Developing a diverse, knowledgeable, and motivated public health workforce to serve communities is essential to improving Mississippi’s health and well-being. Due to retirements and reorganizations, the MSDH has undergone significant personnel changes requiring training for both new and existing personnel to ensure they perform effectively. MCH programs use multiple methods for workforce development, including peer coaching, virtual professional development, and credential programs.

 

In 2021, the MSDH Human Resources conducted agencywide Workforce Assessment which identified needs for improved training, education, and credentialing of personnel, environments promoting employee engagement and efficient service delivery, and increased diversity of the workforce to reflect the communities served. From the results, the average employee was 49 years old with 10.5 years of experience. Agency staff demographics were as follows:

 

Race/Ethnicity	Percentage		Gender	Percentage
Black/African American	50.1%,		female	83%
Caucasian	47%		male	17%
Asian	0.94%
Hispanic	0.79%
American Indian/Alaska Native	0.15%
Other	0.25%

 

During 2022, the MCH Engagement and Coordination Office (ECO), formerly called the MCH Workforce Development Office, assessed the current MCH staff (N=219) to determine their demographics and professional development (PD) needs.[1] The survey had a 55% response rate. Of the respondents, 64% were Black or African American. Additional demographics were as follows:

 

Employment Status	Percentage		Gender	Percentage
Full-time employees	89%		female	92%
Full-time contractors	7%		male	7%
Part-time contractors	4%		preferred not to answer	1%

 

Ages	Percentage		Education Level	Percentage
25-34	15.7%,		High school diploma/GED	2%
35-44	28.1%		Associate/2-yr degree	12%
45-55	35.5%		4-year college degree	46%
55-64	18.2%		Master’s degree	29%
65-70	2.5%		PhD or higher	7%
			preferred not to answer	4%

 

Desired training topics were: Team building, Leadership, Communication, Critical thinking, Customer service, Decision making, and Problem solving.

 

The MCH ECO provides a quarterly newsletter called “Connections: Partnering with You” to highlight current public health trends, leadership topics, MCH Program spotlight, national and state resources, a training calendar, public meeting dates, self-care topics, and other professional development opportunities. The current distribution list includes 422 MSDH staff members and external partners.

 

The Training Calendar offers two webinars weekly, one on MCH Leadership Competencies and the other on requested topics. Over 130 webinars have been provided since 2022, including:

• Best Practices in Public Health Communication to Promote Equity and Inclusion
• Coaching as a Culture
• Communications Crash Course: Social Media for Public Health Communications
• Critical Thinking: Enhancing Judgment and Decision Making
• Declaring Racism as a Public Health Crisis
• Engaging Fathers in Maternal & Infant Health Programs: Importance, Challenges, Strategies
• Managing Conflict in the Workplace
• Public Health & Leadership Introduction
• Put the Ethical Guidelines for the Use of SDOH into Practice

 

The Leadership for All Book Club was started as another professional development opportunity. Books covered included:

• Developing a Leader Within You 2.0 by John Maxwell (6 participants)
• A Leader’s Guide to Unconscious Bias: How to reframe bias, cultivate connection, and create high performing teams, by Pamela Fuller & Mark Murphy with Anne Chow (14 participants)
• The Six Principles for Service Excellence by Theo Gilbert-Jamison (10 participants).

 

The MSDH Learning Management System (LMS) hosts 22 self-paced training modules for the self-paced learner, including:

• basic computer skills
• Cultural Humility for Case Managers
• Reflective Supervision
• Home Visiting Safety for Case Managers
• STD/STI and Pregnancy
• Impact of Substance Use on Pregnancy
• MSDH Introduction to Motivational Interviewing
• Health Service/Title V Programmatic Orientation

 

Thus far, 255 participants have completed different modules and 30 participants have completed the Health Services/Title V orientation.

 

Agency Support for Professional Development

 

The MSDH provides employees with professional development opportunities to build their capacity. Yearly, MSDH mandates training for all MSDH employees which includes annual HIPAA, Privacy Policy Training, and IT Security Policy training. Staff members are encouraged and supported to attend and/or present at national conferences, including CityMatCH Annual Conference, American Academy of Pediatrics and National Conference and Exhibition, AMCHP, American Society of Health System Pharmacist (ASHP) and Training, EHDI Annual Conference, and the Division for Early Childhood Annual Conference. In addition, staff members participate in programs such as CityLeaders, AMCHP Leadership Labs, and national boards such as Workforce and Leadership Development Committee AMCHP.

 

The MCH ECO partnered with the MSDH Office of Preventive Health and Health Equity for the 10th Annual Empowering Communities for a Healthy Mississippi Conference to offer a workforce development track. Presentations included:

• Real Colors
• Six Thinking Hats
• Customer Service–it is not just for Walgreens
• Building Connections: Effective Strategies for Developing
• Wheel of Business Communication
• Navigating Challenging Conversations and Building the Workforce by Learning how to Engage People with Lived Experiences
• Adaptability & Flexibility Training to Encompass Resiliency

 

The MSDH Quality Improvement (QI) Office provides a QI process training to introduce the general benefits and reasoning behind quality improvement, provides the introduction of 11 analytical tools and hands-on group activities. During the reporting period, 122 staff participated in the QI Introduction Training and 91 participated in the QI Intermediate Training.

 

In partnership with the Office of Health Equity, the Office of Oral Health (OOH) conducted Cultural Competency Trainings with Jackson State University School of Public Health in January 2023 and September 2023 with 36 students. Two new OOH staff also received training to become cultural competency trainers on June 28-30, 2023, resulting in a total of six OOH team members who are licensed to provide cultural competence training to organizations.

 

Professional Development Opportunities through Partnerships

 

The MSDH partners with the MS Board of Examiners for Social Work and Marriage & Family Therapists (MBOE) as a Social Work Continuing Education (SW-CE) Designated Provider. The MCH ECO Director and nine MSDH Social Workers serve as an Internal Review Committee for continuing education (CE) to meet MBOE CE guidelines and support licensure renewal. During the project period, MSDH sponsored 9 training events for a total of 25 CE hours at no cost to the social workers. To further increase the capacity of staff, support was provided to social workers preparing for the licensure exam. Twelve Master Level Social Workers participated in a study group with books, sample test questions, flash cards, and summary material provided.

 

Title V partnered with the Essie B. & William Earl Glenn Foundation to support their yearly Adverse Childhood Experiences (ACEs) & Trauma Awareness Symposium. This event brings experts in the field of ACEs and trauma, who share innovative strategies for preventing and mitigating trauma, abuse, and support for vulnerable populations. The 2023 Symposium reached 113 attendees, 23% of whom work for the Mississippi Department of Child Protection Services charged with protecting children, supporting families, and encouraging lasting family connections. Topics included health inequities among under-resourced, vulnerable and marginalized communities, social determinants of health and correlation to ACEs and health issues, natural and man-made environmental issues such as the Flint Water Crisis and Katrina, and the impact of such environmental issues for maternal, fetal and child health outcomes. Evaluations were completed by 53% of symposium attendees who reported 97% stated they “got what they wanted/needed from the Symposium,” 75% stated they were “Very Satisfied” and 97% reported the Symposium sessions were “useful to their professional practice.”

 

To strengthen family planning services throughout the state, three Nurse Practitioners (NP) completed the Comprehensive Colposcopy Courses organized by the American Society for Colposcopy and Cervical Pathology. These NPs will continue with their practicum until they are signed off for independent practice.

 

The MCH ECO participated in the 2022 Exploratory Workforce Learning Journey with the National MCH Workforce Development Center (WDC) between January 2022 to March 2023. The Mississippi team participated in monthly skill building sessions, sharing tools and resources, and individual and group coaching sessions, and completed three projects. The Mississippi team (1) surveyed MCH staff to assess strengths and gaps in their knowledge and skills; (2) developed an orientation on Title V/MCH and public health for new employees and students; and (3) developed a multiyear strategic plan for workforce development activities aligned with the needs and strengths of the MCH public health staff. Surveys of Health Service/Title V on the 12 MCH competencies and other professional development topics identified interests in training on: communication, interdisciplinary/ interprofessional team building, and developing others through teaching, coaching, and mentoring. These results informed the selection of professional development opportunities for the monthly training calendar.

 

Pipeline from Institutes of Higher (IHLs) Learning

 

The MSDH works to develop a “pipeline from IHLs” to Public Health through internships. To support this effort, since October 2021, the MSDH has obtained 35 in-state and 15 out-of-state Memorandums of Understanding (MOU) with IHLs to host interns from Social Work and Public Health programs. During the project period, the MCH ECO hosted three virtual and one on-site interns. The first intern, from the University of Southern Mississippi, School of Social Work, assisted with enhancing the MCH focus of an existing course: Evidence-Based Public Health: Course in Chronic Disease Prevention. The second intern, a 10-week summer GSEP intern through the AMCHP Workforce Development and Capacity Building program, developed a programmatic internal review of strengths and gaps across the MCH Domains (i.e., Women’s/Maternal Health; Perinatal/Infant Health; Child Health; Adolescent Health; CYSCHN; and Cross-cutting/Systems Building) to identify priority areas, strategies, and activities per domain. The third intern, from Walden University’s, Bachelor of Social Work program, assisted with building capacity for the Lead and Healthy Homes program and development of study tools for public health social workers. The fourth intern, a DrPH student from Jackson State University, School of Public Health, developed a tool for comparing MSDH home visiting programs to each other and other national programs.

 

The Office of Oral Health, Program Interns continues to expose students (elementary, middle school, high school, college, and post baccalaureate) to the numerous careers in dentistry and to encourage them to pursue the dental field. During this grant cycle, we offered two intern positions to students seeking a career in dentistry. One participated in our DAT Reimbursement Scholarship Program and is now pursuing a master’s degree from University of Mississippi Medical Center, School of Graduate Studies in Health Sciences Biomedical Sciences program. She is simultaneously applying to dental school and is has been wait listed for one dental school. The other intern has been working in the private sector as a registered dental hygienist but is interested in public health dentistry. She received her Master of Public Health Degree from University of Southern Mississippi in December 2023. These interns participated in a variety of public health and professional training and completed projects on dental workforce efforts, program evaluation/assessment, program planning, and grant writing. Due to their successful performance, each intern was offered a contract position to continue with the OOH to assist with various projects as the OOH workforce is being rebuilt.

 

At least two past interns and DAT scholarship reimbursement participants applied to and received the National Health Service Corps scholarship and are dental scholars with the program. As such post dental school, they have committed to practice dentistry in underserved or underinsured communities that qualify with the appropriate health provider shortage designation scoring. Additionally, one of our dental school students was accepted into a Public Policy program at Meharry Medical College, School of Dentistry.

 

Professional Development Offered by MCH Programs

 

Office of Oral Health (OOH)

Pathways2Possibilities (P2P) is a hands-on, interactive career expo for 8th graders and youth, ages 16-24, in South Mississippi every November at the Coast Convention Center in Biloxi, Mississippi. This career expo has expanded to the MS Delta at the Washington County Convention Center and is held every February. Two OOH contract workers participated in the career fair and shared oral health education as well as allowed students to participate in the indirect vision challenge, and conduct student-led mock oral screenings. Student participation at the coastal event numbered 6,621, and in the Washington County event, 1,352.

 

Community Health Workers Training: District Community Health Workers (CHW) and Regional Oral Health Consultants (ROHC) are both located throughout the state. The following interactions were recorded for the period of December 2022-April 2023:

• Dec. 1, 2022: Shared World Aids Day with CHW Robert (Dylan) McCoy and Patricia Taylor was shared on their social media platforms.
• Jan. 17, 2023: Southern District Meeting with CHW Dylan McCoy and Health Educator Kim Viewig discussed upcoming events and how the CHWs can work with the Office of Oral Health. Based on this meeting, a CHW component was the Forrest General Hospital Oral Cancer Awareness Event.
• April 19, 2023: The Offices of Community Health Worker and Oral Health met to begin conversations on the roles of the ROHCs and CHWs and how to collaborate best to meet the needs of our constituents. This meeting allowed team members to connect based on their locations throughout the state and gather more insight and value for each other’s roles.

 

The University of Mississippi Medical Center Shaping Minds to Inspire Lead and Explore (S.M.I.L.E. U) Summer Program serves as an outreach and recruitment tool for eligible 6-8th grade students from underrepresented groups by providing early exploration of careers in Dentistry. S.M.I.L.E. U brings awareness to the academic curriculum and noncognitive skills needed to increase chance of success for undergraduate acceptance and admittance into professional health programs. The goal of S.M.I.L.E. U is to create interest in pursuance of dentistry as a career choice by teaching the importance of oral health, different career options in the dental field, and the steps to successfully gain admittance into dental school as early as possible through targeted, age specific exploration. On June 8, 2023, the OOH provided hands on learning opportunities for the students on the process of water fluoridation, causes and effects of enamel erosion, and the amount of sugar in common beverages. The students also participated in the Life Course game to “offer a way of looking at health, not as disconnected stages unrelated to each other, but as an integrated continuum.” This game shows how many facets contribute to health outcomes across the course of one’s life. “It builds on the public health and social science literature which highlight the influence of each stage of life on the next and shows how social, economic, and physical environments interact to have a profound impact on individual and community health.”

 

We remain committed to replenishing the dental workforce and showcasing the importance of oral health to overall health. Dr. Filzen participated in the Evidence-Based Public Health (EBPH): A Course in Chronic Disease Prevention training hosted by the Mississippi State Department of Health, August 7-10, 2023. This training was sponsored by the Center for the Study of Community Health, School of Public Health, University of Alabama at Birmingham.

 

The course was centered around the following modules:

1. Introduction and overview of EBPH
2. Assessing and engaging communities
3. Quantifying the issue
4. Developing a concise statement of the issue
5. Searching and summarizing the scientific literature
6. Developing and prioritizing intervention options
7. Developing an action plan and building a logic model
8. Understanding and using economic evaluation
9. Evaluating the program or policy
10. Communicating and disseminating evidence to policy makers

 

Healthy Moms/Healthy Babies Program of Mississippi (HM/HB)

Effective July 2022, the historic perinatal case management program was rejuvenated and rebranded as the HM/HB. This new family support program’s mission is focused on partnering with families and communities to ensure all Mississippi moms and babies have a safe birthing experience and healthy infant development. The program aims to decrease preterm births, improve maternal health, decrease infant mortality, and support infant physical and mental development.

 

To support the transition from a 3-person case management model, i.e., Nurse, Social Worker, and Registered Dietician, to a nurse case manager with social workers and RDs serving as Extended Service Providers, the HM/HB provided training to build workforce capacity. HM/HB significantly increased its staffing of Nurses as Nurse Case Managers, growing from 3 to approximately 40 nurses. In partnership with MPHA and UMMC, HM/HB developed new standards of case management for the program and training modules to prepare new personnel. MSDH social workers were then transitioned to support multiple MCH programs, including Genetics/Newborn Screening, Lead, and CYSHCN.

 

Trainings for staff include:

• Social Work and Psychosocial Assessments (10/6/2022 approx. 60 MSDH staff attended virtually)
• Understanding Complications in Pregnancy (10/18/2022 approx. 60 MSDH staff attended virtually)
• SBIRT training regarding SUDs (11/10/22-11/17/22, 50 staff from HM/HB participated with other MSDH staff)
• Helping Families Cope with Grief (11/17/2022, 60 HM/HB staff attended virtually)
• MS Telehealth Baby and Me Tobacco Free Informational (11/30/2022, 40 HM/HB staff attended virtually)
• HM/HB Nurse Training on Referrals and Targeted Case Management (3/6 and 3/9/2023, 30 staff attended)
• Syphilis and pregnancy education and updates (March 2023, 40 HM/HB staff attended with other MSDH staff)
• Community Health Worker training (4/11/23, 25 staff HM/HB staff attended with other MSDH staff)
• EPIC Cadence Training for Nurse Case Managers (04/19/23, 30 participants attended)
• Postpartum Wellness Summit (5/4/23, 30 staff attended from HM/HB along with other professionals)
• Mandatory Reporting Infant and Child Abuse, Who Reports? Training (05/18/23, 30 MSDH social workers attended)
• Sickle Cell Disease: Promoting Family Cantered Support and Self-Management (6/14/23, 20 HM/HB staff attended)
• Oral Health Training (7/11/23 and 7/13/23, 50 HM/HB staff participated)

 

HM/HB also developed weekly/monthly staff meetings including Monthly Case Rounds, Midwife Monday, Nurse Team Lead Meetings/Updates. HM/HB has partnered with MSDH Quality Improvement dept where 6 HM/HB staff members meet periodically to discuss a logic model to improve program performance and participation. HM/HB were also able to provide nurse case managers with Nurse Home Visiting Kits to be able to provide quality care, education and monitoring of high-risk pregnant women and infants.

 

In August and September 2023, HMHB was able to onboard three phenomenal staff/consultants to the HM/HB leadership team:

• Certified Nurse Midwife – provides clinical consultation to HMHB staff, liaison between providers and HMHB, creates health education, leads Midwife Mondays – clinical updates and training to HMHB staff.
• Pharmacy Consultant- provides medication management education, referrals, advocacy, health education, to patients with diabetes, gestational diabetes, hypertension, pregnancy induced hypertension, preeclampsia. Provides consultation to HMHB staff. Introduced the need for HMHB patients to have access to prenatal vitamins in MSDH clinics.
• Clinical Director – provides clinical oversight and training to HMHB program, directly supervises Nurse Team Leads, nursing staff. Billing and reduction of errors has improved greatly since the Clinical Director was onboard.

 

Early Intervention

Throughout the project period, the Mississippi First Steps Early Intervention Program partnered with the University of Alabama’s Evidence-Based Internation Early Intervention Office (EIEIO) to create a 13-module online course on the Routines-Based Model (RBM), an evidenced-based family-centered model of early intervention service delivery. Fifteen Service Coordinator Coaches participated in the training course both to earn their RBM certification and to become trainers. Upon completion of the course, participants will be able to support additional staff in completing the RBM credential.

 

Each module contained presentations, readings, videos, reflection assignments, practice assignments, and a test. The 13-Modules are as follows:

1. Introduction to the Routines-Based Model
2. Ecomap
3. Routines-Based Interview (Structure)
4. Routines Based Interview (Engagement, Independence, and Social Relationships Details - Digging Deeper)
5. Goal Decision making and matrix
6. Informal RBI Goals to Participation-Based Goals - Family Goals
7. Primary or Comprehensive Service Provider
8. Routines-Based Home Visits (Structure)
9. Routines-Based Home Visit (Family Consultation)
10. Collaborative Consultation to Children's Classrooms/Collaborating
11. Collaborative Consultation to Children's Classrooms/Integrated Services
12. Engagement Classroom Model strategies
13. Data Collection

 

In addition, the Mississippi First Steps Early Intervention Program continued its partnership with the Mississippi State University to maintain the Early Intervention Credential Program-Level I. This credential is designed for entry-level professionals and those who have not earned a credential specific to the provision of early intervention services. All personnel engaged in the early intervention system are expected to earn the Level I credential, preferably prior to or during their first year in the early intervention system. During the project period, 17 personnel completed the EI Credential Program-Level I.

 

The Early Intervention Credential Program, Level I, contains six (6) curriculum modules:

 

Module 1: Introduction to Early Intervention

• Unit 1: Early Intervention Services and Practice
• Unit 2: Federal Guidelines that Govern Early Intervention Services
• Unit 3: The Impact of Atypical Development on the Child and Family
• Unit 4: Working with Special Education and Related Service Providers

 

Module 2: Family Centered Practice

• Unit 1: Introduction to Family Centered Care
• Unit 2: Collaboration and Teamwork with Families
• Unit 3: Supporting Families in Natural Environments
• Unit 4: Interventions During Daily Routines

 

Module 3: IDEA Law

• Unit 1: What is IDEA?
• Unit 2: Part C of IDEA
• Unit 3: Part B of IDEA
• Unit 4: IDEA Due Process

 

Module 4: Evidence-Based Intervention and Instruction

• Unit 1: Typical and Atypical Development
• Unit 2: Individualized Intervention and Instruction
• Unit 3: Assessment Practices
• Unit 4: Introduction to Tele-Intervention for Children and Families

 

Module 5: Coordination and Collaboration

• Unit 1: Effective Communication and Coaching
• Unit 2: Tele-Intervention and Coaching
• Unit 3: Partnering with Families for Effective Evaluation and Services
• Unit 4: Role of a Consultant

 

Module 6: Professionalism

• Unit 1: Using Data to Enhance Services for Children and Families
• Unit 2: Using DEC Code of Ethics, DEC Position Statements, and Recommended Practices
• Unit 3: Advocacy and Equity in Early Intervention
• Unit 4: Being a Reflective Professional

 

Each module is subdivided into four units and contains varied content, including slide presentations, videos, readings, reflective activities, and quizzes. In general, the modules are self-paced, involving asynchronous online instruction supported by experts within the Mississippi State University School of Human Sciences. The 6-module sequence requires participants to complete each module, with passing quiz scores, within a two-month period to be approved to move forward to the next module in the sequence.

[1] The goal is to send this survey out again summer 2024 for a comparison to the 2022 baseline data.