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					Program Operations
Guidelines for STD Prevention




               Training and
               Professional
               Development
             Table of Contents


             FOREWARD                                                                 iii

             INTRODUCTION                                                             iv
               Program Operations Guidelines Workgroup Members                        vi
               Training and Professional Development Subgroup Members                vii
               Training and Professional Development Internal/External Reviewers     vii

             INTRODUCTION                                                            T-1
               Goals/Objectives of Training, Professional, and Career Development    T-2
               Target Audience                                                       T-2
               Responsibilities                                                      T-2

             TRAINING PROCESS                                                        T-3
               Assessment of Training Needs                                          T-3
               Training Approach                                                     T-5
               Areas of Training Need                                                T-6
               Delivery of Training                                                  T-6
               Training Providers and Resources                                      T-7
               Frequency of Training                                                 T-8
               Evaluation of Training Activity                                       T-8
               Post Training and Education Application                               T-9
               Assessing Effects of Skills Development on Performance                T-9

             PROFESSIONAL/CAREER DEVELOPMENT PROCESS                                T-10
               Career Structure                                                     T-10
               Other Developmental Experience Opportunities                         T-11
               Mentoring                                                            T-12
               Individual, Management, and Program Responsibilities                 T-13

             Appendix T-A Job Titles in Public Health                               T-14
             Appendix T-B
               General Examples of Competencies Related to Identified Essential
               Public Health Services                                               T-15
             Appendix T-C Areas of Training in STD Prevention                       T-18



Training and Professional Development                                                       i
     Appendix T-D
       National STD/HIV Prevention Training Centers                          T-23
       Regional Title X Training Centers                                     T-25
       AIDS Education & Training Centers (AETC’s)                            T-26
     References                                                              T-28




ii                                                Program Operations Guidelines for STD Prevention
              Foreword


               The development of the Comprehensive STD Prevention Systems (CSPS) program

               announcement marked a major milestone in the efforts of CDC to implement the
               recommendations of the Institute of Medicine report, The Hidden Epidemic, Con-

               fronting Sexually Transmitted Diseases, 1997. With the publication of these STD

               Program Operations Guidelines, CDC is providing STD programs with the guid-
               ance to further develop the essential functions of the CSPS. Each chapter of the

               guidelines corresponds to an essential function of the CSPS announcement. This

               chapter on training and professional development is one of nine.
                  With many STDs, such as syphilis, on a downward trend, now is the time to

               employ new strategies and new ways of looking at STD control. Included in these

               guidelines are chapters that cover areas new to many STD programs, such as com-
               munity and individual behavior change, and new initiatives, such as syphilis elimi-

               nation. Each STD program should use these Program Operations Guidelines when

               deciding where to place priorities and resources. It is our hope that these guidelines
               will be widely distributed and used by STD programs across the country in the

               future planning and management of their prevention efforts.


               Judith N. Wasserheit
               Director
               Division of STD Prevention




Training and Professional Development                                                                   iii
Introduction



T
          hese guidelines for STD prevention program        topics. The chapter containing the most evidence-based
          operations are based on the essential functions   guidance is on partner services. In future versions of
          contained in the Comprehensive STD Preven-        this guidance, evidence- based information will be
tion Systems (CSPS) program announcement. The               expanded. Recommendations are included in each
guidelines are divided into chapters that follow the        chapter. Because programs are unique, diverse, and
eight major CSPS sections: Leadership and Program           locally driven, recommendations are guidelines for
Management, Evaluation, Training and Professional           operation rather than standards or options.
Development, Surveillance and Data Management,                  In developing these guidelines the workgroup fol-
Partner Services, Medical and Laboratory Services,          lowed the CDC publication “CDC Guidelines—Im-
Community and Individual Behavior Change, Out-              proving the Quality”, published in September, 1996.
break Response, and Areas of Special Emphasis. Ar-          The intent in writing the guidelines was to address
eas of special emphasis include corrections, adoles-        appropriate issues such as the relevance of the health
cents, managed care, STD/HIV interaction, syphilis          problem, the magnitude of the problem, the nature of
elimination, and other high-risk populations.               the intervention, the guideline development methods,
    The target audience for these guidelines is public      the strength of the evidence, the cost effectiveness,
health personnel and other persons involved in man-         implementation issues, evaluation issues, and recom-
aging STD prevention programs. The purpose of these         mendations.
guidelines is to further STD prevention by providing a      STD prevention programs exist in highly diverse, com-
resource to assist in the design, implementation, and       plex, and dynamic social and health service settings.
evaluation of STD prevention and control programs.          There are significant differences in availability of re-
    The guidelines were developed by a workgroup of         sources and range and extent of services among dif-
18 members from program operations, research, sur-          ferent project areas. These differences include the level
veillance and data management, training, and evalua-        of various STDs and health conditions in communi-
tion. Members included CDC headquarters and field           ties, the level of preventive health services available,
staff, as well as non-CDC employees in State STD Pro-       and the amount of financial resources available to
grams and university settings.                              provide STD services. Therefore, these guidelines
    For each chapter, subgroups were formed and as-         should be adapted to local area needs. We have given
signed the task of developing a chapter, using evidence-    broad, general recommendations that can be used by
based information, when available. Each subgroup was        all program areas. However, each must be used in con-
comprised of members of the workgroup plus subject          junction with local area needs and expectations. All
matter experts in a particular field. All subgroups used    STD programs should establish priorities, examine
causal pathways to help determine key questions for         options, calculate resources, evaluate the demographic
literature searches. Literature searches were conducted     distribution of the diseases to be prevented and con-
on key questions for each chapter. Many of the searches     trolled, and adopt appropriate strategies. The success
found little evidence-based information on particular       of the program will depend directly upon how well


iv                                                                 Program Operations Guidelines for STD Prevention
program personnel carry out specific day to day re-         These guidelines, based on the CSPS program an-
sponsibilities in implementing these strategies to in-      nouncement, cover many topics new to program op-
terrupt disease transmission and minimize long term         erations. Please note, however, that these guidelines
adverse health effects of STDs.                             replace all or parts of the following documents:
In this document we use a variety of terms familiar to
                                                            • Guidelines for STD Control Program Operations,
STD readers. For purposes of simplification, we will
                                                              1985.
use the word patient when referring to either patients      • Quality Assurance Guidelines for Managing the Per-
or clients. Because some STD programs are combined
                                                              formance of DIS in STD Control, 1985.
with HIV programs and others are separate, we will use
                                                            • Guidelines for STD Education, 1985.
the term STD prevention program when referring to ei-       • STD Clinical Practice Guidelines, Part 1, 1991.
ther STD programs or combined STD/HIV programs.




    The following websites may be useful:
    • CDC                                                www.cdc.gov
    • NCHSTP                                             www.cdc.gov/nchstp/od/nchstp.html
    • DSTD                                               www.cdc.gov/nchstp/dstd/dstdp.html
    • OSHA                                               www.osha.gov
    • Surveillance in a Suitcase                         www.cdc.gov/epo/surveillancein/
    • Test Complexity Database                           www.phppo.cdc.gov/dls/clia/testcat.asp
    • Sample Purchasing Specifications                   www.gwu.edu/~chsrp/
    • STD Memoranda of Understanding                     www.gwumc.edu/chpr/mcph/moustd.pdf
    • National Plan to Eliminate Syphilis                www.cdc.gov/Stopsyphilis/
    • Network Mapping                                    www.heinz.cmu.edu/project/INSNA/soft_inf.html
    • Domestic Violence                                  www.ojp.usdoj.gov/vawo/
    • Prevention Training Centers                        www.stdhivpreventiontraining.org
    • Regional Title X Training Centers                  www.famplan.org
                                                         www.cicatelli.org
                                                         www.jba-cht.com
    • HEDIS                                              www.cdc.gov/nchstp/dstd/hedis.htm
    • Put Prevention Into Practice                       www.ahrq.gov/clinic/ppipix.htm




Training and Professional Development                                                                          v
     Program Operations Guidelines Workgroup Members

     David Byrum        Program Development and Support Branch, DSTD

     Janelle Dixon      Health Services Research and Evaluation Branch, DSTD

     Bob Emerson        Training and Health Communications Branch, DSTD

     Nick Farrell       Program Support Office, NCHSTP

     Melinda Flock      Surveillance and Data Management Branch, DSTD

     John Glover        Program Development and Support Branch, DSTD

     Beth Macke         Behavioral Interventions and Research Branch, DSTD

     Charlie Rabins     Illinois Department of Public Health

     Anne Rompalo       Johns Hopkins School of Medicine

     Steve Rubin        Program Development and Support Branch, DSTD, New York City

     Lawrence Sanders   Southwest Hospital and Medical Center, Atlanta

     Don Schwarz        Program Development and Support Branch, DSTD

     Jane Schwebke      University of Alabama Birmingham

     Kim Seechuk        Program Development and Support Branch, DSTD

     Jerry Shirah       Training and Health Communications Branch, DSTD

     Nancy Spencer      Colorado Department of Public Health

     Kay Stone          Epidemiology and Surveillance Branch, DSTD

     Roger Tulloch      Program Development and Support Branch, Sacramento, DSTD, California




vi                                                       Program Operations Guidelines for STD Prevention
     Training and Professional Development Subgroup Members

     Frankie Barnes                     Training and Health Communication Branch, DSTD

     Vicki Beck                         Training and Health Communication Branch, DSTD

     John Glover                        Program Development and Support Branch, DSTD

     Mike Mitchell                      Training and Health Communication Branch, DSTD

     Gabe O’Meara                       Training and Health Communication Branch, DSTD

     Anne Rompalo                       Johns Hopkins School of Medicine

     Jerry Shirah                       Training and Health Communication Branch, DSTD

     Kay Stone                          Epidemiology and Surveillance Branch, DSTD




     Training and Professional Development Internal/External Reviewers

     Gale Burstein                      Division of Adolescent and School Health

     Everett Expose                     Training and Health Communication Branch, DSTD

     Rebecca Hathaway                   New York State Department of Health

     Stacy Harper                       Training and Health Communication Branch, DSTD

     Terry Hogan                        Baltimore City Health Department

     Dorotha Thomas                     Epidemiology and Surveillance Branch, DSTD

     Barbara Wills-Hooks                Program Development and Support Branch, DSTD,
                                        Silver Springs, Maryland




Training and Professional Development                                                    vii
Training and Professional Development


INTRODUCTION                                                demic education tend to focus on the development of
                                                            knowledge and understanding. Training emphasizes de-
Training is an essential element in developing the tech-    velopment of skill and proficiency in a specific task or
nical expertise and the skills required for management,     functional area. Developmental work experiences, also
leadership, political effectiveness, and community di-      known as experiential learning, is the practical appli-
agnosis and organization that are needed in a com-          cation of knowledge and skill in an actual on-the-job
plex, multifaceted clinical and social services program.    work setting demonstrating the ability and capacity to
The continuing evolution of public health raises new        perform overall job responsibilities.
challenges to public health personnel, requiring con-
                                                            Health Care Professional in this document is consid-
stant update and enhancement of their knowledge and
                                                            ered synonymous with the term health care worker. It
skills (IOM Future of Public Health, 1988).
   Training, professional development, and career de-       should be used in the broadest sense to include all pro-
                                                            fessions or occupations involved in STD services for
velopment are considered important ways to enhance
                                                            people with or at risk for STDs.
levels of expertise within the organization. All three
processes—training, professional development, and ca-       Training is defined as a set of activities designed to
reer development—play an important role in improv-          develop specific skill levels of workers who are required
ing worker performance of STD prevention activities.        to perform public health prevention functions or tasks.
   Programs to train medical students, physicians, phy-     The training process includes four basic steps: 1) as-
sician assistants, nurse practitioners, nurses, and oth-    sessment of staff proficiency and identification of train-
ers in STD prevention are critical in increasing the ca-    ing needs; 2) development, implementation, and de-
pacity of the primary care system to address public         livery of needed training to address skill and knowledge
health problems, and to ensure delivery of quality ser-     deficiencies; 3) evaluation of the effectiveness of the
vices (IOM Hidden Epidemic, 1997).                          training or skills practice activity on improving skills
   Establishing and maintaining the expertise neces-        development; and 4) evaluation of the effect on worker
sary for health care professionals to perform the re-       performance.
quired functions of STD prevention requires develop-
ing certain knowledge, skills, and abilities. Information   Professional development is a strategy to develop the
                                                            necessary professional expertise within the targeted
seminars, in-service information workshops, health
                                                            workforce. It is considered a higher level of commit-
education, formal academic education, formal orien-
tation, formal training, education and training self-       ment to worker development since it includes infor-
                                                            mation seminars and in-service workshops, formal
study, and developmental work-related experiences are
                                                            academic education, training, and structured experi-
structured methods to support the development of
needed knowledge. Those activities, however, have dif-      ential activities which aid in the growth of workers’
                                                            professional expertise. Professional development is also
ferent emphases from training. Information seminars,
                                                            a four step process but it is broader in scope than the
formal orientation, health education and formal aca-


Training and Professional Development                                                                            T–1
training process. Step one emphasizes overall profes-        Goals/Objectives of Training, Professional, and
sional expertise which includes staff skill proficiency.     Career Development
Step two includes educational and experiential activi-
                                                             The overall staff development goal is to improve per-
ties in addition to training. Steps three and four are
                                                             formance through structured training, professional
similar to the training process.
                                                             development, and career development efforts. STD
Career Development is a planned process that includes        prevention program objectives should reflect these
professional development but also provides opportu-          goals and be consistent with available resources and
nities for worker advancement in a progressive series        overall worker development needs. A training pro-
of jobs within a given field. It is considered the highest   gram, including structured professional development,
level of commitment to worker development since it           should be established to improve and maintain skills
provides a structure offering job progression oppor-         proficiency, and overall expertise, in all staff mem-
tunity for which staff members’ increased levels of          bers and offered as a benefit to external health care pro-
expertise can be applied. Inherent in career develop-        fessionals performing STD prevention related activities.
ment is management’s responsibility for creating a           A career development structure should also be estab-
structure that will support the development of employ-       lished to develop and maintain an effective staff.
ees’ expertise and offer job progression opportunity.

Staff is defined as federal, state, and local personnel      Target Audience
directly supported through program resources, i.e.,
                                                             The target audience may include a wide spectrum of
program employees. This may include persons respon-
                                                             health care workers such as 1) clinicians (physicians,
sible for partner services; supervision and management;
                                                             nurse practitioners, nurses, physician assistants), 2)
clinical and laboratory services; surveillance and data
                                                             disease intervention specialists, 3) clerical support staff,
management; and administrative management and
                                                             4) epidemiologists, 5) health educators, 6) health ser-
clerical functions.
                                                             vice managers or administrators, and administrative
External Partners are defined as health care providers       assistants, 7) social workers, and counselors, 8) scien-
and other professionals responsible for STD preven-          tists, 9) laboratory technicians and technologists, 10)
tion services and activities who are not direct employ-      health information system or computer specialists, 11)
ees of the program. These may include private medi-          public relations, public information, health commu-
cal practitioners; hospital physicians; members of           nications, and media specialists, and 12) biostatisti-
community-based organizations; corrections health            cians. (See attachment T-A for a list of titles). It is the
care personnel; persons working in substance abuse           responsibility of the STD prevention program to ap-
treatment programs; laboratory personnel; profession-        ply its training and other staff development efforts and
als working in and associated with managed care; other       resources continually to improve performance of all
primary care providers, medical or other health pro-         staff and to educate external partners.
fessions students or residents in training, youth coun-
selors, STD/HIV trainers, and outreach workers (IOM
                                                             Responsibilities
Hidden Epidemic, 1997). In addition, partners should
include people and agencies working in special em-           Several key personnel should have direct program re-
phasis areas such as adolescent health centers, man-         sponsibilities for ensuring that an effective training and
aged care organizations, family and primary care phy-        staff development program is part of overall STD pre-
sicians, and reproductive health.                            vention program functions. Managers should estab-
                                                             lish program-level plans, policies, procedures, and
                                                             quality assurance methods to ensure that training, pro-
                                                             fessional development, and career development activi-
                                                             ties and processes are effectively and efficiently incor-
                                                             porated into project management functions. This


T–2                                                                 Program Operations Guidelines for STD Prevention
program structure should support development of the        • identifying possibilities for developing career lad-
staff and external partners as well as reinforce super-      der structures and providing career enhancing op-
visory responsibility for staff development.                 portunities.
   Direct supervisors should be knowledgeable about
                                                           The Division of STD Prevention is responsible for pro-
the particular STD prevention tasks and functions they
                                                           viding technical assistance and evaluation services in
supervise and knowledgeable about tasks and skills
                                                           support of STD prevention program staff development
required to perform these activities. The supervisor
                                                           efforts. That includes responsibility for identifying
should:
                                                           training sources and coordinating provision of train-
• be knowledgeable of the purpose, objectives, and         ing activities required to address skills development
  overall content of training available for members        needs; providing support in training needs assessment
  of their staff                                           and evaluation efforts; and providing technical assis-
• prepare staff for attending training events              tance in support of performance management follow-
• ensure that staff are fully aware of the purpose of      up and quality assurance efforts.
  and the need for training
• ensure that staff understand the requirements and
  expectations for their participation in training
                                                             Recommendations
• ensure or reinforce on-the-job application of skills       • Programs should have in place or should es-
  developed through training                                   tablish a system that incorporates the four
• support using these skills through staff development         basic steps of the training process identified
  efforts                                                      under the definition for training.
• be actively involved in such on-the-job development
                                                             • Programs should develop goals and objectives
  activities as demonstrating skills, observing perfor-
  mance, offering constructive feedback                        for appropriate training for both staff and
                                                               external partners.
• act as a mentor
• assess the skill levels of staff through performance       • Programs should utilize information collected
  observation, feedback, and performance outcome               from evaluation to update and improve the
  review and evaluation                                        entire training process.
• identify and address barriers to the effective perfor-
  mance of any staff member not related to training,         • Programs should establish a policy ensuring
                                                               that training, professional development, and
  such as motivation, communications, or attitude.
                                                               career development are part of their program.
STD prevention programs should assign one or more
                                                             • Program managers should designate individu-
management staff to be accountable for assuring train-
                                                               als with management responsibility for train-
ing and staff development. In smaller programs, a lead
                                                               ing and staff development functions.
person other than management may be designated to
take responsibility. Specific responsibilities include:

• assessing knowledge, skills, and abilities necessary     TRAINING PROCESS
  for proficiency and expertise;
• developing, implementing, and delivering training        Assessment of Training Needs
  and on-the-job developmental experiences to ad-
  dress skill building needs;                              The training needs assessment is part of a systematic
• identifying institutions and other resources which       process to assess the skill proficiency levels of persons
  provide accredited continuing education activities;      performing given functions and to determine what
• evaluating the effect of training and professional or    skills deficiencies need to be addressed by training and
  career development activities on performance; and        other staff development methods. Conducting such
                                                           needs assessments should be a continuing responsibil-
                                                           ity of all STD prevention programs.

Training and Professional Development                                                                          T–3
   Programs should systematically review the need for         skills deficiencies. The results of staff training evalua-
improving performance within the STD workforce,               tion may provide an indication of the training needs
utilizing such sources as performance outcome data;           of external partners.
performance management review; individual employee               Program management should apply a three-phase
issues and concerns regarding development; and                plan for assessing the training needs of STD preven-
changes in mission, functions, or processes. The train-       tion workers. The first phase is to perform a pre-
ing needs assessment process should be used to deter-         assessment or planning stage to determine what is al-
mine what specific skills are needed and what skills          ready known about the skills and training needs and
development responses may be required to address              to establish the plan for gathering and evaluating data
performance concerns identified by those sources.             on the needs assessment. The second phase is the main
   The purpose of the training needs assessment pro-          assessment or data gathering, which includes collect-
cess is to 1) identify the skills and levels of proficiency   ing, analyzing, and synthesizing the information and
that a targeted group of workers may need to perform          opinions regarding skills development needs, and pro-
specific disease prevention activities; 2) determine the      viding criteria and recommendations for the resultant
current level at which the targeted group is in com-          training responses. The third phase of the process in-
mand of these skills; and 3) assess the gap (i.e., the        volves the post-assessment which includes developing
skills deficiency) between these two levels and thus          and explaining the plan to implement the recommen-
determine the training need (USAID Handbook on                dations of the main assessment.
Control of STDs). A training needs assessment is not             Programs should define the purpose for the needs
a survey of employee training wants. It must address          assessment. As part of this process, the program should
the skills development required of specific workers to        1) identify the specific disease prevention activity and
perform an essential program related function.                the related functions or tasks to be assessed; 2)iden-
   Skills deficiencies are likely to occur when 1) a          tify the target group responsible for performing these
worker is new to a given function and the related skill       functions or tasks, and 3) identify the levels of profi-
requirements; 2) the skill requirements of a given func-      ciency needed to perform these functions or tasks. Any
tion have changed owing to advances in methods, tech-         known performance concerns related to these func-
niques, or processes; 3) the worker skills have decayed       tions or tasks should also be identified.
owing to improper use or lack of use; 4) a worker’s              Existing reference documentation that may be help-
basic skill levels need enhancement to make it pos-           ful in collecting training need data should be selected.
sible for an individual to perform more advanced tasks        These reference documents include qualification stan-
and responsibilities.                                         dards, position descriptions, and performance stan-
   The training needs assessment will help program            dards related to the targeted activity. It should also
management determine development and training                 include existing standards of competence established
needs and establish the basis for developing training         for specific public health functions (Appendix T-B).
responses most appropriate to develop workers’ miss-          Existing relevant course training materials, program
ing skills or to strengthen their existing skills (Quality    policies, guidelines, and regulations may be a source
Assurance Guidelines, 1985).                                  of data.
   The training needs assessment process should ap-              The three basic types of data to be collected to de-
ply to both staff and external partners. Although pro-        termine training needs are listed below.
gram management can control the training needs as-
                                                              1. Target participant characteristics. The training
sessment process internally, it does not have the same
                                                                 needs assessment should address the following :
authority with external partners. The project area
                                                                 - educational levels of the targeted audience;
should, however, coordinate with appropriate exter-
                                                                 - length of time in the current job;
nal partners to offer assistance in assessing skill levels
                                                                 - length of time working in public health;
of those personnel performing essential STD preven-
                                                                 - trainees’ ideas about what is needed to perform
tion functions and offer training to address specific
                                                                   requisite tasks or functions (e.g., enhanced per-


T–4                                                                  Program Operations Guidelines for STD Prevention
    sonal knowledge, skill, ability; better communi-           The training needs assessment process should iden-
    cations; supervisory involvement); and                  tify barriers to job-related skills development. Such
  - trainees’ preferences for certain training meth-        barriers may include poor communication of job ob-
    ods.                                                    jectives, responsibilities, priorities, organizational
                                                            policy, and operational or administrative guidelines;
2) Activity information. The training needs assessment
                                                            lack of technical direction and support; poor physi-
   should answer such questions as:
                                                            cal work environment; or an employee’s personal
   - Are the functions or tasks expected to change?
                                                            problems. These types of barriers are indicators of
   - How well are the target participants currently
                                                            operational, administrative, or performance manage-
     performing the functions or tasks?
                                                            ment problems which impede the identification of
   - What barriers might affect successful perfor-
                                                            skills deficiencies and training needs, because of their
     mance?
                                                            impact on overall job performance. Often a worker
   - Which functions or tasks are most critical?
                                                            has the job-related skills needed but is unable to ap-
3. Knowledge, Skill, and Ability information. The           ply them until such barriers are removed (Quality
   training needs assessment should be conducted in a       Assurance Guidelines, 1985).
   supportive environment. Training needs assessment           Determination of the causes of unacceptable per-
   can be viewed by a worker as an intimidating expe-       formance should be based on observation, documen-
   rience instead of creating opportunity for perfor-       tation, and consultation, as well as any personnel de-
   mance enhancement. The training needs assessment         velopment plans. It is the responsibility of the
   should answer such questions as: What knowledge,         supervisor to observe, document, and consult with
   skills, or abilities do the targeted participants need   the employee to determine the causes of unaccept-
   to perform at the level of proficiency expected?         able performance. If unacceptable performance is de-
   What knowledge, skills, or abilities do expert per-      termined to be caused by attitude, motivation, or com-
   formers possess?                                         munication problems, it is not a training issue and
                                                            appropriate personnel actions should be pursued. If
The sources from which to collect such data include
                                                            the unacceptable performance is related to skills defi-
incumbents who are performing the targeted activity;
                                                            ciencies, then appropriate training and development
supervisors and managers who are involved in setting
                                                            should be offered.
the expectations for the targeted participants; techni-
cal or content experts on the targeted activity; and in-
ternal or external “customers” served by the targeted         Recommendation
participants. The methods for collecting the data may
                                                              • STD prevention programs should have a sys-
include direct interviews, surveys, expert panels or
                                                                tematic and regular method of assessing train-
focus groups, direct management observation, and
                                                                ing needs and skills development of staff.
performance review analysis (OPM Training and De-
velopment Services, 1994).
   The ultimate goal of training is to improve job per-     Training Approach
formance. Most skill-based performance problems are
correctable with appropriate training, improved on-         Once it is determined which skills must be addressed
the job communications, and more supervisory assis-         through training efforts, then the program, with the
tance. However, not all performance needs can be ad-        aid of training experts, should determine the appro-
dressed through training. When a training needs             priate training approach. The emphasis of a training
assessment or individual supervisor recognizes a per-       activity should be on demonstrable skills and should
formance barrier or a problem related to attitude,          focus on measurable competencies. Competency-
motivation, or communications, training may not be          based or skills-based training for public health pro-
the solution. The supervisor must determine if train-       fessionals should use adult learning methods. Such
ing can appropriately address the problem.                  training efforts should also use techniques that en-



Training and Professional Development                                                                          T–5
gage students in solving problems or in discussing their     skills development needs. Specific areas of skills de-
experiences. The student then should have a chance to        velopment and existing training are identified in Ap-
demonstrate the skills and behaviors. Specific partici-      pendix T-C.
patory techniques can include small group discussions,           In addition to basic training, all new employees
demonstrations, role plays, case studies, and simula-        should be immediately oriented to the organization,
tions. Focusing on competence and skill provides ac-         learning the program’s mission and function, the
countability and is helpful in considering issues of im-     employee’s place in the organization, the employee’s
proving performance at the organizational and                role in STD prevention, the performance expectations
individual employee levels (Public Health Workforce)         of the job, and coworkers’ organizational roles and
(USAID Handbook on Control of STDs).                         responsibilities.
   Clearly identifying the purpose is a key element in           All Disease Intervention Specialists new to STD pre-
an effective training program. All training activities       vention should receive an orientation on STD trans-
or courses should have clear objectives that describe        mission and control that includes information on
skills that participants will be able to perform and         local epidemiology of STDs, factors affecting trans-
knowledge they will be able to use as a result of course     mission of STDs, the relationship between other STDs
participation. This is a critical step in selecting appro-   and HIV, complications of STDs, factors affecting STD
priate participants and in evaluating the effectiveness      risk and prevention, and beliefs and practices about
of the training (USAID Handbook on Control of                STDs. The CDC STD Employee Development Guide
STDs).                                                       (EDG) is a recommended source for the orientation
                                                             material on STD transmission and control. The EDG
                                                             is in module format and is designed to give new staff
Areas of Training Need
                                                             members a comprehensive background in STD inter-
There is increasing interest among public health agen-       vention. These orientation activities should be com-
cies, including CDC, to assure that public health work-      pleted within four to six weeks of an employee’s ar-
ers are knowledgeable about the core public health           rival on the job.
functions (assessment, policy development, and assur-            Clinicians and administrative staff who perform di-
ance) and competent to perform the ten essential pub-        rect disease intervention functions should be provided
lic health services associated with those core functions     an orientation within the first four to six weeks. These
(see Appendix T-B for a list of essential public health      staff members should have the opportunity to observe
services). Competencies of public health workers to          and to participate in the intervention activities per-
perform essential services should be assessed and train-     formed by experienced colleagues and other STD pre-
ing provided to correct any deficiencies. Staff in STD       vention staff members. Regional prevention training
prevention programs may need training to assure that         centers (PTCs) are also an excellent resource for pro-
they are competent to provide the essential STD pre-         viding training to new staff performing disease inter-
vention functions of behavior change interventions at        vention services.
the community and individual level, medical and labo-
ratory services, partner services, leadership, public
                                                             Delivery of training
health program management (i.e., planning, resource
management, and evaluation), and surveillance and            In addition to the responsibility for determining the
data management.                                             training or staff development needs and topics, (i.e.,
    In many areas of skills development the need for         the knowledge and skills deficiency to be addressed)
specific training is universal. This is particularly true    and for identifying the target audience, project area
for new, inexperienced employees (e.g., new supervi-         managers must determine the best method to get the
sors, new DIS, new clinicians). In such cases, a train-      instruction to the target audience. Consideration must
ing needs assessment may not be required. Standard           also be given to available funds and level of expertise
training activities already address these continuing         of individuals providing the training.



T–6                                                                 Program Operations Guidelines for STD Prevention
   Depending on the cost, content, and the instruc-          vention specialists, and family planning and other part-
tional expertise required, managers should utilize a         ners.
variety of means such as on-the-job training, classroom         The RTCs provide reproductive, clinical, contracep-
work, CDC-supported training, PTCs, and distance             tive management, supervisory, health education, HIV
learning activities to address development needs. Tra-       risk/harm reduction, and other training. The RTCs
ditional approaches to delivering instruction (e.g.,         target health care audience is mainly health care pro-
classroom settings, lectures, conferences, written           viders who work in family planning, maternal and child
materials, etc.) are no longer the sole method for           health, gynecology, and other reproductive health pro-
adequately preparing training participants to enter          grams.
practice or for providing continuing education to a             The Health Resources & Services Administration
widely dispersed public health workforce. Field-based        (HRSA) AETCs provide targeted, multi-disciplinary
learning technologies, such as those involved in dis-        HIV training programs for primary health care, allied
tance learning, should be implemented. These may             health, minority health, and mental health care pro-
include video conferences, computer-based training,          viders. The majority of AETC resources have been
Internet, video/audio tape, etc. (Public Health              focused on areas of high HIV prevalence and incidence,
Workforce).                                                  with remaining resources allocated on suburban and
                                                             rural needs. AETC activities are based on assessed lo-
                                                             cal needs.
Training Providers and Resources
                                                                A list of training centers is provided in attachment
Training Centers. The STD/HIV Prevention Training            T-D. Programs should look to these training centers
Centers (PTCs), Regional Training Centers (RTCs),            as resources to help them provide STD and HIV pre-
and AIDS Education and Training Centers (AETCs)              vention training and needs assessments for their staff
are three CDC-recognized providers or resources for          and external partners.
STD prevention related training. One role of the PTCs,
RTCs, and AETCs is to respond to the need for spe-           CDC, NCHSTP Division of STD Prevention. In addi-
cific training identified by the project area managers.      tion to managing the grants for the Prevention Train-
The PTCs and RTCs provide training based on a list           ing Centers, the Division provides training and devel-
of core topics but can also develop specific training or     opment support in such areas as first-line supervisory
in-service seminars based on program needs. Program          development; medical professional development; and
managers should consider the location and the course         STD surveillance, data management, and epidemiol-
work offered by the different centers and decide which       ogy.
one of the training centers best meets their program
needs. Each type of center operates differently and has      Public Health Practice Program Office offers the Pub-
slightly different target audiences and each center may      lic Health Training Network (PHTN), which is a dis-
offer a slightly different curriculum.                       tance learning system designed to meet the training
   The PTCs provide STD clinical, behavioral, and            needs of the public health workforce nationwide. Some
partner counseling training. The clinical training is pro-   of the subject areas addressed by this program are gen-
vided regionally, and the health behavioral and part-        eral public health practice, core public health skills
ner counseling/partner services training is provided         training, prevention program training, tuberculosis
nationally. The PTCs also work directly with STD             prevention, and HIV/AIDS and other sexually trans-
project areas to assist in identifying training needs and    mitted disease prevention.
developing specific training responses. PTCs provide
training for clinicians (physicians, physician assistants,   NCHSTP, Division of HIV/AIDS Prevention, Train-
nurse practitioners, RNs); laboratorians; health edu-        ing and Technical Support Services Branch provides
cators; public health social workers; mental health,         training in HIV prevention counseling for state and
alcohol, and substance abuse workers; disease inter-         local trainers (training of trainers). The Division also



Training and Professional Development                                                                           T–7
has field staff assigned to project areas who are avail-    Frequency of Training
able to conduct client-centered counseling training to
                                                            The intensity and content of training activities for
direct service personnel. Training is offered in the ar-
                                                            health professionals may vary considerably. Training
eas of prevention counseling, quality assurance for pre-
                                                            may take place as part of the formal professional or
vention counseling, substance abuse, issues affecting
                                                            career development curricula, as part of continuing
patients who test positive for HIV/STD, men who have
                                                            education activities, or as a specific event (IOM Hid-
sex with men, and women’s health care needs.
                                                            den Epidemic, 1997). In all cases, training should be a
                                                            part of a planned management effort consistent with
Schools of Public Health and Schools of Medicine.
                                                            program objectives, performance requirements, and
These schools offer medical professional training and
                                                            required knowledge and skills proficiency. These
education opportunities, as well as graduate-level de-
                                                            should be the determining factors regarding frequency
velopment in the essential elements of public health
                                                            and content of training.
and public health practice.

Partnerships. Partnerships may be created with aca-         Evaluation of Training Activity
demic institutions, managed care organizations
                                                            To get the best results from training, the content and
(MCOs), speciality societies, and local or state medi-
                                                            the process of training should be evaluated. In most
cal societies to provide training, education, in- service
                                                            skills-based or competency-based training, there is an
seminars, and other methods of staff development.
                                                            associated need for enhancement of knowledge related
Partnerships that provide training assistance to exter-
                                                            to the skills being developed. One way to evaluate
nal partners are often a highly effective way to lever-
                                                            knowledge gains is through the administration of pre-
age health department resources to strengthen collabo-
                                                            and post-tests. These may include True/False or mul-
ration and influence STD prevention efforts broadly
                                                            tiple choice questions, case based scenarios, written
in the community.
                                                            essays, oral review (tell what you know), self- assess-
                                                            ment of knowledge, or direct observations. It may be
Topic Experts in local and state health departments,
                                                            useful to do a before and after self-rating by partici-
community-based organizations, family planning or-
                                                            pants to address their perceived competency in per-
ganizations, etc., may be good resources to provide
                                                            forming the skills described in the behavioral objec-
in-service seminars or specific process training.
                                                            tives of the course. Skills evaluation may take place
                                                            through direct observation by an expert observer or
STD Project Areas. When training needs assessments
                                                            by written self-assessment.
identify needs that cannot be addressed by existing
                                                               Participant evaluations at the end of a workshop
sources, local project area training management should
                                                            can be detailed and comprehensive, covering individual
develop the required training. This may include in-
                                                            sessions and daily activities, and indicating satisfac-
service information workshops, training workshops,
                                                            tion with the training. Participants’ feedback on each
or on-the-job training experiences. Training contrac-
                                                            session should be simple and should vary in format to
tors can be used to meet specific project area training
                                                            address the main points covered in the course. Sample
needs. The PTCs and CDC can also be used in devel-
                                                            questions may include: What will you do differently
oping and implementing specific training programs.
                                                            as a result of this training? What was the most or least
                                                            useful aspect of the session? Were trainee’s opinions
  Recommendation                                            valued? and how? What went well or did not go well
                                                            in the session? Such questions should be standardized
  • STD prevention programs should consult with
                                                            through the use of a form. Opportunities for specific
    PTCs for conducting external partners train-            suggestions on ways to improve the course should also
    ing needs.
                                                            be made.




T–8                                                                Program Operations Guidelines for STD Prevention
    Participants, as well as the individual trainer or fa-   Assessing Effects of Skills Development on
cilitator, should evaluate the following course compo-       Performance
nents: venue, organization, quality of presentation, and
                                                             The assessment of training needs and the evaluation
quality of participants’ participation. Elements such
                                                             of training activity effectiveness, conducted in collabo-
as meeting stated objectives, clarity of presentation,
                                                             ration with the employee, are critical steps in improv-
interest in the presentation, and responsiveness to
                                                             ing individual and overall staff performance. Results
participant’s questions and concerns should be used
                                                             from these efforts help management to identify and
in evaluating the trainer presentation (USAID Hand-
                                                             address skills deficiencies, improve resource utilization
book on Control of STDs).
                                                             and cost-effectiveness of training efforts, and provide
    In many cases, these types of evaluation methods
                                                             necessary feedback to training sources to improve the
are performed by training personnel. Whenever pos-
                                                             quality of the content and the process of training ac-
sible, evaluation of training data should be provided
                                                             tivities. These efforts also aid in identifying other pro-
by personnel not under the direction of project area
                                                             gram management needs that affect staff performance,
management, but should be made available to the
                                                             such as improved employee and supervisory commu-
project area’s program management staff. Addition-
                                                             nications, administrative and operational policy and
ally, similar evaluation methods should be used by the
                                                             guidelines, and work environment. The evaluation of
project area’s program management staff for compari-
                                                             training activity effectiveness is a critical step in devel-
son over time.
                                                             oping staff performance. Results of such efforts pro-
                                                             vide important information that addresses the effec-
Post Training and Education Application                      tiveness of skills development efforts and supports
                                                             implementation of needed operational and adminis-
The purpose of training, education, and other staff
                                                             trative policy related to training and staff development.
development efforts is to enhance existing skills and
                                                                Programs should have or should develop specific
knowledge, develop new skills, and gain understand-
                                                             plans to establish a system of quality assurance for
ing of new ideas and technology that will be applied
                                                             training and human resource development. A quality
in job performance. However, the most significant
                                                             assurance system includes documentation, procedures,
phase of this development occurs on the job through
                                                             and processes to assure that staff members are per-
effective practice of the newly learned skills and knowl-
                                                             forming functions according to established standards
edge in a real work environment. Yet all too often,
                                                             of performance directly related to the accomplishment
there is little effort by management to assure the ap-
                                                             of an organization’s mission and objectives. This re-
plication of new skills and knowledge. As stated in
                                                             lates to the performance management and review pro-
the section describing responsibilities, management and
                                                             cess, and to the associated job descriptions and per-
supervisory personnel should be knowledgeable about
                                                             formance standards or requirements.
the training and staff development activities being pro-
                                                                The quality assurance system should recognize the
vided to their employees, should clearly understand
                                                             importance of human resource development in meet-
the associated knowledge and skills being developed
                                                             ing staff performance objectives. Program managers
by these activities, and should prepare workers to at-
                                                             should work with the agency’s Department of Human
tend training or education events. After training, par-
                                                             Resources or Department of Personnel to define, docu-
ticipants should be given the opportunity to review
                                                             ment, and establish responsibility for human resource
the developmental experience and determine how it
                                                             development in support of staff performance. The
should be put into practice on the job. Supervisors
                                                             quality assurance system should include documented
should reinforce application of new skills and knowl-
                                                             procedures for identifying training and human resource
edge through activities such as demonstration, perfor-
                                                             development needs and for providing required train-
mance observation and feedback, mentoring, and other
                                                             ing and development of personnel performing STD
on-the-job development activities. Supervisors should
                                                             prevention activities. The system should also include
also encourage team interaction and support to rein-
                                                             an internal audit or assessment process to review ef-
force the value of new skills and knowledge.

Training and Professional Development                                                                               T–9
fectiveness of training and staff development program      PROFESSIONAL/CAREER
efforts in developing the needed skills, knowledge, and    DEVELOPMENT PROCESS
expertise, and in improving the quality of job perfor-
mance.                                                     Though it is not anticipated that all programs have
   Direct observation of on-the-job performance is the     the need or capacity to develop a comprehensive ca-
best method to evaluate the skills of health care pro-     reer development structure, management should in-
fessionals. To ensure systematic, objective feedback,      corporate career management and staff development
an observation checklist should be used, an assessment     concepts to the extent possible.
of skills and abilities should be provided, and results        Management is accountable for the effective and
of the observed activities should be discussed with the    efficient use of human resources, which includes re-
individual. Direct observation should be conducted         sponsibility for developing and retaining a well-trained,
before and immediately after training and periodically     competent work force. This should be accomplished
thereafter.                                                through a career management system aimed at improv-
   Assessment of health care professionals at their        ing employees’ performance. Career management may
work sites also provides information that can be used      be described as the planned development and use of
in future training sessions, such as additional topics     progressively higher levels of staff expertise within the
or specific areas that need more emphasis (USAID           organization to meet the goals and objectives of the
Handbook on Control of STDs).                              program.
   Training that is a one-time effort or that is not put       To support career development, the program should
into practice can waste precious human and financial       work collaboratively with the Department of Human
resources. Supervisory and program support are criti-      Resources or the Department of Personnel to assure a
cal to the effect of the training on actual on-the-job     system that provides the mechanisms used by man-
performance and to the improvement of performance          agement to recruit, hire, develop, manage performance,
in a given STD prevention activity. Supportive super-      promote, discipline, and reward (pay, benefits, awards)
vision also contributes significantly to an employee’s     employees. The system should provide for the descrip-
application of new skills and principles. When par-        tion of required qualifications, duties, and performance
ticipants are not able to apply new skills and informa-    requirements for each job level within given career
tion, they can become demoralized, and training can        fields in the organization and should include the pro-
lose its credibility (Quality Assurance Guidelines,        cesses needed to attain and move personnel through
1985).                                                     the career steps to meet an organizations staffing needs.
                                                           A career management system should be developed to
                                                           formulate clear guidelines, processes, and competency
   Recommendations                                         requirements for the acquisition, training, develop-
   • Programs should perform a needs assessment            ment, maintenance, and advancement of employees in
     within their STD prevention workforce (both           all professions or occupations within the organization.
     staff and external partners).

   • Programs should be aware of areas of train-           Career Structure
     ing and orientation needed for all staff mem-         Before a program can develop the expertise needed to
     bers.                                                 perform the essential functions of STD prevention, it
   • Programs should evaluate training activities          must describe the composition of the workforce pro-
     and effects on performance.                           viding the essential STD related public health services
                                                           to community members. All health care professionals,
   • Programs should conduct post-training moni-           including staff and external partners, should be in-
     toring and reinforcement.                             cluded in this description. The workforce should be
                                                           categorized within specific career or professional fields



T – 10                                                            Program Operations Guidelines for STD Prevention
of expertise or within occupations needed in the over-       reer management system considering pathways relat-
all field of public health service. Examples of public       ing all possible career fields within the organization,
health professions appear in Appendix T-A.                   recognizing opportunities for career mobility or ad-
   Wherever possible, programs should have a struc-          vancement into different areas of expertise or professions,
ture in place to encourage career development which          and supporting the development of additional qualifica-
involves a series of progressively higher-level jobs.        tions or broader skills and knowledge in different func-
These positions will require application of knowledge,       tions required to bridge into new career fields.
skills, and abilities appropriate to the increased respon-      The program should work with employees to de-
sibilities. This structure should offer adequate promo-      sign and maintain individual staff development plans
tion potential and incentives within the career tracks       that provide a variety of information, education, train-
of the organization.                                         ing, and developmental work experiences needed in a
   The program should also describe the functions, du-       contemporary STD control program environment.
ties, and responsibilities required of personnel within         As staff members become proficient in the basic
each professional field for each job level, as well as       skills needed to perform STD prevention activities,
the qualifications and performance requirements for          their individual development should be further guided
each job level within the given career fields.               by a plan with development goals and objectives, in-
   Programs should establish job competency require-         cluding designated phases of development within the
ments for different job levels within career fields. These   projected career, to stimulate professional growth. De-
are demonstrated skills in addition to knowledge             pending on the occupation or profession, these phases
needed to make an employee capable of effectively            of development may be defined by levels such as en-
performing a given function. They are derived from           try, intermediate, journeyman, senior or managerial,
job functions, qualifications, and performance require-      and executive. The plans should describe occupation
ments and are key to the development of expertise.           or profession-specific competencies and identify spe-
Examples of competencies related to different public         cific training activities, academic education, informa-
health functions appear in Appendix T-B.                     tion workshops, on-the-job development activities
   A career or professional development structure for        (e.g., rotational assignments and special projects) and
staff members should include clear career pathways           self-development initiatives which support develop-
that are essential to ensure a skilled, stable, sensitive,   ment of the skills and knowledge related to the com-
productive, and responsive workforce that contributes        petency requirements.
effectively to STD prevention policy and practice. A            Individual Development Plans should provide em-
career pathway structure provides the program a clear        ployees with a comprehensive list of competencies
outline and plan to address the needed expertise, the        needed for performing major tasks; should provide em-
staff development requirements, and the potential            ployees and their supervisors with a single-source ref-
sources for recruitment within the organization to meet      erence to assist in determining appropriate training and
program operation objectives. It also provides employ-       prepare employees for more responsible positions;
ees a clear picture of career opportunities within the       should assist supervisors in making effective use of
organization.                                                scarce training resources by determining critical com-
   Career paths, however, are not restricted to a given      petencies and training courses; should enable employ-
professional field. The knowledge base, skills, and tasks    ees to plan appropriate career training and develop-
required of different professions may overlap at dif-        ment; and should develop and strengthen employees’
ferent points in a career progression, offering expanded     professional qualifications and leadership abilities.
opportunities for career advancement. This is particu-
larly true at higher job levels when technical compe-
                                                             Other Developmental Experience Opportunities
tency becomes secondary to managerial or adminis-
trative competency. As a result, it is important for         Orientation and basic and advanced skills training are
program management to establish a comprehensive ca-          essential to staff development, but they do not encom-



Training and Professional Development                                                                             T – 11
pass the total development efforts needed to develop a        be related to career satisfaction and progress. The
well-rounded public health workforce. The workforce           planned and structured guidance and sharing of knowl-
should also be provided other developmental experi-           edge and experience by effective supervisory or senior
ences such as information seminars, in-service infor-         staff members can be a very important aspect in the
mation workshops, formal education, and experien-             program’s development of junior staff members. A
tial opportunities structured to support the                  mentor, through repeated modeling and feedback, can
development of the competency-related KSAs and over-          shape a mentee’s expectations, perceptions, and inter-
all job expertise needed to perform and advance               pretations of certain behaviors of the organization. The
through a career structure.                                   result increases the mentee’s self-efficacy and self-as-
    Developmental opportunities to perform advanced           surance with regard to role-specific behaviors, moti-
or cross-functional tasks should be provided to en-           vations, and job satisfaction. In contrast, there are few
hance staff members’ overall expertise in STD preven-         things as frustrating, particularly for creative and
tion. Such career enhancement opportunities may in-           highly technical employees, as a supervisor who with-
clude rotating assignments, temporary duty                    holds information. Supervisors and senior staff mem-
reassignments, and special projects.                          bers need to look past the belief that information is
    Continuing academic career development opportu-           power and the fear of creating new competition. Man-
nities at the undergraduate and post-graduate levels          agement should reinforce the need to realize the posi-
should be made available to staff members. The pub-           tive aspects of mentoring that relate to greater pro-
lic health professional workforce lacks formal public         ductivity and efficiency. One of the greatest
health training and educational opportunities, particu-       compliments that can be paid a manager is for their
larly in the field of public health practice (Public Health   staff to succeed.
Workforce). Schools of Public Health offer a source              Effective, proactive managers who understand ca-
for formal academic education, with a focus on prac-          reer development recognize that, for their employees
tical application in the following essential areas of         to make progress up the career ladder, managers must
public health practice: 1) development and implemen-          continually nurture the personal development of those
tation of information systems; 2) collection and use of       staff members who report to them. A work group with
epidemiologic and surveillance data; 3) design and            an approachable leader who encourages team effort
implementation of community-based behavioral inter-           and the sharing of responsibilities and problems openly
ventions; 4) community empowerment; 5) program                can enhance mentoring relationships. Mentoring rela-
planning; 6) program evaluation; 7) program manage-           tionships, in turn, can contribute to positive intragroup
ment and administration; 8) design and evaluation of          associations (Correlates and Consequences of Protégé
clinical health services; 9) public health policy devel-      Mentoring, 1994). Managers should seek out such high
opment; and 10) public health marketing.                      quality supervisory personnel and staff members to
    Programs should utilize medical and non-medical           serve in mentoring roles.
experts from internal staff, external partners, CDC,             Selecting individuals to mentor is often a difficult
universities, PTCs, etc. These are good sources for tech-     task. Creating special relationships with individual
nical information, in-service sessions, and training          team members can cause resentment and discord within
workshops to enhance workers’ knowledge and un-               the team. Sharing information and providing close
derstanding of and skills proficiency in specific aspects     guidance should not create the appearance of personal
of STD Prevention.                                            favoritism.
                                                                 All team members should be given the opportunity
                                                              to enter into mentoring relationships, provided given
Mentoring
                                                              merit criteria are met. For example, employees could
One of the best ways to help a person fulfill his or her      be required to meet the following criteria:
potential within an organization is through the
                                                              (1) Time investment. It can often take a year or more
mentoring process. Studies have shown mentorship to
                                                                  for an employee to become comfortable with the


T – 12                                                               Program Operations Guidelines for STD Prevention
    culture of the organization. Choosing a mentee            Individual, Management, and Program
    who hasn’t had this exposure could result in early        Responsibilities
    disappointment for both parties.
                                                              Responsibility for an effective career or professional
(2) Performance. Identify an employee with a track            program rests with employees, management, and the
    record of consistently high performance combined          organization. Employees must determine what they
    with demonstrated technical or managerial com-            want their career to be; assess their aptitudes, strengths,
    petence.                                                  and development needs with their supervisor; work
                                                              with their supervisor to develop an Individual Devel-
(3) Motivation. Search for those who demonstrate a
                                                              opment Plan (IDP); and work with their supervisors
    willingness to learn, who are willing to take on
                                                              to schedule appropriate on-the-job training, required
    extra or new tasks, and who can take direction
                                                              formal training, and development activities.
    from others.
                                                                 Managers must support the development and train-
(4) Team building. Finally, a person who fosters a team       ing of their subordinates; determine the job-related
    atmosphere may be a wiser choice than the obvi-           knowledge, skills, abilities, and experiences needed by
    ous self-promoter.                                        employees to effectively accomplish the work of the
                                                              organization; counsel, coach, and guide employees in
Not all situations lend themselves to the establishment
                                                              their professional development planning; and help the
of a true mentoring environment. Limited numbers of
                                                              employee define short- and long-term development and
quality mentors or extreme worker hostility arising
                                                              training needs.
from the perception of inequitable treatment may not
                                                                 Programs must assure an organizational structure
allow the process to be effective. Still, management
                                                              exists that supports the required knowledge, skills,
should take steps to create an environment that recog-
                                                              abilities, and experience development of its employ-
nizes the importance of sharing information, experi-
                                                              ees and must provide resources, including dollars and
ence, and knowledge, and that establishes a structure
                                                              time, for development to occur.
to require such exchange to the extent possible (Jensen,
1995).
   By communicating the consequences of behavior                 Recommendation
and the appropriate responses to work situations and
                                                                 • Programs should consider the mentoring pro-
by providing knowledge of an organizations expecta-
                                                                   cess as an effective method for career devel-
tions, structure, roles, culture, values, rules, and norms,
                                                                   opment.
mentoring can enhance a mentee’s sense of competence
and effectiveness and offset organizational factors that
contribute to alienation (Correlates and Consequences
of Protégé Mentoring, 1994).




Training and Professional Development                                                                              T – 13
Appendix T–A
JOB TITLES IN PUBLIC HEALTH


(From: The Public Health Workforce: An Agenda For The 21st Century)

Definitions are provided for each new occupational category recommended for the field of Public Health.

Epidemiologist                                                  Provides services for persons having mental, emotional, or
Investigates and describes the determinants and distribu-       substance abuse problems. May provide such services as
tion of disease, disability, and other health outcomes and      individual and group therapy, crisis intervention, and social
develops the means for their prevention and control.            rehabilitation. Also may arrange for supportive services to
                                                                ease patients’ return to the community.
Health Educator (e.g., Public Health Educator, Community
Health Educator, School Health Educator)                        Psychologist, Mental Health Provider (e.g., Clinical Psy-
                                                                chologist, Counseling Psychologist, Marriage Counselor
Designs, organizes, implements, communicates, provides
                                                                Psychologist, Psychotherapist)
advice on and evaluates the effect of educational programs
and strategies designed to support the modification of risky    Diagnose and treat mental disorders by using individual,
health-related behaviors of individuals, families, organiza-    child, family, and group therapies. May design and imple-
tions, and communities.                                         ment behavior modification programs. (Requires doctoral
                                                                degree)
Public Health Policy Analyst
                                                                Alcohol and Substance Abuse Counselor, including Addic-
Analyzes needs and plans for the development of health pro-
                                                                tion Counselor (e.g., Substance Abuse Counselor, Certified
grams, facilities, and resources; analyzes and evaluates the
                                                                Substance Abuse Counselor, Certified Alcohol Counselor,
implications of alternative policies relating to health care.
                                                                Certified Alcohol and Drug Counselor, Certified Abuse and
                                                                Drug Addiction Counselor, Drug Abuse Counselor (Associ-
Health Service Manager/Health Service
                                                                ates degree or higher), Drug Counselor (Associates degree
Administrator
                                                                or higher), Alcohol Abuse Counselor (Associates degree or
Plans, organizes, directs, controls, and coordinates health     higher)
services, education, or policy in establishments such as hos-
                                                                Assesses and treats persons with alcohol or drug dependency
pitals, clinics, public health agencies, managed care organi-
                                                                problems. May counsel individuals, families, or groups. May
zations, industrial and other types of businesses, or related
                                                                engage in alcohol and drug prevention programs.
entities.
                                                                Mental Health Counselor (e.g.,Clinical Mental Health Coun-
Public Health and Community Social Worker (e.g., Com-
                                                                selor, Mental Health Counselor)
munity Organizer, Outreach and Education Social Worker,
Public Health Social Worker)                                    Emphasizes prevention and works with individuals and
                                                                groups to promote optimum mental health. May help indi-
Identifies, plans, develops, implements, and evaluates pro-
                                                                viduals deal with addictions and substance abuse; family,
grams designed to address the social and interpersonal needs
                                                                parenting, and marital problems; suicidal tendencies; stress
of populations to improve the health of a community and
                                                                management; problems with self-esteem; and issues associ-
promote the health of individuals and families.
                                                                ated with aging or with mental and emotional health. Ex-
                                                                cludes psychiatrists, psychologists, social workers, marriage
Mental Health and Substance Abuse Social Worker (e.g.,
                                                                and family therapists, and substance abuse counselors.
Alcoholism Worker, Clinical Social Worker, Community
Health Worker, Crisis Team Worker, Drug Abuse Worker,
                                                                Disease Intervention Specialist
Marriage and Family Social Worker, Psychiatric Social
Worker, Psychotherapist Social Worker)                          Interviews patients, at risk individuals, and those infected
                                                                with STDs including HIV. Ensures appropriate examination,
                                                                treatment, and follow-up to persons exposed to or infected
                                                                with an STD.




T – 14                                                                 Program Operations Guidelines for STD Prevention
Appendix T–B
GENERAL EXAMPLES OF COMPETENCIES RELATED TO IDENTIFIED ESSENTIAL PUBLIC
HEALTH SERVICES

(From: The Public Health Workforce: An Agenda For The 21st Century)

Essential Public Health Services :                         Communication
                                                           Skills proficiency to
• Monitor health status to identify community health
  problems.                                                • Communicate effectively both in writing and in
• Diagnose and investigate health problems and health        speaking (unless a handicap precludes one of these
  hazards in the community.                                  forms of communication)
• Inform, educate, and empower people about health         • Accurately and effectively present demographic,
  issues.                                                    statistical, programmatic, and scientific information
• Mobilize community partnerships to define and              for professional and lay audiences
  solve health problems.                                   • Solicit input from individuals and organizations
• Develop policies and plans that support individual       • Advocate for public health programs and resources
  and community health efforts.                            • Lead and participate in groups to address specific
• Enforce laws and regulations that protect health and       issues
  ensure safety.                                           • Use the media to communicate public health infor-
• Link people to needed personal health services and         mation
  assure the provision of health care when otherwise       • Facilitate interview (including cultural competence)
  unavailable.                                               and qualitative survey methods
• Assure a competent public health and personal            • Utilize public relations methods and techniques
  health care workforce.                                   • Engage in social marketing activities, including ac-
• Evaluate effectiveness, accessibility, and quality of      tivities that attempt to persuade specific target au-
  personal and population-based health services.             diences to adopt an idea, practice, or product
• Research for new insights and innovative solutions         through a variety of approaches and channels of
  to health problems.                                        communication in an integrated, planned fashion.
                                                           • Coordinate with existing network of consultants
                                                             and technical assistance and community-based as-
Associated competency areas and related
                                                             sets to collect and analyze community health data
knowledge and skills:
                                                           • Establish ties with community partners such as com-
Analytic                                                     munity based organizations, businesses, managed
Skills proficiency to                                        care organizations and other health care providers,
• Define a problem                                           school health clinics, other government agencies,
• Determine appropriate use of data and statistical          occupational safety offices in industry, volunteer and
  methods for identifying problems and planning, re-         nonprofit organizations, advocacy groups, commu-
  solving, and implementing resolutions                      nity groups, hospitals, physicians, health insurers,
• Select and define variables relevant to defined pub-       faith and church groups, and local pharmacies
  lic health problems
• Evaluate the integrity and comparability of data and     Policy and Developmental/Program Planning
  identify gaps in data sources                            Knowledge of
• Make relevant inferences from data                       • Relevant legal and regulatory information
• Use data to illuminate ethical, political, scientific,
                                                           Skills proficiency to
  economic, and overall public health issues
• Conduct cost-effectiveness, cost-benefit, and cost-      • Collect and summarize data relevant to an issue
  utility analysis                                         • State policy options

Training and Professional Development                                                                        T – 15
GENERAL EXAMPLES OF COMPETENCIES RELATED TO IDENTIFIED ESSENTIAL PUBLIC
HEALTH SERVICES, continued


• Articulate the health, fiscal, administrative, legal,   Surveillance and Data Management
  social, and political implications of each policy op-   Skills proficiency to
  tion                                                    • Apply risk assessment and risk communication
• State the feasibility and expected outcomes of each       methods and techniques
  policy option                                           • Use public health software packages such as Epi-
• Utilize current techniques in decision analysis           Info to track, analyze, and present findings of com-
• Write a clear and concise policy statement                munity health problems
• Develop a plan to implement the policy, including       • Design and operate a surveillance system
  goals, outcome and process objectives, and imple-       • Develop and administer survey instruments
  mentation steps                                         • Apply vital statistics
• Translate policy into organizational plans, struc-      • Use computer and information technology applica-
  tures, and programs                                       tions
• Identify public health laws, regulations, and poli-     • Describe problems in terms of time (persistence),
  cies related to specific programs                         magnitude or severity (scope), dispersion or loca-
• Develop mechanisms to monitor and evaluate pro-           tion (place), and co-occurrence or co-morbidity
  grams for their effectiveness and quality               • Identify and apply existing sources of data
• Utilize and integrate strategic planning processes,     • Make relevant inferences from data
  including assessment methods and modeling when          • Prepare and interpret data from vital statistics, cen-
  developing policies or community health plans             sus, surveys, service utilization, and other relevant
                                                            special reports
Public Health Program Administration
Knowledge of                                              Basic Public Health Sciences
• Program operations and administration of public         Knowledge of
  and private agencies within a community                 • Research methods in all basic public health sciences
• Legal and political factors affecting program change    • Environmental health issues and environmental
                                                            morbidity factors
Financial Planning and Management                         • Study design, including outbreak or cluster investi-
Skills proficiency to                                       gation
• Develop and present a budget                            • Risk assessment and health risk assessment meth-
• Manage programs within budgetary constraints              odologies
• Develop strategies for determining budget priori-       • Basic research designs used in public health
  ties
                                                          Skills proficiency to
• Monitor program performance
• Prepare proposals for funding from external sources     • Define, assess, and understand the health status of
• Apply basic human relations skills to the manage-         populations, determinants of health and illness, fac-
  ment of organizations and the resolution of con-          tors contributing to health promotion and disease
  flicts                                                    prevention, and factors influencing the use of health
• Manage personnel                                          services
                                                          • Apply the basic public health sciences, including
                                                            behavioral and social sciences, biostatistics, epide-
                                                            miology, environmental public health, injury pre-
                                                            vention , and chronic and infectious diseases

T – 16                                                           Program Operations Guidelines for STD Prevention
GENERAL EXAMPLES OF COMPETENCIES RELATED TO IDENTIFIED ESSENTIAL PUBLIC
HEALTH SERVICES, continued


• Utilize risk assessments (i.e., identifying hazardous   Cultural
  exposure and health effects)                            Knowledge of
• Apply laboratory science skills                         • Dynamic forces contributing to cultural diversity
• Identify the scientific underpinnings and ascertain
  strength of evidence from literature, including ef-     Skills proficiency to
  fectiveness of interventions                            • Interact sensitively, effectively, and professionally
• Define, assess, and understand the health status of       with persons from diverse cultural, socioeconomic,
  populations, determinants of health and illness, fac-     educational, and professional backgrounds and with
  tors contributing to health promotion and disease         persons of all ages and lifestyle preferences
  prevention, and factors influencing the use of health   • Identify the role of cultural, social, and behavioral
  services                                                  factors in determining disease, disease prevention,
                                                            health promoting behavior, and medical service or-
Public Health Information and                               ganization and delivery
Communications                                            • Develop and adapt approaches to problems that
Knowledge of                                                take cultural differences into account
• Different theories of education and learning
• Psychosocial and behavioral theories (e.g., health
  belief model)

Skills proficiency to
• Translate information and communicate to differ-
  ent target audiences




Training and Professional Development                                                                      T – 17
Appendix T–C
AREAS OF TRAINING IN STD PREVENTION


Some of the major areas of development related to STD prevention and associated knowledge and skills devel-
opment are detailed here. Training and staff development efforts in these areas should be continuing and based
on need. Also identified are areas of standard or basic training requirements for employees new to a given
function (See appendix T-D for location and website address for PTCs).

1) Clinical Services                                           ventive health services within a community; 3)
   Personnel new to the performance of STD clinical            assess factors that determine the quality and ac-
   care functions should be provided basic training            cessibility of preventive services; and 4) identify
   in STD clinical services within one to three months         opportunities for public or private collaboration
   after assignment of new duties. The training                in health services research and demonstration.
   should emphasize skills development in diagno-
   sis; management; counseling and treatment of            2) Laboratory Methods
   STDs; medical records and protocols; clinic flow;          Persons hired primarily to conduct basic labora-
   performance standards for clinician-patient inter-         tory services in support of STD clinical services
   actions; sexual history taking, and physical ex-           should be provided the skills development train-
   aminations; standard precautions; specimen col-            ing required by CLIA regulations, basic skills de-
   lection; Clinical Laboratories Improvement Act of          velopment training, as needed, in bright-field and
   1988 (CLIA) approved stat laboratory testing;              dark-field microscopy procedures, endocervical
   clinical interpretation of laboratory results; clini-      and urethral specimen slide preparations, pre-
   cal quality assurance; and disease intervention            sumptive culture identification, rapid tests, main-
   overview.                                                  taining laboratory records and protocols, and labo-
      Experienced clinicians should continue to re-           ratory quality assurance.
   ceive advanced training in clinical management                Other STD prevention staff members, such as
   as needs dictate. Non-clinicians, such as disease          disease intervention specialists, who may serve in
   intervention specialists, who are involved in pa-          back-up roles to laboratory personnel must be
   tient services but not required to perform clinical        provided the same basic skills training as stated
   functions, should be provided in-service work-             above to meet CLIA requirements. STD preven-
   shops or information seminars to gain general              tion workers involved in patient services who may
   knowledge or an understanding of the basic clini-          be required to answer specific laboratory-related
   cal functions and tasks listed above.                      questions should be provided in-service workshops
      STD prevention workers required to draw                 or information seminars to provide an understand-
   blood, within the limits permitted by state and            ing or general knowledge of the basic laboratory
   local statutes, should be trained and certified in         methods listed above.
   venipuncture. Such training should take place be-             It is expected that while persons hired prima-
   fore workers independently perform venipuncture.           rily to conduct laboratory procedures will be
      Programs should consider continuing training            trained within the first two months of employ-
   and development efforts to foster expertise in clini-      ment, persons serving in secondary or back-up
   cal design and evaluation of health services. This         roles should be trained to conduct most of the basic
   includes specific expertise to 1) assess health ser-       procedures within the first 6 months of employ-
   vices needs in a community; 2) determine the or-           ment, or as permitted by state or local statutes.
   ganization, distribution, and cost structure of pre-




T – 18                                                            Program Operations Guidelines for STD Prevention
AREAS OF TRAINING IN STD PREVENTION, continued



    All persons conducting basic laboratory proce-           vided by the worker should be interactive, and
    dures should be aware of and adhere to the guide-        should serve to assist the client in building the
    lines governing the conduct of laboratory proce-         skills and abilities to implement behavior
    dures as described in the Clinical and Laboratory        change. Information on adolescent cognitive
    Improvement Amendments of 1988 (CLIA). Ex-               and social development affecting behavior
    perienced laboratorians should continue to receive       should be included.
    advanced training in laboratory methods as skills           The new STD worker should be introduced
    needs dictate.                                           to HIV intervention during orientation, and
                                                             formal training in HIV testing and counseling
3) Community and Behavioral Change Interventions             should take place before the worker is allowed
   STD prevention programs should provide basic              to conduct HIV counseling and testing activi-
   training in individual, group, and community-level        ties independently. Experienced counselors
   interventions to all persons who directly interact        should continue to receive advanced training
   with STD clients. Skills should be developed so           in this area as needs dictate.
   that staff members can provide effective preven-
                                                          b) Community Behavioral Intervention
   tion counseling to clients one-on-one, in groups,
                                                             Basic training in community behavioral inter-
   or to an entire community. This includes skills in
                                                             vention should be provided to STD workers
   interpersonal communications, in maintaining
                                                             involved with community-related intervention
   confidentiality and privacy, and in developing in-
                                                             within six months after assignment of duties.
   tegrated prevention messages for STD, HIV, and
                                                             In addition to the topics listed under commu-
   unintended pregnancy. Training activities in these
                                                             nity and behavioral change interventions, the
   areas should also provide a basic understanding
                                                             training should address the dynamics of com-
   of the technical aspects of STDs including HIV
                                                             munity and agency collaboration, street and
   and an orientation to human sexuality and a level
                                                             community outreach, application of commu-
   of cultural competence or skills proficiency suffi-
                                                             nity-level intervention strategies, and applica-
   cient to allow staff members to recognize and ef-
                                                             tion of STD prevention program planning and
   fectively address cultural diversity issues and con-
                                                             evaluation techniques.
   cerns.
                                                                Training and skills development for experi-
    a) Behavioral Counseling                                 enced workers should continue to address such
       Basic training in behavioral and prevention           areas as: 1) establishing effective liaison with
       counseling for all workers interacting with           community leaders and agencies; 2) identify-
       STD/HIV clients should be provided within             ing individuals and coordinating their cumu-
       three months after assignment of intervention-        lative strengths to achieve public health objec-
       related duties. The training should be designed       tives; 3) organizing and developing alternative,
       to develop skills in providing counseling and         innovative delivery systems for public health
       health education interventions to persons who         programs; and 4) developing effective commu-
       are at risk for STDs, including HIV. A major          nity collaborations such as public-private part-
       emphasis of this kind of training should be           nerships and linkages with community-based
       promoting and reinforcing safe behaviors, with        organizations and other health and human ser-
       sensitivity to the special needs of high-risk         vices providers. Expertise in these areas re-
       populations. The prevention counseling pro-           quires application of ethical and legal principles



Training and Professional Development                                                                    T – 19
AREAS OF TRAINING IN STD PREVENTION, continued



         and practices with respect to cultural, social,   5) Supervision
         age based, and ethnic differences between pub-       All new supervisors should receive basic training
         lic health workers and their clients.                in the principles of supervision, which includes two
             Programs should also provide training and        major areas of skills development. The first area
         staff development support, as needed, to de-         is skill in interpersonal communications with sub-
         velop expertise in designing, implementing, and      ordinates as it relates to performance management
         evaluating community-based or community-             and technical guidance. This includes skill in feed-
         level behavioral interventions. This includes        back and observation techniques. The second area
         expertise in conducting targeted, science-based      is skill in applying basic human resource manage-
         behavior change interventions at the commu-          ment methods related to employee relations, re-
         nity level.                                          cruitment, performance management, position
                                                              classification and pay compensation, and staff
4) Disease Intervention                                       development. Basic supervisory training should be
   a) Interviewing                                            provided within six months after one is assigned
      STD prevention workers who are involved with            supervisory responsibility.
      interviewing or counseling clients should re-               Continuing training should be provided to ex-
      ceive basic training in this activity within four       perienced supervisors to address such supervisory
      to six weeks of their employment, before hav-           skills as guiding and directing subordinates and
      ing independent responsibility for the function.        others to accomplish performance objectives; plan-
      Effective interviewing is critical to successful        ning, organizing, assigning, delegating, implement-
      disease intervention. Skills development in in-         ing, and evaluating day-to-day work activities;
      teractive and client-centered communications,           counseling and advising less experienced person-
      information elicitation, and behavioral risk            nel (mentoring); managing and resolving conflicts,
      reduction is necessary to ensure that patients          confrontations, and disagreements within the
      diagnosed with an STD are treated and remain            workforce; and managing and facilitating meet-
      free of disease and that all sex partners of the        ings
      patients receive prompt and appropriate medi-
      cal attention.                                       6) Leadership
                                                              Continuing training and staff development should
    b) Outreach and Field Investigation
                                                              be provided to members of the management staff
       Outreach activities such as field investigation
                                                              to address leadership skills in such areas as apply-
       and partner notification are important com-
                                                              ing interpersonal coaching and motivation tech-
       ponents of STD disease intervention. All STD
                                                              niques; managing a diverse workforce and effec-
       prevention workers involved in these activities
                                                              tively utilizing cultural diversity; motivating,
       should be trained in these areas and should
                                                              mobilizing, and coordinating activities of individu-
       receive training within the first four to six
                                                              als and groups to accomplish program goals; cre-
       weeks of assignment. Staff members perform-
                                                              ating work teams and organizing their activities;
       ing intervention efforts should continue to re-
                                                              managing group processes and facilitating team
       ceive advanced training in this area as skills
                                                              building; developing clear, agreed-upon goals; ne-
       needs dictate.
                                                              gotiation; and innovative thinking.




T – 20                                                            Program Operations Guidelines for STD Prevention
AREAS OF TRAINING IN STD PREVENTION, continued



7) Surveillance and Data Management                       • Public health program planning—Management
   STD managers should provide continuing train-            personnel should develop expertise in determin-
   ing and development to STD prevention workers            ing priority health risks and problems by using
   involved in the collection and use of epidemio-          and analyzing available disease and behavioral
   logical and surveillance data. Training should de-       surveillance data; targeting and prioritizing pri-
   velop skills and expertise in applying statistical       mary versus secondary prevention strategies
   and epidemiological methods and techniques to            based on program performance information;
   efficiently collect, compile, organize, analyze, in-     and planning disease prevention and control
   terpret, and disseminate data related to public          programs.
   health outcomes, risk factors, and health services.
                                                          • Public health program evaluation—Manage-
   Expertise should also be developed in this area to
                                                            ment personnel should develop skills and ex-
   aid in planning, implementing, guiding, or evalu-
                                                            pertise including developing and implementing
   ating prevention program efforts.
                                                            program evaluation strategies, identifying pub-
      Continuing training and development efforts
                                                            lic health prevention program strengths, weak-
   should be provided to support development of
                                                            nesses, opportunities, and threats, and provid-
   specific expertise in developing, implementing, and
                                                            ing appropriate recommendations to enhance
   evaluating information systems. This should in-
                                                            and improve prevention activities, and to im-
   clude skills development in 1) determining orga-
                                                            prove resource management efficiency.
   nizational public health information needs; 2) de-
   veloping public health information policy; 3)          • Public health program management and ad-
   selecting appropriate technology for implement-          ministration—Management personnel should
   ing an integrated system of data collection, stor-       develop expertise such as managing organiza-
   age, and access; 4) and ensuring integrity and va-       tional conflict and change; financing public
   lidity of data for implementing trends analysis in       health programs, with particular emphasis on
   morbidity prevalence and incidence, health behav-        responding to the effects and implications of
   iors, and access to care.                                competition, regulation, and rationing in health
                                                            services delivery; managing grants and perform-
8) Public Health Management                                 ing strategic planning; managing and develop-
   STD prevention programs should provide continu-          ing human resources within the requirements
   ing training and staff development efforts to sup-       of performance management, employee rela-
   port the development of expertise of management          tions, position management, staff recruitment
   staff and appropriate external partners in such          and training.
   areas as these:
                                                          • Public health policy development—Manage-
    • Health Care Systems—Management staff should           ment personnel should develop expertise such
      develop expertise and knowledge related to the        as developing, implementing, and evaluating
      practices, concepts, and integrated structures        effective local public health policy, legislation,
      of various health care systems. These are needed      and regulation that is consistent with local
      in conjunction with skills in planning, imple-        needs, Federal standards, and national public
      menting, guiding, or evaluating prevention pro-       health goals, and objectives.
      gram efforts.




Training and Professional Development                                                                   T – 21
AREAS OF TRAINING IN STD PREVENTION, continued



9) Health Communications                                  10) Computer Training
   CDC defines health communications as the study             All STD prevention personnel who use automated
   and use of communications strategies to inform             systems should get basic training in the general
   and influence individual and community decisions           use of the computer and standard system software
   that enhance health status. It is a process that has       such as data base, spreadsheet, and word process-
   become an accepted tool for promoting public               ing software; and administrative management soft-
   health. Health communications principles are of-           ware such as E-Mail, which are needed in perfor-
   ten used for various disease prevention and con-           mance of day-to-day work activities. In addition,
   trol strategies, including advocacy for health is-         training on confidentiality of records and infor-
   sues, marketing health plans and products,                 mation should be routine. This training must be
   informing patients about medical care or treatment         ongoing to address the changing computer envi-
   choices, and informing consumers about health              ronment and enhance skills for needed specific job
   care quality issues. Together with other program           responsibilities.
   efforts, health communications can cause sustained
   behavior change and can overcome barriers to and       11) Training
   systemic problems with public health services.             STD prevention personnel should develop the nec-
   These efforts can lead to increased patient satis-         essary skills required to teach the various aspects
   faction, increased compliance with medical regi-           of public health practice.
   mens, and other positive health outcomes, includ-
   ing longer life, earlier detection and treatment of    12) General
   disease, and increased quality of life.                    In coordination with specific skills development
      Programs should develop specific expertise in           in the functional areas listed above, project areas
   the area of health communications that incorpo-            should also provide continued training and devel-
   rates aspects of health education, health promo-           opment opportunities to support development of
   tion, and marketing. Expertise in health commu-            related skills in such areas as written and oral com-
   nications should include skills in communication           munications, problem analysis and solving, nego-
   planning, media relations, media advocacy, writ-           tiation, and diverse cultural interaction.
   ing in journalistic style, crisis and risk communi-
   cation, formative research and evaluation, mes-
   sage design, audience segmentation, and social
   marketing.




T – 22                                                           Program Operations Guidelines for STD Prevention
Appendix T–D
NATIONAL STD/HIV PREVENTION TRAINING CENTERS: PART I —CLINICAL SERVICES



Website Address (for all PTCs) http//www.stdhivpreventiontraining.org

Baltimore STD/HIV Prevention Training Center           New York City Department of Health
Preventive Medicine and Epidemiology                   Bureau of STD Control
210 Guilford Avenue, 3rd Floor                         125 Worth Street, Box 73
Baltimore, Maryland 21202                              New York, New York 10013
ph. (410) 396-4448                                     ph. (212) 788-4423
fax (410) 625-0688                                     fax (212) 788-4431

Boston STD/HIV Prevention Training Center              California STD/HIV Prevention Training Center
Massachusetts Department of Public Health              1947 Center Street, Suite 201
Division of STD Prevention                             Berkeley, California 94704
305 South Street                                       ph. (510) 883-6657
Jamaica Plain, Massachusetts 02130                     fax (510) 849-5057
ph. (617) 983-6953
fax (617) 983-6962                                     Seattle STD/HIV Prevention Training Center
                                                       901 Boren Avenue, Suite 1100
Cincinnati STD/HIV Prevention Training Center          Box 359932
Cincinnati Health Department                           Seattle, Washington 98104
3101 Burnet Avenue                                     ph. (206) 685-9846
Cincinnati, Ohio 45229                                 fax (206) 221-4945
ph. (513) 357-7308
fax (513) 357-7306                                     St. Louis STD/HIV Prevention Training Center
                                                       Washington University School of Medicine
Dallas STD/HIV Prevention Training Center              660 South Euclid, Box 8051
Dallas County Health & Human Services Department       St. Louis, Missouri 63110
2377 North Stemmons Freeway                            ph. (314) 747-0294
Dallas, Texas 75207                                    fax (314) 362-1872
ph. (214) 819-1947
fax (214) 819-1946                                     Florida STD/HIV Training Center
                                                       Hillsborough County Health Department
Denver STD/HIV Prevention Training Center              1105 East Kennedy Boulevard
DCEED-STD-A3                                           Tampa, Florida 33602
4300 Cherry Creek Drive, South                         ph. (813) 307-8000, ext. 4599
Denver, Colorado 80222-1530                            fax (813) 272-7165
ph. (303) 692-2723
fax (303) 782-0904




Training and Professional Development                                                                 T – 23
NATIONAL STD/HIV PREVENTION TRAINING CENTERS: PART II —BEHAVIORAL INTERVENTIONS



Website Address (for all PTCs) http//www.stdptc.uc.edu

California STD/HIV Prevention Training Center            Denver STD/HIV Prevention Training Center
1947 Center Street, Suite 201                            Denver Public Health Service
Berkeley, California 94704                               605 Bannock Street, MC2600
ph. (510) 883-6657                                       Denver, Colorado 80204
fax (510) 849-5057                                       ph. (303) 436-7267
                                                         fax (303) 436-3117
University of Texas Southwestern Medical Center
400 South Zang Blvd., Suite 520                          New York State Centers for STD/HIV Prevention
Dallas, Texas75208                                       Training
ph. (214) 944-1066                                       Monroe County Department of Health
fax (214) 944-1061                                       691 St. Paul Street, 4th Floor
                                                         Rochester, New York 14605-1799
                                                         ph. (716) 530-4381
                                                         fax (716) 530-4378




NATIONAL STD/HIV PREVENTION TRAINING CENTERS: PART III —PARTNER SERVICES


Website Address (for all PTCs) http//www.stdptc.uc.edu

California STD/HIV Prevention Training Center            New York State Centers for STD/HIV
8018 East Santa Ana Canyon Road, Suite 100-165           Prevention Training
Anaheim Hills, California 92808                          New York State Department of Health
ph. (714) 280-1006                                       Empire State Plaza, Room 1168
fax (714) 280-1101                                       Albany, New York 12237
                                                         ph. (518) 473-8549/1692
Denver STD/HIV Prevention Training Center                fax (518) 474-3491
DCEED-STD-A3
4300 Cherry Creek Drive, South                           Texas Department of Health
Denver, Colorado 80222-1530                              Training and Public Education Branch
ph. (303) 692-2723                                       1100 West 49th Street
fax (303) 782-0904                                       Austin, Texas 78756
                                                         ph. (512) 490-2535
                                                         fax (512) 490-2538




T – 24                                                         Program Operations Guidelines for STD Prevention
REGIONAL TITLE X TRAINING CENTERS


Region 1                                Region 6
John Snow, Inc.                         Center for Health Training
44 Farnsworth Street                    421 E. 6th Street, Suite B
Boston, Massachusetts 02210             Austin, Texas 78701
ph. (617) 482-9485                      ph. (512) 474-2166
fax (617) 482-0617                      fax (512) 476-0326
website: www.famplan.org                website: www.jba-cht.com

Region 2                                Region 7
Cicatelli, Inc.                         Development Systems, Inc.
505 8th Avenue, 20th Floor              3100 Main Street, Suite 100
New York, New York 10018-6505           Kansas City, Missouri 64111-1918
ph. (212) 594-7741                      ph. (816) 561-5050
fax (212) 629-3321                      fax (816) 561-4222
website: www.cicatelli.org
                                        Region 8
Region 3                                JSI Research & Training Institute
Family Planning Council, Inc.           1738 Wynkoop Street, Suite 201
260 Broad Street, Suite 1000            Denver, Colorado 80202-1116
Philadelphia, Pennsylvania 19102-3846   ph. (303) 293-2405 ext. 18
ph. (215) 985-6754                      fax (303) 293-2813
fax (215) 732-1252
                                        Region 9
Region 4                                Center for Health Training
Emory University School of Medicine     2229 Lombard Street
United Way Building, Room 802           San Francisco, California 94123-2781
100 Edgewood Avenue, NE                 ph. (415) 929-9100 ext. 406
Atlanta, Georgia 30303-3026             fax (415) 929-9465
ph. (404) 523-1996 ext. 104             website: www.jba-cht.com
fax (404) 521-0271
                                        Region 10
Region 5                                Center for Health Training
Planned Parenthood of Wisconsin         1809 Seventh Avenue, Suite 400
302 North Jackson                       Seattle, Washington 98101-1313
Milwaukee, Wisconsin                    ph. (206) 447-9538
ph. (414) 271-8045                      fax (206) 447-9539
fax (414) 271-2237                      website: www.jba-cht.com




Training and Professional Development                                          T – 25
AIDS EDUCATION & TRAINING CENTERS (AETCs)



Serving New York & the Virgin Islands          Serving Arkansas, Louisiana, Mississippi
New York/Virgin Islands AIDS ETC               Delta Region AIDS ETC
Columbia University School of Public Health    Louisiana State University
600 West 168th Street                          1542 Tulane Avenue
New York, New York 10032                       New Orleans, Louisiana 70112
ph. (212) 305-3616                             ph. (504) 568-7041
fax (212) 305-6832                             fax (504) 568-7893

Serving Washington, Alaska, Montana, Idaho,    Serving North Dakota, South Dakota, Utah,
Oregon                                         Colorado, New Mexico, Nebraska, Kansas,
Northwest AIDS ETC                             Wyoming
University of Washington                       Mountain Plains Regional AIDS ETC
1001 Broadway, Suite 217 Mail Stop ZH-20       University of Colorado
Seattle, Washington 98122                      4200 East Ninth Avenue, Box A-096
ph. (206) 720-4250                             Denver, Colorado 80262
fax (206) 720-4218                             ph. (303) 355-1301
                                               fax (303) 355-1448
Serving Ohio, Michigan, Kentucky, Tennessee
Great Lakes to Tennessee Valley AIDS ETC       Serving Illinois, Indiana, Iowa, Minnesota,
Wayne State University                         Missouri, Wisconsin
2727 Second Avenue, Rm 142                     Midwest AIDS Training and Education Center
Detroit, Michigan 48201                        University of Illinois at Chicago
ph. (313) 962-2000                             808 South Wood Street (M/C 779)
fax (313) 962-4444                             Chicago, Illinois 60612
                                               ph. (312) 996-1373
Serving Nevada, Arizona, Hawaii, California    fax (312) 413-4184
Pacific AIDS ETC
University of California - San Francisco       Serving Delaware, Maryland, Virginia,
5110 East Clinton Way, Suite 115               West Virginia, Washington, D.C.
Fresno, California 93727-2098                  Mid-Atlantic AIDS ETC
ph. (209) 252-2851                             Virginia Commonwealth University
fax (209) 454-8012                             P.O. Box 980159
                                               Richmond, Virginia 23298-0159
Serving Alabama, Georgia, North Carolina,      ph. (804) 828-2447
South Carolina                                 fax (804) 828-1795
Southeast AIDS Training and Education Center
(SEATEC)                                       Serving Connecticut, Maine, Massachusetts,
Emory University                               New Hampshire, Rhode Island, Vermont
735 Gatewood Road, NE                          New England AIDS ETC
Atlanta, Georgia 30322                         320 Washington Street, 3rd Floor
ph. (404) 727-2929                             Brookline, Massachusetts 02146
fax (404) 727-4562                             ph. (617) 566-2283
                                               fax (617) 566-2994

T – 26                                               Program Operations Guidelines for STD Prevention
AIDS EDUCATION & TRAINING CENTERS (AETCs), continued



Serving Texas and Oklahoma                           Serving Florida
AIDS ETC for Texas and Oklahoma                      Florida AIDS ETC
The University of Texas                              University of Miami
1200 Herman Pressler Street                          1611 North West 12th Avenue
P.O. Box 20186                                       ACC West, Rm 301
Houston Texas 77225                                  Miami, Florida 33136
ph. (713) 794-4075                                   ph. (305) 585-7836
fax (713) 794-4877                                   fax (305) 324-4931

Serving Pennsylvania                                 Serving Puerto Rico
Pennsylvania AIDS ETC                                Puerto Rico AIDS ETC
University of Pittsburgh                             University of Puerto Rico
Graduate School of Public Health                     Medical Sciences Campus
130 DeSoto Street, Rm A425                           GPO 36-5067, Rm 745A
Pittsburgh, Pennsylvania 15261                       Rio Piedras, Puerto Rico 00936-5067
ph. (412) 624-1895                                   ph. (809) 789-6528
fax (412) 624-4767                                   fax (809) 764-2470

Serving New Jersey
New Jersey AIDS ETC
University of Medicine and Dentistry of New Jersey
Center for Continuing Education
30 Bergen Street, ADMC #710
Newark, New Jersey 07107-3000
ph. (201) 982-3690
fax (201) 982-7128




Training and Professional Development                                                      T – 27
References

CDC Office of Communications—Role of Health Commu-      OPM Training and Development Services—Training Needs
  nication, 1998.                                         Assessment Workshop, 1994.
Guidelines for STD Control Program Operations, 1985.    Public Health Workforce, An Agenda for the 21st Century;
IOM Future of Public Health, 1988.                        1995.
IOM Hidden Epidemic, 1997.                              Quality Assurance Guidelines for Managing the Performance
                                                          of Disease Intervention Specialists in STD Control, 1985.
Jensen, DG Mentoring Your Potential Successor. Search
   Masters International, 1995.                         USAID Handbook on Control of STDs.




T – 28                                                         Program Operations Guidelines for STD Prevention