigator conducting research obtains 1) data through intervention or interaction with the individual, or 2) identifiable private information." (Citiprogram.org) Risk: The probability of harm or injury (physical, psychological, social or economic) occurring as a result of participation in a research study. Source: Health Sciences Doctoral Programs Faculty Handbook (Aug 2009). ________________ CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 12 of 43 8. Fieldwork Waiver A practical experience is required of our students in order to assure the competency of our graduates when they enter the field of public health. The professional degree students who graduate from our school, as well as all other accredited schools of public health, must have “skills in basic public health concepts and demonstrate the application of these concepts through a practice experience that is relevant to the students’ areas of specialization.” For MPH students who are admitted to the CUNY School of Public Health possessing extensive public health experience, the fieldwork experience may be waived without credit. Before a waiver is granted, the student must demonstrate “experience in application of basic public health concepts and of specialty knowledge to the solution of community health problems.” Public health knowledge includes the core competencies as well as a population approach to health problems, use of a prevention framework, and collaboration with community partners. The student must also show that their previous experiences relate to specialty knowledge acquired in their specialization track. Eligible students should discuss the possibility of a waiver with their academic advisor within one year of enrollment. The associate dean for academic affairs will determine if the written summary of the student’s experiences demonstrates an adequate applied public health experience in the appropriate area of concentration. The summary should include: Name of the organization(s) Name, title and contact information of supervisor(s) Dates and approximate number of hours of experience Description of how the experience demonstrates application of the core and specialty public health knowledge. (Refer to the core MPH competencies and the competencies for your specialization.) When all parties have signed off, the original form and attachment should be forwarded by the student to the school office for inclusion in the student’s academic file. Copies should also be sent to the track advisor, fieldwork faculty member representing the student’s program, and the SPH evaluation coordinator. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 13 of 43 FORMS A. Prospective Fieldwork Student Information Form (Optional) B. IRB Research Determination Form C. Preceptor’s Evaluation of Student D. Student ‘s Evaluation of Fieldwork E. Fieldwork Log (required by selected programs) F. Fieldwork Waiver Request CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 14 of 43 A. Prospective Fieldwork Student Information Form 1. Last name:_____________________________ First name:___________________ 2. SSN last 4 digits __ __ __ __ 3. Home address:_________________________________________ Apt. _______ 4. City:_______________________________________ State:_____ Zip:_______ 5. Employer (or company name):__________________________________________________ Work address: _____________________________________ Floor/suite:____________ City:_______________________ State:____________ Zip:______________ Job title:__________________ How long at present position? ___ months ___ years How long with your present employer? ___months ___ years 6. Daytime telephone:(__ __ __)- __ __ __ - __ __ __ __ Hours:_____________________ Evening telephone:(__ __ __)- __ __ __ - __ __ __ __ Hours:_____________________ Cell phone:(__ __ __)- __ __ __ - __ __ __ __ 7. Most frequently checked e-mail address:________________________________________ 8. Which degree program are you enrolled in? Circle one: MPH MS MS/MPH 9. Your specialization or track. Circle one: Hunter: BIOS COMHE EOHS EPI HPM NUTR NURS / PH Lehman: CBPH Brooklyn: GPH HCPA 10. When are you planning to complete your graduate degree?__ __/__ __ 11. During which semester are you planning to start and complete your fieldwork? (Indicate semester and year) Start End Fall 20 __ __ Fall 20 __ __ Spring 20__ __ Spring 20__ __ Summer__ __ Summer__ __ Not sure Not sure CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 15 of 43 12. Describe the steps you have taken, if any, towards setting up a fieldwork placement (e.g., contacted someone within the organization where you’d like to work; haven’t contacted anyone yet but know whom to contact, not sure whom to contact, etc.) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 13. Have you selected a site for your fieldwork? Circle one: Yes No (Go to question #15) 14. Provide the following information about your fieldwork site, then skip to question #16 Name of organization:_____________________________________________________ Street address:___________________________________________________________ City:___________________________________ State:____ ____ Zip:____ ____ _____ Name of preceptor: __________________________________________________ Preceptor’s degrees & credentials __________________________________________ Preceptor’s job title:__________________________ Preceptors telephone:______________________ E-mail :_________________________ 15. In which type of organization would you like to be involved for your fieldwork? Mark with the number 1 the organization you’re most interested in, number 2 for the organization you’re next most interested in, and so on. __ Consulting firm __ Labor union __ Health care facility __ Community-based organization __ Government agency __ Other (specify) _____________ __ School ____________________________ __ Private employer ____________________________ 16. What ideas do you have regarding the specific organization and types of project activities you would like to be involved in for your fieldwork? Organization Activities/projects 17. Starting with the most recent, list the professional experience (paid and unpaid) you have had in the field of public health. Attach a current resume. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 16 of 43 B. IRB Research Determination Form HUMAN SUBJECTS RESEARCH DETERMINATION FORM PART I: INVESTIGATOR INFORMATION The following fields are required. PI Name: Course Name / No. (for research/ student practica) Faculty Advisor (FA) Name: Project Title: RESEARCH DETERMINATION FORM Instructions - Information At times it is difficult to determine if a project constitutes research under the federal definition of research in 45 CFR 46. The purpose of this form is to solicit sufficient preliminary information from the project staff for the IRB to provide a determination regarding whether the federal human subjects protection regulations apply to the project. Research is defined in the regulations (45 CFR 46.102(d)) as follows: (d) Research means a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge. Activities which meet this definition constitute research for purposes of this policy, whether or not they are conducted or supported under a program which is considered research for other purposes. For example, some demonstration and service programs may include research activities. Human Subject is defined in the regulations (45 CFR 46.102(f)) as follows: (f) Human subject means a living individual about whom an investigator (whether professional or student) conducting research obtains (1) data through intervention or interaction with the individual, or (2) identifiable private information. Intervention includes both physical procedures by which data are gathered (for example, venipuncture) and manipulations of the subject or the subject's environment that are performed for research purposes. Interaction includes communication or interpersonal contact between CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 17 of 43 investigator and subject. Private information includes information about behavior that occurs in a context in which an individual can reasonably expect that no observation or recording is taking place, and information which has been provided for specific purposes by an individual and which the individual can reasonably expect will not be made public (for example, a medical record). Private information must be individually identifiable (i.e., the identity of the subject is or may readily be ascertained by the investigator or associated with the information) in order for obtaining the information to constitute research involving human subjects. By providing the information requested on the following pages, the HRPP Office will be able to make a determination as to whether the project meets the above federal regulatory definition of research with human subjects. Please answer all questions. If the project does not involve research, no further involvement by the IRB will be necessary for this project. If the project meets the definition of research and living human subjects are involved, you will be advised to file an application for IRB review. PART II: PROJECT INFORMATION The following fields are required. To place a check-mark in a box, double click on the box and select “checked”, then select “OK”. To remove a check-mark from a box, double click on the box and select “Not checked”, then select “OK”. A. Brief project summary, including what you hope to achieve: B. Does the project involve collection or evaluation of data, information, or records Yes No (if no, this is not considered human subjects research and about living human subjects? there is no need to proceed) C. What will the end-product be? (Please internal document teaching materials check all that apply) electronic or print publication improvement of my own teaching or student learning information for presentation outside of CUNY Course Information to be shared with individuals outside of CUNY Course thesis pilot data Other, Explain: D. Intent of the project: educational evaluation CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 18 of 43 (Please check all that apply) educational project (learning experience) program evaluation to contribute to generalizable knowledge (conclusions are to be drawn from collected data, and the information from the investigation is to be disseminated) Other, Explain: E. What is the age range of the subjects? 0-7years 7-11years 12-15 years 16-17 years (Please check all that apply) 18 years old or older F. Who will be the subjects for this project? children adults (Please check all that apply) cognitively challenged individuals immigrants minorities college students college faculty high school students high school teachers middle school students middle school teachers grammar school students grammar school teachers Other, Explain: G. How will you recruit the subjects or email word of mouth phone flyer request access to the records? announcement in a periodical (newspaper, magazine, journal) (Please check all that apply) verbal announcement to a group letter from a class that I teach from a school that I teach at from a class that I don’t teach from a school that I don’t teach at from my own private practice Other, Explain: N/A H. Where will you obtain the contact publically available list (phone book, website, etc) information of the subjects you plan to subjects are known to you personally recruit? list-serve (Please check all that apply) referral from an individual who is personally known to you Other, Explain: I. Where will you conduct the project? at a time and place that is mutually convenient for me and the subject (Please check all that apply) over the phone via email internet based survey at a hospital or medical office public observation social networking site CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 19 of 43 in a class that I teach in a school that I teach at in a class that I don’t teach in a school that I don’t teach at at my own private practice Other, Explain: N/A (Conducting projects at specific institutions requires permission of the head of the institution – ex. Principal, Director, President, etc…) J. What information are you collecting name date of birth age ethnicity from each subject/record? grades test scores (Please check all that apply) address email phone # financial data family demographics health records information regarding risky behavior (including criminal, sexual, and/or ethical behaviors) Other, Explain: K. How will the data be collected? survey/questionnaire, paper survey/questionnaire, electronic (Please check all that apply) interview observation publically available data digital, video, or audio recordings/images educational record review educational exam medical record review medical test/exam Other, Explain: L. How will confidentiality be protected? No identifiers will be collected (the subjects are not known to me, and I will Subjects can not be considered anonymous if never have direct contact with them. They will not be including identifiers on they are known to you. Therefore, if you the data I am collecting know the subjects, your response should be Identifiers will be removed and data will be coded regarding protection of confidentiality, not Identifiers will be collected and maintained, but will not be included in the anonymity. final project Identifiers will be collected and will be recorded in final project Other, Explain: M. Will this project be funded? Yes No N. Additional Comments: CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 20 of 43 PART III: SIGNATURES The following fields are required. A. Required Signatures (Sign the package in IRB Net) The above information concerning the proposed project is correct. If the project is judged to involve human subjects research, I will seek and obtain IRB approval prior to beginning the project. PART IV: OFFICE USE FOR HRPP OFFICE USE: The IRB has determined that this project does not constitute research with human subjects. No further IRB review is necessary. The HRPP Office has determined that this project does constitute research human subjects. Further IRB review is necessary. Please prepare an IRB application package and submit it to the IRB office ______________________________________ ____________ HRPP Coordinator Date CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 21 of 43 PRECEPTOR EVALUATION FORMS (Note: Each Campus / Specialization within CUNY SPH @ Hunter has a Unique Forms) PUBLIC HEALTH NUTRITION Fieldwork Preceptor Evaluation Form Student: ____________________________ Preceptor: _________________________________________ Name of Agency: ___________________________________ Dates of placement: _________to ________ Please check one box in each row. Excellent Above Average Below No opportunity (performs on average (needs to average to observe a level that is improve) professional) PROFESSIONAL QUALITIES 1. Appreciation and knowledge of: a) Technical & political climate within which agency works b) Health education principles and concepts 2. Skills in: a) Planning b) Implementation c) Organizing d) Program analysis and evaluation e) Writing f) Verbal communication g) Nutrition counseling/education OVERALL PERFORMANCE 1. Establishes friendly relationship with co-workers. 2. Organizes and uses time effectively. 3. Considers and incorporates the ideas of others 4. Is able to facilitate work of committees and other groups. 5. Submits accurate, well documented work and reports. 6. Accepts responsibility and completes work assignments 7. Raises innovative ideas and brings out creative and innovative ideas in others COMMENTS (Please respond briefly. Use reverse side if necessary): 1. Special strengths: 2. Skills and knowledge needing further improvement: 3. Other comments: Preceptor Signature_________________________________________ Date: _____________ You are encouraged to discuss this evaluation with the student. Kindly return the completed form to: Dr. Arlene Spark, Hunter College, 2180 3rd Ave, NY NY 10035, or firstname.lastname@example.org . CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 22 of 43 EPIDEMIOLOGY/BIOSTATISTICS Fieldwork Preceptor Evaluation Form Student: ____________________________ Site Supervisor: _____________________________________ Name of Agency: ___________________________________ Dates of placement: ___________________ Please check one box in each row. Excellent Above Average Below No oppotunity (performs on average (needs to average to observe a level that is improve) professional) PROFESSIONAL QUALITIES 1. Appreciation and knowledge of: a) Technical & political climate within which agency works b) Public health principles and concepts 2. Skills in: a) Planning b) Implementation c) Organizing d) Program analysis and evaluation e) Writing f) Verbal communication g) Data manipulation/analysis OVERALL PERFORMANCE 1. Establishes friendly relationship with co-workers. 2. Organizes and uses time effectively. 3. Considers and incorporates the ideas of others 4. Is able to facilitate work of committees and other groups. 5. Submits accurate, well documented work and reports. 6. Accepts responsibility and completes work assignments 7. Raises innovative ideas and brings out creative and innovative ideas in others COMMENTS (Please respond briefly. Use reverse side if necessary): 1. Special strengths: 2. Skills and knowledge needing further improvement: 3. Other comments: Site Supervisor’s Signature_________________________________________ Date: _____________ You are encouraged to discuss this evaluation with the student. Kindly return the completed form to: Dr. Lorna Thorpe, CUNY SPH at Hunter College, 2180 3rd Ave, Rm 546, NY, NY 10035, or email@example.com . CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 23 of 43 HEALTH POLICY AND MANAGEMENT Fieldwork Preceptor Evaluation Form Student: ____________________________ Preceptor: _________________________________________ Name of Agency: ___________________________________ Dates of placement: _________to ________ Please check one box in each row. Excellent Above Average Below No opportunity (performs on average (needs to average to observe a level that is improve) professional) PROFESSIONAL QUALITIES 1. Appreciation and knowledge of: a) Technical & political climate within which agency works b) Principles and concepts related to policy development c) Concepts and procedures related to management 2. Skills in: a) Assessment b) Evaluation c) Budgetary processes d) Policy implementation e) Writing f) Oral communication g) Collaborative team work OVERALL PERFORMANCE 1. Establishes collegial relationship with co-workers 2. Organizes and uses time effectively 3. Listens attentively 4. Facilitates work of program 5. Submits accurate, well documented work and reports 6. Accepts responsibility and completes work assignments 7. Shows creativity or innovativeness COMMENTS (Please respond briefly. Use reverse side if necessary): 1. Special strengths: 2. Skills and knowledge needing further improvement: 3. Other comments: Preceptor Signature_________________________________________ Date: _____________ You are encouraged to discuss this evaluation with the student. Kindly return the completed form to: Dr. Linda McDowell, Hunter College Health Policy and Management Program, 2180 3rd Ave, NYC 10035 firstname.lastname@example.org CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 24 of 43 ENVIRONMENTAL AND OCCUPATIONAL HEALTH SCIENCE Fieldwork Preceptor Evaluation Form Student: ____________________________ Preceptor: _________________________________________ Name of Agency: ___________________________________ Dates of placement: _________to ________ Please check one box in each row. Excellent Above Average Below No opportunity (performs on average (needs to average to observe a level that is improve) professional) PROFESSIONAL QUALITIES 1. Appreciation and knowledge of: a) Technical & political climate within which agency works b) Principles and concepts related to policy development c) Concepts and procedures related to management 2. Skills in: a) Assessment b) Evaluation c) Budgetary processes d) Policy implementation e) Writing f) Oral communication g) Collaborative team work OVERALL PERFORMANCE 1. Establishes collegial relationship with co-workers 2. Organizes and uses time effectively 3. Listens attentively 4. Facilitates work of program 5. Submits accurate, well documented work and reports 6. Accepts responsibility and completes work assignments 7. Shows creativity or innovativeness COMMENTS (Please respond briefly. Use reverse side if necessary): 1. Special strengths: 2. Skills and knowledge needing further improvement: 3. Other comments: Preceptor Signature_________________________________________ Date: _____________ You are encouraged to discuss this evaluation with the student. Kindly return the completed form to: Dr. Frank Mirer, Hunter College, 2180 3rd Ave, NYC 10035, or email@example.com CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 25 of 43 COMMUNITY HEALTH EDUCATION Field Supervisor Evaluation Form Student: _______________________________ Site Supervisor: __________________ Name of Agency: ___________________________________________________________ Dates of Placement: ___________________ No Exceptional Above Average Needs Working To Opportunity To (A+, A, A-) (B+,B,B-) Improvement Improve Please write letter grade in each Observe (Average) (Below appropriate box Average) (C+,C,C-) A. PROFESSIONAL QUALITIES 1. Appreciation and knowledge of: technical and political climate within which agency works. health education principles and concepts 2. Skills in: Planning Implementation Organizing Program analysis and evaluation Consultation Writing Verbal communication Teaching Health Counseling B. OVERALL PERFORMANCE 1. Establishes friendly relationship with co-workers. 2. Considers and incorporates the ideas of others. 3. Organizes and uses time effectively. 4. Is able to facilitate work of committees and other groups. 5. Submits accurate, well documented work and reports. 6. Accepts responsibility and completes work assignments. 7. Raises innovative ideas and brings out creative and innovative ideas in others. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 26 of 43 C. BRIEF COMMENTS 1. Special strengths: 2. Skills and knowledge needing further improvement: 3. Other comments: Site Supervisor’s Signature__________________________________ Date: _____________ You are encouraged to discuss this evaluation with the student. Please return to: Charles Platkin PhD, MPH Coordinator of Fieldwork, Hunter College, 2180 3rd Ave, NY, NY 10035 or firstname.lastname@example.org . Thank you!! CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 27 of 43 GENERAL PUBLIC HEALTH HEALTH CARE POLICY & ADMINISTRATION Fieldwork Preceptor Evaluation Form Supervisor’s Name _________________________________ Title_________________________ Agency __________________________________________________________________________ Phone ___________________________________ E-Mail _________________________________ Address __________________________________________________________________________ Name of Fieldwork Student ____________________________________________________ Date of Evaluation________________________________________________________ PART A - Please evaluate the student by checking the appropriate box.. No opportunity FACTORS: Excellent Very Good Good Fair Poor to observe/does not apply Work performance 1. Arrives on time consistently 2. Uses time effectively 4. Reliably completes tasks on time 5. Effectiveness in written communication 6. Effectiveness in oral communication 7. Ability to identify problems and troubleshoot 8. Overall quality of work produced Work attitudes No opportunity FACTORS: Excellent Very Good Good Fair Poor to observe/does not apply 1. Accepts responsibility 2. Takes initiative 3. Follows policies, rules, regulations of agency 4. Accepts ideas and suggestions of others 5. Performs tasks with industry and CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 28 of 43 drive Professional relationships with: No opportunity FACTORS: Excellent Very Good Good Fair Poor to observe/does not apply 1. Professional staff 2. Support staff 3. Supervisor 4. Personnel from other organizations 5. Patients/ clients/participants 6. General public Application of community health No opportunity Excellent Very Good Good Fair Poor to observe/does skills not apply FACTORS: 1 Assessing health problems 2. Developing health objectives 3. Planning health programs and projects 4. Managing planned programs 5. Evaluating program outcomes 6. Developing budgets 7. Applying research methodologies 8. Compiling health data/statistics 9. Facilitating group process Personal characteristics No opportunity to FACTORS: Excellent Very Good Good Fair Poor observe/does not apply CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 29 of 43 1. Dependability 2. Tactfulness 3. Listening ability 4. Sensitivity PART B – Please rate the fieldwork student on his or her personal fieldwork objectives Met Not Met 1. 2. 3. 4. 5. PART C - Please answer as completely as possible. Use a separate sheet if necessary. 1. What are the outstanding strengths of the fieldwork student? 2. What are the areas needing improvement? 3. Other comments regarding the student. 4. What is your overall assessment of this student? (Circle appropriate letter) A =Excellent; A-- =Very good; B+ or B = Good; B- = Fair; Below B- = Poor. THIS FORM, WHEN COMPLETED, SHOULD BE SENT (BY ) DIRECTLY TO: Robert A. Padgug, Ph.D. Brooklyn College, Department of Health and Nutrition Sciences 2900 Bedford Avenue Brooklyn, New York 11210 Or send by Fax #: 718-951-4670 or email: RPadgug@brooklyn.cuny.edu CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 30 of 43 C. Student’s Fieldwork Evaluation Please provide an honest assessment of your Fieldwork experience 1. Student’s name: ___________________________________________________ 2. Title of project:____________________________________________________ 3. Date of this form: __________________________________________________ 4. Fieldwork start & completion dates:____________________________________ 5. Preceptor’s name & title:_____________________________________________ 6. Agency name and address:___________________________________________ _________________________________________________________________ 7. Total number of hours completed:_____________________________________ 8. Describe the primary duties for which you were responsible:________________ ___________________________________________________________________ ___________________________________________________________________ 9. Overall, how would you rate your fieldwork experience? Excellent Very good Good Fair Poor 10. Rate the level of guidance/mentoring you received from your preceptor: Excellent Very good Good Fair Poor 11. Would you consider working for this agency after you graduate? Yes No Not sure 12. Would you recommend this placement for other students? Why or why not? ___________________________________________________________________ ___________________________________________________________________ 13. Please provide a brief summary of the most important things you learned from your fieldwork experience: ___________________________________________________________________ ___________________________________________________________________ CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 31 of 43 14. How prepared do you think you are in the following areas as a result of your fieldwork? Insert an X in the appropriate box for each competency. Not applicable Very well Well Adequately Inadequately Not to my prepared prepared Prepared prepared prepared project Core public health competency Apply the core functions of public health practice (assessment, policy development, and assurance) Understand basic theories, concepts, models and methods from a range of core and related disciplines and apply them to the design of PH research, policy, and practice. Apply ethical and social justice principles and standards Interpret and apply the public health literature. Use basic statistical and informatics techniques Communicate public health information verbally and in writing Explain key social, behavioral, biomedical and environmental determinants of and inequities in health and disease across the lifespan in urban settings Design and evaluate interventions to prevent or control urban public health problems Collect, analyze and interpret public health data Collaboratively engage with diverse groups Describe the legal foundations of the US public health system and its interrelationships with other systems (e.g. health care, education, environmental protection) Use key planning constructs (e.g. values, vision, mission, goals, objectives and outcomes) Demonstrate knowledge of the context of public and private health care systems, institutions, actors, and environments in which health care and public health policy is made and health care is delivered. 15. On the back of this page, please provide any additional comments or suggestions that would help improve the fieldwork experience. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 32 of 43 D. Fieldwork Log Student’s name ______________________ Fieldwork log #______________________ Agency_____________________________ Date of report __________________________ Preceptor’s name_____________________ Inclusive report dates: from______ to _______ Fieldwork project title____________________ Hours completed this reporting period_______ ____________________________________ Cumulative hours completed______________ Assignments for this reporting period: Meetings, conferences, trainings, etc. attended ______________________________________ during reporting period___________________ ___________________________________ _____________________________________ ______________________________________ _____________________________________ Activities performed during reporting period Date(s) interacted with preceptor _____________________________________ In person_____________________________ ______________________________________ By phone_____________________________ ______________________________________ By e-mail_____________________________ Other (specify) ________________________ New skills employed: Significant events, problems, resolution of problems:__________________________ __________ ___________________________ Lessons (e.g., what insights did you gain from _____________________ ________________ your meetings; what have you learned about __________ ___________________________ your skills and abilities; what are some things _____________________ ________________ you learned about how organizations operate; __________ ___________________________ what are some important management skills _____________________ ________________ you’ve observed?)______________________ __________ ___________________________ ____________________________________ _____________________ ________________ ____________________________________ ____________________________________ Other comments (use reverse side if ____________________________________ necessary): ________________________ CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 33 of 43 E. REQUEST TO WAIVE FIELDWORK The student requesting a fieldwork waiver must complete the section below and attach to it a summary of his or her public health experiences. This summary should tell us the type of educational or professional experiences you are submitting in consideration of a waiver of your practice requirement. The summary should include the name of the organization; name, title and contact information of supervisor(s); dates and approximate number of hours of field-based experience; and a description of how the experience demonstrates application of knowledge from the core and specialty public health areas. This waiver form must be submitted to the SPH Office within 12 months of enrollment. I request a waiver of the fieldwork course. I have extensive public health experience and have acquired skills and content in the core and specialty public health areas. A summary of these experiences is attached. Student ______________________________________________________________ E-mail address_________________________________________________________ Degree, track and campus ________________________________________________ Faculty advisor ______________________________________________________ E-mail address ________________________________________________________ Signatures in support Student’s signature _____________________________________ Date____________ Program director’s signature ______________________________ Date___________ Senior associate dean’s signature ___________________________ Date __________ CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 34 of 43 APPENDIX CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 35 of 43 A. SAMPLE FIELDWORK CONTRACT (TO BE PLACED ON LETTERHEAD) Project Title: Compilation of Administrative Data to Characterize Bedbug Infestation Prevalence and Patterns in Residences in New York City Housing Authority Developments January 18, 2011 TO WHOM IT MAY CONCERN: This is an agreement between Nancy Ralph, (fieldwork - CUNY School of Public Health, Hunter College), and Prabhu Gounder (Supervisor - NYC Department of Health and Mental Hygiene) outlining the tasks and goals of both parties as they relate to the fieldwork to be performed from January 15, 2011 to May 31, 2011 for the NYCHA Administrative Bedbug Data Compilation project. The fieldwork student and supervisor agree that the fieldwork student is responsible for 210 hours of service. Project Description Bedbug infestation prevalence is on the rise nationally1 and has increased dramatically in the past few years, with the City’s 311 line reporting 54% increase in annual inquiries (from 21,922 to 33,772) from 2008 to 2009 alone, and the Department of Education reports doubling the amount of public school treatments (from 243 to 426) during the same time period.2 The 2009 NYC Community Health Survey (CHS) estimated the percent of adults experiencing infestations in the past year to be 6.7%, representing more than 400,000 City residents. Preliminary analysis of CHS data show that bedbug infestations disproportionately affect renters, people of color, immigrants and low-income individuals and those living in low-income neighborhoods.3 While bedbugs are not known to carry disease, they may affect the health, mental health and economic pressures of many New Yorkers. Bedbug bites typically create itching and swelling around the bite area, can lead to interrupted sleep, secondary impetigo infection, rarely severe allergic reactions, and have been associated anecdotally with anemia from blood loss with prolonged exposure.4, 5 NYCHA houses more than 400,000 of the City’s population, and maintains records of insect extermination in all of its apartment units. A high proportion of NYCHA residents are older or low- income, thus potentially more vulnerable to the economic and health impacts of bedbug infestation. Because risk factors for infestation are as yet poorly studied and may be related to building type, neighborhood, or individual behaviors, CUNY, NYCHA and DOHMH hope to develop a telephone-based case-control study to examine risk factors for infestation, persistence and eradication. As a preliminary step to this larger initiative, this project will use NYCHA administrative data to better understand the frequency and person-place-time patterns of bedbug complaints from residents, as well as inspection, extermination and eradication results. Project Details NYCHA will provide raw data on extermination work orders in the past year (2010), with additional aggregate data from prior years if available. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 36 of 43 The goals of this fieldwork are to provide the student with skills and experience in rapidly analyzing administrative data for preparation of the case-control study, as well as developing a flow chart of processes within NYCHA regarding bedbug calls and subsequent extermination services. Administrative data on bedbug calls should be examined to answer questions such as: (1) What proportion of bedbug complaints are verified to be true infestations? (2) What person/family, household or building characteristics are associated with unverified complaints? (3) What proportion of true infestations are cleared in the first visit? Second visit? Third visit? Are currently outstanding? (4) What person/family, household or building characteristics are associated with infestation? With rapid clearance? (5) Do rates of infestation differ between geographic neighborhoods? (6) What characteristics are associated with high infestation buildings? The fieldwork will also accompany NYCHA facilities staff to understand the processes of extermination and data capture, and will incorporate this information into the appendix of a descriptive report. The project details will be determined in part by the quality of the data provide by NYCHA, budgets and external considerations, and specific study design and analysis will be formulated jointly by Nancy Ralph and Prabhu Gounder during the course of the fieldwork placement, and is subject to change. Specific tasks and responsibilities of the fieldwork student Under Preceptor supervision: Draft brief literature review Manage data to be organized, evaluated, and tabulated, using appropriate statistical software or analytical tools as the data format and quantity will determine. Analyze data Draft and edit report (Fieldwork student will write up findings as a rapid report) Assist with preliminary design of case-control survey and survey questions It is expected that the Fieldwork student will develop or demonstrate the following competencies during the fieldwork: Literature research, assessment and summary for project background Project documentation Software coding and use of analytical tools Data cleaning and management Data analysis and summary Skills in written presentation as appropriate. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 37 of 43 Fieldwork Student Fieldwork preceptor Signed: ________________________Date:________ Signed: ____________________________Date:_________ Nancy Ralph Prabhu Gounder 1 Joint Statement on Bed Bug Control in the United States from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Environmental Protection Agency (EPA) 2 Recommendations for the Management of Bed Bugs in New York City, New York City Bed Bug Advisory Board, Report to the Mayor and City Council, April 2010. 3 NYC CHS 2009, unpublished data. 4 Anderson A, Leffler K. Bed bug infestation in the news: a picture of an emerging public health problem in the United States. Journal of Environmental Health. 2008;70(9):24-7, 52-3. 5 Severe anemia from bedbugs, Pritchard, MJ, Hwange, SW, CMAJ • September 1, 2009; 181 (5). doi:10.1503/cmaj.090482. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 38 of 43 B. SAMPLE LITERATURE REVIEW Implementing a program to increase school meal participation and improve the school food environment in a low-income New York City elementary school Kimberley Wong In a recently released Food Research and Action Center (FRAC) report, the South Bronx (New York 16th Congressional District) ranked first and central Brooklyn ranked sixth (New York 10 th Congressional District) in food hardship.1 This report’s unsettling results urge us to further explore hunger and food security, defined as “including both physical and economic access to food that meets people's dietary needs as well as their food preferences,”2 in New York City (NYC) where 37% of residents experienced difficulty affording food in 2010.3 In the United States, an estimated 14.7% of households were food insecure in 2009. 4 However, among households below the official poverty line ($21,756 for a family of four), 43.0% were food insecure and 24.9% and 26.9% of Hispanic and Black households respectively were food insecure compared with 11% in whites.4 Twenty-one percent of households with children under 18 years old were food insecure with single parent households having even higher rates: 35.6% in single mothers and 27.8% in single fathers.4 The higher than average prevalence of food insecurity in families with children raises concerns of the health of children. While caloric energy needs are generally met by food insecure children, dietary quality may be compromised.5 Children from food insecure households have greater odds of being in poor health, having a chronic condition, and having asthma than children from food secure households.6 The association between food insecurity and obesity is well-established, with the risk of obesity being greatest in non-whites.7-10 The growing epidemic of childhood obesity disproportionately affects children of low-socioeconomic status (SES) and certain ethnic minority groups, the same groups that are at high risk for food insecurity. Data from the 2007 National Survey of Children’s Health (NSCH) show Hispanics and non-Hispanic Blacks have more than two times the odds of obesity than non-Hispanic whites.11 Consideration of food insecurity and its associated health risks adds to the challenge of our nation’s call to aggressively address childhood obesity. School meal programs are one avenue to strategically address both food security and improve the diets of food insecure children at high risk for developing obesity and diet-related diseases. The federally assisted National School Lunch Program (NSLP) and the School Breakfast Program (SBP) are provided through the United States Department of Agriculture Food and Nutrition Service (USDA FNS). The NSLP serves free and low cost lunches to more than 31 million children each school day12 while the SBP provides free and low cost breakfast to 11.1 million students per day.13 School meal participation and access have shown to strengthen food security; a recent study showed that households with access to the SBP had lower marginal food insecurity than households without access to SBP.14 School meals provided by the NSLP and SBP follow nutritional requirements based on the Dietary Guidelines for Americans (DGAs), and for many NSLP and SBP participants, school meals may be the most nutritious food consumed in their diets. The literature indicates that dietary intake in NSLP participants is superior to non-participants in certain areas including lower consumption of energy-dense, low-nutrient foods; lower consumption of sugar-sweetened beverages; lower caloric intake; higher fiber CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 39 of 43 intake; and higher calcium intake.15,16 School Breakfast Program participants have been shown to have higher intakes calcium, magnesium, phosphorus, fruits and vegetables, and lower intakes of red meat and cholesterol than non-participants.17 Another study found that in an ethnically-diverse, low socioeconomic status (SES) population with low fruit and vegetable consumption, NSLP provided the primary source of FV for schoolchildren,18suggesting that school meals are an important source of nutrient dense food in low-SES, minority populations. In addition to the nutrition provided by school meal programs, NSLP and SBP participation also provide a protective effect against obesity in girls. 19 Another study found that SBP participants had lower body mass indices (BMI) compared with non-participants.20 Despite positive outcomes seen with school meal programs, NSLP and SBP, NYC has low participation rates in both programs which are administered by the NYC Department of Education Office of SchoolFood (SchoolFood). Of 1.1 million children in NYC public schools, 70% are eligible for free and reduced-price meals.21 However, only 38% of NYC high school students, 70% of middle school students, and 84% of elementary school students participate in the school lunch program.21 Breakfast has a citywide participation rate of 22% despite being free to all NYC students. 21 In the South Bronx where the poverty rate is 41%22 and where food insecurity is very high,1 ensuring that children are participating in SchoolFood programs can have a profound effect on both food insecurity and adverse diet-related health problems. Schools represent an ideal location for interventions that can improve both school meal programs and school environments. Children spend more time in school than any other institution and consume up to 50% of their daily calories during school hours,23 making the school food environment a unique location where healthy eating behaviors can be taught, encouraged, and reinforced. The Institute of Medicine identifies the school food environment, which encompasses all foods eaten in and around a school, as a key area for targeting the childhood obesity in the United States.24 Acknowledging the school environment as a focus area for addressing childhood obesity, congress passed the Child Nutrition and WIC Reauthorization Act of 2004 which mandated that all schools participating in the NSLP enact local wellness policies that set standards on school meals and support a healthful school food environment.25 Researchers and organizations also call for strong school wellness policies, but there is a lack of evidence-based strategies for their implementation.23,26,27 Major challenges and barriers include the lack of funds, dedicated personnel, and time needed to implement and maintain wellness policies and work towards a healthier school environment.28-30 Strategies to address these challenges are also sparse in the literature, especially at the local and building-level. Tool kits and practical guides are available through hunger, nutrition, and wellness organizations; however, the guides are not evidence-based and are largely anecdotal.31-33 We hypothesized that there is a gap between policy mandates and building-level implementation that is especially apparent without a key staff member dedicated to school wellness. Additionally, low school meal program participation rates in NYC indicate that there are barriers to participation that should be addressed. The City Harvest Healthy Schools program aims to fill this gap by placing dedicated Fieldwork students in low-resource NYC schools to provide manpower, strategies, and resources to improve school meal participation and the food environment within the school community which in turn can increase food security and access to healthy food in NYC’s high-need communities. Bibliography 1. Food Research and Action Center (FRAC). Food Hardship in America 2011 - Data for the Nation, States, 100 MSAs, and Every Congressional District. http://frac.org/wp-content/uploads/2011/03/food_hardship_report_mar2011. Updated 2011. Accessed March 10, 2011. 2. World Health Organization. Food Security. http://www.who.int/trade/glossary/story028/en/index.html. Updated 2010. Accessed May 4, 2010, 2010. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 40 of 43 3. Duggan A, Baughman AJ, Spota A. NYC Hunger Experience 2010: Less Food on the Table. 2010. 4. Nord M, Coleman-Jensen A, Andrews M, Carlson S. Household Food Security in the United States, 2009. . 2010;ERR-108:U.S. Dept. of Agriculture, Econ. Res. Serv. 5. Kaiser LL, Townsend MS. Food Insecurity Among US Children: Implications for Nutrition and Health. Topics in clinical nutrition. 2005;20(4):313. 6. Kirkpatrick S, McIntyre L, Potestio M. Child hunger and long-term adverse consequences for health. Archives of pediatrics adolescent medicine. 2010;164(8):754. 7. Olson CM. Nutrition and health outcomes associated with food insecurity and hunger. J Nutr. 1999;129(2S Suppl):521. 8. Townsend MS, Peerson J, Love B, Achterberg C, Murphy SP. Food insecurity is positively related to overweight in women. J Nutr. 2001;131(6):1738. 9. Adams E, Grummer Strawn L, Chavez G. Food insecurity is associated with increased risk of obesity in California women. J Nutr. 2003;133(4):1070. 10. Drewnowski A, Darmon N. The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr. 2005;82(1 Suppl):265. 11. Singh G, Siahpush M, Kogan M. Rising social inequalities in US childhood obesity, 2003-2007. Ann Epidemiol. 2010;20(1):40. 12. United States Department of Agriculture Food and Nutrition Service. National School Lunch Program Fact Sheet. http://www.fns.usda.gov/cnd/lunch/AboutLunch/NSLPFactSheet.pdf. Updated 2010. Accessed November 25, 2010. 13. United States Department of Agriculture Food and Nutrition Service. The School Breakfast Program Fact Sheet. http://www.fns.usda.gov/cnd/breakfast/AboutBFast/SBPFactSheet.pdf. Updated 2010. Accessed November 25, 2010. 14. Bartfeld JS, Ahn HM. The School Breakfast Program Strengthens Household Food Security among Low-Income Households with Elementary School Children. J Nutr. 2011. 15. Briefel R, Wilson A, Gleason P. Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants. J Am Diet Assoc. 2009;109(2 Suppl):S79. 16. Clark M, Fox M. Nutritional quality of the diets of US public school children and the role of the school meal programs. J Am Diet Assoc. 2009;109(2 Suppl):S44. 17. Crepinsek MK, Singh A, Bernstein LS, McLaughlin JE. Dietary effects of universal-free school breakfast: findings from the evaluation of the school breakfast program pilot project. J Am Diet Assoc. 2006;106(11):1796-1803. 18. Robinson-O'Brien R, Burgess-Champoux T, Haines J, Hannan P, Neumark-Sztainer D. Associations between school meals offered through the National School Lunch Program and the School Breakfast Program and fruit and vegetable intake among ethnically diverse, low- income children. J Sch Health. 2010;80(10):487. 19. Jones SJ, Jahns L, Laraia BA, Haughton B. Lower risk of overweight in school-aged food insecure girls who participate in food assistance: results from the panel study of income dynamics child development supplement. Arch Pediatr Adolesc Med. 2003;157(8):780- 784. 20. Gleason PM, Dodd AH. School breakfast program but not school lunch program participation is associated with lower body mass index. J Am Diet Assoc. 2009;109(2 Suppl):S118-28. 21. Kwan A, Mancinelli K, Freudenburg N. Recipes for Health: Improving School Food in New York City. 2010. 22. New York City Department of Health and Mental Hygiene. Community Health Profiles: Take Care Highbridge and Morrisania. 2006. 23. Story M, Nanney MS, Schwartz MB. Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q. 2009;87(1):71-100. 24. Institute of Medicine (IOM). Preventing Childhood Obesity: Health in the Balance. Washington, D.C.: National Academies Press; 2005:414. 25. United States Department of Agriculture Food and Nutrition Service. Section 204 of Public Law 108-265 265—June 30, 2004 Child Nutrition and WIC Reauthorization Act of 2004. http://www.fns.usda.gov/TN/Healthy/108-265.pdf. Updated 2004. Accessed November 10, 2010. 26. Bergman EA, Gordon RW, American Dietetic Association. Position of the American Dietetic Association: local support for nutrition integrity in schools. J Am Diet Assoc. 2010;110(8):1244-1254. 27. Belansky ES, Cutforth N, Delong E, et al. Early effects of the federally mandated Local Wellness Policy on school nutrition environments appear modest in Colorado's rural, low-income elementary schools. J Am Diet Assoc. 2010;110(11):1712-1717. 28. Longley CH, Sneed J. Effects of federal legislation on wellness policy formation in school districts in the United States. J Am Diet Assoc. 2009;109(1):95-101. 29. Agron P, Berends V, Ellis K, Gonzalez M. School wellness policies: perceptions, barriers, and needs among school leaders and wellness advocates. J Sch Health. 2010;80(11):527-35; quiz 570-2. 30. Action for Healthy Kids. From the Top Down: Engaging school leaders in creating a healthier, more physically active school environment. 2008. 31. Action for Healthy Kids. Wellness Policy Tool. http://www.actionforhealthykids.org/school-programs/our-programs/wellness-policy-tool/. Updated 2010. Accessed November 29, 2010. 32. California Project LEAN. Tools and Resources. http://www.californiaprojectlean.org/doc.asp?id=20. Updated 2011. Accessed March 13, 2011. 33. Alliance for a Healthier Generation. Resources and Tools. http://www.healthiergeneration.org/schools.aspx?id=3318. Updated 2009. Accessed March 13, 2011. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 41 of 43 C. SAMPLE ‘REFLECTIONS ON FIELDWORK’ DOCUMENT NAME: Elena Hoeppner Degree/Program: MPH with concentration in Community Health Education Address: Email: Mobile: Fieldwork Org: New York City Law Department Address: 100 Church St. NY, NY Purpose: To develop a worksite wellness program Preceptor/Supervisor: Lisa Forrestor-Campos Dates: Summer 2010 Reflection Summary: My fieldwork took place at the New York City Law Department where I developed an employee wellness program. The idea for this program came about from the Staff Quality of Work Life Committee (SQWLC), which represents non-managerial employees. I was hired as a graduate fieldwork student along with an undergraduate public health fieldwork student who I supervised. We worked with the SQWLC to develop the wellness program, particularly the chair of the committee served as a community informant. The wellness program consisted of a Smart Cafeteria, a walking group, health-related articles in the employee newsletter, and a wellness interest questionnaire. The questionnaire was adapted from the National Health and Nutrition Examination Survey (NHANES), served to assess the health-related interests of employees, and their physical activity and eating habits. The questionnaire was distributed in paper copies during division meetings after I introduced the wellness program ideas. To increase employees’ knowledge of healthy eating habits, I developed the Smart Cafeteria. We posted a laminated list of the calorie content of food from the onsite cafeteria and nearby food stores. In addition, we developed healthy tip table toppers for the cafeteria tables. To encourage physical activity during lunch we created a walking group that met bi-weekly. We provided the participants with detailed walking routes, which included preferred walking areas, a brief descriptions of points of interests, the total distance of the route, and a link to calorie burn calculator. In addition, I delivered bi-weekly emails 2 hours before lunch to motivate the participants to walk that day. To increase employees’ general health knowledge we wrote articles for the bi-monthly employee newsletter. These articles touched on a variety of issues, such as healthy eating habits, physical activity habits, healthy sleeping habits, and methods to reduce stress. Links to websites with more information were also provided. Several challenges arose during the development of the wellness program. The biggest challenge for employee participation was a lack of time, especially for lawyers, many of which did not take a lunch hour. For those employees that could participate in the walking program, the lunch hour was the best time for them. We also emailed information on exercises that could be done at their desks. To further promote CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 42 of 43 the program I posted flyers and talked with employees around the office, noting that the bathroom and elevators were prime locations to casually mention the wellness program. Another challenge was developing the SQWLC’s ownership over the wellness program. I thought that because the committee came up with the idea for the wellness program, and that my fieldwork was temporary, that the SQWLC’s ownership of the program, would increase employee investment in the program and increase its sustainability. However, SQWLC’s participation in development was limited due to the transition of committee members at that time. As I reflect now on this challenge, I see that I could have then turned my efforts towards any other interested staff to develop more responsibility over the program. Increasing the dialogue between the employees and myself could have facilitated their ownership over the program. Department policies posed a challenge to exercising in the office, which restricted employees who were interested in participating in a physical activity class on the premises. In addition, during the development of the survey I learned that I was not allowed to ask about demographic information, which is a standard part of surveys. After describing the importance of knowing a population in public health work, I was allowed to collect demographic information on the paper copy of the survey. A brand new challenge during this fieldwork experience was supervising the undergraduate intern. I quickly wondered, “How do you tell someone to do something without sounding bossy?” With creating wording and suggestive language, I found that it can be done. In addition, not only did I have to keep on top of my to do list, but I also had to keep abreast of what she was working on. In addition, it was one of the first times I was reviewing someone else’s work. My experiences with previous managers and supervisors has taught me exactly what I don’t want to do as a supervisor, and what I’m looking for as a supervisee. A lack of public health expertise at the law department was another obstacles to creating high quality program components. However, this obstacle was overcome by reaching out to professors at school who provided technical assistance, for example, in developing the questionnaire. Furthermore, it seems that the lack of easily available expertise and guidance allowed me to get more done and increase the quality of my work as compared to the work completed during other fieldwork experience where the expertise was available, such as the Community School Wellness Internship. Overall, this internship was a great opportunity to apply what I had learned in class about developing programs and working with community members. In addition, it gave me the freedom to be creative and to surpass my own expectations of what I was capable of. CUNY SPH Fieldwork Handbook Fall 2012 Version: New Coming Soon Page 43 of 43
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