Public Health Commons^™

The Opioid Epidemic: A Practice And Policy Perspective, Gail D'Onofrio

Center for Policy Research

I will be talking about the escalating opioid epidemic and some innovative solutions my colleagues and I at Yale University and throughout the state of Connecticut, are working on to mitigate the consequences of this public health crisis.

The Latex Journey: A Narrative Approach To Exploring Condom Use, Stigma, And Education From The Perspective Of Women In Masxha, Kylie Yocum

Independent Study Project (ISP) Collection

Although the South African National Department of Health (NDOH) is spending increasing amounts of money on improving their HIV programs (including the rollout of new, scented condoms for their condom distribution program), the rates of condom use at last sexual encounter are declining. This inquiry focused on young women in the neighborhood of Masxha, Cato Manor, and their opinions surrounding how condoms are being used or misused, as well as the gender norms that perpetrate this (mis)use. This inquiry demonstrated the narratives of these young women on factors such as condom acquisition, gendered stigma, and condom education, including the Life …

Preventing Horse-Related Injuries By Watching Out For Other Humans, William R. Gombeski Jr., Fernanda C. Camargo, Holly Wiemers, Connie Jehlik, Polly Haselton Barger, James Mead

Animal and Food Sciences Faculty Publications

The more one rides or handles horses, the more likely one is to have a horse-related injury. These injuries are caused by many factors, including those generated by other riders, handlers or spectators. An analysis of 266 cases of injured equestrians showed that 16% of those injuries were caused by other humans. A panel of horse riding safety experts felt 63% were preventable, and the injured individuals themselves felt 51% were preventable. The study findings suggest that increased awareness of the role others play in causing horse-related injuries and increased education about common people-caused injuries could reduce the number of …

Nonprofit Hospital Community Benefit Requirements: An Exploration Of National Health Policy Models, Justin P. Swearingen

Dissertations and Theses

Introduction: Nonprofit hospital organizations are public charities with complete tax immunity. Such exemptions are worth $24.6 billion and impact the health of hundreds of millions of people, yet what these charities must do to meet the current “community benefit standard” to maintain their tax-exempt status remains a policy debate. To help inform policymaking, an evaluation of four national requirement models was performed: Tax Value Requirement (at least the value of the tax exemptions must be spent on community benefit), Grassley Requirement (at least 5% of revenue must be spent on community benefit), Expense Requirement (at least 3% of expenses must …

Charting A Pathway Forward: Redesigning And Realigning Supports And Services For Maine's Older Adults, Eileen Griffin Jd, Elizabeth C. Gattine Jd

Disability & Aging

The current growth of the population age 65 and older is one of the most significant demographic trends in the history of this country and is especially significant for Maine, where the number of people age 65 and older is growing even faster than the rest of the nation. By 2025, over a quarter of Maine’s population is expected to be age 65 and older. Because the cost of long term paid support is out of reach for many Mainers, public financing—particularly Medicaid financing—is an essential tool for addressing the long term support needs of older adults. But Medicaid is …

Trends In The Environmental Health Job Market For New Graduates, Jason W. Marion, Timothy J. Murphy Phd, Anne Marie Zimeri Phd

EKU Faculty and Staff Scholarship

The question of whether the job market can support future graduates of environmental health programs remains an important and difficult question for environmental health programs, current and prospective students, parents, and other stakeholders. Our previous report using 2014 data from the U.S. Bureau of Labor Statistics demonstrated anticipated growth and higher than average pay in the profession through at least 2022 for baccalaureate degree holders (Marion & Sinde, 2015). Growth in the profession does not necessarily translate into job availability if the market is saturated with job candidates. While university programs produce graduates, local health departments (LHDs) have suffered tremendous …

2484: Establishment Of The Tennessee-Sickle Cell Disease Network As A Mechanism For Engaging A Rare Disease Population In Patient Centered Outcomes Research, Tilicia Mayo-Gamble, Velma Mcbride Murry, Michael R. Debaun

Health Policy & Community Health: Faculty Publications

OBJECTIVES/SPECIFIC AIMS: Despite the high prevalence of individuals diagnosed with sickle cell disease (SCD) in Tennessee, comprehensive care and education for patients with SCD is not as widely available as healthcare services for individuals managing other chronic illnesses. We aimed to engage SCD stakeholders in patient-centered outcomes research (PCOR) as a mechanism for advancing care and translational research for this rare disease population. METHODS/STUDY POPULATION: Through a partnership with the Sickle Cell Foundation of Tennessee, we implemented Community Health Ambassadors to systematically engage patient partners with SCD and their caregivers, aged 18–50 from rural and urban communities throughout Tennessee, in …

Level Of Exposure Of Childhood Tuberculosis With Adult Pulmonary Tuberculosis Household Contacts, Al Asyary, Tris Eryando, Purwantyastuti Purwantyastuti, Purnawan Junadi, Carol Clark, Edwin Van Teijlingen

Kesmas

Tuberkulosis paru (TB) pada anak kian menjadi masalah kesehatan global yang masih terlupakan seiring dengan peningkatan proporsi TB di Indonesia. Penularan penyakit ini di populasi umum seringkali berdampak pada anak, terlebih ketika kontak TB terjadi di rumah tangga. Penelitian ini bertujuan untuk memperoleh faktor protektif sehingga anak tetap sehat meskipun memiliki kontak dengan penderita TB dewasa serumah. Penelitian ini dilakukan dengan pendekatan kasus kontrol pada 132 responden anak yang berasal dari delapan rumah sakit rujukan dan beberapa puskesmas di Provinsi Daerah Istimewa Yogyakarta. Penelitian dilakukan dalam periode Januari hingga Desember 2014 yang hasilnya dianalisis dengan uji bivariat (kai kuadrat) dan …

Influence Of Quality Of Work Life Towards Psychological Well-Being And Turnover Intention Of Nurses And Midwives In Hospital, Indra Wahju Hardjanti, Aryo Dewanto, Noermijati Noermijati

Kesmas

Selama ini perawat telah dilatih untuk memberikan perawatan pasien dan meningkatkan kualitas hidup pasien, namun kualitas kehidupan kerja dan psychological well-being mereka sendiri terabaikan. Rendahnya kualitas kehidupan kerja perawat di rumah sakit menyebabkan tingginya keinginan pindah kerja perawat. Tingginya angka keinginan pindah kerja perawat dan bidan di Rumah Sakit X Malang merupakan masalah yang memerlukan perhatian dari manajemen rumah sakit agar tidak menjadi menyebabkan rendahnya mutu pelayanan kesehatan di rumah sakit. Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas kehidupan kerja, psychological well-being, dan keinginan pindah kerja perawat dan bidan di rumah sakit. Penelitian ini menggunakan desain penelitian kuantitatif korelasional …

Risk Differences Between Elderly Men And Women Toward Doctor-Diagnosed Diabetes Mellitus In Urban Areas In Indonesia: 2013 National Basic Health Research Data, Meiwita Budiharsana

Kesmas

Diabetes melitus (DM) adalah salah satu penyakit tidak menular yang paling umum di Indonesia. DM disebabkan berbagai faktor risiko. Peningkatan prevalensi DM salah satunya disebabkan oleh perubahan gaya hidup di perkotaan. Penelitian ini bertujuan untuk menguji perbedaan prevalensi DM yang didiagnosis dokter pada laki-laki dan perempuan usia 15 tahun keatas yang tinggal di daerah perkotaan di Indonesia. Analisis menggunakan data sekunder Riset Kesehatan Dasar (Riskesdas) 2013 dengan desain studi potong lintang. Total sampel sebanyak 333.731 responden. Metode analisis menggunakan regresi logistik ganda. Hasil menunjukkan bahwa DM yang didiagnosis dokter pada laki-laki dan perempuan usia 15-39 tahun di perkotaan tidak berbeda. …

Bancroftian Filariasis Transmission Parameters After The Fifth Year Of Filiariasis Mass Drug Administration In Pekalongan City, Tutik Ida Rosanti, Sugeng Juwono Mardihusodo, Wayan Artama

Kesmas

Penelitian ini bertujuan untuk mengukur parameter parasitologi (microfilaria rate, kepadatan mikrofilaria), parameter imunologi (antigen prevalence) dan parameter entomologi (infection rate dan infective rate) pada tahun kelima pelaksanaan mass drug administration di Kelurahan Pabean Kota Pekalongan. Penelitian ini merupakan penelitian observasional dengan pendekatan potong lintang yang dilaksanakan pada bulan Juli sampai dengan Agustus 2015 di Kelurahan Pabean Kota Pekalongan. Microfilaria rate dan kepadatan mikrofilaria ditentukan dengan pemeriksaan darah jari pada 313 responden. Antigen prevalence ditentukan dengan mengukur antigen beredar menggunakan metode immunochromatographic test (ICT) Wuchereria bancrofti. Incective rate dan infection rate diukur dengan cara menemukan larva cacing filaria pada nyamuk hasil …

Provision Of Informed Consent Towards The Level Of Anxiety In Pre-Operative Patients At Mamuju District Public Hospital, Imelda Appulembang

Kesmas

Tindakan pembedahan merupakan salah satu tindakan medis yang dapat mendatangkan stressor sehingga menimbulkan kecemasan pada pasien. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian informed consent terhadap tingkat kecemasan pada pasien pra-operasi di Rumah Sakit Umum Daerah (RSUD) Mamuju. Populasi pada penelitian ini adalah pasien pra-operasi. Sampel ditentukan dengan menggunakan pendekatan accidental sampling sehingga diperoleh sampel sebanyak 32 orang. Jenis penelitian ini adalah penelitian kuantitatif dengan menggunakan metode quasi experimental design melalui pendekatan non-equivalent time sample design yang dianalisis dengan menggunakan uji statistik Wilcoxon. Hasil penelitian menunjukkan bahwa terdapat pengaruh pemberian informed consent terhadap tingkat kecemasan pasien. Dapat disimpulkan pemberian informed …

Effects Of Contraceptive Use On Productivity Of Women Labor At Pt. Bomar Makassar Industrial Area, Masni Mappajanci, Andi Misnawati, Darmawansyah Darmawansyah

Kesmas

Produktivitas kerja potensial pada kelangsungan hidup perusahaan. Penggunaan kontrasepsi dapat memengaruhi fisiologi setiap perempuan, sehingga dapat memengaruhi aktivitas sehari-hari dan akan berdampak terhadap produktivitas tenaga kerja. Penelitian ini bertujuan untuk mengetahui pengaruh penggunaan alat kontrasepsi terhadap produktivitas tenaga kerja perempuan dengan mengontrol usia, pendidikan dan motivasi kerja. Penelitian dengan rancangan potong lintang melibatkan 71 pekerja perempuan PT Bomar Makassar yang telah menikah. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner pada bulan Mei sampai Juni 2015, kemudian dianalisis secara univariat, bivariat, dan multivariat. Hasil penelitian menunjukkan bahwa terdapat pengaruh penggunaan alat kontrasepsi terhadap produktivitas kerja setelah dikontrol dengan variabel usia (nilai …

Influence Of Scaling Up Nutrition Education Towards Knowledge And Attitude Of Students At Santa Elisabeth Medan School Of Health Sciences, Rani Gartika Holivia Silalahi, Yesschi Anggraeni Tambunan

Kesmas

Tingginya angka pernikahan pada usia remaja yang disertai dengan rendahnya pengetahuan tentang pola asuh merupakan salah satu pemicu terjadinya masalah gizi. Remaja merupakan orang tua masa depan. Tujuan penelitian ini untuk mengetahui pengaruh pendidikan 1.000 hari pertama kehidupan terhadap pengetahuan dan sikap mahasiswi Sekolah Tinggi Ilmu Kesehatan Santa Elisabeth Medan tahun 2016. Penelitian ini menggunakan kuasi eksperimental dengan desain one group pre- dan post test. Metode pengambilan sampel dengan metode purposive sampling sebanyak 115 mahasiswi tingkat III program studi Diploma III Kebidanan. Pendidikan dilakukan di kelas sebanyak 4 kali dalam 2 minggu dengan menggunakan metode mengajar dan diskusi. Penelitian ini …

The Profile And Determinant Factors Of Quality Of Life In Patients With Diabetic Neuropathy, Rizaldy Taslim Pinzon, Kadek Sinthia Grahita Adnyana, Marta Lisnawati Zalukhu

Kesmas

Neuropati merupakan salah satu komplikasi tersering pada diabetes melitus (DM). Neuropati dapat memengaruhi kualitas hidup, derajat kesehatan, maupun tingkat ekonomi. Oleh karena itu, penting untuk mengetahui kualitas hidup pasien DM dengan neuropati beserta dampak yang ditimbulkannya terlebih dahulu agar mendapatkan penanganan yang tepat demi meningkatkan kualitas hidup pasien. Penelitian ini bertujuan untuk mengetahui profil kualitas hidup pasien DM dengan neuropati. Penelitian ini merupakan studi observasional menggunakan Short Form 8 (SF-8) Health Survey Standard Indonesia terhadap pasien diabetes melitus dengan neuropati yang diambil secara konsekutif pada bulan Maret hingga Agustus 2016 di Poli Saraf Rumah Sakit Bethesda, Yogyakarta. Terdapat 57 subjek …

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

Barriers And Facilitators To The Integration Of Mental Health Services Into Primary Health Care: A Systematic Review Protocol., Edith K Wakida, Dickens Akena, Elialilia S Okello, Alison Kinengyere, Ronald Kamoga, Arnold Mindra, Celestino Obua, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works.

Methods

This review will use the SPIDER (Sample, Phenomenon of Interest, Design, …

Use Of Emergency Department For Care Access By Refugees Resettling In Kentucky, 2015: Findings From The University Of Louisville Global Health Center, Ruth M. Carrico, Carmen Mitchell, Dawn Balcom, Linda Goss, Anna Persaud, Karen Mutsch, Timothy L. Wiemken, Rahel Bosson, Julio A. Ramirez

Journal of Refugee & Global Health

Background: Kentucky is one of the largest rural resettlement areas for refugees in the US welcoming more than 3,000 refugees and other entrants during 2015. Refugees arrive with a number of chronic health conditions that require ongoing management in a healthcare system where they lack knowledge and ability to navigate. This may encourage them to seek care that is easy to access but episodic and fragmented. The objective of this study was to determine the frequency and reasons for accessing care via a local emergency department by resettling refugees during their first twelve months of resettlement.

Methods: Using data from …

Mapping The Alignment Of Programmatic Mission, Functions And Outcomes With The Attainment Of Health Equity: An Overview Of The Approach And Initial Outcomes Through The Lens Of The Usda’S Cyfar Scp Program, Onyemaechi Nweke, Kara Ryan, Mpp, Bonita Williams, Phd

Journal of Health Disparities Research and Practice

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an …

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

Theses and Dissertations

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.

Creating A Taxonomy Of Local Boards Of Health Based On Local Health Departments’ Perspectives, Gulzar H. Shah, Sergey Sotnikov, Carolyn J. Leep, Jiali Ye, Timothy W. Van-Wave

Health Policy & Community Health: Faculty Presentations (1993-2023)

Objectives: To develop an LBoH classification scheme and empirical definitions to provide a coherent framework for describing variation in the LBoHs.

Data and Methods: This study is based on data from the 2015 Local Board of Health Survey, conducted among a nationally representative sample of LHD administrators, with 394 responses. The classification development consisted of the following steps: (a) theoretically guided initial domain development, (b) mapping of the survey variables to the proposed domains, (c) data reduction using principal component analysis and group consensus, and (d) scale development and testing for internal consistency.

Results: The final classification scheme included 60 …

Marketing Strategy Of School Of Professional Studies In China, Jiahui Liu, Jing Wang, Shuo An, Wengxing Wang, Yiwei Wang

School of Professional Studies

Chinese students are the most visible international presence at many universities across the United States, and the number continues to grow. Since 2010, The number of graduate students studying abroad has entered the period in which the increase has been declining. Under the circumstance of the weak global economy and high cost of education, the administration needs to attract the attention of Chinese students. In the process of competing for applicants, how to develop marketing strategies to attract students’ eyeballs has become an important means of trying to increase school income through Chinese students. The marketing strategy mentioned in this …

Pregnancy Medicaid Expansions And Fertility: Differentiating Between The Intensive And Extensive Margins, Lincoln H. Groves, Sarah Hamersma, Leonard M. Lopoo

Center for Policy Research

The theoretical and empirical links between public health insurance access and fertility in the United States remain unclear. Utilizing a demographic cell-based estimation approach with panel data (1987-1997), we revisit the large-scale Medicaid expansions to pregnant women during the 1980s to estimate the heterogeneous impacts of public health insurance access on childbirth. While the decision to become a parent (i.e., the extensive margin) appears to be unaffected by increased access to Medicaid, we find that increased access to public health insurance positively influenced the number of high parity births (i.e., the intensive margin) for select groups of women. In particular, …

How Canada Can Help Global Adolescent Health Mature, Ashley Vandermorris, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: There is an emerging focus on adolescent health within the global health community as we come to recognize that the adolescent years are formative in determining health and health-related behaviours across the life-course. Such attention is not only relevant on the global scale but is imperative in Canada as well.

Main body: This commentary provides a brief review of recent investments targeting global adolescent health and presents five potential avenues for action which emerged out of the recent Canadian Partnership for Women and Children’s Health (CanWaCH) Global Adolescent Health conference. These avenues are: (1) Demand data; (2) Embrace complexity; …

Swedish Social Welfare And Its Application To American Welfare Systems, Ben Wilson Galloway

Graduate Theses and Dissertations

Swedish Social Welfare and its Application to American Welfare Systems concerns itself with the issue of determining the origins of the modern Swedish social welfare system. Additionally, the causes behind the formation of the system are evaluated for their relevancy concerning the formation of the American welfare system. Multiple areas of study are considered, including racial impacts, economic factors, sociological impactors, and demographic variables.

Call For Submissions. Special Issue – July 2018: Patient & Family Experience In Children’S Hospitals And Pediatric Care, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce a call for submission for its special issue scheduled for July 2018 on the topic of patient & family experience in children’s hospitals and pediatric care. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either children’s hospitals or pediatric care. It is encouraged that articles submitted deal directly with efforts in those care settings. The issue will look for pieces that address evidence-based efforts at improvement, practices that have impact on outcomes or stories that reflect …

Experience-Based Co-Design: A Method For Patient And Family Engagement In System-Level Quality Improvement, Bianca Fucile, Erica Bridge, Charlene Duliban, Madelyn P. Law Dr.

Patient Experience Journal

Integrating patient and family member needs, wants and preferences in healthcare is of utmost importance. However, a standardized patient and family engagement model to understand these needs, wants and preferences in order to translate into high quality improvement activities is lacking. Experience based co-design (EBCD) is an approach that enables patients, family members and healthcare providers to co-design improvement initiatives together. In this study, EBCD was employed to: 1) assess the current state of information and educational resources at a local oncology center and 2) partner with patients, family members, and healthcare providers to create quality improvement initiatives targeting identified …

Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner

Patient Experience Journal

Culture Change leaders in long term care have identified creative ways to implement a model of Person Directed Care to improve the client experience by providing choice, instilling dignity, and fostering deep relationships among its community members. One organization created an environment of care called ”The Small House” and educated its’ workforce using the Green House® Project Legacy Alignment program to redesign the organizational structure, experience and environment. Interviews were conducted with elders, staff, and family members (N=20) about their experiences living, working or visiting a Small House as compared to experiences in their previous dwelling, a traditional nursing home. …

Understanding The Role Of Patient And Public Involvement In Renal Dietetic Research, Andrew Morris Mr, Deborah Biggerstaff, Nithya Krishnan, Deborah Lycett

Patient Experience Journal

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations …

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when …