Implementing a Training Development and Evaluation Plan ... · from the long-term solution of...

2011-2012 Fellow Project National Environmental Public Health Leadership Institute

Implementing a Training Development and Evaluation Plan for the Next Generation of

EHS

2011-2012 Environmental Public Health Leadership Institute Fellow(s)

Maurice Redmond MS REHS Program Director Public Pools and Tourist Accommodations Georgia Department of Public Health Environmental Health Branch 2 Peachtree Street Suite 13-443 Atlanta Georgia 30303 404-657-6534

Cameron Wiggins MUP MPH Program Consultant II Food Service Georgia Department of Public Health Environmental Health Branch 2 Peachtree Street Suite 13-432 Atlanta Georgia 30303 404-657-6534

Mentor

Wade Sparkman BBA Environmental Health Director Nassau County Health Department

Acknowledgements Tim Callahan Program Director Evaluation and Support Georgia Department of Public Health Environmental Health Branch Virgil Fancher MPH Program Consultant II Land Use Georgia Department of Public Health Environmental Health Branch

Giles Roberts Program Director Food Service Georgia Department of Public Health Environmental Health Branch

EXECUTIVE SUMMARY In 2009 the Georgia Department of Public Health Environmental Health Branchrsquos (EHB) management and the Centers for Disease Control and Prevention National Center for Environmental Health used the Environmental Public Health Performance Standards (EnvPHPS) to conduct an assessment of Georgiarsquos Environmental Health (EH) programs and operations within the framework of the Ten Essential Environmental Health Services1 This statewide assessment identified a need for improvement of monitoring and evaluation which supported the EHBrsquos previous decision to fully implement a statewide solution for data recording reporting and analysis needs in environmental health known as the Environmental Health Information System (EHIS)2 Currently the EHIS provides access to Environmental Health inspection data for 131 of the 159 counties within Georgia From a cursory review of food pools and tourist accommodation inspection reports there appear to be inconsistent violation markings written observations and corrective actions After further inquiry into the process the barriers to correcting these inconsistencies appear multifaceted and widespread A systems thinking model demonstrated that the short-term fix of providing EH training to new employees without continual assessment or evaluation shifts the burden away from the long-term solution of developing a comprehensive EH training development and evaluation process This project is intended to strategically intervene on mental models and processes that prevent the EH training from meeting its intended purpose which is to assure a competent workforce that conducts and documents proper risk factor assessment management and communication through consistent inspections As a result we intend to develop a comprehensive training development and evaluation plan to focus on improving instruction management involvement and employee engagement using the framework of the EHB Career Track3 the national core competencies4 and resources in academia federal agencies and the Department

INTRODUCTIONBACKGROUND The mission of Georgiarsquos Department of Public Health (DPH) Environmental Health Branch (EHB) is to provide primary prevention through a combination of surveillance education enforcement and assessment programs designed to indentify prevent and abate environmental conditions that adversely impact human health5 The EHB is comprised of the following programs and functions Food Service Onsite Sewage Management Systems and Non-Public Water Public Swimming Pool Spa and Recreational Water Parks (hereafter referred to as Pools) Tourist Accommodations Chemical Hazards Childhood Lead Poisoning Prevention Program Rabies Control Emergency Preparedness and Tanning Facilities The Office Code of Georgia Annotated (OCGA) grants the authority to enforce the Food Service Pools and Tourist Accommodations Rules and Regulations to the county boards of health Georgia is comprised of 159 county boards of health (each with its own county health department) which are divided into 18 health districts

Each Program within the EHB is responsible for providing introductory course instruction which is referred to as the Georgia EH training program to new Environmental Health Specialists (EHS) employed by the county health departments The Georgia EH training program is designed to introduce new EHS to the various EH programs and to prepare them with foundational tools for each of the programs which will enable them to successfully perform their duties within their respective counties The EHB has a prolonged history of providing training to new personnel which dates back forty-five years EHB records from the late 1960rsquos document new hires receiving a 19-week training program in the relevant areas of environmental health that consisted of 12 weeks of class work and 7 weeks of supervised fieldwork For a period a legislated Georgia Board of Registered Professional Sanitarians existed to move EHS professionals (which were called sanitarians at that time) to work toward qualification for registration and licensure Environmental Health personnel that met the minimum education qualification and experience requirements and successfully passed the Boardrsquos examination became Registered Professional Sanitarians6 The Board was sunset in the mid 80rsquos Today the Environmental Health Branch provides the Georgia EH training program to new employees through a four week training program offered in a series of program-specific modules which extend over a six month period Subject matter experts organize and develop the program-specific training sessions for new employees The four training modules are as follows Food Service module Pools and Tourist Accommodations module Onsite Sewage Management System module and the Catch-all module (Epidemiology Vector Control Environmental Assessment Chemical Hazards Indoor Air Quality Lead and Rabies) At this time all of the aforementioned modules are taught in-person in one week sessions at various sites within the state Currently the state environmental public health workforce is made up of approximately 460 personnel providing EH primary prevention services in 159 counties for an aggregate population of 9687653 million Georgia residents7 Over the last 4 years approximately 160 employees have completed the Pools and Tourist Accommodations and Food Service modules To ensure requisite knowledge the state personnel administration system sets entry level educational requirements for employment as an Environmental Health Specialist I8 and specific programs have additional knowledge skills and abilities criterion For example an EHS working in the food program must complete a nationally recognized food training program and successfully pass a validated examination to become a Certified Food Safety Manager (CFSM) and successfully complete standardization in food safety inspection techniques to become a Standardized Food Service Establishment Inspection Officer certificate within two years of being assigned duties in the Food Service program9 in addition to meeting the educational requirements Additionally the Branch has made completion of these four modules a prerequisite for promotion to EHS III

Problem Statement Why havenrsquot we been able to develop a comprehensive and effective training program for EHS within the State of Georgia We began our inquiry into the Georgia EH training programrsquos effectiveness after reviewing the 2009 statewide assessment of the Georgia Environmental Health System The Branch management and the Centers for Disease Control and Prevention National Center for

Environmental Health used the national environmental public health performance standards instrument to assess how well we perform at providing the ten essential environmental public health services1 This statewide assessment identified a need for improvement of monitoring and evaluation as well as workforce development and mobilization which supported the EHBrsquos previous decision to fully implement a statewide solution for data recording reporting and analysis needs in environmental health known as the Environmental Health Information System (EHIS)2 Our project will focus on the micro level of workforce development monitoring and evaluation by assessing the design delivery and impact of the Georgia EH training program on the quality of risk-based inspections conducted within the food pools and tourist accommodation programs The overall goal of the program is to reduce the occurrence of risk factors for foodborne and waterborne illness at regulated facilities by ensuring that the next generation EH workforce is capable and competent to identify prevent and abate the environmental conditions that adversely impact human health Our model demonstrates that the short-term fix of providing training to new employees without continual assessment or evaluation shifts the burden away from the long-term solution of developing a comprehensive training development and evaluation process which also inadvertently creates a reinforcing addiction loop that justifies maintaining the status quo This leads us to a vicious cycle in which we end up questioning the effectiveness of the EHS training We assume that this vicious cycle is created by a training model that does not focus on training results and unable to maintain pace in a rapidly changing environmental health landscape This archetype also substantiates the aforementioned gaps in evaluation and monitoring identified in the EnvPHPS Without proper evaluation and monitoring of the training program we create the perceptions that prevent the EHB from spending the time and resources to develop an effective long-term solution to the training concerns Figures 2 and 3 show the archetype and Chart 1 provides the benefits of change and the cost of not changing the current system To test this assumption we surveyed the state EH Branch management and program consultants that provide the Georgia EH training program to assess training needs The 13-question survey instrument was emailed to 11 employees (2 upper management directors 6 program directors and 3 program consultants) using Survey Monkey Of the eleven (11) employees surveyed nine (9) responded The survey results provided by respondents remained anonymous Results from the survey are used where applicable in charts to support our archetype We intend to use the information gathered in this survey to develop a questionnaire for the 18 District Environmental Health Directors and the 159 county managers to determine their willingness to assist in the planning of training development and evaluation plan based on concerns that they have with the current Georgia EH training program In the beginning stages of the project we identified that each EH program utilized surveys however each used a differing survey instrument which more often than not was a truncated version of a tool that limited the number of questions limited analysis abilities no support from software professionals and at times even paper-based This was an important finding that we brought to upper managementrsquos attention and prompted the Branch to purchase a uniform survey tool with multiple design collection analysis and support features

We intend to draw on the findings from both surveys to develop a comprehensive training development and evaluation plan which focuses on improving instruction management involvement and employee engagement Based on discussions with experts and the research that we have conducted the framework and activity to achieve these goals should include 1) developing an EHB Training Curriculum (see example in appendix) based on the Departmentrsquos proposed EHB Career Track3 and the national core competencies for Local Environmental Health Practitioners 2) drawing on the various resources available within our Department as well as partners in academia federal agencies and regional Public Health Training Centers to identify opportunities to meet the training needs and 3) instituting a continuum of training evaluation that utilizes Kirkpatrickrsquos four levels of evaluation and encourages accountability on the part of the trainer manager and employee

Key Variables in Behavior Over Time Graph

Our Behavior over Time Graph projected a perceived gap between the decreasing workforce capability and the increasing need to provide effective new EHS training Based on actions taken to explore the problem further we uncovered 3 areas to focus our attention on closing the gap between effective training and workforce capability Adjustments to training design delivery and evaluation methods are key strategies we will employ to improve instruction employee engagement and management involvement

1 Perception training is adequate ndash New EHS training in its current format has been a part of the food pool and tourist accommodation programs consistently for about 8 years Our perception of training may stem from reactionary evaluations that show effectiveness in the short term but also may falsely give state office trainers a sense of long-term success The survey of State EH office staff results confirmed the perceived adequacy of the current training For example when asked ldquoHow would you rate YOUR satisfaction with the overall quality of instruction at the training for new EHSrdquo more than half (556) of the respondents acknowledged that they were satisfied with the current training and 11 were dissatisfied There were 333 were neutral

2 Perception that training resources are sufficient ndash The EH Branch has to make choices

in the face of cut-backs in personnel budgets and use of time External pressures and department priorities determine how funds personnel and resources are expended Based on the survey of State EH office staff over half of the respondents (556) believed that they had access to the resources they needed to carryout their respective training modules and the same response rate (556) felt that EHS were satisfied with the overall quality of the training

3 Gap in workforce capability ndash The EHS receives Environmental Health training for

foodservice pools tourist accommodations and onsite waste disposal (etc) These EHS will perform inspections across program boundaries All training should reinforce learning in risk assessment risk management and risk communication These are the core competencies and common skills used by new and experienced staff throughout the Environmental Health system This was further confirmed in our survey with all

respondents (100) affirming that activities within their program fall within risk assessment and risk communication and 889 affirming that activities their program fall within risk management as well

4 Need for effective training - The new EHS training is a week long program for the

Food Pools and Tourist Programs The objective of the training is to equip new employees with a foundation to perform the tasks and skills essential to the job The modules consist of classroom training in a majority lecture format however various experts in workplace learning and development have determined that it requires multiple training delivery modalities and the use of technology to maintain todayrsquos learnerrsquos attention and to keep them engaged Today real time accessible and continuous training should be available to improve workforce competenciesskills for new EHS as well as serve as refresher training for experienced EHS

5 Inconsistent program inspections ndash The EHB programs have access to inspections for

131 of the 159 counties within Georgia on the EHIS From a cursory review of the pools and tourist program inspection reports and a preliminary audit review of the food standardization process inspection reports there appear to be inconsistent violation markings written observations and corrective actions

Chart 1 The Benefits of Change and the Cost of Not Changing

Benefits of Changing Cost of Not Changing bull Profession valued by all impacted

groups (EHS industry) bull Public support for funding work bull Safer healthier environments for

consumers bull Monitoring efforts for potential

hazards improved bull Increase inspection continuity

throughout Georgia bull Evaluation and monitoring efforts

linked bull Possibly fewer consumer

complaints bull Morale increased for EHS bull Gain confidence from EHS and

regulated facilities bull Change behavior of EHS and

regulated community

bull No oversight of over a large segment of the EHS inspection

bull Public opinion on usefulness erodes

bull Lack of Georgia continuity bull Inaccurate data input into Digital

Health Department system bull Increased industry complaints bull Inconsistent inspections

6 What can you do to building up the benefits of change and costs of not changing Conduct meaningful collaboration with the District and County managers to better understand their day to day requirements and the needs of their EHS Have a dialogue on the impact of not changing our current system and identify what is the valuable for the profession

Figure 1 Behavior Over Time Graph

Diagrams and applicable Archetype General Environmental Health Training

Shifting the Burden and Fixes That Backfire into a Vicious Cycle

1 Perception training is adequate 2 Perception resources are sufficient 3 Workforce capability 4 Need for effective training program 5 Consistent inspections

Key Variables

Time

GAP BETWEEN

Need for Effective Training

amp Workforce Capability

Behavior Over Time Graph

Need for an effective training program for new employees

Continue to provide EH training modules to new hires wout assessing the effectiveness of the training and evaluating the need for continual education

Comprehensive Training Development Toolkit and Evaluation Plan

Perception of adequate training without assessing application impact

Perception of sufficient training resources (time money and expertise)

Health Risk Workforce Capability

Causal Loop Diagrams and applicable Archetype General Environmental Health Training for New Employees

Figure 2 Shifting the Burden and Fixes That Backfire (Focused Archetype)

O

S

O

S

O

S

R

B

Unintended consequences

loop

Addiction loop The training was successful based on the evaluation So letrsquos put this on the shelf until next year

Wersquove been doing it this way for the last 8 years If itrsquos not broken donrsquot fix i

O

S

O

R

How much information can they pack into one week

R

Continue to provide EH training modules to new hires wout

assessing the effectiveness of the training and evaluating the need

for continual education

Comprehensive Training Development Toolkit and

Evaluation Plan

Perception of adequate training without assessing application

impact

Perception of sufficient training

resources (time money and expertise)

Workforce capability

Proper risk factor assessment

management and communication

Consistency of inspection reports

Health risk Inspections

Time for training amp development

Deepen and Widen Causal Loop Diagrams and applicable Archetype Figure 3 General Environmental Health Training for New Employees

Shifting the Burden and Fixes That Backfire into a Long-Term Vicious Cycle and Balancing Loop

(Expanded Archetype))

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

The training was successful based on the evaluation So letrsquos put this on the shelf until next year We donrsquot have time

to ask all those questions to get to the bottom of that Just correct what I marked

Why arenrsquot they getting this We covered this in the new EHS training

We are in a hurry We must conduct the mandated number of inspections to justify the fees we charge

Wersquove been doing it this way for the last 8 years If itrsquos not broken donrsquot fix it

S S

S

O

S

O

B

R

10 Essential Environmental Health Services Our project focus is on assuring a competent workforce through developing monitoring and evaluating policies and practices for training new employees The Environmental Health Branch management used the Environmental Public Health Performance Standards (EnvPHPS) to conduct an assessment of the EH programs and operations within the framework of the Ten Essential Environmental Health Services This project is built on three of the managementrsquos identified priorities for improvement in services The Ten Essential Environmental Health Services the project will incorporate are monitoring evaluation and workforce development The projectrsquos long-term strategy will integrate the use of the statewide Environmental Health Information System (EHIS) and the proposed Workforce Development Plan both featured in projects by previous Georgia fellows in the Environmental Public Health Leadership Institute to monitor evaluate and improve the effectiveness of the Georgia EH training program

Figure 4 10 Essential Environmental Health Services diagram is from

httpwwwcdcgovodocphpnphpspessentialphserviceshtm

National Goals Supported

1 Describe how your project seeks to support one or more of the CDC Winnable Battles (httpwwwcdcgovwinnablebattles) or meets one or more of the Healthy People 2020 Objectives (httphealthypeoplegov2020topicsobjectives2020defaultaspx)

PHI-2 (Developmental) Increase the proportion of Tribal State and local public health personnel who receive continuing education consistent with Core Competencies for Public Health Professionals This project will propose a curriculum that uses on line resources to improve core competencies on a continual basis 2 Describe how your project supports any or all of these national goals or initiatives National Strategy to Revitalize Environmental Public Health Services httpwwwcdcgovncehehsDocsnationalstrategy2003pdf Goal 5 Develop the Workforce Activity V-3 ndash Define the training and continuing education needs of the environmental public health service workforce This project will use the proposed EH career ladder and core competencies to indentify training required to obtain and sustain the requisite skills and abilities to perform job responsibilities Goal 6 Create Strategic Partnerships Activity VI-AI-3 ndash Develop mechanisms for regular communication with stakeholders To implement a training development and evaluation plan we will establish regular communication mechanisms with EH staff at the state district and county levels Additionally internal and external communication will be maintained by meeting with professional partners Regular communication is the only way to successfully achieve the projectrsquos stated process and outcome objectives 3 Environmental Health Competency Project Recommendation for Core Competencies for Local Environmental Health Practitioners httpwwwaphaorgprogramsstandardshealthcompprojectcorenontechnicalcompetencieshtm Environmental Health Competency Project Recommendation for Core Competencies for Local Environmental Health Practitioners ndash This project will focus on incorporating and evaluating the core competencies in new EH training The competencies listed under the functions of assessment management and communication and technical competencies will be addressed in this project

Project Logic Model Goal To provide valued and effective Environmental Health Programs in Food Pools and Tourist Accommodations that change behavior and lessen the potential for foodborne and waterborne illness or injury in the state of Georgia

Partners bull State Office EH Branch staff bull EH District Directors bull County Managers bull County EHS bull FDA bull CDC bull GA Restaurant Association

(GRA) bull Association of Pool and Spa

Professionals (APSA) bull GA Public Health

Association (GPHA) bull GA Environmental Health

Association (GEHA) Financial

bull Grant-in-aid funding bull State appropriations

Resources bull Environmental Health

Information System (EHIS) bull Proposed Workforce

Development Plan bull Ten Essential Services

Program Review bull GA Dept of Public Health

Office of Training and Workforce Development

bull GA Dept of Public Health Graphic Designer

Program Development Develop Management Needs Assessment Survey Develop assessment indicators Develop Training Assessment Tool Develop or use online Training Modules Training Conduct management training on the assessment tool Offer web based training on common program hazards Creating Cooperative Partnerships Develop Training Development amp Evaluation (TDampE) Committee Develop TDampE Plan between state office and partners Presentation of the Plan to partners or at meetings

of meetings with county managers in pilot of on line training modules developed or used of managers completing assessments of web based trainings developed of EHS managers to complete the training of meetings and partnerships of presentations of the Training Development amp Evaluation (TDampE) Plan of public outreach efforts

Learning Improved understanding of core environmental health competencies Improved training delivery of FPT programs Improved impact of risk based assessments Learning Increased number of leaders trained Learning needs are correlated to risk factors Learning Increased partnering between Environmental Health Programs Increase partnerships between EH districts and associations affiliated with PHindustry

Behavior Increase evaluation at all levels by the EH training system Results Overall greater ability to train on assess manage and communicate risk factors Improved level of employee engagement and satisfaction with training Increase in management participation in the evaluation process

ResourcesInputs Activities Output Tier I

ShortLong Term Outcomes

Impacts

PROJECT OBJECTIVESDESCRIPTIONDELIVERABLES

Program Goal To provide valued and effective Environmental Health Programs in food service recreational waters and tourist accommodations that change behavior of regulated establishments and lessen the potential for food or waterborne illness and injury in the state of Georgia

Health Problem The 2009 EHS services performance audit found an overall lack of engagement in workforce development and training statewide The pools tourist and food programs received the lowest scores on this assessment conducted throughout the State of Georgiarsquos 18 Environmental Health Districts

Outcome Objective

By October 2013 the Food Service Pool and Tourist Accommodation Programs will implement a Training Development Toolkit and Evaluation Plan as a framework for improving training instruction management involvement and employee engagement This will focus on evaluating the transfer of knowledge into practical application by EHS performing inspections for Environmental Health programs in the Department of Public Healthrsquos 18 Health Districts

Determinant The of managers completing the application level evaluation of Branch sponsored training for new employees in the foodservice pools and tourist accommodations programs after a 3 month follow up period

Impact Objective By December 2012 pilot an approved evaluation process in 2 Environmental Health Districts to validate its use with managers and new inspectors after a 3 month training follow up period

Contributing Factors 1 Stakeholders (State EH Branch EHS County managers) must recognize the

value that should be placed on their efforts to properly assess manage and communicate EH risks to ensure safe healthful environments are maintained

2 No evaluation framework was previously available for the Local Health Department to monitor inspectors throughout the training continuum The EHIS and the Kirkpatrick Evaluation Model will help track if current training on risk factors are adequately designed by the State Environmental Health Office trainers or appropriately applied at the point of assessment

3 Training opportunities are static infrequent long-lasting and quickly forgotten by the EHS that attend Many opportunities focus on the classroom delivery model

and not on-line resources as opportunities for providing foundational knowledge or as refresher materials

4 Trainers are Program-specific SMEs however successful workplace learning requires the trainer to wear many hats For instance it requires graphic design expertise E-learning expertise human performance improvement expertise statistical expertise knowledge Management expertise training delivery and learning design expertise etc

5 The EH landscape is a rapidly changing environment due to budget constraints age of the workforce technological innovations and emerging threats It is particularly difficult to keep pace in this changing environment with classroom training alone

Process Objectives 1 Between January - April 2012 complete and disseminate a training evaluation

needs assessment for state and district Environmental Health managers and staff to determine their preferences on training delivery learning objectives and measurement of application in the field

2 Between March ndash April 2012 develop a draft Training Development Toolkit for

Trainerrsquos which is based on the Department of Public Health Office of Workforce and Training Developmentrsquos training delivery and design models and aligned with EH core competencies and the Georgia EH career track to address

3 By May 2012 develop a committee to review the curriculum objectives and and

determine evaluation methods to indicate if EHS are knowledgeable engaged and applying their learning on the job This will foster identifying the barriers to changing behaviors before during and after training on pools tourist and food service establishments

4 By September 2012 present a draft of the Comprehensive Training Development

and Evaluation Plan to the committee for comment

5 By November 2012 pilot developed or partnerrsquos web based interactive training for comment Courses should not be static or tedious but supports the employee engagement paradigm that focuses continual awareness on risk based inspection core competencies risk assessment risk management and risk communication for all programs

6 By April 2013 gain branch approval to implement the evaluation component of

the Comprehensive Training Development Toolkit and Evaluation Plan

METHODOLOGY

Events and Activities

1 Event Develop and complete a management needs assessment to asses if training of new EHS is instructionally sound achieving desired goals and properly resourced

Activity Develop a survey instrument that will allow us to properly develop disseminate and collect the questions and responses from our audience Conduct a survey of district and county management on what training methods and evaluation tools would be beneficial to ensure inspections concentrate on risk factors Analyze surveys and release findings to participants Promote and generate awareness of the needs assessment findings and goals to improve risk based inspection behaviors to assess management and communicate risk Conduct training on instructional design and evaluation

2 Event Develop a draft Training Development Toolkit for Trainerrsquos which is

based on the Department of Public Health Office of Workforce and Training Developmentrsquos training delivery and design models

Activity Review national EH core competencies and EH career track ladder with team Identify which core competencies are required or addressed at each level of development Select curriculum that aligned with EH core competencies and the Georgia EH career track Gain approval to use program specific curriculum

3 Event Develop a level 4 evaluation assessmenttraining application

monitoring tool

Activity Identify barriers to management evaluating training application after a new employee receives training by the state office programs Review existing assessment tools to determine compatibility with the Environmental Health Information System inspection inputs for the food pools and tourist accommodation Create a management assessment tool for use in the field by to evaluate the impact of the state training module objectives Pilot the assessment tool in two selected health districts currently using the Environmental Health Information System Develop policy on training evaluation

4 Event Develop or partner with experts for access to readily available

concise risk based inspections training tools for the web

Activity Compose macro-level and micro-level training materials in 30-45 minute segments which draw the attention of EHS and provide common requisite knowledge necessary to conduct risk-based inspections effectively within the food service pool and tourist accommodation programs Submit draft of power point material to partners for comment on potential e-learning conversion Gain Department of Public Health approval for inclusion on the web portal available to all health districts or use existing on line resources

COMPLETED ACTIONSRESULTS

1 Attended the American Society for Training Societyrsquos Annual Conference for training in social media learning adding value to PowerPoint presentations using technology to engage the millennial workforce and measuring success in learning

2 Conducted a joint training session on pools and food service programs for large metro county

3 Purchased a Survey Tool that provides analysis and expanded evaluation capabilities

4 Surveyed state staff on training perceptions and concerns about new employee training

5 Met with the Department of Public Health Office of Workforce Development and Training to identify training delivery design and evaluation models

6 Met with University of Georgia Public Health Training Center to determine their availability to provide E-learning courses for environmental health professionals

7 Developed a framework for a Training Development and Evaluation PlanToolkit 8 Received training on Return on Investment and Economic Evaluations used in

Public Health sponsored by the Georgia Public Health Training Center 9 Reviewed EHIS monitoring and evaluation capabilities to further assess use in

evaluating application impact and ROI of training 10 Developed a food service assessment and verification protocol based on the Food

and Drug Administrationrsquos (FDA) Program Standard 4 (for uniform inspections) to evaluate risk-based inspection consistency and accuracy of documentation This assessment was piloted to the 18 public health districts from June 2011 to December 2011 The assessment will be implemented in January 2012

11 Met with the Food and Drug Administration Regional Retail Specialist to discuss proper risk-based inspection protocols for standardized inspections The FDA Regional Retail Specialist conducted a review of the assessment and verification protocol and provided sample protocols from other states for guidance

ACTIONS PLANNED

1 Conduct a needs assessment of district and county leadership 2 Select a Team amp Partnering Workgroup to complete the comprehensive plan

3 Present a Curriculum Based Training Plan focused on the EH Career Ladder framework and EH core competencies to leadership

4 Provide management tools to monitor the EHIS to further evaluate application

EXPECTED OUTCOMES Based on the survey of the state Environmental Health Branch staff responsible for developing and conducting new employee training there appears to be a willingness among a majority of respondents (556) to conduct training needs assessments prior to the course and to follow-up with managers after the training This data would allow us to better focus the training on areas in which EHS need improvement (for improved employee engagement) and to determine from managers whether the learning was applied post-training (to assess application and achieve greater management involvement) We will use this positive outcome for conducting pre- and post- training assessments as a catalyst to gain support from district and county management in the actions planned stage Adding effective training development and evaluation strategies to the new EH training program should provide for continuous improvement of risk-based inspection behaviors among EHS and ultimately increase the environmental public health impact for controlling risk factors at the more than 35000 food pool and tourist accommodation facilities regulated within the state of Georgia As we collaborate with stakeholders and communicate the gaps in application delivery and training then we can change behavior We can employ methods that improve competency efficiency and value to the counties Also this model depicts training as a shared responsibility among the trainers managers and participants The long-term benefits of changing and cost of not changing will lead us into utilizing other methods resources and structures to continuously provide a learning environment for all EH professionals

LEADERSHIP DEVELOPMENT OPPORTUNITIES Cameron Wiggins The EPHLI program taught me to use systems thinking methods to analyze a chronic problem to understand root causes evaluate why it is occurring and to identify leverage points for substantial impact It has been an eye opening learning experience The coaches mentors fellows and my team member were outstanding and brought ldquoreal worldrdquo experiences to every discussion I thoroughly enjoyed the EPHLI experience and would highly recommend it to environmental public health professionals and future leaders as a great tool for developing leadership capacity and as an enriching opportunity to use a team approach to solve environmental public health problems Through the use of the Myers-Briggs and the Skillscope 360 I was able to see how my colleagues viewed my work ethic as well as understand how my personality plays to my strengths This portion of the program was also very beneficial in helping me to develop my plan to work on leadership skills that my colleagues felt that I needed to improve upon I feel as though this program has provided a roadmap for self-improvement environmental public health problem solving and networking with some of the best and brightest minds in the field In talking with the other fellows it became obvious to me that we are all dealing with a great deal of the same issues risks and concerns within the environmental public health field And it is always good to know that there are other leaders that you can call to share best practices Maurice Redmond The EPHLI program has been a truly rewarding experience that has broadened my vision as an environmental health profession and as an individual The tools of systems thinking coupled with action learning now provides me with a way to visualize a problem in terms of its relationship in a larger system This program has pushed me out of my professional comfort zone and equipped me with new competencies to apply in the programs I now manage I would like to thank all those who provided comments or input into this project Input on my skillscope gave me an opportunity to get feedback on how co-workers and managers viewed my contributions and leadership potential I used that feedback to develop an individual development plan for self- directed professional growth and improvement Finally my partner team members and mentor are definitely some of the brightest young minds in the profession and working with them during this year has been rewarding The work enthusiasm displayed on the conference calls at the face to face sessions and office conversations is what I appreciate most about this experience

ABOUT THE EPHLI FELLOW(s) Maurice Redmond is currently a Program Director for the Public Swimming Pools and Tourist Accommodation Programs for Georgia Department of Public Healthrsquos Environmental Health Branch In this capacity he formulates plans guides and interprets the rules and regulation applicable to the programs He also provides training for district and county environmental health personnel He serves on the Environmental Health Branchrsquos General Sanitation Committee which reviews policies procedures rules and regulations for the Food Service Tourist Accommodations and Swimming Pools Spas and Recreation Waterparks programs Maurice is a Commissioner on the Georgia Structural Pest Control Commission which is responsible of overseeing the licensure of pest control companies in the state of Georgia He is a registered Environmental Health Specialist with National Environmental Health Association Maurice began his environmental health career in the military as an Environmental Science Officer assigned to the Center for Health Promotion and Preventive Medicine Promotion (CHPPM) located in Edgewood Maryland and later served in various environmental health assignments at Fort Benning and Fort McPherson Georgia He began his environmental public health career with the Fulton County Department of Health and Wellness before joining the Environmental Health Branch where he has worked for 12 years Maurice holds a Bachelor of Science degree from East Carolina University in Environmental Health and a Master of Management degree from Troy State University Fort Benning Campus Cameron Wiggins is currently a Program Consultant in the Food Service Program for Georgia Department of Public Healthrsquos Environmental Health Branch In this capacity he interprets the Georgia Food Service Rules and Regulations and provides training for district and county environmental health personnel Cameron is the Chairperson of Georgiarsquos Food Service Technical Review Advisory Committee which reviews HACCP plans for specialized food processes responsible for awarding Continuing Education Units for the Food Service Program serves on the Georgia Food Safety and Defense Task Force and provides standardization assistance to health districts He is certified as a FDA Standardized Retail Food Safety Inspection Officer and as a Georgia Food Service Establishment Inspection Officer Cameron began his environmental public health career in Illinois at the Champaign-Urbana Public Health Districtrsquos (CUPHD) Food Service Program over more than a decade ago At the CUPHD he was responsible for conducting food service inspections providing educational training and managing the Indoor Air Quality Program After several years at CUPHD Cameron moved to Georgia and began working for Northeast Georgia Public Health District 10 as an Environmental Health Specialist Prior to joining the Georgia Department of Public Health team Cameron worked at the University of Georgia in the Department of Food Science and Technology and the Department of

Public Healthrsquos Institute for Health Management and Mass Destruction Defense developing food emergency response plans and conducting exercises to test the plan Cameron holds a Bachelor of Science degree from Alabama AampM University in Environmental Science a Master of Urban Planning degree from the University of Illinois at Urbana-Champaign and a Master of Public Health degree from the University of Georgia

REFERENCES 1 Osaki C eds 10 Essential Services of Environmental Health Northwest Center for

Public Health Practice University of Washington School of Public Health Practice and Community Medicine Seattle 2004

2 Callahan T Initiation of the National Environmental Public Health Performance Standards in Georgia CDC Environmental Public Health Leadership Institute Atlanta 2010-2011

3 Rustin C Developing a Comprehensive Workforce Development Plan to Retain and Recruit Environmental Health Specialistrsquos in the State of Georgia CDC Environmental Public Health Leadership Institute Atlanta 2009-2010

4 CDC A National Strategy to Revitalize Environmental Public Health Services httpwwwcdcgovncehehsDocsnationalstrategy2003pdf accessed August 10 2011

5 Georgia Department of Public Health Environmental Health Branch webpage Available at httphealthstategausprogramsenvservicesindexasp accessed December 1 2011

6 Georgia Board of Registered Professional Sanitarians Chapter 580-4-03(1) httprulessosstategauspagesGEORGIA_BOARD_OF_REGISTERED_PROFESSIONAL_SANITARIANSindexhtml accessed November 1 2011

7 United States Census Bureau Quick Facts Available at httpquickfactscensusgovqfdstates13000html accessed December 1 2011

8 Georgia State Personnel Administration Job Description Environmental Health Specialist I Available at httpwwwgmsstategausjobdescriptionsjobsearchresultsaspreq=3ampjobtitle=19423

9 Georgia Department of Public Health Rules and Regulation for Food Service Chapter 290-5-14-09(1) 2008 Available at httphealthstategauspdfsenvironmentalFoodRulesFoodServiceRulespdf accessed December 1 2011

APPENDIX PROGRAM CIRRICULUM EXAMPLE Food Service Program Proposed Curriculum The Food Service Program Curriculum is divided into four levels The levels correlate to the national curriculum for standards-based career-spanning professional development framework established by the International Food Protection Training Institute (IFPTI) Environmental Health Specialist I (Entry Level) Target audience Newly hired Environmental Health Specialists (EHS) or EHS that have recently been assigned food service responsibilities

Prerequisites The Georgia Rules and Regulations governing Food Service Chapter 290-5-14 the Interpretation Manual for the Georgia Rules and Regulations for Food Service the Food Service Establishment Manual for Design Installation and Construction and Managing Food Safety A Regulatorrsquos Manual for Applying HACCP Principles to Risk-based Retail and Food Service Inspections Objective To prepare new hires or apprentices to the food service program with the basic knowledge to meet the food service training requirements Upon completion of the curriculum the EHS must conduct at least 25 food service inspections accompanied by an experienced Environmental Health Specialist and conduct at least 25 food service inspections on hisher own which are reviewed by an experienced Environmental Health Specialist After completing the curriculum and mentoringcoaching process the EHS should be able attain food service standardization credential within 2 years ANSI-accredited Certified Food Safety Manager (CFSM) training course

(Located at httphealthstategauspdfsenvironmentalFoodEducationAccreditedProgramsdoc)

Georgia Rules and Regulations governing Food Service Chapter 290-5-14 online

course (Located on SABA) EH Food Service Pre-standardization Training may consist of attendance and

completion of Module 2-GA EH training program or completing ORAU-Level I - Basic Core courses (Located at httpswwwcompliancewirecomSecurelogon-cwireasp)

The Module 2-GA EH training program is provided by the State EH office in a

face-to-face classroom format The course is comprised of the following topics

o History of the Rules and Regulations o Application of HACCP Field Verification

o Risk-based Inspections o Communication Skills o Food Safety Hazards o Process Flow Charts o Menu Review o Risk Control Plans

The ORAU Level I online course curriculum is designed to satisfy the new hire training requirements of Standard 2 Trained Regulatory Staff of the FDArsquos draft Voluntary National Retail Food Regulatory Program Standards The online curriculum is as follows

o FDA35 ndash Basic Food Law for State Regulators o FDA38 ndash Basics of Inspection Beginning an Inspection o FDA39 ndash Basics of Inspections Issues and Observations o FDA36 ndash Public Health Principles o MIC01 - Food Microbiological Control 1 Overview of Microbiology o MIC02 - Food Microbiological Control 2AGram-Negative Rods o MIC03 - Food Microbiological Control 2B Gram-Positive Rods amp Cocci o MIC04 - Food Microbiological Control 3 Foodborne Viruses o MIC05 - Food Microbiological Control 4 Foodborne Parasites o MIC16 - Food Microbiological Control Mid-Series Exam o MIC06 - Food Microbiological Control 5 Controlling Growth Factors o MIC07 - Food Microbiological Control 6 Control by Refrigeration and

Freezing o MIC08 - Food Microbiological Control 7A Control by Thermal

Processing o MIC09 - Food Microbiological Control 7B Control by Pasteurization o MIC10 - Food Microbiological Control 7C Control by Retorting o MIC11 - Food Microbiological Control 8 Technology-based Food

Processes o MIC12 - Food Microbiological Control 9 Natural Toxins o MIC13 - Food Microbiological Control 10 Aseptic Sampling o MIC14 - Food Microbiological Control 11 Good Manufacturing Practices o MIC15 - Food Microbiological Control 12 Cleaning and Sanitizing o FI01 ndash Foodborne Illness Investigations 1 Collecting Surveillance Data o FI02 ndash Foodborne Illness Investigations 2 Beginning an Investigation o FI03 ndash Foodborne Illness Investigations 3 Expanding the Investigation o FI04 - Foodborne Illness Investigations 4 Conducting a Food Hazard

Review o FI05 - Foodborne Illness Investigations 5 Epidemiological Statistics o FI06 - Foodborne Illness Investigations 6 Final Report o FDA16 ndash Basics of HACCP Overview of HACCP o FDA17 ndash Basics of HACCP Prerequisite Programs and Preliminary Steps o FDA18 ndash Basics of HACCP The Principles

Environmental Health Specialist II (Proficient) Target audience All current Standardized Food Service Establishment Inspection Officers Prerequisites Completion of the Georgia Food Service Training Curriculum and successful attainment of the Standardized Food Service Establishment Inspection Officer credential Objective To provide continuing education to enable EHS to successfully assess manage and communicate risks to the food service industry and the public FS Module1 Food Service Plan Review course FS Module 3 Environmental Health Assessment course NEHA E-Learning httpnehacertorgmoodlecoursecategoryphpid=33 03 Food Protection course (located at

httplmssouthcentralpartnershiporgscphp)

Implementing a Training Development and Evaluation Plan for the Next Generation of EHS
2011-2012
Environmental Public Health Leadership Institute Fellow(s)
Maurice Redmond MS REHS
Cameron Wiggins MUP MPH
- Program Consultant II Food Service
- Georgia Department of Public Health
- Environmental Health Branch
- - Wade Sparkman BBA
  - Acknowledgements
  - EXECUTIVE SUMMARY
  - INTRODUCTIONBACKGROUND
  - - Problem Statement Why havenrsquot we been able to develop a comprehensive and effective training program for EHS within the State of Georgia
    - Figure 1 Behavior Over Time Graph
    - 10 Essential Environmental Health Services
    - National Goals Supported
    - Project Logic Model Goal To provide valued and effective Environmental Health Programs in Food Pools and Tourist Accommodations that change behavior and lessen the potential for foodborne and waterborne illness or injury in the state of Georgia
    - - PROJECT OBJECTIVESDESCRIPTIONDELIVERABLES
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        By October 2013 the Food Service Pool and Tourist Accommodation Programs will implement a Training Development Toolkit and Evaluation Plan as a framework for improving training instruction management involvement and employee engagement This will
        
        Determinant
        
        Impact Objective
        
        Contributing Factors
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        LEADERSHIP DEVELOPMENT OPPORTUNITIES
        
        REFERENCES

Page 2: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Giles Roberts Program Director Food Service Georgia Department of Public Health Environmental Health Branch

regulated community

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

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regulated community

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 4: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

regulated community

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 5: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

regulated community

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 6: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

regulated community

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 7: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

regulated community

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 8: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 9: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Key Variables

Time

GAP BETWEEN

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 10: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

O

S

O

S

O

S

R

B

loop

O

S

O

R

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Evaluation Plan

impact

O

S

O S O

S

O

S

O

Vicious cycle

R

B

R

loop

Addiction loop

R

S S

S

O

S

O

B

R

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 12: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 13: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 14: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Impacts

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 15: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

Outcome Objective

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 16: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

METHODOLOGY

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 17: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

monitoring tool

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 18: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

ACTIONS PLANNED

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 19: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 20: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 21: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 22: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 23: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 24: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 25: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

Page 26: Implementing a Training Development and Evaluation Plan ... · from the long-term solution of developing a comprehensive EH training development ... Georgia EH training program’s

2011-2012
  - Acknowledgements
  - EXECUTIVE SUMMARY
      - Program Goal
        
        Health Problem
        
        Outcome Objective
        
        
        Determinant
        
        Impact Objective
        
        
        Process Objectives
        
        METHODOLOGY
        
        
        
        EXPECTED OUTCOMES
        
        
        REFERENCES

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