Public Health Commons^™

Tradisi Dan Lingkungan Sosial Memengaruhi Dukungan Menyusui Pada Bayi Berat Badan Lahir Rendah Di Kota Malang, Muladefi Choiriyah, Elsi Dwi Hapsari, Wiwin Lismidiati

Kesmas

Berat badan lahir rendah (BBLR) merupakan salah satu penyebab utama kematian bayi di dunia. World Health Organization tahun 2003 telah merekomendasikan menyusui sebagai salah satu penanganan BBLR. Namun, ibu yang memiliki bayi BBLR mengalami kesulitan di awal persalinan. Selain itu, menyusui di Indonesia juga dipengaruhi oleh sosial dan budaya yang dipercayai sehingga memengaruhi keputusan ibu untuk memilih tetap menyusui atau tidak sama sekali di periode awal postpartum. Tujuan penelitian ini untuk mengeksplorasi makna pengalaman ibu untuk tetap menyusui bayi dengan BBLR. Penelitian kualitatif ini dengan pendekatan fenomenologi. Tujuh orang partisipan adalah ibu yang pernah menyusui bayi BBLR. Pengumpulan data dilakukan …

Pendidikan Kesehatan Reproduksi Formal Dan Hubungan Seksual Pranikah Remaja Indonesia, Anggriyani Wahyu Pinandari, Siswanto Agus Wilopo, Djauhar Ismail

Kesmas

Transisi demografi kedua akan terjadi di Indonesia dan ditandai dengan revolusi seksual dan reproduksi. Masalah potensial di masa ini adalah peningkatan perilaku seksual pranikah, kehamilan yang tidak diinginkan, infeksi menular seksual dan penyalahgunaan obat. Penelitian ini bertujuan untuk menguji pengaruh pendidikan kesehatan reproduksi formal terhadap penundaan hubungan seksual pranikah pada remaja dan dewasa muda Indonesia. Penelitian potong lintang yang dianalisis sebagai kohort retrospektif menggunakan data Survei Kesehatan Reproduksi Remaja Indonesia tahun 2012 (10.980 laki-laki dan 8.902 perempuan). Efek pendidikan kesehatan reproduksi formal terhadap penundaan perilaku hubungan seksual dianalisis menggunakan kurva kaplan meier, uji log-rank, dan uji chi square, sedangkan analisis …

Assessment Of Nutrition Information System Using Health Metrics Network Framework, Mochamad Iqbal Nurmansyah, Catur Rosidati, Riastuti Kusuma Wardani, Badra Al-Aufa

Kesmas

Sistem informasi gizi (Sigizi) dikembangkan oleh Direktorat Bina Gizi Kementerian Kesehatan sejak 2011. Data Sigizi mencakup data penimbangan balita di posyandu, kasus gizi buruk, cakupan pemberian tablet Fe pada ibu hamil, konsumsi garam beryodium, pemberian vitamin A, dan ASI eksklusif. Penelitian ini bertujuan untuk mengukur kinerja pengelolaan Sigizi di Dinas Kesehatan Kota Tangerang Selatan menggunakan kerangka Health Metrics Network yang dikeluarkan oleh WHO tahun 2008. Sigizi merupakan sistem informasi yang diaplikasikan pada tingkat nasional dengan mekanisme pelaporan berjenjang, dari 508 kabupaten/kota menuju 34 provinsi dan bermuara di tingkat nasional. Di Provinsi Banten, terdapat delapan kabupaten/kota yang menjalankan Sigizi. Informan penelitian …

Sikap Remaja Terhadap Keperawanan Dan Perilaku Seksual Dalam Berpacaran, Desi Rusmiati, Sutanto Priyo Hastono

Kesmas

Laporan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007 dan 2012 menunjukkan terjadinya penurunan jumlah remaja yang memiliki sikap positif terhadap pentingnya mempertahankan keperawanan bagi seorang perempuan. Dari laporan yang sama juga diketahui adanya peningkatan perilaku seksual remaja dalam hal berpegangan tangan, berciuman bibir, petting, dan melakukan hubungan seksual. Penelitian ini bertujuan untuk membuktikan adanya hubungan antara sikap remaja terhadap keperawanan dengan perilaku seksual dalam berpacaran dengan melibatkan usia, jenis kelamin, pendidikan, tempat tinggal, usia pertama kali pacaran, pengetahuan, dan pengaruh teman sebaya sebagai variabel perancu. Penelitian ini merupakan penelitian kuantitatif dengan rancangan potong lintang menggunakan model faktor risiko dari …

The Stephen Klein Wellness Center As A Community-Centered Health Home - A Partnership Between Jefferson And Project Home, James D. Plumb Md, Mph, Lara Weinstein Md, Mph, Monica Mccurdy Pa-C, Mhs

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Using Research And Roi To Drive Partnerships In Public Health Delivery Systems, Glen P. Mays

Health Management and Policy Presentations

Stimulating public-private partnerships (PPP) for health and economic development initiatives requires research that can answer key questions: (1) what are the health and economic returns likely to be realized; (2) over what time frames and with what certainty; (3) what investments are required to achieve results; and (4) what are the implementation strategies most likely to succeed. This presentation reviews ongoing research on the PPPs used to deliver public health services in the U.S., and explores the lessons this research offers PPPs in low and middle income countries. We examine how scientific evidence on public health delivery systems and their …

How Has The Affordable Care Act Benefitted Medically Underserved Communities? : National Findings From The 2014 Community Health Centers Uniform Data System, Jessica Sharac, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers represent the single largest comprehensive primary health care system serving medically underserved communities, operating in more than 9,000 urban and rural locations. Newly-released data for 2014 from the Uniform Data System (UDS; the federal health center reporting system) shed important light on the impact of the Affordable Care Act in its first full year of implementation in medically underserved urban and rural communities across the U.S. These communities experience elevated poverty, heightened health risks, lack of access to primary health care, and a significantly greater likelihood that residents will be uninsured.

The UDS data show the ACA’s …

National Advisory Council On The National Health Service Corps (Nhsc), Sara J. Rosenbaum

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Foundational Public Health Services And Health System Reform, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril

Health Management and Policy Presentations

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.

Measuring Changes In Local Surveillance And Investigation Capacity, Christine A. Bevc, Mary V. Davis, Anna P. Schenck

Frontiers in Public Health Services and Systems Research

Background: The outbreak of Ebola virus disease in West Africa and confirmation of the first cases in the United States highlight the need for robust and responsive public health surveillance system. With a 25% decline in funding since 2007, the impact on local surveillance capacities has not previously been described.

Purpose: The Surveillance & Investigation domain of the Local Health Department Preparedness Capacities Survey (PCAS) was reweighted to reflect the national profile of LHDs. Changes in subdomain performance of capacities and the effect of population size on subdomain capacity performance were examined over time.

Methods: Participating LHDs (n=208) …

Optimisations And Challenges Involved In The Creation Of Various Bioluminescent And Fluorescent Influenza A Virus Strains For In Vitro And In Vivo Applications, Monique I. Spronken, Kristy Short, Sander Herfst, Theo M. Bestebroer, Vincent P. Vaes, Erin Sorrell, + 9 More

Health Policy and Management Faculty Publications

Bioluminescent and fluorescent influenza A viruses offer new opportunities to study influenza virus replication, tropism and pathogenesis. To date, several influenza A reporter viruses have been described. These strategies typically focused on a single reporter gene (either bioluminescent or fluorescent) in a single virus backbone. However, whilst bioluminescence is suited to in vivo imaging, fluorescent viruses are more appropriate for microscopy. Therefore, the idea l reporter virus varies depending on the experiment in question, and it is important that any reporter virus strategy can be adapted accordingly. Herein, a strategy was developed to create five different reporter viruses in a …

Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays

Health Management and Policy Presentations

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …

Comparative Analysis Of Dietary Guidelines In The Spanish-Speaking Caribbean, Melissa Fuster

Publications and Research

Objective: Dietary guidelines are important education and policy tools to address local nutrition concerns. The current paper presents a comparative analysis of nutrition messages from three Spanish-speaking Caribbean countries (Cuba, Puerto Rico and Dominican Republic) to explore how these dietary guidelines address common public health nutrition concerns, contextualized in different changing food environments and food culture similarities.

Design: Qualitative, comparative analysis of current dietary guideline documents and key recommendations.

Results: Key recommendations were categorized into sixteen themes (two dietbased, ten food-based and four ‘other’). Only the Cuban dietary guidelines included diet-based key recommendations. Of the ten food-based …

Medicare At Fifty Needs To Grow, William H. Lane

English Faculty Publications

In America everybody has a healthcare story. A bill impossible to read, an inscrutable "additional" charge, trouble getting insurance, trouble keeping it, a friend or family member who's fallen between the coverage "cracks." [excerpt]

King V Burwell: Subsidizing Us Health Insurance For Low- And Middle-Income Individuals, Lawrence O. Gostin, Mary C. Debartolo, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

In King v. Burwell, the U.S. Supreme Court once again saved the Affordable Care Act (ACA) by upholding subsidies (tax credits) offered to low- and middle-income individuals for insurance bought on federal exchanges. A contrary opinion would have put at risk health insurance for 6.4 million Americans and threatened to destabilize insurance markets for millions more.

The ACA is supported by four interlocking reforms, each of which are necessary to realize its promise of expanding health care coverage: (1) guaranteed issue (prohibiting discrimination based on pre-existing conditions), (2) community rating (barring insurers from imposing higher premiums based on health …

Patient Experiences With Family Planning In Community Health Centers, Susan F. Wood, Tishra Beeson, Debora Goetz Goldberg, Holly Mead, Peter Shin, Aliyah Abdul-Wakil, Anna Rui, Bhakti Sahgal, Maya Shimony, Hallie Stevens, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Women of childbearing age represent one of the single largest groups of community health center patients, and family planning plays a critical role in the health, economic, and social circumstances of women, their children, and families. Family planning is a required service at all health centers, and the major expansion of health centers under the Affordable Care Act means that for low-income women of reproductive age this service should be increasingly available. The Quality Family Planning (QFP) Guidelines, jointly developed by the Centers for Disease Control and Prevention (CDC) and the Office of Population Affairs (OPA) and released in 2014, …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Community & Environmental Health Faculty Publications

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

The State Of Accreditation Readiness In Georgia: A Case Study, Angela Peden, Gulzar H. Shah, Russell B. Toal, Dayna S. Alexander, Alesha Wright, Ashton Anderson, Nandi A. Marshall, Scott Uhlich, Jeffery A. Jones

Health Policy & Management: Faculty Publications (2006-2018)

Background: Georgia’s public health districts first began exploring the idea of national public health accreditation in 2008 when Cobb & Douglas Public Health included accreditation in their strategic plan. In May 2015, Cobb & Douglas Public Health was the first Georgia public health district to achieve national accreditation status. This article discusses the current state of accreditation readiness in Georgia and explores strengths and barriers to accreditation.

Methods: This study utilized a case study approach in order to examine PHAB accreditation efforts in Georgia within a reallife context. Data came from three sources: nine Accreditation Readiness Assessments, a PHAB Pre-Application …

Socially Constructing Drug Addicts From The Poor: A Critical Discourse Analysis, Kalynn Susan Amundson

Graduate Theses and Dissertations

Welfare drug testing was authorized by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, and has subsequently garnered extensive legislative interest in numerous states. This policy raises several questions, which are the subjects of the two journal articles and one manuscript included in this dissertation.

The first article addresses the question of a possible confluence of War on Drugs and Welfare Reform policies as evidenced through welfare drug testing policy, and indicated by continuity in policymakers’ rhetoric. This study examines federal-level policymakers’ debate discourse in these two policy streams. The analysis finds themes of the Social pathology, …

Public Health, Universal Health Coverage, And Sustainable Development Goals: Can They Coexist?, Harald Schmidt, Lawrence O. Gostin, Ezekiel Emanuel

Georgetown Law Faculty Publications and Other Works

In her 2012 reconfirmation speech as WHO Director-General, Dr. Margaret Chan asserted: "universal coverage is the single most powerful concept that public health has to offer. It is our ticket to greater efficiency and better quality. It is our savior from the crushing weight of chronic noncommunicable diseases that now engulf the globe ". The UN General Assembly is currently considering proposals for Sustainable Development Goals (SDGs), succeeding the Millennium Development Goals. SDGs, focusing on health, specifically includes universal health coverage (UHC) among its targets. Unquestionably, UHC is timely and fundamentally important. However, its promotion also entails substantial risks. A …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Journal of Health Disparities Research and Practice

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Assessing The Education And Training Needs Of Nebraska's Public Health Workforce, Brandon L. Grimm, Patrik Johansson, Preethy Nayar, Bettye A. Apenteng, Samuel T. Opoku, Anh Nguyen

Health Policy & Management: Faculty Publications (2006-2018)

Introduction: In 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821) conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments, and urban Indian clinic) public health workforce across three professional levels. The objectives of the needs assessment were to determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health training interests, needs, and preferences, and to determine the barriers and motivators to participate in public health training.

Methods: The assessment was developed using the Council on Linkages Between Academia and …

Middle East Respiratory Syndrome: A Global Health Challenge, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

Beginning in May 2015, Middle-East respiratory syndrome (MERS) experienced its first publicly reported “super-spreading” event in South Korea. By mid-June, more than 120 cases and 11 deaths in South Korea had been linked to a businessman returning from travel to Bahrain, United Arab Emirates, the Kingdom of Saudi Arabia and Qatar. Globally more than 1200 had been infected of whom more than 450 died—a high fatality rate of 37%.

What are the most effective legal, social, and public health responses to MERS and other emerging diseases? First, the World Health Organization’s International Health Regulations (IHR) did not effectively guide the …

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …

Learning From Network Analysis: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This methods workshop highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This session will examine the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures.

Learning From Delivery System Behavior, Dynamics & Interactions To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

A new "Systems for Action" national research program flows directly from the Robert Wood Johnson Foundation's Culture of Health action framework. This program will build evidence on how best to align the delivery and financing systems for medical care, public health, and community services & supports so as to promote wellbeing and resiliency, realize efficiencies in resource use, and reduce inequities in health.

Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health “system capital”; and (2) the effects of these changes on preventable mortality and resource use. …

The National Health Security Preparedness Index: National Advisory Committee Meeting, Glen P. Mays, Michael Childress, Anna Goodman Hoover, Chris Bollinger

Health Management and Policy Presentations

This meeting of the National Advisory Committee for the National Health Security Preparedness Index program discussed strategies for improving the theoretical framework, measures, and analytic methodologies used in assessing and comparing preparedness levels across U.S. states and the nation as a whole.

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.