Title:
Public health practice competency improvement among nurses.

Abstract:
Recommendations for improving public health workforce competency led to an academic-practice partnership project conducted to improve competency for providing essential public health services among public health nurses.
To measure competency for public health practice at baseline, identify factors associated with higher competency, document change in competency over 4 years, and assess differential effects associated with project participation.
Perceived competency was assessed using a validated instrument administered through online surveys at baseline (2007) and 4-year follow-up (2011). Analysis was completed in 2014. Overall means and SDs were calculated for each domain in the competency scale. Differences in means by role were tested using multivariate analysis of variance. Factors associated with higher competency were identified using regression analysis. Mean comparisons between baseline and follow-up were tested using paired samples t test and ANCOVA was used to test differential effects of project participation.
Baseline competency levels were low in most domains. Managers reported higher competency in all domains compared to staff. Mean scores in all domains were higher on follow-up than baseline. Factors associated with higher competency in some domains included expected frequency of performance, higher degree, and younger age. Participants in project activities had higher mean competency scores than those who did not, with statistically significant differences (p<0.05) observed in four of nine domains.
Participation in workforce development can contribute to improved perceived competency for public health practice among nurses. Continued investment in workforce development aimed at improving competency and additional research on competency assessment is warranted.