Public Health Commons^™

National Health Insurance Scheme: Internal And External Barriers In The Use Of Reproductive Health Services Among Women, Evi Martha, Herna Lestari, Resvi Siti Zulfa, Yoslien Sopamena

Kesmas

Lack of familiarity among the community, medical workers, and administrative staff regarding reproductive health services covered by Badan Penyelenggara Jaminan Sosial (BPJS) or the National Health Insurance (NHI) in Indonesia remained a problem. Therefore, this resulted in sub-optimal use of the medical services, as shown by surveys from the Women's Health Foundation for three consecutive years (2015-2017). This qualitative study was conducted with a Rapid Assessment Procedure design in three cities within Indonesia: Padang Pariaman, Manado, and Kupang. Data were collected through IDIs (n = 47informants) and 6 FGDs (7 persons/group). Participants also consisted of NHI RHS users (mothers and …

Prevalence And Determinants Of Pre-Lacteal Feeding: Insights From The 2017 Indonesia Demographic And Health Survey, Siti Nurokhmah, Siti Masitoh, Kusuma Estu Werdani

Kesmas

Pre-lacteal feeding is widely known as a distraction to exclusive breastfeeding, and the malpractice continues to be prevalent in Indonesia. Therefore, this study aimed to explore the potential determinants of pre-lacteal feeding among mothers of infants below 24 months. A sample of 6,455 mother-infant pairs from the 2017 Indonesia Demographic and Health Survey (IDHS) was used. Also, multivariate logistic regression was employed to identify factors associated with pre-lacteal feeding practice. In Indonesia, 44% of infants were introduced to solid/liquid feeds in their first three days of life. Infant formula was the most common pre-lacteal feed given, followed by any other …

Inter-Related Factors Influencing Sexual Quality Of Life Among Women Living With Hiv In Banten Province, Indonesia: A Mixed Methods Study, Dyah Juliastuti, Judith Dean, Yati Afiyanti, Lisa Fitzgerald

Kesmas

Socio-cultural concerns often restrict women's sexual rights and well-being living with HIV (WLHIV) in developing countries. These convergent parallel mixed methods study combined quantitative and qualitative approaches to explore factors influencing WLHIV sexual quality of life in Banten Province, Indonesia. A 2017 cross-sectional survey of 207 reproductive-aged WLHIV was analyzed using univariate and multivariate logistic regression statistics. Furthermore, in-depth interviews with a sub-sample of survey participants (n = 30) were thematically analyzed. Most of the women (60%) involved reported loss of sexual pleasure and depressed sexual life. Meanwhile, 48% affirmed low sexual quality of life which was associated with unemployment …

Attitudes Concerning Sexual Behavior Towards Risky Sexual Behavior Of Sexual Transmitted Infections Among Male Adolescents In Indonesia, Helda Helda, Nurul Muchlisa

Kesmas

There has been an increase of sexually transmitted infections (STIs) such as HIV/AIDS worldwide, especially in Indonesia. Several studies on adolescent behavior, especially the male as the main predictor, reported increased in STIs’ cases due to risky sexual behavior. This study aimed to show the relationship between attitudes, sexual behavior, and the risks of STIs among male adolescents in Indonesia based on the Indonesia Demographic and Health Survey (IDHS) data in 2017. This cross-sectional study involved 10,547 male adolescents using the total sampling method according to the inclusion and exclusion criteria. Data were analyzed using a complex sample logistic regression …

The Effect Of Smoking On Carbon Monoxide Respiration Among Active Smokers In Palembang City, Indonesia, Rico Januar Sitorus, Imelda Gernauli Purba, Merry Natalia, Kraichat Tantrakarnapa

Kesmas

Smoking leads to disease and disability as well as harm nearly every organ of the body. Furthermore, smoking of tobacco is known to cause pulmonary dysfunction and lead to complications, pain, or even death. This study aimed to measure the risk factors for the respiration of carbon monoxide among smokers. A cross-sectional design was implemented by involving 156 smokers in Karyajaya Subdistrict, Palembang City. The dependent variable was carbon monoxide levels (ppm), while the independent variables were smoking frequency, duration, and the last period of smoking. The carbon monoxide levels (ppm) measured with a PiCO + Smokerlyzer® device from Bedfont …

The Significance Of Super Depo Sutorejo: Waste Management Project In Surabaya Municipality, Indonesia, Yohanes Kambaru Windi, Dyah Wijayanti, Eko Rustamaji Wiyatno, Loetfia Dwi Rahariyani

Kesmas

The Super Depo Sutorejo Surabaya (SDSS) Project was created to separate household waste into fractions, but its separation effect is unknown. This study assessed the significance of the project in sorting general waste into biodegradable, non-biodegradable, and assorted. The t-test compared the means of general and biodegradable waste (normally distributed). The non-biodegradable and assorted waste were not significantly distributed; therefore, the Wilcoxon Signed Ranks Test was used to compare their medians against general waste. The multivariate analysis compared the significance level of each waste fraction. Each statistical analysis showed that the SDSS significantly sorts the general waste. The p-values were …

Global Journey To Post-Pandemic Normalcy And Revival, Andrzej Sankowski

Journal of Global Awareness

After a year of COVID-19, countries, societies, and individuals are longing for normalcy and beginning to consider what life will be like post-pandemic. Efforts and experiences of countries in the European Union, Asia, Asia-Pacific, Australia, Africa, Latin America, the Caribbean, and the United States are examined as they face challenges to end the pandemic and prepare for the post-pandemic reality. What will be the post-pandemic "new normalcy"? What changes caused by the pandemic are permanent in societies and the world? What are the necessary reforms that have to take place as part of normalcy? Reflections on the impacts of vaccinations, …

Building Back Healthier: The Role Of Public Health In State Disaster Recovery Law, Claire Pendergrast, Nicole Errett

Population Health Research Brief Series

When communities are impacted by disasters, state officials must implement efficient and competent recovery strategies with the health and wellbeing of residents in mind. This research brief summarizes findings from a peer-reviewed study showing that few U.S. states explicitly integrate public health into their disaster recovery laws, and the types of public health requirements and authorizations vary substantially across states.

Disparities In Hiv Clinical Stages Progression Of Patients At Outpatient Clinics In Democratic Republic Of Congo, Raimi Ewetola, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Astrid Mulenga, Apolinaire Kilundu

Health Policy & Community Health: Faculty Publications

Context: In this era of patient-centered care, it is increasingly important for HIV/AIDS care and treatment programs to customize their services according to patients’ clinical stage progression and other risk assessments. To enable such customization of HIV care and treatment delivery, the research evidence explaining factors associated with patients’ clinical stages is needed. Objectives: The primary objective of this study was to produce such scientific evidence by analyzing the most recent data for patients at outpatient clinics in the provinces of Kinshasa and Haut-Katanga and to examine the patient characteristics associated with WHO stages of disease progression. Methods: Using a …

The Relationships Between Stress, Psychosocial Resources, And Mental Health And Adherence Outcomes Among Perinatally Hiv-Infected Adolescents In South Africa, Thabani Nyoni

Brown School Graduate Student Theses and Dissertations

Adolescents living with perinatally acquired HIV (APHs) in sub-Saharan Africa (SSA) constitute a significant population group that is experiencing poor HIV treatment outcomes (CIPHER Global Cohort Collaboration, 2018). Compared to younger children and older adults within the SSA sub-region, APHs experience poorer health outcomes, including retention in care, virologic treatment failure, and mortality rates (Anderson et al., 2019). Among countries in the SSA sub-region, South Africa has 360,000 adolescents living with HIV (ages 10-19), a disproportionate burden, accounting for 20% of the global adolescents living with HIV (UNAIDS, 2019a). The public health costs of suboptimal antiretroviral treatment (ART) adherence in …

Risk Factors For Tb/Hiv Coinfection And Consequences For Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Cong, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, Lievain Maluantesa, Kristie C. Waterfield, Elodie Engetele, Apolinaire Kilundu

Health Policy & Community Health: Faculty Publications

(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from …

Constructing The Panama Canal: A Brief History, Ian E. Phillips

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Seeking to commemorate the construction of the Panama Canal, an engineering marvel widely considered a contender for the eighth wonder of the world, this article attempts to retell the story of the Canal's construction by synthesizing a narrative centered on the Canal under French and American leadership, worker segregation, and labor conditions at the Isthmus.

Measuring The Impact Of The Affordable Care Act Medicaid Expansion On Access To Primary Care Using An Interrupted Time Series Approach, Elizabeth A. Brown, Brandi M. White, Walter J. Jones, Mulugeta Gebregziabher, Kit N. Simpson

Health and Clinical Sciences Faculty Publications

BACKGROUND: The Patient Protection and Affordable Care Act of 2010, commonly referred to as the Affordable Care Act (ACA), was created to increase access to primary care, improve quality of care, and decrease healthcare costs. A key provision in the law that mandated expansion of state Medicaid programme changed when states were given the option to voluntarily expand Medicaid. Our study sought to measure the impact of ACA Medicaid expansion on preventable hospitalization (PH) rates, a measure of access to primary care.

METHODS: We performed an interrupted time series analysis of quarterly hospitalization rates across eight states from 2012 to …

Association Between Childhood Obesity And Lack Of Healthy Food Access In Urban Food Deserts, Nicholas Averell, Rushali Desai, Archana Menon, Ayushi Naik, Arpun Shah

Rowan-Virtua Research Day

Background

Childhood Obesity: growing epidemic affecting almost 20% of children and adolescents in the United States

● Characterized by BMI greater than 95^th percentile of their age and gender

● Often leads to chronic medical conditions: high blood pressure, Type II Diabetes and heart diseases

● Low socioeconomic status(SES), lack of healthy food access and urban neighborhood

Medicare Support For Dental And Podiatry Graduate Medical Education Programs., Candice Chen, Yoonkyung Chung, Geoffrey Broadbent, Elizabeth Mertz

Health Policy and Management Faculty Publications

Importance: Oral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce.

Objective: To examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia.

Design, Setting, and Participants: This cross-sectional …

The Human Services Workforce Crisis: Moving Forward With Intention In Massachusetts, Suzanne Gray Henderson

School of Professional Studies

The human services field is growing rapidly in Massachusetts as it is across the country, and the Commonwealth does not have enough qualified staff to fill vacancies. The workforce shortage has risen to crisis levels due to high turnover, insufficient training, low wages, and a lack of recognition and appreciation for direct support professionals. The individuals receiving services in Massachusetts deserve quality and stability. The state budget – strained by inefficient service models and reactive fixes – also demands systemic change. The human services workforce crisis impacts a variety of stakeholders. Individuals served are directly affected, as are the direct …

Moving From Shelter To A Housing First Reponse, Robyn Kennedy

School of Professional Studies

Massachusetts is a right to shelter state for families who experience homelessness. Based on decisions made several decades ago, the state assigned the response to families who experience homelessness to the Department of Welfare (now the Department of Transitional Assistance) and a shelter, rather than a housing response was adopted. Following national best practice, the state has decided to transition the system to a Housing First response. Through this research, I will be evaluating the trends in the industry and assessing what Massachusetts needs to do to achieve a Housing First approach to serving families who are experiencing homelessness. Unless …

Group Living Environment Responses To Pandemic: A Case Study Of Advocates, And The Covid-19 Crises, Nicole K. Atchue

School of Professional Studies

The literature will take a deeper look in the personal lives of developmentally disabled members and their staff who experienced COVID-19 pandemic in a group living environments. The holistic approach of understanding will navigate the history of care and the level care needed as well as external factors that played a larger role in explanation for the support provided.

The Global Impact Of The Covid-19 Pandemic On Women’S Careers, Allison Bach

School of Professional Studies

This paper explores the impact that the COVID-19 pandemic has had on women’s careers on a global scale in the past year. It begins by focusing on the many pre-existing barriers that existed in realizing gender equality in the workplace prior to the pandemic, such as inadequate access to proper childcare, uneven participation in household labor between the genders, and pay inequality. The paper then continues to examine the impact that the pandemic has had on women’s careers across a variety of industries, countries, and specific groups. It was hypothesized that the COVID-19 crisis had created worse effects for women’s …

Title Ix: Perceptions And Utilization On U.S. College Campuses, Emma Narkewicz

School of Professional Studies

The research study investigated student perceptions and utilization of Title IX services on U.S. university and college campuses, testing the hypothesis that if students hold negative perceptions of Title IX offices, then they will not report campus sexual violence they experience to Title IX offices. There are currently high rates of sexual violence on college campuses but very low rates of reporting. Current or former U.S. college students aged 18-30 (N = 47) completed a mixed methods anonymous survey composed of Likert scale and open response questions. Participants were asked about prior interactions with Title IX offices and their perceptions …

Bail Discrimination: Racial Disparities In The United States Bail Determination Process, Collin Porter

School of Professional Studies

Nationwide, there is a systemic problem with bail determination: the process that a citizen goes through after they are arrested and before they go to trial to determine guilt or innocence for the crime they have been accused of committing. The United States leads all other countries with approximately half a million individuals detained before trial each year, a number nearly double the next highest country (China) (Nejdl, 2017). The high rate of pre-trial detention in the United States is due to both widespread use of monetary bail and the limited financial resources of most defendants; specifically, African American men. …

A Comprehensive Analysis Of Food Insecurity And Solutions In Worcester, Massachusetts, David Sullivan

School of Professional Studies

Worcester, Massachusetts is a postindustrial city with high levels of potential that faces the persistent obstacle of food insecurity for its low-income and ethnic minority communities. This research thesis examines food insecurity in general and explores data and trends in Worcester, then combines this with conceptual frameworks which explain how socioeconomic factors play into food security. It also explains the systemic inequalities present as a result of food insecurity and critiques academic assumptions surrounding food insecurity. One of these assumptions is that food deserts on their own can explain food insecurity in Worcester and elsewhere, though it has been found …

Pernet Family Health Service, Inc.: Organizational Restructuring & Change Management Best Practices, Carly Massino

School of Professional Studies

Research exhibits that between 70-75% of change initiatives fail and a major contributor to this trend is employee resistance. Although change can bring exciting growth and innovation, it can cause employees heightened stress and worsened physical and mental health outcomes. These effects are often amplified when organizations enact multiple change initiatives at once. These worsened outcomes are often a result of feelings of distress, anxiety, powerlessness, and apprehension and unknowns such as how one’s position will be affected, how operations will change, or how one fits into the change. This topic is incredibly relevant for Pernet Family Health Service, Inc., …

Happening In Plain Sight: An Evaluation Of Sexual Harassment In Municipal Government Through A Case Study Of Newark, New Jersey, Hoween R. A. Flexer, Caitlin R. Louie

School of Professional Studies

In the city of Newark, New Jersey, Sebrevious Scott, a participant in the New Jersey Reentry program was hired as part-time office assistant in the city's re-entry office. After being transferred to the city’s Parks and Grounds Departments, she started being sexually harassed, inappropriately touched and propositioned by her supervisor, Richard Kirkland. Scott made repeated attempts to report these actions through the appropriate channels. She was met with dismissal, resistance, and later retaliation. While working in this hostile environment she was also pursuing a full-time employment opportunity with the city upon the completion of the reentry program. Unfortunately, this never …

Understanding Modern History Of International Food Law Is Key To Building A More Resilient And Improved Global Food System, Michael T. Roberts

Journal of Food Law & Policy

This article advocates the need for a history of the development of modern international food law and suggests an analytical approach to complement the chronicling of events. Comprehension of this history will help elucidate the evolution of a complicated modern global food system, including its resiliency and vulnerability as demonstrated by Covid-19, thereby providing valuable context for change in the system where needed. This essay makes the case for such a history in three parts. First, it briefly demonstrates the need for a historical perspective through a critical examination of a journal article that speaks to Covid-19 food security in …

Barriers To Hiv Testing Among Cameroonian Men : The Role Of Stigma And The Impact Of Covid-19, Heidi Iyok

Legacy Theses & Dissertations (2009 - 2024)

ABSTRACT

A Comparative Study Of Recovery Ecosystems For Opioid Use Disorder In Portugal And Appalachia, Jonathan David Mullins

Undergraduate Honors Theses

A comparison of the structure and effectiveness of recovery ecosystems for opioid use disorder in Portugal and Appalachia, with a focus on identifying areas for improvement within the Appalachian region.

Factors Associated With Health Coverage Gaps And Cost Barriers To Health Services In U.S. Adults Before And After The Aca, Danielle Kilchenstein

Loma Linda University Electronic Theses, Dissertations & Projects

Background

Health law known as the Affordable Care Act (ACA) was passed in 2010 and implemented in 2014 in the U.S. It was intended to reduce cost burdens to health coverage and care.

Purpose

Self-reported health coverage gaps and cost barriers to physical, mental, dental care, and prescription medications of U.S adults before and after the implementation of the ACA in 2014 were examined to determine impacts of health reform on marginalized populations.

Methodology

Cross-sectional secondary data analysis was conducted using National Health Interview Survey Data from the Integrated Public Use Microdata Set (2010-2017). The 140,341 surveys represented an average …

Agreement Success Plan, Miranda Holtz

Capstone Projects and Master's Theses

Monterey County Health Department’s Administration Bureau works with contracts and agreements for the Public Health Bureau, which detail what services programs will complete so that they can receive funding or maintain a partnership with the County. The problem was that a large portion of the management analyst’s time was dedicated towards technical support for agreements. The Agreement Success Pan is aimed to increase efficiency by aiding program staff with agreements through a Prezi, which is similar to a self-paced webinar. The project had three phases; interviews of program supervisors or managers, gathering supporting documents, and final launch. Afterward, a questionnaire …

Evaluating Urban Parks Accessibility And Equity: A Case Study Of Hartford, Ct And New Haven, Ct, Natalie Roach, Mara Tu

Honors Scholar Theses

Public parks provide cities with environmental benefits, positive health effects, recreational opportunities, community building, educational spaces, and public amenities. However, certain populations have been systematically denied their fair share of these benefits because of unjust practices in the creation and maintenance of urban parks. With a lens of environmental justice, the goal of this research was to assess park quality and accessibility of two Connecticut cities, Hartford and New Haven, by gathering publicly available information as well as using GIS tools.

The Trust for Public Land (TPL) has an existing ParkScore rating system that evaluates the quality of a city’s …