A Qualitative Evaluation of Community Colleges as a Pathway to the Certified in Disease Intervention Credential

Abstract

Objective:

Community colleges can offer short-term training due to their flexible scheduling, affordable tuition, and capacity to integrate certification opportunities within programs tailored to regional workforce needs. We identified existing assets and readiness to develop a Certified in Disease Intervention credential at community colleges to expand the disease intervention (DI) workforce.

Methods:

From fall 2024 through spring 2025, 2 community colleges in the western United States participated in mapping a DI professional job task analysis (JTA) using course syllabi (n = 12) and assignments to identify curricular gaps. DI employer listening sessions (n = 13) provided additional input on job skills. We conducted listening sessions with 4 college faculty, 3 staff, and 14 students to evaluate the feasibility of DI training and identify student support strategies. The research team evaluated educational frameworks to develop an approach for community colleges to assess readiness for implementing DI professional training.

Results:

Community college courses mapped to the JTA more commonly for knowledge (range, 21.3%-72.3%) than for skills (range, 0%-66.0%). Feasibility to implement DI training at the community college level was viewed favorably by employers, faculty, staff, and students. Students identified needs for additional social supports, particularly for students from underrepresented populations. Steps for community colleges interested in providing curriculum to support DI certification included (1) mapping existing or proposed curriculum, (2) identifying curricular gaps and building opportunities for demonstrating JTA skills, and (3) evaluating the feasibility of adding new programming.

Conclusion:

DI professional training can likely be implemented successfully at community colleges. With modest adjustments to current courses, community colleges can document competencies that may enhance preparation for national DI certification.

Keywords

disease intervention certification workforce development infectious disease

Disease intervention (DI) professionals have a long history of playing an important role in the US public health system’s epidemiologic response to infectious diseases.¹ Because of their expertise in interviewing patients and identifying contacts, DI professionals are essential contributors to public health emergency preparedness and response. At the outset of the COVID-19 pandemic, an estimated 70 000 DI professionals were hired to support large-scale contact tracing across the United States.² The training needs of this expanded workforce were substantial yet time-sensitive, focused primarily on the specifics of COVID-19. Much of the training occurred through the existing National Network of STD Clinical Prevention Training Centers, which includes 8 regional centers, a coordinating center, and a curriculum center.³ This network typically focused on sexually transmitted infection/HIV work but rapidly expanded its curriculum to train COVID-19 contract tracers.⁴

Even with a national network of training centers, public health leaders have pushed for a DI workforce that consistently demonstrates the competencies needed for its ever-expanding role. In 2013, the National Association of County and City Health Officials issued a contract to explore the feasibility of a certification process for DI professionals. The Public Health Accreditation Board took the lead in this effort, completing a job task analysis (JTA), enumerating the workforce, and ultimately recommending a test-based certification model for DI professionals.⁵

Through a cooperative agreement with the Centers for Disease Control and Prevention, the Association of Schools and Programs of Public Health issued calls for research on educational pathways that could lead to national certification of DI professionals.⁶ This study examined community colleges as one such pathway. Community colleges provide vocational and academic training through multiple learning options, including skill-based certificates and associate’s degrees. Community colleges are uniquely suited to offer short-term training due to their flexible scheduling, affordable tuition, and capacity to integrate certification opportunities within programs tailored to regional workforce needs.⁷ Because of the ability of community colleges to offer a variety of tailored programs, they represent a commitment to creating a robust educational infrastructure that supports lifelong learning and economic development.⁷ To evaluate the feasibility of a community college–based Certified in Disease Intervention (CDI) credential, we sought the perspectives of likely employers, as well as faculty, staff, and students in public health or related programs.

Methods

We used a qualitative descriptive approach⁸ to examine (1) existing DI-related programming and curricular gaps at community colleges, (2) the feasibility of implementing DI programming at the community college level, and (3) the support needed to ensure student success, including that for students from communities disproportionately affected by health disparities. This study defines a community college as any institution granting 2-year degrees.

Selection of Educational Organizations

In 2024, we used purposive sampling for maximum variation to select 4 organizations that could provide diverse viewpoints: 2 offered degrees in public or community health; 1 provided a certificate program for community health workers, whom employers viewed as strong candidates for DI training; and 1 was an online training platform developed by 2 universities and a state health department to provide DI training for public health professionals (Table 1).

Table 1.

Characteristics of educational organizations participating in course mapping to job task analysis skills for disease intervention professionals, Western United States, 2024-2025

		CDI-related curriculum
Organization	Location	Certificate	AS	BS	Teaching modality	Priority populations
College A	Urban	×	×	—	Predominantly online for CHL degree	Hispanic, first generation
College B	Rural	×	×	×	In-person and online	American Indian, first generation
College C	Urban	×	—	—	In-person for CHWs	Pacific Islander, first generation, CHWs
Organization D	Online	×	—	—	Fully online	Workforce

Abbreviations: —, no degree offered in this category; AS, associate’s degree; BS, bachelor’s degree; CDI, Certified in Disease Intervention; CHL, community health and leadership; CHW, community health worker.

Mapping Courses

Members of the research team reviewed titles and descriptions for courses leading to the selected degrees (associate and bachelor of science in public health; associate of science in community health and leadership; community health worker certificate) and the professional DI certificate. In consultation with faculty at each organization, we chose courses that were most likely to include DI-related content for mapping. Educational institutions provided syllabi, and some also provided associated assignments for these courses. Three independent reviewers (K.S.G., M.B., and J.D.P.) discussed discrepancies in course mapping and resolved issues through an iterative comparison process.⁹

Using the 2025 version of the JTA developed by the National Board of Public Health Examiners,¹⁰ 3 researchers (K.S.G., M.B., and J.D.P.) independently mapped course objectives, competencies, activities, and assignments to document corresponding knowledge and skills, following the example provided by Mase et al.¹¹ The JTA domains were (1) planning and case analysis, (2) interviewing and case management, (3) field services and outreach, (4) surveillance and data collection, (5) collaboration, and (6) outbreak response and emergency preparedness.

Each domain included a job task titled “adherence to public health principles.” To ensure that this job task was clearly mapped, we created a seventh domain, public health principles, with the following job tasks: Health Insurance Portability and Accountability Act (HIPAA) confidentiality, cultural humility, basic epidemiology, social determinants of health (including socioeconomic status, health literacy, and health equity), and ethical and professional conduct.

The output of this activity was the percentage of JTA skills mapped to each institution. The numerator was any instance (knowledge, competency, task, activity, or assignment) where a course mapped to a specific task. The denominator was the total number of tasks in the JTA. Thus, each calculated percentage reflects the proportion of tasks covered by an institution’s curriculum.

Listening Sessions

Three listening sessions used semistructured question guides to gather input from employers of DI professionals, health sciences faculty and staff, and students at 2 colleges. Maximum variation sampling ensured a meaningful range of perspectives for each listening session.

Employers

The research team first identified individuals known to the researchers who could offer insights for the employer listening session. These individuals then recommended additional qualified colleagues, yielding a mix of purposive and snowball sampling. The listening session covered topics on desired DI professional skills, training expectations, and time to reach proficiency.

Faculty and Staff

At 2 colleges, 4 faculty who taught courses relevant to DI training and 3 staff who provided academic advising and mentoring to students participated in the listening sessions. These listening sessions explored the existing curriculum for DI professional training, gaps in the curriculum, and the feasibility of addressing these gaps within the existing curriculum. Two researchers (L.H.G., K.S.G.) developed questions about the feasibility of DI training based on the program implementation guidelines proposed by Bowen et al.¹² Participants also discussed types of student support needed to promote successful degree completion and facilitate student pathways to employment as DI professionals.

Health Science Students

Faculty identified current students and recent graduates of their degree programs to participate in a listening session. Two researchers (L.H.G, K.S.G.) asked 14 students about their perceptions of educational and professional pathways for DI professionals, as well as existing and desired supports that contribute to successful degree completion and employment. Students responded to questions in 3 key areas of support: social support (eg, emotional support, companionship, mentoring), academic support (eg, conceptual, editorial, linguistic resources), and instrumental support (eg, access to technology or equipment, administrative and financial resources).¹³ Student participants received a $25 gift card at the completion of the listening sessions.

Listening sessions were conducted and recorded via Zoom version 6.0.0 (Zoom Communications Inc). Recordings were transcribed by HappyScribe AI software (HappyScribe) and reviewed by 2 members of the research team (K.S.G., J.D.P.) for accuracy and removal of personal identifiers. Two research team members (K.S.G., J.D.P.) completed deductive coding in Dedoose version 10.0.35 (Sociocultural Research Consultants, LLC), followed by a discussion to resolve differences and identify themes.¹⁴ Recordings and transcripts were stored in a HIPAA-compliant cloud system.

Framework Development

The research team held a series of brainstorming meetings to synthesize the results. These discussions addressed curricular program design,¹⁵ active and experiential learning strategies for the classroom,¹⁶ and practice-based learning opportunities beyond the classroom.^17,18 The final meeting focused on visually mapping a framework that community colleges can use to assess their readiness to implement DI professional training.

This study was approved by the University of Utah Institutional Review Board (00184486). Focus group participants were provided an informed consent cover letter and reminded of their rights and expectations of participation prior to starting the focus group discussion. We obtained verbal consent from participants. Participants were sent a consent letter prior to participating and reminded of the voluntary nature of participation in listening sessions.

Results

Mapping

Course objectives found in the syllabi defined aspirational knowledge and skill attainment but did not offer evidence that JTA skills were directly assessed. Some assignments demonstrated the potential for skills assessment with modification or if the student selected a DI-related topic. Overall, knowledge mapped more frequently to courses (range, 21.3%-72.3%) than to skills (range, 0%-66.0%) (Table 2).

Table 2.

Alignment of community college courses with Certified in Disease Intervention job task analysis domains, Western United States, 2025^a

		College A (3 courses)		College B (6 courses)		College C (3 courses)		College D (12 courses)
Desired skills	Job task analysis tasks	Knowledge	Skills	Knowledge	Skills	Knowledge	Skills	Knowledge	Skills
Domain
Planning and case analysis	6	1	3^b	2	2	1	0	4	4
Interviewing and case management	15	8	2^b	4	1	3	0	14	13
Field services and outreach	10	0	0	2	0	0	0	4	1
Surveillance and data collection	4	1	2^b	1	0	1	0	3	2
Collaboration	4	1	0	1	1	1	0	1	3
Outbreak response and emergency preparedness	4	3	1^b	0	0	1	0	3	4
Public health principles^a	4	1	2	3	3	3	0	5	4
Total, no. (%)^c	47	15 (31.9)	10 (21.3)	13 (27.7)	7 (14.9)	10 (21.3)	0	34 (72.3)	31 (66.0)
Public health principles
HIPAA/confidentiality	NA	–	–	–	–	+	–	+	–
Cultural humility	NA	–	–	–	+	+	–	+	+
Basic epidemiology	NA	–	+^b	+	+	–	–	+	+
Social determinants of health	NA	+	+	+	+	–	–	+	+
Ethical and professional conduct	NA	–	–	+	–	+	–	+	+

Abbreviations: HIPAA, Health Insurance Portability and Accountability Act; NA, not applicable.

Data source: National Board of Public Health Examiners.¹⁰ The research team added the disease intervention job task analysis domain “public health principles” to simplify course mapping and curriculum development. Employers expressed skepticism that components of this domain could be taught in an academic setting. The research team aimed to demonstrate that many courses already include content aligned with its 5 components. A plus sign (+) indicates that the public health principle was mapped. A minus sign (–) indicates that the public health principle was not mapped.

Skills map to the job task analysis if infectious disease is selected for the assignment.

Indicates percentage of job task analysis tasks covered by the combined courses mapped from the institution listed.

Listening Sessions

Employers

Two employer listening sessions were held, each lasting 60 minutes. Participants represented state and local health departments in California, Utah, and the Navajo Nation. Participants included DI staff from state and local health departments, epidemiologists, and DI trainers from an online training organization (Table 3).

Table 3.

Employer categories for Certified in Disease Intervention listening sessions on workforce skills and training, United States, 2024

Employer role	Navajo Nation	Utah	California	Total
Epidemiologist	1	2	0	3
State health department	0	2	4	6
County health department	0	2	0	2
California Prevention Training Center	0	0	2	2

Employers expressed a favorable outlook on community colleges as an appropriate academic setting for DI professional training, where typical wages and skills were commensurate with certificate or associate-level training. Some employers, however, expressed skepticism that durable skills (eg, cultural sensitivity, “street” smarts, motivational interviewing, disease investigation) could be effectively taught in an academic environment. They estimated 6 to 18 months of on-the-job training and experience to develop these skills. Coursework viewed by employers as being most beneficial for DI preparation included epidemiology, disease pathophysiology, outbreak response, HIPAA and mandatory reporting, and medical terminology.

Employers identified several benefits of a well-trained DI workforce: improved retention due to applicants’ more realistic expectations of what the DI positions entailed, reduced onboarding time and associated costs for newly hired employees, certified DI professionals as compared with noncertified staff, and clearer pathways for career growth and promotion.

Faculty and Staff

Two faculty and staff listening sessions were held, each lasting 60 minutes. Participants from college A (urban setting) included 1 faculty member, 1 dean, and 1 wellness team member with experience in student advising and curriculum development. Participants from college B (rural setting) included 2 full-time faculty members, 1 adjunct faculty member, and 1 career academic advisor.

Overall, participants viewed the feasibility of implementing a DI professional training program at their colleges as high. Results from the listening sessions provided insight into each feasibility guideline (Table 4). Employees from both colleges viewed demand and implementation as neutral, while acceptability, adaptation, integration, and limited efficacy were viewed positively in regard to the feasibility of implementing DI curriculum. More details and illustrative quotes related to each guideline are provided (Supplement).

Table 4.

Perceived feasibility for implementing a DI credential at 2 participating community colleges, United States, 2026^a

Feasibility guideline	Question guide prompt^b	College A	College B
Acceptability	Be judged as suitable (satisfying, attractive) to your existing programs? To students?	+	+
Demand	Be used/accessed by students?	±	±
Implementation	Be able to be delivered as intended?	±	±
Practicality	Be implemented using existing resources?	+	±
Adaptation	Require changes be made to existing infrastructure and processes?	+	+
Integration	Be integrated within your existing educational system?	+	+
Expansion	Be expandable to new sites? (within or external to your system)	+	±
Limited efficacy	Show promise for increasing the diversity of the overall DI professional workforce?	+	+

Abbreviation: DI, disease intervention.

A plus (+) sign indicates a positive view of adding a Certified in Disease Intervention credential, and a plus/minus (±) sign indicates a neutral view.

“To what extent would a DI professional training program . . . ”?

Faculty and staff at both colleges identified training that leads to national certification as part of their mission to provide professional development. They viewed certification as an immediate benefit not only for individuals already employed as DI professionals or in related positions but also as a pathway to define employment opportunities for students. Participants from college B expressed concerns about adding new training into an existing program, citing staff capacity and the potential need to restructure upper-division courses to accommodate first- and second-year students. In contrast, participants from college A did not express these concerns because they were considering adding DI programming into a major that was currently under development.

Health Science Students

Participants from college A (n = 9) were first- and second-year students enrolled in various associate’s degree programs within this urban institution’s School of Health Sciences, including nursing, dental hygiene, and occupational therapy assistant. Most students were taking in-person classes. This listening session lasted 30 minutes. Participants from college B (n = 5) were students in this rural institution’s public health major and included 1 recent graduate. Coursework was a mixture of in-person and online. This listening session lasted 50 minutes.

Students at both colleges expressed positive perceptions of the value of a DI professional certificate, with particularly strong enthusiasm among students at college B. Students at this rural campus viewed certification as a way to differentiate themselves in a competitive and limited job market. Despite this interest, students raised concerns about the cost of certification, the ability of student support services to accommodate an additional program (especially when existing services already felt stretched), and the accessibility of required courses across a system of distributed campuses where not all courses were offered at every location. Faculty and staff from college A noted that students who completed the credential while still in school could access higher-paying employment with greater opportunities for professional experience and advancement than typically available to their peers. College A viewed the DI credential as a strategy to reduce student debt and support continued education beyond the associate’s degree.

Students from both colleges provided valuable insights into the types of support available to them (social, academic, instrumental). Students especially valued flexible schedules, access to childcare, mentorship, and funding (Table 5).

Table 5.

Reported examples of student supports and needs at 2 community colleges, from listening sessions with faculty, staff, and students in the health sciences, United States, 2025

	College A		College B
Supports/needs	Faculty/staff	Students	Faculty/staff	Students
Social
Supports	Food pantry, childcare, mental health services, health services	Childcare	Professors able to share personal skills and experience	Flexibility to work while taking online courses
Needs	—	—	Mentorship programs, access/resources for remote students	More access to childcare assistance, mentors, more services for remote students
Academic
Supports	Free tutoring, small class sizes	Helpful and accessible academic advisors	Academics willing to provide guidance with writing	—
Needs	Academic advisors	—	—	Academic advising
Instrumental
Supports	Student emergency fund assistance	Library resources, FAFSA office	Financial assistance/aid, available scholarships	Free tuition, free books
Needs	—	—	—	Grants for certification programs

Abbreviations: —, no examples mentioned during listening sessions; FAFSA, Free Application for Federal Student Aid.

Discussion

Community Colleges as a Pathway to CDI Credentialing

Two-year degree–granting institutions or community colleges proved a viable certificate pathway to support preparation for the CDI credential. Employers, faculty, staff, and students recognized the possibility to quickly implement CDI credential programs nationwide through certification and associate degree–granting institutions. Our findings can guide organizations that seek to expand the training of DI professionals, especially through the framework design.

Framework

We suggested a broad mapping framework at this stage because the granularity of the JTA¹⁰ was too fine for planning an entire program. The initial broad mapping at this step allows for the incorporation of ideas from a range of learning activities, including didactic and active learning, as each has distinct benefits for health sciences students.¹⁹

Our framework discussions resulted in a 3-step process for community colleges to use in developing DI programming. The first step is to map existing or proposed course objectives against 6 broad competencies: (1) familiarity with data collection and privacy considerations; (2) skills for working with clients, such as contact tracing and case management but also cultural responsiveness and professionalism; (3) understanding connections among different resources within clinical and public health systems; (4) epidemiologic concepts, disease pathophysiology, and determinants of health; (5) outbreak response; and (6) considerations for personal safety.

We found that assignments were more useful than syllabi for documenting skill assessment. Assignment design allows community colleges to consider whether classroom experiential learning or practice-based learning (ie, work-based or service-learning opportunities) provides a better opportunity to assess DI professional skills. We developed a template to guide this level of mapping (eFigure in the Supplement).

The second step involves identifying curricular gaps by mapping all courses simultaneously to the broad competencies (eTable 1 in the Supplement). This process helps ensure that the curriculum addresses all competencies and provides an appropriate balance between introducing concepts and building proficiency as students advance through the program. Once program developers are satisfied with the curriculum mapping, the more detailed JTA can be used to develop assignments that assess specific skills required of DI professionals. As students progress toward certification, it is important that assessments document skills attainment, not just knowledge. This step also provides an opportunity to incorporate practice-based learning, such as internships, practica, and/or service learning.

The third step is evaluating the feasibility of program implementation using the guidelines proposed by Bowen et al.¹² We adapted these guidelines to create a list of questions that program developers can use to assess whether adding a DI certification program is feasible at their community college (eTable 2 in the Supplement). Responses to these questions can help identify existing strengths and potential challenges that need to be addressed. As part of this evaluation, we incorporated questions related to student support mechanisms, informed by feedback from students, academic advisors, and faculty in our study.

Comparison With Prior Studies

Our study identified a lower proportion of courses overall that mapped to JTA skills than what was found by Mase et al.¹¹ Mase et al reported mapping 75% of job tasks to their bachelor degree curriculum, while we reported a range across 4 institutions for knowledge (21.3%-72.3%) and skills (0%-66.0%). Notably, our highest-mapping organization provided training for DI professionals and had similar metrics to the single-institution study by Mase et al.¹¹ The lower proportions that we found may be due to mapping courses at the lower division level rather than the 4-year degree or because our study assessed multiple locations demonstrating variability across the materials provided, the curriculum, or both. The first 2 steps in our framework should help individual community colleges assess their own curriculum readiness by identifying gaps and developing assignments that can assess JTA skills.

Perspectives on Implementation and Workforce Impact

Employers, faculty, staff, and students all agreed that community colleges are an appropriate educational setting for training that could lead to a nationally recognized CDI credential. Employers noted strong alignment between the skills and wages associated with DI positions and the training offered at community colleges. Faculty and staff reported that incorporating the necessary training elements was feasible, although doing so with an established program presented more challenges than integrating DI content into a program still under development. Across faculty, staff, and student groups, we found consensus that earning a credential would enhance students’ employability and provide financial benefits, particularly if it enabled students to obtain professional employment while still in school.

Although faculty and staff generally viewed implementing DI training positively, they identified resource concerns. Where existing resources were already constrained, the effort to add programming without additional infrastructure support was a potential nonstarter. Beyond educational programming, additional resource considerations included assessing the capacity of personnel to recruit students, provide adequate educational and social support, and create pathways to employment. Students mentioned the need for increased levels of academic and career mentoring. Resource concerns extended beyond the school level to county and state policy relating to funding allocations and priorities.

Beyond the campus setting, participants identified the challenge of demonstrating the clear connection between certification and improved job placement, a feasibility consideration that varies depending on local workforce opportunities. Participants also highlighted shifting public health–related spending priorities as a potential barrier, influencing decisions about the appropriate timing for introducing new curriculum. Despite these concerns, participants identified skills stacking (ie, combining complementary skills) for current DI professionals, related staff, and students as an immediate benefit. Community colleges have long been a natural place to seek such certification and can tailor their messaging to reflect this role.⁷ The 3-step framework that we proposed allows community colleges to assess the feasibility of adding a DI curriculum to their course offerings.

Limitations

This study had several limitations. First, although we reached saturation in our qualitative assessments, our findings may have limited generalizability because they were based on responses from 2 community colleges and course mapping from 4 community colleges. Additional work at other community colleges could help to confirm our findings and identify whether other issues and contexts should be added to those described in our study. Second, while we found agreement among faculty, staff, and students about the responses for their institutions, future exploration with additional schools may help identify issues that are common to particular contexts, such as 2-year-only schools as compared with 2- and 4-year schools, rural settings, or communities with economic constraints.

Public Health Implications

We found strong endorsement among employers, faculty, staff, and students that community colleges are well suited for DI professional training. Student benefits include early resume-building opportunities, opportunity for meaningful and relevant employment during their educational journey, and enhanced competitiveness for employment and educational pursuits. For community colleges, these benefits align with their mission to prepare students for careers that benefit their communities. The provided framework can help community colleges assess program and institutional readiness to add DI professional training.

Supplemental Material

sj-docx-1-phr-10.1177_00333549261446270 – Supplemental material for A Qualitative Evaluation of Community Colleges as a Pathway to the Certified in Disease Intervention Credential

Supplemental material, sj-docx-1-phr-10.1177_00333549261446270 for A Qualitative Evaluation of Community Colleges as a Pathway to the Certified in Disease Intervention Credential by Kristina S. Gale, Jennifer Dailey-Provost, Mindy Bateman, Judith Hilman, Kimberley Shoaf and Lisa H. Gren in Public Health Reports®

Footnotes

Acknowledgements

The authors thank the faculty contacts at the 4 institutions studied for providing information and resources for mapping courses and recruiting participants.

ORCID iD

Kristina S. Gale, MPP, WEMT

Funding

The authors received the following financial support for the research, authorship, and/or publication of this article: This publication was supported by the Centers for Disease Control and Prevention of the US Department of Health and Human Services through Notice of Funding Opportunity CK20-2003 titled “Improving Clinical and Public Health Outcomes Through National Partnerships to Prevent and Control Emerging and Re-emerging Infectious Disease Threats.” The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, the Centers for Disease Control and Prevention, the US Department of Health and Human Services, or the US government.

Declaration of Conflicting Interests

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

Data Availability Statement

The data that support the findings of this study may be available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Supplemental Material

Supplemental material for this article is available online. The authors have provided these supplemental materials to give readers additional information about their work. These materials have not been edited or formatted by Public Health Reports’s scientific editors and, thus, may not conform to the guidelines of the AMA Manual of Style, 11th Edition.

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