Public Health Social Work in the 21st Century

National Conference Summary Report

I. Overview and Background

On May 19, 2006, approximately 200 public health and social work professionals from across the United States came to Boston for the first national conference on public health social work in more than 30 years. Co-sponsored by Boston University Schools of Social Work and Public Health, and funded by alumni and the schools themselves, Public Health Social Work in the 21st Century had three major goals: 1) to celebrate the 25th anniversary of Boston University’s successful and pioneering MSW/MPH program; 2) to present research on public health social work theory, training, and practice; and 3) to engage major stakeholders in discussion of the visibility, revitalization and importance of public health social work. The conference was dedicated to Ruth Cowin, co-founder of the Boston University MSW/MPH program and inspired public health social worker, who died in 2005. The target audience included MSW/MPH program graduates, associated faculty and directors of MSW/MPH programs, social work and public health practitioners, and representatives and affiliates of related government agencies, foundations and health care organizations.

Members of The Group for Public Health Social Work Initiatives (GPSI) served as Conference Coordinators, with BUSSW Professor Betty J. Ruth as the Conference Chairperson. GPSI is an ad hoc working group affiliated with Boston University and the New York Academy of Medicine. Formed in 2003, GPSI conducts research on multiple aspects of public health social work, and seeks to promote public health social work visibility in educational, professional and community settings.

II. Conference Highlights

Participants were welcomed in the morning by Acting Dean Gail Steketee of Boston University School of Social Work and BUSSW Professor Betty J. Ruth, Conference Chairperson. The conference was dedicated to Ruth Cowin by BUSSW Dean Emeritus Hubie Jones and Associate Dean of BUSPH Leonard Glantz, both of whom recalled her visionary contributions to public health social work. The new Ruth Cowin Memorial Prize in Public Health Social Work, established by Ruth Cowin’s son, Justice William Cowin, was announced by both Deans, and presented later in the day to an outstanding MSW/MPH graduating student, Jamie Wyatt (Class of 2006).

Major speakers from national public health and social work organizations presented the two keynote speeches: Patricia Volland, Vice President of the New York Academy of Medicine and Director of the Social Work Leadership Institute, opened the conference by highlighting the need for a renewed commitment to public health social work. Dr. Elizabeth Clark, Executive Director of the National Association of Social Work, gave an inspired closing speech on the future of public health social work in the context of contemporary practice. BUSSW alumni and faculty helped shape the day and were visible in their contributions: Geoff Wilkinson, BUSSW alumnus and current Executive Director of Massachusetts Public Health Association, and Mary Urban Keary, BUSSW alumna and adjunct faculty member and current President of the Massachusetts Chapter of NASW, presented the afternoon remarks. Gary Bailey, alumnus and adjunct faculty member, introduced Dr. Clark.

Continuing education units were offered at no charge to licensed social workers who attended. Selected scientific papers on public health social work practice, theory, education, and partnerships formed the basis of the knowledge sharing that occurred in the morning sessions. In the afternoon, a series of networking and action planning opportunities were designed to promote dialogue and focused discussion. Small groups were led by Tinka Markham Piper, an experienced facilitator of Mayor Bloomberg’s groups to strategically promote community rebuilding following 9/11 in New York. The small group process evolved into a large group conversation using an action plan model that yielded specific ideas, suggestions, and recommendations for how to move forward. Qualitative and quantitative evaluation methods were used to assess conference outcomes, a synopsis of which follows.

III.Demographic information: Conference participants

  • State of residence: 82.3 % were from Massachusetts, 85.7% from New England, 3.3% from New York, 2.6% from California. A smaller number of individuals came from California, Louisiana, Mississippi, Ohio, Michigan, Missouri and Canada.
  • The majority of those in attendance were MSWs or MSW/MPH graduates:
  • Academic Training:
    • 12.5% Doctorate/MD;
    • 40.3% MSW/MPH;
    • 36.1% MSW;
    • 1.4% MPH;
    • 8.3% graduate students;
    • 1.4% undergraduate students.

Participants worked in a broad array of settings:

  • Current position
    • Advocate 17.8%;
    • Administrator 41.1%;
    • Case Manager 13.7%;
    • Clinician 20.5%;
    • Community Organizer 6.8%;
    • Discharge Planner 4.1%;
    • Professor/Faculty 21.9%;
    • Policy 4.1%;
    • Researcher 11.0%;
    • Trainer/Educator 23.3%;
    • Development 24.7%

Career experience also was varied as captured by the length of time in the field:

  • 0-1 year: 30.3%;
  • 1-5 years: 33.3%,
  • 6-10 years: 19.7%;
  • 11-15 years: 9.1%;
  • 16+ years: 7.6%

Licensed social workers were well-represented:

  • Licensed in Social Work: 51.4%

IV. Scientific Paper Presentations: Building and Sharing Knowledge of Public Health Social Work

The call for abstracts emphasized the need for presentations to address a broad range of themes related to the conceptualization and definition of public health social work. Topics included: best practices in public health social work; related education and training; partnerships that highlight public health social work integration, and social marketing of public health social work. More than 60 abstracts were submitted, reviewed and assessed through a blind peer review process. Eighteen reviewers with a background in public health social work were trained to participate in the review, with each abstract evaluated by three reviewers.

  • A total of 24 abstracts were accepted for presentation and organized under the following themed headings. (Please see Appendix A for full list of abstracts)
    • Leadership, Community, and Collaboration
    • Training for Global Practice
    • Across the Lifespan
    • Aging, Disability, and Research Informed Practice
    • Contemporary Issues in Health and Society
  • Quantitative findings from individual session evaluations suggest that:
    • Presentations as a whole increased attendees understanding of PHSW
    • Multiple examples of public health social work were highlighted
    • Presentations assisted attendees to dialogue about public health social work

V. Quantitative evaluation of conference

Conference participants returned a two page qualitative/quantitative survey at the end of the conference (N=75) Participants were asked to evaluate the conference on a number of dimensions.

Overall results indicate that participant satisfaction was high, and a majority of participants acquired new knowledge public health social work.

Highlights include:

  • 54.1% reported they gained new knowledge related to “best practices” in public health social work.
  • 86.5% reported they are able to identify and describe public health social work as it currently exists.
  • 86.5% reported learning of the development of new initiatives aimed at fostering further development of public health social work.
  • 83.7% reported learning of the obstacles to public health social work visibility and methods for promoting and revitalizing public health social work.
  • 89.2% reported overall satisfaction with the usefulness of information provided.
  • 90.7% reported overall satisfaction with the opportunity the conference presented to reflect on new and old ideas.
  • 61.3% reported overall satisfaction with the opportunity the conference presented to learn new skills.
  • 91.0% reported being satisfied overall with the conference.

While the majority of those who attended found it useful, conference coordinators received some constructive criticism. One observation was that there were significant regional differences in public health social work’s visibility, with the Northeastern US being somewhat less developed than other areas of the country. Hosting a conference where there is a richer and more recent tradition of public health social work might have yielded different questions and considerations. In addition, certain groups of conference attendees found they needed additional time for dialogue or that the questions presented were too basic. This feedback affirms the major finding from the conference: most participants wanted more than a one-day conference, and that Public Health Social Work in the 21st Century was but a beginning step.

VI. Suggestions for Next Steps

Because the conference drew a widely disparate group of participants, conference organizers built in substantive opportunities for dialogue and discussion. The afternoon small-to-large group facilitation was designed to elicit feedback and ideas from participants about possible next steps in promoting continued effort on behalf of public health social work. Participants were organized into 12 pre-assigned groups, each consisting of 7-14 individuals. Groups were facilitated by trained MSW/MPH program alumni facilitators. Each group was given six discussion questions related to public health social work in the current professional and academic environment. Group discussion centered on how public health social work might be advanced in the 21st century, and each groups’ discussion culminated in the contribution of three action steps in order to move this goal forward. After working in the small groups, conference participants reconvened into a large group to debrief. One spokesperson from each group provided feedback and suggested action steps to further establish public health social work, yielding the following suggestions for needed action:

  • Establishment of a clear definition and professional identity for public health social work;
  • Increased research and advocacy efforts related to public health social work;
  • Development of a professional journal dedicated to public health social work;
  • Increased PHSW presence in trans-disciplinary journals;
  • Increased participation in currently established public health social work professional groups (APHA Social Work Section, ASTPHSW, NASW Health Section, development of CSWE section);
  • Development of additional national conferences on topics related to public health social work, targeted to specific topics or to certain interest groups such as MSW/MPH Program Directors;
  • Increased trans-disciplinary awareness of possible roles and contributions of public health social workers in contemporary work settings;
  • Integration of established public health social work standards and competencies into practice and education;
  • Development of a listserv and web site specifically for public health social work.

VII. Future Endeavors and Follow Up

  • As part of the conference follow up, the Group for Public Health Social Work Initiatives (GPSI) will host an informal networking event for conference attendees and interested others at the American Public Health Association Annual Meeting in Boston on Monday November 6, 2006, 5:30-7:00 pm.
  • MSW/MPH Program Directors who convened at the conference have already established a listserv for the larger MSW/MPH community and will meet together at the above APHA meeting.
  • The Group for Public Health Social Work Initiatives is continuing its research, and will be presenting papers related to public health social work topics at Society for Public Health Education (SOPHE) and American Public Health Association (APHA) in November 2006.

VIII. Conclusion

The conference appears to have been successful in meeting its original purpose: (i) “to bring together major stakeholders; (ii) to dialogue and collaborate on enhancing the visibility, revitalization, and importance of public health social work, and (iii) to build a basis for future collaboration.” It is clear there is much work to be done, and that this conference was a positive beginning step. Many good ideas were shared and the conference coordinators hope to build on this event through follow-up initiatives in 2007 and beyond.

Please contact Betty J Ruth at bjruth@bu.edu for additional information or visit the GPSI website at www-staging.bu.edu/ssw/mswmph

Prepared by Jamie Wyatt, Betty J Ruth, Sarah Sisco, and Tinka Markham Piper, September 2006

IX. Appendix A. Complete List of Presentation Abstracts

Session A – Public Health Social Work: Leadership, Community, and Collaboration

Innovations in leadership development for Public Health Social Workers: Working inter-professionally within academic/community partnerships

Authors: Edward Pecukonis & Otima Doyle

This presentation will focus on a MCH Bureau-funded model of interdisciplinary learning at the University of Maryland School of Social Work. The program emphasizes cultural competence and leadership skills through the establishment of academic-community partnerships. This successful educational model may serve as a model for replication.

Public Health Social Work Practice: A Focus on the Successes, Challenges, and Lessons Learned in Building Healthier Communities
Author: Tami Gouveia-Vigeant

Public health social work is a primary field for work in community-based coalitions. Case studies of four different public health collaboratives will provide participants with concrete examples of the lessons, successes, and challenges faced in the coalition building process. The role of public health social work in community-based participatory research will be explored.

Developing and Maintaining a Successful Community-Research Partnership: The Example of La Voz, an HIV-Prevention Program
Authors: Julie Witas, Angela Maina, Timothy Purington, Deborah Chassler, & Lena Lundgren

Community-based participatory research models provide mutually beneficial opportunities for researchers and community organizations in an era of shrinking resources and changing demographics. This presentation will highlight a case study between Boston University School of Social Work and a community-based agency, Tapestry Health, as an example for strategies of a successful academic/community-based partnership.

Redefining Public Health and the role of Social Work
Author: Mary Kiernan-Stern

The application of public health social work to community health broadens the venue and scope of social work practice to include services in the public and private sector of health care. This presentation will discuss a conceptual framework that links public and private sector so that full integration of social work role in health care can result, regardless of the funding source.

A Model for a Collaborative Social Work/Public Health Response to Traumatic and Catastrophic Events: Lessons Learned from Katrina
Authors: Susan Hoffpauir & Annette Woodruff

The Arkansas Chapter of NASW, the Arkansas Division of Health, and the School of Social Work at the University of Arkansas at Little Rock developed a mental health response protocol for use in bioterrorism events. The team was called into action in the aftermath of Hurricane Katrina to provide mental health triage and crisis intervention services to evacuees. This presentation will focus on important issues and recommendations related to efficacy of traditional mental health traumatic response intervention following catastrophes.

Session B – Public Health Social Work: Training for Global Practice

Working with Immigrants: Practice and Ethical Challenges in Public Health Social Work

Author: Elaine Congress

Immigrant family health issues pose ethical challenges for public health social workers. This presentation will explore issues that emerge within the context of guidelines for effective practice with immigrants. Public health social work case examples will be used to discuss ethical dilemmas in this context.

Strengthening the Health Workforce in Developing Countries through Effective Partnerships
Author: Jennifer Braga Leonardo

TCNetwork, Inc. is now a key stakeholder in addressing the crisis global human resources. This presentation will highlight the social work role and advocacy necessary to the establishment of this organization over a three-year period. Implications for public health social workers interested in international health care and the role of social work in organized public health response will be discussed.

Public health social work in an international context: Lessons learned from humanitarian interventions in Sudan and Eritrea
Author: Allyson Brown

Concern Worldwide is an international humanitarian organization committed to the relief, assistance, and advancement of the poorest people in Sudan and Eritrea. Three case examples will be used to illustrate how the organization utilizes public health and social work approaches in cost-effective community-based health care initiatives. Challenges, lessons learned, and recommendations for integrating public health and social work models in international humanitarian settings will be discussed.

Integration of professional training in joint MSW/MPH programs
Author: Bari Cornet

This presentation will focus on the results of an exploratory study examining the degree of integration between and among 18 MSW/MPH programs in the United States. Dimensions studied include recruitment, admissions, advising, faculty appointments, course sequencing, integrated course work, and existence of a capstone seminar(s). As more schools contemplate the establishment and implementation of combined programs in social work and public health, consideration of overall trends and assessment program development is critical.

Community-Based Health Promotion and Adherence Counseling: A Public Health Social Work Intervention
Authors: Christina Bethke & Jessica Aguilera-Steinert

The authors will present an integrative model that combines epidemiological indicators with client-based interventions to improve health outcomes of persons infected with HIV/AIDS. The implications for increased development and testing of client-centered, multi-faceted adherence interventions and the applicability and expansion of this model to other settings will be discussed.

Session C – Public Health Social Work: Across the Lifespan

Healthy Tomorrows: A model for integrating physical and mental health for children
Authors: Victoria Harris, Karen Hacker, Judith Howe, & Fatima Braga

This presentation will discuss the benefits and challenges of providing mental health services using a collaborative approach between pediatrics and child psychiatry/social work. The Pediatric Mental Health Screening and Intervention Project, a project that seeks to encourage mental health screening in pediatrics while providing on-site access to a mental health professional for therapy and consultation, will present its current work on the Healthy Tomorrows Project.

The growing epidemic of childhood obesity: A time for public health social work practitioners to address the mediating factors pervasive in communities
Author: Yvette Sealy

Obesity in children is now an epidemic in the United States, with rates doubling in the past three decades. Results from focus groups conducted with parents of local youth service organizations will be presented with an overview of preliminary data from a mixed-method pilot study. A three-pronged systemic approach to decreasing childhood obesity that includes public health social work, community-planning and education will be discussed.

Understanding treatment adherence in transporting an evidence-based prevention program to new community and cultural contexts
Authors: Susan Stern, Ramona Alaggia, & Katina Watson

This study addresses the challenges of maintaining treatment integrity and external validity when extending an empirically validated Parenting Program to a new population and context. Given the documented relationship between treatment fidelity and outcomes, this presentation will discuss how to advance knowledge of successful strategies to foster efficacious treatments into community-based practice. Overall findings can be helpful to public health social workers interested in research-based prevention programs with diverse families.

Teaching social work students about the public health approach to preventing family violence and sexual assault
Authors: Elana Premack, Alicia Oathout, & Elaine Alpert

The public health approach has advanced understanding of family violence and sexual assault (FV/SA); enabling the development of successful empowerment-based intervention and prevention strategies. To ensure broad and effective responses to FV/SA, more social workers need training in these models. Boston University School of Public Health has developed two courses to help build a critical mass of public health and social work practitioners with expertise in FV/SA. This presentation will briefly describe the approach and content. Recommendations for future initiatives in training public health social work professionals will be offered for discussion.

The Impact of Oral Health on an Aging Population: The Oral Health Equity Project
Authors: Kathy Lituri, Catherine Hayes, Susan Jenkins, Maria Sesma, & Hilde Tilman

The connections between oral health, poverty, racism, and poor health outcomes are clear. Social workers are one key to oral health promotion and need to be trained in culturally-competent oral health case management. This presentation will discuss the Oral Health Equity Project, a program that promotes oral health in public housing sites through utilization of social workers. Results from this project will be shared, as well as future implications for public health social workers in this type of initiative.

Session D – Public Health Social Work: Aging, Disability, and Research Informed Practice

Social Work in Primary Care: An Evidenced-Based Intervention Study for Older Adults
Author: Brownyn Keefe

Data suggests that frail older adults sometimes experience unnecessary hospitalization. The Institute of Geriatric Social Work completed a randomized control trial to test an evidenced-based practice social work intervention with frail older adults in primary care designed to reduce unnecessary hospitalization and improve patient outcomes. Research findings on patient outcomes, cost, and utilization will be discussed as well as implications for integration of social workers into primary care settings.

Public health social work standards and competencies
Authors: Deborah Stokes & Loretta Fuddy

This presentation will discuss the Public Health Social Work Standards and Competencies developed through the Beyond Year 2010: Public Health Social Work Practice Initiative. The standards and competencies will be presented and discussion will focus on their application at all levels of professional practice.

Internationalizing” Public Health Social Work Education: The China Experience

Author: Ed Saunders

Growing recognition that we are all part of the “global village,” suggests the value of “internationalizing” public health social work content and experience. Drawing from his experience teaching a public health social work course at a large university in central China, the presenter will highlight the challenges and opportunities of being the first American professor to teach such a course in the People’s Republic of China. Challenges of teaching the content in a country without a long history of professional social work as well as an overview of the primary public health issues of concern to the students will be included.

Disability rehabilitation as social work public health: The case of spinal cord injury
Authors: Bethlyn Vergo Houlihan & Nancy Powell

Disability has recently become a public health priority, as expressed through Healthy People 2010 goals addressing disability and secondary conditions. For people with disabilities, public health and social work outcomes are often inextricably intertwined. This presentation will discuss one nationally renowned model of coordinating care for those with disabilities, the Boston Community Medical Group, a cost-effective and successful visiting nurse and holistic case management program for severely disabled Medicaid recipients. Implications for the role of public health social work will be discussed.

Advancing the Public Health Social Work Research Agenda
Author: Joan Zlotnik

This presentation will consider the current status of federal support for social work research. The presenter will describe emerging research priorities, research agenda setting, funding mechanisms, and strategies for successful grant-writing. The role of the Institute for the Advancement of Social Work Research as an advocate and technical resource in building research capacity and infrastructure will also be discussed, along with the recommendations of the recent Congressionally-requested NIH Plan for Social Work Research.

Session E – Public Health Social Work: Contemporary Issues in Health and Society

Public Health Social Work Training in Community Violence Prevention: The SURVIVE Community Project Experience
Authors: Ellen Devoe & Kara Dean Assael

The SURVIVE Community Project in South Bronx, New York, is a preventive intervention aimed at mitigating the effects of violence exposure on youth. Students from a variety of disciplines, including social work and public health, participated in this project, gaining experience in programming, grant writing, implementing research protocols, clinical interventions, and community collaboration. An overview of the experience as well as ongoing data analysis of program effectiveness also will be presented.

The Crisis of Public Health: Implications for Social Workers
Author: Stephen Gorin

The presentation will discuss the development of public health in the United States with a focus on the “curative” model of health, which largely neglects social factors. The “new public health” which goes beyond the curative approach and addresses the social determinants of health and opportunities for prevention, will be presented. The role for social workers in the “new public health” arena will be discussed.

Public Health Social Work and HIV/AIDS Prevention Targeting African American Men: Are we listening with our noses?
Author: Darrell Wheeler

HIV/AIDS among Black and African American is unquestionably a significant public health dilemma. The presentation will discuss data from a qualitative study of African American men who have sex with men (MSM). The conceptual framework that emerges from the voice of the participants focuses on communal and individual resilience, social justice, and advocacy as prevention tools for African American MSM. The role of public health social work is highlighted including implications for education and training.

Understanding victims of prostitution and commercial sexual exploitation: Dispelling myths and breaking down barriers
Author: Lisa Grace

The My Life My Choice Project is an innovative public health social work collaborative focused on prevention of sexual exploitation of adolescent girls. Informed by public health and social work frameworks since its inception, this project is evidence-based, multi-disciplinary, community-based, and oriented toward advocacy and social change. Results from both qualitative and quantitative evaluations of this project will be shared during this presentation and implications of how this program is an example of public health social work’s specific contribution to addressing contemporary social issues will be discussed.

Integrating harm reduction principles and multi-disciplinary collaboration to assist homeless/runaway youth: The public health social work paradigm as practiced on the streets of San Francisco
Authors: Eliza Gibson & Chandra Sivakumar

The continuum-of-care services for runaway and homeless youth require an emphasis on harm reduction and health promotion. This presentation will discuss examples of the successful integration of public health social work principles into academic/community/workplace settings on behalf of at-risk youth in San Francisco. Application of the model to other populations and settings will be discussed.