Medicine and Health Sciences Commons^™

Jeffhealth Medical Student Exchange In Rwanda, Amanda Nemecz, Alexander Rowan, Talia Stark

CwiC Posters

Teaching Community Health Workers

In rural Rwandan villages, the communities are linked to healthcare through Community Health Workers (CHW). CHW are appointed based on village election and the requirement that they can read and write. The Rwandan Ministry of Health provides general health training to the CHW so that they can educate and advise the village on health related matters. CHW administer educational sessions at village meetings about prevalent health issues, and advise members of the village when they should go to the Health Center. JeffHEALTH’s teaching aims to supplement the Ministry of Health training. Topics are chosen and approved …

The Public Health Of Youth And High School Athletics, Michael Haines

CwiC Posters

The Problem

• The number of participants in high school sports has increased since 1989 (National Federation of State HS Association).
• From 2000-2010 7% of public schools cut athletic programs while less than 1% added them (Sharp Center Univ. Michigan).
• Some estimates predict 27% of public high schools will not offer varsity athletics by 2020 (Sharp Center Univ. Michigan).
• School’s are dropping athletic programs (as well as music and theater programs) due to budget cuts.
• Alternative approaches schools are taking include “pay to play” which increases the financial burden on students and families.
• In 2011, 3 out of 4 school districts …

School Wellness Assessment: Creating A Culture Of Health, Kaitlyn Petruccelli, Bs, Rickie Brawer, Mph, Phd

CwiC Posters

Introduction

The Center for Urban Health (CUH) and the Office for Student Life and Engagement at Thomas Jefferson University (TJU) are working with two public elementary schools in Philadelphia – Southwark School and Independence Charter School – to create a culture of health in the schools. Both schools wish to establish an environment that promotes health and safety and assists children in developing life-long healthy habits. The offices at TJU set out a plan to

(1) Assess the current policies and climate at the schools,

(2) Identify priority weaknesses to address,

(3) Connect TJU’s various health professional schools and student …

The Intersection Between Medication Tablets And Electronic Tablets: Determining The Usability And Acceptability Of A Patient-Centered Cardiovascular Risk Assessment (Pccra) Ios App, Nisha Patel, Ms2, Geoffrey Mills, Md, Phd, Marianna Lanoue, Phd, Amy Cunningham, Mph

CwiC Posters

Background

One American dies from cardiovascular disease (CVD) every 40 seconds. Risk factor awareness, assessment, and communication has been shown to improve efficacy of patient treatment and also decline overall risk in the population over time. Traditional cardiac risk assessment tools (e.g. Framingham risk assessment, FRA) generate a risk score in a format that may not appreciated or easily understood by all patients. A new patient-centered approach, in which the patient becomes an active participant in the decision-making process, has shown significant increase in patient-provider communication and diagnosis/management.

Clinical Experience At Pasteur Clinic Đà Lạt, Vietnam, Emma Howard-Young, Jordan Howard-Young, Ma

CwiC Posters

History of the Pasteur Clinic Đà Lạt

The Pasteur Clinic is associated with the Institut Pasteur, part of the international network of research institutes dedicated to the prevention and treatment of infectious diseases. The Đà Lạt branch of Vietnam’s Institut Pasteur was built between 1930 and 1936 under the direction of Dr. Alexandre Yersin, a physician remembered for identifying Yersinia pestis as the causative agent of Plague and a student of the eponymous French chemist and microbiologist Louis Pasteur. While many overt references to the French colonial tradition have been supplanted in Vietnam by nationalist sentiments, the Institut Pasteur …

Improving Rural Community Health Through Care Coordination, Alexander Miller

CwiC Posters

DEMOGRAPHICS OF CRAWFORD COUNTY^1,2

• Population – 87,600
• Population density – 86.5 per mi²
• Ratio of patients to PCPs – 1,685:1
• Number of hospitals – 2
• Population 65 and older – 17.4%
• Overweight – 65% Obesity – 32%
• Population with Diabetes – 12%
• Heart disease death rate – 200 deaths per 100,000 people.

The above percentages and rates of disease are either equal to or higher than the averages for the state of Pennsylvania.

Virtual Rounds: Improving Family Participation In Multidisciplinary Rounds Via Telehealth, Gerald Durkan

CwiC Posters

Background

What Are Multidisciplinary Care Rounds (MDR’s)?

MDRs are defined by the unique characteristic of incorporating a multitude of both physician and non-physician specialties into the conversation with the patient for the coordination of their care.

What is Discussed During an MDR?

Activities relating to the care of the patient that may be incorporated into the MDR include summarizing the treatment that the patient has undergone, discussing the treatment approach that is planned for the patient, working through potential issues that may arise from the treatments, and discussing the potential future therapy.

What is Telehealth?

Telehealth is the delivery of …

How A Civil War Surgeon’S Population Health Initiatives Helped Save The Union, 2lt Tyler Walker

CwiC Posters

Introduction

Dr. Jonathan Letterman was the medical director for the Army of the Potomac during the American Civil War. Dr. Letterman graduated from Jefferson Medical College in Philadelphia in 1849. With his appointment to the largest portion of the Union Army, Dr. Letterman was tasked with improving what would today be called a population health nightmare. Soldiers lived in filth, ate food devoid of nutrition, were forced to train beyond what was necessary no matter the conditions, and worst of all, were not provided with an organized medical department to treat them if they were wounded or became ill. He …

Developing Maternal And Child Health Curriculum In Rural Uganda, Rebecca Newbrander, Md Candidate

CwiC Posters

Maternal and Child Health in Iganga District Uganda

Maternal and child health outcomes in the East Central Region of Uganda are especially poor compared to the rest of Uganda [1]:

• Only 32% of women (50.7% nationally) informed about signs of pregnancy or delivery complications
• Only 12% of women (62% nationally) received malaria prophylaxis during pregnancy

The “Three Delays Model” of barriers to care[3]:

• Knowing when to seek care and making the decision to do so
• Access to care once decision is reached to seek it
• Receiving quality care at a health center or hospital

Maternal and Child Heath Care in …

Housing First: A Solution To Urban Homelessness, Kelsey L. Capron, Lara C. Weinstein, Md

CwiC Posters

Homelessness in the United States

• 630,000 homeless in the US in 2012, thousands in Philadelphia
• Over 3% of the US population has been homeless during the past 5 years
• Homeless = no stable residence

Temporary shelters, unsheltered locations (the street, transit stations, parked cars), etc.

• High rates of legal issues, substance abuse/dependency, & lack of stable employment

Severe mental illness = overrepresented & linked to severe health disparities

• Higher risk for all-cause mortality (primarily due to injuries, overdose, CV disease)

Mortality rates 3-4x higher than the general population

Chronic & acute mental & physical health conditions

HIV, tuberculosis, hypertension, diabetes …

The Global Health "Interactive Curricula Experience (Ice) Platform & App": Technology That Enables Inter-Professional Innovation, James Plumb, Md, Mph, Nicholas Leon, Pharmd, Louis N. Hunter, Pt, Dpt, Martha Langley Ankeny, M.Ed, Ellen Plumb, Md, Lucille B. Pilling, Edd, Mph, Rn

College of Population Health Lectures, Presentations, Workshops

17 slide PowerPoint presentation.

Presented at APHA in Chicago Illinois.

Healthy Corner Store Network "Heart Smarts" Program, Nyssa Entrekin, Sandra Sherman, Edd, Rickie Brawer, Mph, Phd, Mches, James D. Plumb, Md, Mph

College of Population Health Lectures, Presentations, Workshops

Objectives:

1. Identify corner stores for nutrition education and health screenings based on criteria presented.

2. Identify education strategies appropriate for a corner store setting when integrating health screenings, nutrition education and food access.

3. List at least two store owner training topics for use in a corner store setting that reinforce nutrition education and disease prevention in the store.

4. Understand methods for evaluating outcomes of an integrated educational effort.

Presented at APHA in Chicago, Illinois.

Purchase Of Loose Cigarettes By Adult Smokers In Philadelphia: Individual-Level Correlates And Neighborhood Characteristics, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background

• Philadelphia has the highest adult smoking rate1 and the highest rate of tobacco retailers2 among the 10 largest U.S. cities.

• Governmental reports have identified high rates of illegal sale of cigarettes in Philadelphia2.

• Studies have found that a main source of cigarette use in low income communities is single (loose) cigarettes purchased at tobacco retailers or from unregulated street vendors3,4.

• While studies have shown that loose cigarette use is a problem among urban youth who reside in disadvantaged neighborhoods, less research has been performed among adults on this topic5,6, and no studies focus on Philadelphia. …

Low-Income African American Women's Perceptions Of Primary Care Physician Weight Loss Counseling: A Positive Deviance Study, Elaine Seaton Banerjee, Md

Master of Public Health Capstone Presentations

The purpose of this study was to qualitatively and quantitatively evaluate the interactions between low-income, African American women who successfully lost weight and the healthcare system. This mixed methods study followed a positive deviance approach, identifying a population at high risk for obesity and then identifying positive deviants within this population. In this case, positive deviants were low-income, African American women who had been obese, and had successfully lost at least 10% of their weight and maintained this loss for at least six months. We collected data from electronic medical records (EMR) and participant surveys of both positive deviant cases, …

Whole Person Orientation In Primary Care: Understanding Priorities And Assessing Performance, Shannon Doyle

Master of Public Health Capstone Presentations

The purpose of this project was to use a participatory research methodology to develop a framework for understanding the concept of whole person orientation in primary care delivery. Whole person orientation is one of the seven Joint Principles of the Patient Centered Medical Home (PCMH) authored by the American Academy of Family Physicians in partnership with several other physician organizations. Although the PCMH model of primary care has been touted as part of the solution to the U.S. healthcare system’s cost and quality issues, there are few tools available to evaluate implementation of the essential components and none at all …

Identification And Linkage To Care Of Hcv-Infected Persons In Five Health Centers-Philadelphia, Pennsylvania, 2012-2014, Catelyn Coyle, Mph

JCPH Alumni

Approximately three million persons in the United States are infected with hepatitis C virus (HCV), a blood-borne pathogen that is an increasing cause of liver disease and mortality in the United States (1,2). Treatments for HCV are curative, of short duration, and have few associated side effects (3), increasing the importance of identifying HCV-infected persons. Many persons with HCV infection were infected decades ago, before implementation of prevention measures and most are unaware of their infection, regardless of when it occurred (4). Most newly diagnosed cases are associated with injection drug use (5). Persons born during 1945–1965 have a fivefold …

Experiential Global Health Education For The Health Professions: Lessons Learned From Experience-Based Learning For Students And Healthcare And Population Health Professionals, Rob Simmons, Drph, Mph, Mches, Cph, James Plumb, Md, Mph, Lucille Pilling, Edd, Mph, Rn, Ellen Plumb, Md

College of Population Health Lectures, Presentations, Workshops

Purpose:

• Describe key components of developing and sustaining a global health experiential learning experience

• Global Health Education for the Health Professions
• An area for multi-disciplinary study, research, and practice that places priority on achieving equity in health for all people worldwide
• Emphasizes transnational health issues, determinants, and solutions that promote interdisciplinary collaboration providing a synthesis of population based prevention, often including individual-level education and healthcare

Addressing Hispanic Adolescent Mental Health In The Texas Border Region: A Policy Analysis, Brian Zepka

Master of Public Health Capstone Presentations

Distinguished MPH Capstone Project 2015

The Texas border region experiences adverse cultural, socioeconomic, environmental, and political challenges that influence the mental health status of adolescents living along the border. The purpose of this research was to provide informed advice to relevant policy makers and facilitate decision-making concerning access to culturally competent mental health services for Hispanic adolescents in this region. A systematic literature review was performed to assess the evidence of barriers these adolescents face when accessing mental health services. Interviews with relevant key stakeholders in the region were then conducted to identify their perspectives on barriers to care. The …

Innovating At Jefferson: Developing The Patient-Centered Medical Home (Pcmh) Cost Tool, Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented at Jefferson School of Population Health Faculty Research Seminar.

Objectives:

Describe the cost-collection tool we created for the PCMH Model

Propose improvements to our tool in order to enhance the response rate

Determine our next steps in terms of research and innovation for PCMH at Jefferson

21 slides

Appendix: Expand Wikipedia Stub On Supplier - Induced Demand, Robert D. Lieberthal, Phd, Juan Leon, Phd

College of Population Health Faculty Papers

Appendix for article that has been accepted for Journal of Economic Education.

Abstract for article:

The authors describe a Wikipedia-based project designed for a graduate course introducing health economics to experienced healthcare professionals. The project allows such students to successfully write articles on niche topics in rapidly evolving health economics subspecialties. These students are given the opportunity to publish their completed projects in Wikipedia. Despite the lack of conventional classroom incentives, the authors have found that the students generally choose to enter their final projects intoWikipedia. The authors explore the motivators for this behavior from the perspective of human capital …

Adolescent Pregnancy In Ecuador, Paige Bates

CwiC-PH

Description of the Problem

• Teen pregnancy, commonly defined as pregnancy in a girl less than 18 or 19 years of age, is often a target of public health efforts because of the far-reaching economic, social and health effects.¹
  • A girl who becomes pregnant attends 2.5 less years of school, and each additional child translates into 1 less year of education.²
  • Girls who get pregnant before age 18 are more likely to experience violence within marriage or a partnership than girls who postpone child-bearing.¹
  • Babies born to adolescent mothers have a higher incidence of perinatal complications (like asphyxia …

An Interdisciplinary Approach To Combat Obesity In The Galapagos, Christopher Busack, Bethany Fox

CwiC-PH

Galapagos Background

• Total Population (2010) = 25,124¹
• Largest city = Puerto Ayora (Santa Cruz)
• Average monthly income in Galapagos = $772.03/month²
• Average monthly income in mainland Ecuador = $251.70/month²
• Booming tourism industry contributes to rapid population growth³

4 of 18 main islands (>1km²) open for human residence (Santa Cruz, Isabela, San Cristobal, Floreana)

Addiction: A Treatable Disease, Nathaniel Graham

CwiC-PH

Addiction: Definitions and Statistics

Nearly 1 in 7 Americans (~40 million people) are addicted to a chemical substance.

An additional 2 in 7 Americans (~80 million people) qualify as risky substance users; those who use chemical substances in ways that threaten their health and safety.

Regional Disparities In Neurocritical Care Outcomes, Kali Graham

CwiC-PH

BACKGROUND

• Determinants of Neurocritical Care Outcomes: Social as opposed to biological disparities can frequently dictate health outcomes for neurocritically ill patients. Survival rates are determined both by a patient’s access to a NCU (Neurocritical Care Unit) as well as the level of inpatient care he or she receive once admitted to a NCU.
• Regional Inequality in Access to Care¹:
• Only 12.8% of Americans have access to a NCU within 45 min by ground transportation and 36.8% have access to a NCU within 45 minutes by air transportation.
• Racial Disparities in NCU Admissions and Outcomes²:
• Non …

Underrepresented Minorities And Jefferson Medical System Healthcare: What Can We Do To Diversify The Physician Workforce?, David Halpen

CwiC-PH

Why Diversity?

• An increasingly diverse workforce leads to better levels of care.¹
• Underserved areas need better care and this is currently not being provided by Physicians from non URM backgrounds. ²
• Research shows that physicians from diverse backgrounds are more likely to return to service the communities of underrepresented minorities (URMs). ³
• There will be a decrease in overall healthcare disparities between different groups. ⁴

Care With Dignity: Understanding How To Care For Hiv Positive And Formerly Incarcerated Populations, Caroline Komanecky, Terry Trudeau, Med, James D. Plumb, Md, Mph, Helen Koenig, Md

CwiC-PH

Philadelphia FIGHT is a comprehensive HIV/AIDS service organization providing primary care, consumer education, advocacy, and research on potential treatments and vaccines. FIGHT was formed as a partnership of individuals living with HIV/AIDS and clinicians, who joined together to improve the lives of people living with the disease. Today, FIGHT serves an even broader patient population and recently received designation as a Federally Qualified Health Center. FIGHT strives to address not only HIV-infected patients, but all at-risk populations through education, outreach, and preventative medicine. The annual Bridging the Gaps interns are responsible for several projects, including a client satisfaction survey, a …

Lgbt Healthcare And Our Role In Smoking Cessation, Leor Krichilsky, John Covotta, Valerie Canavin, Rickie Brawer, Mph, Phd, Robert Winn, Md, Ms, Aahivs

CwiC-PH

Mazzoni’s goal is comprehensive LGBT care

The interns learned the value of comprehensive care through observing roles of the nurses, transgender intake counselor, case managers, and physicians. Mazzoni’s multi-disciplinary model allows patients’ various needs to be met directly.

The interns also learned the importance of LGBT care through discussions about use of unisex bathrooms, preferred pronouns, and inclusive language. This is demonstrated by Mazzoni’s new patient forms.

Universal Healthcare: Costa Rica As A Model, Annie J. Ferris

CwiC-PH

What it Looks Like in Costa Rica

• Run by the Costa Rican Social Security Administration
• Financed by employers, employees, and the Ministry of Health. Employer and employee contributions together make up over 90% of contributions.
• Costa Rica is divided into 105 health areas, which are further divided up into primary care units called Basic Provision Units of Integrated Healthcare, or EBAIS. There are 947 of these primary care centers throughout Costa Rica, and everyone is assigned to one.
• The EBAIS clinics provide a wide range of services to cover the general and specific health needs of the community, including primary …

Health Care In Bolivia: A First Hand Experience, Sanchi Malhotra

CwiC-PH

This research project is based on a one month work experience in Cochabamba, Boliva through the NGO Sustainable Bolivia at Hosptial Viedma, a major public hospital and Centre de Salud Pacata, a rural outpatient health clinic. The information presented below is derived from both research and personal experience. This trip was partially funded by Jefferson Office of International Affairs with the goal of gaining experience and knowledge about the Bolivian health care system.

Establishing Roots In West Philadelphia, Nina Millman, James Larosa, Skip Weiner, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Urban Tree Connection

Urban Tree Connection is an organization that utilizes plots of land which have been abandoned. The organization uses the land to create gardens that grow produce which is then sold at markets and to the community. Their goal is to provide access to fresh fruits and vegetables in the food desert areas of West Philadelphia. Members of the community are able to get involved by allowing some of their land to be used as gardens and helping to maintain the sites. The organization also tries to spread information about sustainability including a compost program in the neighborhood.