Social and Behavioral Sciences Commons^™

Editorial Comment: Changing The Rules In Vaccine Coverage For Vulnerable Populations, Nancy L. Winterbauer

Frontiers in Public Health Services and Systems Research

Increasing life expectancy through decreasing vaccine preventable deaths is a hallmark of modern public health in the United States (1). Two federal vaccine programs help insure coverage for vulnerable populations. The Vaccines for Children (VFC) Program provides vaccines to eligible children[1] at no cost, removing financial barriers to vaccinations. Close to half of US children and 30 percent of adolescents are vaccinated through the VFC program yearly (2). The federal Section 317 Immunization Grant Program (Section 317) complements VFC by supporting the national immunization infrastructure, primarily immunization workforce, delivery systems, and emergency response, as well as by providing vaccines …

The Effects Of The Changes In Section 317 Rules For Administration Of Federally Purchased Vaccines, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Section 317 of the Public Health Services Act is a federal program that provides funds for the purchase of vaccines. These annual Congressional allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2013, Section 317 rules redefined the population eligible for immunization with Section 317 purchased vaccines. In Tennessee, the response was a policy change …

Editorial Comment: A Method For Identifying Positive Deviant Local Health Departments In Maternal And Child Health, Sharla A. Smith, Michael A. Preston, Marylou Wallace

Frontiers in Public Health Services and Systems Research

Improving the well-being of mothers, infants, and children is a vital public health initiative in the United States. Local health departments are designated agents for addressing maternal and child health outcomes. Klaiman and colleagues used a positive deviant (PD) framework in identifying the modifiable activities and approaches for LHDs that contribute to better MCH outcomes.

A Method For Identifying Positive Deviant Local Health Departments In Maternal And Child Health, Tamar A. Klaiman, Athena Pantazis, Betty Bekemeier

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) are under increasing pressure to improve performance with limited resources. While research has found that financial resources may be associated with better health outcomes, there are some LHDs that maintain exceptional performance, even with limited budgets. Our interest was identifying LHDs that positively deviate in MCH outcomes compared to their peers while taking into account local context including geography and finances. We found that our method for identifying positive deviants was effective, and that LHD expenditures may not be linked to MCH outcomes. The next step in our work is to conduct in-depth analysis with positive …

Editorial Comment: Cost-Effectiveness Analysis For Prioritization Of Limited Public Health Resources - Tuberculosis Interventions In Texas, Kaja M. Abbas

Frontiers in Public Health Services and Systems Research

Public health departments have limited evidence to understand and analyze the costs and benefits of different health programs, including tuberculosis control and prevention programs. The study by Miller et. al addresses this challenge to estimate costs and benefits of tuberculosis prevention programs in Texas and identify cost-effective diagnostic and treatment combinations, thereby improving the evidence-based decision making power of the public health departments.

Playing To Our Strengths: An Academic/Health Department Collaboration To Facilitate Public Protections Against Tuberculosis, Thaddeus L. Miller, Erin K. Carlson, Nuha A. Lackan

Frontiers in Public Health Services and Systems Research

Background:

Economic modeling and analysis can facilitate evidence-based policy and practice. Such analyses may exceed the technical capacity and mission of public health agencies, yet may be critical to sustain health protections such as tuberculosis (TB) control. The net effect of TB prevention is incompletely understood, hampering objective value judgments of national TB elimination policies. This may promote inefficiencies and threaten individual and public health protections.

We describe how a HRSA-funded Texas Public Health Training Center (TPHTC) coordinated specialized analytical skills with the needs of a state public health department to create a user-friendly tool to inform planning and resource …

Editorial Comment: Differences In Definitions Of Ebph And Evidence: Implications For Communication With Practitioners, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Through interviews of 12 members of an expert panel – importantly, involving both practitioners and researchers/academicians – Aronson and colleagues sought to understand how evidence-based public health (EBPH) is defined, what counts as “evidence”, and what EBPH actually looks like when operationalized in a local health department. What Aronson and colleagues have shown us is how critical it is that in both creating and implementing EBPH, especially in practice-based research, practitioner and researcher/academician develop a shared understanding of EBPH before the dance begins, especially for practice-based research.

Differences In Definitions Of Ebph And Evidence: Implications For Communication With Practitioners., Robert E. Aronson, Kay Lovelace, Mark Smith, Gulzar H. Shah

Frontiers in Public Health Services and Systems Research

In this study, we interviewed twelve members of an expert panel to elicit their views on Evidence-based Public Health (EBPH), including how they define EBPH, what constitutes “evidence”, and what LHDs do that can be described as EBPH. Telephone interviews lasting 60 minutes were recorded and transcribed for basic content analysis. Experts differed in their definitions of EBPH and their views of what constitutes evidence. Definitions of EBPH ranged from the adoption and implementation of rigorously tested interventions to the application of evidence to decision making for population health improvement. Views on what constitutes evidence also varied, from strict “evidence …

The Futility Of Insurgent Leader Assassination, Arian Sharifi

Ex-Patt Magazine

Questioning the utility of using drones to kill insurgent leaders. Lessons for policy makers.

Exploring The Association Between Long-Term Hpsa Designation And County Population-To-Physician Ratio, Christopher Duffrin, Natalie A. Jackson

Frontiers in Public Health Services and Systems Research

Federal, state, local and public health officials utilize Health Professional Shortage Area (HPSA) designations to manage health and physician workforce development in underserved regions. HPSA designation length by county was examined to determine if there is significant association with population-to-primary care physician ratio since the inception of HPSA designations in 1978. Counties were grouped in 5 categories based on consecutive designation length and analyzed with demographic variables. This report examines the relationship of long-term HPSA status and changes in primary care physician workforce.

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Diffusion Theory And Knowledge Dissemination, Utilization And Integration, Lawrence W. Green, Judith M. Ottoson, César García, Robert A. Hiatt, Maria L. Roditis

Frontiers in Public Health Services and Systems Research

Part of the Community Health and Preventive Medicine Commons, Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, Health Services Research Commons, and the Public Health Education and Promotion Commons

Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners …

Public Health Services Most Commonly Provided By Local Health Departments In The United States, Gulzar H. Shah, Huabin Luo, Sergey Sotnikov

Frontiers in Public Health Services and Systems Research

The primary purpose of this research is to identify the most commonly performed public health services by local health departments (LHDs) and highlight variation by LHD characteristics. Data were drawn from the 2008 and 2010 National Profile of LHDs, conducted by the National Association of County and City Health Officials (NACCHO). The descriptive analysis aims to further the essential dialogue triggered by a recent Institute of Medicine (IOM) report about the standard minimum set of services that all LHDs should provide. This study identified a set of 22 activities performed by LHDs that are common in jurisdictions of all sizes. …

Community Health Assessment By Local Health Departments: Future Questions, Kay Lovelace

Frontiers in Public Health Services and Systems Research

This "Letter to the Editor" is a response to the article "Community Health Assessment by Local Health Departments: Presence of Epidemiologist, Governance, and Federal and State Funds are Critical" published in volume 2, issue 6 of this journal. It considers how LHDs develop CHAs in complex jurisdictions, the roles of other professionals in the development of CHAs, and the conduct, quality, and use of CHAs.

Public Retirement Systems: An Examination Of Governance Characteristics And Their Impact On The Funded Ratio, Chris Groves

MPA/MPP/MPFM Capstone Projects

By almost all accounts, the fiscal health and stability of the United States public retirement system at all levels is in peril. Collectively, local and state public retirement systems are underfunded at a rate of $700 billion as a low estimate to $3 trillion as a higher estimate. While plenty of research has been conducted to identify the reasons that programs are underfunded, the system would be best served if more attention were paid to identifying program characteristics that improve performance. In turn, these characteristics could be evaluated and implemented if not already present. If programs do not want to …

Study Of Thoroughbred Workers: Physical Health, Mental Health, And Income, Marina Byrd

MPA/MPP/MPFM Capstone Projects

Horse racing is a well-known sport and the part of the horse industry best known to the public; however, there is little information on the health status and health needs of people who work in this business. Past research shows that the thoroughbred worker population faces a myriad of health challenges. Swanberg et al. (2013) studied demographics, working conditions, and health of Latinos who work on thoroughbred farms in the United States by analyzing phone interviews, face-to-face interviews, and injury logs. The majority of injuries in this study are general injuries such as getting kicked or injuring fingers.

This study …

Letting Teams Walk: Exploring The Economic Impact Of Professional Sports Franchises Leaving Cities, Jesse Stephenson

MPA/MPP/MPFM Capstone Projects

Cities often use public funding to help construct and renovate the facilities of large, private sports franchises. As the major sports leagues grow in popularity and revenue, cities have had to offer increasingly competitive incentive packages to owners in order to keep their team from relocating to more profitable markets or cities willing to issue public funding for new facilities. Much literature has been conducted on the economic impact of sports teams with a general consensus that there is usually no positive economic effect for cities that serve as homes for these teams from the largest leagues (NFL, MLB, and …

The Effect Of Adopting Right To Work Laws: A Paired State Approach, Johnny Xu

MPA/MPP/MPFM Capstone Projects

The issue of unionization is an enduring one both politically and economically. A major subset within union studies deal with so-called “right-to-work laws.” States with right to work laws are concentrated heavily in the South and in the Plains states and have been that way since the 1940s or 1950s. The most recent additions of right-to-work states are Indiana and Michigan both in 2012. This paper will contribute to the debate by creating a new and novel dataset to analyze what the effects of adopting right to work laws are for a state over time as well as between a …

Preventing Underage Drinking: A Salvadoran Program Evaluation, Fransheska Quijada

MPA/MPP/MPFM Capstone Projects

Through the direct effects on brain development, social choices, and changes in experiences, underage alcohol drinking is a problem that causes long term damage to psychological, social, and economic outcomes. While this is problematic for all underage drinkers, it is especially damaging for middle school students.

Through the direct effects on brain development, social choices, and changes in experiences, underage alcohol drinking is a problem that causes long term damage to psychological, social, and economic outcomes. While this is problematic for all underage drinkers, it is especially damaging for middle school students.

In this study, I evaluate the success of …

State Child Welfare Policy: Causes And Consequences, Dana D. Connelly

Theses and Dissertations--Public Policy and Administration

On any given day almost 400,000 children in the United States are living in an out-of-home care placement due to government intervention. Federal law allows for substantial variance in state child welfare policy on a number of topics. These policy decisions, however, are understudied both in terms of the forces driving them and also the impacts the policies have on actual outcomes for children in care.

Utilizing a unique panel data set comprised of thirteen child welfare policies that vary both between states and over time we examine how well redistributive theory (constituent, institutional, paternalistic and resource pressures) explains state …

Does Overhead Spending Affect Fiscal Performance Of Nonprofits?, Shan Sandee Huang

MPA/MPP/MPFM Capstone Projects

Overhead spending has been used to view nonprofits for decades. Donors consider overhead cost as extra “price” of a donation’s impact and would like to apply limits on overhead costs, thus improving impact ratios. However, nonprofit practitioners and researchers claim that constraints on overhead spending may hinder organizational development. This paper aims to analyze whether overhead spending affects positive fiscal performance.

The research employs the NCCS (National Center for Charitable Statistics) database containing all the data reported on IRS 990 Forms from 1,397 arts, culture and humanities organizations from 2000 to 2003. This paper uses two regression models to evaluate …

Crossing The Border For The Pill: An Analysis Of The Decision To Purchase Oral Contraceptives Over-The-Counter From Mexican Pharmacies, Nadine Johnson

MPA/MPP/MPFM Capstone Projects

In 2012, the American College of Obstetricians and Gynecologists published an opinion statement in which they acknowledged that oral contraceptives were safe to be sold over the counter. Although there are several arguments that the lack of insurance of over the counter birth control would create a bigger cost barrier, research shows that women are in fact willing to pay for contraception if it is available over the counter. Some countries, such as Mexico, have this option available and because of the proximity to the United States, many women who live on the southern border take advantage of this. However, …

Postsecondary Instruction: Changes In The Academic Workforce And State Appropriations For Community Colleges, R. Ryan Kendrick

MPA/MPP/MPFM Capstone Projects

Over the last 30 years continued decline in state appropriations for public institutions has been accompanied by an increase in the use of part-time instruction. Community colleges have been particularly susceptible to both of these problems. Two-year institutions have less freedom than their larger counterparts to raise tuition rates and part time instructors constitute a larger percentage of their workforce. Less revenue has resulted in fewer resources to devote to instruction and student support. Part-time time instruction, on the whole, results in lower student retention and graduation rates.

This analysis intended to establish a connection between cuts to state appropriations …

Riding In Real-Time: Estimating Ridership Effects Of The Adoption Of Mobile Real-Time Transit Tracking Applications, Kendrick Vonderschmitt

MPA/MPP/MPFM Capstone Projects

Advances in technology, and declining costs of adoption have permitted local transit agencies to provide real-time tracking information to their customers. The customers through the use of a mobile phone can find up-to-the-minute wait times for transit stops. This is enabled through the use of GPS technology and modern mapping software to account for networked distance and traffic impedance. This technology is a service upgrade in strict economic terms, but it is important to inquire whether such an improvement would have an effect on service utilization. This study analyzes the relationship between ridership and adoption of this service upgrade.

The …

The Relationship Between Teacher Training Institutions And Student Performance, Shelby King

MPA/MPP/MPFM Capstone Projects

This study intends to contribute to the literature by seeking evidence of a relationship between teacher characteristics and their high school students’ academic success in college. In this study, average college success is defined by six outcomes. The outcomes consist of the average first-year college GPA, average hours completed, percentage of students returning for a second year, percent of students receiving a GPA above a 3.0, percent of students completing 30 plus hours in their first year, and the average college math GPA. The analysis uses aggregated data at the school level from both the 2013 Kentucky High School Feedback …

Science And Public Policy Of Earthquake Hazard Mitigation In The New Madrid Seismic Zone, Alice M. Orton

Theses and Dissertations--Earth and Environmental Sciences

In the central United States, undefined earthquake sources, long earthquake recurrence intervals and uncertain ground motion attenuation models have contributed to an overstatement of regional seismic hazard for the New Madrid Seismic Zone on the National Seismic Hazard Maps. This study examined concerns regarding scientific uncertainties, overly stringent seismic mitigation policies and depressed local economy in western Kentucky through a series of informal interviews with local businessmen, public officials, and other professionals in occupations associated with seismic mitigation. Scientific and relative economic analyses were then performed using scenario earthquake models developed with FEMA’s Hazus-MH software. Effects of the 2008 Wenchuan …

Influences On Reported Nonprofit Lobbying Efforts, Alyson Partain

MPA/MPP/MPFM Capstone Projects

The nonprofit sector holds an interesting role in democracy, as this segment balances the powers of government and business by providing a way to cultivate social justice and afford people a means of acting and promoting interests outside of the government and private sectors. Nonprofit organizations therefore allow people to join together in providing services and programs that strengthen the communities in which they act. Advocacy involves identifying, embracing, and promoting a cause, especially by educating the public about their organization, whether this is through public engagement, coalition building, or lobbying.

Lobbying is a specific but critical component of general …

Does Kentucky’S Merit-Based Scholarship Program, Kees, Improve College Completion?, Alex E. Combs

MPA/MPP/MPFM Capstone Projects

College completion is a complex process involving numerous socioeconomic factors at the individual, institutional, and governmental levels. One important factor is the way in which financial aid is disbursed so that affordability does not serve as a barrier to completion. Awarding scholarships on the basis of merit is one aspect of financial aid structure that has grown in popularity over recent decades, in turn, receiving considerable attention from policy researchers with the intent to assess how they affect an array of postsecondary education outcomes. To date, research of merit-based aid’s effect on college completion has been relatively sparse, yielding contradictory …

The Socioeconomic Impact Of Coal In The Appalachian Region Of Kentucky, Laura Oxley

MPA/MPP/MPFM Capstone Projects

The coal debate seems to be in a state of inertia. Proponents of coal claim the industry brings economic benefit to Kentucky. Environmentalists claim the industry creates irreparable harm to the Appalachian Mountain region. While these opinions are not unfounded, seldom do stakeholders explore the impact incurred directly in the Appalachian communities that mine coal. Moving the debate to a discussion about coal’s direct impact in the communities that support the industry may broaden stakeholders’ perspective. Determining whether the industry helps or harms the Appalachian community may be the break in the debate’s stalemate. Thus, this paper explores the socioeconomic …

Assessment Of The Quality Of Public Data Reporting By Nonprofit Social Service Agencies Receiving Funding From The Lexington-Fayette Urban County Government In Fy 2013, Yuanyuan Song

MPA/MPP/MPFM Capstone Projects

In 2012 and 2013, Lexington Fayette Urban County Government (LFUCG) Department of Social Service requested a “Social Service Needs Assessment Project” in Fayette County, Kentucky. In Aug, 31, 2012, Social Service Department established the “Needs Assessment Budget”. During Mar-Oct, 2013, two teams from The University of Kentucky College of Social Work (COSW) and the Martin School of Public Policy and Public Administration worked together to accomplish this project.

One of the tasks of this project is to assess the quality of data reported by the social service partner agencies of Lexington. “Partner organization” is the name government officials give to …