Health Education Specialists: Professional Practice During a Pandemic

Abstract

Authors conducted survey research on Health Education Specialists’ (HES) involvement in the COVID-19 pandemic. Participants (n = 1,837) completed questions on COVID-19 work and job responsibilities, use of the NCHEC Areas of Responsibility and Competencies in addressing the pandemic, education and training, work with populations at risk, and volunteer work related to COVID-19. The majority of respondents reported some work, either professional or personal associated with the pandemic, and the majority felt prepared to do this work, although it caused additional work responsibilities with no additional pay. Many had to work from home during the pandemic, using technology to accomplish their tasks. Most reported conducting education and prevention and designing and implementing communication strategies regarding the pandemic. Those with MCHES® certification were more likely to use the HESPA-II 2020 competencies in their work and more likely to perform listed COVID-19 activities, with the exception of contact tracing and direct care to COVID-19 patients, which were more likely conducted by CHES® certified HES. Results of this study show the significant level of involvement of HES in the COVID-19 pandemic in a variety of roles and capacities, despite a challenging political landscape during the time the survey was administered. Many HES reported volunteer work in addition to their paid work, including donating money, distributing food, or making masks. Finally, HES welcomed more training on COVID-19 and use of technology. Results of the study may be used to document the roles of HES during the COVID-19 pandemic and to make recommendations for future emergency preparedness efforts.

Keywords

COVID-19 Health Education Specialists pandemic emergency preparedness

Background

The world has changed since the debut of the novel coronavirus (COVID-19). COVID-19 has affected individuals and communities across the United States and the globe. Stay-at-home orders have been implemented requiring work from home and quarantining for some, and job loss for others. The virus has wreaked havoc on employment (National Conference of State Legislatures, 2020) education (Schleicher, 2020), and the economy (Bauer et al., 2020). Mask wearing and social distancing has been required by governors of some states, but there have been many inconsistencies in the application of public health measures across cities and states (Ballotpedia, 2021). At the time of this writing (September 1, 2021), 640,121 COVID-19 deaths have been reported in the United States, the highest number of any country in the world (Johns Hopkins University of Medicine, 2021). Deaths continue despite vaccines being readily available, with 98% to 99% among the unvaccinated and about 1% due to break through infections among fully vaccinated individuals (Johnson & Stobbe, 2021). When the vaccinated are infected, however, their illness is typically much less severe (Centers for Disease Control and Prevention [CDC], 2021a).

Although pandemic and disaster preparedness are core functions of public health practice, most experts would agree that the United States was dramatically underprepared for a pandemic of this nature, including former CDC Director Robert Redfield (Farzan et al., 2020). As early as 2005, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, suggested that the United States ramp up research for vaccines and public health officials draft more than just general plans for a pandemic (Osterholm, 2005). He recommended the development of a detailed blueprint regarding the best way to get through 12 to 24 months in a pandemic, more research on immunology of influenza vaccines, plans for staffing temporary hospitals, increased production of drugs, masks, and antibiotics, and addressing manufacturing shortages (Osterholm, 2005).

Osterholm’s recommendations, however, went unheeded, resulting in the U.S. being drastically underprepared for the COVID-19 pandemic. Shortages of personal protection equipment (PPE), ventilators, morgue space, and intensive care unit beds have been a few of the issues faced by communities and health workers (Liasson & Huang, 2020). In addition, health communications by the CDC were contradicted by then President Trump, eroding public trust (Liasson & Huang, 2020). Recently, a Kaiser Family Foundation (2020) poll indicated a drop in the public’s trust of the nation’s public health institutions and officials to provide reliable information. In spite of the lack of preparedness from the top (Farzan et al., 2020) and the challenges faced by sometimes angry, and even threatening, community members (Barry-Jester et al., 2020), public health workers pushed forward, serving their communities to the best of their abilities.

As part of this public health workforce, Health Education Specialists (HES) have taken on many roles during the pandemic. Some of these roles include preventing personal exposure; testing and contact tracing; developing public health messaging and virtual programs; providing evidence-based information and combating misinformation; policy development; supervising and serving on Incidence Management Teams; working to reduce health disparities among at-risk populations; advocating for public protection; educating to change risk behaviors; health coaching; COVID-19 program planning, implementation, evaluation and management; acting as a resource person; and conducting research on the pandemic (National Commission for Health Education Credentialing [NCHEC], 2020, 2021). Chaney et al. (2020) concluded that HES are often called upon to lead COVID-19 efforts in a variety of settings, and their skills and competencies have proven crucial in performing their jobs during a global pandemic. While these and more roles have been reported in interviews with individual HES, research on the extent of their involvement as a group is limited. Hancher-Rauch et al. (2021) conducted a national study of HES and found that 43% were forced to change their work priorities due to COVID-19. Of the 913 HES who responded to the national survey, 487 reported a required shift in work priorities, with 389 (80%) stating the required shift being a focus on COVID-19 public health issues (Hancher-Rauch et al., 2021). At the time of that data collection (summer 2020), the majority of HES felt prepared to tackle the new responsibilities thrown at them, but many also feared an inability to eventually transition back to previous roles alone.

It is clear from the above list of professional duties during the pandemic that HES are a varied and highly skilled workforce. This likely is due to the solid foundational training completed by HES to fulfill their professional Areas of Responsibility and Competencies (NCHEC & Society for Public Health Education [SOPHE], 2020). To expand on the previous work of others, the framework used for this study was the most recent HES Practice Analysis [HESPA II-2020] (NCHEC & SOPHE, 2020). This practice analysis surveyed over 3,850 HES in various settings to update and validate HES Areas of Responsibility, Competencies, and Sub-Competencies. In the present study, HES were given a list of the HESPA II-2020 Areas of Responsibility and Competencies and asked to check all that they are using during the COVID-19 pandemic. Although these competencies do not specifically address the roles of HES during a pandemic, it is evident how HES could utilize their training in the eight Areas of Responsibility and Competencies as they work through the public health challenges of the current pandemic.

What is not known, however, is how HES practice may change or evolve amid a global pandemic. Because the current HES workforce has never faced a global pandemic like COVID-19, there is much to be learned from their experience. While Hancher-Rauch et al. (2021) found a shift in HES priorities due to COVID and how their work priorities and lives had been changed due to the pandemic, their study focused more on the general shifts of focus, work-life struggles, and concerns about future roles. The current study expands that work to include a more detailed analysis of competencies HES are using during the pandemic, the training received to meet the new challenges, and additional training needed to perform their expanding roles. This information is important to the field, as it is extremely unlikely that the COVID-19 global pandemic will be the last faced by this generation. Better understanding of the ways the profession has been able to shift during COVID-19, as well as how the field can better prepare for future global pandemics through appropriate training, will help ensure smoother responses next time.

The purpose of this study was to assess HES’ (both Certified Health Education Specialists’ (CHES®) and Master Certified Health Education Specialists’ (MCHES®) job responsibilities and workload, competencies used, training received and needed, populations served, and volunteer work during the COVID-19 pandemic. More specifically, authors sought to determine: type of COVID-19 work performed; workload and environment; current job responsibilities and activities related to COVID-19; Areas of Responsibility and Competencies used in addressing COVID-19; comparisons of CHES® and MCHES® COVID-19 work; training received, required or needed; work with priority populations most at risk for COVID-19 prior to and after the onset of the pandemic; and COVID-19 volunteer work reported by HES.

Methods

Participants included HES holding either the CHES® or MCHES® credential. To ensure all CHES® or MCHES® who agreed to provide that information were included in email invitations, a list was obtained from NCHEC, the organization that manages the credentials and continuing education contact hours.

Upon approval from the State University of New York–Cortland institutional review board (IRB), an original email was sent to all 12,049 listed addresses; 11,843 of which were deliverable. Four follow-up emails were sent to nonrespondents. In total, 1,837 surveys were completed. Informed consent was gathered electronically before beginning the survey using the online data collection software, Qualtrics. Responses were anonymous except for an optional question on employment title, from which a respondent’s identity could possibly be derived. IRB approval was received prior to receiving the list of contacts from NCHEC or contacting participants.

Procedure

A single point cross-sectional design was used to assess how work duties for CHES® and MCHES® have changed during the COVID-19 pandemic. Survey design included questions to gather basic demographic information (including credential level, education, degree level, and training) and to assess types of COVID-19 work performed, specific COVID-19 job-related activities, Areas of Responsibility addressed, populations they served, and any COVID-19-related volunteer work. Open-ended response options were included to ensure inclusivity of experiences. Survey items are described in further detail in the Instrument section.

The survey was reviewed by a psychometric expert, a HES, and a professional holding the MCHES® credential to establish content validity consistent with research questions. Face validity was established by a small group of HES that reviewed the final survey draft.

Analysis

A Cronbach’s alpha (.713) was calculated to assess internal consistency of the scales. Frequencies and descriptive statistics were used to assess survey responses. Chi-square analyses were performed to determine differences between CHES® and MCHES® on selected questions pertaining to COVID-19-related work responsibilities and use of the HESPA-II-2020 Areas of Responsibility and Competencies as they pertain to COVID-19.

Qualitative data were collected for two questions on COVID-19 work performed and COVID-19-specific job responsibilities where “other” was selected. Text responses for each question were reviewed independently by three researchers. The responses were sorted into groups with no less than five responses based on the initial reviewer’s analysis of themes. If the three reviewers did not agree, they met to develop consensus, and the primary author would be consulted to mediate and make the final decision. The three reviewers were able to reach consensus on 100% of coded themes and primary author mediation was not needed.

Instrument

There were 10 total demographic questions including gender, race, ethnicity, employment status, highest level of education, work setting, job title (open-ended optional question), changes in job title due to the pandemic, certifications held (CHES®, MCHES®, CPH, and other health-related certifications), and years of experience. The majority of these questions, with the exception of job title were adapted from the HESPA II-2020 survey instrument (NCHEC & SOPHE, 2020).

In addition, the following areas were assessed through forced choice or “all that apply” options: COVID-19 work performed; COVID-19’s effect on employment; training and future education; COVID-19-specific job responsibilities; HES Areas of Responsibility and Competencies used in COVID-19 work (participants were given list of the competencies and asked to check all that apply); work with populations at increased risk for COVID-19; and volunteer activities. These questions were developed by the authors, with the exception of the populations at increased risk question that was adapted from information on CDC websites (CDC, 2020, 2021b).

Results

Demographics

As shown in Table 1, the majority of survey respondents were female (90%), White (74.4%), non-Hispanic (89.1%), and had earned a master’s degree (62.6%). Nearly half (48.6%) had between 1 and 9 years of experience.

Table 1

Descriptive Statistics of Participant Demographics

Demographic	n	%
Gender
Male	155	9.2
Female	1,511	90.0
Transgender	1	0.1
Prefer not to answer	8	0.5
Other (please specify)	3	0.2
Total	1,678	100.0
Hispanic origin
No	1,490	89.1
Yes	183	10.9
Total	1,673	100.0
Race
American Indian or Alaskan Native	10	0.6
Asian	65	3.9
Black or African American	247	14.8
Native Hawaiian or Other Pacific Islander	6	0.4
White	1,238	74.4
Some other race (please specify)	49	2.9
Prefer not to answer	49	2.9
Total	1,664	100.0
Highest level of education
Bachelor’s degree	370	22.1
Master’s degree (MA, MS, MPH, MSPH, MHA, MEd)	1,050	62.6
Doctoral degree (PhD, EdD, JD, MD, HSD, DrPH)	258	15.4
Total	1,678	100.0
Years of experience
1–4 years	405	24.7
5–9 years	393	23.9
10–14 years	246	15.0
15–19 years	161	9.8
20–24 years	163	9.9
25–29 years	117	7.1
30–34 years	52	3.2
35–39 years	44	2.7
40+ years	62	3.8
Total	1,643	100.0

Respondents reported being CHES® (84.4%) or MCHES® certified (15.5%). Some reported additional certifications or qualifications including: Other (12.6%), Wellness Coach (5.0%), Registered Nurse (3.8%), Child Passenger Safety (3.1%), Certified in Public Health (3.0%), and Registered Dietician (1.6%). Less than 1% noted they were Certified Prevention Specialists (.9%) or Certified Diabetes Educators (.8%). Respondents came from a variety of work settings including government (30.1%), health care or hospital (23.3%), university (23.3%), or community/nonprofit (18.5%). The vast majority (81.3%) worked full-time (30 hours or more per week).

COVID-19 Work Performed

Most respondents (65.6%) reported some work, either professional or volunteer, related to the COVID-19 pandemic and of those, 97.2% felt their professional preparation had somewhat or significantly helped them to address the pandemic. When provided a list of types of COVID-19-related work and asked to check all activities that apply, most respondents reported educating on COVID-19 (59.9%), followed by acting as a resource person (52.3%).

Several (29.1%) reported “other” types of work via write-in responses. “Other” responses were categorized as designing and implementing health communications, engaging in surveillance, advocacy, management, providing direct care to COVID-19 patients, and administrative duties related to COVID-19. It should be noted that many of the activities identified as “other” were included in another survey question on current job responsibilities.

Pandemic planning was the next highest response (28.9%), followed by creating COVID-19 policies (19.1%) and performing contact tracing (18.3%). Least reported were conducting COVID-19 research (10.9%) and performing epidemiological analyses (7.5%).

Workload and Environment

In terms of workload and environment, the majority (61.2%) reported that COVID-19 led to additional work responsibilities with no additional pay, and only 5.5% of participants had a change to their job title due to COVID-19. The majority of respondents also were asked to work from home (60.9%) due to the pandemic, requiring them to learn new skills (such as working online) to successfully complete their job responsibilities remotely (58.3%). Additional themes emerged from an open-ended “other” response option and included an impact on child care, a reduction or increase in typical work hours, and finding new employment. Some indicated they had no change in employment.

Current Job Responsibilities Related to COVID-19

Most HES reported conducting education and prevention programs (64.6%) or designing and implementing health communications about the pandemic (47.3%). Nearly one fourth (23.2%) reported managing staff doing COVID-19-related work and 20.9% reported doing contact tracing or supervising contact tracers. Fewer reported managing personal protection equipment (PPE) or supplies (16.2%), conducting evaluation or research studies (13.3%), direct care to COVID-19 patients (6.8%), or testing for the virus or antibodies (6.6%). Several respondents selected “other” (15.3%) and wrote in responses. Themes are included in Table 2 notes.

Table 2

Current Job Responsibilities Related to COVID-19

Job responsibility	n	%
Education and Prevention Programs (e.g., planning, implementation, evaluation)	689	64.6
Designing and/or implementing health communications about the pandemic	504	47.3
Managing staff doing COVID-19-related work	247	23.2
Contact tracing or supervising contact tracers	223	20.9
Managing personal protective equipment (PPE) or supplies for COVID-19	173	16.2
Other^a	163	15.3
Conducting evaluation or research studies on COVID-19 issues	142	13.3
Advocacy (e.g., contacting politicians or leaders about COVID-19 issues)	124	11.6
Direct care to COVID-19 patients (e.g., nurse, first responder, or other health care)	72	6.8
Testing for the virus or antibodies	70	6.6

“Other” responses included coordinating emergency needs (food distribution, housing assistance, etc.), developing new technology (e.g., mobile applications), grant writing (to secure resources), and advocacy (for resources, vaccinations, testing, face coverings, etc.).

Areas of Responsibility Used in Addressing COVID-19

Participants reported which HESPA-II 2020 Areas of Responsibility and Competencies they used in their work in relation to the COVID-19 pandemic. These results are found in Table 3.

Table 3

National Commission for Health Education Credentialing Areas of Responsibility and Competencies Used in the COVID-19 Pandemic

Area of responsibility (competencies applied to COVID-19)	n	%
I. Assessment of needs and capacity (plan assessment, obtain data, analyze data, synthesize findings related to COVID-19)	516	48.7
II. Planning (engage priority populations, partners, and stakeholders; define desired outcomes, determine interventions, develop plans and materials for implementation and evaluating a COVID-19 program) III. Implementation (coordinate program delivery, deliver and monitor implementation of COVID-19 programs)^a	596	56.3
IV. Evaluation/Research (design evaluations/research studies on COVID-19, manage data collection, interpret data, use findings)	257	24.3
V. Advocacy (identify policy, systems or environmental change regarding COVID-19; engage coalitions and stakeholders in the COVID-19 pandemic; planning, engaging or evaluating advocacy related to COVID-19)	290	27.4
VI. Communication (determine factors that affect communication with audiences, determine objectives and messages, methods and technologies for delivery and evaluation communications related to COVID-19)	757	71.5
VII. Leadership and Management (coordinate relationships with partners and stakeholders, prepare others to provide COVID-19 programs, manage human, financial, and material resources, conduct strategic planning with stakeholders for COVID-19 initiatives)	444	41.9
VIII. Ethics and Professionalism (practice in accordance with established principles, serve as an authoritative resource on COVID-19, engage in professional development to maintain or enhance proficiency on the COVID-19 pandemic, promote the health education profession to stakeholders, the public, and others)	481	45.4

Source: Adapted from National Commission for Health Education Credentialing and Society for Public Health Education (2020, 32).

Planning and implementation were combined in error on the questionnaire.

Type of Work by Degree Level

Respondents reported having bachelor’s degrees (370; 22.1%), master’s degrees (1,050; 62.6%) or doctoral degrees (258; 15.4%). About one-fourth of HES holding graduate degrees were managing staff doing COVID-19-related work. More bachelor and master level HES were involved in contact tracing or supervision of contract tracing than doctoral level. Those with doctoral degrees were significantly more likely to report conducting evaluation or research studies on COVID-19 and creating COVID-19 policies. Far fewer at all degree levels were involved in managing personal protective equipment (PPE), doing advocacy work, or direct care to patients.

Comparisons of CHES® and MCHES® on COVID-19 Work

Chi-square tests of independence were calculated comparing COVID-19-related work and activities among CHES® and MCHES®. Some individuals (n = 19) listed having both CHES® and MCHES® credentials. Those cases were reclassified as MCHES®. The final total for the chi-square analyses included 1,386 CHES® and 254 MCHES® (N = 1,640). Type of COVID-19 work and COVID-19-related job responsibilities questions were combined for this analysis. In case of overlapping question topics, only one topic was used for the analysis. Because respondents were asked to check all that apply, individual chi-square analyses were run for each activity. Several significant interactions were found (Table 4).

Table 4

Chi-Square Analyses of CHES® and MCHES® Self-Reported COVID-19 Work and Job Responsibilities

COVID-19 activity	CHES® %	MCHES® %	Pearson chi ²	p value
Creating COVID-19 policies	11.0	18.9	12.33	.000**
Conducting COVID-19 education & prevention programs (e.g., planning, implementation, or evaluation)	37.9	48.4	9.99	.002**
Advocacy (e.g., contacting politicians or leaders about COVID-19)	6.3	11.8	9.92	.002**
Assisting with pandemic planning	17.6	25.2	8.11	.004**
Performing contact tracing	13.1	6.7	8.35	.004**
Acting as a resource person on COVID-19	32.8	40.9	6.41	.011*
Designing or implementing health communications about the pandemic	28.1	35.4	5.63	.018*
Managing staff doing COVID work	13.3	18.1	4.16	.041*
Direct care to COVID-19 patients	4.3	2.8	1.36	.044*
Conducting research on COVID-19	6.3	9.8	4.08	.043*
Testing for the virus or antibodies	4.1	3.5	0.18	.671
Performing epidemiological analyses	4.7	4.7	0.10	.981
Managing personal protection equipment (PPE)	9.7	10.6	0.22	.636
Total N	1,386	254

Note. All chi² had 1 degree of freedom. Respondents were instructed to check all activities that apply. CHES® = Certified Health Education Specialists; MCHES® = Master Certified Health Education Specialists.

p < .05. **p < .01.

Education and Training

Education and training for COVID-19 job duties were reported by 76.1% of the respondents. Most were educated via online presentations or webinars not related to conference proceedings (56.2%) or online learning modules or other online training (53.8%). Nearly two thirds of respondents (66%) wanted additional training to learn more about COVID-19. The majority expressed a desire for additional training on effective program delivery or remote teaching (58.6%), while others wanted more COVID-19-specific training (41.9%) (e.g., contact tracing, proper use of PPE). Only 35% of respondents indicated their workplaces required additional training to address COVID-19.

Work With Populations at Increased Risk for COVID-19

HES reported working with a variety of groups at higher risk for COVID-19 as part of their regular jobs prior to the COVID-19 pandemic. These included people who have underlying health conditions (69.2%); persons of Hispanic, Latinx, or Spanish ethnicity (65.9%); African Americans (64.4%); people aged 65 and older (50.1%); people with disabilities (41.1%); people who experience homelessness or housing insecurity (38.7%); people who are pregnant (33.1%); and Native Americans (24.7%). Chi-square analyses indicated the at-risk populations HES worked with after the onset of the pandemic did not change significantly from those they worked with prior to the start of the pandemic.

Volunteer Work Related to COVID-19

Many respondents reported volunteer activities related to COVID-19 such as donating food, supplies (including PPE), or money to help others (63.3%); making masks or other PPE (22.6%); food distribution to the public through food banks or drive through food pick up locations (21.0%); and contact tracing through their state or local health departments (13.9%).

Discussion

It is clear from this study that HES have a significant level of involvement in the COVID-19 pandemic and have been called on to serve in various capacities. Their work has been inclusive of the HESPA-II-2020 Areas of Responsibility and Competencies, and HES are using these in their practice, especially the areas of communication, program planning and implementation, assessing needs and capacity, and ethics and professionalism. Interestingly, many items had an “other” option, which sometimes included hundreds of responses. These comments verify the abundant contributions of HES during a pandemic. Specifically, comments supported the supervisory roles of these participants. They weren’t just contact tracers; they were supervising contact tracing teams. Rather than only screening or testing, they were supervising the entire testing site. They weren’t just acting as a resource; they were training the resource people. There was a strong supervision theme that emerged in these comments and activities. These findings were similar to case studies described by Chaney et al. (2020).

Most participants felt their professional preparation programs helped prepare them for this moment, and most had additional training about COVID-19 but wanted more. This was particularly true for CHES® and is noteworthy. This finding should be shared with organizations who could provide additional training and resources for HES. HES with doctoral degrees reported doing more research and those with bachelor’s and master’s degrees doing more contact tracing. This makes sense due to a higher level of research knowledge and skills among those with doctoral degrees.

There was not a significant difference between CHES® and MCHES® in performing epidemiological analyses, testing for the virus or antibodies, or managing PPE. While one may think MCHES® would perform more of these activities, they did not. That may be because the majority in each certificate area had master’s degrees or because there were fewer respondents selecting these activities.

There are many examples of individual or team efforts of HES in the COVID-19 pandemic in a variety of settings, demonstrating the crucial role they play, particularly in communication and educating the public. This direct communication with the public is essential to debunk misconceptions about such topics as vaccine safety, the efficacy of face coverings/masks, and need for social distancing. This is particularly important in various demographic groups that are at a higher risk for COVID-19. All of this comes at a price to HES, as they are doing this additional COVID-19 work along with their other work responsibilities but with no additional pay. This finding is similar to the work of Hancher-Rauch et al. (2021) who found that 43% of respondents reported the need to change work priorities, the majority of whom switched their work focus to COVID-19. In addition to the added work many HES are fulfilling during the pandemic, many are volunteering their time in making masks, contributing to the costs of PPE, and donating money and food to assist those in need. Again, this work is happening above and beyond their COVID-19 work duties and shows the dedication of these individuals to their work and communities. It should also be noted that this work is occurring during a time when many in the field of public health have faced a difficult political landscape and push back when attempting to recommend or implement public health measures during the COVID-19 pandemic.

Limitations

Although these findings provide a clearer picture of how HES are contributing to the pandemic, there are limitations to this study. First, despite five emails soliciting participant involvement in the study, response rates were low (15.5%) which limits generalizability and there were missing data. This could potentially be because HES are overworked and did not have time to complete the questionnaire. Second, comparisons between CHES® and MCHES® should be interpreted with caution as there was a much smaller number of respondents with the MCHES® credential. Finally, the Areas of Responsibility and Competencies in planning and implementation were inadvertently combined on the HESPA II Competencies item of the questionnaire and should have been separately listed. This may have affected percentages of responses within this combined area.

Implications for Practice and Research

There are many implications for practice and further research. Future studies should seek a higher response rate, possibly by incentivizing HES to participate during such a difficult time. Also, post hoc analyses might allow HES to reflect on their services once the pandemic is over to better assess their completed training and additional training needs for the future. This could inform the process of determining HES’ responsibilities in the area of emergency preparation, as well as help professional preparation programs design curricula to better include emergency response knowledge and skills.

An additional implication as discussed in Hancher-Rauch et al. (2021) was that other community health concerns might not be addressed during this time due to the need for HES to perform more COVID-19 duties. Future studies could assess what regular work duties were lagging due to prioritizing COVID-19 work, and whether this decreased level of involvement had any impact on communities’ chronic and communicable disease rates, or other community health issues. Follow-up research should be conducted to examine the impact of added work to HES and how this may contribute to “burnout” or work stress given the duration of the pandemic and the push back of communities on public health recommendations. Other studies might investigate the role of CHES®/MCHES® certified nurses in an emergency and how they serve a unique niche of health education, as they were a subset of this credentialed sample.

It is inevitable that another emergency, such as a pandemic, will affect the United States at some point. For that reason, it may be necessary that HES training programs review their coverage of pandemic associated skills as they relate to HES skills and knowledge. There may be ways programs can increase pandemic-specific training to better prepare their students for the likelihood of future pandemic work. In addition, health advocates may be able to utilize the information here to support the need for increased funding of HES positions in their communities. The diversity of roles fulfilled by HES during the pandemic demonstrate their impressive versatility and abilities. These skills are important both during calmer times, as well as during a global pandemic. By surveying HES now, we can utilize this information to better determine their needs and best ensure future HES can meet the work demands placed upon them.

Footnotes

Authors’ Note:

Special thanks to Linda Lysoby, MS, MCHES®, CAE, Executive Director of the National Commission for Health Education Credentialing for conceptualizing this study and reviewing and critiquing survey instrument drafts.

ORCID iDs

Heidi Hancher-Rauch

Alexis Blavos

Jodi Brookins-Fisher

Amy Thompson

References

Ballotpedia. (2021). State-level mask requirements in response to the COVID-19 pandemic. https://ballotpedia.org/State-level_mask_requirements_in_response_to_the_coronavirus_(COVID-19)_pandemic,_2020-2021

Barry-Jester

A. M.

Recht

Smith

M. R.

Weber

(2020, December 11). Pandemic backlash jeopardizes public health powers, leader. Associated Press. https://apnews.com/article/pandemics-public-health-michael-brown-kansas-coronavirus-pandemic-5aa548a2e5b46f38fb1b884554acf590

Bauer

Broady

Edelberg

O’Donnell

. (2020, September 17). Ten facts about COVID-19 and the U.S. economy. Brookings. https://www.brookings.edu/research/ten-facts-about-covid-19-and-the-u-s-economy

Centers for Disease Control and Prevention. (2020, June 25). CDC updates, expands list of people at risk of severe COVID-19 illness. CDC Newsroom. https://www.cdc.gov/media/releases/2020/p0625-update-expands-covid-19.html

Centers for Disease Control and Prevention. (2021a). COVID-19 vaccine breakthrough case investigation and reporting. https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html

Centers for Disease Control and Prevention. (2021b). People with certain medical conditions. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Chaney

B. H.

Wessner

Opp

M. R.

Chambers

(2020). A snapshot of Certified Health Education Specialists on the front lines of the COVID-19 global pandemic. American Journal of Health Education, 52(1), 26–29. https://doi.org/10.1080/19325037.2020.1844098

Farzan

A. N.

Hassam

Bellware

O’Grady

Hawkins

Beachum

Shaban

Kornfield

Iati

(2020, August 13). U.S. was “unprepared for the greatest public health crisis” in a century, CDC director says. The Washington Post. https://www.washingtonpost.com/nation/2020/08/13/coronavirus-covid-live-updates-us/

Hancher-Rauch

Bishop

Cecil

Campbell

Yazel

(2021). Effects of COVID-19 pandemic on the professional roles and responsibilities of health educators. Health Promotion Practice, 2(2), 156–162. https://doi.org/10.1177/1524839920968523

10.

Johns Hopkins University of Medicine. (2021). Coronavirus Resource Center. https://coronavirus.jhu.edu/

11.

Johnson

C. K.

Stobbe

(2021, June 29). Nearly all COVID deaths in US are now among unvaccinated. AP News. https://apnews.com/article/coronavirus-pandemic-health-941fcf43d9731c76c16e7354f5d5e187

12.

Kaiser Family Foundation. (2020). Poll: Most Americans worry political pressure will lead to premature approval of a COVID-19 vaccine: Half say they would not get a free vaccine approved before election day. https://www.kff.org/coronavirus-covid-19/press-release/poll-most-americans-worry-political-pressure-will-lead-to-premature-approval-of-a-covid-19-vaccine-half-say-they-would-not-get-a-free-vaccine-approved-before-election-day/

13.

National Commission for Health Education Credentialing. (2020, Spring). Certified health education specialists: Response to COVID-19. NCHEC News, 31(2). https://assets.speakcdn.com/assets/2251/nchec_news_spring_2020.pdf

14.

National Commission for Health Education Credentialing. (2021). Those working to protect our communities in the fight against COVID-19. https://www.nchec.org/health-education-spotlight

15.

National Commission for Health Education Credentialing & Society for Public Health Education. (2020). A competency-based framework for Health Education Specialists-2020. https://www.sophe.org/resources/framework-for-health-education-specialists-2020/

16.

National Conference of State Legislatures. (2020). COVID-19 impact on employment and labor. https://www.ncsl.org/research/labor-and-employment/covid-19-impact-on-employment-and-labor.aspx

17.

Liasson

Huang

(2020, September). President Trump contradicts head of CDC regarding vaccine, masks. npr. https://www.npr.org/2020/09/17/913897033/president-trump-contradicts-head-of-cdc-regarding-vaccine-masks

18.

Osterholm

M. T.

(2005). Preparing for the next pandemic. New England Journal of Medicine, 352, 1839–1842. https://doi.org/10.1056/NEJMp058068

19.

Schleicher

(2020). The impact of COVID-19 on education. Organisation for Economic Co-Operation and Development. https://www.oecd.org/education/the-impact-of-covid-19-on-education-insights-education-at-a-glance-2020.pdf

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB