Purpose: Today, the majority of social workers are employed in health care-related services, and the number is increasing (Ginsberg, 1995; Keigher, 1999). Recent changes in the health care system, particularly the crises of cost containment and funding, have unquestionably affected the content, process, and future of social work practice in health (Berkman, 1996: Dziegielewski, 1998). The focus on health disparities and a rapidly expanding aging population require a social work labor force skilled in health promotion, epidemiology, and prevention research. The emphases on community-based care, behavioral health, and short term interventions, are particularly relevant to a public health social work (PHSW) orientation (Berkman, 1996; Keigher, 1997; Vourlekis, Ell, & Padgett, 2001).

As a partial response, some twenty master's level dual-degree programs in social work and public health have developed over the past 20 years. Despite their popularity, there has been little research on the impact such programs have on the profession's capacity to meet the challenges of research, prevention and practice within diverse communities. Given the emphasis on evidence-based practice in public health, and the complementary commitment to social justice, it can be hypothesized that dually-trained professionals would be at the helm of addressing linkages between research and practice. However, there is a paucity of literature on this issue.

Methods: We undertook an exploratory qualitative study of how public health social workers trained in MSW/MPH programs experience current challenges in the practice environment. We assessed (i) definition of public health social work, (ii) workplace challenges, (iii) pressures of dual professionalism; and (iv) attitudes toward evidence-based practice and research. We conducted four taped focus groups with fifty national graduates of MSW/MPH programs. Findings were transcribed into word document for analysis by constant comparison method by four PHSW researchers.

Results: We created a person-in-environment model to organize results. The meta-construct included 5 domains: i) internal psychological environment (qualities of persons drawn to PHSW); ii) training environment (academic and practice experiences); transitional environment (job search); professional environment (current challenges in PHSW); and future environment (next steps for PHSW). Participants indicated interest in prevention/intervention and strong commitment to evidence-based practice and research. They cited professional obstacles to PHSW at every level. Many stressed a need for self-definition as PHSW professionals. Respondents expressed difficulty finding truly integrated PHSW workplaces. Graduates discussed how MSW/MPH practitioners practice and perceive professional issues differently, and emphasized the need for both fields to utilize each others' strengths. Respondents argued for social work to be more “research-based,” particularly regarding evaluation and community-based participatory research. Participants identified areas of future concern including a national research agenda for public health social work.

Implications: Findings suggest that public health social work graduates of MSW/MPH programs have unique contributions to make to the process of linking research and practice within social work. Several constituencies, including employers of social workers, educators and dual-degree program administrators, and the growing body of MSW/MPH graduates can benefit from an increased understanding of the important skills dually-trained practitioners bring to meeting the challenge of research in and with diverse communities.