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Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally. |
