Public Health Commons^™

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience: Master of Public Health

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

What Are The Most Important Dimensions Of Quality For Addiction And Mental Health Services From The Perspective Of Its Users?, Priscilla Liu, Shawn Currie, Jassandre Adamyk-Simpson

Patient Experience Journal

There is a need to better engage service users in improving their experience with the care received in Addiction and Mental Health (A&MH). Dimensions of patient experience that are most salient to A&MH service users still remain to be properly defined from the patient perspective. This research focuses on identifying key domains of service experience important to patients of Addiction and Mental Health using patient focus groups. In addition, through a patient and family advisory committee, patients were also engaged as co-partners of the research team. The patient advisors had a major role in overseeing the research project, assisting with …

Exploring Workforce Confidence And Patient Experiences: A Quantitative Analysis, Katie M. Owens, Stephanie Keller

Patient Experience Journal

Confidence is recognized as one of the most influential factors to affect performance. Individual, leader, and team confidence play essential roles in achieving success and the absence of confidence has been connected with failure. While confidence is not a substitute for competency, it creates trusting relationships, empowerment, and resiliency to persevere when challenges arise. Objective: In this study, we examined workforce confidence in the patient experience and patient perceptions of their experience of care. Methods: We compared responses to the Patient-Centered Excellence Survey (PCES) from 41 United States hospitals, measuring workforce confidence in the patient experience provided, to patient’s ratings …

Nursing Transfer Of Accountability At The Bedside: Partnering With Patients To Pilot A New Initiative In Ontario Community Hospitals, Kristina Ba Miller, Aden Hamza, Kateryna Metersky, Dianne M. Gaffney

Patient Experience Journal

The transfer of accountability (TOA) for a patient from one nurse to another at change of shift is an important opportunity to exchange essential patient care information, as well as to enhance the safety and quality of patient care. This study was undertaken to explore nurses’, patients’ and family members’ perceptions associated with the implementation of bedside nurse to nurse TOA. Focus groups were conducted pre-implementation (two with nurses and two with patients and family members) and post-implementation (six with nurses and two with patients and family members). The focus groups were audio-recorded, transcribed and analysed using directed content analysis. …

Family-Centered Caregiving From Hospital To Home: Coping With Trauma And Building Capacity With The Hope For Families Model, Anna Newcomb, L Gordon Moore, Holly C. Matto

Patient Experience Journal

Informal caregivers and families play a significant role in the recovery process of trauma survivors. However, the needs and outcomes of orthopedic caregiving family members in the months following traumatic injury have received almost no attention in the literature. Our study sought to understand the factors impacting orthopedic trauma families’ experience and their ability to cope and provide care post-acute hospitalization. Based on these findings, we designed a hospital-based program to enhance family coping and adjustment post-discharge. Caregivers (N=12) of patients with orthopedic trauma injury engaged in three in-depth semi-structured face-to-face interviews to identify their most salient concerns. Once home, …

How Patients View Their Contribution As Partners In The Enhancement Of Patient Safety In Clinical Care, Marie-Pascale Pomey, Nathalie Clavel, Ursulla Aho-Glele, Noemie Ferré, Paloma Fernandez-Mcauley

Patient Experience Journal

Despite the call from the World Health Organization for more active involvement from patients in the prevention of health care-related risks, there is still insufficient evidence about how patients can be more proactive in the safety of their own care. This study helps understand the perspective of patients as partners regarding their roles, as well as their relatively untapped potential in detecting and limiting adverse events (AEs) for patient safety. 17 patients-as-partners were interviewed on five themes: 1) Behavior of patients/relatives for avoiding AEs; 2) Competencies sought in patients/relatives to play an active role in patient safety; 3) Factors limiting …

The Sherpa Meets Maslow: Medicine And The Hierarchy Of Needs, Rana Lee Adawi Awdish Md Fccp

Patient Experience Journal

A critical care physician returning to medicine after her own critical illness experiences a crisis of orientation. She finds she can no longer serve as the Voice of Medicine. She replaces the former construct with a more humble model, in which the physician serves as an intermediary. She equates this new role to that of the Sherpas of Nepal. Maslow’s hierarchy of needs forms the mountain, as she reimagines her role in her patients’ lives.

The Consumer Has Spoken: Patient Experience Is Now Healthcare’S Core Differentiator, Jason A. Wolf Phd

Patient Experience Journal

In just a few days we will celebrate Patient Experience Journal’s (PXJ) 4^th anniversary since our inaugural publication. In these 4 short and quick years we have seen 163 articles published in our first four volumes that have stirred a significant focus on building the evidence base in patient experience. Not only has PXJ served as the central clearing house for thoughtful research, measurable cases, and insightful narratives, but it also has reinforced the breadth and depth of what patient experience truly encompasses. This integrated view was reinforced by the very voices of healthcare’s consumers in The Beryl Institute’s …

Inventing Pollution : Coal, Smoke, And Culture In Britain Since 1800, Peter Thorsheim

Ohio University Press Open Access Books

Going as far back as the thirteenth century, Britons mined and burned coal. Britain’s supremacy in the nineteenth century depended in large part on its vast deposits of coal, which powered industry, warmed homes, and cooked food. As coal consumption skyrocketed, the air in Britain’s cities and towns filled with ever-greater and denser clouds of smoke. Yet, for much of the nineteenth century, few people in Britain even considered coal smoke to be pollution.

Inventing Pollution examines the radically new understanding of pollution that emerged in the late nineteenth century, one that centered not on organic decay but on coal …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Surveying Access To Healthcare In Kisumu And Siaya Counties, Kenya, Quinn Alsheimer

Independent Study Project (ISP) Collection

This study aims to understand the barriers that many Kenyans face towards accessing healthcare. This study was conducted in Kisumu and Siaya Counties, Kenya. Kisumu is an urban environment, whereas Siaya is a rural environment. Throughout both counties, areas with presumably low access to healthcare were surveyed. In Kisumu County, surveys were conducted in three informal settlements: Nyalenda, Obunga, and Manyatta. In Siaya County, surveys were conducted in Simenya Village.

This study has shown that financial accessibility is a large barrier to healthcare throughout the study population, as the majority of study participants felt that healthcare in Kenya is not …

The Trans Pacific Partnership Agreement, Intellectual Property And Medicines: Differential Outcomes For Developed And Developing Countries, Deborah Gleeson, Joel Lexchin, Ruth Lopert, Burcu Kilic

Health Policy and Management Faculty Publications

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP …

Direct Care Nursing Aide Turnover In Long-Term Care Facility, Qilian Luo

Muskie School Capstones and Dissertations

This capstone project, Direct Care Nursing Aide Retention in a Long-Term Care Facility, will uses both qualitative and quantitative analyses to identify the possible contributors to high nursing aide turnover rates in Maine. The quantitative analyses of this project are based on the staffing payroll data of one Maine assisted living facility. The final product of this capstone project will be shared with the study facility, in the hope that they may find uses for its content.

Healthcare Coverage In The United States And New York Metropolitan Area, 2009 - 2015, Andrew S. Alger

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines trends regarding health insurance coverage in the United States along lines of sex, race/ethnicity, place of birth, and poverty status between 2009 and 2015.

Methods: This study uses the American Community Survey PUMS (Public User Microdata Series) for the years 2009, 2011, 2013, and 2015. These datasets were downloaded from the IPUMS USA website hosted by the University of Minnesota. The variables used in the study describe these populations in terms of sex, the four major race/ethnic groups (non-Hispanic white, non-Hispanic black, Latino, and Asian), being born either within the United States or abroad, and being …

Participatory Development And Menstrual Health Management In South Africa: A Case Study Of Project Dignity, Natalie Geismar

Independent Study Project (ISP) Collection

Menstrual health management (MHM) poses a significant public health concern in many South African communities. Though the national government is beginning to devote attention and resources to MHM, civil society organizations play a critical role in providing menstrual health products and education to female-bodied individuals who may otherwise lack access. This study examines the praxis and impact of Project Dignity, a nongovernmental organization which distributes washable, reusable sanitary pads and panties to students in public schools. The researcher collected qualitative data through participant observation as well as interviews and focus group discussions with Project Dignity’s staff and intended beneficiaries. Using …

Adoption Process For The Model Aquatic Health Code: An Example, William D. Ramos, Allison L. Fletcher, Mike Mettler, Marcus A. Yoder

International Journal of Aquatic Research and Education

In 2014 the U.S. Centers for Disease Control and Prevention (CDC) published the first edition of the Model Aquatic Health Code (MAHC). This document represented the inaugural introduction of a federal policy guideline with a direct focus in the area of aquatic venue operation and maintenance with the sole purpose of improving the nature of public health in the field. The Indiana State Department of Health (ISDH) began the review and adoption process soon after the policy’s release. The ISDH process is proposed as one method for others to consider. The background and history of the MAHC are presented in …

Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd

Long Term Services and Supports

The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.

This study used Medicare Current …

Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger

Public Health Faculty Publications

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety as important. …

Antenatal Care Provider And Cesarean Section In Urban Areas In Indonesia, Terry Yuliana Rahadian Pristya, Milla Herdayati, Besral Besral, Dheni Fidyah Fika

Kesmas

Tren persalinan sesar di Indonesia (2007-2012) mengalami peningkatan dua kali lipat berisiko pada munculnya masalah kesehatan jangka panjang maupun pendek. Penelitian ini bertujuan mengetahui hubungan tenaga kesehatan pemeriksa kehamilan dengan persalinan sesar. Penelitian kuantitatif ini menggunakan desain potong lintang dengan sampel penelitian 5143 wanita usia subur berusia 15-49 tahun yang melahirkan anak terakhirnya, baik melahirkan sesar maupun tidak di wilayah perkotaan yang terpilih dalam sampel Survei Demografi Kesehatan Indonesia tahun 2012. Analisis multivariat regresi logistik digunakan untuk mengetahui hubungan tenaga pemeriksa kehamilan dengan persalinan sesar, dikontrol oleh usia ibu, tempat periksa kehamilan, paritas, dan tempat melahirkan. Hasil penelitian menunjukkan bahwa …

Early Inititation Of Breastfeeding And Vitamin A Supplementation With Nutritional Status Of Children Aged 6-59 Months, Betty Yosephin Simanjuntak, Miratul Haya, Desri Suryani, Che An Ahmad

Kesmas

Masa balita, khususnya dua tahun pertama kehidupan merupakan usia emas bagi anak karena pertumbuhan dan perkembangannya yang cepat. Oleh karena itu, terjadinya gangguan nutrisi pada masa itu bisa bersifat permanen dan tidak dapat diubah. Penelitian ini mengkaji hubungan antara inisiasi dini pemberian air susu ibu dan vitamin A dengan status gizi. Total sampel yang dianalisis dalam penelitian ini adalah 1.592 anak di bawah lima tahun (balita) berusia 6-59 bulan yang diambil dari Pemantauan Status Gizi Indonesia 2015 di Bengkulu. Data termasuk usia, jenis kelamin, inisiasi menyusui dini, panjang kelahiran, berat lahir, suplementasi vitamin Adikumpulkan dengan menggunakan kuesioner. Berat dan tinggi …

Family Support As A Factor Influencing The Provision Of Exclusive Breastfeeding Among Adolescent Mothers In Bantul, Yogyakarta, Maulida Lailatussu’Da, Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa

Kesmas

Kehamilan remaja di Indonesia cukup tinggi. Kecamatan Sewon memiliki angka persalinan remaja tertinggi di Kabupaten Bantul pada tahun 2015-2016. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi pemberian ASI eksklusif pada ibu usia remaja di Kecamatan Sewon, Kabupaten Bantul. Penelitian ini menggunakan desain potong lintang dan sampel penelitian berjumlah 45 orang ibu usia remaja yang mempunyai bayi usia 6-24 bulan. Pengumpulan data menggunakan kuesioner terstruktur. Analisis bivariat menggunakan kai kuadrat dan fisher’s exact test, sedangkan analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa 53.3% ibu usia remaja tidak memberikan ASI eksklusif. Analisis bivariat menunjukkan faktor status kehamilan (nilai p …

Effect Of Nutrition Counseling Knowledge And Attitude Toward Mother Breastfeeding And Baby Growth In Sub Lubuk Pakam, Herta Masthalina, Zein Agustina

Kesmas

Untuk dapat menjalankan program ASI eksklusif, ibu menyusui harus memiliki pengetahuan yang baik. Salah satu cara dalam menambah pengetahuan yaitu dengan memberikan konseling gizi. Penelitian ini bertujuan untuk mengetahui pengaruh konseling gizi tentang ASI eksklusif dan status gizi terhadap pengetahuan dan sikap ibu menyusui di wilayah Puskesmas Kecamatan Lubuk Pakam. Jenis penelitian ini adalah quasi experimental non-equivalent control group design. Sampel sejumlah 60 ibu dibagi ke dalam dua kelompok, yaitu 30 ibu yang diberikan konseling gizi intensif pada kelompok intervensi di wilayah kerja Puskesmas Lubuk Pakam dan 30 ibu pada kelompok kontrol di wilayah kerja Puskesmas Tanjung Morawa. Kelompok perlakuan …

The Effect Of Health Insurance On Institutional Delivery In Indonesia, Mazda Novi Mukhlisa, Pujiyanto Pujiyanto

Kesmas

Pemanfaatan pelayanan persalinan di fasilitas kesehatan berdampak pada menurunnya angka kematian ibu (AKI). Di Indonesia, persalinan di fasilitas kesehatan mengalami peningkatan setiap tahunnya, tetapi masih terdapat sekitar 30% ibu yang bersalin di rumah. Sayangnya, peningkatan pemanfaatan pelayanan persalinan di fasilitas kesehatan tersebut tidak diimbangi dengan penurunan AKI, sehingga Indonesia tidak berhasil mencapai target MDGs. Untuk mencapai Universal Health Coverage, Indonesia mengimplementasikan program Jaminan Kesehatan Nasional (JKN) yang mengintegrasikan empat jaminan kesehatan, yaitu Askes/ASABRI, Jamsostek, Jamkesmas, dan Jamkesda. Jaminan kesehatan dapat mengatasi kendala biaya pada persalinan di fasilitas kesehatan. Dengan menggunakan data Riset Kesehatan Dasar 2013 dan data Potensi Desa 2011 …

Risk Of Adolescent Pregnancy Toward Maternal And Infant Health, Analisis Of Idhs 2012, Anni Fithriyatul Mas'udah, Besral Besral, Bimandra Adiputra Djaafara

Kesmas

Dampak kehamilan pada remaja erat kaitannya dengan risiko kesehatan ibu dan bayi. Penelitian ini bertujuan untuk mengembangkan komposit indeks kesehatan ibu, indeks kesehatan bayi dan untuk menelaah pengaruh kehamilan remaja terhadap kesehatan ibu dan bayi. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012, dengan sampel 2.167 responden yang memenuhi syarat inklusi (wanita usia subur yang pernah melahirkan anak pertama sejak Januari 2007 sampai survei dilaksanakan). Analisis menggunakan Polychoric Principal Component Analysis untuk menentukan komposit indeks kesehatan ibu dan bayi, serta regresi logistik untuk mengetahui besar hubungan kehamilan remaja terhadap kesehatan ibu dan bayi. Kesehatan ibu dapat ditentukan melalui …

Exclusive Breastfeeding Intention Among Pregnant Women, Tria Astika Endah Permatasari, Ratu Ayu Dewi Sartika, Endang Laksminingsih Achadi, Urip Purwono, Anies Irawati, Dwiana Ocviyanti, Evi Martha

Kesmas

Intensi pemberian ASI eksklusif adalah intensi ibu untuk memberikan hanya ASI pada bayinya sejak dilahirkan hingga berusia enam bulan. Intensi pada periode prenatal merupakan penentu langsung pemberian ASI eksklusif. Penelitian ini bertujuan mengetahui faktor paling dominan berhubungan dengan intensi pemberian ASI eksklusif pada ibu hamil di sebuah rumah sakit ibu dan anak di Kota Tangerang Selatan. Penelitian dengan desain studi potong lintang dilakukan secara primer. Sampel berjumlah 143 ibu hamil trimester ketiga dipilih secara purposive sampling. Intensi pemberian ASI eksklusif diukur menggunakan kuesioner the Infant Feeding Intentions scale. Sedangkan sikap, norma subjektif dan persepsi kontrol perilaku dinilai menggunakan modifikasi kuesioner …

Policy Determinants Of Physical Activity Across The Life Course: A Dedipac' Umbrella Systematic Literature Review, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Angela Carlin, Simon Chantal, Donatella Ciarapica, Giancarlo Condello, Tara Coppinger, Cristina Cortis, Sara D'Haese, Marieke De Craemer, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Lina Jaeschke, Martina Kanning, Aileen Kennedy, Fiona Chun Man Ling, Agnes Luzak, Giorgio Napolitano, Julie Anne Nazare, Camille Perchoux, Tobias Pischon, Angela Polito, Alessandra Sannella, Holger Schulz, Rhoda Sohun, Astrid Steinbrecher

Publications

Background Despite the large number of studies and reviews available, the evidence regarding the policy determinants of physical activity (PA) is inconclusive. This umbrella systematic literature review (SLR) summarizes the current evidence on the policy determinants of PA across the life course, by pooling the results of the available SLRs and meta-analyses (MAs). Methods A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus and SPORTDiscus databases up to April 2016. SLRs and MAs of observational studies investigating the association between policy determinants of PA and having PA as outcome were considered eligible. The extracted data were …

The Role Of Rural Hospitals In Addressing Opioid And Other Substance Use Problems, John A. Gale Ms

Mental Health / Substance Use Disorders

Webinar presentation to the Small Rural Hospital Transition project addressing issues of rural opioid and other substance use issues, focusing on the role of rural hospitals, and the importance of community engagement. Component parts of an effective opioid/substance use system of care include prevention, treatment, and recovery. Models must be adapted to the geographic, resource, and cultural realities of rural areas. Examples of strategies are provided.

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Relative Roles Of Race Versus Socioeconomic Position In Studies Of Health Inequalities: A Matter Of Interpretation, Amani Nuru-Jeter, Elizabeth Michaels, Marilyn D. Thomas, Alexis Reeves, Roland Thorpe, Thomas A. Laveist

Health Policy and Management Faculty Publications

An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States. However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry. Additionally, there is wide variability in how SEP is conceptualized and measured, resulting in a lack of comparability across studies and significant misclassification of risk. The objectives of this review are to synthesize the literature regarding common …

Gun Violence: Chicago, Illinois, Kayla Dillon

Global Issues in Public Health

Gun violence has been, and continues to be, a significant problem in Chicago, Illinois. There have been several programs in place that have worked towards improving the level of gun violence. One of the most noticeable being Project Safe Neighborhood, which began in 2001. Part of what makes these programs, and programs similar to it, necessary is that it targets the populations most at-risk of gun violence. By targeting these specific regions of the city, these programs can provide the resources necessary to improve the condition of the city in the long-term, as well as prevent the condition from spreading …