Defining the Technical Competencies for Healthy Homes Training

1
Defining the Technical Competencies for
Healthy Homes Training

• Adrienne S. Ettinger, ScD, MPH Joanna Gaitens
  RN, MSN/MPH Pat McLaine, RN,
  MPH Rebecca Morley, MSPP
  Ellen R. Tohn, MCP
• National Center for Healthy Housing

American Public Health Association 132nd Annual
Meeting (November 6-10, 2004) Abstract 93392
2

• Abstract
• The National Healthy Homes Training Center and
  Network (NHHTCN) project team convened a work
  group of technical experts drawn from the
  disciplines influencing Healthy Homes
  including public health, housing, building
  science, environmental health, and training and
  education. The Work Group brought together
  public health and housing practitioners,
  clinicians, academics, building scientists,
  community advocates and policymakers to provide
  comprehensive and technically sound advice on the
  design, implementation, and evaluation of a
  comprehensive Healthy Homes curriculum. The
  Work Group was charged with identifying,
  describing, and agreeing on the core competencies
  of Healthy Homes for practitioners that would
  subsequently be used to develop the curriculum.
  This included outlining the specific knowledge,
  skills and abilities and level of proficiency
  needed in each sub-competency in a core domain.

3

• Abstract (continued)
• Discussion also focused on types and sources of
  existing curricula that can be adapted to the
  Training Center, the target audience for proposed
  trainings and the necessary training
  infrastructure, including optimal formats and
  settings for specific course offerings by target
  audience (formal classroom setting, on-line/web
  based or in some other forum.) Based on input
  from the Work Group and CDC, NHHTCN and its
  partners developed a consensus statement of the
  core competencies and target audiences in order
  to develop a Healthy Homes curriculum and build
  the infrastructure of a national Healthy Homes
  Training Center and Network. The development of
  a standard set of core competencies was essential
  to conceptualizing the form and functionality of
  the Healthy Homes Network going forward.

4

• Objectives
• To develop and reach consensus on a core set of
  healthy homes technical competencies for health,
  environmental health, and housing professionals
• To use core competencies as a framework for
  curriculum development and performance evaluation

5

• Core Competencies
• Describe the complex combinations of applied
  knowledge, attitude and practices that enable
  people to perform their work effectively and
  efficiently (ref. 1)
• Identify a level of worker performance for
• Front-line staff
• Mid-level supervisors
• Decision-makers/Management staff
• Describe
• Acceptable level of performance
• Knowledge, skills, abilities needed to perform
• Conditions under which the work is executed

6

• Process
• In January 2004 NHHTCN convened a group of
  Health, Environmental Health, and Housing experts
  to discuss how to train a variety of
  professionals in the concepts and practice of
  healthy homes
• Discussion first focused on identifying broad
  categories of competency domains and then on
  specific sub-competencies that fall under those
  domains

7

• Tools used to Guide the Process

8

• Tools used to Guide the Process

9
EXPECTED COURSE OUTCOMES COMPETENCY DOMAINS

• Background Knowledge
• Assessment Skills
• Analytic Skills
• Hazard Control Measures
• Communication Skills
• Community Dimensions
• Ethical, Legal and Other Issues

10
1) BACKGROUND KNOWLEDGE

• Basic environmental public health
• Basic building science
• Specific environmental and safety hazards
• Interior house
• Exterior built environment, neighborhood
• Specific health effects

11
2) ASSESSMENT SKILLS

• Hazard recognition
• Visuo-sensory assessment of the home
• Environmental sampling and measurement
• Resident survey/environmental health history

12
3) ANALYTIC SKILLS

• Baseline data collection on health and
  environmental risk factors
• Evidence and performance-based outcome measures
• Program evaluation

13
4) HAZARD CONTROL MEASURES

• Prevention
• Design, construction, planning
• Maintenance, renovation
• Intervention
• Remediation, actionable hazards
• Emergency action items (i.e. carbon monoxide,
  etc.)
• Best practices and scientific evidence

14
COMMUNICATION SKILLS

• Active listening
• Cultural competency
• Conflict resolution

15
6) COMMUNITY DIMENSIONS

• Training to engage individuals community groups
• Training and interventions for residents, owners,
  community workers
• Knowledge of other agencies and groups roles and
  responsibilities for collaboration and referrals

16
7) ETHICAL, LEGAL, OTHER ISSUES

• Ethical and legal considerations
• Insurance and liability
• Pre-home visit triage
• Codes and regulations
• Personal safety

17

• Next Step in the Process
• Participants Were Divided Into Their Respective
  Disciplines and Asked to Identify the Desired
  Skill Level for Each Competency Based on the Job
  Category
• Front-line Staff
• Mid-level Supervisors
• Decision-makers/management Staff

18

• Desired Skill Levels
• Aware
• Individuals are able to identify the concept or
  skill but have limited ability to perform the
  skill.
• Knowledgeable
• Individuals are able to apply and describe the
  skill.
• Proficient
• Individuals are able to synthesize, critique or
  teach the skill.

19
.

• .

20
.

• .

21
.

• .

22

• Benefits of this approach to curriculum
  development
• Provides a good basic framework.
• Allows flexibility and customization.
• Promotes interdisciplinary collaboration.
• Provides a practical focus for curriculum
  development.

23

• Challenges of this approach to curriculum
  development
• To design curriculum for the various levels.
• Avoid overlapping of information related to
  different competency areas in curriculum.
• Assure consistency in terminology and format
  throughout the curriculum.

24

• Accomplishments and Future Directions
• Competency-based curriculum developed
  (March-August 2004)
• Pilot training session completed (September 2004)
• Focus group tested (September 2004)
• Sub-competencies and curriculum refined
  (on-going)

25

• References
• Competency-to-Curriculum Tool Kit Developing
  Curricula for Public Health Workers (Discussion
  Draft - January 16, 2002) by the Competencies
  Curriculum Workgroup (Chairperson Kristine
  Gebbie) at the Public Health Workforce
  Development Annual Meeting, September 12-13,
  2001, Athens, GA.
• Environmental Health Competency Project,
  Recommendations for Core Competencies for Local
  Environmental Health Practitioners, developed by
  the American Public Health Association and the
  Centers for Disease Control and Prevention, May
  2001.
• Healthy Homes Training Center and Network
  Blueprint for Success (Work Group Report of the
  Healthy Homes Training Center and Network
  Curriculum Development Work Meeting, Baltimore,
  MD January 21-23, 2004). National Center for
  Healthy Housing (NCHH), Columbia, MD, February
  28, 2004.

26

• Acknowledgements

This work was supported by Centers for Disease
Control and Prevention (CDC) U.S. Department of
Housing and Urban Development (HUD)
Workshop Participants Joe Beck, Eastern KY
University Martha Berger, U.S. EPA Patrick
Bohan, East Central University Mary Jean Brown,
CDC Linda Bruce, Johns Hopkins SPH Julia
Burgess, Alliance for Healthy Homes Adrienne
Ettinger, Johns Hopkins SPH Joanna Gaitens,
NCHH Suzanne Gaynor, HUD Jerry Hershovitz, CDC
Randall Hirschhorn, City of Philadelphia Dept of
Public Health H. Patricia Hynes, Boston
University SPH David Jacobs, HUD Carol Kawecki,
NCHH James LaRue, The House Mender Inc. Dennis
Livingston, Baltimore MD Karin Mack, CDC
Stephen Margolis, Rollins School of Public
Health Pat McLaine, NCHH M. Deborah Millette,
CDC Rebecca Morley, NCHH Martin Nee, HUD Steve
Schwartzberg, Alameda County Anthony
Starensinic, University of Wisconsin Ellen Tohn,
ERT Associates Charles Treser, University of
Washington Diane Zerbe, Johns Hopkins SPH.