The Epidemiology and Costs of Disease Intervention Specialist Retention

Abstract

Background The COVID-19 pandemic changed the environment in which disease intervention specialists (DISs) operate, as their skills were in demand beyond sexually transmitted disease (STD) control programs. Workforce conditions generally have changed in the last 2 years, imposing additional challenges. Retaining STD DIS has become more difficult in the changed environment. Materials and Methods We conducted a landscape scan and obtained data from literature and personal observations to characterize current DIS workforce issues. We used published employment data to characterize current labor market conditions and described how cost-effectiveness analysis could be used to assess potential DIS retention interventions. An example illustrating cost-effectiveness concepts was developed. Results Many STD control programs faced difficulties in retaining STD DIS, because competing positions often could be done without field work. Economic and crime issues posed additional challenges. General workforce turnover has increased 33% since 2016. Turnover varies by age, sex, and education. Cost-effectiveness analysis can be used to assess DIS retention interventions, but data on costs and outcomes are needed on an ongoing basis. Changes in the workforce environment could impact both retention and the effectiveness of retention interventions. Conclusions Workforce changes have impacted employee retention. Increased federal funding makes expansion of the DIS workforce possible, but the labor market environment will continue to pose challenges to recruitment and retention.

Creating a Sexually Transmitted Infection Disease Intervention Workforce for the 21st Century

“…Another factor that can impact disease intervention activities is workforce retention. A cost-effectiveness evaluation assessed different changes in hiring and training (e.g., pay increase, mentoring program), and they had different impacts on DIS workforce retention 39 . Open source software could also impact disease intervention because it is publicly accessible and support can be provided by the community of users; however, challenges to adoption include difficulties integrating with existing systems and whether significant customization is needed for a given user 40 .…”

Use of Community Health Workers to Help End the Epidemic of Sexually Transmitted Infections

“…CHW engagement could help alleviate the current DIS workforce shortage, with CHWs trained to perform some of the tasks more commonly performed by DISs. 32 Integrating DIS services into a community setting can also increase their effectiveness in connecting with patients and conducting partner services. For example, the City of Chicago supports DIS-like partner services in a communitybased clinic.…”

“…CHW engagement could help alleviate the current DIS workforce shortage, with CHWs trained to perform some of the tasks more commonly performed by DISs. 32…”