Public Health Commons^™

Development And Validation Of A Simple Convenience Store Shelf Audit, Tanya M. Horacek, Elif Dede Yildrim, Erin Kelly, Adrienne A. White, Karla P. Shelnutt, Kristin Riggsbee, Melissa D. Olfert, Jesse Stabile Morrell, Anne E. Mathews, Terezie T. Mosby, Tandalayo Kidd, Kendra Kattelmann, Geoffrey Greene, Lisa Franzen-Castle, Sarah Colby, Carol Bryd- Bredbenner, Onikia Brown

Faculty & Staff Scholarship

Background This paper describes the development, reliability, and convergent validity of a practical tool—the Convenience Store Supportive Healthy Environment for Life-Promoting Food (SHELF) Audit. Methods Audit items included: a variety of fresh, processed, and frozen fruits and vegetables; low-fat dairy products; healthy staples and frozen meals; healthy food incentive programs; items sold in check-out areas; portion/cup sizes; and pricing. Each audit item was scored using a five-point semantic-differential scale (1 = provides little or no support for healthful foods to 5 = provides high support for healthful foods). Convergent validity was examined by comparing the SHELF audit to Ghirardelli et …

Graduate Admissions Recruitment Project, Kevin Anderson, Chiemela Dike, Yixin Du, Arvinder Kaur, Amanda Popp, Huizhong Yang

School of Professional Studies

In this project, several comparison schools were interviewed and disclosed to have used search lists to find candidates. The organizations that have valuable search lists which may be of good use for the School of Professional Studies include Educational Testing Service (ETS) and the Graduate Management Admission Council (GMAC). By choosing criteria such as demographics, location, academic performance, educational history provided by search lists, we believe there are many quality candidates for SPS programs. However, as we further investigated the functionality and cost-efficiency or return of investment of GRE search list, we spotted many uncertainties and few solid and successful …

Worcester Center For Crafts: A Transition To Online Sales, Monica Gow, Carly Branconnier, Srilatha Prodduturi, Ekaterina Shusharina, Alberta Yamoah

School of Professional Studies

The Clark University School of Professional Studies created a capstone team consisting of Monica Gow, Carly Branconnier, Iana Matkovskaia, Srilatha Prodduturi, Ekaterina Shusharina, and Alberta Yamoah to assist Worcester Center for Crafts (WCC) with the launch of their new online store. Worcester Center for Crafts wanted to showcase their beautiful American handmade crafts on an online platform, Shopify, in order to increase their sales and expand their market reach. The capstone team created a charter that outlined the scope of the project and what the team would deliver to WCC by the end of the project. The team agreed to …

Audubon Data Project Final Report, Askhat Beygenov, Valinur Kutlambetov, Shrikant Patel, Phoebe Roberts, Ulfat Sayyed, Shriram Sivaraman

School of Professional Studies

The Audubon Data Project was initiated as a Clark University Capstone project. The project’s client, Mass Audubon’s Shaping the Future of Your Community program, had identified a need to improve their data management methods and make better use of their data. The Capstone team, composed of Clark University graduate students, met with the client regularly to review the current state of the data and potential improvements to be made. The process began with a data review. During the review we worked with the client to explicitly define the purposes and requirements of the data, the current process for updating and …

Strategies To Combat Opioid Use In Rural Communities, John A. Gale Ms

Mental Health / Substance Use Disorders

Webinar presentation discussing

• Opioid use across rural settings
• Drivers of rural opioid use
• Burden of opioid use in rural communities
• Evidence-based prevention, treatment, and recovery strategies to address rural opioid use

Namibia Has A Strong Foundation For Implementing The Treat All Guidelines And Reaching The Unaids 90-90-90 Targets, Project Soar

HIV and AIDS

In late 2015, the World Health Organization announced new treatment guidelines recommending that anyone who has tested positive for HIV should begin antiretroviral therapy (ART) as soon as possible. In light of this policy, the Government of Namibia included “treat all” in the 2016 National Guidelines for ART, and began nationwide implementation in April 2017. Project SOAR is generating evidence on how the national rollout of the treat all guidelines and decentralization of ART services affect client-level treatment outcomes, quality of ART services, and treatment costs in Namibia. This brief highlights baseline findings that provide a snapshot of ART services …

Implementing A Public Health Perspective In Fda Drug Regulation, Patricia J. Zettler, Margaret Foster Riley, Aaron S. Kesselheim

Faculty Publications By Year

There is, without question, a public health crisis in the United States arising from both illicit and prescription opioid misuse, addiction, and overdose. The Food and Drug Administration (FDA) is one regulator with an important role to play in minimizing the harms associated with prescription opioids, while also ensuring that prescription opioids are available for the evidence-based management of pain. One question, however, is to what extent the agency can consider in its decisions to approve opioids and keep existing ones on the market the provider and patient behaviors contributing to the epidemic. This is, in part, because FDA’s approval …

Risk In Privacy Breach Determination: The Application Of Prospect Theory To Healthcare Privacy Officers, Amanda Walden

Electronic Theses and Dissertations

A significant concern in healthcare is that of patient privacy and how organizations protect against unauthorized access to protected health information. The federal government has responded by instituting policies and guidelines on requirements for protection. However, the policy language leaves areas open to interpretation by those following the guidelines. Reporting to the Office for Civil Rights and/or the patient can open an organization to risk of financial and possible criminal penalties. There is a risk of harm to their reputation which could impact patient visits and market share. Therefore, Privacy Officers might view risk in different ways and therefore handle …

Ensuring Adequate Financing Of Family Planning Commodities And Services, Moazzam Ali, Benjamin Bellows

Reproductive Health

Increasing efficient and effective investment in family planning (FP) through the public and private sectors is key to meeting the FP2020 goal of helping 120 million additional women become modern contraceptive users. This policy brief identifies several policy and program considerations to ensure adequate financing of family planning commodities and services: sustained fundraising, pooling, and strategic purchasing; reaching new users and improving continuation rates among current users; and conducting further research on family planning quality performance metrics to test their correlation with higher continuation rates. Future efforts to reduce unmet need for FP must consider consumers’ out-of-pocket costs, programmatic cost-effectiveness, …

Strengthening The Integration Of Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Brian Mdawida, Charlotte E. Warren, Melsa Lutomia, Jane Koech, Elizabeth Washika, Aparna Jain

Reproductive Health

Study findings reveal that many Kenyan women living with HIV are comfortable receiving family planning (FP) services from community health volunteers and with proper training and support, community health volunteers have the potential to provide integrated FP/HIV services. Community-based integrated FP/HIV services could help connect women living with HIV who want to prevent or postpone a pregnancy to contraceptive services, which can reduce unintended pregnancies and in turn maternal mortality and vertical transmission of HIV. This implementation research study offers evidence of the feasibility, quality of care, and acceptability of using community health volunteers to integrate family planning into HIV/AIDS …

Introduction Of Innovative Medical Practices In Mayo Clinic: Effect Of The Interventions On Patient Outcomes, Duaa I. Aljabri

Theses and Dissertations

Purpose: Assessment of health technologies in medical practice is an ongoing process to provide clinicians and policymakers with information on the value of those applications. This dissertation aims to add to the existing body of literature and fill the gaps in prior studies by assessing two health technologies in Mayo Clinic Florida (MCF). The first paper provides an assessment of patient portal adoption and activity during hospitalization among cancer patients, and determines whether a portal application is associated with selected indices of patient safety, utilization and satisfaction. The second paper provides an assessment of a new approach in pain …

How Do Health System Employees With Established Musculoskeletal Complaints Decide On Their Treatment Pathway? A Qualitative Approach, Noor Alshareef

Theses and Dissertations

Purpose: Non-pharmacologic treatment such as physical therapy (PT) are advocated for musculoskeletal pain for decreasing opioid use. Early access to PT has been shown to decrease costs and improve outcomes through direct access via self-referral. Although self-referral to PT is permitted in the majority of U.S states, health insurance coverage has been identified as a barrier preventing some patients with musculoskeletal complaints from using it. There are few studies examining patient factors related to early access to physical therapy via self-referral. The purpose of this study was to identify the factors outside of insurance that influence the choice to access …

“When One Shingle Sends Up Smoke”: The Summit Beacon Advises Akron About The Epidemic Cholera, 1849, Elizabeth Hall

Nineteenth-Century Ohio Literature

Elizabeth Hall explains the American cholera epidemic of 1849, with special attention to how cholera afflicted Akron, a booming canal town in Northeast Ohio. The article presents the full text of 1849 Akron newspaper articles on cholera and explains how their mix of good and bad information was published right before scientific breakthroughs in cholera research.

Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon

Honors Undergraduate Theses

Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented …

Interaction Between Income, Health Insurance, And Self-Rated Health: A Path Analysis., Atalie Ashley West

Electronic Theses and Dissertations

The political focus of equitable health outcomes in the United States have long centered on access to medical care. However, there is compelling evidence that access to medical care is only the bare minimum necessary to achieve health, and the true influence of health insurance on health is still unclear. Widely accepted models of health estimate that less than 20% of health outcomes can be attributed to clinical care, while greater than 50% is related to social and economic determinants of health, with income being the most consistent predictor. As a result, this study investigated whether earned income is related …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

Health Starts In The Home: An Assessment Of Efforts To Improve Occupant Health Through Healthy Building Materials In San Francisco’S Affordable Housing, Staci Hoell

Master's Projects and Capstones

Americans spend 90% of their lives indoors, and much of this time is spent at home, surrounded by building materials that typically have added chemicals like flame retardants, highly fluorinated compounds, and antimicrobials. Recent research has linked these chemicals to adverse health outcomes such as asthma, endocrine disruption, cancer, neurodevelopmental issues, and reproductive problems (Bayer et al., n.d.; Green Science Policy Institute). Furthermore, these chronic health conditions disproportionately affect low-income populations. Fortunately, substantial efforts in research, practice, and policy are working to reduce the use of these potentially harmful chemicals in building materials, particularly in San Francisco’s affordable housing sector. …

Mental Hell, Jesenia De Moya, Hanaa' Tameez, Maritza Villela

Capstones

Mental Hell explores how difficult it is for low-income Latinos in New York City to access mental health care. Through explanations from experts and the personal stories of three Latinas New Yorkers who have gone through the process of trying to get the care they need, the story guides the reader through the many roadblocks this demographic encounters specifically under the insurance of Medicaid.

This is an extremely important topic that affects many New Yorkers, and we believe something needs to be done to make this type of healthcare more accessible for Latinos. New York City has a very high …

Canines For Disabled Kids, Erin Jerrett, Margarita Mnatsakanyan, Colleen Reynolds, Yin Wang

School of Professional Studies

Canines for Disabled Kids have been working on behalf of children and their families to educate communities and promote service dog partnerships for almost twenty years. Their advocacy with local legislatures, business owners, and community leaders highlighted the difficulties encountered when differentiating service dogs from emotional support/comfort dogs. Service dogs are entitled to access by the Americans with Disabilities Act (ADA), while emotional support/comfort dogs are not protected under the federal statute or to the same rights. Canines for Disabled Kids proposed a study to obtain a current count of licensed service dogs in the Commonwealth and investigate the feasibility …

Improving Service Delivery Through Provider Training: A Process Evaluation Of The Veterans Affairs Palo Alto Health Care System “Commitment To Serve” Workshop, Ismael Barrera

Master's Projects

As the customer-focused management strategies gradually advances into all of the VISNs [Veterans Integrated Service Networks], the Veterans Health Administration in Palo Alto, California implemented a customer service training program for employees to meet the diverse and complex needs of its customers. This research will analyze whether participants in this training, known as Commitment to SERVE, believe that it is achieving its goal. In other words, does the Veterans Affairs Palo Alto Health Care System (VAPAHCS) staff perceive the Commitment to SERVE workshop as a beneficial customer service training program?

Consult Management At The Va Palo Alto Health Care System: Has The Implementation Of Business Rules Improved Consult Management, And Did It Help Measure Performance For Select Services?, Christine Poblete

Master's Projects

This research project was developed to determine whether the new business rules implemented at the VA Palo Alto Health Care System have resulted in an improvement in the delivery of critical health care services through consults; and whether this process can be used as a Key Performance Indicator (KPI) for measuring performance of clinical services by health care administrators.

Access To Healthy Foods: A Descriptive Analysis Of Farmers’ Markets, Food Deserts & Usda Food Assistance Programs In Tennessee Census Tracts, Twanda D. Wadlington

Electronic Theses and Dissertations

Food deserts are a growing problem in the United States, and occur in areas of low-income where people have limited access to healthy foods. In response, the presence of farmers’ markets has grown exponentially, and improved healthy food access. Additionally, the USDA has strived to connect families to healthy foods through food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Senior Farmers’ Market Nutrition Program (SFMNP). This study investigated the relationship between farmers’ markets, their acceptance of food assistance benefits, and their locations within Tennessee …

Santa Clara County Senior Nutrition Program Evaluation Report, Tae Hwan Ihm

Master's Projects

Santa Clara County conducts a Senior Nutrition Program (SNP) in conjunction with the City of San Jose, the Outreach Paratransit Program and local community-based organizations (CBOs) like Sourcewise (Lam, 2015). These programs combined represent a significant investment of public funds, with more than 45% of the SNP program’s funding coming from the county General Fund (Lam, 2015). Such a large financial commitment needs to demonstrate some benefit to the participants, and some positive outcomes from the current program design. This study evaluated the SNP’s effectiveness in achieving its primary goals. Primary goals of the SNP are to promote senior citizens’ …

Increasing Use Of Research Findings In Improving Evidence-Based Health Policy At The National Level, Meiwita Budiharsana

Kesmas

In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program …

The Change In Mental Health Status Of Indonesian Health Care Migrant Worker In Japan, Susiana Nugraha, Yuko Hirano, Honda Sumihisha

Kesmas

Under the Japan – Indonesia Economic Partnership Agreement, more than 1,000 of Indonesian health care workers have migrated to Japan. Social adjustment during the process of migration is linked to mental health changes. This study aimed to figure out the strongest predictor that influences the change in mental health status as a result of migration. Baseline data were collected in Jakarta in 2013 during pre-departure orientation. Follow-up study was conducted one year after the study participants migrated to Japan in 2014. Using longitudinal design, this study employed 92 participants consisting of nurse and certified care worker candidates. The multiple linear …

Husband’S Education Level And Alcohol Drinking Habit As Risk Factors Of Hiv Infection Among Housewives In Pati District, Nurul Aeni, Annemarie Westendorp

Kesmas

Cases of Human Immunodeficiency Virus (HIV) infection in Pati District increase, particularly among housewives. The aim of this study was to analyse the risk factors of HIV infection among housewives in Pati District using case-control study design. The respondents were 90 housewives divided into case and control group. The case group consisted of 30 housewives living with HIV, while the control group comprised 60 housewives living in the similar area of the counterparts. The data collection was focused on demographic, sexual behaviour, and sociocultural variables possessed by housewives and their husbands. The study resulted that the risk factors of HIV …

Implementation Of Cigarette Excise Policy Against Cigarette Consumption Reduction Among Adolescent In Kuningan, Indonesia, Jani Ramjani, Fitri Kurnia Rahim, Icca Stella Amalia, Wahyu Manggala Putra

Kesmas

Indonesia has the highest prevalence of smoking (50.68%) compared to other ASEAN countries. On January 1st, 2017, the Indonesian government raised cigarette excise taxes. The purpose of this study was to analysis the impact of cigarette excise increase on cigarette consumption among adolescents aged 17 to 25 years. The study design used cross-sectional survey. A total of 153 adolescents were recruited in this study through simple random sampling technique. Questionnaires and observation papers were used in this study. A face-to-face interview was conducted to fulfill the data collection through home visit for each respondent. The data were obtained during May …

Spatial Analysis Of Determinants Of Filariasis-Endemic Areas In West Sumatra, Masrizal Masrizal, Fivi Melva Diana, Rosfita Rasyid

Kesmas

West Pasaman District and Agam District are filariasis-endemic areas in West Sumatra with prevalence of 12.40 per 100,000 cases and 11.27 per 100,000 cases respectively. This study aimed to determine risk factors associated with the prevalence of filariasis and mapping the vulnerability of the area in West Sumatra. A case control study design was conducted in the West Pasaman District and Agam District. The study used a sample of 74 cases and 74 controls taken by simple random sampling for the case and purposive random sampling for control. Data analysis used univariate, bivariate, multivariate and spatial. The results in Agam …

Effect Of Health Education On Community Participation To Eradicate Aedes Aegypti-Breeding Sites In Buahbatu And Cinambo Districts, Bandung, Zahratul Elsa, Uun Sumardi, Lia Faridah

Kesmas

Dengue hemorrhagic fever (DHF) is still a major public health problem in many regions in Indonesia including Bandung City. Community participation in implementing Eradication of Mosquito-Breeding Sites is still needed as it is considered the most effective method in controlling the dengue fever. This study aimed to determine the influence of health education towards community participation to eradicate mosquito-breeding sites, which was measured by knowledge level and larva index conducted in Bandung, specifically in two different locations with the highest and the lowest incidence rates of DHF. This study used quasi-experimental method. Samples were 100 people living in Cijawura and …

Maternal Energy Intake At The Sixth Month As Dominant Factor Of Exclusive Breastfeeding Success, Devi Suryanti Sihite, Sandra Fikawati, Ahmad Syafiq

Kesmas

Breastfeeding mothers needed adequate energy intake to provide 6-month exclusive breastfeeding that is necessary for infant growth and development. This study aimed to investigate real intake at the first and sixth month of breastfeeding and determine the dominant factor affecting 6-month exclusive breastfeeding provision. The design of this study was cross-sectional conducted in March-April 2015 among 109 mothers with 6-12- month-old infant living and registered at integrated health care in Kalangan Primary Health Care area. Data were collected through interview using questionnaires. Breastfeeding mothers’ intake was asked using Semi-Quantitative Food Frequency Questionnaire. The study found that 6-month exclusive breastfeeding proportion …