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Spring 2006 Volume 12, No. 2

A Proposed Methodology for the Infrastructure Development of NASPAA Programs with Specialty Tracks: The Case of Health Policy and Management

Anne M. Hewitt, Brenda Stevenson Marshall, and Kent H. Badger

A National Profi le of NASPAA Programs with Health Specialty Tracks Brenda Stevenson Marshall and Anne M. Hewitt

Exploring the Predictors of Health Specialty Track Accreditation for NASPAA Member Programs

Brenda Stevenson Marshall and Carl F. Ameringer

Benchmark Health Policy Programs: A Window on Public Affairs and Administration Education

Judith J. Kirchhoff and Thomas H. Dennison

Public Affairs and Healthcare Administration: Crosscutting Competencies and Multiple Accreditation Challenges for Academic Programs

Karen Harlow-Rosentraub and James L. Perry

Internet Access and Innovation-Diffusion in a National Cancer Institute Preventive Health Education Project: Telecenters, Cybercafes,

and Sociodemographic Impacts on Knowledge Gaps Una E. Medina, Mario A. Rivera, Everett M. Rogers,

W. Gill Woodall, and David B. Buller

NASPAA Gazette: People in Public AffairsNews and Opportunities ■ Interviews and Essays

Student-Produced Journals ■ Public Affairs Organizations ■ International Associations

Flagship Journal of the National Association of Schools of Public Affairs and Administration

National Association of Schools of Public Affairs and Administration1120 G Street, NW, Suite 730, Washington, DC 20005-3801

202-628-8965 fax 202-626-4978 www.naspaa.org

The Journal of Public Affairs Education (JPAE) is the fl agship journal of the National Association of Schools of Public Affairs and Administration (NASPAA). Founded in 1970, NASPAA serves as a national and international resource for the promotion of excellence in education for the public service. Its institutional membership includes more than 250 university programs in the United States in public administration, policy, and management. It accomplishes its purposes through direct services to its member institutions and by

• Developing and administering appropriate standards for educational programs in public affairs through its Executive Council and its Commission on Peer Review and Accreditation;

• Representing to governments and other institutions the objectives and needs of education for public affairs and administration;

• Encouraging curriculum development and innovation and providing a forum for publication and discussion of education scholarship, practices, and issues;

• Undertaking surveys that provide members and the public with information on key educational issues;

• Meeting with employers to promote internship and employment for students and graduates; • Undertaking joint educational projects with practitioner professional organizations; and • Collaborating with institutes and schools of public administration in other countries

through conferences, consortia, and joint projects.

NASPAA provides opportunities for international engagement for NASPAA members, placing a global emphasis on educational quality and quality assurance through a series of networked international initiatives, in particular the Network of Institutes and Schools of Public Administration in Central and Eastern Europe (NISPAcee), the Inter-American Network of Public Administration Education (INPAE), and the Georgian Institute of Public Affairs (GIPA). It is also involved locally; for instance, directing the Small Communities Outreach Project for Environmental Issues, which networks public affairs schools and local governments around environmental regulation policy issues, with support from the Environmental Protection Agency.

NASPAA’s twofold mission is to ensure excellence in education and training for public service and to promote the ideal of public service. Consistent with NASPAA’s mission, JPAE is dedicated to advancing teaching and learning in public affairs, defi ned to include the fi elds of policy analysis, public administration, public management, and public policy. Published quarterly by NASPAA, the journal features commentaries, announcements, symposia, book reviews, and peer-reviewed scholarly articles on pedagogical, curricular, and accreditation issues pertaining to public affairs education.

JPAE was founded in 1995 by a consortium from the University of Kansas and the University of Akron and was originally published as the Journal of Public Administration Education. H. George Frederickson was the journal’s founding editor. In addition to serving as NASPAA’s journal of record, JPAE is affi liated with the Section of Public Administration Education of the American Society for Public Administration.

JOURNAL OF PUBLIC AFFAIRS EDUCATION

JPAE

Journal of Public A

ffairs Education

Vol. 12, N

o. 2 Spring 2006

Guy B. Adams, University of Missouri-ColumbiaDanny L. Balfour, Grand Valley State UniversityFrances Stokes Berry, Florida State UniversityGeert Bouckaert, Katholieke Universiteit Leuven Stuart Bretschneider, Syracuse UniversityWalter D. Broadnax, Clark Atlanta UniversityJonathan Brock, University of WashingtonJeffrey L. Brudney, University of GeorgiaJohn M. Bryson, University of MinnesotaN. Joseph Cayer, Arizona State UniversityRobert E. Cleary, American UniversitySteven Cohen, Columbia UniversityGlen Hahn Cope, University of Missouri–St. LouisRuth H. DeHoog, University of North Carolina– GreensboroJo Ann G. Ewalt, Kentucky Legislative Research CommissionClaire Felbinger, National Academy of ScienceIrwin Feller, The Pennsylvania State UniversityJane Fountain, Harvard UniversityH. George Frederickson, University of KansasLee S. Friedman, University of California-BerkeleyMary Ellen Guy, Florida State UniversityCynthia Jackson-Elmoore, Michigan State UniversityEdward T. Jennings, University of KentuckyPhillip Joyce, George Washington UniversityPan Suk Kim, Yonsei UniversityMarieka M. Klawitter, University of WashingtonDale Krane, University of Nebraska-Omaha

David Landsbergen, Ohio State UniversityKuotsai T. Liou, University of Central FloridaLaurence E. Lynn, Jr., Texas A & M UniversitySteven R. Maxwell, Edison Community CollegeKenneth J. Meier, Texas A & M UniversityCurtina Moreland-Young, Jackson State UniversityKathryn E. Newcomer, George Washington UniversityDorothy Olshfski, Rutgers University, NewarkSonia Ospina, New York UniversityLaurence J. O’Toole, Jr., University of GeorgiaJames L. Perry, Indiana University– Purdue University–IndianapolisHal G. Rainey, University of GeorgiaT. Zane Reeves, University of New MexicoMitchell Rice, Texas A & M UniversityAnn-Marie Rizzo, Tennessee State UniversitySaundra Schneider, Michigan State UniversitySally Coleman Selden, Lynchburg CollegePatricia M. Shields, Texas State UniversityShui-Yan Tang, University of Southern CaliforniaThomas Vocino, Auburn University at MontgomeryCharles W. Washington, Clark Atlanta UniversityBarton Wechsler, University of Missouri-ColumbiaDavid Weimer, University of WisconsinLouis Weschler, Arizona State UniversityHarvey L. White, University of PittsburghMichael Wiseman, George Washington UniversitySamuel Yeager, Wichita State University

JPAEBruce J. Perlman, Editor-in-Chief, University of New Mexico

Mario A. Rivera, Editor, University of New MexicoPatria de Lancer Julnes, Associate Editor for International Education, Utah State University

Scott Talan, Gazette Editor, NASPAAJennifer C. Ward, Production Editor, Georgia Southern University

Juan de Dios Pineda, Editorial Associate H. George Frederickson, Founding Editor

National Association of Schools of Public Affairs and Administration

Daniel Mazmanian, PresidentKathryn Newcomer, Vice President

Eugenia Toma, Immediate Past PresidentLaurel McFarland, Executive Director

Journal of Public Affairs Education is published quarterly by the National Association of Schools of Public Affairs and Administration. Claims for missing numbers should be made within the month following the regular month of pub-lication. The publishers expect to supply missing numbers free only when losses have been sustained in transit and when the reserve stock will permit. Subscription Rates: Institution, $100; Individual, $45; Student, $35; Non-U.S., add $20 to applicable rate. Change of Address: Please notify us and your local postmaster immediately of both old and new addresses. Please allow four weeks for the change. Postmaster: Send address changes to JPAE, National Associa-tion of Schools of Public Affairs and Administration, 1120 G Street NW, Suite 730, Washington, DC 20005-3801. Educators and Copy Centers: ©2006 National Association of Schools of Public Affairs and Administration. All rights reserved. Educators may reproduce any material for classroom use only and authors may reproduce their articles without written permission. Written permission is required to reproduce JPAE in all other instances. Please contact Jacqueline Lewis, NASPAA, 1120 G Street NW, Suite 730, Washington, DC 20005, phone: 202-628-8965, fax: 202-626-4978, email: [email protected]. The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI Z39.48-1984. JPAE is abstracted or indexed in Book Review Index, ERIC’s CIJE Clearinghouse, Public Affairs Information Service, Sage Public Administration Abstracts, Education Index, and Education Abstracts. ISSN 1523-6803 (formerly 1087-7789).

Board of Editors


Journal of Public Affairs EducationSpring 2006 Volume 12, No. 2

From the Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ii

Information for Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

ArticlesA Proposed Methodology for the Infrastructure Development of NASPAA Programs with Specialty Tracks: The Case of Health Policy and Management . . . . . . . . . . . . . . . . . . . . . . . . . .125Anne M. Hewitt, Brenda Stevenson Marshall, and Kent H. Badger

A National Profile of NASPAA Programs with Health Specialty Tracks . . . . .143Brenda Stevenson Marshall and Anne M. Hewitt

Exploring the Predictors of Health Specialty Track Accreditation for NASPAA Member Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165Brenda Stevenson Marshall and Carl F. Ameringer

Benchmark Health Policy Programs: A Window on Public Affairs and Administration Education . . . . . . . . . . . . . .177Judith J. Kirchhoff and Thomas H. Dennison

Public Affairs and Healthcare Administration: Crosscutting Competencies and Multiple Accreditation Challenges for Academic Programs . . . . . . . . . . .197Karen Harlow-Rosentraub and James L. Perry

Internet Access and Innovation-Diffusion in a National Cancer Institute Preventive Health Education Project: Telecenters, Cybercafes, and Sociodemographic Impacts on Knowledge Gaps . . . . . . . . . . . . . . . . . . . . . . .213Una E. Medina, Mario A. Rivera, Everett M. Rogers, W. Gill Woodall, and David B. Buller

NASPAA GazettePeople in Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233News, Programs, and Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235Interviews and Essays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242 Q&A: Brian Atwood, Humphrey Institute of Public Affairs Scott Talan Successfully Connecting Private and Public Careers Dan Goodman NASPAA Launches Executive MPA Center Maja HolmesStudent-Produced Journals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249Roster of Public Affairs Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251Roster of International Associations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259About NASPAA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261

Cover design by Mario A. Rivera i

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ii Journal of Public Affairs Education

From the Editor

This issue of JPAE presents an unusually comprehensive and authoritative symposium treatment of health policy and administration specialization in public affairs education in the United States, with particular stress on the role of accred-itation, and with central emphasis on NASPAA accreditation. The symposium, commissioned under the editorship of Ed Jennings but only recently complet-ing peer review, provides definitive, empirically based, comparative studies on the subject, conducted by a distinguished group of collaborating researchers. Alphabetically, these are Carl Ameringer of the University of Wisconsin-Os-hkosh, Kent Badger of the University of La Verne, Thomas Dennison of the Maxwell School of Citizenship and Public Affairs, Karen Harlow-Rosentraub of Case Western Reserve University, Anne Hewitt of Seton Hall University, Judith Kirchhoff of Long Island University, James Perry of Indiana University-Purdue University Indianapolis, and Brenda Stevenson Marshall of Cleveland State Uni-versity. In addition, Joy Ivey Boufford, past president of NASPAA, was instru-mental in obtaining research funding and in guiding the resulting involvement of what is now NASPAA’s Health Sector Education Programs Section.

The Stevenson, Marshall, and Hewitt article, “A National Profile of NASPAA Programs with Health Specialty Tracks,” presents the findings from a Robert Wood Johnson Foundation (RWJF) funded study aimed at developing a national profile of accredited and unaccredited NASPAA programs with health specialty tracks, so as to establish baselines for comparison and for the creation of ger-mane standards and guidelines. The Stevenson, Marshall, and Ameringer article, “Exploring the Predictors of Health Specialty Track Accreditation for NASPAA Member Programs,” also conducted under the RWJF grant, addresses concerns related to the prospect of separate NASPAA accreditation of graduate public affairs and administration degrees with health specialty tracks and it identifies pertinent program characteristics using program preferences and resources as the critical indicators. The article by Kirchhoff and Dennison, “Benchmark Health Policy Programs: A Window on Public Affairs and Administration Education,” places the evaluation of graduate health policy and management programs in a broader social and policy context, considering the exigencies of “over two decades of fundamental changes in health and medical care policy, financing, organiza-tion, and service delivery” for such programs.

The article by Hewitt, Stevenson, Marshall, and Badger, “A Proposed Meth-odology for Infrastructure Development of NASPAA Programs with Specialty Tracks: The Case of Health Policy and Management,” also arising from the afore-mentioned RWJF funding, traces the evolution and projects the development of health specialty tracks within the NASPAA accreditation framework using a stage-wise Specialty Track Model. Finally, the Harlow-Rosentraub and Perry ar-ticle, “Public Affairs and Healthcare Administration: Crosscutting Competencies

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Journal of Public Affairs Education iii

and Multiple Accreditation Challenges for Academic Programs,” examines four major accrediting bodies, NASPAA and CAHME prominently among them, “to identify commonalities in core elements for curriculum design and competency development.”

These five articles represent the substance of the last legacy issue from the edi-torship of Ed Jennings, who nonetheless, as indicated in the Editors’ welcome to the Winter 2006 issue of JPAE, continues to lend his expert and generous guid-ance to the journal’s editors. The symposium is in every sense a fitting legacy to a distinguished period in the journal’s history, providing as it does a comprehensive as well as authoritative assessment of the provenance, present status, and near- and long-term prospects of health specialization degree programs in public affairs education. One would be hard-pressed to identify a public policy and higher education concern of greater currency and importance in the United States today.

On the premise that there should be six or more articles per issue as a norm, I sought a sixth article pertaining to health policy from the journal’s archive of manuscripts that have completed positive peer review. Finding none, and unable to commission such an article on short notice, I decided to include a previously unpublished manuscript titled “Internet Access and Innovation-Diffusion in a National Cancer Institute Preventive Health Education Project,” which I coau-thored with Una Medina, Everett Rogers, W. Gill Woodall, and David Buller, all of the University of New Mexico. Addressing the emerging issue of “telehealth education,” particularly public health education campaigns aimed at minority communities, with stress on issues of cultural, technical, and socioeconomic dis-tance, the article is noteworthy as one of the final research efforts of the late com-munications theorist Everett Rogers. Rogers, considered one of the leading social scientists of the twentieth century, pioneered diffusion-of-innovations theory, and he afforded the other authors and me the privilege of working with him during the last five years of his life.

Funded by a National Institutes of Health (NIH), National Cancer Institute (NCI) RO1 research grant and minority supplement, the study presents an evalu-ation of an NCI project, the Health Communication Intervention Research Initiative, looking at broad concerns of cultural communication and policy and program implementation, across social and programmatic networks, with some consid-eration of pedagogical and methodological applications of the case in the MPA classroom. Earlier versions of the study, from proposal to field and final reports, were peer-reviewed by the NIH; it then underwent additional independent peer review at JPAE. I invoked what will be the very rare privilege of including my own work in the journal, in deference to the importance of providing a forum for an empirical study complementary to the symposium. It also provides an oppor-tunity for a tribute to the culminating work of a most distinguished colleague.

—Mario A. Rivera, Ph.D., Editor

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iv Journal of Public Affairs Education

Information for Contributors

The Journal of Public Affairs Education (JPAE) is dedicated to advancing teach-ing and learning in public affairs broadly defined, which includes the fields of policy analysis, public administration, public management, and public policy. JPAE pursues its mission by publishing high-quality theory, empirical research, and commentary. The core values of JPAE are rigor, relevance, clarity, accessibil-ity, and methodological diversity.

Articles: JPAE welcomes contributions from all public affairs educators who seek to reflect on their professional practice and to engage JPAE readers in an exploration of what or how to teach. JPAE articles are intended to influence experienced educator-specialists but also to be comprehensible and interesting to a broad audience of public affairs teachers. Articles appropriate for publication in JPAE include comprehensive literature reviews and meta-analyses, carefully con-structed position papers, critical assessments of what we teach and how we teach it, thoughtful essays about commonly shared teaching challenges, experimental and quasi-experimental assessments of students’ learning, evaluations of new cur-ricula or curriculum trends, national and international/comparative disciplinary and pedagogical developments, and field studies of particular teaching methods.

In addition to articles, the editors welcome proposals for symposia. Proposals that are accepted will be announced in the journal and will be accompanied by a call for papers. Submissions for symposia will be considered through the normal review process.

Decisions about the publication of all articles are based on the recommenda-tion of members of the editorial board using a blind review process. Substan-tive content, writing style, and length are all relevant to a decision to publish a manuscript. Depending on the type of manuscript, the review process takes into account the following criteria:

• Research-based: adequacy of theoretical grounding; reliability and va-lidity of findings; significance of the topic; significance of the findings.

• Interpretive, reflective, critical, theoretical: significance of the topic; quality of the argument; quality of the supporting evidence.

• Creative pedagogy: creativity of the approach; soundness of the expla-nation; evidence of effectiveness; utility for faculty.

• Case studies: pedagogical value; scope of potential use; clear teaching purposes.

• In all cases, writing quality is an important consideration.

Manuscripts that are obviously inappropriate or insufficiently developed will be returned without formal review. Interested authors can better understand the journal’s audience and its expectations for content, quality, and focus by examin-

Journal of Public Affairs Education v

ing what JPAE has published in recent years or by contacting members of the editorial board or staff.

Manuscripts submitted should not have been published and should not be un-der consideration elsewhere. Papers presented at a professional conference qualify for consideration; in fact, the submission of manuscripts that have been thor-oughly revised following presentation at a professional meeting is encouraged.

In general, authors are strongly encouraged to have their work reviewed and evaluated by colleagues prior to submission for formal review in order to facili-tate the editorial process.

Manuscripts should be sent to [email protected]. Only electronic submissions sent to this email address as Microsoft Word attachments will be considered. Any accompanying message should be addressed simply to “Editors,” not to a particu-lar editor.

In order for manuscripts to be reviewed as quickly as possible, authors are asked to observe the following requirements:

• Ensure that the manuscript is anonymous by leaving off your name and putting self-identifying references in a separate Microsoft Word file and as a separate attachment.

• Use margins of one and one-half (1-1/2) inches at the left, right, top, and bottom of the page.

• JPAE uses the in-text parenthetical reference system with all references at the end of the text in alphabetical order. Notes are to be kept to a minimum. See the Chicago Manual of Style for guidance.

It is important that you identify the type of manuscript you are submitting: (1) research based; (2) interpretive, reflective, critical, or theoretical essay or position paper; (3) creative pedagogy; or (4) teaching case study.

Creative Pedagogy: The purpose of Creative Pedagogy is to feature innovative approaches to teaching specific public affairs subjects or concepts. The goal of this feature is to present experimental exercises, simulations, role plays, or other creative teaching technologies in a format that colleagues can readily use. Sub-missions are peer reviewed.

Contributions to Creative Pedagogy must include substantive details (e.g., text for the case, role descriptions for a role play exercise) and a narrative discussion about how the pedagogy is used, student response to it, suggestions for instruc-tors who may wish to use it, and results associated with its use. The presentation of the pedagogy should be thorough and lively so that teachers reading the article will be stimulated and able to use the information.

Submissions for Creative Pedagogy should be sent to Editors, JPAE, at jpae@unm. edu, as indicated above.

Review Essays: Reviews will commonly use a cluster format in which several books, videos, software programs, cases, CD-ROMs, Internet sites, or other

vi Journal of Public Affairs Education

instructional materials will be compared and contrasted in an essay. Review es-says should offer a point of view but should seek to treat each item in the cluster fairly. Essays could be structured around a comparison of related resources, re-sources related to the public affairs education enterprise, or resources that directly or indirectly have something to say about public affairs education. Review essays should strive for clarity, brevity, and timeliness. Inquires about review essays should be sent to Mario A. Rivera, Editor, at [email protected].

Copyright Notice: Manuscripts will not be published unless a copyright trans-fer agreement has been signed by all the authors of a manuscript and has been received by JPAE. Copyright transfer forms are sent out by the NASPAA office. Educators may reproduce any material for classroom use only and authors may re-produce their articles without written permission. Written permission is required to reproduce JPAE in all other instances.

ARTICLES

Journal of Public Affairs Education 125

A Proposed Methodology for the Infrastructure Development

of NASPAA Programs with Specialty Tracks: The Case of

Health Policy and Management

Anne M. Hewitt, Seton Hall University

Brenda Stevenson Marshall, Cleveland State University

Kent H. Badger, University of LaVerne

AbstractThe development of health specialty tracks within NASPAA is traced using

a conceptual framework—the Specialty Track Model (STM), which was devel-oped to describe a current phenomenon occurring within NASPAA sections: the evolutionary process from an informally expressed interest to formal recognition of that interest. It is a series of six well-defined phases tracing the specialty track’s development as a progression of events through specified sequential activities: (1) interest and growth; (2) formal recognition; (3) preliminary framing; (4) pro-file development; (5) benchmarking for practice standards; and (6) guideline de-velopment and/or accreditation procedures. The model presented here serves as a framework to guide the infrastructure building process and involves internal and external stakeholders, program directors, faculty and students, and allied profes-sional associations. The specialty track model is used to chronicle the growth and evolution of a specialty track; we also provide recommendations for future uses of the model and its applicability to other areas within professional organizations and in academe.

JPAE 12(2):125-141

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126 Journal of Public Affairs Education

A Proposed Methodology for Infrastructure Development: Health Policy and Management

Framing Infrastructure Development for NASPAA Programs with Specialty Tracks

One of the primary strengths of the traditional MPA and related degree programs continues to be that they prepare students using a strong foundation of core courses and at the same time appeal to a diverse audience by providing additional specialty areas in response to constituent and market demand. The dy-namic environment of public administration education (MPA, MPP, and MPAF degrees) requires constant monitoring, assessment, and reflection of not only the established core curriculum (Cleary, 1990; Roeder and Whitaker, 1993; Breaux, 2003) but also the emerging and/or transitioning specialty tracks. One example of an emerging track phenomenon occurred during the 1996-2001 period when supporters of the nonprofit management specialty track debated the “best place” for nonprofit management education and documented the current standard of practice (Wish and Mirabella, 1998, 1999, 2000; O’Neill, 1998; Grønbjerg and O’Sullivan, 2003). The nonprofit specialization example demonstrates the advan-tage of academic activities and professional consensus necessary to create a dia-logue around an emerging MPA track. However, this transition would benefit from a coherent framework to move a specialty track along a path leading to a logical endpoint such as the accreditation or certification of specialties within NASPAA.

The Specialty Track Model was developed to describe a current phenomenon occurring within NASPAA member programs, the evolutionary process from informally expressed interest to formal recognition of that interest, here identi-fied as a specialty track, within the organization. This conceptual model is not intended to be prescriptive as viewed in the traditional policy analysis framework of Kingdon (1984), with a policy entrepreneur guiding the convergence of policy streams, but instead serves to provide a framework that permits consideration of a multifaceted process with numerous interactions among internal and external stakeholders within a well-defined time frame. In this paper, we describe the evolution of the health specialty track using the specialty track model to orga-nize and identify the pivotal decision points that led to the creation of a formal section, thereby giving the specialty a legitimate and formal presence within NASPAA. While we depict the process as primarily linear in Figure 1, the il-lustration is intended to highlight the phases and not the interactions among the various phases. The model’s simplicity lends itself to adaptation through a more complex design if a specific track’s evolution merits this sort of adjustment. The model is retrospective and prospective in that the first three phases describe events that have taken place; the last three predict what might occur as the pro-cess moves forward.

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The Specialty Track ModelThe proposed Specialty Track Model (Figure 1) serves as a framework to guide

the process of infrastructure development through a protocol that involves internal and external stakeholders, program directors, faculty and students, and aligned professional associations and organizations. Phase 1 of the model accounts for an internal and external demand phenomenon, with its awareness of change within a specific track. This noticeable interest and subsequent track growth translate into formal recognition by the professional association in Phase 2, while Phase 3 chronicles the initiation of activities to better understand the constitu-ents and providers of the specialty track. The first three phases constitute the pre-liminary steps for infrastructure building. Phase 4 focuses on the construction of a comprehensive, national profile; Phases 5 and 6 offer stakeholders directives on pivotal challenges such as best practices and the sort of quality assessment and as-surance procedures preferred by the programs offering these tracks. The last three phases can serve as the implementation component needed if specialty tracks are to gain recognition within NASPAA. Thus, only three of the model phases are fully developed here; a concluding discussion of how the remaining three are and will continue to be carried out as a collaborative effort under NASPAA supervi-sion is also provided.

This proposed framework guides the participants through a learning continu-um using awareness, knowledge, research, and synthesis to attain consensus and achieve a decisionmaking position. Phase 6 is an option only if desired by mem-bers, individual programs, and the professional organizations involved. The time sequence that accompanies this proposed protocol is a function of the interest and initiative of the professional organization, faculty consensus, and commitment to the process. However, contemporary marketing initiatives and competition from other degrees require that this process develop within a compact timeframe.

1. Interestandgrowth2.Formalrecognition3.Preliminaryframing(profiling)

4.Profiledevelopment

5.Benchmarkingforpracticestandards

6. Guidelinesand/oraccreditationprocedures

Figure1.TheSpecialtyTrackModel

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The Model Applied to Health Specialty TracksPhase 1: Interest, Growth, and Convergence—1997-1999

Phase 1 of the specialty track model focuses on external and internal influences converging to create an awareness of significant interest in a particular specialty track. Internally, health specialty track interest coalesced among faculty in 1997 with a meeting of academics involved in healthcare policy and management pro-grams, and subsequent meetings at the 1998 and 1999 NASPAA annual confer-ences focused on the rate of growth and expansion.

With discussion of the newly developed National Center for Healthcare Leadership (NCHL) and the introduction of a possible relationship between the Commission on Accreditation of Healthcare Management Education (CAHME, formerly the Accrediting Commission on Education for Health Services Adminis-tration) and NASPAA, the focus broadened to include the role of external forces. Specialty tracks do not develop in isolation, as Loebs (2001) observes in his article on the evolution of health management education; they develop in response to external events, such as the rapid increase in health management programs in the 1940s in recognition that trained managers were needed to lead the many new hospitals built under the Hill-Burton Act at the end of World War II. However, Loebs (2001, 32) also acknowledges the critically important role that faculty members play when he discusses the lack of uniformity in the location of these programs as revealing the “differences of opinion and preferences on curriculum emphasis and orientation.” Davidson et al. (2000, 80) also attributed the devel-opment of specialty tracks to the coalescence of internal and external sources and noted that “[p]rograms rise and fall based on administrative and governing body decisions and priorities.”

In response to widespread discontent directed at the quality of healthcare man-agement training by health sector leaders and market demand for an MBA rather than the traditional Master of Health Administration as the preferred health management degree, CAHME, NCHL, and other health profession organiza-tions were coming together in an effort to revitalize and reconfigure training for healthcare managers. It is noteworthy that increased interest in NASPAA mem-ber programs with health specialty tracks and the major health professional and accrediting organizations’ awareness of the need to transform management educa-tion occurred within the same time frame. The impetus surrounding the health specialty track programs gained credence when it became apparent that they were among the fastest growing within NASPAA, yet little was known about these programs or their location, curriculum, alumni, or faculty composition. It would be difficult to pinpoint the directionality of these activities. Some NAS-PAA members are also CAHME members, and this shared relationship certainly played a pivotal role in Phase I. It would be equally difficult to assign a top-down or bottom-up designation to Phase I activities, and, in fact, it might not be appropriate to do so, because many academics hold decision-making offices

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in professional organizations and would thus take part in both efforts; this dual role may also result in power asymmetry between the organization and academe. But whatever its makeup, the convergence of internal and external forces led to a renewed push to formally recognize this rapidly growing specialty track and to position it to become part of the national debate on health management education.

This growing interest and emphasis on health sector education resulted in a NASPAA-commissioned survey of all member programs to identify those with health specialty tracks. Thirty-four (37 percent) of the 92 institutions returning the survey (an overall 44 percent response rate) indicated significant health sec-tor activity. Most importantly, these survey results represented the first tentative steps toward infrastructure development and a recommendation that a section be authorized within NASPAA (NASPAA, 1998).

Phase 2: Formal Recognition—1999-2000In Phase 2, the academic community’s interest in the specialty track was rec-

ognized with a formal NASPAA faculty section with additional opportunities for forums, workgroups, or taskforces. For the Health Sector Management Education Section, an informal series of meetings at NASPAA conferences served to bring together the participants needed for formal recognition. This is an important process and certainly provides credence to Tepper’s assertion (2004) that meetings often serve as pivotal forums for the dissemination of key ideas and as a bridge to a more formal process, but a paucity of research constrains the confirmation of these relationships.

Because of continued interest and demonstrated growth, NASPAA member programs with health specialty tracks were able to move quickly into Phase 2 when the newly created Health Sector Management Education Section held its first formal panel discussion at the 2000 NASPAA annual conference. Pivotal recommendations for integrating accreditation requirements and market aware-ness from the 1999 survey were used to develop the program for this first meet-ing, which featured speakers from ACEHSA (now CAHME) and the academic and the practitioner communities. A slate of officers was developed in preparation for an election prior to the 2001 meeting. However, the most significant develop-ment was the creation of a working group to draft an outline for infrastructure development, as this necessary step took the section directly into Phase 3.

Phase 3: Preliminary Framing—2000-2001Phase 3 of the specialty track model constitutes what may be the most impor-

tant phase in terms of a group developing an identity that permits positioning within the sponsoring organization and the relevant larger community. This infrastructure-building step includes the pivotal inquiry process that results in the acquisition of documentation about health specialty tracks. The development of a profile was critical to subsequent phases.

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For health specialty tracks, this process was initiated during the first formal section meeting in 2000 with the decision to explore the possibility of grant funding for the development of a comprehensive profile. Without a basic knowl-edge of the number and type of programs, curriculum format, core course re-quirements, and elective offerings within the health tracks, the development of curriculum parity with other health management degrees would be difficult. To build the foundation for a grant proposal and in preparation for NASPAA’s 2001 annual conference, a Web-based review of NASPAA-accredited programs with health specialty tracks was completed. This step comprised the prelimi-nary framing process essential to obtaining financial support for a more in-depth study. The NASPAA Annual Roster of Accredited Programs (2001) served as the primary source for this study and was supplemented by also including listed participants attending the first section meeting in 2000. All accredited schools were initially evaluated in the late summer of 2001, using the NASPAA Annual Roster dated August 7, 2001. Canadian programs were not included in the study.

The purpose of this preliminary framing study was to• identify the number of NASPAA-accredited programs that have a

health specialty track;• determine the content of core (foundation) and elective courses in these

programs using the elements in Figure 2; and• develop a typology of elements to be studied for a comprehensive pro-

file of these programs.

Web Survey Findings. The 2001 Web study found that, within the United States, 39 states were home to a total of 136 NASPAA-accredited programs. Of these eligible programs, MPA programs with a formal healthcare specialty track are located in 28 states. A total of 58 programs with the specialty track were investi-gated; seven programs not accessible through the Web did not respond to email or phone inquiries. The MPA and related degree programs offered 16 different designations or titles for their health specialty tracks.1 These different track titles were identified and collapsed into four classifications using the key words (e.g., administration, policy) in the specialization name shown in Figures 3 and 4 and by the number of programs and geographic location.

Figure2.BuildingtheCase–TypologyofHealthSpecialtyTracks

TypeofHealthSpecialization/ConcentrationTrack

MPACoreCourses HealthTrack

Required Electives Required Electives

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Figure3. GeographicLocationofNASPAAAccreditedMPAProgramswithHealthSpecialtyTracks,2001

Figure 3

Figure 3. Geographic Location of NASPAA Accredited MPA Programs with Health Specialty Tracks: 2001

Note: = Healthcare Administration = Health Policy & Management = Healthcare Policy or Human Services = Community Health Administration

While the Web-based effort was the section’s first profiling effort, the study did have several limitations, including convenience sampling, variations in inter-pretation because of ambiguous program information, and the use of secondary information sources.

Health Specialty Tracks’ Geographic Location. The study revealed a clear geographic trend. A clustering of programs with health specialty tracks occurred within four specific states; New York and Michigan had the highest concentration with five each, followed by California and New Jersey with four each. Together, these four states offered approximately 31 percent of the nation’s accredited programs with a health specialty track. Although we lack precise historical information on the geographic location of NASPAA programs with health specialty tracks, three possible reasons are explored here. First, a program’s physical location may well hold the answer to geographic distribution. Perhaps the earliest adopters and proponents of health specialty tracks were located in areas with the greatest health sector activity. Historically, these areas were the East, certain parts of the Midwest, and the West Coast. Second, NASPAA member programs with health specialty tracks may be hidden in medical schools, allied professions schools, or other health-related areas of academe where they are not visible enough for a Web search to disclose their presence. Finally, we are only concerned with accredited NASPAA member programs during this phase, so unaccredited NASPAA mem-ber programs with specialty tracks would not be included. This initial effort un-derstates the actual number of NASPAA programs with health specialty tracks. Geographic distribution is clearly an area for future research.

n = Healthcare Administration£ = Health Policy & Management« = Healthcare Policy/Human ServicesÌ = Community Health Administration

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Curriculum. Identification of curricular offerings using a Web survey was com-plicated by the formatting of individual school program listings and require-ments. Many programs indicated requirements by courses; others, by credit hours. The total number of credits for NASPAA programs with health specialty tracks ranged from 36 to 62. The average number of core courses was seven, and the mean for the number of electives was six. Of primary importance was the documentation of the type of courses offered by these programs, as shown in Table 1. Table 2 shows that programs with health specialty tracks appear to require core courses similar to those of other NASPAA-accredited programs. For example, 43 percent of the programs required capstone courses as part of the discipline, and 53 percent of the programs required capstones as part of the specialty track. Capstone course options included internship, practicum, and field experiences. Other health-related courses included health ethics, health plan-ning and marketing, human resources, epidemiology, health service utilization, and long-term care. However, many Web sites’ health track course information and requirements did not clearly delineate between core and electives. Therefore, these two designations were collapsed into a single category for comparisons.

This preliminary Web-based study, presented to the Health Sector Manage-ment Education Section during the 2001 NASPAA Annual Conference (Mar-shall, Hewitt, and Badger, 2001), provided documentation that NASPAA pro-grams with health tracks differed widely in program location, title, and foci. The programs reviewed also offered a wide variation in requirements, electives, and credit hours. A general consensus appears more apparent for the discipline core courses—80 percent offered a similar core—than for the health track, especially in terms of core courses versus electives. At the time of the Web study, a clear lack of information from NASPAA or any other credible source on the scope of

Figure 4

Figure 4. NASPAA Member Programs with Health Tracks by number of offerings and number of states

0

5

10

15

20

25

30

35

40

HCA

Admin

HPol &

Mgmt

HPol &

HumSvcs

Comm

Hlth

# of States

# of Programs

Figure4. NASPAAMemberProgramswithHealthTracksbyNumberofOfferingsandNumberofStates

#ofStates#ofPrograms

HCA HPol& HPol& CommAdmin Mgmt HumSvcs Hlth

4035302520151050

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Number of Number of Number ofProgram Type MPA Core MPA Elective Health Track

Courses Courses Courses

Health Administration Mean 7 5 6 Range 7–10 1-12 3–9

Health Policy and Management Mean 7 7 7 Range 4-10 2-15 6-7

Health Policy and Human Services Mean 6 * * Range 4–7 * *

Community Health Mean 8 2 6 Range 8 2 * *not available

Table1. MPACoreandHealthTrackCoreCoursesbyHealthSpecializationProgramType

Table2.NASPAAProgramCourses:CoreandHealthTrack

Course Name Number of Courses %

MPA Core Statistics/Quantitative 42 78Finance/Budgeting 41 76Org.Behavior/Theory 34 63PublicPolicy 32 60LegalIssues 23 42FoundationsofPublicAdministration 22 41Economics 19 35Health Track HealthManagement/Administration 26 43GeneralElectives 25 41HealthCareSystems 25 41HealthPolicy 21 34HealthFinance 21 33LegalIssuesinHealth 13 21

health specialty tracks in public affairs was evident. However, as noted earlier, the key purpose of Phase 3 is the initiation of activities to better understand the constituents and the providers of the specialty track if a profile is to be developed.

Phase 4: Profile Development—2001–2003 The completed Web survey provided the basis for the submission and subse-

quent award of a Robert Wood Johnson Foundation (RWJF) grant for a more

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comprehensive data collection and analysis process and for the movement to Phase 4 of the specialty track model. Figure 5 and Table 3 present the curriculum typology and the conceptual model developed for the RWJF research study. The results of the National Profiling Study appear in the next article in this sympo-sium (Marshall and Hewitt, 2006).

Phase 4 of the specialty track model began the implementation component, in which infrastructure building was refined through careful documentation, rigorous research, and examination of all relevant program characteristics. It is important to note that the period preceding the Robert Wood Johnson Founda-tion award was not dormant. At the 2002 NASPAA annual conference, Wessel and Hewitt (2002) presented the results of an informal survey administered to program directors and faculty. Respondents indicated an interest in pursuing ac-creditation alternatives that enhanced the marketability of degree programs, and they suggested that any accreditation initiatives must also ensure that students and graduates of MPA and other related degree programs receive value recogni-tion from potential employers. A special concern was the lack of recognition of NASPAA accreditation by important health management constituencies such as NCHL and HRSA for grant awards to train health management students. In addition, a special panel discussion and reaction to preliminary findings from the Robert Wood Johnson Foundation-funded study was part of the 2003 NASPAA annual conference (Marshall and Hewitt, 2003). Guest panelists representing large and small NASPAA programs with health tracks and representatives from the Association of University Programs in Health Administration (AUPHA) and NASPAA executive staff discussed the potential consequences of an additional specialty track accreditation within NASPAA and a linked accreditation with AUPHA. The panel discussion also covered marketability and accreditation stan-dards, with attendees recommending continued dialogue and additional review at future section meetings (Hewitt et al., 2004). However, the hallmark event for Phase 4 was the development of a national profile for NASPAA member pro-grams with health specialty tracks. The profile will become the principal mecha-nism for securing parity within the health sector education programs community, because it provides the information needed to begin benchmarking and develop-ing standards and guidelines.

Phase 5: Benchmarking for Practice Standards—2003-2004 Phase 4 of the specialty track model provided rigorous research and reliable

data to support consensus and advocacy for an alternative specialty track policy. But, before this debate takes place, additional steps are required. For Phase 5, a definitive profiling of any specialty track should provide appropriate benchmark-ing information to establish the foundations of standards of practice. If bench-marking for practice standards is to occur, additional stakeholder influences will need to be documented and examined. This step is essential for ensuring that the

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ProgramDegreeofferedDegreetitleConcentrationtitleAccreditation/statusMissionDualdegreeoptionDistanceeducationEntrancerequirementsExecutiveeducationprogramsContinuingeducation opportunities

StudentAverageageDiversityNumberofyearsinprogramPosition/entryPercentwithjobsatgraduationJobplacementbysector

FacultyNumberoffull-timeNumberofpart-timeFacultycredentialsIndustry-relatedexperienceDiversity

CurriculumMPAcoreHealthcareelectivesMPAelectivesHealthcareelectivesTotalnumberofhoursHealthcarecoursesequence/numberofcoursesinsubjectareaInternship/capstonerequirement/options

AlumniCurrentpositionCareerchoiceTimesincegraduation

SyllabiCoursetitleCoursedescriptionBehavioralobjectivesOutcomes

Table3.ProfilingNASPAAProgramswithHealthTracks:SurveyVariables

Figure5.BuildingtheCase–TypologyofHealthSpecialtyTracks

TypeofHealthSpecialization/Concentration

MPACoreCourses HealthTrack

Required Electives X=6courses

NASPAAPrograms

X=6coursesX=7courses

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Phase 5 benchmarking initiative identifies best practices that form the basis for practice standards that will be acceptable to all stakeholders. It is here that stake-holder preferences will become manifest and power asymmetries will become important.

Because this phase has not been fully implemented (the section agreed to proceed with investigating benchmarking for practice standards at the 2004 NASPAA annual conference), the authors can only speculate on how the process will evolve. Badger suggests a dynamic model for assessing stakeholder preferenc-es and the process through which these preferences are implemented. He further acknowledges that concentrations or programs in health services management are developed and sustained for a number of reasons; however, the key driving forces are faculty interest, expertise, and commitment. Given this framework, Badger’s model may provide insights into the power relationships wielded by such stake-holders as faculty, students, employers, and professional organizations (Badger, 2001; Badger et al., 2004).

The model also documents the influence that the discipline’s core curriculum has on the health specialty track, a pivotal component of benchmarking for prac-tice standards. Completion of Phase 5 will require NASPAA and the Health Sec-tor Education Programs Section executive committee to continue building on the findings from the initial Web survey and the Robert Wood Johnson Foundation-sponsored profile report to further focus on establishing best practices necessary for the infrastructure of NASPAA programs with health tracks. It should be not-ed that in 2004 the Health Sector Management Education Section became known as the Health Sector Education Programs Section (HSEPS) in acknowledgment of the health policy and other health service components of some specialty tracks.

Phase 6: Guidelines and/or Accreditation Procedures: 2004-The final phase of the Specialty Track Model will complete the synthesis of the

research and profiling phases into a formal set of recommendations for guidelines, practice standards, and/or criteria for accreditation. Phase 6 is optional and may be implemented immediately, or it may be postponed pending further study. This decision-making process requires consensus and commitment to selecting the appropriate pathway for either the development of guidelines or a more for-mal accreditation procedure.

The accreditation issue involves multiple decisions, including the necessity of further defining the options between an additional NASPAA accreditation for the health specialty track or aligning NASPAA accreditation with the Accrediting Commission on Education for Health Services Administration (ACEHSA) accred-itation, with the latter a key question in the Robert Wood Johnson Foundation-funded study (Marshall and Hewitt, in this symposium). Harlow-Rosentraub and Perry (also in this symposium) have contributed significantly to the accreditation dialogue by examining commonalities and differences in the core requirements of

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the four primary accrediting organizations: NASPAA, CAHME, the Association to Advance Collegiate Schools of Business (AACSB), and the Council on Educa-tion for Public Health (CEPH). Additional research completed by Kirchhoff and Dennison (2005) examines health sector programs and their core requirements in more detail by focusing only on NASPAA programs with health policy special-izations. This type of research will help prepare all member programs as they address the difficult decisions surrounding accreditation. To further emphasize this perspective, it should be noted that in 2004 ACEHSA became the Commis-sion on Accreditation of Healthcare Management Education (CAHME) and with a renewed focus has continued to examine the roles and competencies necessary for health management and policy sector education.

NASPAA convened a committee comprised of HSEPS members as the first step in the implementation of Phase 6. This committee began to explore the feasibil-ity of developing health sector program guidelines, and it presented its Interim Report on NASPAA Guidelines for Health Sector Education Programs to the HSEPS and the NASPAA membership during the 2004 annual conference. One of the main conclusions of the report (Kirchhoff, 2004) focused on the relation-ship between ACEHSA and NASPAA:

The general consensus…is [that] the key difference between Public Affairs health sector education and ACEHSA-driven health sector education is the emphasis of public affairs on the contexts of decision making as compared to the ACEHSA emphasis on the practice of management.

The committee agreed that guidelines for NASPAA health sector programs were feasible at that time, but that additional information was required to ensure their appropriateness. Since then, the specialty track focus and context for the guidelines have been further researched. The next steps include guideline develop-ment, with the submission of draft guidelines to the NASPAA Executive Council and all section members for review and comment in March 2006. Section mem-bers will vote on approval of the final guidelines at the October 2006 annual conference.

ConclusionThe proposed methodology for the profiling and infrastructure development

of a specialty or concentration for NASPAA member schools as applied to health tracks has successfully provided a framework for dialogue, research, and consen-sus building. The specialty track model offers a foundation for future activities to establish parity with other degrees that provide health specialty track education.

In this example, each of the six sequential phases serves as an enabling activ-ity to achieve a necessary step as part of the final specialty track development.

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During Phase 1, stakeholder interest in health management concentrations and specializations culminated in faculty discussion groups and multiple section presentations at NASPAA annual meetings. The interest and awareness generated by faculty and students, coupled with the results of two national surveys that documented significant program growth, led NASPAA to formally recognize the Health Sector Management Education Section in 2001 as a faculty forum and completed the criteria for Phase 2. The results of a Web-based survey using secondary data sources provided ample information to satisfy the requirements of Phase 3, in which preliminary identification of the specialty track is necessary. During Phase 4, a national profile of NASPAA programs with health tracks was completed with funding from the Robert Wood Johnson Foundation. Current initiatives are entering Phase 5 of the model, in which the primary tasks are to complete a benchmarking of programs and to identify desirable characteristics to serve as best practices. The dynamic model that has been proposed includes exemplary program characteristics and integrates other stakeholder demands and student perceptions. Finally, Phase 6 will require interested participants to reach consensus on guideline development and/or the development of an accreditation process. The NASPAA guidelines committee that was established presented an interim report at the 2004 annual conference, recommending the feasibility of guidelines for MPA/MPP/MPAF programs with health specialty tracks.

The specialty track model provides a framework for future investigation of the movement from informally expressed interest to formal recognition of that inter-est. Based on the authors’ research and the thoughtful comments of the JPAE reviewers, we suggest that the next generation of research on this topic might concern itself with the following:

• Theory-driven model: The development of a more theory-driven model whereby specific hypotheses are formulated and explored within the six phases of the specialty track model. An additional possibility here is the design of a more complex model that delineates the nonlinear aspect of the process.

• Power distribution: The asymmetric distribution of power among stakeholder groups, particularly in Phases 5 and 6 of the model, needs to be explored because of the important implications that this distri-bution has for the specialty track model process. Pursuing this topic, it should also be possible to develop testable hypotheses about the distribution of power within and across organizations (professional and academic) described in Phase 2.

These recommendations for additional research will continue efforts to refine the specialty track model and also will encourage the essential academic dialogue that serves as the underpinning of this framework.

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Notes1. Titles of MPA programs included in Health Administration are health service administration

and policy, health policy, healthcare administration, health administration and policy, health management and policy, health service administration, and healthcare policy management. Titles of MPA programs included in Health Care Management are healthcare management and policy, health services administration and policy, health policy and management, health service management and policy, community health administration, health service management, and health policy administration.

ReferencesBadger, K. H. 2001. “Determinates for Student Competency Building in Health Sector Management.”

Presentation at NASPAA Conference.Badger, K. H., et al. 2004. “What’s in a Name: Does Form Always Follow Function When We

Translate Competencies into Learning Objectives?“ Presentation at AUPHA Conference.D. Breaux, E. Clynch, and J. Morris. 2003. “The Core Curriculum Content of NASPAA-Accredited

Programs: Fundamentally Alike or Different?” Journal of Public Affairs Education, 9(4):259-273.Cleary, R. E. 1990. “What Do Public Administration Master’s Programs Look Like? Do They Do What

is Needed?” Public Administration Review, 50(6):663-673.Davidson, P. L., et al. 2000. “A Framework for Evaluating the Impact of Health Services Management

Education.” The Journal of Health Administration, 18(1):63-110.Grønbjerg, K., and E. O’Sullivan. 2003. “Nonprofit Management Education: Taking Advantage of the

Public Administration Setting.” Journal of Public Affairs Education, 9(3):165-168.Harlow-Rosentraub, K., and J. Perry. 2006. “Public Affairs and Healthcare Administration:

Crosscutting Competencies and Multiple Accreditation Challenges for Academic Programs.” Journal of Public Affairs Administration, 12(2):197-211.

Hewitt, A., et al. 2004. “Profiling NASPAA Programs with Healthcare Concentrations—A Panel Discussion on Building a Foundation to Accredit Specializations.” Public Performance and Management Review, 28(2):262-277.

Kingdon, J. W. 1984. Agendas, Alternatives, and Public Policies. Boston: Little Brown.Kirchoff, J. J. 2004. “Interim Report on NASPAA Guidelines for Health Sector Education Programs

Initiative.” Presentation at NASPAA Annual Meeting.Kirchhoff, J., and T. Dennison. 2006. “Benchmark Health Policy Programs: A Window on Public

Affairs and Administration Education.” Journal of Public Affairs Education, 12(2):177-196.Loebs, S. F. 2001. “The Continuing Evolution of Health Management Education.” Journal of Health

Administration Education. Special Issue:33-50.Marshall, B., A. Hewitt, and K. Badger. 2001. “A Multi-disciplinary Approach to Competency Design

in Health Sector Management Education: Results from a Survey of the Universe of NASPAA Accredited Schools.” Presentation at NASPAA Conference.

Marshall, B., and A. Hewitt. 2003. “NASPAA Accredited Programs with a Health Care Concentration: What We Know, What We Must Find Out, and Why.” AUPHA Annual Meeting, Poster Session.

Marshall, B., and A. Hewitt. 2005. “A National Profile of NASPAA Programs with Graduate Health Management and Policy Tracks.” Journal of Public Affairs Education, 12(2):143-163.

Mirabella, R., and N. Wish. 1999. “Educational Impact of Graduate Nonprofit Degree Programs: Perspectives of Multiple Stakeholders.” Nonprofit Management and Leadership, 9(3):329-340.

Mirabella, R., and N. Wish. 2000. “The ‘Best Place’ Debate: A Comparison of Graduate Education Programs for Nonprofit Managers.” Public Administration Review, 60(3):219-229.

National Association of Schools of Public Affairs and Administration. 1998. “NASPAA Survey Report.”National Association of Public Affairs and Administration. 2000. “NASPAA Annual Roster of

Programs.”O’Neill, M. 1998. “Nonprofit Management Education: History, Current Issues, and the Future.” In M.

O’Neill and K. Fletcher, eds., Nonprofit Management Education: U.S. and Work Perspectives. Westport, CT: Praeger, 1-12.

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Roeder, P., and G. Whitaker. 1993. “Education in the Public Service: Policy Analysis and Administration in the MPA Core Curriculum.” Administration and Society, 24(4):512-540.

Tepper, S. 2004. “Setting Agendas and Designing Alternatives: Policymaking and the Strategic Role of Meetings.” Review of Policy Research, 21(4):523-536.

Wessel, M., and A. Hewitt, 2002. “NASPAA Survey on Accreditation of Health Management and Policy Programs.” Presentation at NASPAA Annual Meeting.

Wish, N., and R. Mirabella. 1998. “Curricular Variations in Nonprofit Management Graduate Programs.” Nonprofit Management and Leadership, 9(1):99-109.

This research is made possible by a grant from the Robert Wood Johnson Foundation. The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation’s largest philanthropic organization devoted exclusively to health and healthcare. It concentrates its grantmaking in four goal areas: to ensure that all Americans have access to quality healthcare at a reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social, and economic harm caused by the abuse of tobacco, alcohol, and drugs.

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Anne M. Hewitt is an assistant professor in the Graduate Department of Public and Healthcare Administration in the Center for Public Service at Seton Hall University. She is also director of the Seton Center for Community Health and is a CCPH Health Fellow. Hewitt received her Ph.D. degree from Temple Universi-ty. Her teaching and research interests involve community health, health dispari-ties, and public health policies. She serves as a health policy advisor to the New Jersey Department of Health and Senior Services.

Brenda Stevenson Marshall is an associate professor and director of the MBA in healthcare administration and of the MPH program at Cleveland State Univer-sity. She holds a Ph.D. from the University of Michigan and an MPH from the University of California, Berkeley. Her teaching, research, and service activities focus on improving accessibility to health services for vulnerable populations and developing more precise competency measurements for health management education.

Kent H. Badger is a professor in the Department of Health Services Manage-ment, program chair for the Bachelor of Science for Health Service Management, director of the Center for Health Services Management Research, and an adjunct professor in the doctoral program in public administration at the University of La Verne. He holds a B.S. in public administration from the University of Arizona, Tucson, an M.P.H. from the University of California, Berkeley, and a D.P.A from the University of La Verne. His teaching, research, and consulting are focused on strategic and tactical planning and on assessing and developing organizational environments for learning and innovation for the public and private sectors in the United States and China.

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A National Profile of NASPAA Programs with

Health Specialty Tracks

Brenda Stevenson Marshall, Cleveland State University

Anne M. Hewitt, Seton Hall University

AbstractThis paper presents the findings from a Robert Wood Johnson Foundation-

funded study designed to develop a national profile of accredited and unaccred-ited NASPAA programs with health specialty tracks, one of the most rapidly increasing practice domains. The results will be used to establish baseline data for the comparison of health specialty tracks, to provide a knowledge base for the creation of standards and guidelines, and to yield insights into program direc-tors’ observations on the initiation of an additional accreditation process. We used a typology with six classifications to examine all facets of these programs through data collected from a cross-sectional study consisting of a written survey, a telephone interview, and a syllabi review. We found 50 percent of NASPAA programs with health specialty tracks to be geographically concentrated but po-sitioned within a variety of institutional locations. Program size as measured by the number of students enrolled, curriculum structure, and the number of faculty varied. Health management and policy specialty tracks continue to increase, and respondents believe this track adds value to the mission of their institutions. Telephone interview responses indicated a slight preference for an additional accreditation of health specialty tracks. However, the shared responsibility for specialty track offerings found in some programs, the variety of institutional settings, and the variation in program size, structure, and resources indicate the need for flexible, adaptable standards and guidelines that are compatible with the unique features of this specialty track.

Health administration and health policy tracks have consistently ranked among the most popular and frequently offered specializations within NASPAA programs. Cleary’s 1990 benchmark work on public administration master’s

JPAE 12(2):143-163

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A National Profile of NASPAA Programs with Health Specialty Tracks

programs ranked this track among the top five specializations offered. A 1998 NASPAA-commissioned survey with a 44 percent response rate (92 of 209 member schools) found that 37 percent of the respondents (34 programs) had a healthcare track (NASPAA, 1998). Rivenbark’s (2001) study on public affairs education and teaching performance found the health administration specialty to be the second most frequently offered by the 126 programs responding to his survey. Our 2001 survey of NASPAA-accredited schools found 53 programs with healthcare tracks in 28 of the 39 states in which there were NASPAA-accredited programs (Hewitt, Marshall, and Badger, 2006).

The methodology and focus of these previous surveys differed. The Cleary (1990) and Rivenbark (2001) studies did not have specialty tracks as a primary content area. The 1998 NASPAA-commissioned survey and the 2001 Internet survey included only accredited schools. Our research differs from the previous work in approach and scope. Specifically, it was undertaken with a Robert Wood Johnson Foundation grant awarded to NASPAA for the development of a more comprehensive and rigorous assessment of master’s programs with health special-ty tracks. All NASPAA programs, accredited and unaccredited, were included. Thus, the findings presented here can establish baseline data for comparing all health specialty tracks, serve as a model for other NASPAA sections wishing to pursue similar studies, and provide a knowledge base for the creation of standards and guidelines. Most important, the results yield insights into program prefer-ences that will be valuable in the initiation of an additional accreditation process, an integral component of NASPAA’s strategic plan.

A discussion of the research methodology is followed by a description of NASPAA programs using the typology developed for the RWJF grant pro-posal. Strategies for developing practice standards and program representatives’ thoughts on an additional accreditation for health specialty tracks conclude the article.

MethodologyStudy design. All NASPAA member programs with a health specialty track

during academic year 2002-2003 comprised the study population. The study population list was developed from the membership roster of the Health Sector Education Section and the NASPAA list of member programs for academic year 2002-2003. Where it was important to test for significant differences between or among study findings, we used the chi-square test because of its flexibility in detecting the magnitude of differences in populations. A crucial area of testing for such differences was the accreditation status of NASPAA programs. NASPAA accreditation does not include specialty tracks (Andersen, Howard, and Schneller, 2004; Hewitt et al., 2004) but instead focuses on the core curriculum and mis-sion attainment. However, we believed that if this study were to provide direc-tion for guidelines, standards, and the accreditation of health specialty tracks, it

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would be useful to determine at this point whether significant differences existed between NASPAA member programs by their accreditation status.

Data. The typology developed for the Robert Wood Johnson Foundation grant and shown in Figure 1 guided the data collection process (Marshall and Hewitt, 2004). Using this typology, syllabi and information on program, student, cur-riculum, faculty, and alumni characteristics were requested. The study consisted of three components: a written survey, a telephone interview, and the submission of syllabi for content evaluation.

The development of the written survey and the telephone interview ques-tions followed a systematic process of literature review, expert and panel analy-sis, and alignment with the previous research efforts in the Web-based study. A copy of the survey used in an earlier NASPAA study of nonprofit organizations (Wish and Mirabella, 1998) was reviewed, and relevant questions were revised

ProgramDegree offeredDegree titleConcentration titleAccreditation/statusMissionDual degree optionDistance educationEntrance requirementsExecutive education programsContinuing education opportunities

StudentAverage ageDiversityNumber of years in programPosition/entryPercent with jobs at graduationJob placement by sector

FacultyNumber of full-timeNumber of part-timeFaculty credentialsIndustry-related experienceDiversity

CurriculumMPA coreHealthcare electivesMPA electivesTotal number of hoursHealthcare course sequence/ number of courses in subject areaInternship/capstone requirement/options

AlumniCurrent positionCareer choiceTime since graduation

SyllabiCourse titleCourse descriptionBehavioral objectivesOutcomes

Figure 1. The Study Variables

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and adapted. Draft versions of the written survey and the telephone interview questions were submitted to selected program directors, faculty members, and NASPAA leaders for comment and revisions. Results from the Web-based study (Hewitt, Marshall, and Badger, 2005) were reviewed to highlight areas for addi-tional questions or item clarity. Both instruments went through several iterations based on expert reviewer comments. A telephone interview protocol was estab-lished to ensure the reliability and validity of the findings.

The survey contained 18 multi-part questions on all six characteristics iden-tified in the conceptual model in Figure 1 and could be completed within 30 minutes if all data were available. Results for all six classifications of the typology are reported here. The telephone interview contained 15 open-ended questions on all six characteristics shown in Figure 1 and averaged 15-20 minutes to complete. These interviews also elicited views on an additional accreditation for the health specialty track.

The survey was mailed to the individual identified as the primary program con-tact (the director or his/her designee) and was also made available on a Web site. We conducted the first mailing of the survey in two waves; the first for unaccred-ited programs, the second for accredited programs. The mailing contained the survey and a letter from NASPAA’s president and executive director emphasizing the importance of the study and encouraging cooperation in the data collection process. This first mailing was followed by an email message or a phone call if the requested materials were not received within a month. This process was com-bined with a third follow-up request at the NASPAA 2003 annual conference in Pittsburgh and with final follow-up calls and emails in December 2003.

At least five attempts were made to secure telephone interviews, because some primary contacts were not available or program administration was in transition, making it difficult to identify a primary contact.

Electronic or hard copies of all syllabi used to teach the program’s health com-ponent were requested in a separate letter mailed with the survey. Syllabi were also requested during each follow-up contact. The syllabi were evaluated through content analysis using the software program N-Vivo.

Response Rate by Study Component. Because of the variation in response, we calcu-lated the response rate separately for each study component (survey, telephone interview, and syllabi) and for the programs that completed all three components. Initially, 88 programs, 59 accredited and 29 unaccredited, comprised our tar-get population. Ten of these programs were eliminated from the study because they self-identified as not having a health specialty track during the study year. However, seven of these programs participated in the telephone interview because they had offered a health track during the prior year. Their comments, while not included in the response rate denominator, are discussed in the conclusion. Using the 78 programs as the obtainable denominator, the response rates for all programs for all study components and by accreditation status are provided in Table 1.

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Although there is no statistically significant difference for the written and syllabi component response rates, the response rate for the telephone interview is significantly different for accredited versus unaccredited programs (χ2=6.645, df=1, sig.=.011). This difference is pivotal because of the accreditation questions contained in that component of the survey. Twenty-four programs, 18 accredited and 6 unaccredited, completed all three survey components, for a 31 percent response rate. These programs should provide the most important information for benchmarking health specialty tracks as complete entities and should constitute an area for future evaluation. The 14 nonrespondents to the survey are compa-rable to the respondents, providing additional credibility to the findings. It is important to note that the total number of respondents for each of the six catego-ries in the typology will vary. A number of surveys were incomplete because data for some health specialty tracks are not centralized. Primary contacts were very cooperative but explained during the follow-up stage that some data would be difficult if not impossible to collect because of decentralization and time con-straints.

Program CharacteristicsTable 2 (page 148) presents survey and telephone interview responses for pro-

gram characteristics, the first component of the model for developing a profile of NASPAA programs with health specialty tracks. Sixty-two of the 64 programs returning the survey completed this component, for a 97 percent response rate. All 60 of the primary contacts answered the program characteristic questions during the telephone interview, for a 100 percent response rate. We define pro-gram characteristics as degree identification by name and type, location within the university, mode of delivery, admission requirements, mission, and accredita-tion status.

The exact nature of the disciplinary core (MPA, MHA, MBA, MPH) and the location of the degree (Breaux et al., 2003) provides meaningful information about curriculum emphasis and perspective for health specialty tracks (Loeb, 2001; Andersen et al., 2000). Eighty-seven percent of the respondents offer the MPA with a health specialty track; the remaining offer a health policy degree

Study Component All Programs Accredited Unaccredited # % # % # %

Written Survey 64 82 41 53 23 31Telephone Survey 60 77 43 55 17 22Syllabi 29 37 21 27 8 10All three components 24 31 18 23 6 8

Table 1. Response Rate by NASPAA Accreditation Status

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All Programs Accredited Unaccredited # % # % # %Program Characteristic 62 97 39 95 23 100

Degree with a Healthcare Track MPA 54 87 35 90 19 83 MPP 5 8 1 3 4 17 Other* 3 2 3 8 0 0Program Location in University School or college 34 55 18 46 16 70 Own department 23 37 19 49 4 17 Institute or center 3 4 2 1 1 4 Political science department 1 2 0 0 1 4 Other* 1 2 0 0 1 4Education Options Distance learning degree (Internet) 3 2 1 3 2 9 Distance learning course (Internet) 2 1 1 3 1 4 Certificate option with healthcare concentration 9 15 5 13 4 17 Does not offer these options 30 48 16 41 14 61 Other* 18 29 16 41 2 9Admission Requirements GRE or GMAT 40 65 22 57 18 78 GPA 58 94 37 95 21 91 Healthcare experience 6 9 1 2 4 17 Management experience 5 8 0.5 1 4 17 Written essays 47 76 30 77 17 74 Application 57 92 39 100 18 78 Personal interviews 3 2 2 3 0 0 References 52 84 35 90 17 74 Other requirements 11 18 8 21 3 13Accreditation Status NASPAA accredited 29 47 29 47 0 0 Seeking NASPAA accreditation 9 15 0 0 9 15 NASPAA & ACHESA** accredited 2 3 2 3 0 0 NASPAA & AACSB accredited 4 7 4 7 0 0 NASPAA & seeking ACHESA accreditation 2 3 2 3 0 0 Unaccredited 13 20 0 0 13 20 NASPAA, ACHESA, AACSB, & CEPH 1 2 1 2 0 0 ACHESA, AACSB, seeking NASPAA 1 2 0 0 1 2 NASPAA & CEPH 1 2 1 2 0 0

* Denotes the response rate as a percentage of the total response for all programs, accredited and unaccredited.

** The Accrediting Commission on Education for Health Services Administration, now the Commission on Accreditation of Healthcare Management Education

Table 2. Program Characteristics by NASPAA Accreditation Status

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(MPP) or a master of health administration (MHA) as their primary health- focused program. Health administration tracks were most frequently mentioned, followed by management and policy, then policy. Forty percent (25) of the pro-grams offered more than one degree with a healthcare track; six of the programs offered the Master of Health Administration (MHA) exclusively without a public administration or policy disciplinary core either as their primary offering or in addition to the MPA or MPP. Forty percent of the respondents also offered dual or joint degree options.

The Clark and Menifield (2004) study found that program location predicted the likelihood of NASPAA accreditation. NASPAA programs with health spe-cialty tracks were not found in a single location such as a school of public health (SPH). Fifty-five percent were located within a school or college, and 37 percent were within a dedicated department. Eight percent were positioned within an institute or center (4 percent), a political science department (2 percent), and an undergraduate college (other at 2 percent).

Admissions criteria appeared to be uniform across programs with almost all requiring applications, references, and a written essay. A majority required the GRE or the GMAT; very few required healthcare and/or management experi-ence, a personal interview, or other admissions criteria. Eighteen percent of the respondents had guidelines for waiving the GRE or GMAT, while 9 percent had a specified GPA waive point; fewer than 1 percent of the respondents waived the remaining criteria. The preceding suggests a standardized admissions procedure with established criteria for waivers of two of the admissions requirements.

The majority of NASPAA members in this study are accredited, with 16 per-cent of the respondents indicating multiple accreditations. Programs frequently use accreditation status as a measure of quality achievement (Brown, 2000; Gelmon, 2004). It may also be an indication, in conjunction with the location within the university environment, of how programs evolve (Andersen et al., 2004). Although we were able to use NASPAA data to ascertain the accreditation status of the study population, we used the respondent-only data to develop the multiple accreditation percentages found here. Eighty percent of the programs returning the survey were either NASPAA-accredited or were seeking NASPAA accreditation, while only 20 percent were not accredited or were not seeking accreditation. The most common reasons for not seeking accreditation included lack of value added, minimal administration support, financial considerations, and no interest in accreditation at the current time.

The geographic concentration of programs with health specialty tracks found in the 2001 Internet study resulted in a more formal inspection of this variable (Hewitt, Marshall, and Badger, 2005). A six-region classification developed by the Health Resources and Services Administration (HRSA) to describe primary healthcare areas was used to classify NASPAA programs in this study by their geographic location. This classification was chosen because it provided an estab-

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lished method of regional identification and because of the conceptual and opera-tional link between the public sector and NASPAA member programs.

Table 3 shows that 67 percent of the programs with healthcare tracks were located in the Northeast and Southeast regions, with more than 50 percent of the programs in the two regions accredited. These regional variations and accredi-tation concentrations hold important implications for program development, employment, and student and faculty diversity.

When the topic of program congruence with the university’s mission was introduced during the telephone interview, all respondents said the specialty track adds value to the university. Program relationships to the mission of the university were usually described as providing community outreach and service (28 percent), satisfying student need and demand (18 percent), or developing and educating professionals (24 percent). However, 25 percent of those interviewed also gave responses ranging from “We offer the only degree with a health concen-tration in this area,” “Our flagship program provides a service to the state,” and “Healthcare is 14 percent of the economy; we need people to run things,” to “We try to serve the quality of life need of the region.” These latter mission congru-ence statements underscore one of the findings of our study: the relevance of the geographic distribution of NASPAA programs with health tracks.

Student CharacteristicsTable 4 presents survey and telephone interview responses for student charac-

teristics, the second component of the model for developing a profile of NASPAA programs with health specialty tracks. Fifty-three of the 64 programs return-ing the survey completed this component for an 83 percent response rate. Five programs (two accredited, three unaccredited) reported not having full-time students, and four (one accredited, three unaccredited) reported not having part-time students. All 60 of the primary contacts answered the program char-acteristic questions during the telephone interview, a 100 percent response rate.

Region All Programs Accredited Unaccredited # % # % # %

Northeast 21 27 14 18 7 9

Southeast 22 28 14 18 8 10

Midwest 15 19 11 14 4 5

Southwest 5 6 1 1 4 5

Northwest 4 5 1 1 3 4

West 11 15 9 12 2 3

Total 78 100 50 64 28 36

Table 3. Regional Distribution by NASPAA Accreditation Status

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We define student characteristics as average age, enrollment diversity, number of years for program completion, percent with jobs at graduation, and job place-ment by sector. Student characteristics as measured by the number of students enrolled, their enrollment status (full- or part-time), and ethnic and racial mix present different facets of a program’s profile that have been evaluated for their impact on the curriculum development and career trajectories of health specialty track enrollees (Andersen et al., 2000).

For NASPAA programs, the average number of students enrolled varies by ac-creditation status. The largest accredited program had a total enrollment of 693 students with a health specialty track enrollment of 229. The largest unaccred-ited program has a total enrollment of 260 students with a health specialty track enrollment of 28. Health specialty track enrollment, as a percentage of the total program enrollment, ranges from 33 percent of the largest accredited program to less than 10 percent (two students) for the smallest unaccredited program.

Very little difference exists in the average age of students enrolled; the aver-age full-time student is 25 years of age, and the average part-time student is 33 years of age, suggesting that the latter are already employed and are seeking an advanced degree for career mobility or a career change. Program completion time ranges from two to three years for full-time students and two to six years for part-time students, reflecting what the Association for University Programs in Health Administration (AUPHA, 2004) has documented as the standard for health specialty tracks. On average, 84 percent of the students who enter a health specialty track program have jobs within six months of graduation. When survey respondents were asked to identify recent graduate positions by job sector and title, 47 of the 53 primary contacts (89 percent) stated that they did not main-tain records with this information. The remaining eight programs (15 percent) maintained only partial records. These partial records from the eight survey respondents showed that graduates of their programs with health specialty tracks

Table 4. Student Characteristics by NASPAA Accreditation Status

All Programs Accredited UnaccreditedStudent Characteristic N=53 N=40 N=13

No. of students in program (Aug. 2003) 132 145 94

No. in healthcare concentration 39 45 12

Average age of full-time 28 27 29

Average age of part-time 32 32 33

Average years for completion: full-time 2 2 2

Average years for completion: part-time 4 4 4

Unemployed and jobs within 84 82 87 six months of graduation

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were working in the public and private sectors in health-related and non-health positions. These positions ranged from management trainee to executive, such as chief executive officer (CEO) and chief operating officer (COO). During the telephone interview, respondents reported few specific barriers in placing recent graduates in healthcare sector positions. Sixty percent (35 respondents) indicated that they had no difficulty in placing recent graduates; the only barrier, geogra-phy, was removed if the graduate was willing to relocate. This positive employ-ment trend was also apparent when respondents were asked to compare health specialty track graduates with graduates from the same discipline but different practice domains.

Grady (2001) observed that “the leaders of our healthcare institutions should reflect the diversity of the communities they serve” but pointed out that this is usually not the norm in health education. In contrast to this statement, 77 percent of the 60 primary contacts completing the telephone interview described their student population as both ethnically and racially diverse. Anecdotal com-ments made during the telephone interviews suggested that minority represen-tation was contingent on a school’s location. Geographic constraints were the principal reason given for a less diverse student population.

Curriculum CharacteristicsTable 5 presents the survey responses for curriculum characteristics, the third

component of the model for developing a profile of NASPAA programs with health specialty tracks. Sixty-one of the 64 programs returning the survey com-pleted this component, a 95 percent response rate. All 60 of the primary contacts answered the curriculum characteristic questions during the telephone inter-view, for a 100 percent response rate. We define curriculum characteristics as the number of required and elective credit hours in the program core and the health specialty track, course sequencing, and the presence of an internship or capstone course. Curriculum content, course sequencing, and total number of credit hours continue to be a topic of interest and controversy within accrediting commissions generally and for health specialty tracks specifically (Kovner, 2001, 2002). The proper sequencing of courses and course content to ensure training appropriate for the demands of a changing health sector environment are recurring topics (Griffith, 2001). Rivenbark (2001) found the public affairs program core adapt-ing to meet the performance demands of the sector it serves; that topic will not be addressed here. We were primarily interested in the hourly requirements for both the core and the health specialty track. Only six of the 61 respondents to this question used the quarter system, and those quarter system curriculum hours were converted to semester hours for comparison in Table 5.

The average number of credit hours for the program and the health specialty track core were very similar, if not identical, across programs. Elective hours for the program and the health specialty track present were comparable. However,

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25 percent of the respondents did not offer electives within the disciplinary core; 13 percent of the respondents reported no required health specialty track core, but a course of study comprised only of electives. These data support the find-ings from our 2001 study, in which very little conformity was apparent within the health specialty track core and elective offerings, but they are at variance with our second curricular conclusion that conformity was present within the disci-plinary core.

Experiential or applied learning is widely viewed to be an important compo-nent of professional training in health specialty tracks, because for new graduates or those desiring a career change it provides the first opportunity to use a newly acquired skill set in their chosen profession (Fine, 2001; Friedman, 2001). In addition, graduates desiring career advancement may achieve this aim through a carefully thought out and executed internship or similar applied experience. It is obvious that programs with health specialty tracks realize the value of this experience; more than 30 different combinations of experiential learning were documented in the survey’s written component survey. Most important, only 10 percent of the respondents did not include this component in their programs. Respondents were asked to select from 10 possible options or any combination of these options. The most frequently mentioned for accredited programs were the master’s thesis and one other experiential project; for unaccredited programs, a research project and/or research experience and an internship were the most frequently mentioned.

Thirty six of the primary contacts (60 percent) who responded to the question “Does your program require any special course sequencing?” stated unequivo-cally that students progressed through the curriculum in an identified sequence. The curriculum pathway begins with an introductory course in health services or healthcare management or administration and concludes with required intern-ships, final papers, projects, a team practicum, or field experience. Approximately half of the primary contacts reported either recently completing a revision of health specialty track courses or planning a review in the near future; the remain-ing were satisfied with their curriculum.

Table 5. Curriculum Characteristics by NASPAA Accreditation Status

Curriculum Characteristic All Programs Accredited Unaccredited N=60 N=37 N=23

Program core (semester)

Required 24 25 22

Elective 9 10 8

Healthcare track core (semester)

Required 12 12 12

Elective 7 8 7

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Table 6. Faculty Characteristics by NASPAA Accreditation Status

All Accredited UnaccreditedFaculty Characteristic Programs

N=60 N=37 N=23Full-time faculty

Tenured 5 5 5

Untenured 3 3 3

Healthcare experience, tenured and untenured 2 2 1

Healthcare track core (semester)

Tenured 4 6 3

Untenured 10 10 11

Healthcare experience, tenured and untenured 5 5 5

Faculty CharacteristicsTable 6 presents the survey responses for faculty characteristics, the fourth

component of the model for developing a profile of NASPAA programs with health specialty tracks. Fifty-three of the 64 programs returning the survey com-pleted this component, an 82 percent response rate. Fifty-five primary contacts answered the faculty characteristic questions during the telephone interview, for a 92 percent response rate. We define faculty characteristics as the total number of full- and part-time faculty, tenured and adjunct, teaching in the program with a health specialty track; the number of faculty with healthcare experience; and faculty diversity.

Qualified health management faculty with industry experience can represent one of the most significant components necessary for establishing program qual-ity and credibility in professional education. Loebs (2001), Kovner (2001), and others have noted the widening breach between the practitioner and academic perspectives on appropriate professional training. One proven strategy to miti-gate this controversy is faculty with healthcare experience. While the average number of faculty for all classifications was uniform across accreditation status, only 63 percent of these full-time faculty and 50 percent of the part-time faculty were reported to have healthcare experience.

During the telephone interview, primary contacts were asked to indicate the level of difficulty they experienced in recruiting qualified faculty. Twenty-four (44 percent) indicated they had no difficulty in recruiting faculty; the remaining respondents stated that finding faculty with both a terminal degree and health industry experience was difficult. However, anecdotal comments suggested that approximately one of every six programs had not recently or ever completed a full-time health specialty track faculty search. In contrast, very few respon-

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dents reported having difficulty hiring adjunct faculty with industry experience. Strategies mentioned most often by interviewees as ways to overcome recruiting difficulties for full-time faculty included advertising in professional health jour-nals, using networking techniques, and word of mouth. One additional strategy mentioned by 33 percent of respondents was reliance on shared appointments with other departments and colleges to increase leverage for faculty lines and to meet salary expectations.

Just as faculty with healthcare experience bring a realistic, applied perspective to their courses, a diverse faculty will bring that same sense of reality to achieve-ment and career expectations for a diverse student population (Grady, 2001). During the telephone interview, primary contacts described the racial and ethnic diversity of full-time and adjunct program faculty. Approximately half of the 55 respondents indicated that neither full-time nor part-time faculty could be con-sidered both ethnically and racially diverse. At least one in four respondents was reluctant to comment on this question because of a lack of specific data for part-time adjunct faculty. For some MPA and MPP programs, another department or college staffed health concentration courses, and data on those faculty members were unavailable.

The lack of control over this critical aspect of graduate education represents a challenge for the programs with health specialty tracks. When asked, “Do you consider your faculty to be ethnically and racially representative of students in your program?” fewer than half of the telephone interview respondents indicated a match between full- and part-time faculty and their student population. At least one in five of the 55 respondents did not have access to the appropriate in-formation for their adjunct instructors and could not comment on this question.

Alumni CharacteristicsAlumni characteristics comprise the fifth component of the model for devel-

oping a profile of NASPAA programs with health specialty tracks. Only 17 of the 64 programs returning the survey partially completed this component, a 27 percent response rate. Fifty-eight primary contacts answered the alumni charac-teristic questions during the telephone interview, a 97 percent response rate. We define alumni characteristics as the current position held, career choice, and time since graduation for the information presented. Graduate placement and alumni career trajectories have drawn the attention of health management and policy educators. Demonstrating appropriate educational outcomes and continuing training in an environment that is referred to as hyper-turbulent is considered a priority (Warden and Griffith, 2001). Ideally, the health specialty tracks would assume most of the responsibility for this role. Respondents who did maintain specialty track specific records for recent graduates by position, title, level, or sec-tor indicated that approximately 90 percent of their graduates hold positions in the public and private health sectors within two to five years of graduation.

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Program graduates can be valuable to current learning processes when they provide opportunities for experiential learning in the form of residencies, shad-owing, and mentoring, three well-documented strategies for developing senior managers (Fine, 2001). Given that students usually select a school and program for career advancement, alumni are also a critically important recruitment and retention resource (Griffith, 2001). However, during the telephone interview, 78 percent of the primary contacts stated that they did not differentiate health from non-health sector alumni when planning activities. Despite acknowledging the necessity of continuing training, 53 of the respondents (92 percent) do not maintain specialty track-specific records for alumni. Primary contacts comment-ed, anecdotally, that alumni and career information were maintained elsewhere within their university, suggesting a decentralized system, or that their students were already employed and did not require tracking. Only 3 percent of the re-spondents noted events at specialty track-specific meetings, such as the American College of Health Care Executives, or that they maintain a listserv for follow-up after graduation. Alumni outreach activities, generally in the form of newslet-ters and annual events, were mentioned by 62 percent of respondents. However, 81 percent of those interviewed strongly believed that their alumni were remain-ing in the health services industry, thereby affirming what should be a strong demand for alumni continuing education activities, if offered, and strong alumni involvement in the program.

Syllabi CharacteristicsCurriculum is an important indicator of structural standardization across pro-

grams, but it provides no information on course content or, by inference, on the expectations for a professional education in the health specialty practice domain. Therefore, a review of syllabi was the final component of the model for developing a profile of NASPAA programs with health specialty tracks. We defined syllabi char-acteristics as course title, description, behavioral objectives, and learning outcomes.

The academic preparation of professionals is unequivocally the single most important topic among decision makers in health management and policy educa-tion today (Begun and Kaissi, 2004; Leatt et al., 2004; CAHME, 2004), and the core competencies appropriate for health professional education at all stages of career development has become a predominant theme for evaluation. One na-tional summit meeting (Griffith, 2001) and a new organization (the National Center for Healthcare Leadership, 2004) devoted to this topic are a result of this interest. A pivotal component of our study—the evaluation of health specialty track syllabi for comparability within public affairs programs and with similar programs such as the master of business administration and the master of public health—evolved from this concern. This information is needed to determine how health specialty tracks within NASPAA programs compare with Commission

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for Accreditation of Healthcare Management Education (CAHME) programs. CAHME programs, either independently or integrated with a disciplinary core such as business, must demonstrate the inclusion of curriculum content in 10 substantive areas during the self-study and subsequent site visit processes.

Thirty-seven of the 64 programs (58 percent) submitted 160 syllabi for analy-sis. Table 7 contains the titles of the 83 most frequently submitted syllabi and the number of syllabi submitted for each title by accreditation status. The re-maining 77 syllabi covered a wide range of topics, with epidemiology, long-term care, health promotion, healthcare information systems, rural health, gender and health, and international public health among the most frequently submitted. A content analysis conducted on course titles, descriptions, and objectives to detect commonalities and differences and to develop objective inferences from these health syllabi examples is forthcoming.

During the follow-up phase of the study, the primary contacts for programs that did not submit syllabi stated that obtaining them would not be possible because faculty from another department or college within the university taught the health specialty component.

After the Typology: Next StepsNASPAA has initiated a discussion of accrediting its most frequently offered

practice domains, such as nonprofit management and health administration and policy (Reed, 2004). An important antecedent to this process is a classification system that may be used for the development of standards, guidelines, continu-ing evidence-based research, and quality assessment and assurance. We developed such a classification system, the specialty track model, and traced the develop-

Health Syllabi All Programs Accredited Unaccredited

Health policy 13 10 3Introduction to health systems 15 13 2Health care management 16 12 4Legal issues in healthcare 12 9 3Health finance 8 6 2Human resource/organizational behavior 3 3 0Health ethics 3 3 0Strategic planning 1 1 0Health marketing 4 2 2Health economics 8 6 2

Total 83 65 18

Table 7. Regional Distribution by NASPAA Accreditation Status

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ment of the first three phases—interest and growth, formal recognition, and preliminary framing—in our first article in this symposium. Phase 4, profile de-velopment, examining the findings from a national profile of NASPAA member programs with graduate health specialty tracks, comprises this article. Phases 5 and 6, benchmarking for practice standards, and guidelines and/or accreditation procedures, constitute the next steps for NASPAA and the now-renamed Health Sector Education Programs Section. The process for Phases 5 and 6 was discussed in the first article; two important preliminary components of each phase were examined in this study.

To begin the process of building a foundation for practice standards, we asked all 60 telephone interview respondents what comprised the most unique aspect of their health specialty track. Thirty-eight (63 percent) of the affirmative responses were varied and ranged from “We are unique because our program has three dif-ferent foci within the health specialty track” to “Our health policy track is only taught by policy makers with extensive experience at all levels of the govern-ment” to “the required course in communications theory and application, because our advisory council sees this as a critical skill that needs to be taught to all senior managers.” Uniqueness is not a substitute for building practice standards, but it may point the way to best-practice curricula offerings for benchmarking.

We also anticipated Phase 6, guidelines and/or accreditation procedures. As part of the telephone interview, primary contacts were asked to answer the two questions on accreditation; these are reproduced in Tables 8 and 9. Fifty-seven of those interviewed answered the first question, for a 95 percent response rate; 59 responded to the second question, a 98 percent response rate. More than half of the interviewees (53 percent) showed support for the accreditation option in Table 8, an additional NASPAA accreditation for health specialty tracks. Simi-larly, more than half of the interviewees (59 percent) also showed support for the accreditation option in Table 9, a joint CAHME and NASPAA accreditation for health specialty tracks. Considerably less support was given to not consider-ing either of these options (32 percent for the first option and 24 percent for the second option). Of interest to NASPAA and the Health Sector Education Programs Section are the primary contacts that require additional information, because they represent an opportunity to create a forum for the discussion of this topic. Respondents appear to favor an agreement for linked accreditation rather than an additional NASPAA accreditation for health specialty tracks. Although no significant differences existed between accredited or unaccredited responses for either of the accreditation options (Table 8, χ2=2.63, df=3, sig.=.452) (Table 9, χ2=.705, df= 2, sig.=.703), NASPAA and the Health Sector Education Programs Section should be sensitive to the smaller number of unaccredited respondents and should initiate a dialogue to learn more of their preferences when the cre-ation of guidelines and/or accreditation options are discussed.

Assessing Performance in NASPAA Graduate Programs


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The Health Specialty Track Profile in PerspectiveThe study of NASPAA programs with health specialty tracks found a small

continuation of the rapid growth observed in 2001 with a 9 percent increase over the three-year period (2000–2003). Seven programs no longer offer the health specialty tracks, with two citing no or slow enrollment and the remaining stat-ing an administrative decision to eliminate all specialty tracks. It is obvious that health as a practice domain remains an attractive addition to the public adminis-tration and policy disciplines. At least three of the programs that eliminated the health specialty track are planning to replace it with an MHA degree designed to provide training for health systems managers only. Health specialty track programs are heavily concentrated within the northeast and southeast, with the remaining 50 percent widely dispersed throughout the nation and more than a dozen states with no health specialty track offerings. The universal acknowledg-ment of programs’ contributions and importance to regional health service mar-kets underscores one of the most significant findings of our study, the relevance of the geographic distribution of NASPAA programs with health tracks.

Table 8. Program Responses to the First Accreditation Option

Telephone Interview Question“Would you support an additional All Programs Accredited UnaccreditedNASPAA accreditation for health # % # % # %care concentrations?” (N=57)

Yes 30 53 22 39 8 14

No 18 32 13 23 5 9

Uncertain, would need more information 8 14 6 11 2 4

NA/We are not the decision maker 1 2 0 0 1 2

Telephone Interview Question “Would you support a joint CAHME All Programs Accredited Unaccredited& NASPAA accreditation for # % # % # %healthcare concentrations?” (n=59)

Yes 35 59 25 42 10 17

No 14 24 9 15 5 9

Uncertain, would need more information 10 17 8 14 2 3

Table 9. Program Responses to the Second Accreditation Option

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Programs are positioned in a variety of academic settings, some with shared responsibility for the health specialty track, implying that the development of practice standards and guidelines must be carefully structured to respect the unique features and the culture of more than one setting within some institu-tions. The uniformity observed among the number of students and faculty masks the variability of these characteristics among programs. This variability underscores the necessity of flexible and adaptable practice guidelines, as does the statistically significant difference in the response rates of accredited versus member programs in this study. The large number of programs with experiential learning requirements in place and the presence of faculty with health experience are encouraging. Diversity will continue to be a challenge for some programs, primarily because of geographic constraints and the underrepresentation of ethnic minorities academically prepared for positions in the practice domain. However, the absence of program-specific and centralized policies for tracking alumni rep-resent opportunities for growth, development, and the expansion of post-graduate curricula offerings through a variety of accessible media.

Perhaps the greatest challenge presented to NASPAA and the Health Sector Education Programs Section is the evaluation of curricular offerings in order to guide the creation of practice standards. Our findings strongly suggest that the design of strategies to ensure greater access to health specialty track syllabi for evaluation constitutes an important consideration if NASPAA and the Health Sector Education Programs Section agree to move forward with program compa-rability and/or accreditation and practice standards.

Our findings also suggest that the number of graduates of programs with a health specialty track is increasing rapidly and that those graduates work in the public, for-profit, and nonprofit sectors, implying that the health focus of the degree may dictate career choices. The 1998 NASPAA study finding that the majority of the graduates worked for private sector healthcare providers, with the remainder employed by the public sector, reinforces the characteristic mobility that was acknowledged in U.S. News and World Report’s 2005 review of public af-fairs programs (Mulrine, 2004).

Another challenging aspect is the need for programs to satisfy two masters, because specialty tracks within graduate programs integrate the core curriculum content of a discipline, such as business or public administration, with that of a specific practice domain, such as health services or environmental policy. Ideally, this integration results in two skill levels. Graduates are expected to demonstrate competence in the overarching discipline and in the specific practice domain, a complex process requiring coordination and thorough documentation. Primary contacts may be required to draw upon two sets of literature with their corre-sponding interpretation and relevance to program design, as we have done here.

Historically, NASPAA and other accrediting associations such as the American Assembly of Collegiate Schools of Business International (AACSB) have pro-

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vided quality assessment and assurance for disciplines such as public and busi-ness administration; accrediting agencies such as CAHME and CEPH assumed the same function for specific practice domains such as health management and public health. The comparability/synchrony and compatibility of two accredit-ing bodies is central to overall standard setting and presents a pivotal aspect of the decisionmaking process for NASPAA and the Health Sector Education Programs Section. Telephone interview responses to accreditation options lead us to conclude that approximately half of the primary contacts interviewed sup-port an additional accreditation with either NASPAA or CAHME. We hope that the research presented here will provide important information for NASPAA to develop a knowledge base and an action plan for master’s-level programs with health specialty tracks that will bring value-added benefits to the process ulti-mately selected.

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Management Education.” The Journal of Health Administration Education, 18(2):153-173.Andersen, R., C. Howard, and E. Schneller. 2004. “Contemporary Models for Accreditation: Lessons

for Health Administration Education and Accreditation.” The Journal of Health Administration Education, 21(2):185-226.

Association of University Programs in Health Administration (AUPHA). 2004. Health Services Administration Education Directory of Programs, 2003-2005. Washington, D.C.:AUPHA.

Begun, J., and A. Kaissi. 2004. “Definition and Scope of Health Service Administration.” The Journal of Health Administration Education, 21(2):227-240.

Breaux, D. A., and E. J. Clynch. 2003. “The Core Curriculum Content of NASPAA Accredited Programs: Fundamentally Alike or Different?” Journal of Public Affairs Education, 9(3):259-273.

Brown, G. D. 2000. “The Role of Accreditation in Transforming Health Services Management Education.” The Journal of Health Administration Education, 18:37-54.

The Commission on Accreditation of Healthcare Management Education (CAHME). 2004. Available at www.cahmeweb.org.

Clark, C., and C. E. Menifield, C. E. 2003. “The Dynamics of NASPAA Accreditations: A Challenge for Organizational Expansion?” Presentation at the 2003 NASPAA Annual Conference, Pittsburgh, PA.

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Gelmon, S. 2004. “Stakeholder Satisfaction with the Accreditation Process.” The Journal of Health Administration Education, 21(2):167-172.

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Hewitt, A., et al. 2004. In press. “Profiling NASPAA Programs with Healthcare Concentrations: A Panel Discussion on Building a Foundation to Accredit Specializations.” Public Performance and Management Review.

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Hewitt, A. M., B. S. Marshall, and K. H. Badger. 2006. “A Proposed Methodology for Infrastructure Development of NASPAA Programs with Specialty Tracks: The Case of Health Policy and Management.” Journal of Public Affairs Education, 12(2):125-141.

Kovner, A. R. 2001. “The Future of Health Care Management Education: An Evidence Based Approach.” The Journal of Health Administration Education. Special Issue:107-116.

Leatt, P., R. Grady, J. W. Begun. 2004. “The Final Report of the Blue Ribbon Task Force on Accreditation.” The Journal of Health Administration Education, 21(2):121-166.

Loebs, S. F. 2001. “The Continuing Evolution of Health Management Education.” The Journal of Health Administration Education. Special Issue: 33-50.

Marshall, B. S., and A. Hewitt. 2004. Final Report to the Robert Woods Johnson Foundation on Profiling the Master’s of Public Administration Programs with a Health Care Management Concentration. Ref ID # 047226.

Mulrine, A. “Public Goes Private.” U.S. News & World Report. 2005. “America’s Best Graduate Schools.” Washington, D.C.

National Association of Schools of Public Affairs and Administration. 1998. NASPAA Survey Report.The National Center for Healthcare Leadership. 2004. Available at www.nchl.org.Reed, B. J. 2004. “NASPAA Annual Meeting, Pittsburgh, October 17, 2003.” Journal of Public Affairs

Education, 10(1):1-4.Rivenbark, W. C. 2001. “Teaching Performance in Public Affairs Education.” Journal of Public Affairs

Education, 7:261-266.The Editors of the Journal of Health Administration Education (JHAE). 2002. “A Conversation with

Anthony R. Kovner on Management Research.”Warden, G. L., and Griffith, J. R. 2001. “Ensuring Management Excellence in the Health Care

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Programs.” Nonprofit Management and Leadership, 9(1):99-109.

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Anne M. Hewitt is an assistant professor in the Graduate Department of Public and Healthcare Administration in the Center for Public Service at Seton Hall University. She is also director of the Seton Center for Community Health and is a CCPH Health Fellow. Hewitt received her Ph.D. degree from Temple Universi-ty. Her teaching and research interests involve community health, health dispari-ties, and public health policies. She serves as a health policy advisor to the New Jersey Department of Health and Senior Services.

Brenda Stevenson Marshall is an associate professor and director of the MBA in healthcare administration and of the MPH program at Cleveland State Univer-sity. She holds a Ph.D. from the University of Michigan, and an MPH from the University of California, Berkeley. Her teaching, research, and service activities focus on improving accessibility to health services for vulnerable populations and developing more precise competency measurements for health management education.

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Exploring the Predictors of Health Specialty Track Accreditation

for NASPAA Member Programs

Brenda Stevenson Marshall Cleveland State University

Carl F. Ameringer

University of Wisconsin-Oshkosh

AbstractNASPAA member programs with health specialty tracks are considering a

separate accreditation process because of the many benefits such a process pro-vides. This article identifies the characteristics of programs that would support the development and implementation of a formal accreditation process for health specialty tracks through the use of a conceptual model that points to program preferences and resources as key indicators. A multinomial logistic regression procedure is employed to develop a classification table using two health specialty track accreditation options as dependent variables. The findings indicate that programs with health specialty tracks that participate in offering dual/joint/other health degrees comprise the subpopulation supportive of an accreditation that involves NASPAA and the health specialty accrediting commission CAHME. Further discussion and formulation of standards should involve both accrediting bodies. A forum should be created for addressing the concerns of programs not supporting this accreditation option.

This article identifies the characteristics of NASPAA member programs that affect whether those programs would support the development and implementa-tion of a formal accreditation process for health specialty tracks. This research was intended to determine

• the nature of the level of interest in formal accreditation• a profile of programs supporting accreditation

JPAE 12(2):165-176


Exploring the Predictors of Health Specialty Track Accreditation for NASPAA Programs

• a profile of programs that may be adversely affected by accreditation• strategies to better inform the development and implementation of

NASPAA accreditation of health specialty tracks.

Currently, NASPAA does not accredit specializations within a public admin-istration or public policy program. Rather, it reviews all specialty tracks for program consistency, a sort of “truth in advertising assessment” (Andersen et al., 2004). NASPAA member programs with health specialty tracks can obtain accreditation from the Commission on Accreditation of Healthcare Manage-ment Education (CAHME) (Marshall and Hewitt, 2005). CAHME, formerly the Accrediting Commission on Education for Health Services Administration (ACEHSA), was organized in 1968 and is the only organization formally recog-nized by the Department of Education to accredit masters’ programs in health administration (Leatt et al., 2004). The value of CAHME accreditation is tan-gible and concrete (Sundre, 2004), offering benefits such as access to government scholarship funds including the Navy Medical Scholars Program and some pro-grams funded by the Health Resources and Services Administration. In addition, many healthcare systems (and state licensing bodies, such as the licensing board for long-term care administrators) give preference to graduates of CAHME-ac-credited programs. Graduates of CAHME programs who complete an approved long-term care internship and a specialization in long-term care may sit for the licensed nursing home administrator examination immediately after graduation, an option not available to graduates of unaccredited programs. Despite these significant advantages, only four of 78 NASPAA member programs with health specialty tracks held CAHME accreditation in 2003, representing 6 percent of the 68 programs that were CAHME-accredited that year.

In addition, NASPAA member programs with health specialty tracks are not represented within CAHME’s infrastructure. The CAHME standard-setting and accreditation review councils do not include a member from a NASPAA-accredited program that also has a health specialty track. This lack of representa-tion is of concern to members of NASPAA’s Health Sector Education Programs Section (HSEPS), because of the many changes that CAHME has proposed for health management education. NASPAA member programs with health specialty tracks, representing approximately 25 percent of all health specialty track pro-grams nationally, should have a greater role in the development and implementa-tion of these changes.

CAHME has indicated its desire to work with NASPAA to facilitate the devel-opment of an accreditation process for NASPAA member programs with health specialty tracks. CAHME’s efforts reflect the findings of a Blue Ribbon Task Force comprised of representatives from the academic and practitioner commu-nity; CAHME and the National Center for Healthcare Leadership (www.nchl.org) created the task force in 2002 to evaluate the health specialty accreditation



process and the efficacy of health management education. The task force recom-mended that CAHME expand the accrediting process to include programs not well represented, such as the MPA and MPP programs (Leatt et al., 2004; Begun and Kaissi, 2004; Campbell and Hilberman, 2004; Smith, 2004). Whether NASPAA or CAHME decide to pursue accreditation of MPA and MPP programs separately or collaboratively is a policy issue that we do not attempt to address. Rather, we seek to inform the process through the exploratory analysis presented here. We begin with a description of the conceptual model, the methodology used to develop the variables, and the hypotheses to be tested. The findings from the descriptive and statistical analyses follow and form the basis for a discussion of the implications of this study for the accreditation of health specialty tracks.

MethodologyConceptual Model. While the literature on health specialty track accreditation is

replete with studies on definitional and policy issues, there exists to our knowl-edge no previous work using a predictive model that explores the characteristics that affect whether they would support CAHME accreditation. Without this benchmarking profile, we reviewed the public affairs and health sector literature. Our conceptual model evolved from several studies that evaluated program ac-creditation (Andersen et al., 2000; Brown, 2000; Gelmon et al., 2004; Andersen et al., 2004; Clark and Menifield, 2004). The Clark and Menifield study most closely approximates our efforts here. Clark and Menifield (2004, 36) sought “to explore why some institutional members of NASPAA are accredited while others are not.” Though they found that a program’s size was an important factor in seeking accreditation, Clark and Menifield (39) also discovered that “Carnegie status—research, doctoral, and master’s universities in descending order—is totally uncorrelated with accreditation.” Many large programs at “elite universi-ties,” Clark and Menifield related, did not believe that NASPAA accreditation enhanced their value and prestige.

Our research differs from that of Clark and Menifield in two important re-spects. First, we consider the value of secondary accreditation for NASPAA member programs with health specialty tracks. Programs may desire a separate health specialty accreditation because it provides an external assessment of educa-tional integrity and validation that a predetermined set of standards and guidelines has been met (Brown, 2000; Gelmon, 2004; Leatt, 2004). CAHME’s Web page elaborates on these benefits by noting that “students entering CAHME accredited programs are assured of appropriate content, high standards of quality, and member-ship in a network of professional colleagues that transcends boundaries of universi-ties and professional associations and colleges.” This external validation of program quality provides a seal of approval important to professionals and to the institution (Brown, 2000), because it may be used as a marketing tool for student and faculty recruitment. Andersen et al. (2004) define to this type of “second level accredita-



tion” as “specialized or programmatic accreditation, which evaluates a specific educational program, department, or school within an institution... that is itself typically accredited by one of the regional accrediting commissions” (190).

The second way in which our research differs from that of Clark and Menifield (2004), which examined the total population of NASPAA member programs, is that it considers a distinct subpopulation—that of NASPAA member programs with health specialty tracks. This subpopulation potentially comprises its own, unique set of variables and characteristics.

As is the case with NASPAA accreditation in general, programs with health specialty tracks must demonstrate that they have sufficient resources to support specialty-track accreditation (Andersen et al., 2000; Leatt et al., 2004). A cer-tain number of full-time faculty must be in place and dedicated to the program; funded research from external sources nationally and within the community is re-quired as an indicator that faculty are active in their profession and that students are exposed to the most current information in the discipline. Given a program’s desires and its financial position, this leads us to the development of a conceptual model that posits the following: preferences for health specialty track accreditation = f (program characteristics and program resources).

The terms of this model closely track those of programs seeking general ac-creditation in the fields of business administration, public health, and public administration. Because this model specifically targets health specialty tracks, it denotes additional and unique requirements. The necessity for coordination of the discipline and the practice domain is addressed in the preceding article in this symposium and is important to the analysis here because of the resources involved.

Hypotheses to be tested. We employed three program characteristics—NASPAA accreditation, the presence of dual/joint degrees, and location within the uni-versity setting—to predict support for accreditation. Programs accredited by NASPAA potentially have the resources to gain health specialty track accredita-tion and, by virtue of their general accreditation, are the only programs eligible for secondary accreditation. In addition, the presence of dual or joint degrees and other degrees with a healthcare concentration likely enhances the incentive for health specialty track accreditation because the benefits of accreditation would flow to multiple degree programs.

Finally, we believe that, if sufficiently autonomous, a program’s institutional setting—school, department, institute, center, etc.—favors program accredita-tion (Loeb, 2001; Andersen et al., 2000). Using the definition rationale from Clark and Menifield (2004), we perceive location as an autonomy indicator for the programs in the study. Programs located in public administration schools, departments, or centers are much more likely to have greater independence in the development and implementation of guidelines and new accreditation procedures than programs located in political science departments. This last variable turned



out to be such an accurate indicator—98 percent, or 62 of the 64 programs re-sponding to the survey were located in a school or college, institute or center, or a department dedicated to the health specialty track—that we did not subject it to further statistical analysis. A characteristic shared by the universe of programs, with few exceptions, is not a unique predictor of who supports and who does not support accreditation.

Two variables, the number of faculty and each school’s Carnegie classification, are used as indicators of program resources. The number of faculty members is a consideration for NASPAA (Clark and Menifield, 2004) and CAHME (Andersen et al., 2004). NASPAA requires at least five full-time faculty members devoted to the public affairs program; CAHME’s requirements are more modest: two full-time faculty members and a program director dedicated to the health specialty track. We employ the Carnegie classification, similar to Clark and Menifeld, as a proxy for resource capabilities. Carnegie classification could also be seen as a pref-erence variable, but we believe it better serves our purpose as a resource indicator.

Data. The target population for this study is the public affairs (MPA or MPP) program with a health specialty track. Programs with health specialty tracks were identified using data from the Marshall and Hewitt (2004) Robert Wood John-son Foundation-funded study of the universe of NASPAA member programs with health specialty tracks. The three-part study of 78 NASPAA member programs with a health specialty track is described in the preceding article in this symposium (Mar-shall and Hewitt, 2006). The data used to construct the variables come from the survey and the telephone interview components of the Marshall and Hewitt study and the Carnegie Classification of Institutions of Higher Education (2000).

The variables used to test the conceptual model and the hypotheses are dis-played in Table 1. The questions used to construct the dependent variables are also shown in Table 1. It is important to note that survey respondents were asked both questions and did not have to choose between the options; thus, program representatives may have elected to respond to one or both options. All variables are constructed as dichotomous, with the “yes” response coded as 1 and the “no” response coded as 0. The program resource variables and the Carnegie classifica-tion of programs were suggested by the Clark and Menifield (2004) study of NASPAA programs most likely to be accredited. The presence of dual and joint degrees and the “primary accreditation status” were suggested by the Andersen et al. survey (2000) that explored the needs and interests of directors of health management programs accredited by CAHME.

Statistical Design. We employed a binary logistic regression model to explore predictors of support for health specialty track accreditation. The model was tested using a multinomial logistic regression procedure because we are inter-ested in classifying subpopulations of NASPAA members based on the variables described in Table 1. The results should identify a subpopulation or subpopula-tions that support health specialty accreditation. This is because the multinomial



logistic regression internally aggregates cases to form subpopulations based on the variables in the model.

A secondary consideration is the relatively small number of cases (fewer than 50) available for the analysis, because not all of the individual programs that re-

Dependent Variables

1. TheNASPAAonlyaccreditationoptioniscodedas1iftheresponseis“yes”;0iftheresponseis“no,”“uncertain,”or“needmoreinformation.”Thisoptionistakendirectlyfromthesurveyquestion,“WouldyousupportanadditionalNASPAAaccreditationforhealthareaconcentrations?”

2. TheNASPAAandCAHMEcombinedaccreditationoptioniscodedas1iftheresponseis“yes”;0iftheresponseis“no,”“uncertain,”or“needmoreinforma-tion.”Thisoptionistakendirectlyfromthesurveyquestion,“WouldyousupportajointACEHSAandNASPAAaccreditationforhealthcareconcentrations?”

Independent Variables in Both Models

ProgramPreferences1. Accreditationstatusoftheprogram:NASPAA-accreditedprogramsaremore

likelytorecognizethemeritsofhavingasecondaryaccreditationforthehealthspecialtytrack.NASPAA-accreditedprogramsarecodedas1;unaccreditedas0.

2.Programswithdual/joint/otherhealthdegreesaremorefavorablydisposedtoahealthspecialtyaccreditationbecauseofthelargernumberofstakeholders(e.g.students,faculty,employers,andthecommunity).Presenceofdual/joint/otherhealthdegreesiscodedas1;theabsencecodedas0.

ProgramResources3. Sizeofhealthcarefaculty:programswithatleasttheminimumnumberoffaculty

forNASPAAaccreditationaremorelikelytoseekhealthspecialtyaccreditationbecausetheyhavetheresources.Healthcarefacultyaredefinedhereasfull-time,tenuretrackfacultywhoteachinthehealthspecialtytrackprogram.Thesefacultymayalsoteachintheprogram’scorecurriculum.Fiveormorehealthcarefacultyarecodedas1;fewerthanfivearecodedas0.Thefivecutpointwasse-lectedbecausetheaccreditationoptionquestionswereconstructedtoassumethatNASPAAaccreditationwouldbepartoftheprocess,eveniffivefacultymeantthreeNASPAAandtwoCAHME..

4. Researchstatusofuniversity:programswiththeCarnegiedesignationof“doc-toral,”eitherintensiveorextensive,withtheemphasisonqualityandvisibility,shouldbemorefavorablydisposedtoahealthspecialtyaccreditation.ProgramswiththeCarnegiedesignationofDoctoral,intensiveandextensive,arecodedas1;Master’sarecodedas0.

Table1.VariablesUsedintheConceptualModelandHypothesestoBeTested



sponded to the telephone interview answered each of the questions in the survey component of the Marshall and Hewitt study. Given the number of cases with incomplete responses, a subpopulation-level approach is more likely to produce useful results, whereas analysis at the individual case level may be less informa-tive (SPSS, 2005). The subpopulation approach is also relevant because of the statistically significant difference the Marshall and Hewitt study (2005) detected in the response rate of accredited and unaccredited programs to the telephone interview component of the study. This difference may prove to be pivotal here, because the dependent variables are drawn from that component of the study. If this difference reappeared in the analyses, it might affect the inferences to be drawn from the findings.

Two equations are evaluated with the dependent variables shown in Table 1. The dependent variables were constructed from the information gathered during the telephone interview component of the Marshall and Hewitt (2005) study. As part of the telephone interview, primary contacts were asked to answer two ques-tions on accreditation. The first question asked whether respondents favored an additional NASPAA accreditation for health specialty tracks; the second ques-tion asked whether respondents favored joint accreditation. Fifty-seven programs answered the first question (a 95 percent response rate); fifty-nine programs responded to the second question (a 98 percent response rate).

Findings. Table 2 provides a descriptive analysis of the variables for the pro-grams that responded to each of the accreditation option questions in the tele-phone interview component of the survey. The descriptive analysis is confined to programs that had valid entries for one or both of the accreditation options and for all of the independent variables. The same target population of primary contacts responded to the questions for accreditation options. While a majority of respondents favored each option, the majority supporting the joint option was stronger. Of special interest is the large affirmative response (45 percent) to the CAHME/NASPAA option from programs that are NASPAA-accredited and that have dual/joint/additional health degrees.

Results for the multinomial logistic regression procedure for both accredita-tion options are shown in Table 3. For each of the equations, two results are important: How well the variables in the equation fit the conceptual model, and how well the model classified the responses of the subpopulations. Each of the equations has four variables or degrees of freedom. Neither model attains statisti-cal significance as demonstrated through the chi-square statistic of .779 for the NASPAA option and .179 for the CAHME and NASPAA option. None of the variables in the NASPAA option are significant at the .10 level. This means that we cannot with any confidence attribute support of this option to one or more of the subpopulations in the model. By contrast, the NASPAA and CAHME option has one variable describing the behavior of the subpopulation with dual/joint/other health degrees that is significant (.026). The programs that have dual/joint/



other health degrees support the development of a joint CAHME/NASPAA ac-creditation.

Based on these data, we can identify a subpopulation of programs that sup-ports one of the two NASPAA accreditation options and develop a profile of this subpopulation. While 60 percent of the programs in the model are classified as having dual/joint/additional health degrees, Table 4 suggests that programs with health specialty tracks with and without dual/joint/other health degrees may be more accurately identified by their similarities than their differences. An impor-tant difference lies in the very large percentage of NASPAA-accredited programs (47 percent) supporting the CAHME/NASPAA option, compared to programs without dual/joint/other health degrees (19 percent) that are unaccredited and do not support the option.

Although our small sample size (45 cases for the NASPAA-only option and 47 cases for the CAHME/NASPAA option) evokes caution, the classification power

Supportfor Supportfor AdditionalNASPAA NASPAAandCAHME Accreditation(N=45) Accreditation(N=47) Yes No Yes NoVariables # % # % # % # % 24 53 21 47 29 62 18 38

Independent Resource FacultySize Lessthan5 14 31 54 12 46 17 63 10375-24 10 53 9 47 12 60 8 40

CarnegieStatus Doctoral 14 52 13 48 18 62 11 38Master’s 10 56 8 46 11 61 7 39 Program Characteristics NASPAAAccreditationStatus Accredited 17 55 14 45 21 66 11 34Unaccredited 7 50 7 50 8 53 7 47

Dual/joint/additionalhealthdegrees Hasdual/joint/additional 16 62 10 38 2 75 7 25Doesnothavedual/joint/additional 8 42 11 58 8 42 11 58

Table2. DescriptiveAnalysisofthePercentageofRespondentsSupportingtheTwoAccreditationOptions



Model Fit and Classification NASPAA Option NASPAA/CAHME Option

DegreesofFreedom 4 4

PearsonGoodnessofFittest .826 .313

Chi-SquareStatistic .779 .179

CorrectClassificationRate 60.0% 68.1%ParameterEstimates B S.E. Sig. B S.E. Sig.

HealthCareFaculty - - - - - -

ProgramAccreditationStatus -.045 .693 .949 .239 .708 .736

Dual/joint/otherhealthdegrees .862 .685 .208 1.617 .724 .026

CarnegieClassification .142 .667 .832 .642 .722 .374

Constant -.465 .632 .462 -1.305 .692 .576

Table3.MultinomialLogisticRegressionProcedureforPercentageofRespondentsSupportingtheNASPAAOnlyandNASPAAandCAHMEAccreditationOptions

Has Dual/ Does Not Have Joint Degrees Have Dual/ Joint Degrees # % # % 28 60 19 40Independent FacultySizeLessthan5 15 56 12 445-24 13 65 7 35

Carnegie StatusDoctoral 14 48 15 52Master’s 14 78 4 22

NASPAA Accreditation Status Accredited 22 69 10 31Unaccredited 6 40 9 60

Table4. PercentageofProgramswithDual/JointDegrees(BasedonQues-tionsAskingWhethertheRespondentSupportedaJointNASPAA/CAHMEAccreditationforSpecialties)



of our model enhances the validity and reliability of certain results. In Table 5, we demonstrate the practical application of the multinomial logistic regression approach for both accreditation options. Table 5 compares the number of cor-rectly classified cases (boldface) to the number of incorrectly classified cases. As anticipated, the classification rate for the NASPAA only option (60 percent) is lower than the classification rate for the CAHME/NASPAA option (68.1 per-cent). Of further importance is the classification rate of affirmative responses for the CAHME/NASPAA option. There were 31 “yes” responses to that option, 23 (79.3 percent) of which the model correctly classified. This very high classifica-tion rate provides additional confidence in the significance level of the dual/joint/other health degree subpopulation.

DiscussionAlthough the results of this statistical analysis are far from conclusive, they

allow us to draw some important inferences. We can say with some confidence that NASPAA programs that favor accreditation are more likely to support joint CAHME/NASPAA accreditation than NASPAA-only accreditation. Moreover, we observe that most programs that support joint accreditation are NASPAA accredited, are highly autonomous within the university setting, and offer more than one degree option in the healthcare field (dual/joint/other).

We further observe that programs that do not support joint CAHME/NASPAA accreditation typically lack dual/joint/other degree options within the healthcare field. Moreover, these programs tend to have fewer than five full-time faculty members in the health specialty track. Nonetheless, many programs that fall into this category (32 percent) are located within research institutions that offer doctoral degrees and/or are NASPAA accredited and highly autonomous within

NASPAA-only Option

Observed Predicted

Noor Yes Percentpredicted otherreasons correctly

Noorotherreasons 11 10 52.4Yes 8 16 66.7OverallPercentage 42.2 57.8 60.0

NASPAA and CAHME Option

Noorotherreasons 9 10 50.0Yes 8 23 79.3OverallPercentage 42.2 57.8 68.1

Table5. ModelClassificationofSubpopulations



the university setting. We speculate that such programs share healthcare faculty with other departments, schools, or colleges and that they experience certain constraints (resources, identity, etc.).

Because the subpopulation we identified most clearly supports joint CAHME/NASPAA accreditation, we believe that further discussion and formulation of standards should involve both accrediting bodies. We are concerned, however, about the potential exclusion of programs that do not fit the subpopulation we have identified. For such programs, we recommend a forum that would address any such concerns. Although joint CAHME/NASPAA accreditation may not be feasible for certain programs, such programs should have the opportunity to participate in the development of standards.

Any standards that NASPAA and CAHME develop can and should act as guidelines for all NASPAA member programs with health specialty tracks. We perceive that all programs would benefit from a broad exchange of ideas and guidelines in order to counter parochialism and to gauge resource constraints. Efforts to remain abreast of the changes that occur in the healthcare market can tax the resources of any program, large or small. A program’s size notwithstand-ing, the healthcare industry continues to consolidate at a hyper-turbulent pace. Students who enter programs with health specialty tracks will need to acquire sophisticated tools and broad analytical perspectives in order to navigate this environment. We hope that the research presented here will inform the devel-opment of standards and guidelines that will advance educational goals in the healthcare arena.

ReferencesAndersen, R. M., et al. 2000. “Program Directors’ Recommendations for Transforming Health Services

Management Education.” The Journal of Health Administration Education, 18(2):153-173.Andersen, R. M., C. C. Howard, and E. Schneller. “Contemporary Models for Accreditation: Lessons for

Health Administration Education.” The Journal of Health Administration Education, 21(2):185-226.Begun, J. W., and A. Kaissi. 2004. “Definition and Scope of Health Services Administration.” The

Journal of Health Administration Education, 21(2):227-240.The Commission on Accreditation of Healthcare Management Education (formerly known as

ACEHSA). Available at www.cahmeweb.org/.Campbell, C. and D. W. Hilberman. 2004. “Accreditation in Health Administration Education: A Call

for Change.” The Journal of Health Administration Education, 21(2):107-114. The Carnegie Foundation for the Advancement of Teaching. 2000. The Carnegie Classification of

Institutions of Higher Education. Carnegie Publications, Menlo Park, California.Clark, C., and C. E. Menifield. 2003. “The Dynamics of NASPAA Accreditation: A Challenge for Organizational Expansion?” Proceedings of the 2003 Annual Conference of the National Association of Schools of Public Affairs and Administration, Oct. 16-18.Gelmon, S. B. 2004. “Stakeholder Satisfaction with the Accreditation Process.” The Journal of Health

Administration Education, 21(2):241-265.Leatt, P. 2004. “The Continuous Pursuit of Quality Through Accreditation.” The Journal of Health

Administration Education, 21(2):115-120.



Leatt, P., et al. 2004. “The Final Report of the Blue Ribbon Task Force on Accreditation.” The Journal of Health Administration Education, 21(2):121-166.

Loebs, S. F. 2001. “The Continuing Evolution of Health Management Education.” The Journal of Health Administration Education. Special Issue:33-50.

Marshall, B. S. and Hewitt, A. M. 2004. “Profiling NASPAA Programs with Healthcare Concentrations.” Proceedings of the 2003 Annual Conference of the National Association of Schools of Public Affairs and Administration, Oct. 16-18.Statistical Package for the Social Sciences (SPSS). 2005. Version 13.5, “The Binary Logistic Regression,

the Multinomial Logistic Regression Procedure.”Smith, D. G. 2004. “Blue Ribbon Kudos.” The Journal of Health Administration Education, 21(2):179-

184.Sundre, S. M. 2004. “ACEHSA Accreditation Safeguards the Public Interest.” The Journal of Health

Administration Education, 21(2):269-276.

This research is made possible by a grant from the Robert Wood Johnson Foundation. The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation’s largest philanthropic organization devoted exclusively to health and healthcare. It concentrates its grantmaking in four goal areas: to ensure that all Americans have access to quality healthcare at a reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social, and economic harm caused by the abuse of tobacco, alcohol, and drugs.

Brenda Stevenson Marshall is an associate professor and director of the MBA in healthcare administration and the master of public health programs at Cleveland State University. She holds B.A., M.A. (economics), and Ph.D. degrees from the University of Michigan, Ann Arbor, and an MPH from the University of Califor-nia, Berkeley. Her teaching, research, and service activities focus on improving accessibility to health services for vulnerable populations and developing more precise competency measurements for health management education.

Carl F. Ameringer is an associate professor in the master of public administra-tion program in the department of public affairs at the University of Wisconsin, Oshkosh. His areas of interest include state medical boards, organized medicine, and federal antitrust policy, and he is a former Maryland assistant attorney gen-eral. Ameringer holds a J.D. from the University of Virginia School of Law and a Ph.D. from The Johns Hopkins University.


Benchmark Health Policy Programs: A Window on Public Affairs

and Administration Education

Judith J. Kirchhoff, Ph.D. Long Island University

Thomas H. Dennison, Ph.D.

Syracuse University

AbstractHealth policy education in public affairs and administration programs is a

timely subject because of fundamental changes in health services financing, organization, and delivery and the associated policy implications. In this study, an examination of health policy core curricula in MPP, MPA, and health-specific degrees provides a hint of what health policy graduates from public affairs and administration programs offer to health industry employers. Examination of benchmark programs suggests that emphasis varies by degree type, with MPP degrees preparing economics-based, quantitative policy analysts and the other degrees providing broader-based generalist foundations.

Examining health administration and policy programs within public affairs and administration programs is timely in the wake of over two decades of fundamen-tal changes in health and medical care policy, financing, organization, and service delivery. The shift from an era when physicians provided outpatient care in inde-pendent practices, hospitals were primarily organized to deliver inpatient medical care, and insurers paid the bills is largely complete. Today, healthcare takes place in an increasingly technology-based system and is delivered in a wide variety of settings, ranging from complex organizations such as vertically integrated health systems made up of physician practices, ambulatory surgery centers, diagnostic

JPAE 12(2):177-196


Benchmark Health Policy Programs

and treatment centers, and hospitals to home care agencies providing combina-tions of high technology and assistance with the activities of daily living in the home. These new organizational arrangements require different management competencies and a much stronger focus on the external environment and public policy. Leaders in today’s healthcare system must balance the technical man-agement of the point of delivery with a shifting policy framework and reduced resources.

Market competition, altered economic incentives, concerns over quality, strengthened patient rights, increased consumer demands, and growing com-plaints that the system is broken have exponentially increased the complexity of the healthcare environment and have generated a need for new policy thinking and leadership.

When profound changes occur in one part of a system, the rest of the system reacts. Such is the case for those of us who educate healthcare professionals, policy analysts, and managers. We question whether our courses, programs, and institu-tions are responsive to changes that affect teaching and learning processes. Fun-damental changes inevitably affect teaching and learning processes and therefore education programs are likely to change. At the individual program level, we may be able to articulate what we do, but what can employers expect from public affairs and administration graduates? What do our public affairs and administra-tion graduate health specializations offer health sector employers? To answer this question, it is necessary to understand how program specialization content builds on core curricula. It is also important to put the skills and competencies acquired through a public affairs and administration program into the context of the skills necessary to manage and lead in today’s healthcare systems.

The research reported here, which addresses the specialization content ques-tion, began as a study focusing on healthcare management education within NASPAA-member public affairs and administration programs; the intent of that study was to profile programs in order to be able to articulate to employers the competencies —knowledge, skills, and values (Lucia and Lepsinger, 1999)——that they can expect students to acquire. In the process of collecting data on health sector programs, it became apparent that health policy programs needed to be profiled separately. Thus, in this article, we identify the key characteristics of health policy programs.

To provide a context for the exploration of health policy programs, we begin with a brief discussion of public policy and public administration programs drawn from the literature. Then we narrow the focus to health policy programs from the Marshall and Hewitt sample (2006), examining the curriculum in a subsample of health policy programs to identify the competencies they address. Finally, we reflect on the results of this examination in the context of answering the question posed earlier: “What do health policy specialization graduates offer to prospective healthcare sector employers?”



Public Policy and Public Administration Education FrameworkBefore describing health policy programs, it is helpful to understand the dif-

fering roles of public policy and public administration education. It is especially helpful because current expectations of career trajectories include movement in and out of the public, private, and nonprofit sectors and from one position to another and one industry to another (Light, 1997). An implication of a com-petency approach to career building is that knowledge, skills, and values are transferable to multiple settings. Indeed, Light (1997), in chronicling “the new public service” from the perspectives of public policy and administration gradu-ates, concludes that the single-sector career is a thing of the past. Based on career movements of five cohorts from 1973 to 1993, Light (1997, 14) shows that the new public service is characterized by movement across sectors. This is particu-larly significant for the healthcare industry—a private sector industry immersed in a public regulatory environment—and for health policy graduates, whom Light finds moving from policy to administrative positions, and sometimes back again, during their careers.

Describing the core methods of policy analysis, Light notes that the 20 top-rated public affairs schools (based on annual U.S. News rankings) focus heavily on microeconomics and quantitative methods such as central tools, devoting more than half of their core curricula to these subjects (1997, 43, 113); public admin-istration programs, he reports, tend to place less emphasis on quantitative meth-ods. Additionally, just 1.5 courses of all core courses in the top schools (1997, 113) address the soft skills—leadership and management (1997, 108)—that respondents in Light’s study identify as most important to their career mobility. Other skills that public administration respondents identify as more important than policy analysis are conflict management, an understanding of information and communications technology, and the ability to influence policymakers (1997, 110). According to Light (1997, 114), the emphases of core public policy and ad-ministration curricula are 1) microeconomics and quantitative methods, equally; 2) organization theory and public management; 3) public budgeting and finance; 4) policy process; 5) ethics; 6) general introduction; 7) leadership.

Echoing these perceptions in a study of 35 chief executive officers of multi-unit healthcare systems and alliances in 19 states, Prybil (2003) identifies what chief executive officers see as their own challenges and what qualities they seek in employees. Prybil identifies competencies at two points in a career trajectory. The challenges facing top managers, in rank order, are sustaining viability under conditions of resource needs and constrained reimbursements (strategy, regulatory knowledge, financial management); workforce crises (human resources manage-ment); patient safety, good clinical outcomes, and improved health status (quality care and outcomes performance); technical and cultural obstacles in redesigning systems (information literacy) and processes (diversity, interpersonal relation-ships); and maintaining access to capital (strategy and financial management).



These are the operational management challenges of essentially private sector organizations that are inextricably linked to public sector policy environments. Thus, one can see how an individual beginning a career in policy analysis eventu-ally can move to operations management, especially if the person following that trajectory has latent leadership and management skills or acquires those skills along the way. This is one example of the mobility thesis that Light articulates. The question for educators is, “What education, if any, can provide the necessary foundations for such a trajectory?”

What the CEOs in Prybil’s (2003) study look for in new hires, in rank order, are willingness and capability to work with others (teamwork, interpersonal skills, enthusiasm for building relationships); dedication to the mission of improving healthcare and the health status of patients, families, and communi-ties (quality care and performance); innovativeness, curiosity, and search and find capability (detective work, ability to make connections); analytical capacity and problem-solving skills (analysis); and honesty, integrity, and high ethical standards (ethics). These characteristics are quite different from what the CEOs express as the challenges facing them, yet it is clear that they rank people skills as more important than individual technical skills. The reasons for these rankings are not discernible from the study.

What the CEOs prefer resonates in a study of Harvard public policy students, who perceive that, to some degree, an emphasis on analytical skills comes at the expense of learning people skills, at least in the Harvard program. They report concern about barriers to analysis and implementation, especially in persuading others to embrace the rationally best alternative (Chetkovich, 2003). If the CEOs studied and the Harvard public policy program are representative, it could be argued that policy graduates are better prepared in analysis than in negotiation and persuasion and are less desirable to healthcare employers as a result.

One might ask what MPA core curriculum has to do with the accreditation of health policy specializations. The answer is that the core curriculum is both the framework for and the foundation of specializations. It is impossible to know what the specialization is providing without knowing what the core curriculum provides. For example, the analysis that follows will show that MPP and MPA programs’ core curricula provide different frameworks and foundations for the health policy specialization; graduates of the two types of programs will view health policy issues through different lenses. That difference would not be dis-cernible without an analysis of the core curriculum.

The literature presented is representative of issues and studies relevant to the exploration of public policy and administration education programs; it is not exhaustive. Its purpose is to provide a helpful context and reference points for interpretation.



Health Policy Programs Sample and MethodologyAs noted earlier, this review of health policy programs or specializations is

derived from the Marshall and Hewitt (2006) examination of health sector educa-tion within public administration programs. It is notable that identifying health policy programs is not straightforward. Such programs can be freestanding (mas-ter of health policy or master of health policy and management), a specialization in a freestanding public policy program or in a public or health administration program, or a nondegree certificate in a public administration program. Clearly, degree title alone cannot be used to identify health policy programs or compo-nents. On the other hand, public affairs and administration programs may have health specializations that are not health policy specializations. Such programs are not the focus of this analysis. It should be noted that health policy may also be a component of non-public administration curricula—for example, in manage-ment, social work, medicine, nursing, or law. This study is limited to programs in the Marshall and Hewitt sample. Others are beyond the scope of this paper.

In the Marshall and Hewitt (2004) study, 76 of the 255 NASPAA members report healthcare components in 16 different university schools, departments, and programs. Twelve different degrees are cited, as well as 15 joint degree pro-grams. Health policy components were not one of the identifiers in the sample, so we consulted additional sources; specifically, the 1997-99 NASPAA Directory of Programs (Donovan, 1997), a 2003 NASPAA-APPAM Web-based survey (Toma, 2003), and the 2004 U.S. News rankings of public administration and policy analysis programs (U.S. News, June 28, 2004). However, as noted above, none of these sources yields the universe of health policy programs. The 1997 NASPAA Directory represents all NASPAA members as of the publication date (209). The NASPAA-APPAM survey was sent to 258 members of those organizations in late 2003; 158 responded. The U.S. News rankings use 253 NASPAA and APPAM member programs as a sample.

In the 1997 NASPAA Directory, 47 members report having both public policy analysis and health policy and management, and 23 report health policy and management only for a total of 70 possible health policy programs. The NAS-PAA-APPAM survey identifies 46 programs with both public policy analysis and health policy and management and 24 with health policy and management only. Respondent schools in the 1997 and 2003 surveys are not exactly the same, so additions and subtractions of health policy programs have occurred, but the changes are very small (fewer than five programs). Of the roughly 70 possible health policy and management programs in the NASPAA and NASPAA-APPAM studies, U.S. News ranks 19 as top schools. Of these, 11 are in the Marshall and Hewitt sample. We use these 11 to profile health policy program characteristics. We refer to them as benchmark programs based on their U.S. News ranking. To understand how the benchmarks behave is surely helpful to other programs, although our intent herein is descriptive, not judgmental.



The data we used to develop profiles came from two sources, the data set col-lected by Marshall and Hewitt, and curriculum and course descriptions from university Web pages. Our assumption was that Web pages provide the official program definition, even though the actual program may differ based on stu-dent course selection and program-authorized exceptions. Marshall and Hewitt prepared specific data analyses of the 11 benchmark programs, and we conducted content analysis of curriculum and course descriptions.

The curriculum evaluation consists of categorizing required courses (core) and specialization or elective courses as Analytical (A), Institutional (I), or Manage-rial (M) based on the course title and description. Designation of a course as A, I, or M involved a judgment call, because categorization is a matter of more or less. The authors accept full responsibility for miscalls, as well as for the analysis as a whole. It should be noted that categorizing some courses as analytical does not intend to imply that other courses are not analytical. The general approach to knowledge in graduate programs is analytical. In this case, analytical generally designates a quantitative approach.

Generally, then, courses are categorized as analytical if their titles and de-scriptions denote them as microeconomics, quantitative, or computational, or if microeconomics or computational courses are prerequisites. Categorization as analytical was straightforward for many courses but required judgment for oth-ers. For example, information technology and communications courses sometimes were analytical, sometimes not. Exit requirement capstone courses or project courses were categorized as analytical, but internships focused on career practice were not.

Institutional refers to courses addressing environments of public administra-tion and health policy—that is, theoretical and conceptual courses that provide knowledge of contexts. Courses such as Health Policy and Public Administra-tion are institutional, as is a course titled Social and Ethical Issues in Health. A course such as Public Finance may be categorized as institutional or as analytical, depending upon its description and prerequisites. Management courses refer to those focused on the practice of management—for example, a broad-based course such as Public Management or a functional course such as Human Resources Management. A course called Financial Management and Budgeting would be categorized as Management even if it also covered the macroeconomic context of public finance.

The point is that course content is not solely analytical, institutional, or management focused, and the categorization decisions reflect this. Public affairs health policy students learn about analysis, institutions, and management, be-cause, as previous analyses show, public affairs programs are designed to cover all these elements. This is the reason that category designations are not absolutes. A course that is designated Institutional will have elements of analysis and manage-ment, but its emphasis will be on institutions.



One limitation of the categorization process is that all students do not take all courses. Sometimes students may choose, even in the core curriculum. For example, in one program’s core curriculum, a student could select either Health Economics or Health Services Delivery and Law. The former course is categorized as A, while the latter is an I course. In such cases, it is not possible to predict how many students take each course; hence it is impossible to judge whether the program is always analytical in its outcome. In addition, it is not always clear from the data how students select among core courses. For example, one Web site lists more courses than credit hours allotted for core courses, but does not provide information about how many credit hours each course earns or whether students self-select the required number. This limitation is especially noticeable in health policy and management programs, in which health policy students may have a very different curriculum from that of health management students. It is espe-cially important in these cases to use the core curriculum required of all students to determine how students are prepared.

In the exercise reported herein, all courses available to students are categorized. For example, some programs require a heavy dose of analytical courses in the core curriculum but offer a wide variety of options in specialization courses. Some programs specify both core courses and specialization courses in a narrow range, offering very few options, either in types of courses or in available topics. Still others provide a blend of different types of courses in both the core and special-ization or elective courses. A summary judgment of each program is not possible, therefore, because the core curriculum may emphasize one type of courses and the specialization another. Thus, the program judgment is made on both elements. It should be noted that the approach used herein goes beyond earlier studies, which focused on core curriculum alone.

Profile of Benchmark Health Policy ProgramsThe profile is constructed in three parts. First, the 11 programs used in the

profile are defined and summarized using Marshall-Hewitt data analyses. Second, the 11 programs are compared on core curriculum and the health policy special-ization. Third, benchmark program courses are compared using the categories to determine whether or not a general profile of all health policy programs can be developed.

Programs in the Profile. Shown in Table 1 are the 19 top public affairs programs as ranked by U.S. News (June 28, 2004). Eleven of these (marked with an asterisk) are in the Marshall-Hewitt sample and are used to profile health policy programs in public administration. Because they are the top-ranked programs, we define them as benchmark programs. For these 11 programs, the table shows the degree that is relevant to this discussion, the program’s NASPAA status (member or ac-credited member). An asterisk indicates programs that hold other accreditations for the program under discussion.



As Table 1 shows, in this sample, health policy is a component of master of public policy degrees (seven schools), master of public administration degrees (two schools), master of healthcare administration (one school), or master of science in healthcare policy and management (one school). This variety among benchmark programs suggests that developing an exhaustive directory of health policy programs would be difficult. Such programs are hidden in many places.

It is notable that, among the 19 top-ranked schools, only the University of California-Berkeley is not a member of NASPAA. Among the 11 programs in the profile sample, three—New York University, the University of Southern Califor-nia, and Indiana University-Purdue University-Indianapolis, shown with **—have dual accreditations for the same health policy program. Some schools have

School Relevant NASPAA OtherAccreditor Degree Status

NYU* MPA A** ACEHSA

Harvard* MPP M

JohnsHopkins* MPP M* ACEHSA

UMichigan-AnnArbor M

UC-Berkeley

GWU-DC* MPP A* CEPH

CarnegieMellon* M.SHCPM A

USC* MPP A** ACEHSA

Duke* MPP M ACEHSA

Syracuse* MPA A

UNCChapelHill A

Georgetown* MPP M

IUPUI* MHCA A** ACEHSA,CEPH,AACSB

Brandeis M

Princeton M

UCLA* MPP M CEPH

UAlabama-Birmingham A

UMinnesota/TwinCities M

UniversityofChicago M

Note:ForNASPAAstatus,M=member;A=accreditedmember

Table1.SchoolsintheProfile



multiple health policy programs, each in a school with different accreditations. Three schools have health policy programs linked to, or otherwise a part of, other campus programs holding either ACEHSA or CEPH accreditation. Other NAS-PAA schools shown in Table 1 are not in the Marshall-Hewitt study sample and therefore are not analyzed here.

Marshall-Hewitt Data Description. The Marshall-Hewitt data affirm and add to the information drawn from program Web sites. For example, the program we considered at IUPUI is NASPAA and CAHME accredited, but IUPUI also offers degrees that hold CEPH and AACSB accreditation in addition to, or instead of, NASPAA accreditation. It also is the case that, for some reason, the Marshall-Hewitt survey results show four MPP programs, whereas the Web search identi-fies seven programs, all of which are in the Marshall-Hewitt sample.

The Marshall-Hewitt data show the 11 profiled programs to have an average of 20 credits in the core curriculum. Assuming three-credit courses, this indicates 6.75 courses in the core curriculum, remarkably close to the seven courses identi-fied by earlier studies for MPA degrees overall. If this sample is representative, health policy program core curricula are typical of other core curricula in public administration as found Breaux, Clynch, and Morris (2003). Since we count all courses offered in the core regardless of whether all students are required to take all courses (in some cases students may select from two options), we do not aver-age Web site data in the same way.

In terms of geographic location, the profiled health policy programs are pri-marily located in the eastern United States, with four programs in the northeast and four in the southeast regions, as Marshall-Hewitt (2004) define those regions. The northeast health policy programs are in Massachusetts (1), New York (2), and Pennsylvania (1). In the southeast, health policy programs are located in Wash-ington, D.C. (1), Maryland (1), and North Carolina (1). The other programs are in the Midwest (1 program in Indiana), and the West (California, 2 programs). All of the schools with health policy degrees are comprehensive; they have a wide variety of degrees and programs in addition to the health policy specialization or program. All report offering other programs with healthcare concentrations as well as joint and dual degree programs that incorporate a healthcare focus, but not health policy.

Health policy program responses to a few questions in the Marshall-Hewitt survey are relevant to this analysis. For example, 54.5 percent reported that they sequence courses for the healthcare concentration, and the rest did not answer. Seven (63.6 percent) of these programs answered yes, and four did not respond to a question about courses that make the program unique. The survey did not ask what courses are unique. Three programs indicated that they planned to revise concentration courses in the near future, four responded “don’t know,” and the rest did not respond. All except two programs required projects or experiential learning in the program, mostly projects, internships, or a practicum, with some



programs requiring two or more of these options. One school did not respond on this item.

Among the 11 profiled programs, four (36.4 percent) said they would support an additional NASPAA accreditation for healthcare specializations, two (18.2 percent) said they would not, and five (45.5 percent) did not respond. Again, 36.5 percent (four responses) favored joint accreditation with another accredit-ing agency, 18.2 percent (2) did not favor joint accreditation, one (9.4 percent) needed more information, and four (36.4 percent) did not respond.

From these responses to program content, it is clear that the profiled programs sequenced courses for healthcare concentrations, believed they have courses that made their programs unique, and required internships or other forms of experien-tial learning. There is no indication that programs were contemplating changes to the healthcare concentration at the time of the survey, nor was there strong support for specialized NASPAA accreditation or joint accreditation at the time.

Curriculum Comparison. The curriculum comparison of the 11 schools included core curriculum and health policy specialization courses. The results are shown in Table 2, wherein courses are reported in the already defined categories as analyti-cal (A), institutional (I), or management (M). The numbers of each type of course are shown, as are our judgments about program type (A, I, M, or B, for balanced) based on number of courses. There are few management courses in policy cur-ricula, so the balance is between A and I courses, with the caveat that either an A or I focus may include a healthy amount of management. Relevant points about specific programs are made in the narrative. Program lengths are measured in several ways by host schools, making it difficult to use credit hours or number of courses taken for the degree as a comparison variable. Also, the number of courses in the core is not necessarily the number taken by every student, because students may choose from among several courses, and their choices affect their outcomes.

Among these 11 programs are seven master of public policy degrees, one master of public affairs degree, one master of public administration degree, one master of science in healthcare policy and management, and one master of health administration degree. Health policy resides in a variety of degree programs. As the core curriculum columns show, program requirements fall heavily into the analytical category, ranging from five to nine courses, with an average of 6.1 courses. Other core courses emphasize the institutional perspective or manage-ment, more frequently institutional, which ranges from one to four courses, with an average of 1.8. The most management courses in a core curriculum is three (IUPUI), and the average is .72. There also is a health policy core in three pro-grams, NYU’s MPA, Duke’s MPP, and IUPUI’s MHCA.

The arrangement of courses for the degree varies. At New York University (NYU), for example, students take seven core courses, five analytical, one insti-tutional, and one in management. Two analytical capstones are taken at the end of the program. An example of an NYU analytical course is “Microeconomics for



School Degree Core HealthPolicy Type Curriculum Core,Specialization A I M A I M Core Spec.

NYU MPA 5 1 1 2 2 A B

Harvard MPP 7 2 2 5 2 A I

JohnsHopkins MPP 9 4 2 13 A I

GWU-DC MPP 8 1 6 4 A A

CarnegieMellon M.S.HCPM 5 2 3 2 A A

USC MPP 6 2 1 1 1 4 A M

Duke MPP 8 2 2 6,1 6,1 4 A,A M

Syracuse MPA 5 3 1 2 3 2 A B

Georgetown MPP 7 2 1 6 4 A A

IUPUI HCA 8,8 2,5 3,0 A,A A

UCLA MPP 8 1 2 2 4 A I

Average* 6.1 1.8 .72

*AverageincludesIUPUIHealthPolicycore.

Public Management, Planning and Policy Analysis,” and the core management course is “Management of Public Service Organizations.” In health policy, there are three required health policy core courses, two analytical and one institutional, along with an elective chosen from among nine available courses, most of them institutional. NYU’s policy core is analytical, but its health policy core is bal-anced.

Harvard’s master of public policy degree is hosted by the Kennedy School of Government. Its core curriculum is analytical, with seven of nine core courses in that category. The health policy component consists of two analytical, five institutional, and two management courses. Thus, the Harvard core curriculum is analytical, while the specialization is institutional.

Johns Hopkins’ MPP degree consists of nine analytical and four institutional courses complemented by five health policy courses selected from 15 available in the School of Public Health, two of which meet the definition of analytical

Table2.ComparisonofCoreandHealthPolicyCurricula



used herein. We rate Johns Hopkins as analytical for the core curriculum and institutional for the specialization. Johns Hopkins is interesting in that it offers three health policy degrees, one in its Institute for Policy Studies in collabora-tion with the School of Public Health (described here), and two additional ones in the School of Public Health, an M.S. in Health Policy and Management and an MPH in Health Policy and Financing, neither of which is in the Marshall-Hewitt sample. Rating these using the methodology described reveals that the M.S. degree’s core is institutional and its health policy component is balanced. This degree is designed for mid-careerists. The MPH degree’s core is analytical and its health policy and financing components are in the management category. If the Johns Hopkins offerings are typical of the variety of health policy degrees across the country, there clearly is diversity in the discipline.

The George Washington University (GWU) program features eight analytical of nine courses in the core and six analytical of 10 specialization courses available. Of the nine courses, students take six required general public policy analytical courses and the one institutional course, “Politics and Public Policy.” One addi-tional required course offers a choice among three courses, all of them analytical. The health policy specialization is the student’s selection of three health policy courses among six analytical and four institutional options. Thus, the GWU pro-gram is rated analytical in both its core and specialization.

The Carnegie Mellon program has analytical core requirements both generally and in the health policy option as well. There are five analytical courses in the core curriculum of seven courses, and three analytical electives among the five specialization courses available; thus, Carnegie Mellon also is analytical in both segments. The University of Southern California (USC) MPP program has a com-mon degree core consisting of six analytical courses, two institutional courses, and one management course. The management course is selected from seven management courses offered, two of which are analytical. The health policy spe-cialization is three elective courses from among six offered. Four of the six avail-able courses are management courses and one is institutional. USC also encourag-es students to customize specializations using courses available anywhere within the university, so there are additional ways to specialize in health policy beyond those described here. Based on the data used here, the USC program would be described as having an analytical core and a management-focused health policy specialization; its program has NASPAA and CAHME accreditation.

Duke University also has a general policy core in its MPP program. Eight of 12 courses in the core curriculum are analytical, two are institutional, and two are management. Health policy students may specialize by taking health policy elective courses available in the MPP program or by completing a health policy certificate in the Center of Health Policy, Law and Management. The MPP pro-gram offers a wide variety of health sector electives, so students can select analyti-cal courses, institutional courses, and management courses as they wish. In the



health policy certificate, three undergraduate analytical courses are prerequisites. There also are two required health policy core courses selected from 12 available, of which six are analytical and six institutional. Additional electives (three) for the certificate are selected from a list containing one analytical, one institutional, and 4 management courses. Based on these requirements, we evaluate Duke as analytical in its general MPP core, analytical in its health policy core (because of the three analytical prerequisites), and focused on management in its health certificate specialization. It should be noted that students may also specialize in health sector management in the MBA Program at Duke.

Syracuse University’s Maxwell School offers an MPA degree with an advanced certificate in Health Service Management and Policy (HSMP) in a collaborative situation with social work, medicine, nursing, law, management, and public policy. Students complete a general MPA core consisting of four (of five avail-able) analytical courses, three institutional courses, and one management course. The Advanced HSMP Certificate consists of two institutional required health sector courses and at least two electives selected from those offered by partici-pating campus partners. In the Maxwell School, seven health sector courses are available for the specialization; two are analytic, three are institutional, two are management. Students also complete a capstone course with the HSMP advisor. The Syracuse MPA program with HSMP certificate has an analytical core and a balanced specialization.

Georgetown University’s MPP degree has a core of 10 courses, seven of which are analytical; two, institutional; and one, management. To specialize in health policy, students select from six analytical and four institutional courses. Thus, Georgetown has an analytical core and an analytical health policy specialization. Similarly, the UCLA MPP has a core consisting of eight analytical core courses, one institutional course and two management courses. Its health policy special-ization consists of two analytical and four institutional health policy courses. UCLA’s core curriculum, then, is analytical, and its specialization is institutional.

IUPUI is the only Master of Health Care Administration (MHCA) program in this sample offering health policy. This program is accredited by NASPAA and CAHME. Because it is a health policy program embedded in a health adminis-tration degree, its core and specialization both are health sector specific and it is therefore reported in the health sector columns of the table. Course examples include U.S. Health Care Systems, Political and Ethical Challenges (institutional) and Management of Health Care Accounting Information for Decision Mak-ing (analytical). The health sector core consists of eight analytical courses, two institutional courses, and three management courses for a total of 13 options. It is not clear how many core courses students take or how they select among those offered. The specialization is more straightforward. It is a choice of four of 13 courses available, eight of which are analytical and five of which are institutional. IUPUI’s core curriculum and specialization are analytical.



If this sample is representative of health policy programs in public administra-tion, clearly such programs have core curricula that focus heavily on analysis. Policy programs are policy analysis programs. The analytical perspective is less pronounced in the health policy specialization. Harvard, Johns Hopkins, and UCLA complement their analytical cores with institutional courses. Syracuse balances its analytical core curriculum with either institutional or management specialization courses.

On average, in benchmark programs, the public policy core curriculum has 6.1 analytical, 1.8 institutional, and .72 management courses available. As we noted earlier, however, it is not necessarily the case that students take exactly that complement of courses, because sometimes students choose from among offered courses. Nonetheless, since the numbers of analytical courses are large compared to institutional and management core courses, it can be said that students from these benchmark programs are analytical in their approach to health policy.

Core Curriculum by Degree Type. Given the heavy focus on analysis in health policy programs, it makes sense to take a closer look at the analytical component. This analysis is shown in Table 3, which is organized by type of degree and types of courses within the core curriculum rather than by school.

As the table shows, MPP degree programs in this sample have an average of 2.0 institutional and .85 management courses in their core curriculum. The emphasis clearly is on analytical courses, with an average of 7.57. Within the analytical category, there are, on average, 2.4 economics courses, 2.85 quanti-tative courses, and 2.3 arguably nonquantitative analytical courses. The MPA programs and the Other programs (Master of Health Care Administration and Master of Health Care Policy and Management) show a different pattern. These programs have a strong analytical focus (5.0 courses on average for MPA and 6.5 for other programs). The MPA has about the same focus on institutional courses (2.0) and a greater emphasis on management courses (2.5 as compared to .85 for the MPP courses). The other programs lie between the MPA and the MPP

MPP(7) MPA(2) Other(2)

TypeofCourse N Avg. N Avg. N Avg.

Institutional 14 2.0 4 2.0 2 1.0

Management 6 .85 5 2.5 5 2.5

Analytical 53 7.57 10 5.0 13 6.5

Economics 17 2.4 3 1.5 3 1.5

Quantitative 20 2.85 2 1.0 3 1.5

Non-Quantitative 16 2.3 5 2.5 7 3.5

Table3.SummaryDegreeComparisonofHealthPolicyProgramCoreCurricula



in terms of analytical courses (6.5 compared with 5.0 and 7.57 respectively), are equivalent to MPA programs with respect to management courses (2.5), and have fewer institutional courses than either the MPP or MPA. Taking a closer look at the analytical breakdowns, analytical courses that are arguably nonquantitative are about equal between MPP and MPA programs (2.3 and 2.5 respectively), and higher for the Other category. The MPA and Other programs are similar to one another in number of economics and quantitative courses; both are lower than MPP programs in this regard.

Core Course ContentNumbers mask content if we fail to go back to course content to provide an

understanding of what students are likely to learn in different program types. Course titles cannot provide an in-depth understanding; they offer a sense of what transpires in the classrooms of these programs, and give those interested guidance in learning more in that they can lead us to basic textbooks and syllabi that some programs make available on the Internet. In describing core course content, we categorize MPP degree program course content and note where MPA and Other degree programs differ from the MPP.

As noted in Table 3, MPP and MPA degrees have the same emphasis on Insti-tutional courses (2.0), while the Other category has less (1.0). Not surprisingly, institutional courses in the MPP degree programs are focused on public policy processes, sometimes broadly (American Policy Institutions), sometimes more focused (Politics of the Policy Process). The policy process focus is contained in all MPP degree program core curricula. Ethics and Citizenship courses are also prominent in MPP core curricula, occurring about half as often as (and in addi-tion to) policy courses. In MPA health policy programs, institutional courses also are focused generally on the policy process or on a specific aspect of that process (e.g., Executive Leadership and Policy Politics). In the Other category, institu-tional courses are industry focused (U.S. Health Care System or Health Delivery Systems).

With respect to management courses, which are more prominent among MPA and Other programs (2.5) as compared to MPP programs (.85), the general focus is on management, for example, Management of Public Service Organizations, and on specific aspects thereof, such as, Management of Individual and Group Behavior. In MPP degree core curricula, management courses are general, with titles such as Public Management, or Leadership and Management.

Regarding the Analytical category, a key difference between the MPP and the other two categories is in the emphasis on economics and quantitative work. In MPP degrees, most programs require both micro- and macro-economics, along with the application of economics to public policy issues (e.g., Markets and Market Failures, Economic Analysis of Public Policies). Some programs pro-vide courses in political economy and applications thereof as well (e.g., Political



Economy of Policy Adoption and Implementation). MPA programs in the sample generally focus on micro- or macro-economics and financial management, with courses like Financial Management, or Managerial Economics. Other programs require general economics and/or applied economic analysis as well as health industry economics courses such as Health Economics.

The MPP degree often requires multiple quantitative methods and statistics courses. Two programs include a course combining quantitative and qualita-tive methods, and one has a program evaluation course that by its description is clearly quantitative. Other program evaluation courses fall into the arguably nonquantitative analytical category because course descriptions are not clear. Other programs provide blended courses such as Quantitative Methods of Policy Analysis or Statistics and Data Analysis for Policymakers, but these are in addi-tion to basic quantitative methods courses. MPA programs require basic statisti-cal methods courses, and the quantitative courses in Other category programs are focused on the health industry; for example, Financial Management in Health Care and Statistical Methods for Health Services.

In the MPP degrees, the arguably nonquantitative Analytical courses are Policy Analysis and a variety of exit requirements including capstones, practica, intern-ships, theses, or projects. One MPP program has a nonquantitative program evaluation course among its required core. Other MPP examples of arguably nonquantitative courses are Strategic Management and Public Organization, and Policy Process Institution Tools. In MPA programs, the nonquantitative analyti-cal courses include public policy analysis, financial analysis, and exit courses such as capstones, internships, or strategy. The Other category has a similar selection but also includes information systems courses.

From this additional review of core course content, clear patterns emerge from the three health policy degree categories evaluated, the MPP degree, the MPA degree, and the two Other degrees, both industry focused. The MPP degree is clearly focused on economics and quantitative methods of analysis, with applica-tions to public policy issues. MPP degrees have two to three times the quantita-tive course requirements of the other programs in the sample. Thus, technical skills of analysis are very strong in these degrees. The institutional focus is on public policy process. Policy implementation and evaluation are not emphasized, nor is management. The MPA degree and the Other degree core curricula in the sample are broad based, covering both policy and policy implementation, with a fair amount of focus on organization and management issues, especially financial management, and including budgeting. Economics and quantitative analysis are in the core curriculum, but with less emphasis. A major difference between the MPA and the Other degrees is that the Other degrees focus solely on the health-care industry in the core curriculum. Only the Other category includes informa-tion systems courses in the core curriculum.



Admittedly, this is a very small sample overall, and an even smaller representa-tion of MPA and Other degrees. Additionally, it is not possible from this analysis to know how many students take the quantitative courses in the MPP degree, because students have a fair number of choices and we don’t know how many stu-dents take the courses available. Nonetheless, the MPP degree core curriculum is sufficiently economics- and analysis-focused to say that it would not be possible for students to get through these programs without strong technical skills of these types. Overall, we must take these results as a hint rather than as a defini-tive statement.

Conclusions and DiscussionWe began this inquiry by asking, “What do health policy graduates of MPP,

MPA, and other NASPAA member schools offer to prospective employers?” Answering the question consists of reviewing a sampling of literature about the nature of health policy programs in public affairs and administration, identifying benchmark health policy programs from U.S. News rankings, and using con-tent analysis of courses in those programs and other information available from the Marshall-Hewitt study and school Web sites to describe the programs and explore their curricula using all courses offered in the core and in the specializa-tion. From the reported findings, the preliminary answer to the question is, “It depends.”

Descriptively, we find benchmark programs offer health policy most frequently in the MPP degree, but health policy also is offered in MPA degrees and other degrees, specifically healthcare industry-focused degrees. The 11 benchmark programs in this analysis are located mostly in the northeast and southeast. These programs have about seven courses in their required core curriculum, and the distribution of content differs by type of program.

The MPP degree strongly emphasizes economics and the quantitative analysis of public policies. The MPA degree core curriculum is broad based, covering policy institutions, management, and analysis, with less emphasis on the techni-cal skills of economic and quantitative methods, and more on policy implementa-tion and organization management. The other programs are similar to the MPA degrees, but their core curriculum content focuses on the health industry specifi-cally and is signaled by the degree title, which references health.

Among these degrees, then, the employer’s choice is between technical spe-cialists and what we might call “context generalists” in the case of MPA gradu-ates, or health industry generalists in the case of the other degrees. The general conclusion, if this small sample is representative, is that different health policy graduates have different foundations that are discernible from the degree they hold. So, if an employer wants a health policy technical analyst, the MPP degree perhaps offers the best foundation. If an employer wants someone with a broader perspective, the MPA degree may offer the preferred foundation. And, if an em-



ployer seeks someone focused exclusively on the health industry, then healthcare administration graduates fit the bill.

In the context of other studies of public administration and affairs programs, this evaluation affirms some parts of previous studies, but not others. Light (1997), for example, found public policy program core curriculum to be equally focused on microeconomics and quantitative methods, with other courses on organization theory, public management, public budgeting and finance, policy processes, and ethics. This study of health policy programs finds greater differen-tiation among core curricula by type of degree. The MPP degrees are consistent with Light’s findings, but MPA degrees and other degrees, where health policy is a specialization, do not reinforce Light’s public policy program findings.

If health sector employers are like Prybil’s sample of CEOs, early health in-dustry careerists need to be inspired by teamwork, interpersonal skills, curiosity and innovativeness. Within the scope of the programs in the sample studied, if these characteristics derive from the MPA and other degree programs that provide management and institutional contexts, perhaps these graduates are more prepared for entry-level positions. MPP health policy graduates’ skills in the quantitative economics analyses of public policies may give them an edge in the strategic thinking and resource analysis strengths that they will need if they find themselves in the executive suite. Or it may be unrealistic to think that any degree can prepare graduates for any and all opportunities. Perhaps it is better to talk about foundations that will need to be supplemented and complemented by experience and additional learning.

In the context of Light’s mobility thesis, the preliminary findings herein also raise questions about the capacity to move from a health policy analyst role to a management role, and from the public sector to the nonprofit and private sectors, and back again. Which graduates are more likely to seek mobility? Do different foundations developed in health policy programs affect confidence about adapt-ing to varied settings differently? Is career mobility strengthened by preparation in analytics in MPP programs or institutional and organizational settings of the MPA and other programs? Answers to these questions go beyond this analysis, but the recognition of differences helps to shape the questions.

How do graduates from these programs compare to health policy graduates from other professional programs (MBA, MSW, or JD)? What are the similarities and differences, and how do employers evaluate graduates from these various set-tings? Which graduates are more likely to ascend to the executive suites of health industry organizations? Study of career trajectories and perceptions of graduates and employers would help to answer these questions.

Finally, it is important to consider two additional aspects of the analysis herein. First, what is the content of the health policy specialization within the various degrees, and how does it complement the core curriculum? Do specializations deepen the foundations or apply the foundations? This requires a similar analysis



of the specialization courses. Second, it is important to determine how represen-tative the benchmarks programs are of the population of health policy programs, both in terms of core curricula and specialization content. If such analysis finds that the patterns of degrees and specializations generally are like those identified herein, then programs will be able to do a much better job of articulating what can be expected of their graduates, making employers more confident in hiring them. Clearly, this examination begins a quest for new knowledge about health policy education in public affairs and administration.

ReferencesBreaux, David A., Edward J. Clynch, and John C. Morris. 2003. “The Core Curriculum Content

of NASPAA-Accredited Programs: Fundamentally Alike or Different?” Journal of Public Affairs Education, 9(4):259-273.

Chetkovich, Carol. 2003. “What’s in a Sector? The Shifting Career Plans of Public Policy Students,” Public Administration Review, 63(6):660-674.

Cleary, Robert E. 1990. “What Do Public Administration Master’s Programs Look Like? Do They Do What is Needed?” Public Administration Review, 50(6):663-673.

Donovan, Craig Poulenez. 1997. The Guide to Graduate Education in Public Affairs and Public Administration. Washington, D.C.: NASPAA.

Hawkesworth, M.E. 1988. Theoretical Issues in Policy Analysis. Albany, NY: SUNY Press.Light, Paul C. 1997. The New Public Service. Washington, D.C., The Brookings Institution Press.Lucia, A. D., and R. Lepsinger. 1999. The Art and Science of Competency Models: Pinpointing Critical Success

Factors in Organizations. San Francisco: Jossey-Bass.Marshall, Brenda Stevenson, and Anne M. Hewitt. 2006. “A National Profile of NASPAA Programs

with Health Specialty Tracks.” Journal of Public Affairs Education, 12(2):143-163.Nathan, Richard P. 2000. Social Science in Government, The Role of Policy Researchers. Albany, NY:

Rockefeller Institute Press.Prybil, Lawrence D. 2003. “Challenges and Opportunities Facing Health Administration Practice and

Education.” Journal of Healthcare Management, 48(4):223.U.S. News. June 19, 2004. “America’s Best Graduate Schools 2005, Public Affairs Specialties: Health

Policy and Management.” Available at www.usnews.com/usnews/edu/grad/rankings/pub/premium/padsp4.php.

Judith J. Kirchhoff is an associate professor of public and health administration and director of the MPA program in the School of Business, Public Administra-tion and Information Sciences at Long Island University-Brooklyn. She has 20 years of experience in public, private, and nonprofit organizations and holds a Ph.D. in government and politics from the University of Maryland at College Park. Kirchhoff’s research on health and social services has been published in Public Productivity and Management Review, the Journal of Health and Human Services Administration, and in a collaborative report on social services policies in 11 na-tions for the Ministry of Social Affairs and Employment in the Netherlands.

Thomas H. Dennison is an advisor in the Health Services Management and Policy Program at the Maxwell School, Syracuse University. He holds a Ph.D. in health planning from Pennsylvania State University. He completed a residency in



hospital administration at St. Anne’s Hospital Corporation, Fall River, Massachu-setts; has been a hospital administrator and executive director of a health systems corporation in New York State; was a consultant to healthcare organizations; and was a director of PriceWaterhouseCoopers, L.L.P., a health consulting practice in home healthcare, community-based services, and long-term care. He holds a New York State nursing home administrator’s license and serves on the boards of health services and advocacy organizations.


Public Affairs and Healthcare Administration:

Crosscutting Competencies and Multiple Accreditation Challenges

for Academic Programs

Karen Harlow-Rosentraub Case Western Reserve University

James L. Perry Indiana University-Purdue University Indianapolis

AbstractThis paper examines four of the major accrediting bodies to identify com-

monalities in core elements for curriculum design and competency development. Some are detailed and specific; others focus on broad knowledge areas. CAHME is considering recommendations that will enhance the possibility for joint accredi-tation visits that streamline an accreditation process. Substantial overlap among the accrediting bodies is identified. Comparative guidelines and benchmarks for gauging their program’s success are viewed positively by a majority of pro-grams that wish to be proactive in designing competency and outcome measures. Smaller programs that do not have the resources to offer separate courses for health and public affairs students will find the crosscutting themes encouraging, because they mean that the same program and resources can satisfy the same basic requirements of multiple accrediting bodies.

The purpose of this paper is to examine four of the major accrediting bodies to identify common, core elements for curriculum design and competency develop-ment. Some of these guidelines are quite detailed and specific, while others focus on broad, general knowledge areas, leaving the details of the specific courses and

JPAE 12(2):197-211


Crosscutting Competencies and Multiple Accreditation Challenges for Academic Programs

skills associated with those areas to the individual programs. These differences in emphases represent difficulties in making comparisons across accrediting bodies, because the “language” is not the same. Nonetheless, a close examination orga-nized by the skill areas proposed by the BRTF can serve as a starting point for understanding potential areas of similarity, overlap, or gaps among the accredit-ing bodies.

A goal of accreditation for any graduate professional program is to assure em-ployers and stakeholders that graduates have been exposed to and mastered the skills required at the entry level of a professional position in that field. The pro-cess varies by accrediting agency, but all involve in-depth self-study components that include community stakeholders, faculty, students, and administrators in an ongoing, evaluative process that documents mission, goals, objectives, resources, faculty characteristics, student characteristics, curriculum content, and quality improvement processes. These activities require substantial investment of faculty and staff time as well as dollars for data gathering, focus groups, and student and stakeholder surveys. For many programs this investment represents a sometimes onerous burden. Nonetheless, educators, students, and employers alike value ac-creditation (Begun and Kaissi, 2004; Gelmon, 2004).

In the healthcare administration industry, accreditation by the Commission on Accreditation of Healthcare Management Education (CAHME) is generally recognized as the primary badge of recognition for graduate programs. CAHME, until recently known as the Accrediting Commission on Education for Health Services Administration (ACEHSA), is the only organization formally recog-nized by the United States Department of Education as an accrediting body for master’s-level health service administration in the United States (Blue Ribbon Task Force, 2004). Other accrediting agencies, such as Council on Education for Public Health (CEPH), accredit a general public health degree that may contain a specialized track in health administration and policy, which overlaps many of the same concerns and types of courses found in a CAHME-accredited program. As the healthcare industry has shifted toward more for-profit organizations over time, interest within schools of business has resulted in CAHME accredita-tion of several Association to Advance Collegiate Schools of Business (AACSB) programs that house health administration degrees. The majority of the 66 CAHME-accredited programs are situated within schools accredited by CEPH or AACSB. Approximately six of those programs in any given year are housed in schools of public affairs (www.acehsa.org, 2004).

One of the fastest growing areas of interest in the specialization fields within public affairs is that of healthcare administration/policy (Andersen, Howard, and Schneller, 2004). NASPAA’s Healthcare Sector Education Programs Section has spent the past two years, supported by a grant from the Robert Wood Johnson Foundation, gathering data about health programs associated with public af-fairs programs across the nation. NASPAA reports 248 members, with 142 of



those accredited and 78 that have identifiable health programs within the schools (Marshall and Hewitt, 2004). NASPAA does not provide a targeted set of criteria for subspecialties within public affairs. Health programs housed within NASPAA find they may be forced to participate in the accreditation effort of other agencies either to achieve separate recognition or at a minimum to understand the require-ments of other standards or benchmarks in the field so that they may develop ap-propriate and competitive training programs for their students. Fourteen percent of the NASPAA-accredited programs that have health emphases house health degrees that are fully accredited by other professional agencies such as AACSB, CEPH, or CAHME, and an additional five percent are seeking that additional accreditation. Or they may co-exist on campuses where those accredited health degrees are housed in other schools, thus representing a rich source of opportu-nity for multi-disciplinary teamwork. Other NASPAA programs exist in schools and universities where none of the standard health accreditation programs are located and where even membership in the Association of University Programs in Health Administration (AUPHA), a prominent health professional interest group that does not accredit, may not exist (Hewitt et al., 2005).

As NASPAA approaches the challenge of providing guidelines and possible benchmarks for the development and evaluation of health specialty tracks within public affairs programs, a multitude of guidelines used by other accrediting bod-ies are available for comparison. CAHME is undergoing major self-examination, and its forthcoming recommendations include a shift toward more flexibility that recognizes the differing missions of programs based in schools of business, public health, health professions, and public affairs. AACSB does provide the option for joint site visits with CAHME, but this option is rarely exercised. No such option exists for NASPAA/CAHME programs, but discussions between the two groups have been opened to address this possibility. All of the major accrediting bodies devoted to health programs are working to develop and validate appropri-ate competencies for their respective programs (BRTF, 2004). The Blue Ribbon Task Force (BRTF) initiated through the National Center for Healthcare Leader-ship (NCHL) and CAHME in 2001 combined representatives of the practice and academic communities to focus on incorporating educational outcomes into the CAHME accrediting process. Its final report, published in 2004, will serve as the basis for the future transformation of accreditation processes as well as criteria (acehsa.org, 2004)

CAHME is considering recommendations that will enhance the possibility for joint accreditation visits that streamline an accreditation process, although these recommendations are not uniformly accepted among CAHME board members or AUPHA (Stefl, 2004). Universities that have multiple accreditation respon-sibilities would certainly appreciate a streamlining of the process (Hewitt et al., 2005). For the many health programs that remain unaccredited or that are considering beginning the accreditation process, an examination of the core



elements from each program, each of which appears to be moving toward more competency-based measures, can clarify where areas of agreement occur. These overlaps offer smaller schools with fewer resources some important indicators of ways to enhance their offerings by teaming with interested faculty in their own programs or in other schools on their campus where similar competencies might be produced.

Comparing Requirements Across Accrediting OrganizationsIn 2004, an examination of accrediting guidelines for four organizations was

completed: NASPAA, CAHME, AACSB, and CEPH. Table 1 sets out the 2004 iteration of skills that are commonly expected of healthcare administration graduates across the nation. The Blue Ribbon Task Force (BRTF, 2004) convened by CAHME and NCSL identified six competency areas for health sector manage-ment. The guidelines do not identify specific courses in a curriculum but rather the competencies acquired through didactic courses and integrative field expe-riences. A survey of NASPAA, CAHME, and AACSB guidelines yields many overlapping descriptive categories that are covered in different courses in each type of curriculum. The CEPH guidelines are somewhat different. They identify eight domains associated with core requirements and specialized training in one or more tracks within a school of public health. Each domain has multiple indi-cators; a detailed list of those indicators is contained in Appendix A.

The Blue Ribbon Task Force recommended six areas of competency for health-care administrators:

• Leadership—Create and communicate a shared vision, champion solu-tions for organizational and community health challenges, and energize commitment to goals.

• Collaboration and Communication—Develop cooperative relationships and effective information exchanges within the organizations and the broader communities served.

• Learning and Performance Improvement—Continuously assess and improve the quality, safety, and value of healthcare.

• Professionalism—Demonstrate ethics, values, and professional practices; stimulate social accountability and community stewardship; and com-mit to personal and organizational development.

• Personal and Community Health Systems—Integrate the needs of individu-als with those of the community, “optimizing opportunities to improve the health of the populations served within the context of the health-care environment and policy” (Smith, 2004, 181-182).

• Management Practice—Identify, evaluate, and implement strategies and processes designed to yield effective, efficient, and high-quality customer-oriented healthcare.



To facilitate developing a comparative framework for Table 1, the management practice section was expanded to include a list of technical skills and responsi-bilities developed by the Medical Group Management Association (MGMA), a resource that was utilized by the BRTF in the initial stages of its project (Leader-ship Conference, AUPHA, 2003). An expanded list of detailed skills identified by MGMA for each management area is presented for reference in Appendix B. This detailed list of skills that are subsumed under the more general category of technical skills in Table 1 represents a well-developed model that could serve as a goal for the agencies that are building their own skill set definitions. For the table, an additional component of application of skills to practical situations was added to illustrate the areas of a curriculum that might include residen-cies, internships, or community-based projects. Lists of skills sought or expected from graduates by an accrediting agency were identified for NASPAA, CAHME, AACSB, and CEPH and matched to an overall competency category list proposed by the Blue Ribbon Task Force for CAHME adoption. The table identifies the ac-crediting agencies’ current guidelines that match those skill areas. Some catego-ries may apply to two or more skill areas. For example, under the CEPH heading, Domain 4, Cultural Competency Skills, at a minimum could be linked with the BRTF skill areas of Leadership and Collaboration and Communication, as well as the technical skills of human resource management.

Comparisons across the accrediting groups show similar emphases on compe-tencies expected in almost all categories. Although the terminology used by each group is not identical, the skill areas of leadership and collaboration and commu-nication are competencies that are addressed in the NASPAA curriculum area of organization and management concepts and behaviors. Under technical knowl-edge and skills, the NASPAA standard would also address professional responsi-bilities under the category of organization and management concepts of behavior. The only BRFT skill area where overlap does not occur for all accrediting organi-zations is the area of personal and community health. AACSB has no comparable skill area, and courses that focus on this skill would probably be identified as electives rather than core expectations.

A helpful exercise for any NASPAA-affiliated program considering positioning its health program for accreditation in any of the groups compared here would be to compare the skills listed in the left column of Table 1 to the emphases expect-ed by NASPAA to determine similarities. Courses that are likely to produce these competencies can be identified, and the efficiencies provided by offering common core classes that combine traditional public affairs students and healthcare ad-ministration students can be determined. Programs must decide whether or not a human resource class, a systems management class, or a statistics class for public administrators produces the necessary competencies for an individual who plans to enter the healthcare field. If not, then specialized courses with a healthcare



Domain4-Culturalcompetencyskills;5-CommunityDimensionsofPracticeSkills;8-LeadershipandSystemsThinkingSkills

Domain2-CommunicationSkills;4-CulturalCompetencySkills;5-CommunityDimensionsofPractice;8-Leadership/SystemsThinkingSkills

Domain1-AnalyticAssessmentSkills;7-FinancialPlanningandManagementSkills;8-LeadershipandSystemsThinking

Domain5-CommunityDimensionofPracticeSkills;6-BasicPublicHealthScienceSkills

Domain8-LeadershipandSystemsThinkingSkills

Domain1-AnalyticAssessmentSkills;7-FinancialPlanningandManagementSkills

Domain4-CulturalCompetencySkills;7-FinancialPlanningandManagementSkills;8-LeadershipandSystemsThinking

Domain2-PolicyDevelopment/ProgramPlanningSkills;5-CommunityDimensionsofPractice

Domain2-PolicyDevelopment/ProgramPlanningSkills;8-LeadershipandSystemsThinking

Domain1-AnalyticAssessmentSkills;3-Communi-cationSkills

Domain1-AnalyticAssessmentSkills


Internships,practicum,andcommunityfieldwork;Domain5-CommunityDimensionsofPractice

Group/individualdynamicsinanorga-nization;capacitytoapplyknowledgeinnewcircumstances

Communicationabilities,groupandindividualdynamicsinorganizations

Analyticalskills,statisticaldataanalysistosupportdecision;managementofchange

Ethicalunderstandingandreasoning

Financialtheories;creationofvalueinproduct

Groupandindividualdynamicsinorganizations

Multiculturalanddiversityunderstand-ing

Domesticandglobaleconomicenvi-ronmentsoforganizations

Useofinformationtechnology

Statisticaldataanalysistosupportdecisionmaking

Analyticalskills

Internships,cooperativeplacements

Organizationandmanage-mentconceptsandbehavior


Decisionmakingandprob-lemsolving

Politicalandlegalinstitutionsandprocesses;Economicandsocialinstitutionsandprocesses


Budgetingandfinancialprocesses

Humanresources

Politicalandlegalinstitutionsandprocesses

Policyandprogramformula-tion,implementationandevaluation

Informationmanagement,technologyapplicationsandpolicy



Internshipsfellowships

Table1:AComparisonofAccreditationStandardswiththeTaskForceSkillAreas.Skills NASPAA ACEHSA

Leadership,interpersonalrelations,conflictandcommunicationskills

Interpersonalrelationsandcom-munication

Managementofchange;qualityas-sessmentofbusinesspracticesandhealthmeasurement

Assessmentandunderstandingofhealthstatuscharacteristicsandhealthrisksofdiversepopulations

Legalandethicalanalysis

Financialmanagementofhealthorganizations

Managinghumanresourcesandhealthprofessionalsinvariousset-tings

Governmenthealthpolicyformula-tion,implementationandevaluation

Structuring,marketing,positioningandgoverningtheperformanceofhealthorganizations

Managinginformation,economicanalysis

Economicanalysis

Economicanalysis

Internshipsandresidencies

.AACSB CEPH

Leadership

CollaborationandCommunication

Learning/PerformanceImprovement

Personal/CommunityHealthSystems

ProfessionalResponsibility

ManagementPractices:TechnicalSkills

Financialmanagement

Humanresourcemanagement

Governanceandorganizationaldynamics

Planningandmarketing

Informationmanage-ment

Riskmanagement

Businessandclinicaloperations

Applied/IntegrativeExperiences



Domain4-Culturalcompetencyskills;5-CommunityDimensionsofPracticeSkills;8-LeadershipandSystemsThinkingSkills

Domain2-CommunicationSkills;4-CulturalCompetencySkills;5-CommunityDimensionsofPractice;8-Leadership/SystemsThinkingSkills

Domain1-AnalyticAssessmentSkills;7-FinancialPlanningandManagementSkills;8-LeadershipandSystemsThinking

Domain5-CommunityDimensionofPracticeSkills;6-BasicPublicHealthScienceSkills

Domain8-LeadershipandSystemsThinkingSkills

Domain1-AnalyticAssessmentSkills;7-FinancialPlanningandManagementSkills

Domain4-CulturalCompetencySkills;7-FinancialPlanningandManagementSkills;8-LeadershipandSystemsThinking

Domain2-PolicyDevelopment/ProgramPlanningSkills;5-CommunityDimensionsofPractice

Domain2-PolicyDevelopment/ProgramPlanningSkills;8-LeadershipandSystemsThinking

Domain1-AnalyticAssessmentSkills;3-Communi-cationSkills



Internships,practicum,andcommunityfieldwork;Domain5-CommunityDimensionsofPractice

Group/individualdynamicsinanorga-nization;capacitytoapplyknowledgeinnewcircumstances

Communicationabilities,groupandindividualdynamicsinorganizations

Analyticalskills,statisticaldataanalysistosupportdecision;managementofchange

Ethicalunderstandingandreasoning

Financialtheories;creationofvalueinproduct

Groupandindividualdynamicsinorganizations

Multiculturalanddiversityunderstand-ing

Domesticandglobaleconomicenvi-ronmentsoforganizations

Useofinformationtechnology

Statisticaldataanalysistosupportdecisionmaking

Analyticalskills

Internships,cooperativeplacements




Politicalandlegalinstitutionsandprocesses;Economicandsocialinstitutionsandprocesses



Humanresources

Politicalandlegalinstitutionsandprocesses

Policyandprogramformula-tion,implementationandevaluation

Informationmanagement,technologyapplicationsandpolicy



Internshipsfellowships

Table1:AComparisonofAccreditationStandardswiththeTaskForceSkillAreas.Skills NASPAA ACEHSA

Leadership,interpersonalrelations,conflictandcommunicationskills

Interpersonalrelationsandcom-munication

Managementofchange;qualityas-sessmentofbusinesspracticesandhealthmeasurement

Assessmentandunderstandingofhealthstatuscharacteristicsandhealthrisksofdiversepopulations

Legalandethicalanalysis

Financialmanagementofhealthorganizations

Managinghumanresourcesandhealthprofessionalsinvariousset-tings

Governmenthealthpolicyformula-tion,implementationandevaluation

Structuring,marketing,positioningandgoverningtheperformanceofhealthorganizations

Managinginformation,economicanalysis

Economicanalysis

Economicanalysis

Internshipsandresidencies

.AACSB CEPH

Leadership

CollaborationandCommunication

Learning/PerformanceImprovement

Personal/CommunityHealthSystems

ProfessionalResponsibility

ManagementPractices:TechnicalSkills

Financialmanagement

Humanresourcemanagement

Governanceandorganizationaldynamics

Planningandmarketing

Informationmanage-ment

Riskmanagement

Businessandclinicaloperations

Applied/IntegrativeExperiences



focus become necessary, or partnerships with other campus programs that address health issues may be explored.

Many health programs may coexist on campuses with affiliated health profes-sional or medical schools. These schools are responding to a recent report by the Institute of Medicine (2003) that calls for clinical disciplines to move to com-petency-based criteria (Andersen, Howard, and Schneller, 2004). Although not included for comparison in the Table 1 because of the clinical versus management basis, an examination of their suggested list also identifies substantial overlap.

• Provide patient-centered care—identify, respect, and care about patients’ differences, values, preferences and expressed needs, relieve pain and suffering; coordinate continuous care; listen to, clearly inform, commu-nicate with, and educate patients; share decision making and manage-ment; and continuously advocate disease prevention, wellness, and promotion of healthy lifestyles including a focus on population health. This skill area addresses both personal and community health systems and the marketing aspect.

• Work in interdisciplinary teams—cooperate, collaborate, communicate and integrate to ensure that care is continuous and reliable. Both learning and performance improvement as well as collaboration and communi-cation areas are consistent with this category.

• Employ evidence-based practice—integrate best research with clinical ex-pertise and patient values for optimum care, and participate in learn-ing and research activities to the extent feasible. This component also shares common elements with learning and performance improvement.

• Apply quality improvement—identify errors and hazards in care; understand and implement basic safety design principles, such as stan-dardization and simplification; continually understand and measure quality of care in terms of structure, process, and outcomes in relation to patient and community needs, and design and test interventions to change processes and systems of care, with the objective of improv-ing quality. Learning and performance improvement as well as the technical skill of risk management share common concerns with this category.

• Utilize informatics—communicate, manage knowledge, mitigate error, and support decision making using information technology (IOM, 2003). Information management as a technical skill is similar in na-ture.

Some Implications of the CommonalitiesSmaller programs that do not have the resources to offer separate courses for

health and public affairs students will find the crosscutting themes encouraging, because they mean that the same program and resources can satisfy the same basic



requirements of multiple accrediting bodies. However, a cautionary observation is appropriate. Many site visit teams will expect to see documentation that core classes that are used to meet the needs of more than one degree program (e.g., MPA and MHA degrees) utilize readings, case studies, projects, and other teach-ing tools that provide the necessary emphasis on the specific discipline. Thus, an underlying challenge of moving toward common competencies and shared, core classes is the involvement of faculty, who must prepare and evaluate different as-signments, case studies, and projects based on the students’ needs. One outcome of a move toward competency-based accreditation will be the increased workload, commitment, and critical involvement of faculty at every stage of the process. Courses, syllabi, and assignments must be evaluated and redesigned to address the competency areas, and, in programs where core curriculum courses are shared among degree programs, the challenge becomes even more daunting.

The joint accreditation process offers other barriers in addition to the need for coordinating curriculum content. Other issues addressed in site visits include faculty-student ratios, diversity of faculty and students, faculty productivity, and external research records and program resources. Although this examination has focused solely on curriculum issues, joint accreditation guidelines and processes would be required to address variations in these other important areas as well.

As part of the BRTF recommendations, AUPHA and CAHME propose seek-ing federal funds to encourage research that can validate competency measures and associate them with actual work performance. They also propose funding for pilot studies to develop streamlined, joint accreditation strategies for programs that must prepare multiple site-visit reports to different agencies. Stakehold-ers commenting on the task force recommendations have not been uniformly positive concerning the joint accreditation strategy. Previous experimentation with this approach was not successful in part because the accrediting organiza-tions were unable to reach enough compromises to truly streamline the process. Nonetheless, if the cooperating bodies demonstrate genuine interest, the proposal to develop and pilot new strategies using this approach may be supported (Stefl, 2004).

ConclusionThe health education task force for NASPAA has been charged with developing

guidelines and benchmarks that can aid NASPAA health programs in evaluat-ing and developing their curricula whether or not they choose to remain unac-credited. According to the Robert Wood Johnson Foundation-funded study by Marshall and Hewitt described earlier in this issue, the need for these guidelines is supported by a majority of health programs based within NASPAA-member universities. Although members do not view a new form of accreditation for a subspecialty as necessary, comparative guidelines and benchmarks by which members can gauge their program’s success are viewed positively by a majority of



programs that wish to be proactive in designing competency and outcome mea-sures that reflect the performance of their programs.

ReferencesAccrediting Commission on Education for Health Services Administration (ACEHSA). 2004.

“Accredited Programs.” Available at www.acehsa.org/programs.htm.Andersen, R., C. Howard, and E. Schneller. 2004. “Contemporary Models for Accreditation: Lessons

for Health Administration Education and Accreditation.” Journal of Health Administration Education, 21(2):185-226.

Association of University Programs in Health Administration (AUPHA). 2004. www.aupha.org.Association to Advance Collegiate Schools of Business (AACSB). 2004. www.aacsb.org. Begun, J., and A. Kaissi. 2004. “Definition and Scope of Health Service Administration.” Journal of

Health Administration Education, 21(2):227-240.Blue Ribbon Task Force. 2004. “The Final Report of the Blue Ribbon Task Force on Accreditation.”

Journal of Health Administration Education, 21(2):121-166.Council on Education for Public Health, 2004. www.ceph.org.Gelmon, S. 2004. “Stakeholder Satisfaction with the Accreditation Process.” Journal of Health

Administration Education, 21(2):167-172.Hewitt, A., et al. 2004. “Profiling NASPAA Programs with Health Concentration—A Panel Discussion

on Building a Foundation to Accredit Specializations.” Public Performance and Management Review, 28(2):259-274.

Institute on Medicine. 2003. Health Professions Education: A Bridge to Quality. http://books.nap/catalog/1068.1

Marshall, B., and A. Hewitt, 2004. Final Report to the Robert Woods Johnson Foundation on Profiling the Master’s of Public Administration Programs with a Health Care Management Concentration. Ref ID # 047226.

Medical Group Management Association (MGMA). 2004. www.mgma.org.Smith, D. 2004. “Blue Ribbon Kudos.” Journal of Health Administration Education, 21(2):179-184.Stefl, M. 2004. “The Report of the Blue Ribbon Task Force: Challenges and Opportunities.” Journal of

Health Administration Education, 21(2):167-172.



AppendixACompetenciesExpectedWithinDomainAreas

bytheCouncilonEducationforPublicHealth(CEPH)

Domain1:AnalyticAssessmentSkills1. Definesaproblem.2. Determinesappropriateusesandlimitationsofbothquantitativeandqualitative

data.3. Selectsanddefinesvariablesrelevanttodefinedpublichealthproblems.4. Identifiesrelevantandappropriatedataandinformationsources.5. Evaluatestheintegrityandcomparabilityofdataandidentifiesgapsindata

sources.6. Appliesethicalprinciplestothecollection,maintenance,use,anddisseminationof

dataandinformation.7. Partnerswithcommunitiestoattachmeaningtocollectedquantitativeandquali-

tativedata.8. Makesrelevantinferencesfromquantitativeandqualitativedata.9. Obtainsandinterpretsinformationregardingrisksandbenefitstothecommunity.10.Appliesdatacollectionprocesses,informationtechnologyapplications,andcom-

putersystemsstorage/retrievalstrategies.11.Recognizeshowthedatailluminateethical,political,scientific,economicandover-

allpublichealthissues.

Domain2:PolicyDevelopment/ProgramPlanningSkills1. Collects,summarizes,andinterpretsinformationrelevanttoanissue.2. Statespolicyoptionsandwritesclearandconcisepolicystatements.3. Identifies,interprets,andimplementspublichealthlaws,regulations,andpolicies

relatedtospecificprograms.4. Articulatesthehealth,fiscal,administrative,legal,social,andpoliticalimplications

ofeachpolicyoption.5. Statesthefeasibilityandexpectedoutcomesofeachpolicyoption.6. Utilizescurrenttechniquesindecisionanalysisandhealthplanning.7. Decidesontheappropriatecourseofaction.8. Developsaplantoimplementpolicy,includinggoals,outcomeandprocessobjec-

tives,andimplementationsteps.9. Translatespolicyintoorganizationalplans,structures,andprograms.10.Developsmechanismstomonitorandevaluateprogramsfortheireffectiveness

andquality.

Domain3:CommunicationSkills1. Communicateseffectivelybothinwritingandorallyorinotherways.2. Solicitsinputfromindividualsandorganizations.3. Advocatesforpublichealthprogramsandresources.4. Leadsandparticipatesingroupstoaddressspecificissues.5. Usesthemedia,advancedtechnologies,andcommunitynetworkstocommunicate

information.6. Effectivelypresentsaccuratedemographic,statistical,programmatic,andscientific

informationforprofessionalandlayaudiences.



Domain4:CulturalCompetencySkills1. Utilizesappropriatemethodsforinteractingsensitively,effectively,andprofessionally

withpersonsfromdiversecultural,socioeconomic,educational,racial,ethnic,andprofessionalbackgrounds,andpersonsofallagesandlifestylepreferences.

2. Identifiestheroleofcultural,social,andbehavioralfactorsindeterminingthedeliv-eryofpublichealthservices.

3. Developsandadaptsapproachestoproblemsthattakeintoaccountculturaldiffer-ences.

Domain5:CommunityDimensionsofPracticeSkills1. Establishesandmaintainslinkageswithkeystakeholders.2. Utilizesleadership,teambuilding,negotiation,andconflictresolutionskillstobuild

communitypartnerships.3. Collaborateswithcommunitypartnerstopromotethehealthofthepopulation.4. Identifieshowpublicandprivateorganizationsoperatewithinacommunity.5. Accomplisheseffectivecommunityengagements.6. Identifiescommunityassetsandavailableresources.7. Develops,implements,andevaluatesacommunitypublichealthassessment.8. Describestheroleofgovernmentinthedeliveryofcommunityhealthservices.

Domain6:BasicPublicHealthScienceSkills1. Identifiestheindividual’sandorganizations’responsibilitieswithinthecontextofthe

EssentialPublicHealthServicesandcorefunctions.2. Defines,assesses,andunderstandsthehealthstatusofpopulations,determinantsof

healthandillness,factorscontributingtohealthpromotionanddiseaseprevention,andfactorsinfluencingtheuseofhealthservices.

3. Understandsthehistoricaldevelopment,structure,andinteractionofpublichealthandhealthcaresystems.

4. Identifiesandappliesbasicresearchmethodsusedinpublichealth.5. Appliesthebasicpublichealthsciencesincludingbehavioralandsocialsciences,bio-

statistics,epidemiology,environmentalpublichealth,andpreventionofchronicandinfectiousdiseasesandinjuries.

6. Identifiesandretrievescurrentrelevantscientificevidence.7. Identifiesthelimitationsofresearchandtheimportanceofobservationsandinter-

relationships.

Domain7:FinancialPlanningandManagementSkills1. Developsandpresentsabudget.2. Managesprogramswithinbudgetconstraints.3. Appliesbasicbudgetprocesses.4. Developsstrategiesfordeterminingbudgetpriorities.5. Monitorsprogramperformance.6. Preparesproposalsforfundingfromexternalsources.7. Appliesbasichumanrelationskillstothemanagementoforganizations,motivationof

personnel,andresolutionofconflicts.8. Managesinformationsystemsforcollection,retrieval,anduseofdatafordecision-

making.



9. Negotiatesanddevelopscontractsandotherdocumentsfortheprovisionofpopula-tion-basedservices.

10.Conductscost-effectiveness,cost-benefitandcostutilityanalyses.

Domain8:LeadershipandSystemsThinkingSkills1. Createsacultureofethicalstandardswithinorganizationsandcommunities.2. Helpscreatekeyvaluesandsharedvisionandusestheseprinciplestoguideaction.3. Identifiesinternalandexternalissuesthatmayimpactdeliveryofessentialpublic

healthservices(i.e.,strategicplanning).4. Facilitatescollaborationwithinternalandexternalgroupstoensureparticipationof

keystakeholders.5. Promotesteamandorganizationallearning.6. Contributestodevelopment,implementation,andmonitoringoforganizationalper-

formancestandards.7. Usesthelegalandpoliticalsystemtoeffectchange.8. Appliestheoryoforganizationalstructurestoprofessionalpractice.

AProjectoftheCouncilonLinkagesbetweenAcademiaandPublicHealthPracticefundedbytheHealthResourcesandServiceAdministration.

AppendixB

PerformanceDomainsofTechnical/ProfessionalSkillsIdentifiedbytheMedicalGroupsManagementAssociation(MGMA)

FinancialManagementTasksTask1. Prepareandmanagebudgetstoachieveorganizationalobjectives.Task2. Developaccountingandfinancialcontrolsystems.Task3. Preparefinancialstatementsandconductfinancialanalysis.Task4. Developandmanagematerialprocurementandpaymentsystems.Task5. Developcodingandreimbursementpoliciesandprocedures.Task6. Facilitateinvestmentplanning,managementandcompliance.Task7. Establishbusinessrelationshipswithfinancialadvisers.Task8. Establishfeeschedulesforphysicianservices.Task9. Negotiatethird-partycontracts.Task10. Developreconciliationsystemsforthird-partypayerreimbursement.Task11. Facilitateretirementplanning,managementandcompliance.Task12. Maintaincompliancewithtaxlawsandfilingprocedures.

HumanResourceManagementTasksTask1. Designcompensationandbenefitsprogramsconsistentwiththevaluesofthe

organization.Task2. Establishjobclassificationsystems.Task3. Developemployeeplacementprogramsandfacilitateworkforceplanning.Task4. Establishemployeeappraisalandevaluationsystems.Task5. Developandimplementemployee-trainingprograms.



Task6. Establishemployeerelationsandconflictresolutionprograms.Task7. Maintaincompliancewithemploymentlaws.

GovernanceandOrganizationalDynamicsTask1. Leadandmanagetheorganizationalchangeprocessforpracticeimprovement.Task2. Constructandmaintaingovernancesystems.Task3. Evaluateandimprovegoverningbylaws,policies,andprocesses.Task4. Conductstakeholderneedsassessmentsandfacilitaterelationshipdevelopment.Task5. Facilitatestaffdevelopmentandteaming.Task6. Facilitatephysicianunderstandingandacceptanceofgoodbusinessmanagement.Task7. Developandimplementqualityassuranceprogram.

PlanningandMarketingTasksTask1. Developstrategicplans.Task2. Createbusinessplans.Task3. Createmarketingplans.Task4. Monitorandevaluatetheeffectivenessofstrategic,business,andmarketingplan

activities.Task5. Pursueandestablishpartnershipsandstrategicalliances.Task6. Developandimplementcommunityoutreach,publicrelations,andcustomerrela-

tionsprograms.

InformationManagementTasksTask1. Conductinformationsystemneedsanalysis.Task2. Facilitateinformationsystemprocurementandinstallation.Task3. Developandimplementinformationsystemtrainingandsupportprograms.Task4. Overseedatabasemanagementandmaintenance.Task5. Developinformationnetworksecuritysystems.Task6. Provideaccesstoelectroniceducationandinformationresourcesandsystems.RiskManagementTask1. Maintainlegalcompliancewithcorporatestructure.Task2. Maintaincorporatehistoryanddeveloprecord-keepingprocedures.Task3. Developconflictresolutionandgrievanceprocedures.Task4. Assessandprocureliabilityinsurance.Task5. Establishpersonnelandpropertysecurityplansandpolicies.Task6. Developandimplementqualityassuranceandpatientsatisfactionprograms.Task7. Establishpatient,staffandorganizationalconfidentialitypolicies.Task8. Conductauditsofat-riskfinancialactivities.Task9. Developprofessionalresourcenetworksforrisk-relatedactivities.Task10. Negotiateandcomplywithcontractualarrangements.Task11. Maintaincompliancewithgovernmentcontractualmandates.

BusinessandClinicalOperationsTask1. Facilitatebusinessoperationsplanning.Task2. Conductstaffinganalysisandscheduling.Task3. Developancillaryclinicalsupportservices.Task4. Establishpurchasingprocurementandinventorycontrolsystems.



Task5. Developandimplementfacilitiesplanningandmaintenanceprograms.Task6. Establishpatientflowprocesses.Task7. Developandimplementpatientcommunicationsystem.Task8. Developclinicalpathwaystructuresandfunctions.Task9. Createmonitoringsystemsforlicensure,credentialing,andrecertification.Task10. Developandimplementprocessimprovementprogramsforclinicoperations.

ProfessionalResponsibilityTasksTask1. Advanceprofessionalknowledgeandleadershipskills.Task2. Balanceprofessionalandpersonalpursuits.Task3. Promoteethicalstandardsforindividualandorganizationalbehaviorand

decision-making.Task4. Conductself-assessments.Task5. Engageinprofessionalnetworking.Task6. Advancetheprofessionbycontributingtothebodyofknowledge.Task7. Developeffectiveinterpersonalskills.

Karen Harlow-Rosentraub is an associate professor of nursing at Case-West-ern Reserve University. Her areas of interest include health policy and program evaluation; family caregiving and respite care; and volunteerism, healthy aging, and nonprofits. She holds a Ph.D. in urban administration from the University of Texas.

James L. Perry is Chancellor’s Professor of Public and Environmental Affairs and Director of the Institute for the Study of Government and the Nonprofit Sec-tor at Indiana University-Purdue University Indianapolis. Perry earned his MPA and Ph.D. at the Maxwell School of Citizenship and Public Affairs at Syracuse University.


Internet Access and Innovation-Diffusion in a National Cancer Institute

Preventive Health Education Project: Telecenters, Cybercafes, and

Sociodemographic Impacts on Knowledge Gaps

Una E. Medina, Mario A. Rivera, Everett M. Rogers, W. Gill Woodall, and David B. Buller

University of New Mexico

Abstract

Policymakers and analysts cite the availability of free Internet telecenters at libraries and community centers as a viable way to close the so-called knowl-edge gap and the digital divide among minority and poor communities. This study looks at policymakers’ dissemination of a National Cancer Institute (NCI) Web-based, preventive health education intervention to low-income people in Northern New Mexico and Southern Colorado through free Internet access. Al-though free public access Internet telecenters would appear to offer the potential of bridging these gaps, knowledge and information gaps persist because of the differentials between free and pay Internet access, as well as access through direct personal ownership of computers with Internet connections. The rate of increase of knowledge diffusion is much higher for individuals and communities of higher socioeconomic status who pay for access than for those with lesser means and who access free electronic resources. Pay-for-Internet cybercafes and free Internet tel-ecenters have different accessibility thresholds, offer different user environments, and attract at least two different types of customers or clients.

The socioeconomic differences in the two types of patrons are presented in this study by way of the results of an electronic user survey and a telecenter survey in the aforementioned project locales. While a learning and knowledge gap is

JPAE 12(2):213-232


Telecenters, Cybercafes, and Sociodemographic Impacts on Knowledge Gaps

evident between patrons of pay and free access sites, both types of public Inter-net access are, in relative terms, severely limited. Residually, a large knowledge gap persists among users of public access sites compared to computer owners with their own Internet connections. These disparities have implications for the dissemination of Web-based health information, particularly among the poor in minority communities.

The Internet access evaluation is placed in the larger context of the NCI proj-ect, the Health Communication Intervention Research Initiative, looking (1) at broader concerns of cultural communications and policy and program implemen-tation (2) across social and programmatic networks, with consideration to (3) pedagogical applications of the case in the MPA classroom.

This study considers the impact of differential access to the Internet for ef-fective exposure on the part of minority communities to Web-based preventive health information. The study reports its findings in relation to an assessment of a Web-based, cancer prevention nutrition-education project of the National Cancer Institute (NCI), centered on project sites in northern New Mexico and Southern Colorado. The project, the Health Communication Intervention Research Initiative (hereafter Initiative) was implemented by a network of research agencies, nonprofit organizations, and community and tribal representatives relying on the use of telecenters and cybercafes for the dissemination of Web-borne health education and information materials. Author Rivera has presented the project as a case in the classroom in the Master of Public Administration program of the University of New Mexico to illustrate the role of culture, demographics, and social and programmatic networks in the implementation of social programs, and this is a final analytical element brought into consideration in this study.

The Initiative, concluded in 2005, was self-consciously intended to close the so-called digital divide and knowledge gap between majoritarian and minor-ity communities, often represented as the gap between affluent and low-income individuals, in the diffusion of public health information. The Initiative was carried out in low-income and minority—including tribal—communities across the nation by the NCI and its parent, the National Institutes of Health (NIH), at the Department of Health and Human Services, with additional sponsorship from the National Technical Information Administration, the National Library of Medicine, eRate, and others. The Initiative, in whose design, deployment, and evaluation the authors were variously involved, was funded by the NCI and implemented nationally in seven study sites by a network of research and social service institutions, for the purpose of (1) effectively reaching cultural or linguis-tic minority, low-income communities; (2) otherwise addressing disparities of



information and healthcare access, for instance through reliance on free Internet access at community telecenters; and (3) ascertaining which approaches worked best in different settings, and why. Project assessments have been reported in the practitioner literature (Kreps and Viswanath, 2001; Buller et al., 2001).

The authors were specifically concerned with program implementation in a project site covering 40 locations in the rural Upper Rio Grande Valley of north-ern New Mexico and southern Colorado (map, Figure 6). Beyond the involve-ment, program implementation and review were carried out by a far-reaching network of higher education institutions, community-based nonprofits, advocacy groups, and change agents hired as community outreach Internet trainers. These community outreach trainers were trained and supervised by a consortium of the University of New Mexico, Colorado State University, the Cancer Research Center in Denver, La Plaza Telecommunity, and the San Luis Valley Community Interconnections organization.

Process and impact innovations at the 40 sites provided an alternative ap-proach to public health pedagogy and program implementation and evaluation within the NCI national program, namely one aimed principally at members of low-income, rural Hispanic and tribal communities, as well as at low-income individuals irrespective of race or ethnicity. There was an effort to target minority communities because they were known to suffer from a high prevalence of various forms of cancer that could be combatted with dietary and related lifestyle chang-es. The Web-based community intervention consisted of three innovations. These entailed (1) the use of change agents (Community Outreach Trainers) drawn from target communities and therefore equipped to operate in them with maximum impact; (2) the use of tribal languages and Spanish in program outreach whenever feasible; and (3) the use of free-access telecenters as actual contact points between the Web-borne educational material and members of target communities.

Using survey, communications audit, and cross-case evaluation techniques, data were gathered through pre- and post-tests, cross-sectional purposive surveys, focus group studies, and structured interviews to gauge successful and less-than-successful patterns of innovation in this program across the Upper Rio Grande Valley region. The functionality of collaborative and social networks as a crucible for program implementation was also of interest to researchers.

Evaluation findings suggest that communication and coordination among these network members and between them and their target communities are critical for programmatic success. Equally important are cultural communication factors, indicating the appropriateness of Web site pretest and focus group research as a means for (a) determining the self-identified priorities and needs of client com-munities and (b) evaluating the efficacy of Web site design from the standpoint of those communities. Factors related to cultural communications, implementa-tion sequencing, and involvement by early adopters and opinion leaders from tar-get communities were found to be key to successful implementation of the Initia-



tive. The receiving communities came to be regarded, properly, as sociocultural networks requiring effective communicative engagement with the implementa-tion network. The author/researchers attended, at the same time, to indicators of network functioning, for instance to indices of goal congruence among providers and clients and of cultural fit in the form and content of the Web material used. Also important was the formative role of computer and Web technologies them-selves, as these, as expected, sensitized clients to the potential value of Web access and use. Finally, the success of the program was found to turn on the effective availability of Internet access through community-based telecenters, which came to be the principal intervention medium for the NCI Initiative; the results of a corresponding component evaluation is presented later.

A research note and brief case study reporting on the overall evaluation of the program were published previously by authors Rivera and Rogers as “Evaluat-ing Public Sector Innovation in Networks, Extending the Reach of the National Cancer Institute’s Web-based Health Communication Intervention Research Initiative,” The Innovation Journal: The Public Sector Innovation Journal, Vol. 9, No. 3, 2004, available at http://innovation.cc/volumes-issues/vol9-iss3.htm. That case study, amplified with ancillary materials into a teaching tool for Master of Public Administration classes, typically generates intense interest from students, who seem drawn to the study of the functioning of network-based intergovernmental and intersectoral collaboratives in social policy and program implementation.

Use of the case study and supportive materials has also allowed the consider-ation of issues of equity, culture, and demographics, and of the limitations of ameliorative programs. As students broaden the scope of their analysis beyond programmatic to causal factors—such as poverty, gender, race, and culture—there inevitably comes to the fore in class discussion consideration of the shortcomings of closely delimited interventions such as those comprising the NCI initiative. Theoretical studies concerning related issues of computer-mediated communica-tion and online health education are also available to students on a class Web page (www.unm.edu/~marivera); for example, Wright and Bell’s (2005) study of health-related support groups on the Internet.

Project Research Related to Internet AccessAuthor Medina conducted evaluation research on an Internet access aspect

of the project, the one involving telecenters and cybercafes, for the NCI Initia-tive through a minority supplement attached to an NIH R01 major research grant. The purpose of the minority supplement was to train Medina as an NIH researcher, and her specific intention was to investigate the functionality of the community Internet access points upon which the component project of the NCI Initiative depended for the conveyance of its Web-based nutrition information.

With ever more widespread use of the Internet, the NIH and NCI have become interested in using the Internet to disseminate health information, in this case in-



formation aimed at promoting increased consumption of fruits and vegetables to reduce the risk of cancer, particularly among Hispanic and Native target commu-nities. Of particular encouragement to these agencies was the fact that informa-tion on diet, nutrition, vitamins, and nutritional supplements is one of the more popular health topics searched on the Internet (Fox, 2005). It was also known that low-income, rural individuals have a higher prevalence of cancers and would benefit from the preventive effects of eating more fruits and vegetables, ideally at least five servings a day. The “5-a-Day the Rio Grande Way” Web site project, so named—it was hoped—for popular appeal, investigated the use of free-access Internet to advance these nutritional aims in the project region and locales.

The design and content of the 5-a-Day Web site was guided by social cogni-tive theory (Bandura, 1986) and diffusion of innovations model (Rogers, 2003), focus groups on dietary preferences (Buller et al., 2001), and Web site usability and message design evaluations (Slater et al., 2003; Zimmerman et al., 2003). The Web site provided information on the health benefits of fruit and vegetables; on necessary skills for buying, storing, and preparing these foods; on methods for increasing fruit and vegetables in the family diet (especially for children); on gardening, recipes, seasonal foods, and local organizations that sold fruits and vegetables and gardening supplies; and on other Internet resources related to fruits and vegetables. As the project wore on, at Rogers’ and Medina’s insistence, there was an effort to more closely tailor these nutrition and lifestyle messages to the culinary and life cultures of targeted communities, and an effort to keep to the priority originally given to minority communities.

One concern that arose over the project’s three-year history was over the disap-pointingly low number of recruits for the program intervention, particularly those of Hispanic and Native ethnicity. With the decline in numbers, the young women who had served as the first wave of Community Outreach Trainers quit, and they were replaced by older women and a man who together were seen to have more social collateral in their communities, and who did a little better with recruitment rates. In the end, some recruiters seized on the idea of going to Tem-porary Assistance to Needy Families (TANF) welfare-to-work training workshops and recruiting entire groups at one time. This unusual device got recruitment levels up and had the effect of saving the local Initiative project. There was some controversy among project designers about the relative merits of keeping to original recruitment approaches as opposed to improvising recruitment, as well as relating to the impact of different recruitment efforts on the racial, ethnic, and sociodemographic distribution of intervention targets. The changes were assimi-lated without sacrificing the integrity of the project, through the use of purpo-sive and stratified sampling, but not without dissent; these adjustments offer an interesting topic for class debate, since they point both to the realities of program functioning and to the threats posed to research validity.



Evaluation Survey Protocol. To evaluate the Web site, 778 adults living in the project region were enrolled in a pretest-posttest controlled field trial and ran-domized to either receive immediate access to the Web site (Intervention Group) or delayed access to it after post-test (Control Group). Adults were recruited from June 2002 to January 2004 by lay people hired and trained to consent and pre-test participants, provide training in basic computer and Internet skills, and help gain access to the Web site. These laypersons, the Community Outreach Trainers, were identified in target communities such as Pueblos with the help of commu-nity leaders, and were therefore invested with legitimacy and credibility by the community members who were the subject of outreach.

After participants were recruited, it became evident through interviews that their limited ability to access the Internet through free community telecenter and library sites was a major factor impeding their participation in the Web site project (Lenz et al., 2000; Rogers and Shukla, 2001). It was then that NCI engaged a minority investigator (Medina), a member of one of the target popula-tions (Latina women), to investigate the functionality of the community-access telecenters. Rogers, then Medina’s thesis advisor and an advisor to the Initiative, suggested that she investigate both pay-per-use cybercafes and the free commu-nity access points located at community telecenters and libraries.

The following section discusses the implications of sociodemographic differ-ences for Internet accessibility, focusing specifically on the two types of Internet access prevalent in the Upper Rio Grande Valley: pay-per-use cybercafes and free community telecenters. It also explores the effect of these two types of Inter-net access on the NCI nutrition-education campaign, with an eye toward wider policy implications.

Free Internet Access versus Cybercafe and Computer Owner Access. Pay-for-use cybercafes in New Mexico’s Upper Rio Grande Valley are typically open extended hours beyond the workweek, while free Internet access telecenters in New Mexico offer limited or no extended hours (Fig. 5), contributing to an economic and con-venience barrier to Internet use among those who do not own computers with Internet connections. Pay-per-use cybercafes typically offered long hours in the evenings (until 11:00 p.m. or midnight) and early mornings (from 6:30 a.m.). Colorado’s portion of the Valley has no cybercafes, but two Colorado telecenters offered evening hours until 8:00 p.m. on one or two days per week to patrons (and project clients) at their locales, while another eight telecenters offered lim-ited or no hours beyond the typical work day.

The difference in accessibility from telecenter to telecenter and between tel-ecenter and pay-per-use cybercafe contributes to access disparities and therefore knowledge disparities by socioeconomic status. This section attempts to docu-ment these disparities by investigating the different socioeconomic profiles for users at the free versus paid Internet access sites, thereby quantifying a socioeco-nomic-based knowledge gap in Internet use despite limited availability of free



Internet access. These two types of public Internet access, free and paid, are then compared to the access available to computer owners with Internet connections, for the disparate learning impacts—knowledge gaps—of particular interest to the present study.

Tichenor, Donohue, and Olien (1970) define knowledge gap in this context as occurring when “the infusion of mass media information into a social system increases, segments of the population with higher socioeconomic status tend to acquire the information at a faster rate than the lower status segments, so that the gap between these segments tends to increase rather than decrease.” Author Rogers (2001) linked the knowledge gap to a digital divide defined as “the gap that exists between individuals advantaged by the Internet and those individuals relatively disadvantaged by the Internet.”

Gomez, Hunt, and Lamoureux (1999) of the International Development Research Center (IDRC) in Canada note that telecenters cannot be isolated from the sociocultural environments of their locations or the demographics of their users. It is therefore important to measure the different socioeconomic stratifica-tion of users in the pay versus free Internet telecenters. Looking empirically at the differing socioeconomic status of telecenter patrons is a critical consideration for telecenter usefulness, given the telecenter’s potential social impact (Urribarri, 2003).

This portion of the evaluation of the NCI Initiative originated in part as a fol-low-up to a study by Zimmerman et al. (2003) on “Integrating Usability Testing into the Development of a 5-a-Day Nutrition Web Site for At-risk Populations in the American Southwest.” It was in pursuing the implications of that study that the investigators for the 5-a-Day component study of the NCI Initiative realized that limited telecenter access might compromise the effective extension of the nutrition Web site to low-income persons. While previously published literature discusses pay and free access as different types of Internet access, it does not look squarely at issues of equitable access, for instance the role of disposable income or prior education and reading level. The portion of the 5-a-Day evalu-ation documented here examines the impact of such socioeconomic differences among target populations, through analysis of a user survey administered at free access telecenters and for-pay cybercafes in selected program locales.

Research Questions and Hypotheses. Are there significant and germane socioeconom-ic differences in the types of patrons who frequent free versus pay Internet access sites? What are those differences in relationship to disposable income, financial stability as evidenced by home ownership, and racial/ethnic group identification? Is there a discernible and quantifiable difference in hours of access and therefore ease of access for free versus pay Internet access centers? Is there a difference in the percentages of users accessing free versus pay Internet access sites during nonworking hours?



The following hypotheses were investigated: • Hypothesis 1: Patrons of free versus paid Internet access sites will differ

on the dimension of race/ethnicity, with Anglo users predominant at paid sites and non-Anglo users predominant at free sites.

• Hypothesis 2: Patrons of free versus paid Internet access sites will differ on the dimension of household income with paid site users showing higher incomes and free site users showing lower incomes.

• Hypothesis 3: Patrons of free versus paid Internet access sites will differ on the dimension of home ownership with paid site users predominant-ly homeowners and free site users predominantly non-homeowners.

• Hypothesis 4: Free Internet access sites will have fewer cumulative percentages of non-workday hours than pay Internet access sites.

• Hypothesis 5: Free Internet access sites will have lower percentages of users accessing the Internet during nonworking hours than pay Inter-net access sites.

Operationalization of Variables. Hypothesis 1 defines one variable: “patron differ-ences,” operationalized as race/ethnicity, with units of measurement as categories of Anglo and non-Anglo.

Hypothesis 2 names one variable: “patron differences,” operationalized as household income, with dimensions of “Less than $15,000,” “$15,000 to $29,999,” “$30,000 to $50,000,” and “More than $50,000.”

Hypothesis 3 names one variable: “patron differences,” operationalized as home ownership, with dimensions of “homeowner” or “non-homeowner.”

Hypothesis 4 names one variable: “cumulative percentages of non-workday hours,” operationalized as the ratio obtained by dividing non-workday hours (hours earlier than 8:00 a.m., plus hours after 5:00 p.m.) by total number of hours open during the week. The cumulative percentages of non-workday hours are measured in two dimensions: “Pay” versus “Free” Internet access sites.

Hypothesis 5 names one variable: “percentages of users accessing the Internet during nonworking hours,” operationalized as the ratio obtained by dividing number of respondents accessing the Internet during nonworking hours (workday hours earlier than 8:00 a.m., plus the lunch hour between noon and 1:00 p.m., plus hours after 5:00 p.m., plus weekend hours) by the total number of respon-dents.

Methods Participants. Participants were users at free and paid telecenter access sites in

Alamosa, Monte Vista, Del Norte, South Fork, La Jara, and San Luis, Colorado, and in Taos and Española, New Mexico. Participants were recruited for the present component of the study when they noticed an Internet Explorer icon on their telecenter computer desktop that said “FREE DISKETTE.” When they



clicked on the icon they were taken to an electronic user survey that offered a free diskette (available at the telecenter) in exchange for their survey response. Fifty persons responded to the survey: 31 users from 11 free sites, and 19 users from two paid sites.

Materials and Instruments. An Internet Explorer icon marked with the words FREE DISKETTE was placed on desktops at 11 free Internet telecenters and at two paid-access Internet telecenters. The icon was linked to the electronic survey page hosted on the researcher’s Web site.

Design and Procedures. The data were collected electronically from each user sur-vey and, upon the user’s click of the submission button, were sent to the research-er’s email address. The researcher collected the data in a file daily, as it arrived in real time, and then carried out her analysis.

ResultsThe data collected in the survey supported all five of the hypotheses:

• Hypothesis 1, that patrons of free versus paid Internet access sites would differ on the dimension of race/ethnicity, was supported (Figure 1). More than 80 percent of patrons at paid sites were Anglo, while more than 60 percent of patrons at free sites were non-Anglo.

• Hypothesis 2, that patrons of free versus paid Internet access sites would differ on the dimension of household income, was supported (Figure 2). Paid site users reported predominantly high incomes, more than $50,000, while free site users reported predominantly low in-comes, less than $15,000.

• Hypothesis 3, that patrons of free versus paid Internet access sites would differ on the dimension of home ownership, was supported (Fig-ure 3). More than 50 percent of paid site users were homeowners, and more than 60 percent of free site users were non-homeowners.

• Hypothesis 4, that Free Internet access sites would have fewer cumula-tive percentages of non-workday hours than pay Internet access sites, was supported (Figure 4). Computer owners with Internet connections had 100 percent availability of the Internet during the non-workday hours, while non-computer owners who frequent free and pay Inter-net access sites had cumulative access for less than 20% of extended (non-workday) hours. Lower socioeconomic persons who frequent free Internet access sites had cumulative access for less than 6% of extended (non-workday) hours.

• Hypothesis 5, that free Internet access sites would have fewer percent-ages of users accessing the Internet during nonworking hours than pay Internet access sites, was supported (Figure 5). Internet users at free Internet access sites during extended hours were a smaller percentage of the total number of users than those at pay Internet access sites.



Validity and Reliability. The measurements performed as the design intended and yielded accurate measures of race/ethnicity, income, and homeownership that were self-reported by patrons of free versus paid access sites. The self-reports are assumed to be accurate, because they corresponded with anecdotal user profiles that were reported by telecenter site managers. Data were consistently collected daily from both types of sites using the same collection procedures. Participants responded to the same electronic survey in the different environments. The only real difference was the user environment of pay versus free Internet access.

Discussion of the Internet Access Component EvaluationAlthough the presence of free public access telecenters has potential in reduc-

ing disparities in Internet access—i.e., in bridging the digital divide (Rogers and Shukla, 2001)—the gap continues to widen. Disparities grow because gains in accessibility (Medina, 2003) and therefore greater rates of increase in knowl-edge acquisition—Web-based learning—occur more readily for individuals who can afford a personal computer and an Internet connection. They occur much less readily and at a slower rate for individuals of lesser means who cannot afford these amenities (Figures 2 and 4).

Cybercafes, which offer more accessibility (more hours) to non-computer own-ers, are commercially sponsored and therefore charge for Internet access or require customers to purchase a minimum order of food and drink in order to use avail-able computers. Cybercafe patrons tend to have more disposable income, higher socioeconomic status, and greater financial stability, and they tend to be Anglo

Difference in Race/Ethnicity

Free vs. Paid Sites

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Figure 1. Difference in Race/Ethnicity for Free versus Paid Telecenter Sites for Telecenters in the Upper Rio Grande Valley



Difference in Household IncomeFree vs. Paid Sites

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Figure 2. Difference in Household Income for Free versus Paid Telecenter Sites for Telecenters in the Upper Rio Grande Valley

Figure 3. Difference in Home Ownership for Free Versus Paid Telecenter Sites for Telecenters in the Upper Rio Grande Valley

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(and recently relocated to the Upper Rio Grande Valley; Figures 1, 2, 3, and 4). On the other hand, free civic-sponsored Internet access telecenters and libraries, which for the most part offer fewer hours and thus less Internet access, tend to be frequented by predominantly low-income, non-Anglo users who tend to be na-tives of the Valley region (Figures 1, 2, 3, and 4).

For-pay cybercafes and free-access telecenters offer two different levels of acces-sibility and attract two different types of customers by socioeconomic profile. As already indicated, the two different settings also provide different levels of access and accessible hours (Figures 4 and 5), and the barrier that separates the two is the availability of disposable income.

Pay-for-Internet cybercafes thrive in New Mexico, filling slack evening and weekend hours when Internet access is not available at libraries, but while pre-dominantly higher income patrons access these cybercafes, low-income persons are effectively excluded by the just-noted financial barrier. Cybercafes charge for their Internet time and offer no tutors or classes. Higher-educated, higher socio-economic status, and (as it happened) Anglo patrons who had recently relocated predominate in the use of cybercafes. In contrast, non-Anglo or minor-ity subjects whose families have lived in the Valley for generations tend to be less educated and of lower socio-economic status. They generally do not patronize the for-pay cybercafes, despite the extended hours these businesses afford patrons (see Figure 1). Cybercafes were conspicuously absent in Colorado during the time

Figure 4. Cumulative Percentage of Free versus Pay Telecenters Measured in Percentage of Possible Extended Hours

Note: 100%Extendedhoursisequaltothenumberofextendedhours(hoursoutsideofthe8-5 workday)thatcomputerownerswithInternetaccesshaveaccesstotheInternet



0%

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Figure 5. Extended Hours Access as a Percentage of Total Respondents at Free Versus Paid Internet Access Sites

Note:LunchHouris11:45a.m.to1:00p.m.Afterhoursisafter5:00p.m.

Extended Hours Access: Percent of Total Respondent by Group

Legend Location and Name of the Project’s Internet Access Sites

*IPNumber Telecenter65.121.116.186 Taos Youth and Family Center, Taos65.112.216.34 Island Coffees and Hawaiian Grill, Taos65.19.11.84 Let’s Read Adult Literacy Program, Española148.78.249 Magic Bagel, Taos169.203.201.3 Taos Pueblo Day School, Taos Pueblo199.3.18.13.1 Casa de Amistad, San Luis204.151.72.26 La Plaza Telecommunity, Taos205.188.209.112 Oasis Café, Española207.188.128.246 Northern New Mexico Community College, Española209.94.68.11 Senior Citizens Center, Alamosa209.94.70.103 Costilla County Library, San Luis209.94.69.14 Carnegie Library, Monte Vista209.95.84.16 Del Norte Library, Del Norte209.94.67.66 Southern Peaks Library, Alamosa209.94.65.75 Conejos County Library, La Jara209.94.70.72 South Fork Library, South Fork216.31.18.228 Española Public Library, Española



of the study, while two free public-access sites in Alamosa and Monte Vista, the most populous Upper Rio Grande Valley towns, offered some extended hours.

Study Findings. It is evident from the perspective of this study that low-income individuals who rely on free Internet sites are disadvantaged in their access to Web-based health information as compared to others with more disposable in-come (Figures 2, 4, and 5). Different sample sizes for free access sites (11 sites for the user survey and 23 sites for the hours survey) over against pay sites (2 sites for user surveys and 4 sites for hours survey) are a limitation of this study. However, the purposive sample yielded sample distributions that accurately reflected the proportion of free sites to pay sites in the study area, and the findings were suf-ficiently robust to underscore the importance of these different means of Internet access for the study.

Another limitation of the Internet-access portion of the study concerned its inability to break out access patterns by gender as well as socioeconomic status; however, that limitation derived from the project design and not from the survey design. A final limitation was the study’s inability to independently assess read-ing level, since a college reading level is required to comprehend most Internet content, including much of the content in the NCI Initiative; this problem has been explored in other research (Berland et al., 2001). A further consideration that had to await impact evaluations of the larger NCI Initiative concerned the extent to which the availability of the NCI material and of the Outreach Trainers helped sensitize members of target populations to the value of Internet-medi-ated information and communication resources, informing potential users how they could gain access and to what end or for what benefit (see Colle and Roman,

Figure 6: Map of the Study Area in the Upper Rio Grande Valley



2002). Ways to address educational inequity continue to be explored in educa-tional research such as open and distance education (Dikshit, et al., 2002), and the topic provides grist for class discussion in pedagogical uses of the present case.

Discussion: Cross-cultural Communications, Sociodemographics, and Innovation Diffusion

To place the NCI Initiative in its most comprehensive context, it is necessary to consider the role of culture in the project. Communication within and across cultures—which Dennet (2003) calls “Web[s] of cooperative interdependence”—depends on tacit as well as expressed communicative conventions. While some conventions are taken for granted, as cultural norms, others result from concerted bridging efforts, as with programs, such as the NCI initiative, that attempt to bridge sending and receiving cultures. It is therefore the case that communica-tions and coordination presuppose shared valuation systems, at least as these pertain to cross-cultural efforts (Rogers, 1995). It is in this vein that Cooper and Zmud (1990) view the implementation of social programs as a process involving the diffusion and the creation of a new social network, spanning the sending and receiving networks. Cooper and Zmud build an implementation model that turns on Rogers’ postulate of mutual causation in innovation-diffusion between the sociocultural organization of senders and that of adopters (Rogers, 1995).

The diffusion literature, largely initiated by the work of author Rogers (Rogers, 1995; Rogers and Shoemaker, 1971) and developed by others (e.g., Cooper and Zmud, 1990; Lai and Mahapatra, 1997), considers the adoption and utilization of innovations—particularly in the area of social programs—as strongly related to implementation over time, involving timing and sequencing decisions and im-plicating adoption thresholds. This general thesis is further developed by Kwon and Zmud (1987), who specify six temporal stages of implementation: initiation, decision, adaptation, acceptance, routinization, and infusion. Bass (1969) devel-oped an influential epidemiological model for the forecasting of consumer- durable sales driven by advertising campaigns, a model now used in social mar-keting and public education campaigns such as the NCI Initiative, and one that is sensitive to the temporal dimension of innovation diffusion.

System-level lags and thresholds in the diffusion of innovations are found reflected in now standard, corresponding adopter categories, such as those of early, early-majority, late-majority, imitative, and laggard adopters. One analyti-cal scheme applied to the evolution of the Internet has a multi-stage evolutionary cycle of involving, among other stages, penetration, adaptation, and convergence, emphasizing the conflict in adopting communities between new media and older, culturally established means of communication (Lehman-Wilzig and Cohen-Avigdor, 2004). Time-sensitive threshold-diffusion models have become an im-portant theoretical complement to the spatial-diffusion models that dominated early innovation-diffusion theories.



Anticipation of implementation lags and thresholds can be used in directed dif-fusion efforts, by addressing behavioral contagion—thereby predicting patterns of innovation diffusion—and by carefully identifying and differentiating opinion leaders and imitative followers (Valente, 1996).

Thresholds may be seen as “tipping points,” as Gladwell (2002) characterizes the transitional moments when a technology, idea, normative behavior, market-ing campaign, epidemic, or other physical, biological, or social process reaches a critical diffusion mass.

Enabling or predisposing conditions—for example the deployment of change agents such as the Outreach Trainers to facilitate social marketing and educa-tion campaigns—render the innovation diffusion and adoption process more predictable (Gladwell, 2002). Uncertainty affects predisposition toward innova-tion adoption along two different dimensions, namely environmental complexity (heterogeneity) and environmental variability (variety), and in accordance with three innovation characteristics—perceived relative advantage, compatibility, and complexity (in the sense of difficult to learn and adopt). On balance, environmen-tal and adoption complexity are negatively correlated with perceived advantage and compatibility, and therefore with probability of adoption (Sia et al., 2004). This contextual factor was a consideration in Medina’s assessment of the differing environments of telecenters and cybercafes, along with differential ease of access and variable utility of for-pay cybercafes.

It is widely acknowledged in the literature that cultural distance is a liability associated with Internet technology (Brass and Labianca, 1999; Gargiulo and Benassi, 1999), with a high frequency of culturally determined communications failures between social program designers and their stakeholders, client groups, or constituencies (Gulati, 1998). In this study, and in particular in author Medi-na’s survey work, socioeconomic status, taken together with ethnicity, became a proxy for minority culture and for cultural distance from Web-based material.

To the extent that the NCI Initiative fell short of expectations, cultural factors were at play. Of particular concern to Rogers was the inadequacy of Web mate-rial presented in English only and without due attention to the local culinary cultures and related attitudes toward diet, prevention, and health. There was also an apparent underestimation of the difficulty involved in changing embedded cultural patterns, here relating to diet and preventive health, and particularly do-ing so in the direction of majoritarian cultural patterns of outlook and behavior. Medina’s study of socioeconomic factors hindering target population access to the Internet had signaled early that sociocultural barriers would seriously hinder the reach of the NCI Initiative.

As the evaluation progressed, a lack of goal congruence among providers and clients in the NCI Initiative was identified and was found to owe largely to cul-tural distance. Also crucial in that instance was the constraining role of computer and Web technologies themselves. These technologies were for the most part



alien to these target communities and were seldom used in private or public (hence the difficulty in recruiting subjects), notwithstanding the aforementioned enlistment of the Community Outreach Trainers from those same communities or later refinements in the use of community telecenters. A much more active facilitation role for those same Outreach Trainers became an important consid-eration in the project, particularly for older telecenter patrons unfamiliar with computers and the Internet.

Because of the involvement of community leaders as well as the trainers, the NCI Initiative redefined key programmatic and pedagogical elements to ensure a better fit for target populations. The Initiative owed its relative success to the extent of its cultural responsiveness, as well as its willingness to make mid-course corrections that allowed made it more culturally attuned with target communi-ties. Cultural networks fundamentally involve identity-type relations, i.e., in-terpersonal and inter-group relations based on shared values and outlooks. Social program implementation networks, such as those involved in the NCI Initiative rely, therefore, on cultural affinities, which must be sought and cultivated by interventionists and program planners.

Culture connotes community, and communication by definition is easier within than across communities. Therefore, boundary-spanners and change agents recruited from target communities can be essential actors in public education and information programs such as the NCI Initiative. In many instances, these change agents—in this case, the Community Outreach Trainers—fulfill both functions, as both within-community and inter-group actors.

The NCI Initiative made clear that the effective communication of social in-novation involves—and is in fact inseparable from—cultural communications. As Medina’s survey had indicated from the outset, and Rivera’s own work suggested, socioeconomic and cultural factors would coincide in acting as reinforcing bar-riers to access and adoption. In this case—and this suggests its suitability to the classroom—the intersection of sociocultural and socioeconomic influences defined the strength of barriers to innovation diffusion and therefore to project imple-mentation.

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215-227.Berland, G. K., et al. 2001. “Health Information on the Internet.” Journal of the American Medical

Association, 285(20).Brass, D. J., and G. Labianca. 1999. “Social Capital, Social Liabilities, and Social Resources

Management.” In R. Th. A. J. Leenders and S. M. Gabbay, eds., Corporate Social Capital and Liability. Dordrecht: Kluwer, 323-340.

Buller, D. B., et al. 2001. “Formative Research Activities to Provide Web-based Nutrition Education to Adults in the Upper Rio Grande Valley.” Family and Community Health, 24(3).



Colle, R. D., and R. Roman. 2002. The Telecenter Movement: Using ICTs for Social Change. Unpublished manuscript, Department of Communication, Cornell University, Ithaca, NY.

Cooper, R., and R. W. Zmud. 1990. “Information Technology Implementation Research: A Technological Diffusion Approach.” Management Science, 36(2):123-139.

Delgadillo, K., R. Gomez, and K. Stoll. 2002. Community Telecenter Development: Lessons from Community Telecenters in Latin America and the Caribbean. Ottawa, Ontario, Canada: IDRC.

Dennett, D. C. 2003. Freedom Evolves. New York: Viking Press.Dikshit, H. P., et al. 2002. Access and Equity: Challenges for Open and Distance Learning. New Delhi:

Kogan Page.Gagne, P. 2003. “World Summit on the Information Society.” Available at www.itu.int/wsis/basic/

about.html. Retrieved July 16, 2003.Gargiulo, M., and M. Benassi. 1999. “The Dark Side of Social Capital.” In R. Th. A. J. Leenders and S.

M. Gabbay, Corporate Social Capital and Liability. Dordrecht: Kluwer, 298-322.Gladwell, M. 2002. The Tipping Point: How Little Things Can Make a Big Difference. New York: Black

Bay Books.Gomez, R., P. Hunt, and E. Lamoureux. 1999. “Focus on Telecentres: How Can They Contribute to

Social Development?” CHASQUI-Latin American Review of Communication, June.Gulati, R. 1998. “Alliances and Networks.” Strategic Management Journal, 19:293-317.Kreps, G. L., and K. Viswanath. 2001. “Communication Interventions and Cancer Control: A Review

of the National Cancer Institute’s Health Communication Intervention Research Initiative.” Family and Community Health, 24(4).

Kwon, T. H., and R. W. Zmud. 1987. “Unifying the Fragmented Models of Information Systems Implementation.” In R. J. Boland and R. A. Hirschheim, Critical Issues in Information Systems Research. London: John Wiley and Sons, 227-248.

Lai, V. S., and R. K. Mahapatra. 1997. “Exploring the Research in Information Technology Implementation.” Information and Management, 32:187-201.

Medina, U. E. 2003. “Telecenter Functionality Index: A Measurement for Bridging the Digital Divide.” Unpublished manuscript, Department of Communication and Journalism, University of New Mexico, Albuquerque.

Rivera, M. A., and E. M. Rogers. 2004. “Evaluating Public Sector Innovation in Networks: Extending the Reach of the National Cancer Institute’s Web-based Health Communication Intervention Research Initiative.” The Innovation Journal: The Public Sector Innovation Journal, 9(3).

Rogers, E. M. 1995. Diffusion of Innovations, fourth edition. New York: The Free Press.Rogers, E. M. 2001. “The Digital Divide.” Convergence, 7(4).Rogers, E. M., and R. Agarwala-Rogers. 1976. Communications in Organizations. New York: Free Press.Rogers, E. M., and F. Shoemaker. 1971. Communication of Innovations: A Cross-cultural Approach, second

edition. New York: Free Press.Rogers, E. M., and P. Shukla. 2001. “The Role of Telecenters in Development Communication and

the Digital Divide.” Unpublished manuscript, Department of Communication and Journalism, University of New Mexico.

Sia, C., et al. 2004. “Effects of Environmental Uncertainty on Organizational Intention to Adopt Distributed Work Arrangements.” IEEE Transactions on Engineering Management, 51(3):253-268.

Tichenor, P. J., G. A. Donohue, and C. N. Olien. 1970. Mass Media Flow and Differential Growth in Knowledge. Public Opinion Quarterly, 34:159-160.

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Valente, T. W. 1996. “Social Network Thresholds in the Diffusion of Innovations.” Social-Networks, 18(1):69-89.

Wright, K. B., and S. B. Bell. 2005. “Health-Related Support Groups on the Internet: Linking Empirical Findings to Social Support and Computer-Mediated Communication Theory.” Available at www.gmu.edu/depts/comm/courses/620/620B/B30,%20Wright.doc. Retrieved August 14, 2005.

Zimmerman, D. E., et al. 2003. “Integrating Usability Testing into the Development of a 5 a Day Nutrition Web Site for At-risk Populations in the American Southwest.” Health Psychology, 8(1):119-134.



Una E. Medina is a Ph.D. candidate in the Department of Communication and Journalism at the University of New Mexico, where she teaches persuasive communication. She conducted research on the cybercafe and telecenter proj-ect for the National Institutes of Health’s National Cancer Institute through a minority supplement attached to the R01 grant. Medina was privileged to work as a research assistant to Everett M. Rogers and has been indelibly marked by his legacy. David B. Buller was Medina’s principal investigator in “5-a-Day the Rio Grande Way,” with co-principal investigators Rogers and W. Gill Woodall, who supervised Medina upon Roger’s death. Medina also acknowledges the mentor-ship of Mario Rivera, who stepped in to see this project to completion.

Mario A. Rivera is Regents’ Professor of Public Administration at the Univer-sity of New Mexico in Albuquerque, New Mexico. He was honored to collabo-rate on research for publication with Everett M. Rogers, who is renowned for his pioneering and enduring contributions to diffusion of innovations theory, from 2000 to 2004. The first of their coauthored articles was a research note cited in this study: “Evaluating Public Sector Innovation in Networks, Extending the Reach of the National Cancer Institute’s Web-based Health Communication Intervention Research Initiative.” Because that research note was in part the ba-sis—though with significant revision and extension—for the present, completed study, Rogers’ contribution to this study’s authorship is acknowledged. Con-tributors Rivera and Medina are the lead coauthors of the present study and are responsible for any omissions or misstatements that may be found in it.

W. Gill Woodall, Senior Scientist, Center on Alcoholism, Substance Abuse, and Addictions (CASAA), and Associate Professor of Communication and Journal-ism, The University of New Mexico, is an experienced NIH investigator focused in the area of Health Communication, and has served as principal or co-principal investigator on 10 NIH-funded R01 projects. These projects have spanned the research areas of drunk driving prevention (primary and secondary prevention), Responsible Beverage Service (RBS) research, adolescent alcohol and substance abuse prevention research, Internet interventions for adolescent smoking preven-tion and cessation, Internet interventions for dietary change among multicultural rural adults, Internet interventions to reduce risky alcohol consumption among college students, and Internet interventions to train and diffuse responsible bev-erage service practices. He has served as a permanent member of three NIH study sections for 12 years, and he teaches classes in Health Communication, Research Methods, and Nonverbal Communication at the University of New Mexico.

David B. Buller is a senior scientist and director of research at Klein Buendel, Inc., a health communication research and media development firm in Golden, Colorado. He is also an adjunct professor in the Department of Communication

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at the University of Colorado at Denver and Health Sciences Center and in the Department of Journalism and Technical Communication at Colorado State Uni-versity, and a member of the Colorado Cancer Center.

Everett M. Rogers was Distinguished Professor and Regents’ Professor at the University of New Mexico, in the Department of Communication and Journal-ism, until his untimely death in October 2004. The originator of diffusion-of-innovations theory and one of the greatest social scientists of the twentieth century, Ev was also one of the most collegial and generous of men. He is missed by many, and the impact of his scholarship is most enduring.

The authors wish to thank the sponsors of the research here presented: the National Cancer Institute; the Cooper Institute; the Department of Prevention, Education and Research at the University of New Mexico Center on Alcoholism, Substance Abuse, and Addiction (CASAA); respondents to the Telecenter User Survey; and the University of New Mexico Department of Communication and Journalism. A field report of the research findings was submitted to the Society for Prevention Research, Washington D.C., May 25-27, 2005. Correspondence about the project or this article should be addressed to Dr. Mario A. Rivera, School of Public Administration, The University of New Mexico, or emailed to [email protected].

GAZETTE


People in Public Affairs

SUNY–AlbanyFrank Thompson, dean of the Nelson Rockefeller College of Public Affairs and

Policy for 17 years, retired from that position in January. Under his leadership, the Rockefeller College was consistently ranked in the top 10 public affairs graduate schools by U.S. News and World Report.

Thompson served as the first chair of COPRA and subsequently as president of NASPAA. His major NASPAA initiative was to promote the movement to-ward the current mission-based accreditation processes. As president and chair of COPRA, he worked to ensure that accreditation processes were a quality-driven mechanism for schools going under review. Thompson plans to take a sabbatical to do research at Rutgers University, then return to teach and do research at the Rockefeller College.

University of ConnecticutAndrea Hetling has joined the MPA faculty at the University of Connecticut.

Hetling earned her Ph.D. in policy studies from the University of Maryland’s School of Public Policy. She won the 2003 NASPAA Annual Dissertation Award for her dissertation titled “Has the Family Violence Option Benefited Abused Women?” Hetling’s research interests include social policy and policy implementa-tion and she has published several articles in these areas.

Duke UniversityThe Terry Sanford Institute of Public Policy is launching a new Ph.D. program

in fall 2007. The new program will further develop the ability of faculty members and students to study policy questions, according to Bruce Jentleson, former direc-tor of the Sanford Institute.

“In most programs, master’s degrees still account for most of the students, but Ph.D. students are an important component,” said Jentleson. “Adding a Ph.D. pro-gram will further enhance our prominence.”

The department also recently revised its undergraduate curriculum to encour-age students to do more research and to provide more opportunities for hands-on experience.


Gazette

Georgia State UniversityDennis R. Young joined the Andrew Young School of Policy Studies in fall

2005 as the Bernard B. and Eugenia A. Ramsey Chair of Private Enterprise. Young is nationally recognized for his work in applying economic principles to nonprofit management. He taught at Case Western Reserve University before going to the Andrew Young School.

IllinoisKaren Mossberger has joined the faculty of the College of Urban Planning

and Public Affairs at the University of Illinois at Chicago as an associate profes-sor in the graduate program in public administration. Prior to her appointment at UIC, Mossberger taught at Kent State University. She is the author of The Politics of Ideas and the Spread of Enterprise Zones (2000) and coauthor of Virtual Inequality: Beyond the Digital Divide (2003), both published by Georgetown University Press. Her research interests include information technology, the digital divide, economic development, and policy analysis.

Yonghong Wu also accepted an appointment as an assistant professor in the graduate program in public administration at the University of Illinois at Chicago in fall 2005. Wu earned his Ph.D. from the Maxwell School at Syracuse University in 2004 and was a visiting assistant professor at UIC during the 2004-05 academic year. His specializations include budgeting and finance, technology policy, and theory. He recently published an article on state research and development policy in the Journal of Policy Analysis and Management and is engaged in research projects on local government finance.

Naval Postgraduate SchoolRobert Beck became dean of the Graduate School of Business and Public Policy

in October 2005.Larry Jones was honored recently as the recipient of the Aaron B. Wildavsky

Award for Lifetime Achievement in the field of public budgeting and financial management. The award was presented to Jones by the Association for Budgeting and Finance, a section of the American Society for Public Administration. Jones is one of the leading professors in the Financial Management Group at the Naval Postgraduate School in Monterey, CA (www.nps.navy.mil/gsbpp).

University of Missouri–Kansas CityDavid Renz, director of the Midwest Center for Nonprofit Leadership and the

Beth K. Smith/ Missouri Chair in Nonprofit Leadership at the Cookingham Insti-tute of Public Affairs in the Bloch School of Business and Public Administration, was awarded the Excellence in Community Engagement Chancellor’s Award on September 15, 2005.


Gazette

University of Southern MaineThe Muskie School of Public Service has appointed William H. Foster as in-

terim dean. Foster was formerly at Columbia University.

Villanova UniversityVillanova’s Department of Political Science is pleased to announce the appoint-

ment of Christine Kelleher as assistant professor beginning fall 2006. Kelleher received the 2004 Best Dissertation Award from the Urban Politics Section of the American Political Science Association. She will teach the research and statistic courses in the MPA core as well as undergraduate and graduate courses on urban politics.

University of West GeorgiaStanley M. Caress was appointed director of the NASPAA-accredited MPA

program at the University of West Georgia. He is a core professor in the program and previously served as its acting director. Caress, who has been at the University of West Georgia since 1992, will also oversee the Murphy Public Service Center, which conducts community outreach projects.

News, Programs, and Opportunities

Clark Atlanta University Launches Recruitment CampaignClark Atlanta University, one of six pilot schools in the Call to Serve Recruit-

ment Initiative, held its campaign launch ceremony in mid-January. The Initia-tive is aimed at drawing college students into federal service.

Vice Provost Beverly Edmond presided over the ceremony, titled “Learn, Lead, Change—Public Service Will Get You There!” Clark Atlanta President and American Society for Public Administration past president Walter D. Broadnax and his wife, Angel Broadnax, both former federal employees, rallied a crowd of more than 200 students, faculty members, and other community participants. Dr. Broadnax emphasized that Clark Atlanta, as the Recruitment Initiative’s only historically black university, was proud to be supporting the program. Myrtle S. Habersham, chief strategic officer of the Social Security Administration and a member of Clark Atlanta’s Class of 1968, delivered an inspirational keynote ad-dress. Representatives from Blacks in Government, the Atlanta Federal Executive Board, the Congressional Research Service, and the Partnership for Public Service also called on the campus community to learn more about the range of opportu-nities in the federal government.

The other pilot schools in the Initiative are George Washington University, Louisiana State University, Ohio State University, Stanford University, and the University of New Mexico. (Information courtesy of Call to Serve E-News).


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University of Missouri–Kansas CityThe Master of Public Administration (MPA) in the Cookingham Institute of

Public Affairs (CIPA) of the Bloch School of Business and Public Administration was recently designated as a Peace Corps Fellows/USA program. The program will recruit returned Peace Corps Volunteers to CIPA’s MPA degree program to use their knowledge and experience in community-building while they intern in Kansas City’s urban core. CIPA will provide full tuition for three Peace Corps Fellows and stipends for their internships.

“Peace Corps Fellows will be a tremendous asset in the classroom and the com-munity,” said Robyne Turner, Schutte/Missouri Professor of Urban Affairs and director of the Cookingham Institute. “They bring first-hand knowledge and experience from the field that will enrich the dialogue in the classes. Through their internships, they will be key players in community-building organizations, bringing confidence, savvy, and creativity to the work of nonprofits by addressing crucial problems with limited resources.”

The Peace Corps will inform eligible volunteers about the Cookingham Insti-tute’s MPA program through its Web site and newsletter, reaching Peace Corps volunteers nationally and internationally. According to the Peace Corps, approxi-mately 30 graduate schools participate in its Fellows Program and some 2,000 former volunteers have participated in the program since its inception in 1985.

Through their internships, Fellows will work side-by-side with community activists, residents, and professionals to address the challenges of the urban core. The work conducted by these student leaders will assist residents in achieving clean and safe neighborhoods and a stronger community.

“We recognize that each volunteer has his own special skill set,” Turner said. “But overall, we know they will be integral to developing the Kansas City com-munity.”

For more information, contact Liana Riesinger, Cookingham research associate, at [email protected] or 816-235-2291.

New Section of JEPA: Policy InnovationThe Journal of Comparative Policy Analysis is pleased to announce a new regular

section of the journal titled Policy Innovation. The purpose of the section will be to report on specific, innovative policies that have been adopted (legislatively approved or already implemented) by a national or subnational government. Its broader purpose is to disseminate to the global policy community knowledge of new, innovative policies that are being adopted and implemented. Innovative policies may be in any policy area, such as social welfare, health care, transporta-tion, regulation, or pensions.

The Journal encourages submissions on policy innovation from all regions of the world. Submissions to this section of the journal will be evaluated by the


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section coeditors, Anthony Boardman of the University of British Columbia and Aidan Vining of Simon Fraser University. They will draw upon additional referees where appropriate. Please send all submissions to Diana Walker at [email protected] with “Policy Innovation” in the subject line.

Kentucky and Martin School Public Finance SymposiumThe Martin School of Public Policy and Administration is pleased to announce

a symposium addressing current issues in public finance and financial manage-ment on May 18 and 19, 2006, in Lexington, Kentucky. The symposium, “The Buck Starts Where? Paying for Public Services,” will feature a variety of papers on topics including financing transportation, infrastructure, education, and homeland security.

The Martin School of Public Policy and Administration has a longstanding special focus on public budgeting and finance. The School is named in honor of James W. Martin, a scholar, public servant, and professor whose accomplishments have created a lasting legacy of scholarship and service through public finance. This symposium coincides with the 30-year anniversary of the Martin School. For more information on this symposium, go to www.martin.uky.edu~web/buckstarts/.

University of Massachusetts Offers Online Graduate Courses in Public Policy and Administration

The Center for Public Policy and Administration at the University of Mas-sachusetts Amherst is now offering online, graduate-level courses geared to-ward professionals in the public, nonprofit, and private sectors. Course offerings include Budgeting for Policymakers, Making Public Policy, Policy Analysis, and Introduction to Geographic Information Systems using Free/Libre and Open Source Software.

University of North Texas School Gets New NameThe School of Community Service at the University of North Texas has been

renamed the College of Public Affairs and Community Service. The College has eight academic departments including the Department of Public Administration, which offers three degrees: a bachelor of science in emergency administration and planning, the NASPAA-accredited MPA, and a new Ph.D. in public administra-tion and management (see www.unt.edu/padm).

Princeton UniversityPrinceton’s Wilson School has created a new program called “Scholars in the

Nation’s Service.” This scholarship encourages students to enter government ser-vice and trains them for future federal work. Beginning next year, all Princeton


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juniors will be eligible to apply to this six-year program. The first two years will be spent finishing studies at Princeton while working in a summer internship in the federal government. After graduation, scholars will be placed in a federal agency for two years of service.

Finally, they return to the Wilson School to earn a master of public affairs degree. The program’s design is practical: Offering the program to all Princeton juniors instead of just Wilson School students encourages the most qualified and dedicated students to apply regardless of their original choice of major. In addi-tion, the program targets students with achievement in natural sciences, engi-neering, and less commonly spoken foreign languages. This emphasis encourages candidates with potential in needed areas to become specialists once in govern-ment service.

Rutgers-Newark Awards Professor Marc Holzer Highest Academic Honors

Professor Marc Holzer was recently honored with the title of Rutgers Board of Governors Professor of Public Administration. The recognition was made dur-ing the Rutgers Board of Governors meeting on the Newark campus of Rutgers, where Holzer is chair of the graduate department of public administration and director of its doctoral program. Board of Governors professorships recognize a small number of the university’s most internationally distinguished faculty.

“Marc Holzer’s innovative research into public performance and productivity reaches far beyond the borders of Rutgers—indeed, far beyond the U.S. borders,” said Newark Provost Steven Diner. “But Marc’s area of scholarship is especially pertinent to our campus, with our distinctly urban mission. Civic involvement, combined with efficient and effective government, is especially vital to urban areas and critical to their economic revitalization.”

Levin College Offers New Executive Format Graduate Certificate in Research Administration

Through the efforts of Professor Vera Vogelsang-Coombs and College Budget Manager Rene Hearns, the Maxine Goodman Levin College of Urban Affairs at Cleveland State University has created a new graduate certificate in research administration. This is a collaboration with the Society of Research Administra-tors International (SRA), a nonprofit association dedicated to the education and professional development of research administrators and the enhancement of public understanding of the importance of research and its administration. This effort will combine the expertise of faculty from the Levin College with that of research administration professionals affiliated with the SRA and distinguished experts from leading research institutions.

The Graduate Certificate Program in Research Administration is designed to help practitioners address the challenges and opportunities facing research ad-


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ministrators, such as changing mandates, ethical dilemmas, international issues, and budgeting priorities. This multidisciplinary program also assists experienced administrators from higher education, healthcare, government, business, and the nonprofit sector.

The Levin College will administer the program. The Graduate Certificate in Research Administration will be run in an executive format; each student will perform coursework via WebCT and will participate in an intensive nine-day ses-sion at Cleveland State University.

Faculty members for the Graduate Certificate in Research Administration include Vera Vogelsang-Coombs, Dean Mark Rosentraub, Sylvester Murray, Jen-nifer Alexander, Larry Keller, Nancy Meyer-Emerick, Levin College Budget Man-ager Rene Hearns, Samuel Richmond (Department of Philosophy), Dean Mark A. Tumeo (College of Graduate Studies), Chenchu Bathala (Department of Finance), and Kathryn Watkins-Wendell (Office of Sponsored Programs and Research). (See http://urban.csuohio.edu/academics/certificates/ra-cert/.)

International Outreach to Prospective Students: NASPAA Partners with World Grad School Tour

Many top-notch graduate students across the globe not only choose between one or two programs in a particular country, but compare three or four differ-ent offerings in very different country locations. To reach out to foreign students considering enrolling in graduate programs in the United States, NASPAA is developing an International Web Portal on behalf of all member schools.

Similarly, the 2006 QS World Grad School Tour reaches out with almost two dozen graduate school fairs in Latin America, Europe, and Asia. In 2005, the Tour traveled with 140 institutions from 26 countries to 22 cities and attracted well over 21,000 candidates. This year’s Tour will continue to use print media, radio, and the Internet in addition to dedicated and tailored market research in order to reach grad school candidates interested in attending NASPAA schools and programs as well as complementary areas in the social sciences, law, business, and international relations.

The QS World Grad School Tour has worked with institutions such as Ameri-can University, the London School of Economics, Tufts University’s Fletcher School, the Heinz School at Carnegie Mellon University, the University of Den-ver Graduate School of International Studies, and Pepperdine University’s School of Public Policy.

For more information, see www.topgraduate.com/uploads/media/WGST_2006.pdf .


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Fulbright FellowshipThe Fulbright Scholar Program is offering 122 lecturing, research, or

combined lecturing/research awards in political science, and 55 in public administration, for the 2007-2008 academic year in countries around the world. U.S. Fulbright scholars enjoy an experience of a lifetime, one that provides a broad cultural perspective on their academic disciplines and connects them with colleagues at institutions internationally.

Awards for faculty and professionals range from two months to an academic year. Faculty in political science may apply not only for awards specifically in their discipline, but also for one of the many All Discipline awards open to any field. Grants are awarded to faculty of all academic ranks, including adjunct and emeritus. In most countries, lecturing is in English, though awards in Latin America, Francophone Africa, and the Middle East may require proficiency in another language.

The application deadline for Fulbright traditional lecturing and research grants worldwide is August 1, 2006. U.S. citizenship is required. For other eligibility requirements, detailed award descriptions, and an application, visit www.cies.org or send a request for materials to [email protected].

Forum on Presidential LeadershipThe Chronicle of Higher Education’s first-ever Forum on Presidential Leadership

will bring together the most influential leaders in American higher education: presidents, chancellors, vice presidents, board chairmen, and trustees of universi-ties and four-year colleges. The Challenge of Presidential Leadership: A Chronicle Forum, held in Washington, D.C., June 12, 2006, will cover the latest thinking on crisis management, board relations, mentoring, compensation and contracts, and work and family and will provide useful information on how to work in part-nership to lead institutions. Additionally, it will provide valuable intelligence to aspiring college presidents on how to better prepare for the job.

Attendees also will receive an in-depth report with a new look at the results of the Chronicle’s survey of college presidents, including previously unpublished findings, articles on better ways of preparing for the presidency, and other new research. For more information, see www.chronicle.com/presidentsforum.

The Naval Postgraduate School SymposiumThe Naval Postgraduate School’s Third Annual Acquisition Research Sym-

posium, “Acquisition Research: Creating Synergy for Informed Change,” will be held May 17-18, 2006, in Monterey, California. The Honorable Kenneth J. Krieg, Undersecretary of Defense for Acquisition, Technology, and Logistics, and The Honorable Delores M. Etter, Assistant Secretary of the Navy for Research, Development, and Acquisition will be the keynote speakers.


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This symposium serves as a forum for the exchange of ideas among scholars and practitioners of public sector acquisition. It will feature papers and presenta-tions on recently completed and ongoing projects conducted by researchers from universities and institutions from around the country, including projects in the Graduate School of Business and Public Policy’s Acquisition Research Program (www.nps.navy.mil/gsbpp/ACQN/).

The Symposium is intended to bring together a diverse audience of influential attendees from academe, government, and industry who are well placed to shape and promote future research in acquisition. If you would like to attend the sym-posium, see www.researchsymposium.org.

Additionally, a presymposium roundtable, “Accounting for Intellectual Capital in the Strategic Acquisition Process,” will be held on May 16, 2006, from 1-4 p.m. at the Naval Postgraduate School. The roundtable will feature Baruch Lev, Philip Bardes Professor of Accounting and Finance at New York University, Stern School of Business, and the director of the Vincent C. Ross Institute for Account-ing Research, and Bernard Marr, an expert on strategic performance management and balanced scorecards as distinguished panelists.

If you would like to attend the presymposium roundtable, simply register at www.researchsymposium.org/ocs/index.php?cf=6. The roundtable is free to all Symposium participants and other interested parties.

Washington Center Offers Unique Academic Seminars in SpringThe Washington Center for Internships and Academic Seminars is proud to

announce its lineup of academic seminars for May 2006. Utilizing the resources of the nation’s capital, The Washington Center seeks to provide unique experiences that will have a lasting impact upon its student participants.

Now in its thirtieth year, the Washington Center is a vital nonprofit organization serving hundreds of colleges and universities in the United States and other coun-tries by providing selected students challenging opportunities to work and learn for academic credit in Washington, D.C. The program has more than 33,000 alumni and leaders in numerous professions and nations around the world.

Leaders on Leadership ‘06: Critical Issues in the Age of Globalization will be held May 13-20, 2006. This one-week program, developed in consultation with The Wash-ington Center’s Honors Academic Advisory Committee, is designed for faculty and students in honors programs and members of honor societies and focuses on the leadership resources of the nation’s capital and its role in global policymaking. A diverse array of major speakers will address the group. The keynote speaker will be Colman McCarthy, director of the Center for Teaching Peace and former Washing-ton Post columnist.

From Government to Governance: Rethinking Democracy, Citizenship, and Politics for the 21st Century will take place May 13-19, 2006. This one-week program is being of-fered in cooperation with the Center for Democracy and Citizenship. Its intent is to


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promote civic engagement, with government being a partner and a resource for citi-zens rather than the solution to society’s problems. It is designed for students who ask, “How can I become involved?” or “How can I make a difference?” A diverse array of speakers involved in promoting civic engagement will address the group.

A highlight of both programs will be issue tracks that will allow small groups to focus on specific policy areas. For more information on costs and registration, see www.twc.edu/.

World Bank Conference on Inequality The III World Bank Conference on Inequality will focus on the interaction

between economic and political inequalities and on their consequences for institu-tional and economic development. The World Bank has issued a call for papers for the conference on the following topic: The distributions of income, wealth and politi-cal power are jointly determined, with economic status both affecting and being affected by political influence. In addition, the impact of inequality on the nature of institutions and on policy choice is one of the key channels through which income and wealth distributions affect economic performance.

Theoretical and empirical papers on any aspect of this subject are invited for consideration by the program committee. The conference will take place June 5-6, 2006, in Washington, D.C. It will be a plenary-only gathering, with space for up to 18 papers and 30 minutes allocated to each paper. Accommodation and travel costs (economy) will be covered by the organizers. Full papers must be submitted by March 15th, 2006. Please send an electronic version to [email protected]. Decisions will be sent out by April 15.

Interviews and EssaysThis new section of the JPAE Gazette offers essays, profiles, and Q&A inter-

views. The focus on these new features all relate in some way to public service, people serving in the field, or NASPAA schools or professional education. If you have a possible contribution or idea for this section, please contact Scott Talan, director of communications, at [email protected].

Internationalized Public Affairs EducationBrian Atwood, Chair of NASPAA International Committee, and Dean, Humphrey Institute of Public Affairs, University of Minnesota an interview by Scott Talan

ST: What is the current atmosphere in internationalized public affairs education? Where do you see things heading in the next five years?

BA: There is a direct connection between the demand for a public affairs educa-tion and the spread of democracy around the world. As people expect more


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professionalism and responsiveness from institutions that serve the public, the need for public affairs education increases. We have seen tremendous growth in the number of programs, both here and abroad. Competition around the globe is becoming intense, and what was once an exclusive preserve of Ameri-can universities is no more.

Public affairs degree programs in the United States still are in demand, but we have been losing foreign students because of more stringent post-9/11 visa requirements and because the United States has lost some prestige in the world. This trend can be turned around over the next five years, but it will require NASPAA members to engage more with foreign counterparts, learn more about the peculiar circumstances of professional life in other countries, and continue to globalize our curriculum.

ST: Why does the University of Minnesota believe it is important to offer a curricu-lum that has international elements?

BA: The Humphrey Institute at the Uni-versity of Minnesota always has had strong International Relations and International Development programs. We have found that the demand for these “concentrations” in our Master of Public Policy degree program has increased greatly since 9/11. Students are much more aware of the world beyond our borders and they want to prepare themselves for it. In fact, we have made an effort to introduce international literature and cases in our domestic courses as well. Most of our faculty members have had relevant international experiences and they use those experiences in the classroom.

ST: Tom Friedman argues that the “world is flat” and says borders are porous in terms of talent, ideas, products, and services. Does this analysis apply to public affairs educa-tion? If so, what steps should NASPAA and its internationally focused schools be taking to stay competitive?

BA: The modern-day public affairs professional must be prepared to operate easily among the public, not-for-profit, and private sectors. Each of these sectors is in turn influenced by new global economic, political, and envi-ronmental realities with which the professional must grapple. We are more interdependent that ever before, and in twenty years time, global issues will have either made nations more cooperative or they will do us in.

NASPAA can be a leading edge for sharing the best of our educational ap-

“There is a direct connection between the demand for a public affairs education and the spread of democracy around the world. As people expect more professionalism and responsiveness from institutions that serve the public, the need for public affairs education increases.”

—Brian Atwood


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proaches, research, and standards. As nations struggle to offer solutions to domestic and global problems, they will be looking to a new generation of leaders who possess the tools needed to make interdependence a natural and positive reality. NASPAA should see its role as providing that kind of leadership.

ST: Are you concerned at all that American students will increasingly start to choose to attend a foreign school to get their MPA/MPP degree?

BA: I am less concerned that Americans will look to go abroad for a public af-fairs education so long as we maintain a high standard. What concerns me more is that foreign students find our schools less attractive because of the obstacles we place before them and because our international policies seem to be making the United States a less popular destination.

We should, of course, encourage American students from high school on to have an intercultural learning experience. Many Humphrey students go abroad for their required internship or already have had an experience living overseas. Many are former Peace Corps volunteers. However, when it comes time to consider a degree in public affairs, NASPAA schools are still the best—by a narrower margin than before, but still the best.

Successfully Connecting Private and Public Careers by Dan Goodman

Almost twelve years ago, fresh out of graduate school, I joined a boutique management consulting firm in Boston. It was 1994, and business students everywhere were clamoring to enter the glamorous and high-energy consulting world. The only thing was, I wasn’t a business school graduate. I had an MPP from Harvard’s Kennedy School of Government. Most of my classmates were off to be Presidential Management Interns or to work in state economic develop-ment or any number of other pursuits that, when I began my graduate studies, I had thought would engage me. Today, four jobs later, I am able to combine my private sector experience with my twelve-year-old degree in a very public sector role. Far from being a detour, the sometimes circuitous path from a public policy degree through a career in the private sector was ideal preparation for what I’m doing now.

The world has changed since I received my MPP. The career options open to graduates of all kinds of professional schools have evolved incredibly rapidly. For a public policy student, however, I imagine some of the questions remain the same when deciding between the public and private sectors for a career path.

Where do I want to be in ten years, and in twenty? How much does money matter to me? In my own case, having studied the impact of government regula-tions on business and society, I thought to myself, “Go out and understand busi-ness from the inside before you try to start regulating it in pursuit of the public good.” Yes, and there was also the money.


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And so I began a decade of explaining to supervisors, colleagues, and business partners that no, I didn’t actually have an MBA. In some respects I had a leg up. Especially in the quasi-academic consulting world, my grasp of economics and statistics often surpassed that of my MBA-wielding colleagues. But occasionally when people spoke of something being the basic stuff of Marketing 101, I would quietly wrinkle my brow in thought. After all, I had never taken Marketing 101.

Many skills must be learned on the job, regardless of one’s background. The ability to exert influence effectively, for example, does not seem to be taught in business or policy school. I learned negotiating skills as a graduate student, but the opportunity to influence arises in many situations. How do you make your views known in a crowded meeting without seeming overbearing? What should you do with a colleague who presents with extraordinary confidence, but whose reasoning seems faulty? It’s somewhat surprising that these skills are not taught in policy school, since in many ways they are simply the skills of politics. They are nevertheless useful in many different situations, and I wish I had been exposed to them more formally in an academic environment.

In time, I realized that my lack of an MBA didn’t really matter in the busi-ness world. After four years of consult-ing, barely out of my twenties—and with lots of remedial reading about marketing—I was able to land a job as a director at a Fortune 100 company in the technology sector. As my career pro-gressed, at times I would wistfully look around at my former classmates’ devel-oping careers on Capitol Hill and at the World Bank, wondering whether I had made a mistake not embarking upon a career in public service. But, for the path I had chosen, I was succeeding.

Life has twists and turns in any career field, and after I moved to a short-lived Internet startup and then to another Fortune 100 technology company, the prin-ciples that originally attracted me to a degree in public policy began to reassert themselves with greater strength. Suddenly I faced a new set of challenges that seemed much more daunting than my first career decision. Self-help books are rife with reports that the typical person changes careers seven times, but how, I wondered. I was a successful mid-level executive and was accustomed to the re-sponsibilities—and compensation—associated with it. We often see stories in the news of this or that CEO becoming a governmental department head, but, at that moment, I didn’t see my own possibilities.

Fortunately, I was content and secure enough in my existing position that I did not have to pursue my planned career change with any sense of desperation.

“It’s strange, now that I’ve moved from the private sector to the public sector, that I don’t think of the transition as having been difficult.”

—Dan Goodman


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For once I was able to follow that other staple of career counseling: networking. I think networking can be oversold as a means to finding a job—in my experi-ence it’s important, but only one of many simultaneous sources that a job-seeker should pursue. In this case, however, my networking contacts were uniquely valuable in helping me recognize the transferability of so many of my skills from the private sector to the public sector. I just had to be willing to apply that set of skills to a new opportunity. With experience in business development, I could learn grantwriting and fundraising. Having worked on Web strategy, I could do the same a governmental organization. And so on.

In time, with patience and luck, the perfect opportunity came along. In my various jobs in the private sector I had built Web portals, written business plans, negotiated with partners, and had contacts in the world of cable television. Last spring, while browsing through an alumni career email, I found a job description that seemed to have been written for me.

The long list of required experience and education almost read like my resume. The job would be challenging, I realized, but I felt like I was perfectly suited to meet the challenge head on. Of course, the hiring process was not so simple as submitting a resume and asking when do I start, but the stars were aligned, I was mentally prepared for the transition, and, when the offer came, I did not hesitate.

Today, as Director of the National City Network (NCN), I’m able to bring it all together. NCN is a new service of National League of Cities and is intended to be the premier resource for elected city officials, city government workers, and engaged citizens to share information about best practices and to network with each other across the United States. Because of my background I was actually able to hit the ground running, something that is often much easier said than done. I’ve had the chance to work with top think tanks to aggregate the best analysis about city programs into an online virtual library. In previous jobs, I explored the ability of emerging Internet and video technologies to facilitate user participation in the creation and dissemination of content. At NCN, I can help extend those capabilities to the work of cities and communities. The role very clearly draws upon my business experience in the private sector, but it also requires my knowl-edge of and passion for public issues.

It’s strange, now that I’ve moved from the private sector to the public sector, that I don’t think of the transition as having been difficult. When I look back on the pre-transition period, however, I remember how difficult it was to define how I wanted to make the transition. I didn’t want an entry-level job, but I didn’t have the experience or the political connections to jump into a senior-level policy or administrative role. In retrospect, my willingness to be open to a range of pos-sible ways to leverage my private sector skills may have been the most important factor in facilitating a smooth transition.

As perfect as the fit seems, there is no single best path for any career, but may-be that’s the point. I could hardly have predicted 12 years ago that this is where I


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would be today. It reminds me of one of my favorite quotes, which seems to have originated with the Roman philosopher, Seneca, that “luck is what happens when preparation meets opportunity.” Even though I had no idea what picture was being drawn by the dots of my career path while I was in the middle of them, I see now that my work in the private sector, combined with my degree in public policy, was in fact ideal preparation for what I’m doing today. And I feel lucky.

NASPAA Launches Executive MPA Center: Promoting Executive Education for Experienced Public Sector Professionalsby Maja Holmes, NASPAA Executive MPA Center Coordinator

Leaders at all levels of government are facing a human capital crisis; city managers are grappling with developing regional collaborations, and nonprofit directors are adapting to performance-based management. As a result, NASPAA member schools are witnessing a growing demand to help policy directors, pro-gram managers, and senior advisors successfully navigate these emerging chal-lenges. Execution Education programs invite seasoned public sector professionals to reflect on their professional experiences, refine their political process skills, and identify relevant connections between theory and experience to help them do what they do best: meet the needs of the public.

Different Executive Education Models to Meet Diverse NeedsThe options for experienced public and nonprofit sector professionals in build-

ing their educational portfolio are as diverse as their individual experiences. Pub-lic affairs and administration schools are offering a range of Executive Education options, including:

• Executive Master’s degrees that offer the benefit of a more comprehensive degree program addressing the myriad of issues critical to today’s public and nonprofit sector leaders, including policy and program evaluation, political process skills, and transformative leadership. The executive-level master’s degree, which goes by different names—Mid-Career MPA, Executive Master of Public Policy, and Executive Master of Policy Man-agement—can be completed in 18-36 months and is structured to accom-modate professionals who work full-time by offering evening and weekend classes.

• Certificate programs generally encompass a series of courses emphasizing current legal and management trends and practical process skills in navi-gating through a specific policy domain, such as human resource manage-ment or environmental management.


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• Leadership training, typically offered as one-day or weeklong seminars, emphasizes a more experiential approach to encouraging professionals to reflect and improve upon their leadership capacity within the complex domain of public and nonprofit management.

Defining New Opportunities in Promoting and Developing Executive Education ProgramsIn an effort to promote Executive Education programs and support the devel-

opment of quality degree and nondegree options for public sector professionals, NASPAA has launched the Executive MPA Center. The Center aims to link prospective students to programs and serve as resource center for schools offering Executive Education programs by

• implementing an online searchable directory of executive education pro-grams for prospective students;

• conducting a survey to assess what public and nonprofit sector employers value as critical leadership skills;

• researching the most appropriate content and approaches to teach seasoned public sector professionals; and

• connecting dozens of executive education leaders who are interested in sharing best practices, curriculum designs, and marketing strategies at the NASPAA conference.

Lead It. Manage It. Transform It. To find out more about Executive Education visit www.naspaa.org/execmpa or

contact Maja Holmes at [email protected] or 202-628-8965, ext. 109.


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Student-Produced JournalsNASPAA has compiled a roster of public affairs/public administration jour-

nals produced solely by students. These journals cover an array of topics, cur-rent trends, and issues in the field of public administration. Promoting quality student scholarship can help bring more exposure to the field of public admin-istration and demonstrate the strength of public affairs/public administration academic program; it is our hope that you will share this information with your colleagues and students.

This listing of journals is updated continually and published annually in the Gazette. If you know a journal that should be included on this list, please send us the information. This listing can also be found on the NASPAA Web site at www.naspaa.org.

Asian American Policy ReviewJohn F. Kennedy School of Government, Harvard University79 John F. Kennedy Street, Cambridge, Massachusetts 02138Web: www.ksg.harvard.edu/aapr/ Email: [email protected]: 617-496-8655 Fax: 617-384-9555

Harvard Journal of Hispanic PolicyJohn F. Kennedy School of Government, Harvard University79 John F. Kennedy Street, Cambridge, Massachusetts 02138Web: www.ksg.harvard.edu/hjhp/ Email: [email protected]: 617-496-8655 Fax: 617-384-9555

Journal of African American Public PolicyJohn F. Kennedy School of Government, Harvard University79 John F. Kennedy Street, Cambridge, Massachusetts 02138Web: www.ksg.harvard.edu/HJAAP/ Email: [email protected]: 617-496-0517 Fax: 617-384-9555

The Public Purpose: An Interdisciplinary JournalAmerican University School of Public Affairs 4400 Massachusetts Ave. NW, Washington, DC 20016 Web: www.auglc.org/SPA/publicpurpose

Chicago Policy ReviewHarris Graduate School of Public Policy, University of Chicago1155 E. 60th Street, Room 191, Chicago, Illinois 60637Phone: 773-834-0901 Fax: 773-702-2286Email: [email protected]: www.harrisschool.uchicago.edu/publications/cpr/index.html

The Georgetown Public Policy ReviewGeorgetown Public Policy Institute, Georgetown University 3600 N Street NW, Suite 200, Washington, DC 20007-2670Phone: 202-687-8477 Fax: 202-687-2289 Email: [email protected] Web: http://gppi.georgetown.edu/GPPR/index.html

The Heinz School ReviewThe H. John Heinz III School of Public Policy and Management Carnegie Mellon University, 4800 Forbes Avenue, Pittsburgh, PA 15213 Email: [email protected] Web: http://journal.heinz.cmu.edu

Journal of International AffairsSchool of International and Public Affairs, Columbia UniversityBox 4, International Affairs Building420 West 118th St., New York, NY 10027Phone: 212-854-4775 Fax: 212-662-0398Email: [email protected] Web: http://jia.sipa.columbia.edu/

Journal of Public and International AffairsWoodrow Wilson School, Princeton University, Princeton, NJ 08544-1013 Email: [email protected] Web: http://www.princeton.edu/~jpia/

LBJ Journal of Public AffairsLyndon Baines Johnson School of Public AffairsThe University of Texas at AustinDrawer Y, University Station, Austin, Texas 78713-8925Phone: 512-471-3622Email: [email protected] Web: http://www.lbjjournal.com

Perspectives in Public AffairsArizona State University School of Public AffairsAttn: Anne Ellis, P.O. Box 870603, Tempe, AZ 85287-0603Phone: 480-965-3926 Fax: 480-965-9248Email: [email protected] Web: http://asu.edu/mpa/journal.htm

Pi Alpha Alpha On-Line JournalPAA National Office1120 G Street NW, Suite 730, Washington, DC 20005Phone: 202-628-8965 Fax: 202-626-4978Email: [email protected]: www.naspaa.org/initiatives/paa/journal/journal.asp


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Policy Perspectives: The George Washington University Journal of Public AdministrationThe George Washington UniversitySchool of Public Policy and Public Administration805 21st Street NW, Media and Public Affairs Building, Room 602Washington, DC 20052Phone: 202-994-6295 Fax: 202-994-6792Email: [email protected] Web: www.gwu.edu/~pad/journal

The Rockefeller ReviewNelson A. Rockefeller College of Public Affairs and PolicySUNY—University at Albany135 Western Ave., Milne Hall Room 103, Albany, NY 12222Phone: 518-442-5253Email: [email protected]: www.albany.edu/rockefeller/rockreview/rcr_index.htm

The Urbanist Center for Urban Research and Policy, Columbia University420 W. 118th St., Mail Code 3355, New York, NY 10027Phone: 212-854-2072 Fax: 212-854-8925Email: [email protected]

The Wagner ReviewRobert F. Wagner Graduate School of Public Service, New York University4 Washington Square North, New York, New York 10003-6671Phone: 212-998-7400 Fax: 212-995-4162Email: [email protected]: www.nyu.edu/clubs/wsa/wagnerreview.htm

Roster of Public Affairs OrganizationsNASPAA has compiled a partial list of organizations that share common

interests within the field of public administration. This roster is continu-ally updated and published annually in the Gazette. Please email NASPAA ([email protected]) with corrections and additions.

American Academy of Certified Public Managers www.cpmacademy.orgThe AACPM is a professional association of public sector managers. Among its purposes is to unite Certified Public Managers, encourage the acceptance of management in government as a profession established on an underlying body

of knowledge, promote a high professional, educational, and ethical standard in public management, and facilitate positive changes to enhance the delivery of public services.President: Bill Herman, CPMContact: P.O. Box 207, New Durham, NH 03855; phone 603-859-

2091; fax 603-859-6644; email: [email protected]: The CPM Connection (newsletter)—Greg Hyland, editor

American Assembly of Collegiate Schools of Business www.aacsb.eduAACSB—the International Association for Management Education—is a non-profit association of educational institutions, corporations, and other organiza-tions devoted to the promotion and improvement of higher education in busi-ness administration and management.President: John J. FernandesContact: 777 South Harbour Island Boulevard, Suite 750, Tampa, FL

33602-5730; phone 813-769-6500; fax: 813-769-6559; email: [email protected]

Publications: BizEd Magazine

American Political Science Associationwww.apsanet.orgAPSA is the major professional society for those engaged in the study of politics. Its mission is to reach out to scholars, teachers, students, and others throughout the world to facilitate learning, teaching, and research in the field of political science.President: Susanne Hoeber RudolphExec. Director: Michael BrintnallContact: 1527 New Hampshire Avenue, NW, Washington, DC 20036-

1290; phone 202-483-2512; fax 202-483-2657; email: [email protected]

Publications: American Political Science Review—Lee Sigelman, editor; PS: Political Science and Politics—Robert Hauck, editor; Perspectives—Jennifer L. Hochschild, editor.

American Society for Public Administrationwww.aspanet.orgASPA is the largest and most prominent professional association in the field of public administration. It is a focal point for linking thought and practice within the field of public administration. President: Donald C. MenzelExec. Director: Antoinette Samuel


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Contact: 1120 G Street, NW, Suite 700, Washington, DC 20005-3885; phone 202-393-7878; fax 202-638-4952; email: [email protected]

Publications: Public Administration Review—Larry D. Terry, editor; P. A. Times—Christine J. McCrehin, editor.

Association for Research on Nonprofit Organizations and Voluntary Action www.arnova.orgARNOVA brings together academic scholars and researchers from voluntary nonprofit organizations representing more than 20 disciplines from more than 35 countries. This unique blend of theoretical and applied interest helps scholars gain insight into real-world concerns while providing practitioners with valuable perspectives and data relevant to their work.President: David C. HammackExec. Director: Katherine M. FinleyContact: 550 West North St., Suite 301, Indianapolis, IN

46202; phone 317-684-2120; fax 317-684-2128; email: [email protected], [email protected]

Publications: Nonprofit and Voluntary Sector Quarterly, ARNOVA Abstracts, ARNOVA News

Association of Collegiate Schools of Planningwww.acsp.orgACSP, founded in 1959, is an organization of university departments and schools that teach urban and regional planning. Its purpose is to enhance and promote education and research in the field.President: Dr. Christopher Silver University of Illinois at Urbana-ChampaignContact: Phone 217-333-4555; email: [email protected]: Journal of Planning Education and Research—Karen Christensen,

editor ([email protected]); ACSP Update—Nancy Frank, editor.

Association of Government Accountants www.agacgfm.orgAGA is an international organization recognized as a leading professional asso-ciation dedicated to the enhancement of public financial management. The association serves its members by providing education, encouraging professional development, influencing governmental financial management policies and prac-tices, and acting as an advocate for the profession.President: Jullin RenthropeExec. Director: Relmond Van Daniker


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Contact: 2208 Mount Vernon Avenue, Alexandria, VA 22301-1314; phone 703-684-6931/800-AGA-7211; fax 703-548-9367; email: [email protected]

Publications: The Journal of Government Financial Management, Topics, AGA Today, Journal CPE Online

Association for Public Policy Analysis and Managementwww.appam.orgAPPAM encourages excellence in research, teaching, and practice in the field of public policy analysis and management.President: Richard Nathan, Rockefeller Institute of GovernmentExec. Director: Erik DevereuxContact: P.O. Box 18766, Washington, DC 20036-8766; phone 202-

496-0130; fax 202-496-0134; email: [email protected]: Journal of Policy Analysis and Management—Maureen Pirog,

Indiana University School of Public and Environmental Affairs, editor

Association of Professional Schools of International Affairswww.apsia.orgAPSIA is an institutional membership organization comprised of U.S. graduate schools of international affairs. These schools are dedicated to advancing global understanding and cooperation by preparing men and women to assume posi-tions of leadership in world affairs. President: Tom Farer, University of DenverExec. Director: Daniel WhelanContact: 2101 South Gaylord Street, Denver, CO 80208, phone 303-871-

4021; email: [email protected], [email protected].

Consortium of Social Science Associations www.cossa.orgCOSSA is an advocacy organization for federal support for the social and behav-ioral sciences and represents the full range of social and behavioral sciences. President: Orlando Taylor, Howard University Exec. Director: Howard J. Silver Contact: 1522 K Street NW, Suite 836, Washington, DC 20005; phone

202-842-3525; fax 202-842-2788; email: [email protected], [email protected]

Publications: COSSA Washington Update


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Council for Excellence in Governmentwww.excelgov.orgThe CEG is a national organization whose mission—improving the performance of government—responds to a critical national challenge. The Council works directly with public and private executives and organizations to achieve its objectives.President/CEO: Patricia McGinnisChair: John D. Macomber, JDM Investment GroupContact: 1301 K Street NW, Suite 450W, Washington, DC 20005;

phone 202-728-0418; fax 202-728-0422; email: [email protected]

Publications: E-News Online, Prune Books, Partnership for Trust in Government Newsletter, Scotty Campbell Senior Fellows Newsletter

Independent Sectorwww.independentsector.orgIndependent Sector is a national leadership forum working to encourage philan-thropy, volunteering, nonprofit initiatives and citizen action that help us better serve people and communities. Its mission reflects the shared value of every non-profit organization: to pursue a goal for the public good. President: Diana AvivChair: William E. Trueheart, Pittsburgh FoundationContact: 1200 18th St NW, Suite 200, Washington, DC 20036; phone

202-467-6100; fax 202-467-6101; email: [email protected], [email protected]

Publications: Giving and Volunteering Signature Series

International City/County Management Associationwww.icma.orgICMA is a professional and educational organization of appointed administrators and assistant administrators service cities, counties, other local governments, and regional entities. The purposes of ICMA are to enhance the quality of local gov-ernment through professional management and to support and assist professional local government administrators internationally. President: J. Thomas LundyExec. Director: Bob O’Neill, [email protected]: 777 N. Capitol Street NE, Suite 500, Washington, DC

20002-4201; phone 202-289.4262; fax 202-962-3500; email: [email protected]

Publications: ICMA Newsletter, Job Opportunities Bulletin for Minorities and Women in Public Management, IQ Reports, Public Management, Publications and Services Catalog (800-745-8780)


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International Personnel Management Associationwww.ipma-hr.orgIPMA is a nonprofit membership organization of human resource professionals representing the interest of more than 6,000 individual and 1,300 agency mem-bers at the federal, state, and local levels of government.Exec. Director: Neil Reichenberg, [email protected]: 1617 Duke Street, Alexandria, VA 22314; phone 703-549-

7100; fax 703-684-0948Publications: Public Personnel Management, IPMA News, Agency Issues,

Center for Personnel Research Services Review

National Academy for Public Administrationwww.napawash.orgNAPA is an independent, nonprofit, nonpartisan organization chartered by Congress to assist federal, state, and local governments in improving their per-formance. The Academy, through its many projects, is at the forefront of efforts to create more efficient, effective, and accountable government.President: C. Morgan KinghornContact: 1100 New York Avenue NW, Suite 1090 East, Washington, DC

20005; phone 202-347-3190; fax 202-393-0993Publications: NAPA Publications, phone 202-347-3190, ext. 3130

National Forum for Black Public Administrators www.nfbpa.orgThe NFBPA is a professional membership organization dedicated to the advancement of black leadership in the public sector. It includes managers and executives in virtually all disciplines represented in state and local governments. It is dedicated to strengthening the capacity of state and local government man-agers in a multitude of disciplines through intensive training, professional devel-opment programs, and a powerful network of black public leadership.President: Cheryl Perry League, [email protected]. Director: John E. Saunders, III, [email protected]: 777 N. Capitol Street NE, Suite 807, Washington, DC 20002;

phone 202-408-9300; fax 202-408-8558Publications: NFBPA Forum

The Partnership for Public Servicewww.ourpublicservice.orgThe Partnership is a nonpartisan organization dedicated to revitalizing public service. It seeks to restore public confidence in and prestige to the federal civil service through an aggressive campaign of public-private partnerships as well as focused research and educational effort.


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President: Max Steir, [email protected]: Daily Pipeline, Partnership ReportsContact: 1725 Eye St. NW Suite 900, Washington, DC 20006;

phone 202-775-9111; fax 202-775-8885; email: [email protected]

Pi Alpha Alphawww.naspaa.org/initiatives/honor.aspPAA is the national honor society for the field of public affairs and public administration. NASPAA-member universities and colleges are eligible to estab-lish a PAA chapter. The society is dedicated to recognizing outstanding scholar-ship and accomplishment in the field.President: J. Steven Ott Contact: 1120 G Street NW, Suite 730, Washington, DC 20005-

3081; phone 202-628-8965; fax 202-626-4978; email: [email protected]

Publications: Online JournalsMeetings: National Council Meeting in conjunction with the NASPAA

Annual Conference and the Biennial Society Meeting in odd-numbered years.

Policy Studies Organizationswww.ipsonet.orgThe purpose of PSO is to promote the application of political and social sci-ence to import policy problems. Policy studies is interested in the impact of policy causes, such as policy schools, the causes of policies, such as free speech versus repression; the impact of policies, such as free trade versus tariffs; and the achievement of desired effects, such as policies to promote peace, prosperity, and public participation.President: Paul J. Rich, [email protected]: David Merchant, 1527 New Hampshire Ave NW; phone

202-483-2512, ext. 107; fax 202-483-2657; email: [email protected]

Publications: Policies Studies Journal, Policy Studies Review, Policy Evaluation News, Developmental Policy Studies Consortium, and PSO Books

Public Employees Roundtable www.theroundtable.orgPER, a nonpartisan, nonprofit, educational association, was formed in 1982 to address the need for improved communication and understanding between government and the citizens it serves. Its mission is to inform Americans about the contributions public employees make to the quality of our lives, to encour-


Gazette

age excellence and esprit de corps in government, and to promote public service careers.Chief Operating Officer: Adam Bratton, [email protected]: Kirke HarperContact: 1301 K Street NW, Washington, DC 20005; phone 202-728-

0418; fax 202-728-0422; email: [email protected]

Society for Human Resource Managementwww.shrm.orgSHRM is the leading voice of the human resource profession, representing the interests of 91,000 professional and student members from around the world. SHRM provides its membership with education and information services, con-ferences and seminars, government and media representation, online services, and publications that equip human resource professionals for their roles as lead-ers and decision makers within their organizations.Contact: 1800 Duke Street, Alexandria, VA 22314; phone 703.548-

3440; fax 703-535-6490; email: [email protected]. Director: Sue MeisingerChair: Johnny C. Taylor, Jr.Publications: HR Magazine, HR News, Employment Management Today

Urban Affairs Associationwww.udel.edu/uaa/The UAA is the international professional organization for urban scholars, researchers, and public service provider. UAA encourages the dissemination of information and research findings about urbanism and urbanization and provides leadership in fostering urban affairs as a professional and scholarly discipline.Chairperson: Nancy Kleniewski, Bridgewater State CollegeExec. Director: Pamela LelandContact: University of Delaware, 298 Graham Hall, Newark, DE 19716;

phone 302-831-1681; fax 302-831-4225; email: [email protected]: Journal of Urban Affairs—Scott Cummings, St. Louis University,

editor


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Roster of International Associations This is a list of international associations that share common interests with the

field of public affairs and public administration. Any additions and/or corrections should be sent to NASPAA.

The African Association of Public Administration and Managementwww.aapam.orgAAPAM is an international professional association for African public admin-istrators and managers. It has membership of more than 500 top administra-tors and managers from many African nations and fifty corporate members that include institutions and schools of public administration and management in Africa.President: Mr. John MitalaContact: The Secretary General of African Association for Public

Administration and Management (AAPAM), British American Centre, Ragati & Mara Roads, P.O. Box 48677, 00100 GPO, Nairobi, Kenya; phone 254-20-2730505; email: [email protected]

Canadian Association of Programs in Public Administrationwww.cappa.ca/index.htmlCAPPA is an association of schools, programs, and departments across Canada engaged in teaching public administration, with 45 affiliated programs. All involved are dedicated to the improvement of the quality of public administra-tion education. CAPPA sponsors an annual mini-conference on teaching and conducts occasional sessions at the annual meetings of the Canadian Political Science Association.President: Sandford Borins, University of Toronto at Scarborough; email:

[email protected]: Canadian Association of Programs in Public Administration,

1075 Bay St., Suite 401, Toronto, ON M5S 2B1 Canada; phone 416-924-8787; fax 416-924-4992.

Commonwealth Association for Public Administration and Managementwww.capam.orgCAPAM is devoted to the exchange of timely information of the renewal efforts of the 51 members of the Commonwealth. CAPAM’s aim is to enhance Commonwealth cooperation to improve managerial competence and organiza-tional excellence in government. President: Jocelyne Bourgon


Gazette

Exec. Director: Gilliam Mason, [email protected]: 1075 Bay Street, Suite 402, Toronto, Ontario, Canada, M5S

2B1; phone 1-416-920-3337; fax 1-416-920-6574; email: [email protected]

European Group of Public Administrationwww.iiasiisa.be/egpa/agacc.htmThe EGPA aims to organize and encourage the exchange of information on devel-opments in the theory and practice of public administration; foster comparative studies and the development of public administrative theory within a European perspective; facilitate the application of innovative ideas, methods, and techniques in public administration; and include young teachers, researchers, and civil ser-vants in its activities.President: Dr. Geert Bouckaert, Professor, Instituut voor de Overheid

(Public Management Institute), K.U. Leuven Van Evenstraat, 2A, B-3000 Leuven, Belgium, phone 32-16-32-32-70; fax 32-16-32-32-67, email: [email protected]

Contact: rue Defacqz, 1, Bte. 11, B-1000 Bruxelles (Belgique) Belgium; phone 32-2-536-08-84; fax 32-2-537-97-02; email: [email protected]

Inter-american Network for Public Administration Educationwww.inpae.netInitially a NASPAA initiative in Latin America, the independent organization INPAE seeks to establish and strengthen the relationship between the North and the South in view of improving education in public administration in the Americas.Interim Co-president: Sonia Ospina/Robert F.Wagner Graduate School of Public

Service, New York University, [email protected]: 1120 G Street NW, Suite 730, Washington, DC 20005-3801

USA; phone 202-628-8965, ext.102; fax 202-626-4978

Network of Asia-Pacific Schools and Institutes of Public Administration and Governancewww.intanbk.intan.my/napsipag/NAPSIPAG is the result of a technical assistance project of the Asian Development Bank (ADB) to establish a network of schools and institutes of pub-lic administration within Asia and the Pacific region.Exec. Director: Dr. Mohd. Gazali Abas, [email protected]: c/o National Institute of Public Administration (INTAN), Jalan

Bukit Kiara, 50480 Kuala Lumpur, Malaysia, phone 603-2084-7777; fax 603-2096-2205; email: [email protected]


Gazette

International Association of Schools and Institutes of Administrationwww.iiasiisa.be/schools/aeacc.htmIASIA is a specialized association of the International Institute of Administrative Sciences (IIAS) and is a network made up mainly of schools, institutes of admin-istration, and other organizations providing services related to training, educa-tion, consultancy, research, and publications that respond to the institutional development needs of public management and public administration. President: Turgay ErgunExec. Dir: Juan Cabrera-ClergetContact: rue Defacqz 1, Bte 11, B-1000 Bruxelles (Belgique) Belgium;

phone 32-2-536-08-80; fax 32-2-537-97-02; email: [email protected]

International Institute of Administrative Scienceswww.iiasiisa.be/iias/aiacc.htmThe IIAS is an international scientific association specializing in public adminis-tration and the administrative sciences. Its scope includes questions that concern contemporary public administration at the national and international levels.Chair: Franz StrehlDirector General: Michael DuggettContact: rue Defacqz 1, Bte 11, B-1000 Bruxelles (Belgique) Belgium;

phone 32-2-536-08-80; fax 32-2-537-97-02 ; email: [email protected]

Publications: International Review of Administrative Science Request catalog of publications from address above.

National Network of Institutes and Schools of Public Administration in Central and Eastern Europewww.nispa.sk/NISPAcee supports the development of public administration education and training programs in Eastern and Central Europe.Exec. Dir: Ludmila Gajdosova, [email protected]: Hanulova 5/B, P.O. Box 163, 840 02 Bratislava 42, Slovak

Republic; phone 421-2-64285357; fax 421-2-64285557; email: [email protected]

About NASPAANASPAA is an association of more than 253 schools of public affairs and ad-

ministration in the United States and assorted associate members in the United States and abroad. We are committed to promoting quality in public affairs education and to promoting the ideal of public service. NASPAA serves as the


Gazette

specialized accrediting body for academic programs in public administration, public policy, and public affairs. This accreditation practice now includes a roster of 155 accredited programs.

Featured activities on NASPAA’s agenda include an active campaign for public service and public service education, which includes initiatives addressing media relations and the tracking of public policy issues relevant to NASPAA’s mis-sion. We are sponsoring research and action on the status of minorities in public affairs education. NASPAA works closely with the International City/County Management Association (ICMA) on education and training for local government management. In recognition of the broadening dimensions of our field, we have developed a set of guidelines for nonprofit education in collaboration with the Nonprofit Academic Centers Council. We are also working on outreach in other areas central to NASPAA programs, such as health management education. In addition, we are engaged internationally, particularly in the development of the Network of Institutes and Schools of Public Administration in Central and East-ern Europe (NISPAcee) and the new Inter-American Network for Public Admin-istration Education (INPAE).

NASPAA’s Annual Conference on public affairs and public affairs education is focused on research and dialogue on academic program administration, on curriculum and teaching, and on the synthesis of research on topics of current importance and the relationship of this research to teaching and practice. The conference is an active mix of program administrators, faculty, students, and practitioners in our field.

NASPAA on the InternetWeb site: www.naspaa.org Listserv: To subscribe to the NASPAA listserv, email

your request to [email protected]. The subject line should remain blank. In the body of the message, type only the following line: subscribe naspaa your complete name. To submit items to the listserv, address them to [email protected].

NASPAA also has specialized listservs for career directors and doctoral program directors. Please see www.naspaa.org/principals/news/listserv.asp for details on how to join these lists.


Gazette

NASPAA Staff Directory

Inquiries about specific program areas may be sent to the following email addresses or to NASPAA at 1120 G Street NW, Suite 730, Washington, DC 20005. Phone: 202-628-8965. Fax: 202-626-4978.

General Information: [email protected]: [email protected]: [email protected]: [email protected]: [email protected]

Please send news about your program, faculty, events, or honors for upcoming issues of the JPAE Gazette to us at [email protected].

Laurel McFarland Executive [email protected]

Crystal Calarusse Interim Academic [email protected]

Ryan Gottschall Project [email protected]

Maja Husar Holmes Executive MPA Center [email protected]

Jacqueline F. Lewis Conference/Project Coordinator National Director, Pi Alpha Alpha [email protected]

Ana Mejia International Programs [email protected]

Barbara Ridgely Finance [email protected]

Katherine Saad Project [email protected]

Scott Talan Director of Marketing/[email protected]

Geoffroy Trinh Project [email protected]

Cosima Wadhwa Project [email protected]

Monchaya Wanna Office [email protected]

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Spring 2006 Volume 12, No. 2

A Proposed Methodology for the Infrastructure Development of NASPAA Programs with Specialty Tracks: The Case of Health Policy and Management

Anne M. Hewitt, Brenda Stevenson Marshall, and Kent H. Badger

A National Profi le of NASPAA Programs with Health Specialty Tracks Brenda Stevenson Marshall and Anne M. Hewitt

Exploring the Predictors of Health Specialty Track Accreditation for NASPAA Member Programs

Brenda Stevenson Marshall and Carl F. Ameringer

Benchmark Health Policy Programs: A Window on Public Affairs and Administration Education

Judith J. Kirchhoff and Thomas H. Dennison

Public Affairs and Healthcare Administration: Crosscutting Competencies and Multiple Accreditation Challenges for Academic Programs

Karen Harlow-Rosentraub and James L. Perry

Internet Access and Innovation-Diffusion in a National Cancer Institute Preventive Health Education Project: Telecenters, Cybercafes,

and Sociodemographic Impacts on Knowledge Gaps Una E. Medina, Mario A. Rivera, Everett M. Rogers,

W. Gill Woodall, and David B. Buller

NASPAA Gazette: People in Public AffairsNews and Opportunities ■ Interviews and Essays

Student-Produced Journals ■ Public Affairs Organizations ■ International Associations

Flagship Journal of the National Association of Schools of Public Affairs and Administration

National Association of Schools of Public Affairs and Administration1120 G Street, NW, Suite 730, Washington, DC 20005-3801

202-628-8965 fax 202-626-4978 www.naspaa.org

The Journal of Public Affairs Education (JPAE) is the fl agship journal of the National Association of Schools of Public Affairs and Administration (NASPAA). Founded in 1970, NASPAA serves as a national and international resource for the promotion of excellence in education for the public service. Its institutional membership includes more than 250 university programs in the United States in public administration, policy, and management. It accomplishes its purposes through direct services to its member institutions and by

• Developing and administering appropriate standards for educational programs in public affairs through its Executive Council and its Commission on Peer Review and Accreditation;

• Representing to governments and other institutions the objectives and needs of education for public affairs and administration;

• Encouraging curriculum development and innovation and providing a forum for publication and discussion of education scholarship, practices, and issues;

• Undertaking surveys that provide members and the public with information on key educational issues;

• Meeting with employers to promote internship and employment for students and graduates; • Undertaking joint educational projects with practitioner professional organizations; and • Collaborating with institutes and schools of public administration in other countries

through conferences, consortia, and joint projects.

NASPAA provides opportunities for international engagement for NASPAA members, placing a global emphasis on educational quality and quality assurance through a series of networked international initiatives, in particular the Network of Institutes and Schools of Public Administration in Central and Eastern Europe (NISPAcee), the Inter-American Network of Public Administration Education (INPAE), and the Georgian Institute of Public Affairs (GIPA). It is also involved locally; for instance, directing the Small Communities Outreach Project for Environmental Issues, which networks public affairs schools and local governments around environmental regulation policy issues, with support from the Environmental Protection Agency.

NASPAA’s twofold mission is to ensure excellence in education and training for public service and to promote the ideal of public service. Consistent with NASPAA’s mission, JPAE is dedicated to advancing teaching and learning in public affairs, defi ned to include the fi elds of policy analysis, public administration, public management, and public policy. Published quarterly by NASPAA, the journal features commentaries, announcements, symposia, book reviews, and peer-reviewed scholarly articles on pedagogical, curricular, and accreditation issues pertaining to public affairs education.

JPAE was founded in 1995 by a consortium from the University of Kansas and the University of Akron and was originally published as the Journal of Public Administration Education. H. George Frederickson was the journal’s founding editor. In addition to serving as NASPAA’s journal of record, JPAE is affi liated with the Section of Public Administration Education of the American Society for Public Administration.


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