The Alive! Maryland Needs Assessment

The 2022 Alive! Maryland Workforce Needs Assessment

HealthHIV, in partnership with the Center for HIV/STI Integration and Capacity (CHSIC) within the Infectious Disease Prevention and Health Services Bureau at the MDH, conducted a follow-up needs assessment for the Alive! Maryland project to gain insight into the evolving training and technical assistance needs of Maryland’s primary care and infectious disease workforce. The 2022 assessment reflected data gleaned from the needs assessment and programmatic evaluations in 2021 in order to identify opportunities to augment Alive! Maryland’s educational programming. 

This assessment retained many elements of the 2021 assessment, as well as several new sections addressing the following topics:

• Community Health Worker issues, roles, and reach;
• Burnout, retention, and turnover issues, etc.; and
• Caring for transgender and non-binary individuals.

The findings reflected the significant extent of challenges facing healthcare providers in Maryland in the wake of COVID-19, MPox, and other emerging epidemics. Respondents emphasized the emotional burden of managing the fallout of these public health crises and providing care in the current social and political context. Their responses highlighted the need for a more responsive approach to address scarcity of resources, provider burnout, and ongoing stigma and mental health issues affecting patient populations. Additional points observed in the data described in this report include the need for: 

• Integrating CHWs into programming and services;
• Providing mental health services at the workforce and patient/patient level;
• Investing in staff retention;
• Developing training on gender-affirming care; and
• Addressing stigma.

The 2021 Alive! Maryland Workforce Needs Assessment

​​In 2021, the Maryland Department of Health engaged HealthHIV to begin Alive! Maryland, a comprehensive capacity building initiative for the state of Maryland’s primary care and HIV, viral hepatitis, STI, and harm reduction workforce. Alive! stands for Assess, Learn, Integrate, Visualize, Engage—representing each phase of the program—and serves as a motivational call to action to build capacity to improve health in Maryland. 

Alive! Maryland administered a mixed-methods needs assessment to gain insight into training and technical assistance needs of Maryland’s primary care and infectious disease workforce. Alive! Maryland outlined the following pillars, which were used to address the needs assessment through a syndemic, comprehensive, and coordinated approach: 

• Health Equity
• Harm Reduction
• Self Determination
• Sexual Health Promotion
• Social Determinants of Health 

The assessment examined these pillars to inform the design, development, and delivery of the curricula to strengthen the technical capacity of Maryland’s infectious disease and primary care workforce.

The results indicated that COVID-19 greatly impacted prevention and care activities at all levels and highlighted the need for a more responsive approach to address the intersectionality of the HIV, STI, hepatitis, and opioid epidemics through a health equity lens. Additional areas observed in both the quantitative and qualitative data collection and described in detail in this report are: 

• Integrate HIV, STIs, HCV, and harm reduction prevention and health services into COVID-19 services;
• Provide mental health services at the workforce and client/patient level;
• Invest in staff retention;
• Incorporate sustainable and accessible telehealth models; and
• Address support services.