Public Health Commons^™

A Pay-For-Performance Innovation Integrating The Quantity And Quality Of Care In Maternal, Newborn And Child Health Services In Bangladesh, Laila Rahman, Ubaidur Rob, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Md. Noorunnabi Talukder, Md. Hafizur Rahman

Reproductive Health

The Population Council explored the possibilities of introducing a Pay-for-Performance (P4P) scheme in Bangladesh to improve maternal, newborn and child healthcare (MNCH) services. Based on the consultation and with guidance from the Government of Bangladesh, the Population Council and UNICEF provided technical assistance to the Directorate General of Health Services (DGHS) to test two P4P strategies for MNCH service providers to improve service volume and quality of care, and for poor clients to receive services subsidized through vouchers or coupons. The first strategy is a combination of pay-for-performance for providers and subsidized coupons for poor pregnant women, newborns, and under-five …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

The Relationship Of Race And Social Integration On The Health Status Of Older Adults In An Urban City, Thomas T. Jordan

Dissertations, Theses, and Capstone Projects

Durkheim argues that an individual is more vulnerable to self-destruction the more s/he is detached from the collective. This dissertation will explore the relative impact of social integration on older adults who have transitioned into their new roles in the social structure in relationship to their physical (obesity) and psychological (stress) health status. Additionally, the dissertation examines how social integration varies in its impact from one racial group to another, and how such variations influence the health status of the older adults who are members of these groups.

This dissertation employs data from the Brookdale Center for Healthy Aging and …

The Effects Of An Integrated Health And Physical Education Program On Student Achievement, Myralynn B. Catchings

Walden Dissertations and Doctoral Studies

In recent years, several schools have addressed the No Child Left Behind (NCLB) Act of 2001 by focusing on promoting skill acquisition in reading and math, often overlooking physical education (PE) as a significant part of a child's education. The purpose of this causal-comparative study was to evaluate the effectiveness of an integrated health and physical education (HPE) program on student achievement. This study was grounded in action-based learning theories. The research question examined differences in posttest scores, adjusted for pretest differences, from 204 freshman students enrolled in a Biology-1 class at an urban high school. Students in Group A …

Drills And Exercises As Interventions To Improve Public Health Emergency Response, Donna Beth Knutson

Walden Dissertations and Doctoral Studies

The 2001 destruction of the World Trade Center and the subsequent anthrax attacks highlighted the inability of an antiquated public health system in the United States to respond effectively to emergencies. Little documentation exists to define how public health agencies can improve performance. The overarching research question was the extent to which drills and exercises improve performance in public health emergencies. Adult learning theory and deliberate practice theory were explored in this context. The research data were from 50 state public health departments, which were required to report performance information to the U.S. Centers for Disease Control and Prevention. The …

Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards, Salma Theus

Walden Dissertations and Doctoral Studies

U.S. Army Regulations require soldiers to be fit, as excessive weight negatively impacts their readiness, health, and morale. A quantitative study examined if personal, behavioral, and/or environmental factors predict a soldier's self-efficacy and body mass index. Data were obtained from 117 soldiers on 6 scales: the Armed Services Vocational Aptitude Battery, the Army Physical Fitness Test, the General Self-Efficacy Scale, the Stress Management Questionnaire, the Lifestyle Assessment Inventory, and the Multifactor Leadership Questionnaire. Multiple regression analysis was used to determine if personal (intellectual capabilities and physical fitness), behavioral (lifestyle and stress management), and/or environmental (supervisor leadership) factors predict self-efficacy and …

The Impact Of Managed Care On The Utilization And Distribution Of Inpatient Surgical Procedures With Demonstrated Volume And Outcome Endogeneity, Linda Stephens Gipson

USF Tampa Graduate Theses and Dissertations

Purpose

This study is designed to determine whether managed care has had an influence on the number and distribution of procedures with demonstrated volume and outcome endogeneity in Florida healthcare markets; in addition, methods are developed to determine which measures of managed care activity best predict the impact of managed care in health care markets.

Rationale

A retrospective population based cohort design is used capitalizing on the variability among Florida markets between 1995 and 1999, a period which captured the full business life cycle of managed care plans statistical areas and competing hospitals (market share) over time. Multiple regression models …

Epidemiological Study Of Contributing Factors In The Development Of Peptic Ulcer And Gastric Cancer Initiated By Helicobacter Pylori Infection In India, Rahul Suresh Mhaskar

USF Tampa Graduate Theses and Dissertations

Background: Helicobacter pylori (H. pylori) infection is a significant risk factor for peptic ulcer (PU) and gastric cancer (GC). Apart from the virulent CagA genotype of H. pylori environmental and dietary factors influence disease outcomes. There have been no studies addressing these factors in Western India. Hence, we conducted a case control study enrolling PU, GC patients and controls at Pune, India.

Methods: Risk factors for PU and H. pylori infection were assessed in participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. To understand treatment effect, we followed 100 H. pylori positive patients.

Results: We …

The Affordable Care Act, Medical Homes, And Childhood Asthma: A Key Opportunity For Progress, Meagan Lyon, Anne Rossier Markus, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The medical homes provisions of the Affordable Care Act offer a major opportunity to advance high quality, cost-efficient health care for children with asthma. This policy brief examines evolving national medical homes policy in a childhood asthma context. Following a brief background that examines childhood asthma and explores the origins and evolution of medical homes policy (a concept developed with children in mind), the brief then describes how the Affordable Care Act can advance the implementation of medical homes policies to improve health outcomes for children with asthma.

Accessibility Of Primary Health Care Settings For People With Disabilities, Nancy R. Mudrick, Mary Lou Breslin, Mengke Liang, Silvia Yee

Social Work - All Scholarship

People with disabilities report physical barriers in doctors’ offices that affect the quality of care. The analysis seeks to describe overall primary care office physical accessibility and identify (1) in which areas offices meet access criteria, (2) which accessibility criteria are most often not met, and (3) whether there are urban/non-urban differences.

Inactivation Of Ascaris Suum By Ammonia In Feces Simulating The Physical-Chemical Parameters Of The Solar Toilet Under Laboratory Conditions, Ligia Maria Cruz Espinoza

USF Tampa Graduate Theses and Dissertations

Access to sustainable sanitation systems is a determining factor in human health and economic development. However, more than a third of the world’s population lives without access to improved sanitation facilities. To meet the sanitation United Nations Millennium Development target, "halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation", a wide range of non conventional sanitation technologies have been implemented in developing countries, including waterless systems. These systems function by diverting urine away from feces and collecting, storing, and dehydrating the fecal material in watertight dehydration vaults. From a public …

Agenda: 2010 World Energy Justice Conference: Emerging Solutions For The Energy Poor: Technological, Entrepreneurial And Institutional Challenges, University Of Colorado Boulder. Center For Energy & Environmental Security, Colorado Journal Of International Environmental Law And Policy

2010 World Energy Justice Conference (November 5)

This conference is a sequel to the 2009 World Energy Justice Conference (WEJC 2009) which began examining ways of mainstreaming safe, clean, and efficient energy for the world's Energy Poor (EP). The EP number two and a half billion people living on less than $1-2 a day who have no access to modern energy services. WEJC 2010 more fully develops these themes. WEJC 2010 will explore how the next round of global warming meetings in Cancun could design new flexibility mechanisms that give credits, for example, for the reduction of black carbon by the adoption of cookstoves, and embrace small …

Roundtable On The National Health Security Strategy And At‐Risk Individuals, Behavioral Health, And Community Resilience, Daniel B. Fagbuyi, +Conference Participants

GW mHealth Collaborative

No abstract provided.

Phenotypic And Genotypic Analysis Of In Vitro Selected Artemisinin Resistant Plasmodium Falciparum, Matthew Scott Tucker

USF Tampa Graduate Theses and Dissertations

Artemisinin and its derivatives provide faster clearance of parasitemia than any other antimalarial drugs and these drugs are part of frontline combination therapies in areas where drug-resistant Plasmodium falciparum exists. Clinical resistance to artemisinins is emerging on the Thailand-Cambodia border, making it imperative to investigate mechanisms of artemisinin resistance. Previous work in our laboratory showed ring-stage parasites enter a dormant state after exposure to artemisinin. We hypothesize that this period of dormancy is directly related to recrudescence and prolonged parasite clearance times in patients, and possibly resistance. The target of artemisinin is currently unknown, and potential resistance mechanisms are not …

A Case Study Of Appendicitis At Antanimalandy Lutheran Hospital, Jennifer Gemmell

Independent Study Project (ISP) Collection

From the introduction:

The island of Madagascar houses a total of 19,159,000 people who spend only $34 per person per year on health care (“Madagascar,” 2008). The government claims to have “committed itself to the principle that good health is a right of each Malagasy citizen, and has made significant studies in the area of health care,” according to the country study for the Library of Congress. However, with political corruption, political crisis after political crisis, and lack of international support, the government does not dispense the funds necessary to support this commitment (Metz, 1994). For example, in 1976 the …

Public Health Insurance Utilization In New York City, 2008, Rachael Varra

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines demographic and socioeconomic factors of racial/ethnic groups in New York City between as of 2008 – particularly the utilization of public health insurance (PHI) benefits.

Methods: Data on Latinos and other racial/ethnic groups were obtained from the U.S. Census Bureau American Community Survey, reorganized for public use by the Minnesota Population Center, University of Minnesota, IPUMSusa. Cases in the dataset were weighted and analyzed to produce population estimates.

Results: Of the 25% of New Yorkers receiving PHI in 2008, the absolute number of whites, blacks and Latinos receiving PHI was similar. However, greater proportions of Latinos …

Finding The Right Fit: Unique Challenges Faced By Health Ngos In The Health System Of Lamu District, Lauren Hartel

Independent Study Project (ISP) Collection

This study examines how nongovernmental organizations and community-based organizations in Lamu District interact with the governmentally structured health care system at the district level. This is done through participatory observation, interviews and removed observation of NGOs, CBOs and government officials. From these observations, this study then identifies major challenges faced by health NGOs that inhibit them from performing to the best of their ability, and at times even compromise the health of the people they are trying to help. The results of this study show that in Lamu District, the most relevant challenges are continuity of care, dissemination of information, …

Perceptions And Evaluation Of An Urban Environment For Pedestrian Friendliness: A Case Study, Elizabeth H. Lee

Master's Theses

Public health is an increasingly important issue addressed from both environmental and public health sectors for the future development of urban environments. From a planning perspective, one possible solution is to increase walkability throughout the cities. Many assessment methods are being developed and administered to evaluate the quality of existing urban environments to promote walkable cities/communities. The results from using these methods provide policymakers and stakeholders with valuable information regarding the existing physical conditions of the environment. Although several US cities started to develop and refocus plans toward pedestrian-oriented policies approaches, results from this particular study determined that the quality …

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

School of Public Health Faculty Research

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

Renewing Health Services Management Research: Redrawing The Citizen-Client In Irish Health Care Policy, Vivienne Byers

Conference Papers

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Envisioning Nevada’S Future: Goals & Strategies For Advancing Our Quality Of Life, Nevada Vision Stakeholder Group, Moody’S Analytics

Brookings Mountain West Publications

Nevada’s severe downturn has brought to light many of the long-term challenges facing the state. Not only is its economy subject to painful swings, but Nevada’s primary drivers— consumer services (primarily gaming, hospitality and housing) and resource extraction—will provide less support than they have in past business cycles. Less economic vitality will make it harder to offer Nevadans the quality of life they expect.

The importance of the economy to quality of life is equally clear—quality of life is a hollow promise without a healthy and supportive economy. Similarly, a proper fiscal structure—both in terms of spending and revenues—is critical …

Core Promoter Function In Brugia Malayi, Michelle Bailey

USF Tampa Graduate Theses and Dissertations

Previous studies have indicated that the promoters of the human filarial parasite Brugia malayi are unusual in that they do not exhibit the CAAT or TATAA sequences usually found in the core domains of promoters of most eukaryotic organisms. Analysis of the promoters of the ribosomal proteins showed that the region flanking the splice leader (SL) addition site plays an important role in transcription and may function as the core promoter domain in B. malayi. To test the hypothesis that the SL addition domain is the most important essential region of the ribosomal protein promoters, the SL addition site of …

Weighing In: A Critical Analysis Of New York City’S Calorie Labeling Law, Josephine Barnett

Publications and Research

The ‘obesity’ epidemic has The health of New York City Residents has been a significant concern of public health officials with the rates of obesity and diabetes ranking eighth of all cities nationally. The New York City (NYC) Board of Health laid the foundation and influenced the legislative efforts of means to address the ‘obesity-diabetes’ epidemic for public health officials consider this to be one of the major health concerns among Americans and particularly NYC residents. The major initiatives implemented by NYC official include: (1) a ban on trans-fat (2) a city registry of those with diabetes, and (3) menu-labeling. …

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

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

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

Strengthening Primary Care To Bend The Cost Curve: The Expansion Of Community Health Centers Through Health Reform, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The recent enactment of health reform sets into motion important changes that will expand health insurance coverage, increase funding for community health centers and alter the way that health centers are paid. These reforms will have a major impact on two major challenges of health reform: bolstering the capacity of the nation's primary care system and reducing the long term growth in health care costs.

Our analyses examine the impact of the new health reform law on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall …