Public Health Commons^™

Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi

Reproductive Health

In collaboration with the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium, the Population Council implemented a project to increase the demand for secondary school education in Homa Bay County, Kenya—an area characterized by high, unintended teenage pregnancy and female school drop-out rates. To foster awareness of the school re-entry policy, the Population Council collaborated with the Homa Bay County Department of Education (Ministry of Education) to convene a policy dialogue for all principals of public, day, girls-only, and co-educational secondary schools in the area. The policy dialogue helped to create visibility around the issue of …

Do Air Pollutant Emissions Lead To An Increase In Total Personal Health Care Costs By State?, Dana Jespersen

MPA/MPP/MPFM Capstone Projects

Total personal health care costs are increasing in the United States every year. Currently personal health care costs are predicted to increase at a national average rate of 6.5 percent. This is on track with the historical data. The increase has returned to the 6.0 percent mark after falling down to an increase of 3.7 percent in 2013. Recovering from the recession and the implementation of the Affordable Care Act has contributed to the steady increase back up to the average 6 percent increase per year. When looking at individual states, all averaged around the 6 to 8 percent increase …

The Healthy, Hunger-Free Kids Act And High School Obesity, Derek Grills

Walden Dissertations and Doctoral Studies

United States high school student obesity rates have doubled in the past 30 years to 13%, threatening the health of millions of adolescents. To mitigate the epidemic, Congress passed the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, which mandated significant changes to school nutrition and physical education. From a public policy perspective, the HHFKA changed school nutrition and exercise policy to affect obesity rates by changing intake and energy expenditure at school, though no study using national-level data examined this relationship. As such, the purpose of the study was to examine whether HHFKA policy compliance had a statistically significant effect …

Determinants Of Usage Of Age-Appropriate Child Safety Seats In Connecticut, Giuseppina Mendillo Violano

Walden Dissertations and Doctoral Studies

In the United States, motor vehicle crashes are one of the leading causes of unintentional injury death and disability for children ages 1'15 years. Despite local, state, and federal legislative and educational efforts, children continue to be restrained improperly and thus face harm. Identifying behaviors and barriers that place child occupants at risk is crucial for implementing focused, injury-prevention programs and policies. The purpose of this study was to evaluate the effectiveness of Connecticut's child passenger safety law that was strengthened in 2005. This study involved a multifactorial approach to predicting child seat use, guided by Roger's diffusion of innovations …

U.S. Army Enlisted Soldiers' Adherence To Prescribed Malaria Chemoprophylaxis In Afghanistan, Michael Paul Brisson

Walden Dissertations and Doctoral Studies

Over the past 13 years, the United States Army has been engaged in armed conflict within Afghanistan. Unfortunately, the United States Army has been forced to evacuate soldiers from the battlefield because of malaria, a parasitic disease that is endemic in Afghanistan. Even though the U.S. Army has adopted an effective chemoprophylaxis protocol, soldiers' adherence to their prescribed medication has been historically low. This research addressed a gap in literature regarding the adherence rates of U.S. Army enlisted soldiers to their prescribed oral malaria chemoprophylaxis. In addition, this research investigated self-reported reasons for soldiers' nonadherence to this medication. The study …

Relationships Between A Prenatal Nutrition Education Intervention And Maternal Nutrition In Ethiopia, Divya Lakshmi Selvakumar

Walden Dissertations and Doctoral Studies

In Ethiopia, 17% of pregnant women ages 18-49 are malnourished and have low awareness of prenatal nutrition, which may relate to increasingly high rates of maternal and infant mortality. The purpose of this mixed methods research study was to determine the effects of a community-based prenatal nutrition education intervention program on maternal nutrition knowledge and attitudes in the Alaje district of Ethiopia. The theoretical framework was Sen's capability theory of poverty, in which opportunities can lead to well-being and promote economic development. Research questions focused on the relationships among 8 independent variables-age, income source, degree of program implementation, marital status, …

Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri

DNP Projects

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.

Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …

Is Conflict A Factor In A Population's Quality Of Life? A Comparative Study Of University Students In The Palestinian Territories And Jordan, Yara Asi

Electronic Theses and Dissertations

As nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken in an effort to understand how long-term conflict manifests itself in noncombatant populations. However, existing studies focus primarily on indicators within the …

An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic has demonstrated that the world remains ill-prepared to respond to infectious disease outbreaks. A host of institutions are now reviewing what went wrong, and new institutions are being considered, including an African Centers for Disease Control and Prevention and World Bank-initiated Pandemic Emergency Facility. The World Health Organization itself failed in one of its core functions by allowing a preventable infectious disease to spiral out of control in the world’s poorest region. The 68th World Health Assembly (WHA), held in May 2015, provided an opportunity for the Organization to reflect on what went wrong and …

Indonesia Has It Backward: It's Not E-Cigarettes That's The Problem But Smoking, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Indonesia has announced it will be banning e-cigarettes. But that would do nothing to reduce smoking, which should be the main target of those interested in reducing tobacco use deaths and harms. Rather than ban e-cigarettes, it makes more sense to regulate them effectively so that they can serve as a useful anti-smoking tool. The availability of e-cigarettes to smokers can also make much more aggressive anti-smoking strategies more practically and politically viable-–perhaps even paving the way for banning cigarettes, instead.

The Normative Authority Of The World Health Organization, Lawrence O. Gostin, Devi Sridhar, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The World Health Organization (WHO) was born after the devastation of World War II, as a normative agency endowed with unprecedented constitutional powers. But even as it has achieved stunning successes, such as the eradication of smallpox, it has failed to live up to the exalted expectations of the postwar health and human rights movement e exemplified most recently by its inadequate response to the Ebola epidemic. Our aim is to offer innovative ideas for restoring the Organization to its leadership position by exercising its normative authority, even as it faces a crowded and often chaotic global health architecture. Before …

Marketplace Clinics Complementing Community-Based Diabetes Care For Urban Residing American Indians, Robert Steven Rick

Walden Dissertations and Doctoral Studies

The American Indians population in Minneapolis, Minnesota has experienced limited health care access and threefold diabetes health disparity. The purpose of this study was to measure the extent to which collaborating marketplace clinics and community-based support groups expanded diabetes care and provided self-management education for this largely urban Indian neighborhood. The marketplace clinics located in nearby CVS, Walmart, Target, and Supervalu stores committed financial support, certified educators, and pharmacy staff for the community-based support group. The study was conducted within the patient activation measure (PAM) analytical framework to assess the participants' acquired knowledge, skills, and confidence for diabetes self-management. A …

A Retrospective And Prospective Analysis Of The West African Ebola Virus Disease Epidemic: Robust National Health Systems At The Foundation And An Empowered Who At The Apex, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic is a pivotal moment for the global health system. Just as the depth of the crisis ultimately spurred an unprecedented response, the failures of leadership demand innovative reforms. This analysis offers a template for these reforms, responding to the profound harms posed by fragile national health systems, delays in the international response, deficient resource mobilization, ill-defined responsibilities, and insufficient coordination. The scope of the reforms must address the failures evident in the Ebola response, as well as entrenched weaknesses that enabled the epidemic to reach its heights, transforming the existing inchoate, organically developed global health …

3 Critical Challenges For Global Health Security, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

International institutions are poised to make one of the most momentous decisions about the future of global health security since the formation of the World Health Organization (WHO) in 1948.

By the end of this year, 5 global commissions will have published major critiques of global health preparedness, all spurred by the Ebola epidemic, which exposed deep flaws in the international system.

Sexual Assaults Among University Students: Prevention, Support, And Justice, Rebecca B. Reingold, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Sexual assault is common among college-aged women (18 to 25 years), with 1 in 5 reporting having experienced these crimes during their college years. Acute and long-term consequences of sexual assault may include physical trauma, sexually transmitted infections, posttraumatic stress disorder, depression, and substance abuse. Survivors have the option of reporting assaults to the university or to the police, but the goals of these 2 systems—and women’s experiences with them—can be quite different. The criminal justice system’s principal aim is to adjudicate guilt, but the university has the broader purpose of fostering a safe learning environment.

This article explores how …

Exploring The Process, Models, And Outcomes Of Hospital-Public Health Partnerships, Danielle M. Varda, Jessica H. Retrum, Carrie Chapman

Frontiers in Public Health Services and Systems Research

Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) requirement that hospitals conduct community health needs assessments, taking into greater consideration the public health of their respective communities. This has led to growing strategies to develop partnerships between hospitals and public health (PH) as a way to meet these needs¹. Meantime, there is a need for data on Hospital-PH partnerships, due to the growing emphasis that these types of partnerships get implemented in practice. In this paper we analyze a secondary data set to explore how hospitals and public health …

A Case Study Of Cross-Jurisdiction Resource Sharing: The Merger Of Two Tuberculosis Clinics In East Tennessee., Anne Kershenbaum, Margaret A. Knight, Martha L. Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Cross-jurisdiction resource sharing is considered a possible means to improve efficiency and effectiveness of public health service delivery. A merger of the Tuberculosis (TB) clinics of a rural and a metropolitan jurisdiction in East Tennessee provided an opportunity to study service provision changes in real time. A mixed methods approach was used, including quantitative data on latent TB treatment outcomes and qualitative data from staff interviews, as well as documentation of changes in staffing time in TB services. Results showed a mix of efficiency changes, indicating probable increased pressure on key service providers after the merger, in addition to expected …

Health Communication As A Public Health Training And Workforce Development Issue, Nancy L. Winterbauer, Ann P. Rafferty, Katherine A. Jones, Mary Tucker-Mclaughlin, Colleen Bridger

Frontiers in Public Health Services and Systems Research

Effective communication is one of the core competencies for public health professionals and is required for local health department (LHD) accreditation. Public health communication specialists play a critical role as conduits of health information, particularly with regard to managing relationships with media and the message that is ultimately represented by news outlets. However, capacity for engagement with traditional media in community health improvement at the local level has not been well-described. As part of a larger study examining the use and impact of the County Health Rankings in North Carolina, LHD media staffing and interaction with traditional media were examined …

What “Community Building” Activities Are Nonprofit Hospitals Reporting As Community Benefit?, Erik Bakken, David Kindig, Jo Ivey Boufford

Frontiers in Public Health Services and Systems Research

In 2008, the Internal Revenue Service (IRS) revised and standardized the reporting policy for community benefit expenses for nonprofit hospitals. These expenses are required for tax exemption. At that time, the IRS designated some categories of activities as non-eligible as a community benefit, but still mandated their reporting on hospitals’ Form 990, the annual tax filing for nonprofit organizations. One such category was community building, which encompasses a broad range of nonmedical determinants of health and an important potential source of population health revenue. This is the first study to analyze community-building dollars at any level, examining New York State’s …

Combating Hiv/Aids In Marginalized Communities: Papua And West Papua Provinces, Indonesia, Bani Cheema

Master's Theses

My study focuses on foreign aid and local initiatives for HIV/AIDS prevention in eastern Indonesia using the provinces of Papua and West Papua as a case study. The two provinces are home to indigenous tribal groups that are socioeconomically marginalized and most affected by the epidemic. My research investigates behavior change communication as a principal strategy undertaken by multiple organizations for HIV/AIDS prevention in this region. I take a qualitative approach by examining the effectiveness of this strategy in local communities and by revealing social and cultural barriers that impede success. Obstacles that negatively impact prevention efforts include structural violence, …

The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …

Discovering A Gold Mine Of U.S. Government Information: Exploring The Hathitrust Catalog And Its Rich Veins, Bert Chapman

Libraries Faculty and Staff Presentations

The Hathitrust Catalog provides researchers at member institutions with exponentially expanded access to historical U.S. Government information resources. This presentation describes how researchers can use this resource to conduct substantive research using government information resources on public policy issues such as Internal Revenue Service program problems, infectious diseases such as Ebola, and U.S. foreign relations with the former Soviet Union/Russian Federation.

Opportunities And Future Directions For The National Health Security Preparedness Index™, Glen P. Mays

Health Management and Policy Presentations

This presentation examines options and opportunities for future development of the National Health Security Preparedness Index, created through a partnership of national public health and health care organizations led by the U.S. Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO).

Let’S Talk About Sex, And What Happens When We Don’T: How Limited Sex Education In Nepal’S Government Schools Affects Women In Arranged Marriages, Isabelle Stillman

Independent Study Project (ISP) Collection

In Nepal’s government secondary schools, the reproductive health curriculum is often covered in a single week, and many teachers neglect to administer the lessons thoroughly due to beliefs that sex is a private matter, inappropriate or unnecessary for students. The government curriculum not only lacks detail about reproduction and intercourse, but, in the information it does include, defines male and female puberty processes, reproductive systems, sexual health, roles in family planning, and intercourse in ways that further the gender inequality so deeprooted in Nepali culture. Following secondary school, many women in Nepal are married in arranged matches, to men they …

Adults With Intellectual Disability Or Autism Spectrum Disorder. Executive Summary, Kimberly I. Snow Mhsa, Ba, Stuart Bratesman Mpp, Taryn Bowe, Julie T. Fralich Mba

Disability & Aging

This chartbook describes Maine’s historical trends in meeting the needs of adults with ID/ASD through institutional and community based services in comparison to other states; a detailed analysis of the population’s utilization of different types of services and their costs in SFY 2010; the implementation of the Supports Intensity Scale (SIS) as a means of identifying the supports needs of the adults with ID/ASD; and the complement of providers serving this population in Maine.

Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin

Independent Study Project (ISP) Collection

Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …

A Wellness Profile Of Student-Veterans At 4-Year Higher Education Institutions: The Role Of Gender, Combat Tours, And Deployment, William Monroe Heath

Graduate Theses and Dissertations

Afghanistan and Iraq war student-veterans have increased in population on college campuses in the United States (U.S.) as a result of using the Post 9/11 GI Bill. Healthy Campus 2020 (American College Health Association, 2012) highlighted the importance of college student wellbeing, health promotion and disease prevention, while the U.S. Department of Veteran Affairs has called for an approach to services that is strength based (United States Department of Veteran Affairs, 2008). To date, however, wellness studies conducted on Iraq and Afghanistan student-veterans using an evidenced-based model of holistic wellness have not been conducted. This study was designed to address …

Listening To The Ranks: Perceptions Of The U.S. Air Force Occupational Health And Safety Training, Melissa Jo Breunig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational health and safety hazards are abundant in military environments. Due to the hazardous occupational settings, injuries remain a public health concern in the United States military. Public health plays a critical role in injury reduction by addressing the need for comprehensive safety education training, and more specifically, exposure related injuries. A secondary data analysis was completed using Communication Theory as the overarching framework to analyze 13 qualitative interviews conducted with Airmen to gain their perceptions of the occupational health and safety training at Nellis and Creech Air Force Base (AFB). Pedagogy and training content were the two main themes …

Pengaruh Rejimen Terhadap Ketidakpatuhan Berobat Tuberkulosis, Rizka Nur Fadila, Pandu Riono

Kesmas

Beban tuberkulosis di Indonesia termasuk lima tertinggi di dunia. Temuan kasus dan pengobatan adalah pilar utama program penanggulangan tuberkulosis. Survei nasional menunjukkan peningkatan penggunaan rejimen tidak standar dari 16,8% (2010) menjadi 55,6% (2013). Peningkatan penggunaan rejimen tidak standar diduga berpengaruh terhadap ketidakpatuhan berobat. Penelitian ini bertujuan untuk mempelajari ketidakpatuhan berobat pada orang dengan tuberkulosis yang menerima rejimen tidak standar dan rejimen standar. Penelitian menggunakan data sekunder Riset Kesehatan Dasar 2010. Analisis logistik multivariabel dilakukan pada sampel 971 orang dengan tuberkulosis yang selesai mendapatkan pengobatan. Hasil penelitian menunjukkan ada kecenderungan orang dengan tuberkulosis yang menerima rejimen tidak standar memiliki ketidakpatuhan berobat …

Annual Parasite Incidence Malaria Di Kabupaten Banyumas, Dwi Sarwani Sri Rejeki, Ruthi Armita Sari, Nunung Nurhayati

Kesmas

Kabupaten Banyumas merupakan kabupaten endemis malaria di Provinsi Jawa Tengah. Data Dinas Kesehatan Kabupaten Banyumas tahun 2008 - 2013 menunjukkan angka annual paracite incidence (API) yang selalu mengalami fluktuasi. Dari 27 kecamatan, 22 di antaranya termasuk dalam kategori medium case incidence (MCI) dan low case incidence (LCI). Faktor lingkungan, perilaku, sosial ekonomi, dan iklim berdampak pada tinggi rendahnya kejadian malaria. Tujuan penelitian adalah mengetahui faktor yang berhubungan dengan API di Kabupaten Banyumas. Data dikumpulkan dari Januari 2011 - Desember 2013 menggunakan penelitian analitik dengan rancangan penelitian potong lintang dan menggunakan data sekunder dari Dinas Kesehatan, Dinas Pertanian, dan Badan Pusat …