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Community Health Assessment Opportunities and Challenges in the 21st Century: Implications for Professional Development

Smith, Lillian U. DrPH; Burdine, James N. DrPH

Journal of Public Health Management and Practice: July/August 2017 - Volume 23 - Issue - p S63–S64
doi: 10.1097/PHH.0000000000000601

Department of Community & Environmental Health, School of Allied Health, College of Health Sciences, Boise State University, Boise, Idaho (Dr Smith); and Department of Health Promotion and Community Health Sciences and Center for Community Health Development, Texas A&M School of Public Health, College Station, Texas (Dr Burdine).

Correspondence: Lillian U. Smith, DrPH, Department of Community & Environmental Health, School of Allied Health, College of Health Sciences, Boise State University, 910 University Dr, Boise, ID 83725 (

The authors declare no conflicts of interest.

When the music changes, so must the dance.

Nigerian proverb

Change is the new normal in public health. Learning to adapt to change, to be agile and proactive, is our challenge. Buzz phrases 5 years ago, including collective impact, developmental evaluation, community engagement, health in all policies, interprofessional education, and integrated clinical and community health, are now part of the public health lexicon. New phrases and roles, such as chief health strategist,1 have emerged. “Defining while applying” new concepts in the midst of changing political foci and funding requires professionals to be prepared to not only work but also excel in shifting environments.

As large bureaucracies, academic institutions, and governmental public health agencies have struggled to respond to significant changes in proactive ways, a few visionary leaders have begun to address this challenge with specific suggestions. A review of the articles in this supplement found the need for enhanced capacity in building community relations. Unfortunately, there are few academic programs that teach community engagement beyond phases and definitions. Students and professionals generally lack opportunities to develop skills needed to engage multisector stakeholders in community health assessment or to align resources for implementation among other applications.

After reviewing the manuscripts in this supplement, we have identified a few professional development themes: skills tied to leadership, facilitation, developmental evaluation, and communication.

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Leadership in public health has traditionally followed the hierarchical pathways of medicine, whether the context is a hospital, health department, or community agency. But bringing cross-sector organizations together depends on collaborative leadership; a very different model.2

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While leaders can bring stakeholders to the table, effective facilitation helps keep them coming back. Community members tire from meetings and processes that do not lead to decisions and implementation. Unfortunately, too many of us have sat through meetings where most of those attending were there to protect turf and resources rather than agree for meaningful change. Community buy-in relies on facilitation methods that give people a voice, move from meeting agendas to community action, share credit, create an inclusive environment, and help stakeholders leave agendas at the door.3

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Developmental Evaluation

A relatively new form, developmental evaluation is useful when addressing complex social issues and using existing interventions and processes in new or different ways. Components of developmental evaluation include debriefing and after-action reports that enhance organizational learning and agility, allowing organizations to take advantage of emergent strategies. Practitioners and funders need to become more comfortable with such “moving target” or “inside-out” evaluation strategies.4

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Just like the public health emphasis on policies, systems, and the built environment make “the healthy choice the easy choice,” we should focus on the systems and infrastructure that make communication possible. Internal and external communication processes should ensure that information has a purpose, not just a frequency, and includes social media, newsletters, e-mails, project management, and strategic direction.

While integrating these skills into our academic and professional development programs will be challenging, it is essential for our workforce to have 21st-century skills and be prepared for a future of chief health strategists.

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1. Public Health Leadership Forum. The High Achieving Governmental Health Department in 2020 as the Community Chief Health Strategist. Washington, DC: RESOLVE, 2014.
2. Nicola Ray. Collaborative Leadership & Public Health - Developing a Culture of Shared Meaning. Northwest Center for Public Health Practice, University of Washington, Take the Lead Blog. http:// Published on March 1, 2013. Accessed on April 21, 2017.
3. Technology of Participation. http:// Accessed May 5, 2017.
4. Patton Michael. Developmental Evaluation: Applying Complexity Concepts to Enhance Innovation and Use. Guilford Press, 2011.
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