661491 research-article2016

HEBXXX10.1177/1090198116661491Health Education & BehaviorAlber et al.

Perspective

Documenting 15 Years (2000-2015) of SOPHE Achievements: Recent Developments and Future Directions

Health Education & Behavior 2017, Vol. 44(2) 205­–215 © 2016 Society for Public Health Education Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1090198116661491 journals.sagepub.com/home/heb

Julia M. Alber, PhD, MPH1, Jay M. Bernhardt, PhD, MPH2, Michael Stellefson, PhD3, and Samantha R. Paige, MPH3

Abstract For over six decades, the Society for Public Health Education (SOPHE) has been a leading professional organization for the field of health education (HE). This historical research extends the work of Cissell and Bloom by investigating the recent history of SOPHE. The aims of this historical study were to (1) identify key SOPHE and HE events from 2000 to 2015, (2) describe key contributions of SOPHE to the HE field during this time period, and (3) identify potential future directions for SOPHE. Johnson and Christensen’s five steps for historical research were followed to conduct an eDelphi study and one-onone interviews. During the three-round eDelphi study, SOPHE officers (n = 16) and senior staff (n = 5), who served between 2000 and 2015, identified significant SOPHE’s leaders and rated the importance of SOPHE’s recent events. Key leaders (n = 25) participated in semistructured interviews to describe their involvement in SOPHE, specific SOPHE activities, and future directions for SOPHE. Brief, structured intercept interviews were also conducted with student (n = 10) and professional SOPHE members (n = 11). Data collected during the eDelphi study were analyzed to determine central tendency statistics and percent agreement on each event evaluated in the second- and third-round surveys. Qualitative interview data were analyzed with NVivo using thematic analysis. Data from the eDelphi study revealed 29 SOPHE and 17 HE events that occurred between 2000 and 2015 as being “important” or “very important.” Results from the thematic analysis revealed several themes in three areas: SOPHE accomplishments, benefits of SOPHE membership, and possible future directions for SOPHE to explore. Keywords health education, health promotion, public health, SOPHE achievements, workforce development For over six decades, the Society for Public Health Education (SOPHE) has been a leading professional organization for the field of health education (HE). Previous work by Cissell (1976) and Bloom (1999) documented the contributions and developments of SOPHE to the field before the turn of the century. This earlier work highlighted SOPHE’s origins, as well as significant changes to the organization, such as the transition of the national SOPHE headquarters from Berkeley, California, to Washington, D.C., that occurred during the first 50 years of SOPHE. Other SOPHE contributions, such as the development of the peer-reviewed journal, Health Education Monographs (now Health Education & Behavior), and leading initiatives for quality assurance in HE professional preparation programs, were highlighted in these documents (Bloom, 1999; Cissell, 1976). Challenges and future directions for the HE field and SOPHE were also documented. For example, Bloom (1999) discussed disagreement regarding certification for HE professionals, varying definitions of HE, and inconsistencies in professional preparation programs.

Now, in an effort to build a foundation for SOPHE’s future development and growth, this updated research extends the contributions of these seminal studies by investigating, chronicling, and indexing the history of SOPHE between the years of 2000 and 2015. Through a financial contribution made by Dr. Flora Bloom, SOPHE established the SOPHE Doctoral Fellowship, which funded the lead investigator on this project to (1) identify key SOPHE and HE events that have occurred from 2000 to 2015, (2) describe key contributions that SOPHE made to HE during this period of 15 years, and (3) identify potential future 1

University of Pennsylvania, Philadelphia, PA, USA The University of Texas, Austin, TX, USA 3 University of Florida, Gainesville, FL, USA 2

Corresponding Author: Julia M. Alber, Center for Health Behavior Research, University of Pennsylvania, 110 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-4385, USA. Email: [email protected]

206 directions for SOPHE. By examining the history of SOPHE and relevant HE events during this time period, this article addresses an existing gap in the historical documentation of SOPHE. Findings from this study can be used to understand the recent changes in SOPHE and HE to provide direction for future initiatives for both SOPHE and the field.

Method Johnson and Christensen’s (2008) five steps for historical research were followed: (1) research topic identification, (2) data collection, (3) data evaluation, (4) data synthesis, and (5) report preparation. Data were collected through an eDelphi study, one-on-one semistructured interviews with key leaders, and structured intercept interviews with SOPHE members. Similar to previous historical work (Bloom, 1999), this study capitalized on qualitative methods (e.g., interviews) to expand on the reactions, feelings, and opinions of SOPHE leaders, staff, and members related to specific HE and SOPHE events. A mixed methods approach was used to allow qualitative data (i.e., interviews, open-ended items) to inform quantitative findings (i.e., event ratings). An advisory group consisting of SOPHE members, including HE researchers, practitioners, and one student, was established to provide guidance for the study. Approval from the University of Florida’s and the University of Pennsylvania’s institutional review boards was secured prior to data collection.

eDelphi Study An eDelphi method provides an anonymous mechanism for obtaining convergence of opinions on a specific topic. During this structured communication process, each participant was encouraged to provide their opinion on the most important events in SOPHE and HE between 2000 and 2015, and then independently reevaluate their opinion based on the feedback received from other participants (Hasson, Keeney, & McKenna, 2000). Current and past SOPHE officers (n = 29) who served between the years of 2000 and 2015, as well as senior SOPHE staff members (n = 12) currently or previously employed by SOPHE during this period of time, were invited via e-mail to participate in a three-round eDelphi study over a 6-week period. For each survey, one reminder e-mail was sent to participants. In the first-round survey, participants were asked to identify (1) up to five individuals who made the most significant impact or contributions to SOPHE from 2000 to 2015, (2) up to five significant events that occurred in SOPHE from 2000 to 2015, and (3) up to five significant events that have occurred in HE from 2000 to 2015. Sixteen SOPHE officers and five senior staff members (21/41, 51.22% response rate) completed the first-round survey. Responses from the first-round survey were referenced to create lists of important events, while the list of

Health Education & Behavior 44(2) individuals was used to select potential participants for key leader interviews. In the second-round survey, participants from the firstround survey were provided with the lists of events (SOPHE and HE events) that occurred from 2000 to 2015. For each list, participants were asked to rate the importance of each event on a 6-point Likert-type scale (1 = very unimportant to 6 = very important) based on their perceptions of each event’s impact on SOPHE and HE over the past 15 years. Fifteen out of the 21 participants from the first-round survey (71.43% retention rate) completed the second-round survey. In the third-round survey, participants were provided with a group summary of the ratings (i.e., option selection percentages) for each of the events evaluated in the secondround survey. After reviewing group summary ratings, participants were asked to reconsider the importance of each event again using the 6-point Likert-type scale (1 = very unimportant to 6 = very important). Sixteen participants completed the third-round survey (76.19% retention rate from first-round survey). Participants received a $5.00 Amazon egift card for each web-based survey completed for the study. eDelphi study data were analyzed using SPSS Version 21 to determine frequency of response options, median scores, and interquartile ranges for each SOPHE and HE event. Percent agreement was also computed to determine what proportion of respondents rated each event as “important” or “very important” in the second- and third-round surveys. Consensus was defined as when 50% or more participants selected “important” or “very important” (Keeney, Hasson, & McKenna, 2006).

Member Interviews Brief (≈5 minutes), structured intercept interviews were conducted with a convenience sample of SOPHE student and professional members who were recruited during SOPHE’s 66th Annual Meeting in Portland, Oregon, on April 24, 2015. Approximately 800 HE professionals attended the 3-day conference. Conference participants were approached by two researchers at conference poster sessions and outside conference events from 8:00 a.m. to 8:00 p.m., and 36 participants were asked to participate in an interview about SOPHE’s history. All interviews were video-recorded and participants were asked to answer five preestablished interview questions: (1) What is your current title and place of work? (2) How have you been involved with SOPHE? (3) How long have you been a member of SOPHE? (4) How has SOPHE benefited your professional career? (5) What do you believe to be the future directions for SOPHE? Participants were offered a $5.00 Starbucks or Amazon egift card for participating in the structured interview. Due to videographer-related expenses, interviews were limited to only 1 day of the

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Alber et al. conference. Ten students and 11 professional members completed interviews (21/36, 58.33% response rate).

Key Leader Interviews SOPHE leaders identified during the eDelphi study were invited to participate in a 45-minute semistructured video-/ audio-recorded interview. Thirty-seven SOPHE leaders were initially identified in the first round of the eDelphi study. To narrow the selection, only SOPHE leaders who were mentioned more than once were invited to a one-onone interview (n = 17). Two SOPHE leaders had passed away. Leaders were asked questions regarding the following: (1) their involvement in SOPHE, (2) specific SOPHE activities identified in the eDelphi study, (3) the contributions of SOPHE to the field of HE, and (4) future directions that SOPHE should consider. Using a semistructured method, participants were asked preestablished questions, such as “How has SOPHE benefited your professional career?” and “What do you believe to be the future directions for SOPHE?” as well as follow-up questions to particular responses (e.g., “Why do you believe that happened?”). Interviewees were also asked to list names of other key HE leaders that should be interviewed about specific SOPHE-related events or issues. Interviews with those suggested by others continued until data were saturated, meaning the leaders were providing the same information on important HE events. During these interviews, 15 additional individuals were mentioned and subsequently contacted to be interviewed. In total, 30 SOPHE leaders were invited to participate, and 25 completed a oneon-one interview (83.33% response rate). Participants were offered either a $25.00 Starbucks or Amazon egift card for completing the interview.

Interview Data Analysis First, the recorded interviews were transcribed by the lead investigator. The lead investigator and a trained graduate student used open-coding to identify initial codes. The project leader subsequently collated the initial codes into broader codes with operational definitions that were included in a codebook. Another member of the research team reviewed and revised the definitions. Once definitions were established, the project leader and a trained graduate student independently coded the same 10% of the interview data (Tian & Robinson, 2014). Cohen’s Kappa was calculated to provide an intercoder reliability estimate for each code based on data that were dual-coded. After adequate intercoder reliability was established (i.e., ≥0.70; Laila, 2008; McHugh, 2012; Viera & Garrett, 2005), the lead investigator coded the remaining data using the codebook. Next, the lead investigator identified potential themes that emerged from the codes using thematic analysis (Braun & Clarke, 2008) with the computer program NVivo.

Qualitative data from the interviews with SOPHE leaders and members were used to identify themes within the area of “benefits” and “future directions,” while only leader interview data were used to explore themes within the area of “accomplishments” as only leaders were asked about SOPHE accomplishments. Themes were reviewed and revised based on how they were represented across the data set; when ≥20% of interviewees referred to similar idea or issue, the idea or issue was considered to be representative (Namey, Guest, Thairu, & Johnson, 2008). Finally, themes were named and defined by the lead investigator and a trained graduate student.

Results Health Education Events In the first-round survey, participants identified 22 different HE events as significant. In the second-round survey, 18 HE events reached consensus as being “important” (see Table 1). The following events received the highest consensus in the second-round survey: (1) Greater Focus on Health Disparities and Health Equity (93.30%), (2) Greater Focus on Social Determinants of Health (93.30%), (3) Greater Focus on Policy and Advocacy (93.30%), and (4) Health Educator Is Officially Recognized as a Distinct Occupational Classification by the U.S. Department of Labor, Bureau of Labor Statistics (93.30%). In the third-round survey, a total of 17 HE events (see Table 1) reached consensus as being “important.” There were some changes to the consensus percentages for the events rated in third-round survey with the following events receiving the highest percentages: (1) Public Health Accreditation Includes Health Education (93.80%), (2) Greater Focus on Health Disparities and Health Equity (87.60%), (3) Focused Attention on Obesity Prevention (87.50%), and (4) Greater Focus on Social Determinants of Health (87.50%). The following events (n = 4) were listed in the first-round survey, but did not achieve consensus in the third-round survey: (1) Use of Cell Phones and Hand-Held Devices for Tracking and Recording Potential Ebola Cases (43.80%), (2) September 11th (33.30%), (3) Anthrax Attack (12.50%), and (4) AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance) Changes Name to SHAPE (Society of Health and Physical Educators; 12.50%).

SOPHE Events Thirty-six different SOPHE events were identified by participants as being significant events that occurred between 2000 and 2015 in the first-round survey. In the second-round survey, 35 SOPHE events reached consensus as being “important.” Consensus was highest among the following SOPHE events in the second-round survey: (1) Advocacy Summit Reaches 250 Attendees Annually (93.40%), (2) Significant Increase in

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Table 1.  Health Education Events That Reached Consensus in the Second- and Third-Round Surveys. Second-round survey (n = 15) Event Public Health Accreditation Includes Health Education Greater Focus on Health Disparities and Health Equity Focused Attention on Obesity Prevention Greater Focus on Social Determinants of Health Greater Focus on Policy and Advocacy Health Education Role Delineation Project Health Educator Is Officially Recognized as a Distinct Occupational Classification by the U.S. Department of Labor, Bureau of Labor Statistics Congressional Focus on Funding for Physical Activity/Physical Education but Not Recognizing Role of Health Education Loss of Health Education Programs in School Health Teacher Preparation Move From Health Education to Health Promotion or Health Behavior by Institutions of Higher Education National Certification Board of Diabetes Educators (NCBDE) Recognizes MCHES (Master Certified Health Education Specialist) Designation as Eligible to Take the Certified Diabetes Educator Exam Passage of the Patient Protection and Affordable Care Act Fewer Schools of Public Health Offering Degrees Masters and Doctoral Degrees in Health Education Move From SABPAC to CEPH Accreditation Development of the Master Certified Health Education Specialist (MCHES) Examination Expansion of Social Media Channels by Nonprofits and Public Health Agencies Health Communications Splitting off From Health Education

Median

IQR

6.00 6.00 5.00 6.00 6.00 6.00 6.00

6.00-5.00 6.00-5.00 6.00-4.75 6.00-5.75 6.00-5.00 6.00-5.00 6.00-6.00

73.30 93.30 73.40 93.30 93.30 80.00 93.30

5.00

6.00-4.50

6.00

Third-round survey (n = 16)

Consensus (%) Median

IQR

Consensus (%)

6.00 6.00 5.00 6.00 6.00 6.00 6.00

6.00-6.00 6.00-5.00 6.00-5.00 6.00-6.00 6.00-5.75 6.00-5.00 6.00-5.00

93.80 87.60 87.50 87.50 82.30 81.30 81.30

66.70

5.00

6.00-5.00

81.30

6.00-4.50

66.60

6.00

6.00-5.00

75.10

5.00

6.00-5.00

80.00

5.50

6.00-5.00

75.10

5.50

6.00-5.00

80.00

5.50

6.00-5.00

75.10

6.00 6.00

6.00-4.00 6.00-4.75

73.30 66.70

6.00 6.00

6.00-5.00 6.00-5.00

75.00 75.00

5.00 5.50

6.00-4.00 6.00-4.75

73.30 73.40

5.00 6.00

5.50-5.00 6.00-4.75

68.80 68.80

5.00

6.00-4.75

66.60

5.00

6.00-4.00

68.80

5.00

5.00-4.00

53.40

5.00

5.00-4.00

56.30

Note. IQR = interquartile range; SOPHE = Society for Public Health Education; SABPAC = SOPHE-AAHE (American Association for Health Education) Baccalaureate Program Approval Committee; CEPH = Council on Education for Public Health.

SOPHE’s National Presence (93.30%), and (3) Launch of the Journal, Health Promotion Practice (92.80%). In the thirdround survey, a total of 29 SOPHE events (see Table 2) reached consensus as being “important.” Consensus for the event, Launch of the Journal, Health Promotion Practice, increased from 92.50% in the second-round survey to 100% in the thirdround survey. This event, along with two other events, Launch of the Journal, Pedagogy in Health Promotion: The Scholarship of Teaching and Learning (87.60%) and SOPHE Provides Testimony on Capitol Hill (87.50%) received the highest percentage of consensus in the third-round survey. Several events (n = 7) did not reach consensus in the third-round survey, including (1) Launch of Member Communities (43.80%), (2) The Galway Consensus Conference (37.60%), (3) Former Assistant Secretary Howard Koh is a Featured Speaker at SOPHE Annual Meeting (31.30%), (4) The Development of the Open Society Commission (31.30%), (5) Launch of SOPHE Knowledge Center (31.30%), (6) SOPHE Commences Work as Convener of the REACH Coalition’s Advisory Group (25.00%), and (7) Former HHS Secretary Kathleen Sebelius is a Featured Speaker at SOPHE Annual Meeting (25.00%).

An interactive timeline chronicling SOPHE events described in this manuscript can be located at http://www.sophe.org/ SOPHE_History.cfm.

Themes From Interview Data Results from the thematic analysis revealed themes in three main areas: Accomplishments (9 themes), Benefits (7 themes), and Future Directions (9 themes). Tables 3 to 5 list the theme definitions and the corresponding representation of themes during interviews. SOPHE Accomplishments. The majority of leaders (n = 20, 80.00%) referenced the willingness of SOPHE and its members to work with other organizations as well as HE specialists from all settings. Many leaders also emphasized SOPHE’s extensive involvement in advocacy initiatives (n = 17, 68.00%). For example, one leader stated, SOPHE has taken the lead on the [Health Education] Advocacy Summit for the past [several] years and it has grown so much over

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Alber et al. Table 2.  SOPHE Events That Reached Consensus in the Second- and Third-Round Surveys. Second-round survey (n = 15) Event Launch of the Journal, Health Promotion Practice Launch of the Journal, Pedagogy in Health Promotion: The Scholarship of Teaching and Learning SOPHE Provides Testimony on Capitol Hill The Initiation of SOPHE’s 21st Century Campaign Advocacy Summit Reaches 250 Attendees Annually Growth of the Journal, Health Education & Behavior SOPHE Shares Resources with SOPHE Chapters Significant Increase in SOPHE’s National Presence Significant Increase in SOPHE’s Strategic Relationships With Government and Nongovernmental Organizations Merger Discussions Between SOPHE and AAHE The Update of the SOPHE Mission Statement SOPHE Revamps its Website SOPHE Launches Center for Online Resources and Education (CORE) Release of the Issue Brief, “Affordable Care Act: Opportunities and Challenges for Health Education Specialists” Launch of the National Task Force on Accreditation SOPHE Cofunds 3 Competency Updates for Certified Health Education Specialists CDC Awards SOPHE With Cooperative Agreements Separation of the SOPHE Annual Meetings From APHA Annual Meeting SOPHE Revitalizes Resource Development Committee Development of a Socially Conscious Investment Portfolio in SOPHE Move to a Single SOPHE Annual Meeting The Updates to SOPHE’s Bylaws SOPHE Updates Financial Infrastructure Development of Communities of Practice (CoP) Development of SOPHE Affiliate Membership SOPHE’s Summit, Health Disparities and Social Inequities: Framing a Transdisciplinary Research Agenda in Health Education The Update to the SOPHE’s Governance Structure SOPHE 50th Anniversary Initiation of the Health Equity Project

Third-round survey (n = 16)

Median

IQR

Consensus (%)

Median

IQR

Consensus (%)

6.00 5.00

6.00-6.00 5.25-4.00

92.80 71.40

6.00 5.00

6.00-6.00 6.00-5.00

100.00 87.60

6.00 6.00 5.00 6.00 5.00 6.00 6.00

6.00-5.00 6.00-4.50 6.00-4.00 6.00-5.00 6.00-4.50 6.00-5.00 6.00-5.75

73.30 66.60 93.40 80.00 66.70 93.30 80.00

5.00 6.00 5.00 6.00 5.00 6.00 6.00

6.00-5.00 6.00-5.00 6.00-5.00 6.00-5.00 5.00-5.00 6.00-5.00 6.00-5.75

87.50 81.30 81.30 81.30 81.30 81.30 81.30

5.00 5.00 5.00 5.00

6.00-4.75 5.50-5.00 6.00-5.00 6.00-5.00

73.30 80.00 73.30 80.00

5.00 5.00 5.00 5.00

6.00-5.00 5.00-5.00 6.00-5.00 5.25-5.00

78.00 75.10 75.10 75.10

5.00

5.25-4.75

73.30

5.00

6.00-5.00

75.00

5.50 5.00

6.00-4.75 6.00-5.00

73.40 80.00

6.00 5.00

6.00-5.00 6.00-5.00

75.00 75.00

5.50 5.00

6.00-4.00 6.00-3.75

71.40 66.70

6.00 5.00

6.00-4.00 5.00-4.00

68.80 68.80

5.00 5.00

6.00-4.00 6.00-4.00

53.40 53.40

5.00 5.00

6.00-4.75 5.00-4.00

68.80 68.80

5.00 5.00 6.00 5.00 5.00 5.00

5.25-4.00 5.25-4.00 6.00-5.00 6.00-4.00 6.00-4.00 6.00-5.00

60.00 60.00 60.00 73.40 66.60 73.30

5.00 5.00 6.00 5.00 5.00 5.00

5.00-4.00 5.00-4.00 6.00-4.00 5.00-4.00 5.00-4.00 5.50-4.00

62.60 62.60 62.60 62.60 62.60 56.30

5.00 5.00 5.00

5.50-4.00 6.00-4.75 5.50-5.00

60.00 73.40 73.30

5.00 5.00 5.00

5.00-4.00 5.00-4.00 6.00-4.00

56.30 50.10 50.00

Note. SOPHE = Society for Public Health Education; IQR = interquartile range; AAHE = Association for the Advancement of Health Education; CDC = Centers for Disease Control and Prevention; APHE = American Public Health Association.

the years. I think it’s a really strong testament that now professional preparation programs are including advocacy training in their curriculum.

Leaders (n = 17, 68.00%) discussed how SOPHE has built a solid organizational infrastructure with dedicated staff and members. For example, one leader stated, What really impressed me about SOPHE was their infrastructure and template for being ahead, getting actions done. The fact that

the organization had monthly board committees meetings. So you really have a lot of interaction with SOPHE leadership, staff, and the Board of Directors, which moves the organization forward from my perspective.

Leaders (n = 15, 60.00%) also expressed that they believed that SOPHE has emerged as the leading HE organization. Furthermore, many leaders (n = 14, 56.00%) believed SOPHE has been on the forefront of the international and national agenda in HE, highlighted in one leader’s statement, “SOPHE

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Table 3.  SOPHE Accomplishments Themes and Definitions. Theme Solid Organizational Infrastructure, Staff, and Membership Base Quality Assurance and Professional Preparation Promotion of the National and International Agenda Promotion of the Profession Professional Development Leading Organization for Health Education Collaboration and Openness Chapters Advocacy

Number of leader interviewees (N = 25) that referenced theme

Definition The organization has a solid infrastructure and vision, as well as dedicated, engaged staff and members, that have been instrumental in supporting and building the organization thus far. SOPHE has been a critical force in assuring the quality of health education professional preparation programs and certifications. SOPHE has been at the forefront of discussing and addressing issues on the national and international agenda related to health education, such as health disparities. SOPHE has been a driving force in the advancement and direction of the health education profession. The organization has provided numerous professional development resources and opportunities to its members. Over the years, SOPHE has emerged as the leading organization for health education. The organization and its members have been open to working with other organizations and all types of health education specialists in order to ultimately promote and improve the profession and the health of the public. SOPHE has established numerous chapters that help members connect on the local level. SOPHE has been involved with advocacy-related activities and efforts, such as providing training to health education specialists in advocacy and advocating for health education initiatives.

17 (68.00%) 12 (48.00%) 14 (56.00%) 13 (52.00%) 13 (52.00%) 15 (60.00%) 20 (80.00%)

9 (36.00%) 17 (68.00%)

Note. SOPHE = Society for Public Health Education.

has and continues to stand up and stand out and shout out for people who have limited access or not being treated appropriately.” Leaders also believed SOPHE had advanced the HE profession (n = 13, 52.00%), provided numerous opportunities for professional development (n = 13, 52.00%), and had established many SOPHE chapters that help keep members connected at a local level (n = 9, 36.00%). Many leaders felt that SOPHE has been a driving force in ensuring the quality of HE professional preparation programs and would continue to do so in the future (n = 12, 48.00%). Leaders mentioned SOPHE’s involvement in task forces related to quality assurance. For example, one leader stated, I think because the work of these task forces and SOPHE’s vigilance around the issue of quality assurance, I think we’ve made great progress. And the model is moving in that direction.

Benefits of SOPHE Membership.  Throughout the interviews, students, professional members, and leaders described several benefits of SOPHE membership. Over half of the participants (n = 27, 58.70%) described the many opportunities for networking and learning from others. For example, one student stated, “It [SOPHE] has benefited me the most by giving me this opportunity to come to this conference and network with people in health education.” Half of the participants (n = 23, 50.00%) described resources provided through the annual meeting, trainings, journals, and leadership opportunities. Participants (n = 14, 30.43%) also discussed various

resources and opportunities provided through SOPHE, such as scholarships through the 21st Century Campaign, that are particularly helpful for students and new professionals. Participants (n = 11, 23.91%) described how being part of SOPHE meant being part of a close-knit community where members can share ideas and receive feedback from leaders in the field. For example, one leader stated, “I’ve always felt like an owner of SOPHE.” Interviewees (n = 13, 28.26%) also described the numerous opportunities for building their skills and education through SOPHE. Several participants (n = 10, 21.74%) believed SOPHE provided a professional home for HE specialists from all areas of practice. For example, one SOPHE leader stated, I do what I do for my students [because of] what was done for me, I introduce them to people they are reading about. It makes a difference because they need a professional home and SOPHE has been that for me.

Future Directions for SOPHE.  One challenge for SOPHE, as well as for the field of HE, discussed by participants (n = 13, 28.26%) is recruiting and training the next generation of leaders. For example, on the topic of the next generation of HE leadership, one SOPHE leader stated, We are going have to be innovative and do some new things to recruit and train this next generation. Specifically focusing on college programs that train our new professionals is going to be

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Alber et al. Table 4.  SOPHE Membership Benefits Themes and Definitions. Theme Tailored to Health Education Skill and Knowledge Building

Resources for Students and New Professionals Networking and Learning From Others

Close-Knit, Member-Centered Organization Chapters

Access to Physical and Online Resources

Number of interviewees (N = 46) that referenced theme

Definition SOPHE is tailored to the needs of health education specialists and provides a professional home for health education specialists. SOPHE provides numerous opportunities and resources to enhance skills and knowledge related to the field of health education. This includes skills in leadership, writing, research, and teaching. Educational opportunities also are provided to learn about a particular type of research, about the history of health education, and how to become involved in advocacy and improving the profession. The organization provides resources and opportunities specifically for students and new professionals. For example, SOPHE provides various scholarships to students through the 21st Century Campaign. The organization provides opportunities for members to network, meet other students and professionals, and learn from others about their work and research. Through conferences, involvement in SOPHE leadership, and other SOPHE-related activities, members can help develop new ideas and obtain information that can be applied to their own work and research. SOPHE members feel that they have a closer relationship and the conferences are more intimate compared to other conferences. The organization is also member-orientated and allows for its members to feel like owners of the organization. Chapters provide members with several benefits, such as the opportunity to engage at the local level, leadership positions that can help prepare them for leadership positions at the national level, and conferences and activities that are located closer to their residence. Membership provides access to an abundance of physical and online resources through both National SOPHE and at the chapter level. Examples of these resources include the journals, continuing education credits, and webinars.

10 (21.74%) 13 (28.26%)

14 (30.43%) 27 (58.70%)

11 (23.91%)

9 (19.57%)

23 (50.00%)

Note. SOPHE = Society for Public Health Education.

one area that I think will be successful. All of us have a history of coming to SOPHE through a connection to another professional or a faculty member.

In terms of bringing in new members and retaining current members, others mentioned the need to update the ways in which SOPHE communicates and interacts with members. For example, several participants (n = 10, 21.74%) discussed the need to update the format of the conference to ensure that it is encompassing innovative, interactive components to attract younger students and professionals, as well as to retain the more established professionals as a forum for continuing education. SOPHE leaders and staff have started to consider new ways to increase the interactivity of its conference. For example, the SOPHE 67th Annual Meeting in 2016 included new conference session formats, such as Ignite sessions (i.e., quick presentation to create new ideas for discussions) and Thinktank sessions (i.e., sessions focused on a question or issue to drive discussions of future approaches). According to interviewees, it will also be important for the organization to continue to expand the resources made

available to members. Several SOPHE members and leaders (n = 15, 32.61%) mentioned the need for additional resources, such as leadership trainings. For example, one leader stated, One thing we need is leadership training. . . . In a local chapter, you have four people apply and their resume may be good, but leadership trainings are definitely needed. Because sometimes people get overwhelmed . . . it’s not just about being a warm body, it is about leadership in a group, group consensus, and meeting the parameters of the strategic plan.

Overall, many participants (n = 15, 32.61%) believed SOPHE will likely continue to adapt and change to meet the needs of both HE specialists and the public. One leader highlighted this theme stating, “Some challenges for both SOPHE and health education is how we ensure that we are constantly responding to changes in the national and global landscape.” Changing to meet the needs of both the public and HE specialists also entails expanding partnerships and visibility of the organization according to members (n = 13, 28.26%). For example, one leader stated,

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Table 5.  SOPHE Future Directions Themes and Definitions. Theme Recruiting and Training Next Generation Technology and Communication Continuing to Promote and Guide the Profession Partnerships and Visibility Updating and Changing to the Local and Global Landscape Membership Engagement SOPHE-Related Resources Continuing to Define the Mission and Vision of SOPHE Continuing to Strength Chapter Additional Professional Development

Number of interviewees (N = 46) that referenced theme

Definition Recruiting, training, and preparing the next generation of SOPHE leadership. Updating, changing, and improving technology-related and communication aspects of SOPHE. For example, updating the conference format and components, the website, the membership database, and other SOPHE resources. SOPHE will continue to promote the field of health education by increasing awareness of health education, refining what it means to be a health education specialist, identifying mechanism for financial resources for health education specialists, and assuring the quality of professional preparation programs. Increasing visibility of SOPHE as a leading health organization on the local, national, and international level through partnerships and other activities. Changing and updating to meet the needs and demands of the changing local and global landscape. This includes being aware of prevention opportunities for research and funding, connecting research and evidence to practice, and staying active in relevant policy issues. Continuing, expanding, and improving methods for recruiting and engaging new professionals and students, existing members, and seasoned professionals. Continuing to seek and identify existing and alternative resources, related to funding, time, and staff, in order to support SOPHE activities and meet the needs of their membership. Continuing to understand the role of SOPHE in the field of health education and who they are as an organization, and understanding the focus of SOPHE and its membership. For example, SOPHE could potential increase their focus to include becoming a leader in school health. Continuing to build and strength the chapters through reorganization, expanded collaboration, and increased resources. Providing additional resources for professional development, such as classes, trainings, webinars, and skill-building activities. For example, creating online leadership modules.

13 (28.26%) 10 (21.74%)

15 (32.61%)

13 (28.26%) 15 (32.61%)

13 (28.26%) 15 (32.61%) 11 (24%)

10 (21.74%) 13 (28.26%)

Note. SOPHE = Society for Public Health Education.

I also believe SOPHE has a grand role to play in the global landscape. . . . I think we have great potential to even have a greater sphere in working with other organizations, such as the WHO [World Health Organization], to make a bigger impact on a global scale.

Several interviewees (n = 15, 32.61%) also commented on the need to expand the visibility and understanding of HE among the public and employers. Other members (n = 10, 21.74%) described the need to continue to build and strengthen the SOPHE chapters. For example, one student stated, “We don’t have a chapter in all of the states, so expanding in that way and strengthening the state chapters that we do have would be a direction for us to go.”

Discussion SOPHE has played an important role in significant changes and events in the field of HE. For example, in terms of

accreditation and certification, SOPHE cofunded three competency updates (i.e., Competency Update Project 2006; Health Education Job Analysis 2010; Health Education Specialist Job Analysis 2015) to reverify entryand advanced-level HE competencies. This effort eventually led to the delineation of the Master Certified Health Education Specialists (MCHES). Furthermore, SOPHE has cosponsored SABPAC (SOPHE-AAHE [American Association for Health Education] Baccalaureate Program Approval Committee) from its inception in the 1980s, and beginning in 2002, SOPHE promoted the transition of SABPAC to CEPH (Council on Education for Public Health), an effort to move from an undergraduate approval process to accreditation recognition by the Department of Education through CEPH. Once this was accomplished, SOPHE phased out SABPAC in 2015. SOPHE has also been active in providing professional support and resources to HE specialists, as well as guiding

Alber et al. discussions on the changing landscape of HE in public health. For example, over the past decade, a greater focus on health disparities and health equity has emerged in the field of HE. SOPHE led the Summit on Health Disparities and Social Inequities in 2005, which discussed and provided an agenda for future research in this area (Gambescia et al., 2006). SOPHE’s journals, Health Education & Behavior and Health Promotion Practice, have also featured special issues on health disparities. SOPHE has been on the forefront of stakeholder advocacy and advocacy skill building in HE. SOPHE provided impetus and staff support for the Health Education Advocacy Summit since its inception and now plays the sole leadership role in organizing the Summit each year. One leader commented on the importance of the Health Education Advocacy Summit stating, We need to come together at the Advocacy Summit and practice our pitch, practice our speech, practice our translation of the data for policy-relevant data. If we don’t have a mechanism or a platform to do that, it won’t happen.

Through its involvement with the Coalition of National Health Education Organizations, SOPHE successfully advocated for the U.S. Department of Labor official recognition of “health educator” as a distinct occupational classification in 2000. During the period of 2000 to 2015, several substantial changes and events occurred within SOPHE. Many of these related to the governance and financial infrastructure of the organization. One SOPHE leader highlighted two major changes to the governance structure: Two of the major changes that came about in the governance structure was allowing student members to be part of the officer role . . . and the other was with the chapters . . . recognizing the Speaker of the House as a member of the SOPHE Board of Trustees and the SOPHE Executive Committee.

Other governance changes included an update of SOPHE’s mission statement and an addition of a vision statement for the organization (i.e., “A healthy world through health education”) in 2010. A leader described the process of updating the SOPHE mission statement: Our mission statement had been, “to promote the health of all people through education.” As the Board of Trustees and the Strategic Planning Committee was looking at that, they really thought it was appropriate at this point in time to modify the mission statement to say what we have today “to provide global leadership to the profession of health education and health promotion and to promote the health of society.” It was a global emphasis if you might note right there and an emphasis on we, as SOPHE, providing leadership to the profession of health education and health promotion.

Another SOPHE leader described some of the major changes in the financial infrastructure of the organization:

213 If you go back in time [before 2000], we were really an organization that had a part-time bookkeeper. . . . Now we have a full-time financial officer. . . . We have really great reporting, we have really good accounting systems, and we have full-time oversight.

Switching from two national meetings each year to one annual meeting, as well as moving away from having the annual meeting adjacent to the annual meeting of the American Public Health Association (APHA) in 2013, enhanced SOPHE’s financial infrastructure and lessened the burden on staff and volunteer time. One leader described the decision behind moving to a single national meeting: One of the things we were looking at was that we had an annual and midyear meeting and the amount of time that took, of volunteer effort. . . . It was one of those things, it wasn’t an easy decision. But I think we looked at it from very informed decision making. . . . I think moving it away from [APHA] in some ways actually helped SOPHE from a financial standpoint, because we don’t have to be in one of those large cities.

From 2000 to 2015, SOPHE greatly expanded the resources that it provides to HE specialists. SOPHE launched two additional journals, Health Promotion Practice in 2000 and Pedagogy in Health Promotion: The Scholarship of Teaching and Learning in 2015. One leader stated that Health Promotion Practice was developed after “people started asking for more practice-based work.” When describing the launch of Pedagogy in Health Promotion: The Scholarship of Teaching and Learning, one leader stated, The idea that we have not had a major comprehensive pedagogy journal in the field of public health, in general, and health education, in particular, or health promotion, in particular, is just surprising. . . . I am glad that we were able to, that SOPHE was the organization that stepped forward and says that this is the time that we really need to have that.

Furthermore, SOPHE launched the Center for Online Resources and Education (CORE) that provides an abundance of resources for continuing education. CORE was developed in response to changes in technology. Additionally, SOPHE created the Communities of Practice (CoP) in 2010 that allow members with similar interests to connect and collaborate. While SOPHE previously had Special Interest Groups (SIGs), SOPHE created the CoP to expand the topics and features of SIGs. One leader described this process: As we began to think about the Special Interest Groups and what their capacity could be, we moved from an alignment that was traditionally based on worksites. . . . Based on what our membership was telling us, they had an interest in collaborating, not only in work setting, but also in topic areas. And really as the field has involved in more interactive opportunities for that to happen, we wanted to expand it to topic areas and also give them interactive opportunities.

214 Other important additions provided by SOPHE that have expanded resources to HE specialists include the Affiliate Organization Member (previously Associate Member) in 2014 and new scholarships and fellowships for students (e.g., SOPHE Student Fellowship in Patient Engagement). Parallels can be drawn between the current research and previous work documenting SOPHE’s history. In previous work exploring SOPHE’s history from 1950 to 1975, Cissell (1976) contributed part of SOPHE’s growth to the formation of the chapters, which linked professionals to local interests. Similarly, Bloom (1999) highlighted that the number of SOPHE chapters had expanded to 18 states as of 1997. Today, SOPHE chapters still play a powerful role in SOPHE membership with 21 chapters in over 30 states, northern Mexico, and western Canada. In the past decade, SOPHE has continued to improve its chapters. In 2006, SOPHE established the SOPHE Task Force on the State and Status of SOPHE Chapters, which provided recommendations for expanding resources for the chapters. Given the benefits of the SOPHE chapters, SOPHE will likely continue to strengthen the chapters in the future. Cissell (1976) stated that the two factors that influenced the development of SOPHE were the desire to have the HE profession recognized by others and that existing organizations did not meet the needs of HE specialists. Bloom (1999) noted the challenge of defining HE stating, “Among the most common issues of debate in health education are the nature of the discipline and whether health education is a profession” (p. 356). While recognition of a HE specialist still remains a challenge, SOPHE has been involved with numerous steps in the past 15 years that have increased the visibility of the profession. For example, they have supported professional certification through funding three HE competencies updates. Interestingly, Bloom (1999) described initial opposition from some SOPHE members regarding certification; however, today, SOPHE actively supports CHES and was involved with the development of the MCHES. Both Bloom (1999) and Cissell (1976) described events related to SOPHE redefining its priorities, changing its governance structure, improving its financial infrastructure, and expanding its relationships with other organizations. Event likes these will likely continue to occur as SOPHE moves forward. Bloom (1999) described several relationships SOPHE had developed in the 1980s, such as those with the United Nations and the Centers for Disease Control and Prevention. During the leader and member interviews, several participants highlighted the importance of these relationships and the need to expand partnerships on the local, national, and international levels. As seen in the current time period of interest, SOPHE had also updated its mission statement in 1997 (Bloom, 1999), which emphasizes the fact that the organization has and will continue to redefine its mission. Throughout the interviews, professional members, student members, and leaders in SOPHE highlighted similar

Health Education & Behavior 44(2) benefits to membership such as networking, access to resources, SOPHE chapters, and the organization being tailored to HE. However, more leaders and professional members discussed the member-centered nature of the organization. This may be because student members have less experience in SOPHE leadership compared to the leaders and professional members. Many similarities in perceptions of future directions were also seen across the type of interviewees related to the need to strengthen chapters, increase visibility of the organization, and continuing to guide the profession. However, leaders more often discussed the need to recruit and train the next generation and to increase member engagement. Leaders noted that many SOPHE officers were generally further along in their careers and may be retiring in the near future, which would leave openings for other SOPHE members to become involved with SOPHE’s leadership. In terms of member engagement, leaders more often noted that it is important to use new techniques to constantly engage both seasoned and emerging professionals.

Implications for Research and Practice By comparing SOPHE events to major HE events, it is clear that the actions of SOPHE have played some part in shaping the field of HE. Through initiatives, such as leading the Health Education Advocacy Summit and the Summit on Health Disparities and Social Inequities, SOPHE has been at the forefront of major HE issues. SOPHE’s involvement with quality assurance and credentialing has assisted with further establishing the profession. This highlights the importance of having a professional organization representing the voice of HE specialists. Many of the future directions described by interviewees in this study are applicable to the field overall. For example, several interviewees describe the need for HE specialists to adapt to the local and global landscape. This includes being aware of research needs, identifying and obtaining research funding, and ensuring that HE research is connecting evidence to practice. Although HE is not a new profession, there is still a continued necessity to increase public and employer awareness of HE among other fields in health care and public health.

Limitations There are some limitations to this study. First, not all senior officers and staff that served during the study period participated in the eDelphi study; therefore, the results may not represent the views of all those who served between 2000 and 2015. While only 21 senior staff members and officers participated in the eDelphi study out of roughly 4,000 SOPHE members and staff, participants represented those who were most heavily involved in the day-to-day operations and priority setting activities during this time frame. Similarly, not

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Alber et al. all SOPHE leaders participated in the key leader interviews. A convenience sample was used to select individuals for member interviews, which may not be representative of all SOPHE members. Additionally, other sentinel events that SOPHE actively took part in may have occurred after the eDelphi study was completed (e.g., passage of the Every Student Succeeds Act that includes health as a well-rounded subject in K-12 education in December 2015) and therefore were not mentioned in this study.

Funding

Conclusions

References

The field of HE has changed and will continue to evolve to address the health needs of the public and the professional needs of HE specialists. For six decades, SOPHE has been an important place for HE professionals to come together to identify and address the key issues facing HE. From 2000 to 2015, several important changes in HE have occurred, such as the addition of the MCHES. As seen in the previous work (Bloom, 1999; Cissell, 1976), SOPHE has continued to redefine its priorities for HE, improve its governance structure, and expand its relationships with other organizations. Events and themes highlighted in this study have shown how SOPHE has played a part in the changes and events that have occurred within the field of HE. Significant changes to the staffing, governance, and financial infrastructure, alongside a strong leadership team and an engaged membership, have allowed SOPHE to grow and provide additional resources to the field of HE. Although there will be many challenges to face in the future, such as recruiting the next generation of HE leaders, SOPHE seems very well positioned to meet these challenges and will likely continue to prosper.

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Acknowledgments We gratefully recognize the time and support received from the SOPHE History Group, including Elaine Auld, Kelli Brown, Joseph Dake, Linda Forys, Elaine Hicks, Sue Lachenmayr, Daniel Perales, Judith Ottoson, Chandra Story, and Victoria Zigmont. We would also like to thank the SOPHE staff and SOPHE leaders for providing historical information for this study.

Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Alber received research support through a fellowship from the Society for Public Health Education (SOPHE). SOPHE, as well as the funder of the fellowship, Dr. Flora Bloom, did not direct the design of the study; the collection, analysis, or interpretation of the data; or the preparation or review of the manuscript. SOPHE staff did, however, provide historical documents and SOPHE leaders’ contact information for use during this historical research project.