Public Health Commons^™

A Trip To Healthcare, David E. Matz

Patient Experience Journal

This narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was. This essay sets out where I made my mistakes, why I believe I made those mistakes, and how the hospitals, intentionally or not, made good decision-making harder. I offer two suggestions for enhancing the role of the patient in decision-making including 1) Every doctor in a diagnostic-decision-making interview should use the sentence “You have some choices here.” The doctor will have preferences, of course, but the patient needs …

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we …

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as …

Supporting And Retaining Village Health Teams: An Assessment Of A Community Health Worker Program In Two Ugandan Districts., Daniel C Mays, Edward J O'Neil, Edison A Mworozi, Benjamin J Lough, Zachary J Tabb, Ashlyn E Whitlock, Edward M Mutimba, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Uganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to …

The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell

Journal of Health Disparities Research and Practice

Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the …

Utilizing Title Vi As A Means To Eradicate Health Discrimination, Adrian D. Samuels, Mariah L. Cole

Journal of Health Disparities Research and Practice

Health disparities among people of color are persistent and detrimental to the overall wellness of these groups. Discrimination in the provision of health care services is one of the primary causes of health disparities. Title VI of the Civil Rights Act of 1964’s availability as a tool to prevent discrimination and, in turn, disparities among these groups is underdocumented. The legislative intent of Title VI and the historical context of the law have been helpful in its use outside of the health care arena to prevent discrimination. This sheds light on the ways that the law can influence the health …

Religious Coping And Types And Sources Of Information Used In Making Prostate Cancer Treatment Decisions., Janice V Bowie, Caryn N Bell, Altovise Ewing, Ballington Kinlock, Ashley Ezema, Roland J Thorpe, Thomas A Laveist

Health Policy and Management Faculty Publications

Treatment experiences for prostate cancer survivors can be challenging and dependent on many clinical and psychosocial factors. One area that is less understood is the information needs and sources men utilize. Among these is the influence of religion as a valid typology and the value it may have on treatment decisions. The objective of this study was to assess the relationship between race, religion, and cancer treatment decisions in African American men compared with White men. Data were from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 877 African American and White men. The main …

Use Of Prostate-Specific Antigen Testing In Medicare Beneficiaries: Association With Previous Evaluation, G S. Cooper, T D. Kou, M D. Schluchter, A Dor, S M. Koroukian, S P. Kim

Health Policy and Management Faculty Publications

Objective: Determine uptake of prostate-specific antigen (PSA) testing in Medicare beneficiaries according to previous receipt of PSA testing. Methods: A 5% random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims. We measured the annualized frequency of PSA screening among men due for PSA testing, stratified by PSA testing use in the previous 2 years, and clustered by ordering provider. Results: Throughout the study period, PSA testing use was consistently higher for men with previous screening than for men without previous screening. For men without previous screening, there …

Pharmaceutical Federalism, Patricia J. Zettler

Faculty Publications By Year

There is growing interest in states regulating pharmaceuticals in ways that challenge the U.S. Food and Drug Administration’s (FDA) federal oversight. For example, in 2013 Maine enacted a law to permit the importation of unapproved drugs, reflecting concerns that federal requirements are too restrictive, while in 2014 Massachusetts banned an FDA-approved painkiller, reflecting concerns that federal requirements are too lax. This Article provides an account of this recent state interest in regulating drugs and considers its consequences. It argues that these state regulatory efforts, and the nascent litigation about them, demonstrate that the preemptive reach of the FDA’s authority extends …

Mental Illness Stigma, Socially Acceptable Treatment, And Barriers To Health, Frances Renee Gellert

Independent Study Project (ISP) Collection

This paper discusses the topic of mental illness stigma and treatment in Uganda as explored through internship in the Social Work Department at Butabika National Referral Mental Hospital. The objectives of this project were to complete a meaningful internship while exploring causes of mental illness in Uganda, contradictions between traditional and modern approaches to treatment, and the affect of stigma on mental well-being. The internship included a total of 120 hours at Butabika Hospital. Individual research using documentary and literature review methods accompanied the internship. Butabika Hospital did not consent to the completion of formal research at, so any conclusions …

Understanding The Factors That Make Public Participation Effective In Health Policy And Planning: A Realist Synthesis, Celso P. Pagatpatan Jr., Paul R. Ward

Ateneo School of Medicine and Public Health Publications

Although researchers argue for the importance of involving the public in developing health policy, there has been little focus on central research questions – such as what techniques of public participation work, in what circumstances, and why. This paper presents a realist synthesis which identifies and explains the underlying mechanisms and specific contextual factors that lead to effective public participation in health policy and planning. Peer-reviewed, English language literature was searched, which resulted in 77 articles for review and synthesis. This synthesis uncovered the underlying mechanism of ‘political commitment’ that generates public participation effectiveness. The other three possible underlying mechanisms, …

The Riddle Of Malnutrition : The Long Arc Of Biomedical And Public Health Interventions In Uganda, Jennifer Tappan

Ohio University Press Open Access Books

More than ten million children suffer from severe acute malnutrition globally each year. In Uganda, longstanding efforts to understand, treat, and then prevent the condition initially served to medicalize it, in the eyes of both biomedical personnel and Ugandans who brought their children to the hospital for treatment and care. Medicalization meant malnutrition came to be seen as a disease—as a medical emergency—not a preventable condition, further compromising nutritional health in Uganda.

Rather than rely on a foreign-led model, physicians in Uganda responded to this failure by developing a novel public health program known as Mwanamugimu. The new approach prioritized …

The New York City Childcare Influenza Vaccine Mandate: A Case Study, Amy E. Metroka

Dissertations and Theses

Background. In 2014, New York City (NYC) became the third jurisdiction in the United States (US) to enact a childcare influenza vaccine mandate, after the states of New Jersey and Connecticut. The mandate was enacted by the NYC Board of Health by amending the NYC Health Code. The mandate’s goal was to increase vaccination rates among 6-59-month-olds attending city-regulated public and private childcare programs, including prekindergarten, to protect children, families, and the community against influenza. Children younger than 5 years are at high risk for severe illness and complications from influenza. Children are also known to be a major source …

Research Brief: "Impact Of Military Trauma Exposures On Post-Traumatic Stress And Depression In Female Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relation between combat stressors, depression, and PTSD among female veterans. In policy and practice, health providers should refer female veterans to services if they have experienced military sexual trauma; the DoD and VA should conduct analysis on the experiences of service and veteran women, and how they can best support service women who experienced military sexual trauma. Suggestions for future research include using an expanded sample and more sampling strategies, as well as use clinical interviews to collect data.

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Counterfeit Medicines In Socioeconomic Perspective, Desy Nuryunarsih Nuryunarsih

Kesmas

Obat-obatan palsu berpotensi mencapai 70% dari pasaran obat internasional dengan proporsi terbanyak ditemukan di negara berkembang. Meningkatkan kesadaran masyarakat akan adanya obat-obatan palsu akan secara langsung memengaruhi permintaan produk obat palsu yang akhirnya akan mengurangi kegiatan pemalsuan obat. Akan tetapi, meningkatkan pengetahuan masyarakat akan bahaya obat-obatan palsu tidaklah mudah sebab profesi kesehatan masyarakat harus juga mempertimbangkan keberagaman faktor-faktor sosial, ekonomi dan pendidikan. Laporan ini menelaah artikel jurnal yang ditelaah oleh kelompok seminat, laporan media, laporan resmi pemerintah dan non-pemerintah. Sebanyak 179 artikel (dari 1990 sampai 2014) ditelaah untuk mengetahui hubungan antara indeks pembangunan manusia (IPM) dari USA, Jepang, Brasil, Iran, …

The Use Of “Kakayu Dental Flipbook” In Oral Health Knowledge Improvement For Elementary School Students In Depok, Rikawarastuti Rikawarastuti, Eka Anggreni, Rahaju Budiarti, Nurlaila Ramadhan Suid

Kesmas

Perlu adanya edukasi untuk meningkatkan pengetahuan anak Indonesia tentang pentingnya memelihara kesehatan gigi dan mulut. Penelitian ini bertujuan untuk menjelaskan hubungan antara faktor siswa sekolah dasar seperti kelas, usia, jenis kelamin dengan jumlah anak dalam keluarga atau faktor ekonomi seorang ibu rumah tangga atau berpenghasilan tetap, yang dipengaruhi oleh peningkatan pengetahuan dari edukasi kesehatan gigi dan mulut. Disain penelitian quasi experiment pre-test dan post-test tanpa desain grup kontrol melibatkan 141 siswa yang dipilih melalui purposive sampling. Sampel tersebar pada siswa kelas IV, V, dan VI sekolah dasar swasta di Depok, Jawa Barat, Indonesia pada April-Oktober 2016. Data penelitian diperoleh dari …

Extrovert Personality Type And Prolonged Second Stage Of Labor, Yuni Kusmiyati, Chandra Tyas Nurfitria, Suherni Suherni, Heni Puji Wahyuningsih

Kesmas

Kepribadian dapat memengaruhi respons individu yang dapat berdampak pada proses persalinan lama. Penelitian sebelumnya menunjukkan adanya hubungan kepribadian dengan waktu persalinan. Tipe kepribadian ekstrover (tipe A) cenderung lebih rentan terhadap stres dibandingkan orang dengan tipe kepribadian introvert (tipe B). Penelitian ini bertujuan untuk mengetahui hubungan tipe kepribadian ekstrover dan variabel luar (pendidikan, ekonomi, usia ibu dan paritas) dengan persalinan kala II lama. Studi kasus kontrol dilakukan pada 156 ibu bersalin yang memenuhi kriteria inklusi pada tahun 2015 di Yogyakarta. Sampel kasus adalah 52 ibu dengan persalinan kala II lama dan kontrol adalah 104 ibu dengan persalinan kala II normal. Penelitian …

Impact Of Women’S Empowerment On Infant Mortality In Indonesia, Hanik Stiyaningsih, Febri Wicaksono

Kesmas

Secara umum, otonomi dan pemberdayaan perempuan menjadi salah satu faktor penting dalam pembangunan. Kurangnya otonomi dan pemberdayaan perempuan dapat menyebabkan hasil negatif pada kesehatan dan kematian anak. Belum terdapat penelitian terkini yang menganalisis hubungan antara pemberdayaan perempuan dan kematian bayi di Indonesia. Penelitian ini berusaha mengisi kekosongan tersebut dengan menelusuri pengaruh pemberdayaan perempuan terhadap kematian bayi di Indonesia. Sampel berjumlah 9.754 perempuan berusia 15-49 tahun yang terakhir melahirkan pada periode tahun 2007-2012 diambil dari Survei Demografi dan Kesehatan Indonesia 2012. Pemberdayaan perempuan diukur dengan menggunakan indeks komposit yang dibangun dari delapan indikator dari tiga dimensi pemberdayaan perempuan, yaitu partisipasi dalam …

Risk Factors Of Acute Respiratory Infections In Practice Area For Community Of Medical Students In Semarang, Siti Thomas Zulaikhah, Purwito Soegeng, Titiek Sumarawati

Kesmas

Infeki saluran pernapasan akut (ISPA) menempati urutan pertama dari 10 besar penyakit di Puskesmas Bangetayu dengan persentase terbanyak di Kelurahan Penggaron Lor. Keterampilan untuk mempelajari distribusi dan frekuensi penyakit serta faktor determinan yang memengaruhi manusia sangat diperlukan untuk menetapkan intervensi yang paling efektif untuk meningkatkan derajat kesehatan masyarakat. Perlu dilakukan penelitian untuk mengetahui faktor risiko yang paling dominan berhubungan dengan kejadian ISPA di lokasi praktik komunitas mahasiswa Fakultas Kedokteran Universitas Islam Sultan Agung Semarang. Penelitian ini menggunakan desain potong lintang dengan jumlah responden 100 orang dan sampel dikumpulkan dengan menggunakan stratified random sampling. Sepuluh variabel yang diteliti adalah faktor risiko …

Effects Of Multilevel Intervention In Workplace Health Promotion On Workers’ Metabolic Syndrome Components, Zahtamal Zahtamal, Wasilah Rochmah, Yayi Suryo Prabandari

Kesmas

Sekitar 10-30% orang Asia dewasa mengalami sindrom metabolik. Penelitian ini bertujuan untuk mengungkap efek Promosi Kesehatan di Tempat Kerja PKDTK dengan intervensi multilevel pada komponen/penanda pekerja yang menderita sindrom metabolik. Penelitian ini dilakukan pada tahun 2014-2015 dengan menggunakan desain quasi experimental dengan intervensi subjek secara multilevel di Indonesia. Program PKDTK untuk kelompok intervensi multilevel berupa kombinasi latihan fisik, diet, pendidikan kesehatan, dukungan sosial, dan advokasi salama 12 minggu. Program PKDTK untuk kelompok kontrol hanya pendidikan kesehatan. Instrumen penelitian seperti IPAQ, table food recall 24 jam, alat pengukuran fisik, dan laboratorium klinis. Analisis data menggunakan Marginal Homogeneity, paired sample t, Mc …

Controlling Factors That Potentially Against Transmission Of Dengue Hemorrhagic Fever At State Elementary Schools In Yogyakarta, Tri Baskoro Tunggul Satoto, Nur Alvira, Tri Wibawa, Ajib Diptyanusa

Kesmas

Sekolah dasar merupakan tempat yang dapat mengakibatkan peningkatan penyakit dengue pada anak karena faktor lingkungan, adanya potensi penularan, belum adanya system manajemen lingkungan yang baik dan beberapa upaya pengendalian yang tidak lagi efektif. Penelitian ini bertujuan untuk mengetahui faktor yang berpotensi terhadap penularan demam berdarah dengue bagi anak, sehingga sistem kewaspadaan dini dapat ditegakkan. Jenis penelitian ini adalah analitik dengan rancangan potong lintang. Penelitian dilaksanakan pada 91 sekolah dasar negeri di Kota Yogyakarta. Variabel yang diobservasi adalah serotype virus DEN, resistensi insektisida, kepadatan vektor,dan kondisi fisik sekolah. Analisis data menggunakan analisis deskriptif dan korelasi-regresi (a = 0.05). Hasil menunjukkan bahwa …

Rebon Shrimp Powder Addition Influence To Nutritional Values, Organoleptic Properties And Acceptance Of Supplementary Food By Children Aged 4-5 Years Old, Priyo Sulistiyono, Dewi Marhaeni Diah Herawati, Insi Farisa Desy Arya

Kesmas

Prevalensi gizi kurang dan stunting pada anak bawah lima tahun (balita) di Kota Cirebon masih cukup tinggi yaitu mencapai 13,9% dan 15,7%. Udang rebon (Acetes erythraeus) memiliki kandungan protein dan kalsium yang tinggi. Pengaruh penambahan udang rebon dalam makanan tambahan (bubur lemu dan bolu kukus) terhadap kualitas gizi diteliti. Penelitian ini bertujuan untuk mengetahui pengaruh bubuk udang rebon terhadap nilai gizi, sifat organoleptik dan daya terima. Uji laboratorium dan perangkat lunak Nutriservey digunakan untuk analisis nilai gizi bubuk udang rebon dan gizi makanan tambahan. Uji organoleptik menggunakan rancangan acak lengkap dengan empat perlakuan (bubuk udang rebon 0%, 5%, 10%, 15%) …

Public Schools, And Health Care: A Strategy To Promote Social Inclusion, Jana Sladkova, Anahi Viladrich, Nicholas Freudenberg

Occasional Paper Series

Sladkova, Viladrich, and Freudenberg refer to “social inclusion” as the process through which the newly arrived find their voice in an already complex, cacophonous society. They describe an approach to social inclusion for adult immigrants that melds learning English at the same time as learning to negotiate our often-Byzantine health care system. They highlight programs that work and a new perspective on how to maximize the effectiveness of limited adult education opportunities.

Do Marketing Strategies Impact Condom Sales In Uganda?, Meyhar Mohammed

Master's Theses

What attracts people to buy condoms? HIV/AIDS remain one of the biggest health dangers of the world, especially in Sub-Saharan Africa. A lot of efforts have been pursued in the past two decades to drastically reduce prevalence of HIV and increase awareness about preventive mechanisms. In order to prevent relapse of success achieved so far, it is important to recognize transformation of consumer behavior due to growth in social networks, education and awareness over time. There are a lot of behavioral triggers captured by social marketing interventions in the field of public health. In an attempt to investigate the role …

Research Brief: "The National Veteran Sleep Disorder Study: Descriptive Epidemiology And Secular Trends, 2000–2010", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relation between sleep disorder diagnosis and cardiovascular disease, cancer, and mental health disorders among veterans. In policy and practice, physicians should familiarize themselves with signs of and screenings for sleep disorders and should discuss factors that affect sleep with their veteran patients; the VHA should continue recommending policies that help veterans receive a prompt diagnosis and treatment of their sleep disorders, policymakers should fund early intervention programs to help veterans learn how to cope with reintegration, and the VHA should create a database on sleep disorders in veterans. Suggestions for future research include studying veterans …

After Closure: Options For Pursuing A High Performance Rural Health System, Andrew F. Coburn Phd

Rural Hospitals (Flex Program)

Presented at the 2017 National Rural Health Association Annual Meeting. Coburn, a member of the Rural Policy Research Institute Panel, discussed the following key questions: What kind of rural health system is possible in places that cannot support a full-service hospital? How does a rural community navigate the transition from hospital-centric care toward new models that deliver high performance? What implementation support will be needed? Coburn noted that there is no single model for re-configuring the rural health system after hospital closure; local assets, affiliations and partnerships, financial and delivery flexibility and capacities must be critically assessed to determine the …

New Outpatient Experience Survey Design: A Quality Improvement Case Study, Nathan Paluso

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate the implementation process for a new survey methodology introduced by Maine Medical Partners (MMP), by following the Plan-Do-Study-Act (PDSA) quality improvement cycle framework. This new survey has been implemented to collect data on patients’ experiences in the MMP outpatient facilities, and is offered to the patients via iPad at check-out after their appointment. Through observation at MMP practices and MMP staff interviews, strengths and weaknesses of the implementation process have been identified. Evidence-based solutions pertaining to the identified weaknesses have been selected through a literature review and are incorporated in recommendations …

The Role Of Public Versus Private Health Insurance In Ensuring Health Care Access & Affordability For Low-Income Rural Children, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Amanda Burgess Mppm

Access / Insurance

Medicaid and the Children’s Health Insurance Program (CHIP) have played a critical role in ensuring access to health insurance coverage among children and have been particularly important sources of coverage for rural children. More than 35.5 million children were enrolled in Medicaid or CHIP in September 2016—accounting for just over half of total Medicaid and CHIP enrollment. Given the large proportion of rural children covered by public insurance, it is critically important to understand the role of that coverage in ensuring access to affordable healthcare for rural children. Using data from the 2011-2012 National Survey of Children’s Health, this study …

Umass Memorial Healthcare Information System Job Ladder, Matthew Simoncini, Vamsi Kavuru, Antariksh Nanda, Tahaseen Mahaboob Basha, Vikram Patil

School of Professional Studies

The capstone project report emphasizes the importance of a job ladder and the need of an hour to implement it at UMASS Memorial health care. The scope of this project is to create a well-established job ladder at UMASS with pre-defined standards on job levels related to Information Technology department that would facilitate in hiring, developing and promoting employees at various stages.