Medicine and Health Sciences Commons^™

The Hearst Health Prize: The First Five Years, Alexa M. Waters, Alexis Skoufalos, Emily Frelick, Gregory Dorn, David B. Nash

Department of Family & Community Medicine Faculty Papers

The Hearst Health Prize is the first national annual award for excellence in population health. The prize was established "to discover, support, and showcase the work of an individual, group, organization, or institution that has successfully implemented a population health program or intervention that has made a measurable difference" in health outcomes. Now, 5 years since the award's inception, this article reflects on how submissions for the prize collectively mirror - and may even predict - changes within the field of population health. It examines how the most successful programs demonstrated genuine, measurable improvements in health outcomes and/or health behaviors. …

Us Vs. Wales: Comparing And Improving Refugee Health Policy, Payton Ramsey

Senior Theses

Inadequate strides have been made to bolster the short and long-term health of growing numbers of refugees awaiting resettlement. The United Nations Higher Commission for Refugees (UNHCR), as well as many countries of resettlement, guarantee the right to health as signatories of the UN 1951 Refugee Convention, but in many situations refugee accessibility to healthcare and health resources is limited by time restrictions on benefits, immigration status, and/or financial circumstances.

This thesis provides a synopsis of the historical roots of current policies and legislative frameworks relating to refugee health for Wales and the US. Through the analysis of governmental policy …

Sex Education In The United States: Implications For Sexual Health And Health Policy, Eliana R. Johnson

The Corinthian

There is much disagreement over what constitutes effective sex education in the United States. There are several reasons why America’s sex education system is outdated and problematic. First, it often advocates only for abstinence, which leaves people unprepared and unable to protect themselves if/when they choose to have sex, leading to higher rates of unintended pregnancies, abortions, and sexually transmitted infections in the U.S. than in any other developed nation in the world. In addition, the culture of fear surrounding sex education leads to negative attitudes among young people about sex. This can not only cause sexual dysfunction and strife …

Association Between Education And Health Outcomes Among Adults With Disabilities: Evidence From Shanghai, China, Tong Ge, Qi Zhang, Jun Lu, Gang Chen, Mei Sun, Xiaohong Li

Community & Environmental Health Faculty Publications

Background

Adults with disabilities often have worse health outcomes than do their peers without disabilities. While education is a key determinant of health, there is little research available on the health disparities across education levels among adults with disabilities in developing countries. We therefore examined the association between health outcomes and education among adults with disabilities in Shanghai, China.

Methods

We used the health examination records of 42,715 adults with disabilities in Shanghai in 2014. Five health outcomes, including two diseases (fatty liver and hemorrhoids) and three risk factors (overweight [body mass index ≥ 24]), high blood glucose, and high …

Exploring The Impact Of Efficacy Messages On Cessation-Related Outcomes Using Ecological Momentary Assessment, Victoria Lambert, Stuart G. Ferguson, Jeff Niederdeppe, David Hammond, James W. Hardin, Jim Thrasher

Faculty Publications

Introduction:
Observational studies indicate that cigarette package inserts with efficacy messages about the benefits of quitting (i.e. response efficacy) and recommendations for successful cessation increase smokers’ self-efficacy to quit and promote sustained cessation. However, the effects of inserts with such efficacy messages have not been studied using experimental designs. This study used ecological momentary assessment (EMA) to assess smokers’ responses to efficacy inserts.

Material and Methods:
In a randomized case-crossover study among smokers from the United States (n=23), participants received a one-week supply of cigarettes with efficacy inserts and a one-week supply without any inserts, and were randomized to use …

Testing Cessation Messages For Cigarette Package Inserts: Findings From A Best/Worst Discrete Choice Experiment, Jim Thrasher, Farahnaz Islam, Rachel E. Davis, Lucy Popova, Victoria Lambert, Yoo Jin Cho, Ramzi G. Salloum, Jordan Louviere, David Hammond

Faculty Publications

This study assessed smokers’ responses to different smoking cessation topics and imagery for cigarette package inserts. Adult smokers from Canada (n = 1000) participated in three discrete choice experiments (DCEs): DCE 1 assessed five cessation benefit topics and five imagery types; DCE 2 assessed five messages with tips to improve cessation success and five imagery types; DCE 3 assessed four reproductive health benefits of cessation topics and four imagery types. In each DCE, participants evaluated four or five sets of four inserts, selecting the most and least motivating (DCEs 1 & 3) or helpful (DCE 2) for quitting. Linear mixed …

Evaluating The Impact Of Statewide Policy Implementation On Interorganizational Collaboration At The Regional Level : An Application Of Network Analysis., Nida Moez Ali

Electronic Theses and Dissertations

One challenge to improving population health in the United States is that the systems tasked with the responsibility of providing services across the continuum of care often operate in silos, missing opportunities to provide quality, coordinated care. In 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a five-year 1115(a) Medicaid Waiver Demonstration Project. This dissertation focuses on one element of the Waiver, the Delivery System Reform Incentive Payment (DSRIP) Program, which was designed to incentivize activities that support organizations’ collaborative efforts with other organizations in addressing the Triple Aim strategies. DSRIP was implemented through …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

Assessing Feasibility And Readiness To Address Obesity Through Policy In American Indian Reservations, Valarie Blue Bird Jernigan, Gail Boe, Carolyn Noonan, Leslie Carroll, Dedra Buchwald

Journal of Health Disparities Research and Practice

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy …

Reducing The Role Of The Food, Tobacco, And Alcohol Industries In Noncommunicable Disease Risk In South Africa, Peter Delobelle, David Sanders, Thandi Puoane, Nicholas Freudenberg

Publications and Research

Noncommunicable diseases (NCDs) impose a growing burden on the health, economy, and development of South Africa. According to the World Health Organization, four risk factors, tobacco use, alcohol consumption, unhealthy diets, and physical inactivity, account for a significant proportion of major NCDs. We analyze the role of tobacco, alcohol, and food corporations in promoting NCD risk and unhealthy lifestyles in South Africa and in exacerbating inequities in NCD distribution among populations. Through their business practices such as product design, marketing, retail distribution, and pricing and their business practices such as lobbying, public relations, philanthropy, and sponsored research, national and transnational …

The Role And Impact Of School Nurses And Intentions To Delegate Diabetes-Related Tasks Amidst Budget Cuts And Legislative Changes, Michelle J. Lineberry

Theses and Dissertations--Kinesiology and Health Promotion

As the percentage of school children with chronic conditions such as diabetes continues to rise, funding for school nurses to keep those students healthy and safe is decreasing. This dissertation includes three studies: (1) a systematic review of the literature on the role and impact of American elementary school nurses, (2) a focus group study that further examined the role of Kentucky school nurses and described their reaction to a new regulation that necessitates delegation of diabetes-related nursing tasks to unlicensed assistive personnel (UAP), and (3) a quantitative study that examined Kentucky school nurses’ past behaviors and future intentions regarding …

Reflections And Projections: Prevention, Policy And Health, Drew Harris Dpm, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Structural Approaches To Health Promotion: What Do We Need To Know About Policy And Environmental Change?, Lisa D. Lieberman, Shelley D. Golden, Jo Anne L. Earp

Department of Public Health Scholarship and Creative Works

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is …

Structural Approaches To Health Promotion: What Do We Need To Know About Policy And Environmental Change?, Lisa D. Lieberman, Shelley D. Golden, Jo Anne L. Earp

Department of Public Health Scholarship and Creative Works

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is …

Understanding The Early Stages Of Development Of A Global Health Partnership, Wendy Raquel Gonzalez Navarrete

Theses and Dissertations

Maternal and child undernutrition contributes to more than one-third of child deaths. Global Health Partnerships (GHP) have emerged as a response to undernutrition and other pressing health problems. GHPs promote joint decision-making among donors, multilateral agencies, and country partners. Despite their positive impact on health problems, GHPs have generated unintended negative effects on country partners. This study aimed to understand the factors, strategies, and processes conducive to the establishment of an effective GHP in the context of a cooperative regional effort to reduce undernutrition and improve maternal and child health in eight countries in Latin America, Regional Health Initiative (RHI). …

The Potential Impact Of Plain Packaging Of Cigarette Products Among Brazilian Young Women: An Experimental Study, Christine M/ White, David Hammond, Jim Thrasher, Geoffrey T. Fong

Faculty Publications

Background: Tobacco use is responsible for 5.4 million deaths every year worldwide and is a leading cause of preventable death. The burden of these deaths is rapidly shifting to low and middle-income countries, such as Brazil. Brazil has prohibited most forms of tobacco advertising; however, the cigarette pack remains a primary source of marketing. The current study examined how tobacco packaging influences brand appeal and perceptions of health risk among young women in Brazil.

Methods: A between-subjects experiment was conducted in which 640 Brazilian women aged 16–26 participated in an online survey. Participants were randomized to view 10 cigarette packages …

Employers' Perceptions Of Factors Related To The Workforce Development Of Community Health Workers In El Paso, Texas: A Descriptive Study, Aurora Aguirre Polanco

Open Access Theses & Dissertations

Workforce studies are necessary for regional economic development and for having a diverse workforce that meets the communities' needs. Workforce studies explore the most salient factors of models aimed at balancing economic forces of supply and demand. Community Health Workers (CHWs) are frontline health workers recognized by both the United States (US) Department of Labor (DOL) and the Patient Protection and Affordable Care Act of 2010 (PPACA). CHWs' service is oriented towards health promotion and disease prevention; they deliver public health interventions.

External and internal factors to the US health care system such as health care and wealth disparities, changing …

The Impact Of Corporate Practices On Health: Implications For Health Policy, Nicholas Freudenberg, Sandro Galea

Publications and Research

Although corporate practices play a substantial role in shaping health and health behavior, public health researchers have rarely systematically studied these practices as a social determinant of health. We consider case studies of three products - trans fat, a food additive and a preservative; Vioxx, a pain killer; and sports utility vehicles - to illustrate the role of corporate policies and practices in the production of health and disease and the implications for health policy. In recent years, public health advocates, researchers, and lawyers have used strategies to reduce the adverse health impact of corporate practices. Systematic analysis of these …

Changing Corporate Practices To Reduce Cancer Disparities, Nicholas Freudenberg, Sandro Galea, Marianne Fahs

Publications and Research

While reducing racial/ethnic and socioeconomic disparities in cancer mortality has been identified as a national goal, current policies are unlikely to achieve it. In order to advance the development of policies for the primary prevention of cancer and cancer disparities, we propose that the practices of the tobacco, alcohol, and food industries be considered as modifiable social determinants of health. We review evidence that the practices of these industries in product design, marketing, retail distribution, and pricing contribute to cancer risk behavior, incidence, and disparities, then examine public health strategies designed to reduce health-damaging practices of these industries and encourage …