MAPPING DUAL-DEGREE PROGRAMS IN SOCIAL WORK AND PUBLIC HEALTH: RESULTS FROM A NATIONAL SURVEY

Dory Ziperstein, MSW, MPHAshley Clement, MSW/MPH CandidateJamie Wyatt Marshall, MSW, MPHEsther Velásquez, MSW, MPHBetty J. Ruth, MSW, MPH

A P H A A N N U A L M E E T I N G , B O S T O N , M AM O N D AY N O V E M B E R 4 T H , 2 0 1 3

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.

Overview

• 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).

BackgroundMethodsResultsLimitationsConclusions

Relevant ResearchBackgroundMethodsResultsLimitationsConclusions

• 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)

MSW/MPH Programs Reflect Profession’s History

• 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

BackgroundMethodsResultsLimitationsConclusions

MSW/MPH Programs Build on Similarities Between Two Fields….

BackgroundMethodsResultsLimitationsConclusions

Public HealthSocial justice missionUse 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

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

… But Emphasize Different Skills and Methods!

BackgroundMethodsResultsLimitationsConclusions

Public HealthFocus on preventionUse of public health

models/systemsPopulation 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”

Why We Need MSW/MPH ProgramsBackgroundMethodsResultsLimitationsConclusions

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

Strengths and Ongoing Concerns 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

BackgroundMethodsResultsLimitationsConclusions

Purpose of the MSW/MPH Program Mapping Study

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

BackgroundMethodsResultsStudy Conclusions

Survey Design and InstrumentStudy 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

BackgroundMethodsResultsLimitationsConclusions

Sample• 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

BackgroundMethodsResultsLimitationsConclusions

Distribution and AnalysisSurvey• 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

BackgroundMethodsResultsLimitationsConclusions

RESULTS

Study Results BackgroundMethodsResultsLimitationsConclusions

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

Type of Institution Offering MSW/MPH Programs (n=36)

BackgroundMethodsResultsLimitationsConclusions

71%

23%

6%Public

Private

Hybrid

Location of MSW/MPH Programs (n=36)

BackgroundMethodsResultsLimitationsConclusions 8 West 11 North

10 South

7 Midwest

MSW/MPH Programs Over Time (n=36)

BackgroundMethodsResultsLimitationsConclusions

1980 1985 1990 1995 2000 2005 20100

5

10

15

20

25

30

35

Year Program Began

Cum

ulat

ive

Num

ber o

f Pro

gram

s

MSW/MPH Program Characteristics (n=36)BackgroundMethodsResultsLimitationsConclusions

• 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)

Respondents’ Reported Student Characteristics

• 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)

BackgroundMethodsResultsLimitationsConclusions

Faculty Perceptions of MSW/MPH Student Debt (n=14)

BackgroundMethodsResultsLimitationsConclusions

11-20K 21-30K 31-40K 41-50K 51-60K 61-70K 71K +0

1

2

3

Freq

uenc

y of

P

rogr

ams

Debt reported at Graduation: (thousands of dollars)

Institutional Support for Faculty Roles in MSW/MPH programs (n=36)

BackgroundMethodsResultsLimitationsConclusions

Faculty Coordinator

at Both Schools

Faculty Advisors at

Both Schools

Faculty Course Relief

Yes 30 31 1

No 1 1 30

Unsure* 2 1 5

Did not respond 3 3 0

*Respondent unsure of program support

Institutional Support for MSW/MPH Programs (n=36)

BackgroundMethodsResultsLimitationsConclusions

• 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

Use of Public Health Social Work Framework

• 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*)

BackgroundMethodsResultsLimitationsConclusions

*n is greater than 37 because some programs had two responses

QUALITATIVE COMMENTS

Reported SuccessesBackgroundMethodsResultsLimitationsConclusions

Successful alumni in leadership roles

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.

Graduation rate for completion of both degrees is high… Our alumni who have gone on to great positions which combine the two fields well.

Reported ChallengesBackgroundMethodsResultsLimitationsConclusions

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.

Reported Challenges, ContinuedBackgroundMethodsResultsLimitationsConclusions

• 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.

Reported Goals

BackgroundMethodsResultsLimitationsConclusions

• 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.

Study Limitations BackgroundMethodsResultsLimitationsConclusions

• Response rate high, but missing data • Sampling challenges • Potential self-reporting and perception biases • Does not represent direct experiences of

students and alumni perspective

Conclusions: The Good NewsBackgroundMethodsResultsLimitationsConclusions

• 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.

Conclusions: Recommendations BackgroundMethodsResultsLimitationsConclusions

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 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.

Conclusions: Recommendations BackgroundMethodsResultsLimitationsConclusions

“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

Thank You!Participating Administrators and Professors

of the MSW/MPH Programs

Boston University School of Public HealthLeonard Glantz, JD

Additional Members of the Group for Public Health Social Work Initiatives:

Dr. Sally Bachman, PhDLuz Lopez, PhD, MSW, MPH

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