Public Health Services Research, Moving to
the Mainstream: Recent Experiences with
Performance Measures, Quality
Improvement, Accreditation and
Certification
Sunday June 26, 2005
Harrison C. Spencer, MD, MPH
President and CEO
Association of Schools of Public
Health
ASPH Member Schools
Historical Goals of Credentialing
• Make public health a recognized public
health profession;
• Raise the visibility of public health; and
• Measure and improve the competency and
standards set for public health workers
nationwide.
Past Efforts:
• Both ASPH and APHA established task forces on the
credentialing of public health workers in the late 1980’s,
stimulated, in part, by the call from the U. S. Surgeon
General for such an effort.
• ASPH commissioned a formal study of public health
worker credentialing in 1989, which recommended that if
ASPH did decide to undertake credentialing that it should
pursue it independently and in a “pro-active, reformist
role.”
Past Efforts (cont.)
• A survey of the opinions of public health leaders on the
issue of credentialing public health workers was published
in 1995. Of those who participated in the survey 45%
supported a national certification effort with an additional
30% undecided on the issue.
• In 1999, the APHA/ASPH Task Force on Public Health
Workforce Credentialing was formed. After receiving
encouragement from both the APHA and ASPH Executive
Boards, the Task Force reached out to other stakeholders in
the credentialing process and became the Steering
Committee on Public Health Workforce Credentialing.
The Current Plan:
In January of 2002, ASPH’s Executive Committee
approved moving forward to develop an independent
National Board of Public Health Examiners to issue
examinations and provide those that pass the exam
with a public health credential.
ASPH Credentialing Taskforce created:

Dean Bernard Goldstein (Pittsburgh) -- Chair
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Dean James Curran (Emory)

Dean James Kyle (Loma Linda)
 Dean Donna Richter (South Carolina)

Dean Steven Shortell (Berkeley)

Dean Alfred Sommer (JHU)
Consultant: Dr. Charles Mahan (USF)
Priority:
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Address that SPH and accredited program
graduates are competent to serve as public
health professionals through:
Competency development
Voluntary exam
Core MPH Competency
Development Project
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Why now?
Aims
Process
Deliverables
Working model
Recent input
Why now?
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Increasing accountability in higher education
Proliferation of competency-based training
Challenges of 21st century practice
Recommendations by IOM, etc.
Increasing incorporation of competencies into
accreditation criteria
• Development of a voluntary credentialing exam
Aims
• Version 1.1 incorporates two sets of core MPH
competencies:
 The first set represents each of the five core areas
plus public health biology, and
 The second set aims to serve as an interdisciplinary,
cross-cutting set
• The sets are intended to serve as a resource and guide
• ASPH will not prescribe the methods nor processes for
achievement
Process
• Guided by 6 discipline-specific workgroups
• Direction from an expert consultant (J. Calhoun)
• Total of 135 academic (both SPH and program reps)
and practice participants
• Nominal group processes (Delphi Technique)
• Integration by an expert panel consisting of
academic and practice partners
• Oversight by the ASPH Education Committee
Deliverables
• Two consensus lists of core MPH
competencies:
(a) discipline-specific set, and
(b) interdisciplinary/cross-cutting set
• Background documents
• Dissemination plan
Working
Model
Blue =
interdisciplinary/
cross-cutting comps
Purple = disciplinespecific comps
Recent Input
* From the ASPH membership:
-- “Town-hall” presentation of the sets in May by the
Education Committee
-- Review by ASPH’s associate deans in June
-- Review by the ASPH deans in July
-- Ratification by the board in November
* From external stakeholders:
-- “Town-hall” input from partners in May
-- From November 2004 to date at
“competency@asph.org”
Review & Comments Welcome
• See current and previous draft lists at:
http://www.asph.org/document.cfm?page=851
• Send a response to competency@asph.org
National Board of Public Health
Examiners
• Purpose: Ensure the competence of public
health graduates from public health schools
and programs, accredited by the Council on
Education of Public Health (CEPH) through
developing, preparing, administering and
evaluating certification examinations for
students and graduates from CEPH
accredited schools and programs of public
health.
National Board (cont.)
“Representative members” will nominate individuals:
• ASPH
• APHA
• ATPM
• ASTHO
• NACCHO
• Private sector representatives
These committee members will then form a nominating
committee to complete the 24-member board. Board
members will be required to hold a degree from an
accredited SPH or program.
Exam
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Based on competencies
Inexpensive
Voluntary
Cumulative
Timeline
• Board Nominations Completed
Summer‘05
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1st Board Meeting (12 members)
Fall ‘05
Competency Process Finalized
Fall ‘05
2nd Board Meeting
Fall ‘06
1st Exam Delivered
Spring ‘07
For further information, contact:
1101 15th Street, NW,
Suite 910, Washington, DC 20005
voice: (202) 296-1099
fax: (202) 296-1252
e-mail: khelsing@asph.org
website: www.asph.org