Medicine and Health Sciences Commons^™

Statement Of The Aspher Task Force On War And Public Health On The Conflict In Israel/Palestine, Oliver Razum, Paul Barach, Tomasz Bochenek, Colette Cunningham, Nadav Davidovitch, Polychronis Kostoulas, Jutta Lindert, Henrique Lopes, Vladimir Prikazsky, John Reid, Mirjana Kujundžić Tiljak, John Middleton

College of Population Health Faculty Papers

No abstract provided.

The Importance Of Triple Panel Testing For Hepatitis B And The Burden Of Isolated Anti-Hepatitis B Core Antibodies Within A Community Sample, Catherine Freeland, Vivek Sreepathi, Richard Hass, Jonathan Fenkel, Jessie Torgersen, Kenneth Rothstein, Chari Cohen, Robert Gish

College of Population Health Faculty Papers

Within the United States (US), 2.4 million individuals are living with chronic hepatitis B, but less than 20% are diagnosed. Isolated anti-hepatitis B core (iAHBc) antibodies indicate serology in an individual that is positive for anti-HBc antibodies, while negative for surface antigen (HBsAg) and surface antibodies (anti-HBs). A result of iAHBc could indicate a chronic occult bloodstream infection, necessitating further testing. This study assesses the prevalence and risk factors associated with anti-HBc and iAHBc within community high-risk screening in Greater Philadelphia. Participants (n = 177) were screened for HBsAg, anti-HBs, and anti-HBc during community screening events in 2022. Chi-square tables …

Changing The Playbook For Immigrant Health, Cheryl Bettigole, Patricia C. Henwood, Sage Myers, Maura Sammon

Department of Emergency Medicine Faculty Papers

Philadelphia’s response to welcoming Afghan evacuees during the COVID-19 pandemic suggests the need for a new approach to immigrant health care.

"I Believe More In The Ability Of The Small Person To Make Big Changes": Innovation And Social Entrepreneurship To Promote Public Health In Israel., Keren Dopelt, Nila Mordehay, Shir Goren, Aviya Cohen, Paul Barach

College of Population Health Faculty Papers

Social entrepreneurship has grown worldwide in recent decades as it attempts to create and implement innovative solutions to social and environmental issues through business strategies. The aim of this study was to explore what motivates public health social entrepreneurs to act, the challenges and barriers they face, achievements, and competencies required for success. As such, we interviewed 15 social entrepreneurs in Israel. Budget issues, regulatory barriers, and struggles against powerful companies were the frequent barriers to success. The interviewees indicated several achievements at the health policy level by positioning and becoming an authority in the field, positively influencing other people's …

Strategies For Strengthening The Resilience Of Public Health Systems For Pandemics, Disasters, And Other Emergencies, Benjamin Ryan, Mayumi Kako, Rok Fink, Perihan Şimşek, Paul Barach, Jose Acosta, Sanjaya Bhatia, Mark Brickhouse, Matthew Fendt, Alicia Fontenot, Nahuel Arenas Garcia, Shelby Garner, Abdülkadir Gunduz, D Mike Hardin, Tim Hatch, Lashonda Malrey-Horne, Makiko Macdermot, Ryoma Kayano, Joshua Mckone, Chaverle Noel, Shuhei Nomura, Jeremy Novak, Andrew Stricklin, Raymond Swienton, Ismail Tayfur, Bryan Brooks

College of Population Health Faculty Papers

OBJECTIVE: The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach.

METHODS: The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all …

Simulation As A Key Training Method For Inculcating Public Health Leadership Skills: A Mixed Methods Study, Keren Dopelt, Itamar Shevach, Ofek Eliad Vardimon, Katarzyna Czabanowska, Jascha De Nooijer, Robert Otok, Lore Leighton, Osnat Bashkin, Mariusz Duplaga, Hagai Levine, Fiona Macleod, Maureen Malowany, Leah Okenwa-Emegwa, Shira Zelber-Sagi, Nadav Davidovitch, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Successful management of public health challenges requires developing and nurturing leadership competencies. We aimed to evaluate the effectiveness of training simulations to assess public health leadership and decision-making competencies during emergencies as an effective learning and training method.

METHODS: We examined the effects of two simulation scenarios on public health school students in terms of their experience (compared to face-to-face learning) and new skills acquired for dealing with similar emergent situations in the future. A mixed-methods design included developing a validated and pre-tested questionnaire with open-and closed-ended questions that examined the simulation impact and the degree of student satisfaction …

A Novel Method For Measuring The Burden Of Breast Cancer In Neighborhoods, Russell K. Mcintire, Hee-Soon Juon, Scott W. Keith, Nicole L. Simone, Dexter Waters, Eleanor Lewis, Charnita Zeigler-Johnson

College of Population Health Faculty Papers

Community-based breast cancer prevention efforts often focus on women who live in the same neighborhoods, as they tend to have similar demographic characteristics, health behaviors, and environmental exposures; yet little research describes methods of selecting neighborhoods of focus for community-based cancer prevention interventions. Studies frequently use demographics from census data, or single breast cancer outcomes (e.g., mortality, morbidity) in order to choose neighborhoods of focus for breast cancer interventions, which may not be optimal. This study presents a novel method for measuring the burden of breast cancer among neighborhoods that could be used for selecting neighborhoods of focus. In this …

Choosing Not To Look: Not A Solution, Rosemary Frasso

College of Population Health Faculty Papers

No abstract provided.

Emerging Lessons From The Covid-19 Pandemic About The Decisive Competencies Needed For The Public Health Workforce: A Qualitative Study, Osnat Bashkin, Robert Otok, Lore Leighton, Kasia Czabanowska, Paul Barach, Nadav Davidovitch, Keren Dopelt, Mariusz Duplaga, Leah Okenwa Emegwa, Fiona Macleod, Yehuda Neumark, Maya Peled Raz, Theodore Tulchinsky, Zohar Mor

College of Population Health Faculty Papers

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between …

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. …

What Is Population Health? Ten Years On…., Mitchell Kaminski

College of Population Health Faculty Papers

No abstract provided.

Health Design Thinking: An Innovative Approach In Public Health To Defining Problems And Finding Solutions, Sylvie Abookire, Colin Plover, Phd, Rosemary Frasso Phd, Msc, Cph, Bon Ku

College of Population Health Faculty Papers

No abstract provided.

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Health Outcomes In Pathways To Housing Clients, Kimberly Alfonso, Lara Weinstein, Md

Phase 1

Introduction: Homelessness is widespread throughout the United States, with homeless individuals accounting for over half a million of the country’s population. In addition, chronic mental, behavioral, and medical issues are overly expressed in this population. Therefore, the purpose of this project was to determine if the Housing First Model, represented by Pathways to Housing PA, would alleviate these chronic conditions over the course of stay.

Methods: The target population of the study was the homeless population, specifically within the city of Philadelphia. Data was collected via the SAMHSA (Substance Abuse and Mental Health Services Administration) NOMs (National Outcome Measures) survey. …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: Breastfeeding is essential for health and bonding within the mother-child dyad. Most guidelines, therefore, suggest women continue breastfeeding up to twelve months post-partum. Discrepancies in achieving this exist across zip codes and race in Philadelphia, despite high overall rates of breastfeeding. Our research goal is to understand these discrepancies and the relationship between attitudes and practices of breastfeeding Philadelphian women, in order to target them with breastfeeding resource.

Methods: General population data was collected via an online survey taken by residents of Philadelphia and the surrounding counties, whereas the focus group survey was taken in-person by Maternity Care Coalition …

Perceptions Of Centering Pregnancy At Jefferson’S Maternal Addiction Treatment, Education & Research (Mater) Program, Lindsay Caldarone, Ms, Vanessa Short, Phd, Mph

Phase 1

Introduction: Opioid use and misuse, including during pregnancy, is prevalent across the United States. Many women with opioid use disorder (OUD) face multiple barriers to care, including prenatal care. Group prenatal care, as compared to individual prenatal care, may lead to beneficial outcomes such as reduced odds of preterm birth.

Objective: This study aimed to assess the perceptions of Centering Pregnancy (CP), a group prenatal care program, among women in treatment for OUD.

Methods: The target population included women who participated in the CP program at MATER. Participants (N=6) completed a survey after the last CP session. Survey questions assessed …

The Experience Of Intimate Partner Violence Among Pregnant Women Seeking Treatment For Opioid Use Disorder, Julia Dewey, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Intimate partner violence (IPV) is a major health issue among those with substance use disorder. A history of partner violence is associated with increased health problems and less improvement in treatment. The perinatal period is a time of increased risk of IPV for women, as well as a key opportunity for opioid use disorder treatment intervention. The purpose of this study is to characterize the experience of partner violence and evaluate the typology of sequelae associated with it in a population of pregnant women seeking medication assisted treatment for opioid use disorder.

Methods: The population of interest in this …

Adolescent Hiv Pre-Exposure Prophylaxis Prescribing Practices Among Family Medicine Physicians: Limited Immediate Uptake, Emma T. Cooper, Steven A. Elsesser, Md, Amy Cunningham, Phd, Mph, Marshal Miller, Md

Phase 1

Introduction: In the United States, individuals aged 13-24 made up 21% of new HIV infections in 2016. In 2018, the FDA approved tenofovir/emtricitabine as HIV pre-exposure prophylaxis (PrEP) for adolescents aged 15-17. In 2019, we examined adolescent PrEP prescribing practices among family medicine physicians at an academic family medicine practice.

Methods: Physicians were invited to complete an online questionnaire assessing PrEP knowledge, attitudes, and prescribing practices. Differences in PrEP knowledge and attitudes among providers who prescribe PrEP to adolescents versus those who do not were examined using independent samples t-tests.

Results: 50 out of 99 surveys were completed. Respondents were …

Perspectives On Lung Cancer Screening In The Philadelphia Lgbtq Community, Kaitlin Demarest, Kristine Pham, Mph, Rickie Brawer, Phd

Phase 1

Introduction: Lung cancer is the leading cause of cancer deaths in the United States, but there are low screening rates across the country. While the prevalence of smoking in the LGBTQ population is disproportionately high, the LGBTQ community may have decreased access to screening, since they are reported to be less likely to have health insurance, more likely to receive inferior care or be denied care. The objective of this project was to better understand the knowledge, beliefs, and attitudes toward lung cancer screening in the LGBTQ community in Philadelphia in order to develop appropriate, community-focused educational materials to increase …

Building Connections: Skmc – Ces Medellín International Exchange Program Development, Elias Borne, Kaitlin Demarest, Rosemary Frasso, Phd, Andres Fernandez, Md, Msed

Phase 1

Introduction: To date, there has been no formal evaluation of the exchange program that sends medical students from Sydney Kimmel Medical College (SKMC) to CES University, Colombia. While many medical schools have international exchange partnerships, little is known about what makes a successful global training experience. This project aims to evaluate the SKMC-CES student exchange program with the goal of improving collaboration between the two universities and creating a logic model backbone for the program going forward.

Methods: Surveys and interviews were done with program participants from the 2018 and 2019 academic years (6 students interviewed and 4 surveyed) exploring …

Lgbt Elder Initiative Thrivers Program Evaluation, Darcy Curtis, David Griffiths

Phase 1

Introduction: Aging with HIV is a critical area of study, especially as the generation that was initially affected by the disease grows older. The LGBT Elder Initiative (LGBT EI) is an organization in Philadelphia that supports and advocates for older members in the LGBT community. The LGBT EI Thrivers program is a community group that meets monthly to discuss what it means to “thrive” with HIV. The purpose of this study is to evaluate the LGBT EI’s Thrivers program and determine what motivates older individual with HIV to become involved in this program and identify the impact of the program. …

Thomas Jefferson Health System Medical Legal Partnership, Theresa Clark Rihn, Ema, Jd, Martha Romney, Rn, Ms, Jd, Mph, Rickie Brawer, Mph, Phd, Mches, Jennifer Roman, Bsn, Rn, Ccm

Phase 1

Introduction: Medical-legal partnerships (MLPs) provide civil legal services in concert with healthcare services to mitigate complex social conditions with health-harming effects. Currently, there are 333 MLPs in 46 states. Thomas Jefferson Health System (TJHS) does not have a systemwide MLP. (Magee Rehabilitation Hospital does have an MLP used by qualifying Magee patients). This project sought to identify the core components of an MLP and to demonstrate the value an MLP would provide TJHS.

Methods: Assessed existing literature. Interviewed an existing MLP director. Patients from the Jefferson Hospital Ambulatory Practice (JHAP) clinic completed a written survey regarding health-harming social-legal …

A Photovoice Project With Latino Youth In Easten North Philadelphia, Maria F. Arisi, Vincent Pepe, John Mckeegan, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd

Phase 1

Introduction: Eastern North Philadelphia is home to both the highest density Latino population in Philadelphia and some of the poorest health measures of the city. This Latino population is known to face a multitude of barriers to health, such as high rates of poverty, low educational attainment, and language barriers. There is little data showing what the self-identified priority needs of these Latino populations are, and even less showing the needs of Latino youth. Understanding how youth perceive the impact of their social and built environments can bring attention to the issues that the community needs addressed.

Methods: We conducted …

Increasing Food Access: Evaluation Of A Food Buying Club In Philadelphia, Kimberly Hoover, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Children living in food insecure homes are at higher risk of developing a variety of negative health outcomes, including cardiovascular disease, obesity, and cognitive, emotional and behavioral problems. In order to combat these outcomes, Mercy Neighborhood Ministries of Philadelphia (MNMOP) established a Food Buying Club to increase accessibility and affordability of fresh produce. However, the satisfaction with this program among participants needs to be determined in order to strengthen the program.

Objective: The objective of this quality improvement study was to evaluate parental satisfaction with the MNMOP program, specifically regarding produce options, cost, and variety.

Methods: An online survey …

Examining Israeli Emergency Medical Preparedness In The Context Of Jefferson And Affiliates Practices, Jamie D. Garden, Amit S. Padaki

Phase 1

Introduction: Recent domestic disasters have demonstrated the challenges and vulnerabilities in the US health care disaster preparedness framework, challenges that extend to Thomas Jefferson University Hospital System (TJUH), in Philadelphia, PA. As Israel serves as a global leader in civilian defense and disaster preparedness, this study examines best practices in response to a mass casualty event at Hadassah Hospital in Jerusalem, Israel, and compares them with existing protocol at TJUH. The list of best practices generated from this research allows for a greater understanding of standards that are feasibly employable at TJUH.

Methods: This study examined hospital staff response practices …

High Retention In An Fqhc Moud Program Despite Substantial Vulnerabilities In Population, Qais Iqbal, Lara Weinstein, Md, Mph, Drph

Phase 1

Background: Seventy-thousand people in Philadelphia use heroin, and another 50,000 misuse prescription opioids. Philadelphia has increased its capacity for medication for opioid use disorder (MOUD) with buprenorphine from 100 slots in 2017 to 2,906 as of December 2018, but clearly there is still a need for thousands of more treatment slots. Additionally, recent evaluations reveal people from vulnerable populations, including homeless, non-white, and those with chronic medical diseases, have compounded difficulty accessing MOUD, even if there is sufficient capacity. Our objective was to describe and report initial outcomes of a low-threshold MOUD program at our Federally Qualified Health Center (FQHC) …

Predictors Of Negative Outcomes And Causes Of Loss To Follow Up Among Breast Cancer Patients In Port-Au-Prince, Haiti, A. Johnson, R. R. Henderson, G. Jones, Y. Fujii, P. Haley, J. Bernard, V. Degennaro

Phase 1

Objective: To determine predictors of negative outcomes and causes of loss to follow-up (LTFU) in patients with breast cancer in Haiti.

Design and Methods: Patients seen by Innovating Health International’s (IHI) cancer program were designated as LTFU after at least six months of non-contact (n=606). A cohort of LTFU breast cancer patients (n=101) was compared to the larger population of breast cancer patients (n=939), and a regression model constructed in order to identify risks for death and LTFU. Multiple calls were made to contact LTFU patients, and reasons for LTFU were recorded.

Results: Death and LTFU status were associated with …

Quality Improvement Study Of Behavioral Health Resources Access In 19121 And 19132, Courtney Kaye, Rickie Brawer, Mph, Phd, Mches, Jeanne Felter, Phd, Lpc

Phase 1

Introduction: Children who have experienced four or more ACES (adverse childhood events) are shown to have negative mental health outcomes. Adolescents living in the Philadelphia zip codes 19121 and 19132 have higher ACE scores. This makes it necessary for adolescent providers to screen for behavioral health issues in their patients and refer out to appropriate resources.

Objective: The purpose of this quality improvement study is to see what current barriers exist relating to physician referral and access to behavioral health resources for their patients.

Methods: A guide of behavioral health resources available to adolescents in 19121 and 19132 was …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: It is recommended that women breastfeed for twelve months because breastfeeding is an important part of infant development and maternal bonding. Research shows that despite high overall breastfeeding rates, discrepancies exist in breastfeeding rates across zip codes and race in Philadelphia. The research goal is to develop a community resource to promote breastfeeding in Philadelphia and to understand the impact race and zip code have on breastfeeding attitudes and practices.

Methods: Data was collected from residents of Philadelphia and neighboring counties through an online general population survey and focus group survey. Both surveys addressed demographics and the women’s attitudes …

War On The Wards: The Collapse Of Health Care Infrastructure Resulting From Violent Conflict, Nathan Hersh, Amy Hagopian, Barry Levy

Phase 1

Introduction: While utilizing satellite images to verify reports of hospital damage resulting from armed conflict allows for remote assessment, the use of private satellites to gain access to images prohibits widespread use. The questions this study sought to answer were: Is it possible to replicate the findings of previous reports of hospital damage that used the services of private satellite imagery using open source software, such as Google Earth? What variations exist among the different sites where damage to hospitals is visible, and what gradation is possible? Is this methodology applicable to other examples of armed conflict?

Methods: Using the …