increased workload. With the backlash from the public and a perceived increase in politi- cal involvement in public health, many EH professionals feel more stress and thus have an increased desire to leave the workforce (Montana Public Health Workforce Develop- ment Group, 2020). In addition, there exists a short supply of graduates who choose to enter the field. Montana State University (MSU) recently developed a bachelor’s level environmental health program that is accred- ited by the National Environmental Health Sciences and Protection Accreditation Coun- cil (EHAC, 2020). In 2020, a public health workforce assess- ment survey was completed by the Montana Public Health Workforce Development Group (MPHWDG, 2020), which is made up of pro- fessionals from the Montana Public Health Association (MPHA), Montana Public Health Training Center, Montana Department of Pub- lic Health and Human Services, and Montana Environmental Health Association (MEHA). The assessment classified needs into three tiers of general categories: 1) policy development and program management, 2) communication skills, and 3) cultural competency. The assess- ment was designed to obtain a deeper under- standing of the current conditions and needs of EH professionals practicing in Montana, with the hope of addressing current needs and future challenges while learning what recruit- ing and retention strategies are preferred to grow the workforce. EH respondents reported feeling that their level of skill and familiarity with public health concepts were between “not much” and “a little” for tiers 1–3. This finding sug- gests that the EH workforce could benefit from various trainings and continuing educa- tion eorts to fill gaps in needed knowledge, skills, and abilities. Results also suggest that education and recruitment to the profes- sion should begin at the high school level (MPHWDG, 2020), which would provide an introduction and early exposure to the field of public health for college-bound students. MSU and the University of Montana School of Public Health are working to develop ways to increase the number of students entering the public health field. In April and October 2020, a national needs assessment of EH professionals was conducted in response to the ongoing COVID-19 pandemic (NEHA, 2020a, 2020b).
Results from the initial assessment revealed that 60% of EH professionals at local health departments were involved with COVID-19 responses in addition to their usual respon- sibilities. Respondents prioritized needs for COVID-19 cleaning and disinfection, per- sonal protective equipment (PPE), and safe food guidance (NEHA, 2020a). The follow- up assessment in October (NEHA, 2020b) revealed that high-priority needs included increased stang and personnel, more PPE, more consistent and high-quality COVID-19 information, and more technical support and guidance from the Centers for Disease Con- trol and Prevention. Based on a subset of data from the 2020 workforce study survey conducted by MPHWDG, it was determined that a separate survey that focused on the needs of EH profes- sionals in Montana would be useful to identify the eect of COVID-19 on the workforce. This separate survey would also garner ideas for sustaining and growing the profession given recent challenges such as the COVID-19 pan- demic. Our eort included a needs assessment survey developed to identify and characterize needs and gaps in information associated with EH practice, conditions, concerns, priorities, influences of the pandemic, and strategies for growing the workforce. We sought to answer the following ques- tions through the needs assessment: • What are the key characteristics of the cur- rent workforce? • Is the workforce adequately trained, staed, and paid? • How has the COVID-19 pandemic aected the workforce? •Are current social and political forces aecting the workforce? • What are the recommendations to support growth of the workforce? •What strategies might improve working conditions for the workforce? Methods The needs assessment survey was designed to focus on the needs, circumstances, inter- nal and external forces, and conditions of the EH workforce in Montana, with an empha- sis on improving recruitment and retention. A 57-question survey was developed. Ques- tions were designed to identify and classify the work-related duties prior to COVID-19, levels of satisfaction, and how these duties
changed because of COVID-19. Another area of interest was the qualification and training methods preferred by EH professionals, as well as projected needs for the future. Survey domains included demograph- ics, work status and position, education and licensure, work prior to COVID-19, practice in times of COVID-19, professional prepara- tion and continuing education, job satisfac- tion, recruitment and retention, and emerg- ing issues. Of the 57 questions, 36 were quantitative and 21 were qualitative. Ques- tion structures included single or multiple choice, completion, and open-ended ques- tions (see Supplemental Survey). The completed survey was approved by the institutional review board (IRB) of the University of Montana under the exempt category in accordance with federal regula- tions. After IRB review, a Qualtrics link to the survey was sent in 2022 to all public health departments across Montana for distribution to EH employees. The invitation and survey instructions informed participants of the pur- pose of the needs assessment and that partici- pation was voluntary. It also stated that ano- nymity would be assured and results would be aggregated. Completed surveys were downloaded from Qualtrics into an Excel spreadsheet for coding and analysis. The analysis was carried out using Minitab 20 and included frequencies, descriptive statistics, and cor- relations. Comparison of proportions was carried out using chi-square goodness of fit test when suitable sample counts and pro- portions were available. Results There were 100 completed or partially com- pleted surveys received from 135 respondents (74% response rate). We propose that vari- ability in the number of responses to each question occurred based on the comfort level of participants, perceived anonymity, time, and personal choice. Demographics Of the 100 participants surveyed, 58% self- identified as female. The largest age groups were 30–39 years and 50–59 years, at approx- imately 25% each. Only 1% of respondents identified as younger than 25 years and 7% identified as younger than 30 years. The majority of participants self-identified as
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