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© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.047993
RESEARCH AND PRACTICE |
At the time the research was completed, the following authors were with the University of North Carolina at Chapel Hill School of Public Health: Karl Umble, David Steffen, and Janet Porter (North Carolina Institute for Public Health); Delesha Miller and Amy Lowman (Department of Health Behavior and Education); and Susan Zelt (Department of Health Policy and Administration). Kelley Hummer-McLaughlin is a private consultant in Chapel Hill, NC.
Correspondence: Requests for reprints should be sent to Karl Umble, PhD, MPH, Campus Box 8165, UNC-CH, Chapel Hill, NC 27599 (e-mail: umble{at}email.unc.edu).
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Recent public health literature contains calls for collaborative public health interventions and for leaders capable of guiding them. The National Public Health Leadership Institute aims to develop collaborative leaders and to strengthen networks of leaders who share knowledge and jointly address public health problems. Evaluation results show that completing the institute training increases collaborative leadership and builds knowledge-sharing and problem-solving networks. These practices and networks strengthen interorganizational relationships, coalitions, services, programs, and policies. Intensive team-and project-based learning are key to the program’s impact.
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Many authorities assert that public health improvements will require the sustained actions of coalitions and partnerships1–4 and frequently call for leaders with the vision and skills to foster them.2,3,5–8 The National Public Health Leadership Institute (PHLI) seeks to develop collaborative leaders who convene or participate in partnerships,9–13 and to strengthen national networks of leaders who trust one another, share knowledge, and work together to improve public health.14–26
The Centers for Disease Control and Prevention (CDC) founded PHLI in 1991 and remains its sponsor. For its first 9 years, PHLI was offered in California and annually enrolled 50 to 60 individual leaders (or "scholars").27,28 In 2000, the CDC selected a new partnership to offer PHLI: the University of North Carolina at Chapel Hill (UNC) School of Public Health, the UNC Kenan-Flagler Business School, and the nonprofit Center for Creative Leadership, Greensboro, NC.
PHLI now enrolls multiorganizational teams of 2 to 4 senior leaders, and requires intensive teamwork-based learning projects.29–31 (The program has begun to accept several individual scholars each year in addition to teams, to accommodate the preference of some learners; but at the time of this study all learners came in teams.) Learning methods for the 12-month program include leadership style assessments, personal feedback and coaching, assigned readings, interactive lectures/discussions, case studies, regular conference calls with experts, and a team project.32 A week-long retreat includes seminars and simulations in leadership, teamwork, systems thinking, negotiation, communication, and succession planning.33 Recent evaluation questions included (1) what are the effects of PHLI on scholars’ leadership understanding, perspectives, and practices; and (2) what have the team leadership projects achieved during the program and after graduation?
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METHODS |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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A telephone interview was completed34 with 1 member of each team (n = 25) from the first 2 cohorts 12 to 18 months after graduation to ascertain activities and accomplishments, lessons learned, whether scholars had applied those lessons to other situations, changes in scholars’ joint problem-solving activities, 15 and the number and identity of other leaders that they talk with about their challenges. Interview transcripts and project final reports were analyzed using content analysis methods.34 For a third cohort, only project final reports were examined.
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RESULTS |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Individual Outcomes
Many scholars said their PHLI experience helped them understand that activities are often best carried out by partnerships instead of single agencies (Figure 1
), and described a shift in their perspective away from the individual leader to shared roles among many leaders in the whole system of organizations concerned. Scholars attributed to PHLI their ability to engage in new leadership practices, including coaching and teaching others, managing conflicts, negotiating win–win partnerships, and securing funding through collaboration. Most interviewees (92%) said that, not counting their team project, they had taken on more or different kinds of leadership roles since PHLI, such as serving on state or national boards or running new programs.
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Network Outcomes
Most interviewees (96%) said their PHLI experience had increased both the number of leaders they talk with about challenges and how often they talk with them. Of these, 88% said that they still talk with team members, 46% still talk with other class members, and 33% still talk with other people met through PHLI, such as CDC staff. Scholars reported that collaborations within and outside of the project team had led to more relationships that possess the network characteristics of trust, information transfer, and joint problem solving.15 Many scholars turned their project work into an area of expertise that they share with regional or national working groups.
Team Project Outcomes
Teams addressed issues such as workforce development, improving access to care, reducing disparities, and improving data. Of all the respondents in the 3 UNC cohorts (Table 1), 81% completed a needs assessment or other research, several strengthened an existing coalition (9%) or developed a new one (19%), and others developed new policies and procedures for collaboration within (14%) or among (30%) organizations. Still others planned (21%) or implemented (16%) a new program or service, obtained increased resources (staff, funding, space, materials) (42%), or developed new communication tools (33%). Several teams started leadership development institutes.
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Project work was almost always sustained; 50% of respondents had put more than 5 person-days of work time into the project beyond the scholar year, 17% put in 3 to 5 days, and 29% put in 2 or fewer days (data not shown). A portfolio of learning projects is available online.35
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DISCUSSION |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Our evaluation supports the proposition that networks and collaborative leaders can be developed through education, and that groups thus created can improve services and programs. Many scholars reported that they more fully understood leadership as a collaborative activity, and had widened their collaboration and networking activities. Enrolling teams and using an intensive work-based learning project contributed strongly to learning and outcomes reported, and is consistent with global trends in leadership and management development.29–31,36–40 Limitations include having interviewed only 1 member per team, and having only interview data on team outcomes as opposed to more robust and concrete evidence.
Collaborative leadership development contributes to the social capital25,41 of the public health community, defined as the resources available to leaders and organizations through professional and interorganizational networks.25 Social capital should be considered an important aspect of the public health infrastructure, alongside financial capital, human capital (well-trained staff), organizations, and information systems.42 The relationship between strengthening leadership and improving the social capital of the public health community should be the focus of more theory development, interventions, and evaluation43,44 in the near future.
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Acknowledgments |
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The National Public Health Leadership Institute is funded by the Centers for Disease Control and Prevention (CDC), Atlanta, Ga.
We especially thank Steve Frederick of the CDC; Jim Dean and staff of the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill; Steve Hicks (of the Kenan-Flagler Business School at the time of the study); and the staff (especially Joan Gurvis, Susan Rice, and Deborah Torain) of the Center for Creative Leadership, Greensboro, NC, for their expert help in developing and conceptualizing this program.
We also thank Hugh Tilson, Rachel Stevens, and Ed Baker for comments on drafts and support, and Nancy Tolliver and Dannette Aultman for help in developing the program.
Human Participant Protection
This research was approved by the Public Health Institutional Review Board, Office of Research Ethics, University of North Carolina at Chapel Hill.
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Footnotes |
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Peer Reviewed
Contributors
K. Umble conceptualized and led the evaluation planning, data collection, and analysis, and wrote and edited much of the brief. D. Steffen helped conceptualize the evaluation, design the instruments, and analyze and interpret the data, and also commented on drafts. J. Porter offered conceptual help in study design and data interpretation. D. Miller, K. Hummer-McLaughlin, and A. Lowman helped with instrument design, data collection, and data analysis and interpretation, and also offered comments on drafts. S. Zelt helped develop the literature review and the interpretative framework for the study, and helped with decisions about which data to present.
Accepted for publication October 2, 2004.
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References |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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