Knowledge, Skills, and Training for the COVID-19 Contact Tracer Workforce

by Vanessa Lamers and Justin Ren


Contact tracing is a tried and true public health intervention that stops the spread of disease by tracking down and interviewing “contacts” of people who are infected, and preventing them from infecting others. It has been a pivotal tool in the toolbox of state, tribal, local, and territorial public health for responding to and stopping outbreaks. Contact tracers have been a crucial part of the public health workforce, combating the spread of diseases such as syphilis, HIV, tuberculosis, and Ebola. Conducting contact tracing successfully and efficiency requires a diverse set of skills – clinical knowledge of disease transmission, adept interpersonal skills to effectively interview patients and contacts, and an understanding of surveillance data best practices.

To facilitate the building of knowledge and skills for the contact tracing workforce, the Public Health Foundation (PHF) completed an environmental scan in June 2020 of contact tracing-related trainings. PHF scanned a variety of training repositories, including the TRAIN Learning Network, PHF’s live searches of COVID-19 training, the Public Health Learning Navigator, and content from Public Health Training Centers, OpenWHO, the Centers for Disease Control and Prevention (CDC), training-source.org, the National Emerging Special Pathogens Training and Education Center, and the Office of the Assistant Secretary for Preparedness and Response Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE), and identified 180 relevant trainings for COVID-19 contact tracers. The availability of so many trainings showcases the deep infectious disease expertise available, and the speed at which the public health community has collectively developed and launched new, just-in-time, remote learning, or adapted or updated existing training resources to build skills for this rapidly growing workforce.

The identified trainings were categorized by and cross-walked with CDC’s Training Case Investigators and Contact Tracers guidance, which identifies 10 knowledge and skills public health workers may need for effective contact tracing. An analysis of the categorized trainings found many trainings that addressed handling patient confidentiality, effective interviewing, and surveillance and data collection best practices, but a need for more training addressing cultural sensitivity, crisis counseling, and how to work with contacts of varying immigration statuses.

To support the initial training and continuing education of the contact tracing workforce, PHF identified two to three high quality trainings that align with CDC’s 10 knowledge and skills. Each of these trainings were available through a single online platform, TRAIN Learning Network. These trainings are grouped under each of CDC’s identified 10 knowledge and skills, and provided below.

1. A keen understanding of the need for patient confidentiality and the ability to conduct case interviews with care in order to protect confidentiality and to conduct contact tracing without disclosing the identity of the patient (case).

COVID-19: Data Sharing for Public Health Surveillance, Investigation and Intervention The Network for Public Health Law https://www.train.org/main/course/1090857/
HIPAA Learning Bundle A PHF compilation of various HIPAA trainings from health departments, legal firms, and other organizations https://www.train.org/main/training_plan/3919

2. Understanding of, and ability to explain in plain language, the medical terms associated with COVID-19 and principles of exposure, infection, infectious period, potentially infectious interactions, symptoms of disease, pre-symptomatic and asymptomatic infection, types of tests used to diagnose infection, and available prevention and control interventions (eg, isolation/quarantine, social distancing, environmental surface cleaning).

Making Contact: A Training for COVID-19 Contact Tracers Association of State and Territorial Health Officials and National Coalition of STD Directors https://www.train.org/main/course/1091302/compilation
COVID-19 Public Health Strategy – Basic Concepts North Dakota Public Health Training Network https://www.train.org/main/course/1090675/
CDC COVID-19 Case Investigator Training: Guidance, Resources and Sample Training Plan Centers for Disease Control and Prevention https://www.train.org/main/course/1091416/

3. Excellent and tactful interpersonal skills, cultural sensitivity, and language and interviewing skills that allow them to build and maintain trust with clients and contacts.

Introduction to Telephone Interviewing for DIS Centers for Disease Control and Prevention https://www.train.org/main/course/1090632/
COVID19: Using a Health Equity and Human Rights Lens to Protect Vulnerable Populations during this Pandemic and Beyond Region 2 Public Health Training Center https://www.train.org/main/course/1090906/
Community Health Workers and COVID-19 MCD Public Health https://www.train.org/main/course/1091430/

4. Basic skills of crisis counseling and the ability to confidently refer clients and contacts for further care, if needed.

Making Contact: A Training for COVID-19 Contact Tracers Association of State and Territorial Health Officials and National Coalition of STD Directors https://www.train.org/main/course/1091302/compilation
Psychological Resiliency – Building Personal Resilience and Self-Reliance Tulane University School of Public Health and Tropical Medicine https://www.train.org/main/course/1010943/

5. Resourcefulness in locating and communicating with clients and contacts who may be difficult to reach or reluctant to engage in conversation.

Interviewing Unit 5: Cluster Interviews and Re-Interviews Centers for Disease Control and Prevention https://www.train.org/main/course/1089364/
Effective Communication Federal Emergency Management Agency https://www.train.org/main/course/1052535/

6. Awareness of the sensitivities surrounding immigration status and how this can be a barrier to case investigation and contact tracing activities.

Immigration and Health Disparities: Beyond Acculturation Region 2 Public Health Training Center https://www.train.org/main/course/1059816/
Building Cultural Competence in Disaster Preparedness and Response The Institute for Public Health https://www.train.org/main/course/1012857/

7. Understanding of when to refer individuals or situations to medical, social, or supervisory resources.

Making Contact: A Training for COVID-19 Contact Tracers Association of State and Territorial Health Officials and National Coalition of STD Directors https://www.train.org/main/course/1091302/compilation
COVID-19 Contact Tracing (Coursera MOOC) Johns Hopkins University https://www.train.org/main/course/1091439/

8. Ability to help clients and contacts identify any needs they may have for social support during self-isolation/self-quarantine.

COVID-19 Digital Classroom: Addressing Mental Health and Wellness (Course 3) Community Health Academy https://www.train.org/main/course/1091885/
How to Respond to Ethical Challenges and Moral Distress During the COVID-19 Pandemic American Nurses Association https://www.train.org/main/course/1091026/
Evolving Strategies in the Management and Prevention of COVID-19 Topic: Social Issues in Management of COVID-19 MedLearning Group https://www.train.org/main/course/1093054/

9. Ability to collect basic standardized surveillance data per protocols.

COVID-19: Data Sharing for Public Health Surveillance, Investigation and Intervention The Network for Public Health Law https://www.train.org/main/course/1090857/
General Contact Tracing Phone Calls Michigan Department of Health and Human Services https://www.train.org/main/course/1091008/
Introduction to Outbreak Investigation Northwest Center for Public Health Practice https://www.train.org/main/course/1016812/

10. Understanding of when the use of public health legal authorities may be necessary and how to notify the appropriate public health officer for authorization.

COVID-19 Real-Time Legal Response: Focus on Quarantine, Isolation, and Other Social Distancing Powers The Network for Public Health Law https://www.train.org/main/course/1090658/
COVID-19 Real-Time Legal Responses: Local Governments on the Frontlines The Network for Public Health Law https://www.train.org/main/course/1090856/

Did you have an additional contact tracing or relevant courses to add? Contact Vanessa Lamers at vlamers@phf.org.


Vanessa Lamers

Vanessa Lamers is the Assistant Director of Performance Management and Quality Improvement at the Public Health Foundation in Washington, DC.

 

 

 

 

Justin Ren

Justin Ren is an MD/MPH Candidate at the Tulane School of Medicine and Tulane School of Public Health and Tropical Medicine.