Executive Summary

The rapid deployment of digital tools and their accompanying successes and failures during the COVID-19 pandemic drew attention to critical gaps in the public health workforce’s capacity to leverage the maximum potential of digital technologies. Public health interventions continue to use digital tools like artificial intelligence, machine learning and digital dashboards for real-time disease surveillance and epidemiology, mobile apps for symptom screening and health promotion, and social media for health promotion and behaviour change campaigns. However, the workforce is not yet fully capable of leveraging these tools to their full potential especially because they have not fully learned to promote foundational public health principles of social justice and health equity while using these technologies. Broader digital transformation in society has influenced public perception of public health services and highlighted the need to build digital competencies within the public health workforce to meet these changing expectations.

Therefore, we conducted a 3-phase study, to identify and develop recommendations for digital public health practice competencies, training models and approaches and partnerships required to implement these models in Canada. This research was consistent with Canada’s Chief Public Health Officer’s vision to transform Canada’s public health system. Specifically, it addressed the need to ensure workforce expertise and human resource capacity (building block 4) and leverage medical and digital health technologies (building block 3). In the first phase, we conducted a rapid literature review documenting existing recommendations for digital public health competencies. Next, we conducted an environmental scan of digital public health training programs and courses globally. Finally, we conducted interpretive description of Canadian public health practitioners’ perspectives of digital public health competencies through focus groups.

Recommendations for digital public health practice competencies and accompanying training approaches were limited in the literature as only 12 articles made specific recommendations. However, these articles suggest new digital competencies are required across the existing Core Competencies for Public Health in Canada framework first published in 2007. The evidence also supports a potentially new competency category related to the efficient and ethically sound use and protection of new digital data sources, and managing and governing digital infrastructure and systems required to leverage new digital data sources. We referred to this category as “Data, data systems and governance”. The identified recommendations reiterate the need for training approaches that establish and deepen transdisciplinary partnerships through adapted degree awarding public health training programs and ongoing professional development.

In the second phase, we found 58 programs and courses globally, 5 were from Canada. The identified programs focused on three main areas. The first two – public health data science (50%) and public health informatics (28%) specifically addressed the new competency category identified in phase-1 – “Data, data systems and governance”. A mix of programs and courses formed the third focus area exploring various digital competencies (22%). This mix addresses competencies relevant in designing, implementing and evaluating digital technologies applied across public health functions and understanding threats and opportunities of widespread adoption of digital technologies, especially the digital determinants of health. Proprietors and developers of identified programs highlighted their goals for ideal digital public health practitioner who should have deep understanding of public health principles while also embracing other disciplinary perspectives – a concept described as “T-shaped professional”. However, they emphasize the need to develop shared vocabulary among disciplines and administrative challenges with navigating novel programs in this context. These include challenges gaining support, funding and leadership support to implement the programs.

In the third phase, Canadian public health practitioners emphasized the need for an integrated, systems-focused approaches to digital competencies where the health systems keep pace with digital competencies. They also suggested we must strengthen basic digital literacy, while promoting a core understanding of public health before considering how digital tools may facilitate or affect the core public health functions. Their suggestions reinforced the need for an integrated approach to digital competencies that explores opportunities to build digital competencies across the existing public health curriculum. Practitioners also suggest these general competencies can be built while creating space for specialized digital public health competencies and roles where necessary.