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Full-Text Articles in Medicine and Health Sciences

Editorial: Leading People - Managing Organizations: Contemporary Public Health Leadership, James W. Holsinger Jr., Erik L. Carlton, Emmanuel D. Jadhav Nov 2015

Editorial: Leading People - Managing Organizations: Contemporary Public Health Leadership, James W. Holsinger Jr., Erik L. Carlton, Emmanuel D. Jadhav

Preventive Medicine and Environmental Health Faculty Publications

Effectively leading people engaged in the practice of public health has never been more critical than in the early years of the twenty-first century. Likewise, effectively managing the organizations in which these individuals practice the various professional disciplines of public health has become increasing important and difficult. Taken together, leading the people and managing public health organizations requires well educated and appropriately trained public health leaders and managers. Although leadership is often viewed as one of the key attributes of management, not every great manager will be a great leader and vice versa. While some leaders may be born with …


Assessment Of Quality Improvement In Ontario Public Health Units, Madelyn P. Law, J. Ross Graham, Erica Bridge Nov 2015

Assessment Of Quality Improvement In Ontario Public Health Units, Madelyn P. Law, J. Ross Graham, Erica Bridge

Frontiers in Public Health Services and Systems Research

Background: Quality Improvement (QI) approaches are used extensively in healthcare settings and increasingly in public health. However, the proliferation of QI in Canadian public health settings is unknown.

Purpose: The purpose of this study was to (a) assess the QI maturity in Ontario local public health units in Canada, and (b) to determine the relevance of the QI Maturity Tool in a Canadian setting

Methods: The QI Maturity Tool (Version 5) was used to conduct a cross-sectional assessment of the QI maturity of 36 local public health units in Ontario, Canada. After tool items were reviewed for relevance, individuals most …


Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays Oct 2015

Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Health Management and Policy Presentations

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.


Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays Aug 2015

Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays

Health Management and Policy Presentations

Health services researchers face growing clinical and policy imperatives for estimating how the effectiveness of medical and public health interventions vary across patients, population groups, and community settings. Recent advances in local instrumental variables estimation techniques allow for the estimation of person-specific and community-specific treatment effects in the presence of unobserved heterogeneity. This presentation explores examples from both medicine and public health following the local IV methods developed by Basu et al. (2013).


Foundational Public Health Services And Health System Reform, Glen P. Mays Aug 2015

Foundational Public Health Services And Health System Reform, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …


Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril Aug 2015

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril

Health Management and Policy Presentations

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.


Applying Failure Modes And Effects Analysis To Public Health Models: The Breathe Easy At Home Program, Johnna S. Murphy, Margaret Reid, Amanda Ali, Laura Harrington, Megan Sandel Aug 2015

Applying Failure Modes And Effects Analysis To Public Health Models: The Breathe Easy At Home Program, Johnna S. Murphy, Margaret Reid, Amanda Ali, Laura Harrington, Megan Sandel

Frontiers in Public Health Services and Systems Research

Failure Modes and Effects Analysis (FMEA) is a structured process used to identify and prioritize risks by ranking them based on severity, occurrence, and detectability. Historically, FMEA has been used within industries, including automotive and health care. This project explored the adaption of the FMEA template to a small public health program designed to improve asthma outcomes. The Breathe Easy at Home (BEAH) program is a multi-sector partnership that uses a web-based system to link clinical sites with housing code inspections and enforcement for patients with asthma.

In July and August 2014, an FMEA was conducted to uncover risks within …


Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays Jul 2015

Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays

Health Management and Policy Presentations

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …


Public Health Metrics: Key Considerations And Criteria For Food Safety Modernization, Glen P. Mays Jun 2015

Public Health Metrics: Key Considerations And Criteria For Food Safety Modernization, Glen P. Mays

Health Management and Policy Presentations

Robust measures of public health impact are needed to guide implementation of the U.S. Food Safety Modernization Act. This session describes strategies used in the field of public health services research to specify and select measures based on considerations of relevance, tractability, attribution, precision, and feasibility.


Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays Jun 2015

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …


Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril Jun 2015

Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health “system capital”; and (2) the effects of these changes on preventable mortality and resource use. …


Cost Estimation In Public Health Services & Systems Research, Glen P. Mays Jun 2015

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.


Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays Apr 2015

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Health Management and Policy Presentations

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.


Answering The Call To Integrate: Simple Strategies From Public Health And Healthcare Executives In One Urban County, Erik L. Carlton, Paul C. Erwin Mar 2015

Answering The Call To Integrate: Simple Strategies From Public Health And Healthcare Executives In One Urban County, Erik L. Carlton, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Background: As the Affordable Care Act transforms the practice of both public health and health care, it also provides opportunity for both to become more closely linked through improved integration and collaboration. Yet, while public health agencies are increasingly called to work with healthcare partners to address population health needs, both public health leaders and their healthcare counterparts may not be well equipped to answer that call. Although recent studies have begun exploring the collaborative strategies and capacity of public health system partners, there is still much to learn. The purpose of this study was to identify, through the perspective …


Practice-Based Research Networks For Next-Generation Public Health, Glen P. Mays Mar 2015

Practice-Based Research Networks For Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

U.S. public health agencies face an existential imperative to transform their work from a collection of discrete programs and policies into a coherent enterprise for population-wide health improvement. Practice-based research networks (PBRNs) and the advancing science of public health delivery systems can help to achieve this transformation.


Collective Impact Through Public Health And Academic Partnerships: A Kentucky Public Health Accreditation Readiness Example, Angela L. Carman Mar 2015

Collective Impact Through Public Health And Academic Partnerships: A Kentucky Public Health Accreditation Readiness Example, Angela L. Carman

Health Management and Policy Faculty Publications

In the ever-changing, resource-limited public health environment, the use of partners found in the faculty and students of Colleges of Public Health can provide training, consultation, and technical assistance needed to increase local health department (LHD) workforce capacity to meet new public health demands including national public heath accreditation. This manuscript describes the provision of the backbone support activities of facilitation, data management, and project management by University of Kentucky’s College of Public Health to Kentucky’s LHDs seeking national public health accreditation.


The Journey Toward Voluntary Public Health Accreditation Readiness In Local Health Departments: Leadership And Followership Theories In Action, Angela L. Carman Mar 2015

The Journey Toward Voluntary Public Health Accreditation Readiness In Local Health Departments: Leadership And Followership Theories In Action, Angela L. Carman

Health Management and Policy Faculty Publications

Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.


Estimating The Costs Of Foundational Public Health Services, Glen P. Mays, Cezar B. Mamaril Feb 2015

Estimating The Costs Of Foundational Public Health Services, Glen P. Mays, Cezar B. Mamaril

UKCPHSSR Research Briefs and Reports

The Institute of Medicine’s 2012 report on public health financing called for the convening of expert panels to identify the components of a “minimum package” of public health services and cross-cutting capabilities that should be available in every U.S. community to protect and improve population health. This report also called for studies to identify the resources required to make these services universally available across the country. This research brief describes the research methodology in use to generate first-generation estimates of current resource use and estimated resource needs for implementing foundational public health services and capabilities.


Defining Comprehensive Public Health Delivery Systems, National Coordinating Center For Public Health Services And Systems Research Feb 2015

Defining Comprehensive Public Health Delivery Systems, National Coordinating Center For Public Health Services And Systems Research

Health Management and Policy Reports

This brief describes the methodology for defining Comprehensive Public Health Delivery Systems using data from the National Longitudinal Survey of Public Health Systems. The systems meeting this definition have been shown to deliver a broader range of recommended public health services, using fewer resources, than the more prevalent types of U.S. public health systems that do not meet this definition. Over time, comprehensive systems are associated with larger gains in population health status than are their counterparts.


Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays Feb 2015

Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays

Health Management and Policy Presentations

Implementation of high-value public health strategies for chronic disease prevention, communicable disease control, and environmental health protection vary widely across U.S. states and communities. The Multi-Network Practice and Outcome Variation Examination Study (MPROVE) supported by the Robert Wood Johnson Foundation creates the measurement and analytic foundation for investigating the causes and consequences of practice variation in public health.


The Synergistic Impact Of Income And Rurality On Timely Mammograms In A National Sample Of Women In The United States, Asri Mumpuni Jan 2015

The Synergistic Impact Of Income And Rurality On Timely Mammograms In A National Sample Of Women In The United States, Asri Mumpuni

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction. Breast cancer is the cancer of highest incidence among women in the U.S., making it a significant public health problem. Currently, the U.S. Preventive Services recommends biennial screening mammography for women ages 50-74. This study examined the associations between socioeconomic status and rurality on breast cancer screening behavior. Methods. Data for this study come from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey (BRFSS). Breast cancer screening behavior was dichotomized into those who did not meet screening mammogram recommendations (2 years or more) and those who met screening mammogram recommendations (within the …