The Los Angeles County Department of Public Health has over 5,000 employees and serves a population of more than 10 million residents across 4,753 square miles of southern California. When SARS-CoV-2 (COVID-19) appeared in L.A. County in 2019, the Department of Public Health (DPH) began contact tracing as a primary public health strategy to help stop the spread of the disease since there was no vaccine or medication at the time. As COVID-19 cases rapidly rose and were projected to exceed DPH’s COVID-19 Case and Contact Interviewing Branch’s (CCIB) capacity to sufficiently maintain its efforts through its existing workforce, an additional workforce of contact tracers was needed to meet the increase in daily reported cases.  

CCIB sought the expertise of DPH’s Division of Organizational Development and Training (ODT) to train a new workforce of more than 4,000 case and contact interviewers. This new workforce included government and non-government staff who were reassigned from DPH and other L.A. County departments or volunteered through the California Department of Public Health, L.A. City agencies, colleges and universities in and out of California, and registry and staffing agencies. Most people worked or studied in disciplines other than public health such as law, library, sanitation, nursing, maintenance, building and safety, administration, and education.   

ODT’s daily operational charge is to enhance workforce excellence by educating and training a skilled and effective public health workforce. Its goal in response to the COVID-19 pandemic was to quickly provide case and contact tracing training to a new large workforce, who had little or no prior public health experience, so they could rapidly deploy and perform case and contact tracing interviews for Los Angeles County. ODT created a project to implement the DPH COVID-19 Contact Tracing (CT) Training Program. This program was quickly planned and developed in two weeks’ time and turned into a comprehensive, 5-day training program. Staff who had no knowledge or experience in public health practice were swiftly provided education and training about public health, COVID-19, contact tracing principles, phone interviewing skills and related tracing and case management systems.  This staff was equipped to rapidly deploy into CCIB teams and competently perform work on behalf of the Department of Public Health in roles as case interviewers and contact tracers.  

The pandemic changed how everyone worked and proceeded through daily life. Training, which was traditionally done by ODT as classroom-based in-person learning, quickly pivoted to online live webinars or web-based trainings. ODT staff created the COVID-19 Contact Tracing Training Program as a 100% virtual training to reach the new workforce where they were – online. It was known that trainees had little knowledge about infectious disease, limited use or familiarity with technology, and were uncomfortable when talking with the public, especially when asking questions related to peoples’ health and personal information. Therefore, training needed to be all-inclusive to meet their learning needs. The training program was created as a four-part curriculum that consisted of approximately 8-9 hours of synchronous live training webinars and 8-10 hours of asynchronous self-paced training modules delivered to cohorts of trainees over a span of 5 days. It contained information about L.A. County’s Department of Public Health; the basic principles of public health and epidemiology related to COVID‐19; the importance of case investigation, contact tracing, isolation and quarantine; contact tracers’ role and responsibilities, including cultural sensitivity and confidentiality; interview skills practice, observation and feedback; and Q&A with subject matter experts and experienced contact tracers.   

To deliver this program, several new technology systems were used as training platforms and to connect with trainees who were external to L.A. County’s network. ODT staff quickly learned Microsoft Teams, WebEx, and Amazon Web Services. They gained a strong working knowledge of these systems which was crucial to providing trainees help and support as they used these new and unfamiliar technologies. In line with this, the Training Advisor (TA) Program, created as an accompaniment to the CT Program, provided an additional layer of support to trainees. The TA program assigned training advisors to groups of trainees each week. TAs held daily meetings that addressed trainees’ barriers which giving trainees a space to ask questions, seek help with training technologies and materials, meet and engage with peers, and participate in supplemental mini trainings of step-by-step demonstrations on how to use technologies for contact tracing. Since the TA program was developed in-house and used existing staff, it was an innovative, efficient, and cost-effective enhancement to the CT training program that provided more support to trainees and improved their on-time completion of training. 

The DPH COVID-19 Contact Tracing Training Program was not solely the effort of ODT. Internal and external partnerships were formed to accomplish the goal. A key stakeholder was the Case and Contact Interview Branch. It is through CCIB that ODT received more than 4,000 trainees and graduated them back to CCIB as new workers. That collaboration extended ODT’s work with other stakeholders such as the State and L.A. City to train reassigned staff and volunteers and show educational institutions how to train students and interns for these specific COVID response duties. Trainees needed to access training and communication platforms being used so ODT collaborated with Public Health’s Information Systems division to ensure issues were addressed so that people could gain access to the County network or other systems of use. Another unique opportunity for collaboration was inviting CCIB and DPH COVID-19 Call Center’s staff and team leaders to join a segment of the weekly training for a Q&A panel with subject matter experts. Experienced CCIB interviewers and Call Center staff spoke about their work, interview experiences, and answered trainees’ questions. This additional component of the training program benefited trainees by allowing them to hear first-hand experiences working with the communication and data collecting tools they will use, as well as insight into what to expect in this new role through the personal experiences that the panelists shared about the pride, challenges, and sense of purpose they felt working as contact tracers.   

As the COVID-19 Contact Tracing Training Program was implemented and delivered ODT continuously evaluated, modified, and made quality improvements to assure that the training content, methods, and learning for the trainees were current, accurate, high-quality, and supportive. Curriculum revisions were made as more was learned about COVID-19, resources and services were expanded, and vaccines became available. Improvements like adding the Training Advisor Program showed that 81% (4,067) of trainees completed and graduated on-time between May 2020 and June 2021. Trainees reported that 78% were satisfied and highly satisfied with the program and had a 42% increase in knowledge. The CT Training has evolved over time to meet the specific needs of various trainee groups. One version of the program was adapted for student/intern trainees whose academic schedules left them with limited capacity to participate in the scheduled live webinar trainings. Hence, the live webinars were recorded and converted into video modules for self-paced training. Another version of the program was modified for a new group of Community Contact Tracers who do work that brings them into communities to perform contact tracing in the field. Training curriculum was modified to include field safety and logistics topics.   

Contact tracing remains a primary strategy for the Department of Public Health along with vaccinations to prevent the spread of COVID-19 in Los Angeles County. The Division of Organizational Development and Training continues to run the COVID-19 Contact Tracing Training Program to train new case interviews and contact tracers as new variants of COVID-19 emerge and surges continue to impact the health of those who live, work, and visit Los Angeles County.