Public Health Commons^™

Childhood Obesity And Its Relationship To Sedentary Behavior Patterns Vs. Other Independent Risk Factors Of Obesity Among Navy Dependent Adolescents, Shaye Lauren Arluk

Human Movement Studies & Special Education Theses & Dissertations

Background According to data gathered in the NHANES 1999 survey 14% of American children are now classified as obese, a 60% increase in prevalence from the NHANES II survey in 1976. Multiple research studies have looked at the role of dietary intake, heredity, and physical activity participation as independent risk factors of obesity with mixed results. However, sedentary behavior patterns, which have markedly increased in the past ten years, have not been extensively studied in relation to childhood obesity. The goal of this study was to focus on the relationship between various sedentary behaviors and childhood obesity.

Methods Two descriptive …

Welfare Reform And The Well-Being Of Families: Successes To Date And Challenges Ahead, Jane Koppelman

National Health Policy Forum

This issue brief discusses a key issue in evaluating the 1996 Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA): the status of families after the implementation of this landmark welfare reform program. The new block grant program to states to administer the Temporary Assistance to Needy Families(TANF) program has been extremely effective when measured by lower welfare rolls and higher work rates and earnings for recipients. However, an equally important dimension described by the paper is what is known about longer-term effects and the status of people who have left welfare, with special emphasis on how children have …

Welfare Reform And Substance Abuse: Innovative State Strategies, Ginger P. Parra

National Health Policy Forum

This issue brief highlights key facts about the impact of substance abuse on welfare reform and recipients of Temporary Assistance to Needy Families, or TANF. After outlining some of the data on the incidence of substance abuse as well as its costs and treatment, it concludes by describing innovative state welfare programs attempting to lower barriers to employment and self-sufficiency.

A Peculiar Logic Of Pro-Abortion Advocacy, Ibpp Editor

International Bulletin of Political Psychology

This article identifies a weakness in pro-abortion advocacy and how this weakness can be resolved to support said advocacy.

Evidence For The Importance Of Community Involvement: Implications For Initiatives To Prevent Mother-To-Child Transmission Of Hiv, Ann Leonard, Purnima Mane, Naomi Rutenberg

HIV and AIDS

This paper offers lessons learned from a literature review of community involvement in biomedical and other technologies that can guide appropriate and effective introduction of services for prevention of mother-to-child transmission of HIV. A companion paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about barriers to using voluntary counseling and testing services; stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission …

Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade

HIV and AIDS

Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. …

Women, Communities, And The Prevention Of Mother-To-Child Transmission Of Hiv: Issues And Findings From Community Research In Botswana And Zambia, Laura Nyblade, Mary Lyn Field-Nguer

HIV and AIDS

This paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about the barriers to using voluntary counseling and testing services; the stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission of HIV. A separate Population Council publication (“Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations”) offers recommendations for community involvement strategies that will encourage program planners to …

Trends In Indian Health 1998-99, Division Of Program Statistics, Staff Office Of Planning, Evaluation And Research, Indian Health Service.

Native Health Database Full Text

The IHS Trends in Indian Health attempts to fulfill the basic statistical information requirements of parties that are interested in the IHS. The tables and charts contained in the IHS Trends in Indian Health describe the IHS program and the health status of American Indians and Alaska Natives residing in the IHS service area.

2000 Navajo Middle School Youth Risk Behavior Survey, Navajo Area Indian Health Service

Native Health Database Full Text

The Navajo Area Indian Health Service, Health Promotion Program administered a modified version of the New Mexico 2000 Middle School Youth Risk Behavior Survey in April, 2000. The survey was developed to monitor priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems, among youth and adults in the United States. These behaviors fall into six categories: (1) behvaiors that result in unintentional and intentional injuries, (2) tobacco use, (3) alcohol and other drug use, (4) sexual behaviors that result in HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancies, (5) dietary behaviors, and …

Client Preferences And Acceptability For Medical Abortion And Mva As Early Pregnancy Termination Method In Northwest Ethiopia, Mulatu A. Woldetsadik, Tegbar Y. Sendekie, Mary T. White, Desaleng T. Zegeye

Population and Public Health Sciences Faculty Publications

Background

Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services.

Methods

A prospective …

Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …

Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health

Reproductive Health

To support the Government of Ghana’s plan to expand community-based distribution (CBD) programs, the Planned Parenthood Association of Ghana (PPAG) and the Population Council conducted a study in 1999 of the CBD programs of 13 nongovernmental agencies. The study also assessed in depth PPAG’s CBD program, which is the country’s largest and oldest. Data sources included interviews with 301 CBD agents, 27 supervisors, and 20 clinicians in rural and urban areas in 16 districts; observations of 51 PPAG agents interacting with 6 clients each; and 15 focus group discussions with community members, former CBD agents, and CBD clients. CBD programs …

Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …

South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health

Reproductive Health

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, …

History, Culture And Alcohol: Drinking Patterns In Poland And Australia, Barbara Wolska

Theses: Doctorates and Masters

It is a widely held view in Poland that for centuries those in power have promoted heavy drinking among their subjects in order to achieve their various goals and that this contributed to the development of Polish drinking patterns. There is some empirical evidence that the political economy of alcohol in Poland promoted heavy drinking among the Polish population. Drinking alcohol in Poland was an important aspect of social situations. The most popular beverage was vodka(s). Social pressure to drink in the extreme was attributed to the tradition of hospitality. Cultural norms encouraged very heavy drinking among men and imposed …

The Federal-State Medicaid Match: An Ongoing Tug-Of-War Over Practice And Policy, Karen Matherlee

National Health Policy Forum

Reviewing Medicaid match issues since the latter 1980s, this issue brief traces ways in which some states have used creative financing to get more Medicaid matching dollars than they otherwise would qualify for from the federal government. It explores the latest mechanism, states' use of so-called intergovernmental transfers of funds (to avoid established upper payment limits) to increase their matches, triggering efforts by the Senate Finance Committee and the federal Medicaid agency to ban such transfers.

An Analysis Of Risk Factors Associated With High Rates Of Cesarean Births In Three Selected Northeast Tennessee Hospitals., Karen Stewart-Hall

Electronic Theses and Dissertations

This study consists of an analysis of hospital discharge data from three Northeast Tennessee hospitals to identify maternal demographic factors that may be linked to higher rates of cesarean sections in this region of Appalachia. Maternal age, race, insurance status, length of stay, and birth weight were evaluated to identify regional trends in the prevalence of these factors over a two-year period.

There were 1,678 (23.3%) singleton live births by cesarean section of which 7.6% were repeat cesarean section deliveries. Less than one percent of the 7,181 births were vaginal births after cesarean (VBAC) delivery. Overall, insurance and maternal age …

Caring For The Elderly: Oregon's Pioneers (Portland, Oregon), Nora Super, Lisa Sprague

National Health Policy Forum

This site visit looked at the continuum of care for its elderly and disabled citizens in the first state ever to secure Section 1915(c) and (d) waivers under Medicaid to support home- and community-based services. More than three-quarters of Oregon's Medicaid clients now receive care in these settings. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed strategies and partnerships focused on alleviating workforce shortages and highlighted Oregon nurses' authority to delegate certain caregiving tasks to laypeople. Multnomah County staff described county-level activities, especially …

Emerging Issues In The Use Of Binding Arbitration To Resolve Disputes Between Individuals And Health Plans, Karl Polzer

National Health Policy Forum

After briefly describing the federal legal framework fostering the growth of binding arbitration, this paper identifies controversies surrounding arbitration as well as arguments supporting and opposing its use. The paper describes the use of arbitration among certain types of collectively bargained employee health plans regulated under the Employee Retirement Income Security Act of 1974 (ERISA), by health maintenance organizations (HMOs) in California, and by a large employer operating a self-insured ERISA health plan. Evidence cited by the California Supreme Court that the largest HMO in California operated its mandatory arbitration program in an unfair way is presented, along with the …

Schip In The Formative Years: An Update, Judith D. Moore

National Health Policy Forum

This issue brief examines the status of the State Children's Health Insurance Program (SCHIP) three years after authorizing legislation was enacted. Topics addressed include enrollment and retention of children in new programs, funding allotments and expenditures, evaluation activities planned and underway, the interaction of Medicaid and SCHIP, and problems common across many states.

Medicare+Choice: Where To From Here?, Nora Super

National Health Policy Forum

This issue brief examines Medicare+Choice (M+C) plan participation, benefit coverage, and enrollment and the factors that have contributed to plans' decisions to participate in or withdraw from certain markets. In addition, the issue brief explores what has been happening to M+C enrollees in terms of costs, benefits, and continuity of care. Lastly, the issue brief examines the reasons that alternative plan options — such as preferred provider organizations (PPOs) and provider-sponsored organizations (PSOs) — have not taken hold. Legislative proposals that might affect the future of M+C are also discussed.

Readiness For Health Promotion, Colleen Murphy-Southwick Ph.D., Tom Seekins Ph.D., University Of Montana Rural Institute Rural Institute

Health and Wellness

There is growing interest in health promotion, wellness, and the prevention of secondary conditions among people with disabilities. In rural areas where there is limited access to health care providers knowledgeable about disability, managing one’s own health and wellness and using strategies to prevent secondary conditions may be particularly important (Offner, Seekins & Clark, 1992; Seekins, 1992; Center for Disability Policy and Research, 1995; Seekins, Clay & Ravesloot, 1994; Seekins, et al., 1999).

Community-Based Nursing Education At The Campsite, M. Susan Jones, Donna Bussey, Carrie Morgan

Nursing Faculty Publications

No abstract provided.

The Asthma Epidemic: Prospects For Controlling An Escalating Public Health Crisis, Richard Hegner

National Health Policy Forum

This background paper examines the dimensions of the recent asthma epidemic and what could be done to contain it. Information about the prevalence and consequences of asthma across demographic groups is presented. Factors that impede the control of asthma are also identified. The paper also examines the possible causes of asthma and the asthma epidemic as well as new theories about the relationship of asthma to overall advances in health care and economic development. It also discusses the economic implications of asthma and possible cost avoidances linked to better asthma management. The paper concludes with discussions of asthma and public …

Insuring Virginia's Children: Local Outreach And Enrollment (Northern Virginia), Lisa Sprague, Judith D. Moore

National Health Policy Forum

This one-day visit to a nearby jurisdiction was designed to allow participation by federal staff who have been unable to commit the three days required by a typical Forum site visit. Site visitors were given an overview of health care in Virginia and an introduction to the Children's Medical Income Security Program (CMSIP) as well as its proposed replacement, the Family Access to Medical Insurance Security program (FAMIS). A panel representing community organizations and providers shared their experience, touching on provider concerns, coordination of outreach efforts across counties, and assistance for clients after they are enrolled. The group visited the …

Outpatient Commitment In Mental Health: Is Coercion The Price Of Community Services?, Coimbra Sirica

National Health Policy Forum

This paper reviews the debate over civil commitment to outpatient settings of people with mental illness who are considered too ill and/or too dangerous to be left on their own in their communities. The choices of two states — Maryland and New York — in dealing with this issue are reviewed. Alternative ways of drawing people into treatment and keeping them there are also discussed.

Hcfa's Outpatient Pps: Finally Ready To Roll?, Karen Matherlee

National Health Policy Forum

This issue brief centers on hospital outpatient department services, scheduled to be on a prospective payment system (PPS) July 1, 2000, 17 years after enactment of legislation mandating PPS for hospital inpatient services. It looks at the challenges to providers and patients, including coding and other process issues, redistribution of payments, and changes in beneficiary co-payments.

Using Schip To Subsidize Employment-Based Coverage: How Far Can This Strategy Go?, Karl Polzer

National Health Policy Forum

This background paper examines and analyzes early efforts by states to subsidize employment-based health insurance under the State Children's Health Insurance Program (SCHIP), which offers states a more generous funding rate than under Medicaid. As the Health Care Financing Administration prepares to issue regulations governing SCHIP, the paper summarizes complaints by state officials that federal rules governing how job-based coverage might be subsidized under the program are overly complex and rigid. After interviewing officials at the federal level and in six states as well as a variety of researchers and policy experts, the author considered whether and to what extent …

Pharmaceutical Marketplace Dynamics, Robin J. Strongin

National Health Policy Forum

This issue brief provides a profile of the pharmaceutical industry and explores topics such as competition, generics, intellectual property, research and development, pricing, and distribution. It also discusses government programs such as the Department of Veterans' Affairs federal supply schedule and Medicaid rebates.

Trends. Controlling Aids Through Control, Ibpp Editor

International Bulletin of Political Psychology

This article discusses the concept of political control and public health in the context of the HIV/AIDS epidemic.