Public Health Commons^™

Great (Soft) Power Competition: Us And Chinese Efforts In Global Health Engagement, Michael W. Wissemann

The US Army War College Quarterly: Parameters

Global health engagement, an underutilized strategy rooted in the strengths of soft power persuasion, can lead to more military-to-military cooperation training, help establish relationships that can be relied on when crises develop, stabilize fragile states, and deny violent extremist organizations space for recruiting and operations. Examining Chinese efforts worldwide to curry favor and influence and the challenges posed by the COVID-19 pandemic, this article shows health as a medium is a very compelling and advantageous whole-of-government approach to national security policy concerns.

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

Proper Medication Adherence Is A Challenge For Older Snap Participants With Chronic Health Conditions, Colleen Heflin, Chinedum O. Ojinnaka, Irma Arteaga, Lauryn Quick

Population Health Research Brief Series

Diabetes and hypertension are among the leading causes of poor health and mortality in the United States. Properly taking prescribed medications to manage these conditions is critical for maintaining health and preventing complications. This is especially true for older adults, who are more likely to live with these chronic conditions. This brief summarizes findings from a study of an older adults in Missouri who participated in the Supplemental Nutrition Assistance Program (SNAP) between 2006 and 2014. On average, 1 in 4 individuals with hypertension and 1 in 3 with diabetes did not properly take prescribed medications to manage their health …

Conflicts Of Interest: An Invisible Force Shaping Health Systems And Policies, Afifah Rahman-Shepherd, Priya Balasubramaniam, Meenakshi Gautham, Eleanor Hutchinson, Freddy E. Kitutu, Robert Marten, Mishal S. Khan

Community Health Sciences

No abstract provided.

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …

Measuring Routine Childhood Vaccination Coverage In 204 Countries And Territories, 1980–2019: A Systematic Analysis For The Global Burden Of Disease Study 2020, Release 1, Natalie C. Galles, Patrick Y. Liu, Rachel I. Updike, Stephen S. Lim, Jonathan F. Mosser, Asma Tahir Awan, Gbd 2020, Release 1, Vaccine Coverage Collaborators

Environmental & Global Health Faculty Research

Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific …

Building Patient Participation In Quality Of Care Through The Healthcare Stories Project: A Demonstration Program In New York State Hiv Clinics, Abigail Baim-Lance, Freda Coren, Margaret Brown, Hazel Lever, Daniel Tietz, Bruce Agins

Patient Experience Journal

There is growing recognition that patients should play a central role in defining, assessing, and improving the quality of healthcare, thereby enhancing patient experiences. Healthcare organizations struggle to meet these goals, which require becoming more patient-centered and patient-involved. The Healthcare Stories Project (HCSP), a demonstration program of the NYS Department of Health AIDS Institute, aimed to address this. HCSP comprises three, stepwise activities to: 1) Capture how patients define and experience ‘quality of care’ in the clinic; 2) Engage patients and providers as equal partners in understanding and improving the quality of care; and through partnerships, 3) Support the building …

The Right Premtm: Rasch Analysis Of A New Patient Reported Experience Measure For Use By Older People In Hospital, Louise Heuzenroeder, Jyoti Khadka, Alison Kitson

Patient Experience Journal

Healthcare rights exist to protect older people from harm and to empower older people to participate in their care with independence, choice and control. Multiple investigations revealing abuse provide evidence that older people’s rights are being breached. Older people must have the opportunity to report on their experience of care against their rights. The Right PREM^TM is a new instrument designed to measure older people’s experience of care against their healthcare rights. The objective of this cross-sectional validation study was to assess the psychometric properties of a new instrument to measure the experience of care consistent with the healthcare …

"When They See Someone Who Is Poor, They Step On Them": The Social Determinants Of Health Among Survivors Of Sex Trafficking In Cambodia, James P. Havey, Glenn M. Miles, Lim Vanntheary, Nhanh Channtha, Hanni Stoklosa

Dignity: A Journal of Analysis of Exploitation and Violence

Social determinants of health (SDH) are defined as the non-medical yet health-affecting conditions of a person’s life. They include such considerations as working conditions, discrimination, and access to health services. The aim of this study was to explore the SDH impacting those who have survived sex trafficking in Cambodia. This study employed a mixed methods, secondary analysis, focusing on 52 survivors of sex trafficking in the Butterfly Longitudinal Research Project from 2010 through 2019. Participants described myriad social determinants of health, including: gender, age, relationship status (marriage), ethnicity, national identification documentation (statelessness), social class, formal education, vocational training, occupation, and …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Health Policy & Community Health: Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Health Policy & Community Health: Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

The Impact Of Covid-19 On Church Gatherings In The Philippines: A Policy Analysis, Grace Zurielle Malolos, Joseph Christian Obnial, Rena Mallillin, Pamela Bianca Pasco, Erika Ong, Arianne Andes, Faith Ann Apat, Emma Teresa Carmela Aportadera, Rafael Valencia, Don Eliseo Lucero-Prisno Iii

Ateneo School of Medicine and Public Health Publications

The Philippines is the largest Christian-majority country in Asia. With church gatherings playing a vital role in the nature of Christianity in the Filipino culture, the advent of the coronavirus disease (COVID-19) pandemic in the Philippines posed challenges to public religious practices amid efforts to mitigate COVID-19 community transmission. Various policy pronouncements from both the government-led Inter-Agency Task Force (IATF) on Emerging Diseases and the church-led Catholic Bishops’ Conference of the Philippines (CBCP) were issued. These guidelines were implemented in order to address the two-pronged problem on healthcare and religious obligations. While these guidelines were initially contributory to the mitigation …

Disease, Development, And Disorder: Examining The Effect Of Health On Subnational Development And Conflict In Sub-Saharan Africa, Dlorah C. Jenkins

Doctor of International Conflict Management Dissertations

Progress towards achieving the Sustainable Development Goals (SDGs) has been uneven across and within countries - particularly in Africa, least developed countries, and low-income countries. The COVID-19 pandemic has threatened to reverse much of the progress made towards achieving the SDGs, especially SDG 3, which aims to “ensure healthy lives and promote well-being for all at all ages”.

The tendency for disease, underdevelopment, and conflict to occur concomitantly suggests potential causal mechanisms linking them. This study attempts to address two pieces of the puzzle: the causal effect of disease on underdevelopment and the impact of development on conflict risk. Focusing …

Assessment Of The Financial Health Of Rural Hospitals After Implementation Of The Georgia Rural Hospital Tax Credit Program, Bettye A. Apenteng, Samuel T. Opoku, Charles Owens, Emmanuel Akowuah, Linda Kimsey, Angela Peden

Health Policy & Community Health: Faculty Publications

Importance In 2016, Georgia implemented the Rural Hospital Tax Credit Program, which allows taxpayers to receive a tax credit for contributions to qualifying rural hospitals in the state. Empirical evidence of the program’s association with the viability of the state’s rural hospitals is needed.

Objective To examine the association of the tax credit program with the financial health of participating rural hospitals.

Design, Setting, and Participants This longitudinal cross-sectional study used hospital financial data from the Centers for Medicare & Medicaid Services for 2015 to 2019. A difference-in-differences analytic approach was used to examine the association of the tax credit …

Review Of Sexual Health Issues Linked With Cardiovascular Disease And Type 2 Diabetes Mellitus In Aboriginal And Torres Strait Islander Males, Veronica Collins, Tamara J. Swann, Jane Burns, Tim Moss, Mick Adams

Australian Indigenous HealthBulletin

There are well established links between male sexual health conditions and chronic disease, particularly cardiovascular disease (CVD) and type 2 diabetes (T2DM). Erectile dysfunction (ED) and low testosterone are two sexual health conditions that are relatively common among the wider male population. However, there is a lack of data specifically about these sexual problems among Aboriginal and Torres Strait Islander males.

One of the most important findings of research regarding the links between sexual health and chronic disease is that ED can be a risk marker for future CVD or undiagnosed T2DM. Understanding these links can lead to more holistic …

Impact Of Covid-19 On The Severe Acute Malnutrition Admissions Among Children Under 5 Years Of Age Seeking Nutrition Services In Afghanistan, Sahar Sayedy

Graduate Theses and Dissertations

The purpose of the study was to assess the impact of COVID-19 on the number of admissions of severe acute malnutrition among children under 5 years of age seeking nutrition services in Afghanistan especially in the provinces where the prevalence of COVID-19 was high, for the period of February – September 2020. The study used comparison and analysis of secondary datasets of the Integrated Management of Acute Malnutrition – a national program for detection and management of moderate and severe acute malnutrition in the country.

This study analyzed the association between COVID-19 cases and severe acute malnutrition (SAM) admissions of …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Personal Mastery And All-Cause Mortality Among Older Americans Living With Diabetes, Ho-Jui Tung, Ming-Chin Yeh, Randall Ford, Gulzar H. Shah

Health Policy & Community Health: Faculty Publications

Introduction: Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time.
Methods: A total of 1,779 participants were identified from an off-year survey of the Health and Retirement Study. Proportional Hazard Models were used to evaluate the significance of selected variables in predicting the survival of participants over a 13-year period.
Results: A substantial proportion (46.7%) of the diabetic patients had survived by the end of 2016. Adults with lower mastery …

Perceived Benefits Matter The Most In Covid-19 Preventive Behaviors: Empirical Evidence From Okara District, Pakistan, Gulzar H. Shah, Ansar Ali Faraz, Hina Khan, Kristie Cason Waterfield

Health Policy & Community Health: Faculty Publications

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a faceto- face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara …

Student Loans And Health-Related Financial Hardship, Sophia T. Anong, Robin Henager

Journal of Student Financial Aid

Research has shown that student loan borrowers in repayment exhibit physical and mental health problems. These can be exacerbated by and contribute to health-related financial hardship. We use the 2015 U.S. National Financial Capability Study to examine the likelihood of having past due medical bills and of avoiding health care services by not purchasing prescribed medication, skipping tests or follow-up with a doctor or not seeking care for a medical problem. Borrowers on income-driven repayment plans and those who made late payments are found to be more likely to have unpaid medical bills and to have avoided required medical attention. …

Evidence On Child Nutrition Recommendations And Challenges In Crisis Settings: A Scoping Review, Aniqa Islam Marshall, Gideon Lasco, Mathudara Phaiyarom, Nattanicha Pangkariya, Phetdavanh Leuangvilay, Pigunkaew Sinam, Rapeepong Suphanchaimat, Sataporn Julchoo, Watinee Kunpeuk, Yunting Zhang

Development Studies Faculty Publications

Adequate child nutrition is critical to child development, yet child malnutrition is prevalent in crisis settings. However, the intersection of malnutrition and disasters is sparse. This study reviews existing evidence on nutrition responses and outcomes for infants and young children during times of crisis. The scoping review was conducted via two approaches: a systematic search and a purposive search. For the systematic search, two key online databases, PubMed and Science Direct, were utilized. In total, data from 32 studies were extracted and included in the data extraction form. Additionally, seven guidelines and policy documents were included, based on relevance to …

The Great Swedish Experiment, Xiaofan Gong, Michael Ratzkin

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

As COVID-19 spread across Europe, many countries chose to implement swift and stringent lockdown measures on their populations in March 2020 by shutting down businesses and banning large public and private gatherings. Sweden, however, chose to manage the pandemic by relying on its citizens to make the best decisions for themselves and their families. This paper places Sweden’s response to the COVID-19 pandemic in a political and economic context. The paper also analyzes the country’s response and effectiveness in implementing voluntary and stepwise actions. Research finds that although measures taken to slow transmission while accounting for efforts to preserve the …

Experiences Of Nonbinary And Gender Nonconforming Individuals Within The Healthcare System, Chloe B. Lacey

Intuition: The BYU Undergraduate Journal of Psychology

Though nonbinary and gender nonconforming people are becoming increasingly recognized in North America, specialized healthcare—specifically gender-affirming procedures—are not becoming available to them. Researchers have examined the subjective experiences of these individuals as they have navigated the healthcare system in order to further understand possible limitations for nonbinary and gender nonconforming populations. Methods include assessing the procedures available to participants and their interpersonal experiences with healthcare professionals and family members. Scientific resources on this topic are limited, and the results are overwhelmingly represented by self-report. Furthermore, the content of the results is majorly negative toward the participants’ experiences. Participants report verbal …

The Use Of Mobile Apps To Increase Physical Activity Level: A Systematic Review, Dziyana Nazaruk, Kelli Rouser

Health Policy & Community Health: Faculty Publications

Background: About 82% of the U.S. adult population owns a smartphone. More than half of that population downloaded a fitness or health app to increase the physical activity level. The current review included studies that have utilized mobile apps in conjunction with other intervention strategies to increase physical activity levels. Methods: The search was conducted in five electronic databases. Studies were included if they were randomized controlled trials, utilized mobile apps, physical activity was the primary outcome, written in English, and conducted between the years of 2007 and 2019. Results: Thirteen studies were included in the final review. Results indicated …

Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Ghana is working toward achieving universal health coverage (UHC). This is driven, in part, by the Sustainable Development Goals (SDGs), specifically SDG 3—Good Health and Well-Being, which seeks to ensure healthy lives and promote well-being for all at all ages. Achieving this feat will improve equity of access as people, especially the poor can access quality health services without financial hardships. Ensuring equitable access to family planning (FP) is essential to securing the well-being of women and supporting the health and development of communities. One pathway to ensuring equity is the inclusion of FP in affordable insurance. While the inclusion …

Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana

Reproductive Health

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased …

The Essence Of Telemedicine For Bridging The Gap In Health Services, Budi Wiweko, Sarah Chairani Zakirah, Atha Luthfi

Kesmas

This study aimed to review the essence of telemedicine in this modern era of technology and innovation, especially in developing countries. It also investigated the regulation aspect as the main component for healthcare services. There were five main categories of telemedicine: revenue stream and technology literacy, health facilities, human resources, data authorization and security, and health protocol. Furthermore, when combined with wearable devices, it enhanced healthcare delivery opportunities. There were two major components of global electronic health, namely telehealth and health informatics, based one-commerce and e-learning systems. The World Health Organization (WHO) has been able to describe the roles of …

The Determinants Of Stunting For Children Aged 24-59 Months In Kulon Progo District 2019, Chatrine Aprilia Hendraswari, Yuliasti Eka Purnamaningrum, Tri Maryani, Yani Widyastuti, Sakinah Harith

Kesmas

This study pertains to stunting in children in Indonesian with z-scores of less than -2 Standard Deviation (SD) and less than -3 SD. The preliminary study results showed the highest prevalence of stunting to be 22.6%, at the Temon II Primary Health Care in Kulon Progo District. The study aimed to assess the determinants of stunting children aged 24–59 months. This study was conducted from September 2018–May 2019. The design of this study was analytical observational with study design case-control. The sample was 60 children aged 24–59 months. The method utilized proportional sampling, whereas the data analysis applied chi-square and …

A Path Analysis Model For Explaining The Factors Influencing Wearing A Mask Among Commuting Workers Using Commuter Line Bogor-Jakarta, David Kusmawan, Shofi Andari, Ira Gustina, Indri Hapsari Susilowati, Mufti Wirawan

Kesmas

Jakarta is one of the most air-polluted cities in the world, which can increase the health risk of commuting workers exposed to pollutants. This study aimed to determine the factors that directly and indirectly affect healthy behavior (wearing a mask) for commuters using the Bogor-Jakarta Commuter Line. Furthermore, a total of 155 respondents participated and the data collected were analyzed using descriptive and path analysis. The commuters aware of the hazard potential related to air pollution during commuting were 137 people (88.4%). While 104 people (67.1%) were aware of the good perception of pollution and 125 uses masks during commuting …

Empowering Health Cadres To Support Drug-Resistant Tuberculosis (Dr-Tb) Patient To Enroll In Treatment, Esty Febriani, Adik Wibowo, Neeraj Kak, Hala Jassim Al Mossawi

Kesmas

Tuberculosis (TB) remains a big challenge globally, while the involvement of health cadres’ constitutes one of the key strategies for the TB program in Indonesia. These roles were further expanded to providing support to DR-TB patients. This study was a qualitative study, conducted in 2015 to explore the various factors which influence the performance of health cadres’ in supporting DR-TB patients to enroll in treatment. A total of 39 informants consisting of 24 health cadres, three nurses, four DR-TB patients, and three family members, two peer support, a head of primary health care, and two TB staffs from the District …