Mapping dual-degree programs in social work and public health: Results from a national survey

1. Mapping dual-degree programs in social work and public health: Results from a national survey Apha annual meeting, boston, ma Monday November 4th, 2013 Dory Ziperstein, MSW, MPH Ashley Clement, MSW/MPH Candidate Jamie Wyatt Marshall, MSW, MPH Esther Velásquez, MSW, MPH Betty J. Ruth, MSW, MPH

2. Presenter Disclosures Dory Ziperstein and Ashley Clement The following personal financial relationships with commercial interests relevant to this presentation existed during the past twelve months: No relationships to disclose.

3. Overview Background Methods Results Limitations Conclusions • MSW/MPH programs: programs in which masters’ students study knowledge, theories, approaches and methods of both professions, earning MSW & MPH degrees • Exact number of MSW/MPH programs unclear; most recent estimates suggested 20-30 MSW/MPH programs nationwide, with many under development (Cornet, 2006; Marshall, et al., 2011; Reardon, 2009).

4. Relevant Research Background Methods Results Limitations Conclusions • Despite popularity, dual-degree programs relatively understudied (Ruth, et al, 2008) • In one effort to establish national prevalence of dual degree programs in general, researchers found increase in both number and type, with approximately 1/3 of MSW programs offering a dual degree program of any type (Miller, Hopkins & Grief, 2008). • Many unanswered questions and critical need to understand growth in MSW/MPH programs, particularly in era of ACA, growing emphasis on prevention, and increasing focus on health equity and disparities (Ruth, Wyatt Marshall, Hill, Taranto, Sisco & Bachman, 2011)

5. MSW/MPH Programs Reflect Profession’s History Background Methods Results Limitations Conclusions • First MSW/MPH programs developed in 1970’s, built upon social work’s early and long standing involvement in PH • MSW/MPH programs have potential to reflect/reinforce critical and re-emerging area of practice known as “public health social work”: Social work practice based on an epidemiologic approach to preventing, addressing, and solving social health problems -Ruth & Hill, 2010

6. MSW/MPH Programs Build on Similarities Between Two Fields…. Background Methods Results Limitations Conclusions Social Work • Social justice mission • Use of social sciences to drive theory and method • Focus on “person in environment”approaches • Emphasis on strengths-based approach • Goals: improve human functioning/well-being Public Health • Social justice mission • Use of social sciences to drive theory and intervention • Focus on ecological models/role of “environment” • Emphasis on resilience and protective factors • Goals: promote health and health conditions

7. … But Emphasize Different Skills and Methods! Background Methods Results Limitations Conclusions Public Health • Focus on prevention • Use of public health models/systems • Population emphasis with exclusive macro focus • Based on biological sciences, EBP, epidemiology • “up in the balcony” • Social Work • Focus on interventions • Reliance on medical models/systems • Clinical emphasis with focus on individuals, groups, families • Emerging research utilizing EBP interventions. • “down on dance floor”

8. Why We Need MSW/MPH Programs Background Methods Results Limitations Conclusions MSW/MPH programs educate public health social workers who can respond and lead on major issues: • Increased globalization and information exchange • Population changes: aging, growth, immigration • High rates of urbanization • Natural disasters and war • Pervasive chronic/infectious diseases • Rampant health disparities and inequities • Dissemination of evidence-based and promising practices in both social work and public health • Implementation of Affordable Care Act and Prevention Strategy

9. Strengths and Ongoing Concerns Background Methods Results Limitations Conclusions MSW/MPH Program Strengths • Build on the natural overlap between public health and social work • Attract students interested in trans-disciplinary, research-based practice • Catalyze graduate schools to integrate prevention, research, and social epidemiology into curricula MSW/MPH Program Concerns • Cost of three year program • Would graduates continue to “identify” with or flee SW? • Workplace responsiveness to dual alumni • Inadequate support/leadership for programs, especially re: integration of PH and SW

10. Purpose of the MSW/MPH Program Mapping Study Background Methods Results Study Conclusions In order to better study MSW/MPH program alumni and to build public health social work, it is essential to locate and understand MSW/MPH programs. The purpose of this study: • To create a national “map” of MSW/MPH programs in US • Develop baseline understanding of similarities, differences, and demographics of MSW/MPH programs

11. Survey Design and Instrument Background Methods Results Limitations Conclusions Study design: • Online cross sectional exploratory survey of all MSW/MPH Programs • 27 items composed of multiple choice, Likert scale, and short-answer questions • Scope of questions included institutional demographics, program details, alumni, funding, faculty involvement, reported successes and challenges, future plans

12. Sample Background Methods Results Limitations Conclusions • All MSW/MPH programs in US eligible • Identified MSW/MPH programs using multiple methods: • Analyzed websites (APHA’s PHSW Section List; CSWE list of dual programs; schools identified as having both PH and SW programs) • Consulted key informants • Identified all programs’ “key personnel” and contact persons including coordinators, faculty members, directors from both SW and PH • Sample included all key personnel

13. Distribution and Analysis Background Methods Results Limitations Conclusions Survey • Individual surveys made for each school; some schools had several key personnel Distribution • Survey link with email reminders to all key personnel at every program distributed three times during Fall 2012 Analysis • Survey data aggregated once all programs had responded

14. Results

15. Study Results Background Methods Results Limitations Conclusions A total of 37 MSW/MPH programs identified: • 36 completed study (response rate: 97%) • 9 schools had more than one respondents (25%) • Respondents ranged from directors of programs to graduate assistants • 23 respondents from SW school • 16 reported from PH school • 1 reported had dual appointment in PH and SW

16. Type of Institution Offering MSW/MPH Programs (n=36) Background Methods Results Limitations Conclusions

17. Location of MSW/MPH Programs (n=36) Background Methods Results Limitations Conclusions 8 West 11 North 7 Midwest 10 South

18. MSW/MPHPrograms Over Time (n=36) Background Methods Results Limitations Conclusions Cumulative Number of Programs Year Program Began

19. MSW/MPH Program Characteristics (n=36) Background Methods Results Limitations Conclusions • Average length of program: 3 years • Requiring specific major in one or both programs: 53% programs • Integrative (PH and SW) Seminar offered: 22% programs • Majority offer MSW/MPH-specific internships (71%, n=35) • Mean number of graduates per year: 6.8 students, range 0-25 (n=35)

20. Respondents’ Reported Student Characteristics Background Methods Results Limitations Conclusions • Program directors’ perception of why students enroll (n=32) • Believe it will make them more marketable 91% • Desire competencies of public health and social work 88% • Want to tackle big trans-disciplinary issues 69% • Want to be PHSW 56% • Licensure/Certification • Majority of programs report that some or most of their students pursue SW and PH licensure (88%, 75%, n=30) • Financial Aid for Students • A total of 84% reported their programs DID NOT have specific MSW/MPH aid available (n=14)

21. Faculty Perceptions of MSW/MPH Student Debt (n=14) Background Methods Results Limitations Conclusions Frequency of Programs Debt reported at Graduation: (thousands of dollars)

22. Institutional Support for Faculty Roles in MSW/MPH programs (n=36) Background Methods Results Limitations Conclusions *Respondent unsure of program support

23. Institutional Support for MSW/MPH Programs (n=36) Background Methods Results Limitations Conclusions • Percentage of programs that DO NOT have specific budget to support its activities: 77% • MSW/MPH Specific Services for Alumni Activities • 11% offer career services • 9% offer continuing education

24. Use of Public Health Social Work Framework Background Methods Results Limitations Conclusions • Number of programs reporting Faculty interested in PHSW: 19 (53%, n=36) • Number of programs that reported purpose included to train Public Health Social Work professionals: 19 (53%, n=35) • Number of programs who reported using “public health social work” framework to describe mission, goals or activities: 7 (18%, n=38*) *n is greater than 37 because some programs had two responses

25. Qualitative comments

26. Reported Successes Background Methods Results Limitations Conclusions Successful alumni in leadership roles Graduation rate for completion of both degrees is high… Our alumni who have gone on to great positions which combine the two fields well. Excellent students / involved with interesting projects once they graduate. Many of our dual folks are Returned Peace Corps Volunteers and many seek to return to international work.

27. Reported Challenges Background Methods Results Limitations Conclusions Inflexibility of program curriculum including lack of electives Neither program has very much flexibility or elective credits to use so the combination does not save a student very much time or course work.

28. Reported Challenges, Continued Background Methods Results Limitations Conclusions • Building partnerships between schools • Lack of funding/financial aid for students • Difficulties combining field placement opportunities • Demanding schedule for students; logistics of classes on two campuses • Marketing the program To improve coordination between both schools, make faculty more responsive to needs of dual-degree students, and improve tracking systems for dual-degree students/logistics.

29. Reported Goals Background Methods Results Limitations Conclusions • Grow programs: Continue to attract strong students, refine marketing, increase visibility • Curriculum and program development: build flexibility and options, including international component • Increased collaboration between schools • Funding for program and students [The program is] a leader and it will continue to grow. However, the need for serious funding is clear.

30. Study Limitations Background Methods Results Limitations Conclusions • Response rate high, but missing data • Sampling challenges • Potential self-reporting and perception biases • Does not represent direct experiences of students and alumni perspective

31. Conclusions: The Good News Background Methods Results Limitations Conclusions • High interest and increasing enrollments • Promotes collaboration across programs • Graduates appear successful • Important growth area for SW during critical time Great curriculum, terrific students, successful collaboration between schools / The students graduate and go on to do great things.

32. Conclusions: Recommendations Institutional Support • Need for funding for students and programs • Commitment to program outcomes evaluation Clarification of Programs’ Mission and Purpose • Improve conceptualization/integration of PHSW • Cross-profession/within-profession dialogues on value of MSW/MPH Background Methods Results Limitations Conclusions This program is great! But it needs to include courses that are meant to integrate these fields in a tangible way. We are not sure how to do this and still keep the integrity of the program design.

33. Conclusions: Recommendations Background Methods Results Limitations Conclusions “MSW/MPH programs are not merely educational enhancements for students; they have the potential to become the profession’s building blocks for trans-disciplinary and inter-professional collaboration in the new health care arena. However, to maximize the opportunities associated with these programs, cross-school leadership, resources, and investment are needed. Successful MSW/MPH programs do not come cheap: they require vision, faculty time, student funding, specific internships, career services, and post-graduate professional education dedicated to public health social work.” -Ruth, Marshall, Velásquez, & Bachman, in press

34. Thank You! Participating Administrators and Professors of the MSW/MPH Programs Boston University School of Public Health Leonard Glantz, JD Additional Members of the Group for Public Health Social Work Initiatives: Dr. Sally Bachman, PhD Luz Lopez, PhD, MSW, MPH

35. Contact Info • Dory Ziperstein, LCSW, MSW, MPH • dory.zip@gmail.com • Ashley Clement, B.S., MSW/MPH Candidate • aclement@bu.edu • Betty J. Ruth, MSW, MPH • bjruth@bu.edu For more information: www.publichealthsocialwork.org