Social and Behavioral Sciences Commons^™

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

The Communicative Capacities Of The Medical Discourse In Authoritarian Societies : The Case Of Aids In Iran, Elham Pourtaher

Legacy Theses & Dissertations (2009 - 2024)

This study explores the role of medical discourse in the Iranian formal public sphere. It examines how an epidemiological wave of HIV/AIDS—known as "the third wave"—highlighted nontraditional sexual behaviors in public and enabled a shift in policy and discourse by the Islamic Republic State. Through analyzing published content on HIV/AIDS from five major Iranian newspapers between 2009 and 2013, this study identified four competing narratives of the third wave which coexist and have a dynamic relationship with one another. First, the medical narrative warns of an unfolding public health crisis and provides a technical perspective to make sense of the …

“It’S Like 1998 Again”: Why Parents Still Refuse And Delay Vaccines, Jiana L. Ugale, Heather Spielvogle, Christine Spina, Cathryn Perreira, Ben Katz, Barbara Pahud, Phd Amanda F. Dempsey Md, Jeffrey D. Robinson Phd, Kathleen Garrett Ma, Mph Sean T. O’Leary Md, Mph Douglas J. Opel Md

Communication Faculty Publications and Presentations

We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = …

Shifting Coronavirus Disease 2019 Testing Policy And Research To Include The Full Translation Pipeline, Joseph Catania, Jeffrey Martin, M. Margaret Dolcini, E. Roberto Orellana, Jeffrey Henne

School of Social Work Faculty Publications and Presentations

The current severe acute respiratory syndrome coronavirus 2 testing policy and practice limits testing as a prevention tool. Radical shifts are required to increase the scale of rapid testing strategies and improve dissemination and implementation of venue-based and self-testing approaches. Attention to the full translation pipeline is required to reach high-risk segments of the population.

Three Essays On Health Economics, Jihye Kim

Legacy Theses & Dissertations (2009 - 2024)

This thesis focuses on various factors affecting health of American adults and the elderly based on the Health and Retirement Study (HRS). In chapter 1, I examine the role of educational and racial differences in life expectancy (LE) and health-adjusted life expectancy (HALE) for Americans at ages 45-64 using Health and Retirement Study (HRS) during 2000-2016. I compute severity-weighted prevalence of diseases with comorbidity adjustments based on the Global Burden of Disease (2015), and map onto the information on 17 doctor-diagnosed diseases and four self-rated disabling health conditions from HRS. This approach allows us to evaluate the importance of major …

A Public Health Recommendation Countering The Online Anti-Vaccination Movement, Grace M. Neumann

University Honors Theses

The anti-vaccination movement had posed a threat to the health of communities, since the inception of the smallpox inoculation practice. As the anti-vaxx movement continues to grow in strength and reach, public health officials must be prepared to combat the flow of misinformation, with sound scientific data in a way that connects with individuals from all communities. Online platforms such as blogs and social media, allow newfound access to vaccine opinions and information, posing an even greater risk of vaccine misinformation being spread to the public. Different communities hold different reasons for vaccine hesitancy and avoidance. An effective public health …

Organizational Risk In Multi-Sector Health Partnerships: A Case Study Of Oregon's Accountable Health Communities, Shauna Jean Nicole Petchel

Dissertations and Theses

The literature on collective action has documented that the perception of organizational risk -- both the uncertainty of potential outcomes and the meaning attached to them -- is an important factor in whether and how organizations engage in cross-sector collaborations. Yet there are few examples to date that document how health and social service leaders perceive organizational risks in cross-sector health partnerships focused on social determinants of health, or how their perceptions influence organizational commitment and willingness to engage in these partnerships over time.

This research aimed to fill this gap through a mixed methods case study of health and …

Crisis, Legitimation And Contention : China's Environmental Health And Safety Crises In Global Public Spheres, Haoyue Cecilia Li

Legacy Theses & Dissertations (2009 - 2024)

My project focuses on China’s environmental health and food safety crises to examine the changing interrelations among the Chinese state, media, civil society organizations and the international society. The debate on the environment-society relationship generates two conflicting theoretical explanations. While political economy theorists emphasize the non-compatible relationship between economic development and environmental improvement, the modernization theorists, especially in the traditions of risk society/reflexive modernity and of ecological modernization, contend that risks drive the changes of state-media-civil society relationship in a positive way towards a more compatible environment-society relationship. By investigating multiple cases, including the 2005 Songhua River Chemical Spill, the …

Winners And Losers In The Remaking Of American Healthcare Payment Systems Following The Aca : A Theory Of Private-Actor Policymaking And Implications For Democratic Decision Making, Heather G. Bennett

Legacy Theses & Dissertations (2009 - 2024)

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law, thereby ushering in the most sweeping, expansive changes to the American healthcare system since the creation of Medicare and Medicaid in 1965. Supporters, including healthcare advocates, celebrated the passage of the ACA as a defining moment in healthcare history. As broad policy reform influenced practice on the ground in the months and years after passage, physicians working in private practices and hospitals changed some things about the way that they treat patients. Yet, following interviews with doctors and medical office practice managers to talk …

The Shadows Of Life: Medicaid's Failure Of Health Care's Moral Test, Barak D. Richman, Kushal T. Kadakia, Shivani A. Shah

Faculty Scholarship

North Carolina Medicaid covers one-fifth of the state’s population and makes up approximately one-third of the budget. Yet the state has experienced increasing costs and worsening health outcomes over the past decade, while socioeconomic disparities persist among communities. In this article, the authors explore the factors that influence these trends and provide a series of policy lessons to inform the state’s current reform efforts following the recent approval of North Carolina’s Section 1115 waiver by the Centers for Medicare and Medicaid Services. The authors used health, social, and financial data from the state Department of Health and Human Services, the …

Public Program Evaluation In Health Economics : An Empirical Study, Linna Xu

Legacy Theses & Dissertations (2009 - 2024)

This dissertation consists of three essays on public program evaluation in health economics. This dissertation explores the estimation of treatment effects of public programs on risky behaviors, health insurance status, labor market outcomes or other health-related outcomes among adolescents or young adults and addresses causality inferences based on empirical modeling, analysis and applications. The first chapter in this dissertation identifies the causal treatment effects of keg registration laws on underage alcohol consumption and related outcomes: alcohol-related traffic fatalities, by exploiting the substantial variations in the timing of the introduction of these laws across different states at different times. Using the …

Essays On Health Disparities And Income-Related Health Inequality In Sub-Saharan Africa, Marshall Makate

Legacy Theses & Dissertations (2009 - 2024)

This dissertation comprises of five empirical essays. Essay one assesses the impact of prenatal care quality and its components on child mortality using nationwide data from the Zimbabwe Demographic and Health Surveys (ZDHS), 1999-11. Results indicate that increasing prenatal care quality by one unit improves neonatal, infant and under-five survival by about 42.33, 30.86, and 28.65%, respectively and all statically significant at the 1% level.

Nevada Should Opt-In To Organ Policy Changes, Alex Velto

Brookings Mountain West Publications

Organ donation shortages are a problem in Nevada. A shift in policy towards an opt-out system could more than double the number of registered organ donors in Nevada. A Libertarian Paternalistic strategy would allow potential donors to express their preference for organ donations more accurately. Currently Nevada abides by an opt-in policy where people are only organ donors if they explicitly request to become donors. Under an opt-out policy, people would be presumed organ donors unless they requested not to be donors. Policy changes during the 2015 Legislative session were a good start but failed to fully utilize behavioral economics …

Negotiated Bodies : Institution Building And Participatory Policymaking In Mexico's Public Health Sector, Katherine Truby

Legacy Theses & Dissertations (2009 - 2024)

This dissertation examines the relationships between the state and civil society organizations within the context of HIV policy in Mexico. The Mexican context is important in this analysis: Mexico has relatively recently transitioned to a more democratic form of governance, including expanding institutional opportunities for civil society organizations to participate in processes of policy development and implementation. Further, Mexico has an HIV epidemic that is concentrated in the most at-risk communities. These communities typically face political and social exclusion. The extent to which civil society organizations advocating on behalf of these marginalized communities successfully negotiate the creation of new policy …

Advancing Southern Nevada’S Regional Priorities: Overview Of The 77th Session Of The Nevada Legislature, David F. Damore

Brookings Mountain West Publications

On January 10, 2013 the elected leadership of Southern Nevada met to discuss the region’s governance, K--‐12, higher education, infrastructure, economic development, and health care needs. From that bipartisan discussion emerged policy priorities for the 77^th Session of the Nevada Legislature. This report examines the degree to which the region’s elected senators and assembly members advanced these priorities and represented the interests of Southern Nevada in state government.

Household Catastrophic Medical Expenses In Eastern China: Determinants And Policy Implications, Xiaohong Li, Jay J. Shen, Jun Lu, Mei Sun, Chengyue Li, Fengshui Chang, Mo Hao

Public Health Faculty Publications

Background: Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China.

Methods: Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants.

Results: The incidence of household catastrophic …

The Long-Term Coercive Effect Of State Community Benefit Laws On Hospital Community Health Orientation, Charles B. Moseley, Jay J. Shen, Gregory O. Ginn

Nevada Journal of Public Health

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors …

Health Care Priorities And The Effects Of Double Rationing, Christine Marie Muller

Legacy Theses & Dissertations (2009 - 2024)

The purpose of my research is to investigate "double rationing" which entails rationing at two levels of the health care system. At one level, policy makers prioritize treatments that will be covered under a publicly financed health care system. At a lower level, doctors or other health care professionals prioritize patients in need of scarce medical treatments. Traditionally, research focusing on health care rationing has treated these two activities as if they were separate and unrelated events. This research considers the effects of lower level prioritization activities on the ability of policy-makers to achieve their own (and arguably, societal) health …

Contingent Valuation Studies And Health Policy, Matthew D. Adler

Faculty Scholarship

No abstract provided.

Lost In Translation : Ideas Of Population Health Determinants In The American Policy Arena, Maria Gilson Sistrom

Dissertations and Theses

A growing body of research reveals the determinants of population health to be social, political and economic, yet health policy in the United States remains largely individualistic (Evans, Barer, & Marmor, 1994). At the same time research is revealing these structural determinants of health, measures of population health in the United States are worsening in comparison to other developed countries (Bezruchka, 2001). Explanations for this include the influence of culture, medical, public health and governmental institutions and historic development and processes on health policy. Researchers hold to a view of the policy process that is informed by science, yet policy …

Qalys And Policy Evaluation: A New Perspective, Matthew D. Adler

Faculty Scholarship

No abstract provided.

Providing Quality Health Care For All, Vic Ellison

Journal of the Minnesota Academy of Science

No abstract provided.

How To Argue About Health Care, Don Herzog

Articles

Despite the aggressive title of this article, my goals are modest. I begin by explaining briefly what should at any rate be obvious: that health care policies inescapably raise moral and political difficulties, difficulties that no technical fix could resolve. I move on to puzzle over the connections between some of the more abstract issues of moral and political theory and medical policy: here I urge that we develop a more sustained taste for exploring the moral conflicts embedded in our current practices. Finally, I suggest a strategy for making nitty-gritty facts-from the concrete world of third-party payment, expensive technology, …

Social Structure, Health Orientation And Health Behavior, Khalifa Ali Baej

Dissertations and Theses

An attempt has been made to examine the relationship between social structure and medical factors in a framework which links cosmopolitanism to health orientation and behavior. Specifically, this study has attempted to investigate the variations in health knowledge, beliefs, attitudes and behavior among individuals whose social structure varies in terms of cosmopolitanism.