Building a public health workforce for a university campus during a pandemic using a practicum framework: Design and outcomes

Carolyn S. Dewa; Zoe Che; Andrea M. Guggenbickler; Rebecca Phan; Bradley Pollock

doi:10.1371/journal.pone.0270488

Peer Review History

Original SubmissionJuly 2, 2021
7 Feb 2022 Decision Letter - Anand Nayyar, Editor PONE-D-21-21695Building a public health workforce for a university campus during a pandemic using a practicum framework: design and outcomesPLOS ONE Dear Dr. Dewa, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Mar 24 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This paper describes the use and outcomes of a practicum framework to create a university-based public health workforce to limit the spread of COVID-19 on a university campus. We address two questions: (1) Using a practicum framework, what are important considerations in designing and building a public health workforce for a university campus? and (2) What are the benefits to the workforce in terms of public health education and professional growth? Methods: As part of its COVID-19 reopening plan, a West Coast university developed a public health workforce comprised of 282 undergraduates tasked with encouraging compliance with COVID-19 mitigating healthy behaviors. Program secondary data were used to describe who was included in the workforce and their learning outcomes. The majority indicated they learned new skills/developed new attitudes (71.7%) and became aware of strengths and opportunities for professional growth (73.7%). The types of new skills and attitudes learned included communication (49.2%), conflict management (20.4%), time management (7.5%), and open-mindedness/less judgmental attitude (14.6%). What did they learn about public health? They gained an understanding of infectious disease prevention (40.9%), that it is a multi-disciplinary field (20.5%), and it involves a community effort (36.8%). Comments to work upon: 1. Abstract need to be restructured 2. Introduction lacks contribution and structure of what the other section will provide. 3. Abstract should reflect the background knowledge on the problem addressed need to be added. 4. Abstract should reflect the wide range of applications and its possible solutions need to be added. 5. Abstract should reflect the problem addressed need to be justified with more details. 6. In Introduction section, the drawbacks of each conventional technique should be described clearly. 7. Introduction section can be extended to add the issues with respect to existing work 8. What is the motivation of the proposed work? 9. Literature review techniques have to be strengthened by including the issues in the current system and how the author proposes to overcome the same 10. Research gaps, objectives of the proposed work should be clearly justified. 11. The conclusion should state scope for future work. 12. Authors should include some graphs, flowcharts for better presentation of work Reviewer #2: 1. Are there any patterns across academic majors in terms of STEM vs. non-STEM students? 2. Are there statistically significant differences in perceptions due to their gender? 3. Additional factors that the authors could have considered include compensation, assignment of trivial work, competitive co-interns, and work overload. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. 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Revision 1
13 Apr 2022 Author Response REVIEWER COMMENTS IN CAPS. 1. ABSTRACT NEED TO BE RESTRUCTURED. Thank you for pointing this out. As suggested, the Abstract has been restructured. 2. INTRODUCTION LACKS CONTRIBUTION AND STRUCTURE OF WHAT THE OTHER SECTION WILL PROVIDE. Text in the Introduction was revised with clarification, Using a practicum framework, a West Coast university with an undergraduate enrollment of 31,162 students, developed a public health workforce of undergraduate peer educators to address its reopening plans and meet its COVID-19 health promotion mandate. In this paper, we describe the use and outcomes of a practicum framework to create a university-based public health workforce to limit the spread of COVID-19 on a university campus. We address two questions: (1) Using a practicum framework, what are important considerations in designing and building a workforce for a university campus? and (2) What are the benefits to the workforce in terms of public health education and professional growth? This paper contributes to filling the gap in the literature about how a practicum framework can be used on a large scale as an effective learning tool in an urgent public health crisis. 3. ABSTRACT SHOULD REFLECT THE BACKGROUND KNOWLEDGE ON THE PROBLEM ADDRESSED NEED TO BE ADDED. As suggested, a Background section was added. It reads: Background: The reopening of college and university campuses was seen as presenting a high risk for transmission of COVID-19. Thus, these institutions faced with a new public health challenge never heretofore faced on this scale. To magnify the problem, they needed to rapidly develop and implement re-opening plans in an environment filled with uncertainty and for a population that was significantly less likely to observe COVID-19 mitigation behaviors. In response, within three weeks of opening, as part of its COVID-19 public health strategy, a West Coast university created and trained a public health workforce comprised of 282 undergraduates tasked with encouraging compliance with COVID-19 mitigating healthy behaviors. 4. ABSTRACT SHOULD REFLECT THE WIDE RANGE OF APPLICATIONS AND ITS POSSIBLE SOLUTIONS NEED TO BE ADDED. As suggested, text has been added: These findings demonstrate an effective way of rapidly addressing public health concerns that allowed for on the job training and opportunities for young adults to learn and grow. 5. ABSTRACT SHOULD REFLECT THE PROBLEM ADDRESSED NEED TO BE JUSTIFIED WITH MORE DETAILS. As suggested, additional text Background: The reopening of college and university campuses was seen as presenting a high risk for transmission of COVID-19. Thus, these institutions faced with a new public health challenge never heretofore faced on this scale. To magnify the problem, they needed to rapidly develop and implement re-opening plans in an environment filled with uncertainty and for a population that was significantly less likely to observe COVID-19 mitigation behaviors. In response, within three weeks of opening, as part of its COVID-19 public health strategy, a West Coast university created and trained a public health workforce comprised of 282 undergraduates tasked with encouraging compliance with COVID-19 mitigating healthy behaviors. 6. IN INTRODUCTION SECTION, THE DRAWBACKS OF EACH CONVENTIONAL TECHNIQUE SHOULD BE DESCRIBED CLEARLY. As suggested, text was revised and added: But, to provide effective education, peers must be prepared with knowledge and communication skills. In public health, practicum structures are used as a teaching vehicle. Practicums present students opportunities to apply public health knowledge and skills in practice [12]. Undergraduate practicum projects have been shown to be highly effective to train students for public health work [13]. Thus, the practicum is considered a capstone in an undergraduate student’s public health experience [14]. This assumes that the practicum is being offered within the context of a public health major, raising the question of the effectiveness of a practicum framework to introduce and teach public health to students who are not majoring in public health. Furthermore, there is a paucity of literature on the use of the practicum model on a large scale to address a community’s public health needs that a pandemic demands. These demands include continuously keeping up to date with quickly changing scientific knowledge, public health policies, and educating a potentially frustrated public while creating a positive learning experience. 7. INTRODUCTION SECTION CAN BE EXTENDED TO ADD THE ISSUES WITH RESPECT TO EXISTING WORK. As suggested, text was revised and added: But, to provide effective education, peers must be prepared with knowledge and communication skills. In public health, practicum structures are used as a teaching vehicle. Practicums present students opportunities to apply public health knowledge and skills in practice [12]. Undergraduate practicum projects have been shown to be highly effective to train students for public health work [13]. Thus, the practicum is considered a capstone in an undergraduate student’s public health experience [14]. This assumes that the practicum is being offered within the context of a public health major, raising the question of the effectiveness of a practicum framework to introduce and teach public health to students who are not majoring in public health. Furthermore, there is a paucity of literature on the use of the practicum model on a large scale to address a community’s public health needs that a pandemic demands. These demands include continuously keeping up to date with quickly changing scientific knowledge, public health policies, and educating a potentially frustrated public while creating a positive learning experience. 8. WHAT IS THE MOTIVATION OF THE PROPOSED WORK? As suggested, text was added: This paper contributes to filling the gap in the literature about how a practicum framework can be used on a large scale as an effective learning tool in an urgent public health crisis. It also created an infrastructure to expeditiously educate and prepare a large workforce while providing ongoing education about new, salient, and rapidly changing scientific knowledge and public health policies to a potentially confused and frustrated populace. 9. LITERATURE REVIEW TECHNIQUES HAVE TO BE STRENGTHENED BY INCLUDING THE ISSUES IN THE CURRENT SYSTEM AND HOW THE AUTHOR PROPOSES TO OVERCOME THE SAME. The explanation was added: But, to provide effective education, peers must be prepared with knowledge and communication skills. In public health, practicum structures are used as a teaching vehicle. Practicums present students opportunities to apply public health knowledge and skills in practice [12]. Undergraduate practicum projects have been shown to be highly effective to train students for public health work [13]. Thus, the practicum is considered a capstone in an undergraduate student’s public health experience [14]. This assumes that the practicum is being offered within the context of a public health major, raising the question of the effectiveness of a practicum framework to introduce and teach public health to students who are not majoring in public health. Furthermore, there is a paucity of literature on the use of the practicum model on a large scale to address a community’s public health needs that a pandemic demands. These demands include continuously keeping up to date with quickly changing scientific knowledge, public health policies, and educating a potentially frustrated public while creating a positive learning experience. This paper contributes to filling the gap in the literature about how a practicum framework can be used on a large scale as an effective learning tool in an urgent public health crisis. 10. RESEARCH GAPS, OBJECTIVES OF THE PROPOSED WORK SHOULD BE CLEARLY JUSTIFIED. The explanation was added: But, to provide effective education, peers must be prepared with knowledge and communication skills. In public health, practicum structures are used as a teaching vehicle. Practicums present students opportunities to apply public health knowledge and skills in practice [12]. Undergraduate practicum projects have been shown to be highly effective to train students for public health work [13]. Thus, the practicum is considered a capstone in an undergraduate student’s public health experience [14]. This assumes that the practicum is being offered within the context of a public health major, raising the question of the effectiveness of a practicum framework to introduce and teach public health to students who are not majoring in public health. Furthermore, there is a paucity of literature on the use of the practicum model on a large scale to address a community’s public health needs that a pandemic demands. These demands include continuously keeping up to date with quickly changing scientific knowledge, public health policies, and educating a potentially frustrated public while creating a positive learning experience. This paper contributes to filling the gap in the literature about how a practicum framework can be used on a large scale as an effective learning tool in an urgent public health crisis. 11. THE CONCLUSION SHOULD STATE SCOPE FOR FUTURE WORK. As suggested, text was added to suggest further work, This approach may not be fully replicable for universities without a public health educational program. But, they may be able to find other related fields from which to draw. Future work could pursue innovative ways of replicating a similar workforce through academic and governmental partnerships. 12. Authors should include some graphs, flowcharts for better presentation of work As suggested, the flowchart was moved from supplemental material to the manuscript. Reviewer #2: 1. ARE THERE ANY PATTERNS ACROSS ACADEMIC MAJORS IN TERMS OF STEM VS NON-STEM STUDENTS? We examine whether the differences in satisfaction by STEM. There were none. We included these analyses in Table 3 and the text, Of the PHA respondents, 98.8% rated their satisfaction with the PHA role (Table 3). The majority indicated they were satisfied with their role (95.2%, n = 238). Few were dissatisfied with their role either (4.8%, n = 12. In addition, 96.8% (n = 242) were satisfied the educational value of the program and 94.0% (n. =235) were satisfied with the value for their professional interests. There were no significant differences by either gender or STEM/Non-STEM major. Furthermore, none of the PHAs developed COVID-19 as a result of their role. 2. ARE THERE STATISTICALLY SIGNIFICANT DIFFERENCES IN PERCEPTIONS DUE TO THEIR GENDER? We examine whether there were differences in satisfaction by gender. There were none. We included these analysis in Table 3 and the text, Of the PHA respondents, 98.8% rated their satisfaction with the PHA role (Table 3). The majority indicated they were satisfied with their role (95.2%, n = 238). Few were dissatisfied with their role either (4.8%, n = 12. In addition, 96.8% (n = 242) were satisfied the educational value of the program and 94.0% (n. =235) were satisfied with the value for their professional interests. There were no significant differences by either gender or STEM/Non-STEM major. Furthermore, none of the PHAs developed COVID-19 as a result of their role. 3. ADDITIONAL FACTORS THAT THE AUTHORS COULD HAVE CONSIDERED COULD HAVE CONSIDERED INCLUDE COMPENSATION, ASSIGNMENT OF TRIVIAL WORK, COMPETITIVE CO-INTERNS, AND WORK OVERLOAD. All were paid the same rate. The APHAs were assigned the same roles. We were careful to ensure that their roles involved public health policy education and the role did not deviate from this function. Most worked 10 hours/week. Attachments Attachment Submitted filename: PlosOneReponse_032322FIN.docx https://doi.org/10.1371/journal.pone.0270488.r002
13 Jun 2022 Decision Letter - Anand Nayyar, Editor Building a public health workforce for a university campus during a pandemic using a practicum framework: design and outcomes PONE-D-21-21695R1 Dear Dr. Dewa, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Paper title: Building a public health workforce for a university campus during a pandemic using a practicum framework: design and outcomes Discusses Well: The majority of students indicated that through the practicum, they learned new skills/developed new attitudes (71.7%) and became aware of their own strengths and opportunities for professional growth (73.7%). The types of new skills and attitudes learned included communication (49.2%), conflict management (20.4%), time management (7.5%), and open-mindedness/less judgmental attitude (14.6%). In terms of public health, they gained an understanding of infectious disease prevention (40.9%) that is multi-disciplinary (20.5%), and involves a community effort (36.8%). Conclusions: These findings demonstrate an effective way of rapidly addressing public health concerns that allowed for on the job training and opportunities for young adults to learn and grow. The practicum framework allowed the expeditious development of a public health workforce that ensured a fit between student interests and the role. This led to high retention with the majority of students continuing into the winter quarter. Only 5% of students reported not being satisfied with their position. None of the students contracted job-related COVID-19. The role gave students a sense of purpose during the pandemic’s uncertain times that helped to protect them from the negative effects of stress. The practicum structure and support fostered a safe environment in which students were able to feel part of the larger community while gaining valuable work experience and skills and serve their community As a conclusion, the technical content is good. Therefore, the contribution of this article is also satisfactory. I am accepting article for publication in this journal. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No ******** https://doi.org/10.1371/journal.pone.0270488.r003
Formally Accepted
12 Jul 2022 Acceptance Letter - Anand Nayyar, Editor PONE-D-21-21695R1 Building a public health workforce for a university campus during a pandemic using a practicum framework: design and outcomes Dear Dr. Dewa: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Anand Nayyar Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0270488.r004

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