Poster #74 - Navigating Role Conflict and Ambiguity: Challenges for Disease Intervention Specialists in Public Health Collaboration

• In Event: Friday Poster Reception

Abstract

This study explores how conflicting and ambiguous expectations influence the roles of Disease Intervention Specialists (DIS) in public health organizations. Grounded in role theory—especially the concepts of role conflict and role ambiguity—this work emphasizes the challenges DIS officers face as they navigate the competing demands of various stakeholders. DIS serves as frontline public health officers, typically engaging with individuals who test positive for Sexually Transmitted Infections (STIs) or HIV.  This engagement includes linking government agencies with healthcare providers and community-based organizations, ensuring individuals get treated, and encouraging sexual partners to get tested and treated. DIS responsibilities encompass disease investigation, care coordination, and collaboration with healthcare facilities.

 

To capture these dynamics, we conducted a series of semi-structured interviews from October 17, 2022, to November 28, 2023, with 34 participants: DIS (n=10), DIS supervisors (n=5), technical assistants (n=4), program managers (n=3), and healthcare providers (n=12). By bringing together these diverse perspectives, the study revealed how changing organizational mandates and stakeholder expectations create uncertainty for DIS in their daily work. The interviews examined their primary responsibilities, inter-organizational collaboration, and the pressures experienced when reconciling potentially conflicting norms and priorities. Using a grounded theory approach, the research team identified key patterns related to the emergence of role conflict and ambiguity, drawing on participants’ lived experiences to illustrate how these phenomena impact both frontline workers and broader public health outcomes.

 

Findings reveal two primary sources of role challenges. First, internal role conflict arises from the tension DIS experiences when reconciling existing job tasks—such as partner notification and disease surveillance—with newer responsibilities like care coordination. Although recent policy directives have formally expanded the DIS role to include care coordination, not all specialists and healthcare providers have internalized this shift into their roles. This lack of awareness has contributed to DIS’s sense of overload and increased stress. Second, external role conflict occurs when DIS tries to collaborate with healthcare providers who may be unfamiliar with DIS’s expertise and authority. Concerns about patient HIPPA confidentiality and providers’ lack of information about their roles and authority often result in delayed information sharing and leave patients out of care.

 

These role-based challenges have implications for the DIS's work. When providers hesitate to share essential patient data or overlook DIS recommendations, critical follow-ups and timely referrals can be missed, thereby increasing the risk of disease transmission.

 

From a practical standpoint, the study identifies several opportunities for improvement: having a designated contact person, an integrated data management system to create linkages, and structured training programs that foster trust and enhance awareness among healthcare providers. By implementing these strategies, public health agencies can enhance cross-sector partnerships, reduce uncertainty, and improve disease intervention outcomes.

Author

• Youjung Song, University at Albany
  Presenting Author