Health Policy Commons^™

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Department of Health Policy and Community Health Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …

Social Media Usage And Transitioning Into Online Classes During Covid-19- A Survey Of Undergraduate Students In Georgia, United States, Sylvia Ofori, Janet Choongo, Mario Kekop, Gulzar H. Shah, Haresh Rochani, Joseph Telfair

Department of Health Policy and Community Health Faculty Publications

Previous studies on the use of social media (SM) during the COVID-19 pandemic have focused on the use in sustaining academic communication. This study aimed to assess the association between SM and the ease of transitioning to online classes during the COVID-19 pandemic using survey data from 872 undergraduate students. The findings showed that Snapchat and Instagram were the most preferred social media sites among participants. Compared to students who use SM for <2 hours a day, use for > 5 hours (AOR= 2.44; 95% CI, 1.13 – 5.25) or 3 to 5 hours a day (AOR = 2.01, 95% CI 1.06-3.81) increased the odds of easily …

Low Acceptance Of Helmet-Use And Injuries From Motorcycle Accidents In Rawalpindi And Abbottabad, Pakistan, Maryam Siddiqa, Gulzar H. Shah, A. Munam

Department of Health Policy and Community Health Faculty Publications

Background: Motorcycle accidents are a major cause of head injuries and the current study evaluated the beneficial impact and effectiveness of helmet usage among injured Motorcycle users. This study has been performed to observe the Motorcycle collisions within 6 months in Rawalpindi and Abbottabad cities of Pakistan

Objectives: Implications of helmet usage were assessed and the risk factors for severe injury during motorcycle accidents were identified.

Results: The multivariate analysis indicated that riders without a helmet were more likely to experience severe (AOR, 2.216; 95% CI, 2.02 to 10.5) or moderate injury (AOR, 1.215; 95% CI, 0.84 …

Indicadores De Desigualdad Y Mortalidad Por Enfermedades Cardiometabólicas En Guatemala / Inequality Indicators And Cardiometabolic Diseases Mortality In Guatemala, Alejandro Cerón, Gila Y. Goldstein

Anthropology: Faculty Scholarship

La medición de las desigualdades en salud al interior de los países de ingresos bajos y medios es necesaria para la planificación, monitoreo y evaluación de intervenciones de salud pública, especialmente para problemas que contribuyen altamente a la carga de enfermedad, como las enfermedades cardiometabólicas. El objetivo de este estudio fue caracterizar los patrones de desigualdad de las tasas de mortalidad para las principales causas cardiometabólicas en Guatemala. Se usó datos del Censo Nacional de Población, y estadísticas oficiales de defunción de 2018 para calcular tasas crudas de mortalidad para diabetes (DM), infarto agudo de miocardio (IAM), y accidente cerebrovascular …

Senior Center Response To Covid-19: Mid-Year Operations 2021, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

Senior centers/COAs in Massachusetts remained largely operational through the height of the COVID-19 pandemic, and continued to assist older adults in the community. With the introduction of a vaccine, return to ‘normal’ operations has become more feasible. By mid-2021, senior centers were returning to some in-person operations and continued adaptations for safety, including mask-wearing, limiting capacity, fewer walk-ins, and increased hand sanitization availability.

Senior Center Response To Covid-19: Involvement With Vaccine Distribution, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

In early 2021, access to a COVID-19 vaccine was prioritized for older adults and people with multiple co-morbidities. Between high demand and emerging supply, and new systems for booking a vaccine appointment, many people had challenges getting an appointment. Senior centers across the state became a crucial resource for access to the vaccine and additional information about its efficacy and safety.

Planning For Evacuation And Sheltering Of Vulnerable & Medically Fragile Populations During The Post-Vaccine Period Of A Compound Hurricane-Pandemic Threat: After-Action Report (Aar) Summarizing Results Of A Workshop Hosted On September 27, 2021, Wie Yusuf, Converge Covid-19 Working Group, Old Dominion University, University Of South Florida

School of Public Service Faculty Publications

From the Executive Summary:

The CONVERGE COVID-19 Working Group’s Workshop on Planning for Evacuation and Sheltering of Vulnerable and Medically Fragile Populations during the Post-vaccine Period of a Compound Hurricane-Pandemic Threat was held virtually on September 27, 2021. The 137 workshop participants represented federal, state, and local governments, the nonprofit sector and advocacy organizations, businesses, and academic institutions. Participants primarily represented functional areas of emergency management, planning, and public health. Geographically, the workshop participants came from 20 states, primarily along the Eastern seaboard plus the U.S. Virgin Islands and Canada.

From Pandemic Response To Portable Population Health: A Formative Evaluation Of The Detroit Mobile Health Unit Program, Phillip Levy, Erin Mcglynn, Alex B. Hill, Liying Zhang, Steven J. Korzeniewski, Bethany Foster, Jasmine Criswell, Caitlin O'Brien, Katee Dawood, Lauren Baird, Charles J. Shanley

Urban Studies and Planning Faculty Research Publications

This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease “hotspots” based on publicly available SARS-CoV-2 testing data and …

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …

Non-Elderly Adults On Disability In The Cf Population, Lea Nolan, Semret Seyoum, Julanne Wilson, Marsha Regenstein

Health Policy and Management Issue Briefs

No abstract provided.

Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project

Reproductive Health

As the global health community demonstrates an increasing commitment to investing in community health workers (CHWs) to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health (FLH) project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies. This brief describes the Population Council’s …

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

Lessons Learned From The Hiv/Aids Pandemic And Access To Medicines For Covid-19 Treatment, Thalia Le

Independent Study Project (ISP) Collection

There is an imminent need to address the healthcare disparities in accessing all COVID-19 medicinal products in developing countries. While logistical issues like inadequate production facilities such as the lack of vaccines administration capacity, storage issues, gap between supply and demand as well as vaccine hesitancy can certainly play a part in impeding COVID19 medicines distribution, patent monopolies and intellectual property protection laws further exacerbated the problem, especially when vaccines were at its early stages of authorization. Historical and contemporary case studies of efforts to challenge patents on HIV AVRs treatment provide a useful lens through which we may glean …

Helmintos Transmitidos Por El Suelo En Ecuador; La Respuesta Comunitaria Y Las Percepciones A Ellos En Baños Y Puyo, Audrey Chesney

Independent Study Project (ISP) Collection

This investigation was a qualitative study focused on soil-transmitted helminths (STHs) in Baños and Puyo, Ecuador. The perceptions of the communities regarding STHs and the community response to STH and STH infections was studied. The objectives of this study aimed to discover and learn about the perceptions of STHs from the affected communities, to comprehend the barriers that are present against better treatment for STH infections, and to learn about the community action taking place to improve the situation of soil-transmitted helminths (STHs) in the community. Soil transmitted helminths are intestinal worms that are transmitted through the contamination of the …

Disability And Healthcare Access In Morocco: Social And Cultural Influences, Christa Shipman

Independent Study Project (ISP) Collection

I stepped into the SIT Multiculturalism and Human Rights program as a pre-physical therapy student with experience working and volunteering in the disability rights arena. Striking personal encounters with Moroccans combined with these past experiences drew me to investigate how social and cultural factors influence access to healthcare for people with disabilities. I hypothesized that access to medical care is limited by social or cultural mindsets, perceptions, or beliefs for those in my target population. This subject is relevant to Morocco as a developing country and as a society with, in some cases, fixed social dynamics, while in other areas …

The Influence Of The Urban Food Environment On Diet, Nutrition And Health Outcomes In Low-Income And Middle-Income Countries: A Systematic Review, Susannah Westbury, Iman Ghosh, Helen Margaret Jones, Daniel Mensah, Folake Samuel, Ana Irache, Nida Azhar, Lena Al-Khudairy, Romaina Iqbal, Oyinlola Oyebode

Community Health Sciences

Introduction: Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.
Methods: We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of …

Assessing The Need For And Access To Migrant-Sensitive Rehabilitative Healthcare: An Analysis Of Current Swiss And German Practices, Lauren Cuppy

Independent Study Project (ISP) Collection

In recent years, the noticeable increase in migration has placed scrutiny on the migrant-sensitive services provided in healthcare settings globally. Migrants, in general, experience different health issues and worse health outcomes than non-migrants. In response to this, healthcare systems around the world have begun implementing migrant-sensitive healthcare (MSHC) systems; yet, although nearly a third of the world’s population experiences some health condition that would benefit from rehabilitation, the implementation of MSHC rehabilitation services have been critically understudied. This paper seeks to investigate the geographic and MSHC accessibility of rehabilitation in Geneva, Switzerland to fill the current gap of literature and …

The Multi-Step Approach To Covid Prevention In The Casamance Region, Saraí Hernandez Salguero

Independent Study Project (ISP) Collection

Located in the Oussouye Department approximately 43 kilometers away from the city of Ziguinchor in the Basse Casamance region of southern Senegal is the Oussouye commune where I had the pleasure of staying for three weeks. I had learned that the inhabitants of this village were not significantly impacted by the Covid-19 virus since it became global knowledge at the start of 2020. As of March 2020, the village had only reported 69 active cases and the department saw only 8 deaths in total. I sought to figure out what could be the cause of this and through a series …

Analysis Of The Moroccan Government & Ngos Responses To Migrant Health Crisis, Jepchirchir Mutwol

Independent Study Project (ISP) Collection

Healthcare access in Morocco for migrants has been a topic of growing interest. With the implementation of migration reforms in response to Morocco becoming a destination for migrants, it is important to assess the effectiveness of government policies in aiding migrant health. Additionally, assessing other political actors' influence in government policies is equally important. Through research of existing scholarship, I theorize that the biggest issue impacting migrant access to health is the illegalization of migrants. Without being a legal resident, let alone in asylum or a refugee, migrants cannot access public health services without the fear of deportation. Local and …

Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell

Independent Study Project (ISP) Collection

Research Question: What are the psychological and social effects of teen pregnancy facing teen mothers in 2021 and how do they impact their lives? Objective: The general objective is to describe the psychosocial implications produced by teen pregnancy. Background: Teen pregnancy rates of Latin America and the Caribbean are second in the world, second only to the region of Subsaharan-Africa. Within Latin America, Ecuador has the highest rates of adolescent pregnancy, surpassed only by Venezuela. Recently, the taboo surrounding reproductive health has been challenged, with the matter of abortion being brought to the supreme court. In conjunction with the matter …

Vaccine Hesitancy Within Nevada Counties, June 2021, Kelliann Beavers, Madison Frazee-Bench, William E. Brown Jr.

Health

This fact sheet highlights estimated rates of vaccine hesitancy, vaccination rates, the index of social vulnerability, and the level of concern for 17 Nevada counties as of June, 2021. The data are reported in the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) estimates.

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

Conflicts Of Interest: An Invisible Force Shaping Health Systems And Policies, Afifah Rahman-Shepherd, Priya Balasubramaniam, Meenakshi Gautham, Eleanor Hutchinson, Freddy E. Kitutu, Robert Marten, Mishal S. Khan

Community Health Sciences

No abstract provided.

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Department of Health Policy and Community Health Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Department of Health Policy and Community Health Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

The Impact Of Covid-19 On Church Gatherings In The Philippines: A Policy Analysis, Grace Zurielle Malolos, Joseph Christian Obnial, Rena Mallillin, Pamela Bianca Pasco, Erika Ong, Arianne Andes, Faith Ann Apat, Emma Teresa Carmela Aportadera, Rafael Valencia, Don Eliseo Lucero-Prisno Iii

Ateneo School of Medicine and Public Health Publications

The Philippines is the largest Christian-majority country in Asia. With church gatherings playing a vital role in the nature of Christianity in the Filipino culture, the advent of the coronavirus disease (COVID-19) pandemic in the Philippines posed challenges to public religious practices amid efforts to mitigate COVID-19 community transmission. Various policy pronouncements from both the government-led Inter-Agency Task Force (IATF) on Emerging Diseases and the church-led Catholic Bishops’ Conference of the Philippines (CBCP) were issued. These guidelines were implemented in order to address the two-pronged problem on healthcare and religious obligations. While these guidelines were initially contributory to the mitigation …

Assessment Of The Financial Health Of Rural Hospitals After Implementation Of The Georgia Rural Hospital Tax Credit Program, Bettye A. Apenteng, Samuel T. Opoku, Charles Owens, Emmanuel Akowuah, Linda Kimsey, Angela Peden

Department of Health Policy and Community Health Faculty Publications

Importance In 2016, Georgia implemented the Rural Hospital Tax Credit Program, which allows taxpayers to receive a tax credit for contributions to qualifying rural hospitals in the state. Empirical evidence of the program’s association with the viability of the state’s rural hospitals is needed.

Objective To examine the association of the tax credit program with the financial health of participating rural hospitals.

Design, Setting, and Participants This longitudinal cross-sectional study used hospital financial data from the Centers for Medicare & Medicaid Services for 2015 to 2019. A difference-in-differences analytic approach was used to examine the association of the tax credit …

Personal Mastery And All-Cause Mortality Among Older Americans Living With Diabetes, Ho-Jui Tung, Ming-Chin Yeh, Randall Ford, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

Introduction: Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time.
Methods: A total of 1,779 participants were identified from an off-year survey of the Health and Retirement Study. Proportional Hazard Models were used to evaluate the significance of selected variables in predicting the survival of participants over a 13-year period.
Results: A substantial proportion (46.7%) of the diabetic patients had survived by the end of 2016. Adults with lower mastery …

Perceived Benefits Matter The Most In Covid-19 Preventive Behaviors: Empirical Evidence From Okara District, Pakistan, Gulzar H. Shah, Ansar Ali Faraz, Hina Khan, Kristie Cason Waterfield

Department of Health Policy and Community Health Faculty Publications

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a faceto- face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara …