Public Health Commons^™

A Rapid Situation Analysis Of The Access To Care Project In Northern Thailand, Ratana Panpanich

HIV and AIDS

A rapid situation analysis (RSA) study, supported by the Horizons program, was undertaken to understand the strengths and weaknesses of the Thai government’s Access to Care (ATC) project in northern Thailand. The ultimate aim of the study was to make recommendations for action that will improve the quality of the antiretroviral (ARV) therapy that clients receive and to enhance their adherence to HAART. The RSA has shown high levels of support for the ATC project from health providers, HAART clients, their relatives, and even those who had dropped out of the program. However, the RSA has also shown that there …

Public Posting As A Strategy To Increase Walking: A Worksite Intervention, Rayleen Earney, Timothy J. Bungum

Environmental & Global Health Faculty Research

Because most American adults do not meet recommended physical activity guidelines, the need for new and innovative strategies is apparent. The current study employed public posting in an attempt to increase walking behavior in a worksite setting. Pedometer generated data was publicly posted in a prominent location in the worksite. In our study that utilized a pre-experimental design, we found that walking steps were statistically higher during the intervention and in a post intervention period as compared to the baseline data. We conclude that the public posting of physical activity data has the potential to increase walking behavior.

Access To Health, Natalie Huls

Human Rights & Human Welfare

Access to health is an often-overlooked aspect of the right to health. Without practical access, the right to health becomes an empty promise. International human rights conventions and declarations do not directly mention access to health, but the above comment on the International Covenant on Economic, Social, and Cultural Rights does address the issue.

Transitions To Adulthood In The Context Of Aids In South Africa: The Impact Of Exposure To Life Skills Education On Adolescent Knowledge, Skills, And Behavior, The Transitions To Adulthood Study Team

HIV and AIDS

This study is a collaborative research project of the University of Natal-Durban, the Horizons program, and Tulane University. One objective of the study was to contribute to understanding the effectiveness of life skills education in changing behavior in South Africa. The findings indicate substantial short-to-medium-term effects of exposure to life skills education on certain areas of sexual and reproductive health-related knowledge, confidence to use condoms, and condom use behavior. Further research is needed to assess whether the observed effects are transitory or long-term in nature, whether the observed behavioral changes have an impact on HIV infection rates among youth, and …

Using Incentives To Encourage Aids Programs And Policies In The Workplace: A Study Of Feasibility And Impact In Thailand, Simon Baker, Srisuman Sartsara, Patchara Rumakom, Philip Guest, Katie D. Schenk, Anthony Pramualratana, Suparat Suksakulwat, Surachai Panakitsuwan, Sikarat Moonmeung

HIV and AIDS

A recently completed Horizons study in Thailand examined the question of how to encourage the private sector to become actively involved in developing and improving workplace HIV/AIDS programs. The study found that the AIDS-response Standard Organization (ASO) initiative mobilized a moderate proportion of different types of companies to develop and improve HIV/AIDS workplace policies and programs. The data also reveal that companies that were eligible for the insurance discount made the greatest improvements. Thus a financial incentive combined with efforts to tap into managers’ willingness to respond to the epidemic can be important motivators for certain companies to improve their …

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …

Did A Rising Tide Lift All Boats? The Nih Budget And Pediatric Research Portfolio, Daniel P. Gitterman, Robert S. Greenwood, Keith C. Kocis, Rick Mayes, Aaron N. Mckethan

Political Science Faculty Publications

This paper examines National Institutes of Health (NIH) pediatric research spending in absolute terms and relative to the doubling of the NIH overall budget between fiscal years 1998 and 2003. Pediatric spending increased by an average annual rate of 12.8 percent during the doubling period (almost on par with the NIH average annual growth rate of 14.7 percent). However, the proportion of the total NIH budget devoted to the pediatric portfolio declined from 12.3 to 11.3 percent. We offer recommendations for implementing existing commitments to strengthen the pediatric research portfolio and to protect the gains of the doubling period.

Maine Employer Experience And Perceptions Related To Providing Health Insurance: 2003 Summary Report, Gino Nalli, Elizabeth Kilbreth

Disability & Aging

No abstract provided.

Multijurisdictional Approach To Biosurveillance, Kansas City., Mark A Hoffman, Tiffany H Wilkinson, Aaron Bush, Wayne Myers, Ron G Griffin, Gerald L Hoff, Rex Archer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Long-Term Care: Informed By Research, Francis G. Caro

Gerontology Institute Publications

Health services research has contributed to health policy and service developments that have led to major improvements in the quality of long-term care in the United States. This policy brief highlights a few areas in which publicly and privately funded research has informed the long-term care field.

Nevada "Nurselessness": An Acute Or Chronic Condition? An Examination Of The Etiology And Possible Treatment Alternatives, Jeanine Warren-Newmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Data released by the Department of Health and Human Services in February, 2001, revealed that Nevada has the lowest number of registered nurses per 100,000 population in the nation. The state’s population is growing faster than the nursing programs are currently able to produce new graduates. Current predictions are that the existing nursing shortage will become more severe and have a longer duration than has ever before been experienced. While there may not be one single identifiable causative factor, the aging nursing workforce, low unemployment, and the universal nature of the shortage magnify the problem. This paper focuses on the …

Trends. A Casualty Of War: Suicide As A Response To An American-Led Invasion Of Iraq, Ibpp Editor

International Bulletin of Political Psychology

This Trends article discusses the political psychology of suicide as protest.

Political Authority And Social Cognitions On The War On Terrorism With Global Reach: Airport Security, Terrorism Contingent On A United States-Led Attack On Iraq, Smallpox Vaccinations, Ibpp Editor

International Bulletin of Political Psychology

This article presents analyses of three common social cognitions embraced by many representatives of political authority concerning aspects of the war on terrorism with global reach.

Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart

Center for Integrated Behavioral Health Policy

No abstract provided.

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

Legal Movements In Intellectual Property: Trips, Unilateral Action, Bilateral Agreements, And Hiv/Aids, Margo A. Bagley

Faculty Articles

This Article begins with an overview of the relationship between the Agreement on Trade-Related Aspects of Intellectual Property Rights (the "TRIPS Agreement") and the HIV/AIDS pandemic which created the need for the Doha Declaration. It then discusses two trade-related movements, unilateral action and TRIPS-plus bilateral agreements, that call into question the long-term effectiveness of the TRIPS Agreement process, generally, and the benefits of the Doha Declaration, in particular, in addressing multiple facets of the access to essential medicines problem. This Article concludes that a consideration of these issues should be included in the development of any further TRIPS-related solutions to …

Evaluation Of Rink Link Alpha One – Center For Independent Living, Josephine M. Laplante

Disability & Aging

No abstract provided.

The Politics Of Public Health: A Response To Epstein, Lawrence O. Gostin, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

Conservatives are taking aim at the field of public health, targeting its efforts to understand and control environmental and social causes of disease. Richard Epstein and others contend that these efforts in fact undermine people’s health and well-being by eroding people’s incentives to create economic value. Public health, they argue, should stick to its traditional task—the struggle against infectious diseases. Because markets are not up to the task of controlling the transmission of infectious disease, Epstein says, coercive government action is required. But market incentives, not state action, he asserts, represent our best hope for controlling the chronic illnesses that …

Trends. Fantasies, Death, And Violence, Ibpp Editor

International Bulletin of Political Psychology

This Trends article examines violence and death in the context of the goals of international health organizations.

Erisa Health Plans: Key Structural Variations And Their Effect On Liability, Phyllis Borzi

Health Policy and Management Faculty Publications

No abstract provided.

State Eligibility Rules Under Separate State Schip Programs--Implications For Children's Access To Health Care, Sara Rosenbaum, Anne Rossier Markus

Health Policy and Management Issue Briefs

This Policy Brief is the fourth in a series of reports1 issued by the George Washington University Center for Health Services Research and Policy that examine the design of separately-administered State Children’s Health Insurance Programs (SCHIP) that is, programs that operate directly under the authority of the federal SCHIP statute rather than expansions of state Medicaid programs.2 These Policy Briefs also consider the implications of states’ design choices for children’s access to health care.

School-Based Health Centers And Managed Care Arrangements: A Review Of State Models And Implementation Issues, Jennel Harvey, Lissette Vaquerano, Lea Nolan, Colleen Sonosky

Health Policy and Management Faculty Publications

No abstract provided.

The Impact Of The State Children's Health Insurance Program (Schip) On Community Health Centers, Lea Nolan, Jennel Harvey, Karen Jones, Lissette Vaquerano, Ann Zuvekas

Health Policy and Management Faculty Publications

Nearly 12 million children in the United States do not have health insurance, and therefore often lack access to health care. In response, Congress enacted the State Children’s Health Insurance Program (SCHIP) in August 1997, the largest expansion of health insurance coverage since the inception of the Medicare and Medicaid programs. The SCHIP provides states with federal matching funds for children’s insurance either by expanding the existing Medicaid program, by creating a separate state program, or a combination of both.

The George Washington University’s Center for Health Services Research and Policy (CHSRP) was funded by the Health Resources and Services …

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Applying Managed Fee-For-Service Delivery Models To Improve Care For Dually Eligible Beneficiaries, Stuart Bratesman, Paul Saucier

Disability & Aging

No abstract provided.

Welfare Reform Reauthorization In 2002:What Are The Issues For Tribal Communities And Indian Families?, Kathleen A. Maloy

Health Policy and Management Issue Briefs

American Indian tribes have new options under the 1996 Welfare Reform legislation that created Temporary Assistance for Needy Families (TANF), a block grant enacted to replace the Aid to Families with Dependent Children (AFDC). TANF, which expires in September of this year, provides cash assistance to poor families with children, including poor American Indian Families, and gives tribes the option to design and administer their own family assistance programs following approval of the plan by the Department of Health and Human Services. As Congress considers TANF reauthorization, three new publications prepared for the Kaiser Family Foundation provide insight into the …

The Precautionary Principle And Radiation Protection, Kenneth L. Mossman, Gary E. Marchant

RISK: Health, Safety & Environment (1990-2002)

The authors examine the application of the precautionary principle through a case study of ionizing radiation control and suggest a reevaluation of current radiation safety standards and practices.