Ledelse mellom sterke ideologier og lillebrorkomplekser – en eksplorerende studie i tverrfaglig spesialisert rusbehandling

Background: Substance use treatment has long traditions in Norway, but it was not until 2004 that it became part of the specialist health service, leading to new leadership requirements. The aim of this study was to understand how the field is perceived from a leadership perspective and how leaders perceive their leadership role. Method: The study is based on three focus group interviews with the mentors of 28 network groups. Data were analysed through systematic text condensation. Results: The analysis resulted in a clustering of four aspects the informants reported to characterise their perceptions of their leadership role: the inferiority complex, values ​​in substance use treatment, pragmatic leadership, and subjective leadership. Implications: The analysis shows that informal hierarchies of power, ideology, and expectations of interdisciplinarity in all decisions provide fertile ground for a flat structure and ambiguity in management. The findings reveal the need for measures to strengthen recognition of the field and develop the leadership role. Keywords: Substance use treatment, leadership, drugs, addiction, health, leadership development

An Evaluation of Epidemic Intelligence Service Alumni in Public Health Leadership Roles

Background The U.S. Centers for Disease Control and Prevention (CDC) has administered the Epidemic Intelligence Service (EIS) fellowship for over 50 years, with the goal of developing scientists and leaders in applied epidemiology. Our objective was to understand the extent to which CDC EIS alumni are present in select public health leadership roles. Methods We conducted an evaluation describing EIS alumni representation in five preselected leadership positions (CDC director [1953–2016]; CDC center director, state epidemiologist, Field Epidemiology Training Program [FETP] resident advisor, and Career Epidemiology Field Officer [CEFO] [2000–2016]). We developed a dataset using multiple sources to identify staff in selected positions. We then matched these data with an internal EIS alumni dataset. Results Selected positions were staffed by 353 persons, of which 185 (52%) were EIS alumni; 10 persons served in >1 leadership position, of which 6 were EIS alumni. Among 12 CDC directors, four (33%) were EIS alumni; collectively these alumni led CDC for approximately 25 years. EIS alumni accounted for 29 (58%) of 50 CDC center directors, 61 (35%) of 175 state epidemiologists, 27 (56%) of 48 Field Epidemiology Training Program resident advisors, and 70 (90%) of 78 Career Epidemiology Field Officers. Of 185 EIS alumni in leadership positions, 136 (74%) were physicians, 22 (12%) were scientists, 21 (11%) were veterinarians, 6 (3%) were nurses; 94 (51%) were assigned to a state or local health department. Among 61 EIS alumni who served as state epidemiologists, 40 (66%) were assigned to a state or local health department during EIS. Conclusions EIS alumni accounted for between approximately one-third (CDC directors and state epidemiologists) and 90% (CEFOs) of people serving in essential leadership positions at multiple levels.

Adaptive Leadership and Independent Opinions: Lessons From the National COVID-19 Immunisation Programme

Malaysia was slow to begin its COVID-19 immunization program for various reasons. However, it is one of the fastest developing countries to vaccinate 80% of its adult population. Nontraditional health leadership played a large role in the implementation of the National COVID-19 Immunisation Programme (NCIP). Independent opinions from academia also helped the NCIP and may be useful as a way of pushing forward recommendations that may otherwise be difficult to make.

Preferences and patterns of response to public health advice during the COVID-19 pandemic

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examined and quantified public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice, and (b) the advice’s adherence likelihood. In a series of studies about preference for public health leadership advice, we asked 1061 participants to choose between (5) strict advice that is medically optimal if adhered to but which is less likely to be broadly followed, and (2) relaxed advice, which is less medically effective but more likely to gain adherence—given varying infection expectancies. Participants’ preference was consistent with risk aversion. Offering an informed choice alternative that shifts volition to advice recipients only strengthened risk aversion, but also demonstrated that informed choice was preferred as much or more than the risk-averse strict advice.

Leadership in public health

This chapter explores the concepts of leadership relevant to and as applied in public health practice. It looks at various concepts of leadership, frameworks for developing public health leaders, leadership development, and explores how one’s leadership practice and values evolve across their career and life course. It draws upon examples and case studies of public health leadership at global, national, and local levels; in a variety of organizations; and in various contexts to illustrate the diversity of leadership challenges, approaches, and applications. As with other public health skills, effective leadership may be taught, evaluated, and developed, with an individual’s comfort and competence with their preferred and alternative leadership styles evolving over time. This is however highly dependent upon one’s professional ambition, engagement, experience, environment, opportunities, and challenges, both in professional and private spheres. The chapter ends by exploring the principles of authentic leadership, reinforcing the importance of practitioners, at whatever phase in their career, understanding their core values, life purpose, and aligning with their day-to-day practices and the organization’s priorities. While not everyone will currently or ever be in a senior executive leadership role, many aspire to do so at some stage in their career, and everyone working in public health will be called upon to lead an activity at some stage—whether a project, administrative task, strategy, or analysis. So, leadership is ultimately everyone’s business, and the time to prepare by laying strong foundations is now. Leadership is a craft that can be learnt, nurtured, and shared, but it will be for the individual to decide when, where and how they are being called to do so, and ultimately what their answer will be.

Disaster Prevention Achieved

Many communities in the US Upper Midwest have been battling record floods in recent decades. This chapter focuses on a spring flood event in 2009, when the Greater Fargo area avoided destruction from the Red River of the North by utilizing mitigation efforts. Included in the undertaking was the mobilization of the community to place millions of sandbags, as well as the creative repurposing of resources. This case study presents a model of community resilience in a geographically vulnerable region. It illustrates the achievement of flood disaster prevention in the face of imminent and severe threat; the reinforcement and enhancement of community resilience based on averting disaster; the channeling of fear-related behaviors into constructive community actions; and the complexity of factors that create unique flood risks along the Red River of the North. Lessons-learned provided for not only a recovery framework, but also a recognition of the value of behavioral health leadership in disaster situations.

Optimizing health leadership in early prevention efforts in village communities

This study aims to optimize health leadership in preventing Covid-19 from an early age in the village. The author believes that health status is determined by treatment; prevention can be more effective and efficient. We collect public health literature from many databases of public health publications. We start from the journal Esavier, Medpub, Google Book, and several websites that discuss public health issues at home and abroad. We are targeting based data published in the last ten years to find the latest data and validity. The research involves a data coding system, high evaluation, and conclusion drawing in order to be able to answer research questions with high reliability. We conclude that health leadership is characteristic of how medical roles lead people to health. Value health and maintain it until community members find physical and mental health. The medical team minimizes stress by communicating openly and creating a healthy and safe environment for its citizens' creative thinking and expression. These results are helpful for the development of literature and public health applications.

A new era of health leadership

Traditional models of health leadership are characterized by top-down structures dependent on hierarchy – which emerged historically from military models. With supporting evidence, many of today’s leaders are now working hard to shift their organizations to models of empowered teams and servant leadership with the hopes of inciting a broader cultural shift. The concern is that these early signs of progress could unravel due to the many challenges now exacerbated by COVID-19 and its implications. One such example is fostering respect and civility (i.e. the pillars of empowerment and servant leadership) which is placed at risk during times of change and crisis – more so during a pandemic when command-and-control structures are deemed necessary. The evolution of modern health leadership must be implemented with plans for mitigating related risks. Ultimately, the behaviours that are tolerated during times of stress are what become the value system of any organization.