Personal Leadership

Public health is a "team sport" in the sense that many of the population-level problems that we want to address are too big for any one person or organization to solve. While collective efforts do result in measureable benefits for the public and constituents we serve, at an individual level and on a day-to-day basis, the impact of a team's work can feel less tangible. I feel like appreciative inquiry provides a process for the team to think about the bigger picture about our mission, goals, and objectives. The AI process also provides a framework for engaging all team members in reassessing current activities and imagining potentially better approaches for achieving our goals. I can see how aligning proposed changes with a larger dream/vision could energize a team and add meaning to the daily work. We are at the beginning of implementing a 5-year viral hepatitis grant. We will be hiring new staff. The AI process could be a way to engage our team early in the implementation of the grant and foster ownership of the grant activities.

Public Health is a natural fit for the appreciative inquiry framework as many people in the field are extremely passionate about the work they do, and this would help fuel the discovery portion of an AI session. In a lot of what we do in Massachusetts we like to convene advisory groups that draw from different sectors and knowledge bases. These stakeholders help to ensure that we cover items a smaller gathering might miss and would also be very helpful in the dreaming portion of AI work – having diverse experiences can bring in ideas that may not be traditional public health practices. Additionally, most of my public health practice has been based on quality improvement foundations such as PDSA cycles. A QI background helps participants in the design phase to implement changes and have more flexibility in pivoting away from ideas that do not work. 

I became interested in doing disability research in MA because I was focused on a problem (lack of available data, less staff concentrated in this area) rather than strengths the department already has. I like the idea of reframing the underlying philosophy behind this research towards strengths because there are other research areas (such as improving racial health disparities) where MA already has a deep bench of knowledge and experienced staff. Looking at how to pivot their successes to working with disability-based health disparities is energizing and expands the group of individuals that we can work with.

Public health, by being part of state- and local-government agencies, can have its share of challenges. Therefore, our first thoughts are often, "how is this process not working?" or "what is the issue at hand?". These thoughts often have a negative connotation associated with them, and therefore, can lead to pessimistic points of view from your team. Taking the opposite approach and thinking of ways processes do work encourages optimistic points of view and potentially more rich, involved discussions with your team. Almost like you are "building up" the idea, the way you would "build up" a co-worker when you praise them for something. This is why the appreciative approach can be beneficial for forward thinking on your team. 

My team actually experienced this first hand when working with one of our local partner agencies in the past year. Our focus for the grant in year 4 was quality improvement. This meant that we would provide quality metric data reports back to the agency to show how they progressed with their grant-related tasks over the past few months. At first, we noticed some of the reports could be portrayed as just showing the agency their "flaws", essentially. Instead of presenting the data that way, we decided to change the report to show their "progress to a goal", in that way, putting a positive spin on the conversation while thinking of what is working-- consequently, this often also spurred unintentional conversations by the local staff of how they wanted to improve. I think it was because they felt more empowered to do so because the feel of our discussions was just more positive, in general.

We have received so much positive feedback from this method of conducting monthly meetings, I plan to integrate that into my project as well for the STD Surveillance Unit monthly meetings. 

I agree with Amy, with regards to public health being a natural fit for the Appreciative Inquiry approach, because so many people go into public health as a chosen career and are very passionate about it. I also think that "rediscovering" why people went into public health and what sparks their interests, especially prompting them to think about highpoints along the way, is a natural fit for public health professionals. I work with communicable disease outbreaks, and there are so many examples of times when things went well in a response, and times that things did not go as well. The AI approach could be a useful tool in soliciting some "best times" to use for future responses, to ensure a more timely and fulfilling response. As my team is getting larger, I think it is a good time to engage new and seasoned time members with this approach.  

On a different topic, but one that was introduced in this overall lesson, I found it very informative to take the different personality tests. The one that was very interesting to me was this one: 16 personalities. NERIS Type Explorer®

It "labeled" me as a Mediator (INFP-T) and as I read the descriptions for the various attributes, I think it was validating to see how this impacts my work relationships, for strengths and weaknesses. I plan to acknowledge and keep these in mind when managing my team BUT ALSO how I'm impacted by my leadership, and why I'm frustrated at times.

"In general, people with this personality type don’t micromanage. Instead, they keep their eyes on the big picture. They see it as their responsibility to support their employees, not to tell them exactly what to do and how to do it. Whenever possible, they encourage the people who work for them to develop their own ideas and use their own best judgment."

"There is a downside to this management style. Sometimes Mediators may struggle to set boundaries, drill down on inefficiencies, or offer criticism, even when it’s necessary. This can slow down their team and create needless stress, both for Mediators and for their employees. At times, managers with this personality type may need to be strict for the good of their team – and the workplace as a whole." 

The appreciative inquiry framework does indeed align well with the typically behavior-modification role that many aspects of public health actions find themselves focused upon. One key point to consider is that when thrust into the milieu of other competing and potentially conflicting dynamics, this strength can be perceived as a weakness. 

One example I can help but recall is many years ago attending my first Bioterrorism National exercise (named "TopOff"). Members off many response communities including the traditional First Responder community were present. One of the biggest criticisms of Public Health at the time was that "all they did was stand around quoting journal articles and never making a decision". 

My "take home" message is that frameworks are good, but the understanding and interacting with other frameworks are key to ensuing that the Public Health message isn't lost in the fray of activity.

(Appologize for my late post)
At this most challenging time in the history of public health, I think appreciative inquiry is extremely important in keeping our morale up. Amy made a good point that our public health workforce came to this field with the passion for the wellbeing of people, society, and the world. On the other hand, like Prabhu pointed out, the level of appreciation we get doesn’t always match the efforts we invested. Therefore, it is extremely important for us to focus on “what worked” when we reflect. 

An example from my agency’s experience is building connections with community partners, specifically law enforcement. It was a spiral process. Several of our programs tried at different time. The first few times were not successful. But every time, someone made small progress somewhere. And these small progress accumulated to build up our collaborations. By the time we apply for the Overdose Date to Action (OD2A), we have our linkage to care team stationed at the detention center, and our trainers meet with the officers regularly for naloxone distribution. If we didn’t focus on “what worked”, we would have given up at early stage, and we would never have an ally from the law enforcement. The appreciative inquiry framework has been the philosophy behind many of our successes.