Background: Across the U.S., college and university students exhibit high levels of stress, anxiety, depression, and other mental health issues. While counseling, medications and, in more severe cases, hospitalization are all appropriate treatments for such conditions, an increasing body of evidence has demonstrated that spending time in nature can provide tangible benefits for mental health and well-being. The aim of this study was to define a “dose” of time in nature that could be prescribed to college-age students, as a preventative and supportive mental health and well-being intervention. The specific objectives of this scoping review were thus: to define the minimum amount of time in nature that results in positive impact on mental health and well-being for college-aged students; to describe the types of engagement with nature that elicited the impact; and to describe and explore the most commonly used measure of effect pre- and post-time in nature. Methods: This scoping review was conducted following the PRISMA-ScR Checklist. A review protocol was developed but not registered. Fourteen bibliographic databases were searched and all results were blindly screened using established inclusion criteria. All titles and abstracts were screened by at least two reviewers, a third being used as a tie-breaker if needed. Studies were included if: subjects were of average college age; they examined a treatment of time (hours or minutes) in nature; they examined change in measures of mental health and well-being pre- and post-exposure; they compared participants across at least two environments; the study was published in English or French; and if the study was <20 years old. Results: Initially, 11,799 titles were identified and once de-duplicated, 10,917 titles were screened. One hundred fifty-five papers were given full text reviews, of which 14 studies were included in this review. In summary, 13 of the 14 papers explicitly noted that the participants were college students. Two-thirds of the studies (n = 10) took place in Japan. One study took place in Sweden, and the remaining studies took place in the United States (n = 3). These studies show that, when contrasted with equal durations spent in urbanized settings, as little as 10 min of sitting or walking in a diverse array of natural settings significantly and positively impacted defined psychological and physiological markers of mental well-being for college-aged individuals. Within the included studies, 22 different measures were used to assess the effects of nature doses on mental health and well-being. Conclusions: This review provides time-dose and activity-type evidence for programs looking to use time in nature as a preventative measure for stress and mental health strain, and also demonstrates opportunities in six specific foci for more research in this area.

Context: Schools and programs of public health have been preparing graduates to join the workforce for a century, but significant gaps in numbers and abilities exit. Many have called for a change to the status quo, to transform public health education to create a competent workforce able to address current and emergent needs. Objective: This study explored if Master of Public Health (MPH) programs have shifted their program design, curriculum, and/or instructional methods (instructional design), and if so, how and why. Design: A sequential mixed-methods study. Setting: MPH programs accredited by the Council on Education for Public Health, and approved applicants. Participants: Some 43% of accredited MPH programs in the United States (n = 115) responded to the online survey (open November 21, 2019-December 20, 2019), providing a representative sample. Stratified purposeful sampling was used to select 8 MPH programs for follow-up semistructured interviews. Categorical and qualitative data were analyzed for trends, association, and themes. Main Outcome Measures: Degree of, types of, and reasons for shifts in MPH program instructional design considered and implemented. Results: MPH programs in the United States have shifted their approaches and curriculum to meet identified and emergent workforce needs. In the last 5 years, 81% made changes to program design (focal competencies, admissions, graduation criteria), 88% to curriculum (added or removed courses, changed course content), and 65% to pedagogical methods (where and how learning is supported). Conclusions: Despite concerns about stagnation, MPH programs have shifted to competency-based education aligned with workforce needs, have adapted approaches to support diversity of future workers, and are focused on bolstering workforce readiness. These changes were made to enhance focus on knowledge acquisition, skills building, and professionalism, factors recognized as critical for success, and facilitate more engaged pedagogical strategies, working with communities for impact.

Context: Research and policy studies alike have enumerated population and community health benefits of system integration between medical, public health, and social entities. The emergence of the COVID-19 pandemic revealed the necessity of a well-trained and adequately staffed public health and medical workforce in order to process SARS-CoV-2 cases and prevent subsequent transmission. Higher education systems, in particular, represented defined populations of exposure and transmission. Opportunities existed for collaboration and task sharing between institutions of higher education and local public health departments to limit spread and impacts. Program: This article describes the Pandemic Response Officer (PRO) program at Cornell University, a team of staff and students created during the intensity of the pandemic to benefit the Tompkins County and Cornell University communities. Implementation: The PRO program was formed in January 2021, with an original team of 8 individuals, working iteratively to investigate and support employee cases and exposures. Implementation was motivated by Cornell University's dual responsibility as a large employer that also possessed SARS-CoV-2 test results of employees. PROs loaded case information into a shared HIPPA-compliant electronic record that collected information for case notification, case investigation, isolation support, contact tracing, contact notification, and quarantine support. Over time, the PROs grew to a team of 25, gaining responsibilities as university and public health systems shared roles to maximize resources. Evaluation: From January 1 to December 31, 2021, PROs managed 773 employee and 2943 student cases. During the Omicron surge (November 28-December 31, 2021), PROs saved the public health department an estimated 2797 hours of effort, equating to more than 10 professionals working full-time, evenings and weekends, to process cases and contacts during this interval. Discussion: By integrating efforts between a university and public health agency, this intervention minimized SARS-CoV-2 transmission via expedient case support and alleviated strain on public health systems by expanding the public health workforce.

Objectives: For decades, there have been calls to action to change the status quo of public health education in the United States to respond to workforce needs and help reinforce capacity. During the last 10 years, schools and programs of public health have planned and implemented programmatic and curricular changes. This study explored the focus of master of public health (MPH) education in the United States today. Methods: We used a 3-phase mixed-methods study to compile data to describe the current state and focus of MPH education in the United States via survey data collection (November–December 2019), semistructured interviews (January–February 2020), and document reviews. Results: Survey responses represented at least 43% (93/215) of eligible MPH programs in the United States. Most respondents (86%, 99/115) reported that the primary focus of MPH education in the United States is to prepare graduates for public health practice and employment linked to public health, and 54% (59/109) reported that their MPH programs adopted this focus in the last 5 years. MPH programs invested in student learning, competence development, and supporting workforce readiness, including a focus on leadership abilities. Programs noted that they seek to develop strategic thinkers and engaged leaders with abilities to understand and address emergent public health needs. Conclusions: Public health education in the United States is in a period of change. MPH programs reported responding to workforce needs by closing gaps in workforce capacity and developing compassionate and professional leaders who can understand needs, collaborating with communities, and facilitating action that will ameliorate health disparities and promote social injustice by practicing public health in new ways.

Since the onset of the COVID‐19 pandemic, many states in the United States have limited emergency public health authority. These limits could undermine public health efforts and raise concerns about how states and localities will prevent and respond to future public health challenges. We examined which of the 50 US states passed laws to set limits on public health emergency authority in 2021 through 2022, and their relationship to COVID‐19 death rates. We explored five government characteristics: COVID‐19 policy response, political partisanship (Republican control), legislative professionalism, local government autonomy, and broader non‐COVID‐19 related preemptions. Results of T‐tests and a Generalised Structural Equation Model show that states with unified Republican control had greater odds of limiting emergency public health authority of the state executive, state governor, state health official, and local health officials. Limits of emergency public health authority were associated with a higher COVID‐19 death rate. We found that states setting limits on emergency authority are primarily related to politicisation and political competition between state executives/governors and legislatures, rather than pushback against the COVID‐19 public health response. Limiting emergency public health authority is less common in states with more professional state legislatures. Structural changes related to party control, legislative professionalism, and local autonomy may facilitate public health authority.

As SARS-CoV-2 was detected in the US, emergency public health measures took effect, including shutting down schools.¹ As prevention and control measures improved, emergency response policies were rolled back.¹ Cornell University opened for residential instruction in Fall 2021 using an extensive testing, contact tracing, and isolation program in partnership with the Tompkins County Health Department (Table).² Vaccination was mandated for all students and encouraged for employees. Masks were required on-campus, and isolation orders and contact tracing occurred within hours of any positive result. We hypothesized that these measures would limit COVID-19 spread on campus and sought to monitor this with a case-series study of university testing records.