Digital Commons Network^™

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

Developing Nations And Disadvantaged Populations: How The 2009 H1n1 Influenza Pandemic Exacerbated Disparities And Inequities, Rebecca Lebeaux

Independent Study Project (ISP) Collection

The 2009 H1N1 influenza pandemic, although not as deadly or long lasting as initially projected, demonstrated that the world was and is ill prepared to handle a mass pandemic. As the first pandemic of the twenty-first century, the pandemic revealed global health insecurities and asymmetrical disease burdens for disadvantaged individuals and countries. This paper will analyze why both developing countries and disadvantaged individuals suffered disproportionately from the pandemic. Using the framework of structural violence, this paper will investigate how socioeconomic and political disparities encountered before and during the pandemic caused differential health, societal, political, and economic outcomes. These preexisting disparities …

The Importance Of Nature: An Investigation On How Geography Influences Well-Being, Christina Cobb

Independent Study Project (ISP) Collection

The objective of this community service project (CSP) was to study how a community’s location, specifically within nature, influences their well-being. I hoped to see how the community’s location, within Chapada Diamantina national park, influences the many ways health is promoted, and how these ways are affected by their location within nature. This project was built upon a review of the literature, which found that there is a theoretical basis for the notion that contact with nature is beneficial, a term deemed Biophilia. There is a robust body of academic research that highlights the health benefits deriving from contact …

Hspm 7090a - Selected Topics In Health: Geographic Information Systems, Jeffery A. Jones

College of Public Health: Faculty Syllabi (2014-2021)

This course will introduce students to geographic information systems (GIS) to map and spatially analyze public health and demographic data. Students will learn the fundamentals of the ArcMap software system and ways to integrate cartography into biomedical informatics practice. Beyond use of GIS for cartography, this course will also examine ethical issues and methods of analyzing demographic and spatial health patterns using GIS and demography analysis methods. The versatility of GIS in a public health setting will be examined and will include exercises involving GIS applications in health marketing, demography, epidemiology, and health care systems. For example, we will look …

Comparing Effectiveness Of Active And Passive Client Follow-Up Approaches In Sustaining The Continued Use Of Long Acting Reversible Contraceptives (Larc) In Rural Punjab: A Multicentre, Non-Inferiority Trial, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghazunfer Abbas, Erik Munroe, Rebecca Harrison, Wajahat Hussain Shamsi, Ghulam Mustafa, Omar Farooq Khan

Community Health Sciences

Background: The use of long-acting reversible contraceptive (LARC) methods is very low in Pakistan with high discontinuation rates mainly attributed to method-related side effects. Mixed evidence is available on the effectiveness of different client follow-up approaches used to ensure method continuation. We compared the effectiveness of active and passive follow-up approaches in sustaining the use of LARC-and within 'active' follow-up, we further compared a telephone versus home-based approach in rural Punjab, Pakistan.
Methods: This was a 12-month multicentre non-inferiority trial conducted in twenty-two (16 rural- and 6 urban-based) franchised reproductive healthcare facilities in district Chakwal of Punjab province, between November …

A Case Study Of Individual And Organizational Stakeholder Perspectives On State Factors Impacting Access To Rural Health Care Services In Idaho, Molly Vaughan Prengaman

Nursing ETDs

The purpose of this case study was to describe individual and organizational perspectives on the state factors and political context impacting access to rural health care services in Idaho. Approximately 50 million Americans, roughly 20% of the United States population, live in rural areas (U.S. Census Bureau, 2012). For over 100 years, U.S. rural residents have experienced health disparities and health care access barriers (De Alessi & Pam, 2011). Rural residents evidence greater health risks, fewer health care providers, poorer health outcomes, and greater mortality than most urban residents (Jones, Parker, Ahearn, Mishra, & Variyam, 2009). Since many rural health …

Community Schools: A Public Health Opportunity, Catherine Diamond

Dissertations and Theses

Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many U.S. cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the students enrolled, they provide an opportunity to improve community health. It has been proposed that community schools influence the health and education of the area residents through three pathways: building trust, establishing norms, and linking people to networks and services. However, no research has been published exploring …

An Evaluation Of The Effect Of Abortion Laws On The Timing Of Abortion, Elizabeth Fuentes

Dissertations and Theses

A record number of restrictive abortion laws, particularly those known as Targeted Regulation of Abortion Providers (TRAP), have been passed in US states in the past half-decade. TRAP laws differ from abortion laws that target patients, such as parental involvement and waiting period policies, because they are often expensive, difficult, or impossible for providers to comply with, resulting in the reduction or elimination of abortion services. This can result in farther travel to and higher costs of abortion services for patients; however, there are no studies assessing whether one consequence of reduced geographic accessibility of abortion services is delays in …

Perceptions Of Fidelity And Adaptation In Evidence-Informed Interventions By Women Of Color Sexuality Health Educators, Sara C. Flowers

Dissertations, Theses, and Capstone Projects

Sexuality health educators (SHEs) adapt interventions to the participants’ needs in the dissemination and implementation of comprehensive sexuality education (CSE) programming. However, there is a lack of understanding of how, why and when SHEs make such adaptations. Success or failure of the transfer of prevention technology to practitioners occurs by determining community capacities and preparedness to adopt/adapt high-impact interventions to effectively manage implementation. Experts argue for evidence-informed interventions (EII), as opposed to evidence-based interventions (EBI), as the best way to incorporate research in applied settings. EBIs are solely guided by recommendations from current evidence, whereas EIIs recognize and incorporate the …

Cross-Sectional Survey Of Perceived Barriers Among Community Pharmacists Who Do Not Immunize, In Wayne County, Michigan, Sarah E. Kelling, Anthony Pattin, Abdulbaset Salim, Paul Kilgore, Steven R. Erickson

Department of Pharmacy Practice

Introduction: The goal of the study was to identify perceived barriers to implementation of vaccination services encountered by independent and small-chain community pharmacies in an urban setting.

Methods: Pharmacists in independent and small-chain pharmacies located in 29 Michigan ZIP codes were visited and asked to complete a 5- to 10-min semi-structured interview.

Results: A total of 93 independent and 12 small-chain pharmacies participated (n = 105; 61%). The pharmacies filled an average of 700 prescriptions each week with 1.1 pharmacist full-time equivalents and 57 h of technician time. The most common services that participating pharmacies provided were dispensing outpatient …

Multi-Sectoral Partnerships And Patient-Engagement Strategies In Accountable Care Organizations, Margae Knox, Hector P. Rodriguez, Stephen M. Shortell

Frontiers in Public Health Services and Systems Research

Background: Patient-engagement strategies are increasingly recognized for enriching traditional medical care and improving population health. Accountable Care Organizations (ACOs) may be well positioned to leverage multi-sector organizational partnerships to improve the reach of their patient-engagement strategies, particularly given incentives to meet cost, quality and population health goals. Little is currently known about the relation of multi-sector partnerships and patient engagement in ACOs.

Purpose: To examine the relation of patient-engagement strategies and breadth of multi-sectoral organizational partnerships in 71 primary care practices affiliated with one of two ACOs.

Methods: Clinical and administrative leaders from each practice were surveyed. Questions assessed practice …

Sustainable Global Medical Mission Work: The Csb/Sju Global Medical Brigade, Tyler J. Bruinsma

Forum Lectures

International medical mission work, especially programs that include undergraduate students are under increasing fire as an unsustainable method for providing care to marginalized populations in developing countries. Medical mission work is often short-sighted and neglects to address the underlying causes of diseases. Annually, the CSB/SJU Global Health Affairs Club plans and executes a "Global Medical Brigade" to Honduras in conjunction with Global Brigades, a 501(c)3 non-profit organization. Global Brigades is different than most medical mission organizations in that it follows a holistic model to address health concerns. Through seven separate "brigades," Global Brigades addresses both immediate health concerns and their …

Outpatient Antibiotic Prescribing Among United States Nurse Practitioners And Physician Assistants., Guillermo V Sanchez, Adam L Hersh, Daniel J Shapiro, James F. Cawley, Lauri A Hicks

Prevention and Community Health Faculty Publications

We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs.

Implementation Of Survivorship Care Plans At Three Health System-Based Cancer Centers In A Rural State, Mary Isaacson, Polly Hulme, Jenna Cowan, Jennifer Kerkvliet, Mary Minton

College of Nursing Faculty Publications

The purpose of this project is to describe the development and implementation of cancer SCPs at three health systems’ cancer centers in a rural state. Collectively, these centers serve most cancer patients residing in SD, making the partnership across the cancer centers innovative. Each of the three health systems and their affiliated cancer centers is unique in its history, culture, and infrastructure. In addition, each cancer center was at a different point in the development and implementation of SCPs at the time of this project. Therefore, a description of the processes, successes, and challenges involved in the development and implementation …

Geographic And Age-Based Variations In Medicare Reimbursement Among Assh Members., Michael P. Gaspar, Patrick M. Kane, Grace B. Honik, Eon K. Shin, Sidney M. Jacoby, A. Lee Osterman

Department of Orthopaedic Surgery Faculty Papers

Background: The purpose of this study was to investigate how American Society for Surgery of the Hand (ASSH) members' Medicare reimbursement depends on their geographical location and number of years in practice. Methods: Demographic data for surgeons who were active members of the ASSH in 2012 were obtained using information publicly available through the US Centers for Medicare and Medicaid Services (CMS). "Hand-surgeons-per-capita" and average reimbursement per surgeon were calculated for each state. Regression analysis was performed to determine a relationship between (1) each state's average reimbursement versus the number of ASSH members in that state, (2) average reimbursement versus …

Association Of Tobacco Use And Other Determinants With Pregnancy Outcomes: A Multicentre Hospital-Based Case-Control Study In Karachi, Pakistan., Shafquat Rozi, Zahid Ahmad Butt, Nida Zahid, Saba Wasim, Kashif Shafique

Community Health Sciences

OBJECTIVES:

The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan.

DESIGN:

A multicentre hospital-based case-control study.

SETTING:

Four leading maternity hospitals of Karachi.

PARTICIPANTS:

A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, …

Health Workers’ Perspectives, Knowledge And Skills Regarding Community Case Management Of Childhood Diarrhoea And Pneumonia: A Qualitative Inquiry For An Implementation Research Project “Nigraan” In District Badin, Sindh, Pakistan, Fauziah Rabbani, Shagufta Perveen, Wafa Aftab, Aysha Zahidie, Kashif Sangrasi, Shamim Ahmad Qazi Ahmad Qazi

Community Health Sciences

BACKGROUND:

Pakistan's Lady Health Worker Programme aims to provide care to children sick with pneumonia and diarrhoea, which continues to cause 27 % under-five mortality in Pakistan. The quality of supervision received by Lady Health Workers (LHWs) in the programme influence their knowledge and skills, in turn impacting their ability to provide care.

METHODS:

This study is part of an implementation research project titled "Nigraan" (an Urdu word meaning supervisor), and explores LHW and Lady Health Supervisor (LHS) perspectives regarding the role of supervision in improving LHWs performance and motivation in district Badin, Sindh, Pakistan. Their knowledge and skills regarding …

Use Of Telehealth In Nhsc Grantee Sites, Patricia Pittman, Clese Erikson, Xiaoli Wu, Emily Bass

Health Workforce Research Center Publications

Telehealth has long been viewed as an important pathway for increasing access to care for underserved populations, while providing high quality care at low cost. The spread of telehealth in the United States, however, has been hampered by a range of reimbursement, equipment costs, and licensure barriers. In this study we examined the extent to which telehealth is being used in settings that are among the locations most in need: the National Health Service Corps (NHSC) approved grantee sites. Key Questions

1. To what extent and how are NHSC using telehealth and telemedicine services?
2. What are the barriers to adoption and …

Leisure Time Physical Activity Preferences, Behaviors, And Hypertension: Evidence From The China Health & Nutrition Survey, 2004-2011, Junmin Zhou

Theses & Dissertations

Background: Physical activity has been continuously declining in China. At the same time, prevalence of hypertension has dramatically increased. The associations between leisure time physical activity preference, behavior, and development of hypertension in Chinese adults remained not fully understood and few studies have examined these associations using longitudinal data.

Objectives: This dissertation examined the interrelationships among leisure time activity preference, behavior, and the incidence of hypertension using longitudinal data from 2004 to 2011 in the China Health and Nutrition Survey. It also assessed the urban-rural disparities.

Methods: A total of 2,687 adults were included in the analysis. Multivariate logistic regressions …

Partnerships For Change: A Collaboration For Global Wellbeing, Ravneet Gill

Master's Projects and Capstones

Partnerships For change (PFC) consists of a team of social impact strategists and practitioners. The organization is dedicated to promote sustainable development through direct humanitarian action and transforming social and economic conditions of underserved communities around the globe. With the commitment to elevate and empower individuals to reach their ultimate potential, PFC partnered with Jaipur foot, world's largest organization for prosthetic devices, to network Jaipur Foot to innovators and funders. They have also started the building of a health clinic in Johnsonville, Liberia due to inadequate medical support for individuals living in the community. There are several steps in building …

Building From The Hiv Response Toward Universal Health Coverage, Jonathon Jay, Kent Buse, Marielle Hart, Robert Marten, Scott Kellerman, Morolake Odetoyinbo, Jonathan D. Quick, Timothy Evans, Peter Piot, Mark Dybul, Agnes Binagwaho

Dartmouth Scholarship

Universal health coverage (UHC) has gained prominence as a global health priority. The UHC movement aims to increase access to quality, needed health services while reducing financial hardship from health spending, particularly in low- and middle- income countries.
As a policy agenda, UHC has been identified primarily with prepayment and risk-pool- ing programs. While financing policies provide important benefits, increasing access to health services will require broader reforms.
For lessons, the UHC movement should look to the global HIV response, which has confronted many of the same barriers to access in weak health systems. Considerable success on HIV has resulted …

Contact Point, Arthur A. Dugoni School Of Dentistry

Contact Point

No abstract provided.

Crispr Humans: Ethics At The Edge Of Science, Insoo Hyun

Center for the Study of Ethics in Society Papers

No abstract provided.

Automobile, Construction And Entertainment Business Sector Influences On Sedentary Lifestyles, Diana C. Parra, Thiago H. De Sá, Carlos A. Monteiro, Nicholas Freudenberg

Publications and Research

Sedentary lifestyles contribute to premature death and health inequalities. Researchers have studied personal and community-level determinants of inactivity but few have analyzed corporate influences. To reframe the public health debate on inactivity and open new doors for public sector intervention, we conducted a scoping review of evidence from several disciplines to describe how the business and political practices of the automobile, construction, and entertainment sectors have encouraged sedentary lifestyles. In the last 50 years, these industries have found it profitable to produce motor vehicles, housing, and entertainment, which intentionally or unintentionally discourage physical activity. Ceding primary authority for policy decisions …

Geographical Location And Stage Of Breast Cancer Diagnosis: A Systematic Review Of The Literature, Faustine Williams, Aimee S. James, Stephen Jeanetta

ETSU Faculty Works

Objective: To examine systematically the literature on the effect of geographical location variation on breast cancer stage at diagnosis, race/ethnicity, and socioeconomic status.

Methods. Eight electronic databases were searched using combination of key words. Of the 312 articles retrieved from the search, 36 studies from 12 countries were considered eligible for inclusion.

Results. This review identified 17 (47%) of 36 studies in which breast cancer patients residing in geographically remote/rural areas had more late-stage diagnosis than urban women. Ten (28%) studies reported higher proportions of women diagnosed with breast cancer resided in urban than rural counties. Nine …

Fuzzy Logic In Health Care Settings: Moral Math For Value-Laden Choices, Sarah Voss

Journal of Humanistic Mathematics

This essay is intended as an example of “moral math”, i.e., ideas culled from mathematics which can positively impact social behavior. Specifically, it combines fuzzy logic with the ethical decisions which hospital staff and others are sometimes forced to make about health care (e.g., euthanasia issues following Hurricane Katrina). The assumption is that such decisions involve value-laden choices which lend themselves to “fuzzy” or “smart” protocols. The article discusses the history of fuzzy logic – what it is, how it is used, and how it might be even better-used as a support basis for making difficult choices …

A Century Of Trends In Adult Human Height, Con Burns, Tara Coppinger

Publications

Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people …

National Health Security Preparedness Index Joint Workgroup Meeting On Model Design And Analytic Methodology, Glen P. Mays

Health Management and Policy Presentations

This workgroup meeting of the National Health Security Preparedness Index reviews results from the 2016 release of the Index and examines opportunities for enhancing the Index measures and analytic methodologies for subsequent releases.

Intersystem Implications Of The Developmental Origins Of Health And Disease: Advancing Health Promotion In The 21st Century, Michael D. Barnes, Thomas L. Heaton, Michael C. Goates, Justin M. Packer

Faculty Publications

The developmental origins of health and disease (DOHaD) theory and life course theory (LCT) are emerging fields of research that have significant implications for the public health and health promotion professions. Using a DOHaD/LCT perspective, social determinants of health (SDH) take on new critical meaning by which health promotion professionals can implement DOHaD/LCT guided interventions, including recommended policies. Through these interventions, public health could further address the sources of worldwide chronic disease epidemics and reduce such disease rates substantially if related policy, programs, and interdisciplinary and multi-sector collaboration are emphasized. Additional characteristics of the most effective interventions involve context-specific adaptation …

Partnership In Action: A Case Study In Nursing Workforce And Leadership Development In East Africa, Sharon Brownie

School of Nursing & Midwifery, East Africa

Session presented on Saturday, July 23, 2016: East Africa suffers an inordinate burden of disease and does not have the numbers of suitably qualified nurses and midwives to address this challenge.' Focussed efforts in nursing workforce capacity building are needed to build capacity within nursing education, practice and leadership. An enhanced nursing and midwifery workforce is needed across all disciplines with development required at all levels including upgrade of the existing workforce, development of speciality qualifications and enhancement of leadership capacity.'This presentation involves a case study in which university private-public partnerships have successful contributed to nursing capacity enhancement of nursing …