Public Health Commons^™

Medicare's Accountable Care Organization Regulations: How Will Medicare Beneficiaries Who Reside In Medically Underserved Communities Fare?, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations implementing the Medicare Shared Savings Program (MSSP). The thrust of the MSSP is to promote savings to Medicare as well as the greater clinical integration of health care through incentive payments to accountable care organizations (ACOs) that meet Medicare standards for structure, performance, and health care outcomes. The effort to spur greater clinical integration through the MSSP was part of a broader set of reforms contained in the Affordable Care Act (ACA) whose aim was to improve health care quality and efficiency. Among these reforms …

Exploring Student Perceptions To Explain The Relationship Between Physical Activity And Academic Achievement In Adolescents: A Mixed Methods Study, Megan J. Hylok

College of Education and Human Sciences: Dissertations, Theses, and Student Research

A nationwide survey conducted by the Center for Disease Control in 2007 reported 65% of high school students did not meet the recommendation that youth participate in at least 60 minutes of physical activity most days of the week (CDC, 2008). While research has focused its attention primarily on bodily health, growing evidence supports the benefits of physical activity on brain health (Ratey & Hagerman, 2008). Physical activity is important and many adolescents are not meeting the recommendation, therefore, it is important to explore the adolescent perceptions to understand which factors influence physical activity participation. The significance of this study …

Aids/Hiv Denialism: Patients’ Privacy Rights, Fadia Abdullah, Guadalupe Medrano

Festival of Communities: UG Symposium (Posters)

HIV is a sexually transmitted disease that develops into AIDS. There is no cure for it, only treatment. In this poster, we look at the pros and cons of disclosing this type of information. People who decide to disclose their HIV status may have various reasons for doing so, but most do it for emotional support and for prevention of spreading the disease. Those who decide to keep it private primarily do it to not face rejection, discrimination, degradation, and loss of respect. (Petronio Page 72) The problem with creating a public database is that many organizations are against the …

Aids Denialism, Erika Jenel Delos Santos, Roy Llana, Jocelyn Tan

Festival of Communities: UG Symposium (Posters)

AIDS denialism is a growing issue in many parts the world. Through scholarly journal articles, book resources and other research tactics, further understanding how HIV/AIDS denialism is unethical can be distinguished. Discovering that AIDS is most prominent in South Africa explains why denialism is as critical as it is. However, the unethical aspect of AIDS denialism is in effect particularly amongst families. When a South African inhabitant realizes they have AIDS, they feel outcasted by their families due to shame. They fear as though they will be disowned because they have flaws that are unacceptable. These family values are significant …

Vaccines Controversy, Jackelin Ruiz, Keith Wellman

Festival of Communities: UG Symposium (Posters)

Our research was conducted on a Vaccine controversy which raised the question on ethics, morality, safety and effectiveness of vaccination on children. The case study we focused on was about a study done by Dr. Andrew Wakefield and twelve other Colleagues, which was published in a well know journal The Lancet. The study has recently been retracted because an investigation found that he failed to mention that his research of the MMR vaccine was funded through solicitors seeking evidence to use against vaccine manufactures (Deer, Brian). To conclude our research we compared the current vaccination rates with the rates …

Making Sense Of Health Care Planning In Ireland; The Street Level Public Organization (Slpo)., Vivienne Byers

Conference Papers

One of the central mechanisms of the Strategic Management Initiative (SMI) (Government of Ireland 1996) is the devolution of accountability and responsibility from the centre to executive agencies. Service planning was introduced in the Irish health care sector as part of this strategic planning ethos. This paper reports on a study that examined both the intent and the consequences of implementing legislatively mandated planning in the Irish health services, in the context of significant organizational change. In an effort to draw broader lessons, a comparison is drawn with the Canadian experience of service planning.

The choice was made to study …

Local Health Departments’ Governance: A Visual Display Using Lhd Shape Files, Gulzar H. Shah Dr., Carolyn J. Leep, Reba Novich

Health Policy & Management: Faculty Presentations (2008-2022)

Analyses conducted for public health systems and services research (PHSSR) frequently include a variable that represents the relationship between state and local health departments (i.e., a governance category) in their analyses, either as an explanatory variable or a control variable. A number of organizations and researchers has categorized states according to governance, but the categorizations have been inconsistent across studies. This lack of agreement regarding governance category has been problematic for PHSSR.

The Association of State and Territorial Health Officials (ASTHO) in conjunction with NORC at the University of Chicago and with input from the National Association of County and …

Tyrie, Betsy (Fa 22), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid only for Folklife Archives Project 22.  "The Life of Dr. C. C. Howard," an oral history project conducted by Betsy Tyrie about Dr. Carl Clifford Howard, the outstanding Glasgow, Kentucky, physician who was instrumental in the fight against tuberculosis and in founding hospitals in Glasgow.  Project contains interviews with Dr. Howard's family, friends, and colleagues as well as archived autobiographical information about Howard.

Youth Dating Culture In Urban Vietnam: Attitudes, Behaviors, And Influences, Alexa Difiore

Independent Study Project (ISP) Collection

This paper attempts to research urban youth’s attitudes and behaviors concerning everything having to do with dating (the process, PDA, typical dating spots and behavior) and opinions towards “hot issues” in contemporary, Vietnam such as pre-marital sex and co-habitation. My research question focuses on what the term “dating” means among youth in urban Vietnam, and the various influences that affect youth’s dating and sexual lives. Through an extensive literature review, I learned that there is an overall lack of information and discussion about sex in Vietnam. There is also a general idea that from parents, the government, and school that …

Influenza Vaccination Of The Health Care Workforce: A Literature Review, Alexandra M. Stewart, Marisa A. Cox, Mallory O'Connor

Health Policy and Management Faculty Publications

Since 1981, the Centers for Disease Control and Prevention (CDC) has recommended that all health care workers (HCWs) receive an annual influenza vaccination. The Healthy People objectives aimed for 60% coverage of HCW influenza vaccination by 2010 and 90% coverage by 2020. Although influenza vaccine uptake among HCWs has trended upward over the past several years, the percentage of immunized HCWs has remained approximately 40% between 2004 and 2008.

In order to complete the literature review, researchers identified and analyzed peer reviewed literature, news articles, professional organization position statements, and institutional policies published between 1991 and 2011. In the absence …

Influence Of Sexual Education On Sexual Behavior And Contraceptive Use Among 15 To 19 Year-Olds At Colégio Azevêdo Fernandes In Salvador, Brazil, Julia Still

Independent Study Project (ISP) Collection

Although sexual health education provided by the government through schools has shown positive results, such as those distributed by the Brazilian Ministry of Health, it is not the only source, nor the most implemented source, in which adolescents are exposed to and gain knowledge on the subjects of sexual behavior and sexual health. Just as Article 24 of the Convention on the Rights of the Child details, parents, schools and communities play important roles in the process of sexual education and are required to provide guidance and direction to youth (Pan American Health Organization, 2010). In addition to sexual health …

El Uso Escondido De Anticonceptivos Modernos: Una Reflección Del Machismo De Los Hombres Y El Empoderamiento De Las Mujeres En El Alto Y La Paz, Kathleen Elizabeth Trocin

Independent Study Project (ISP) Collection

Contraception use has proven to be an extremely important public health issue in Bolivia since the later 20^th century given its relationship with the country’s high maternal and infant mortality rate in comparison to other nations in South America. In this research paper, I explore the hidden use of contraception in Bolivia. More specifically, I study women in the areas of El Alto and La Paz who hide their contraception use from their partners. This paper discusses machismo as the cause of the hidden use of contraception, the effects of hidden contraception use on the women, and the broader …

Let's Move! From Dc To Pc: Policy And Programming In Providence Charter Schools Around Student's Awareness Towards Living Healthy, Carmine Perrotti

Public & Community Service Studies Student Scholarship

A thesis developed out of an intership for the Office of the First Lady's "Let's Move Initiative". Following said internship, the author conducted original research on the local level - namely, Providence charter schools - to design, implement, and assess a series of educational “interventions”. These interventions were created to provide information to students and their parents about the benefits of healthy eating and exercise. Over 500 elementary-level students were surveyed for the research. See document abstract for more information.

Can Water Professionals Transform Pharmaceutical Disposal Practices Of Hospice Nurses?, Jennifer L. Mccoy, Kimberly P. Holland

Dissertations, Theses and Capstone Projects (Full IR Collection)

This project is an explanatory case study that illustrates the problems associated with pharmaceutical disposal in regard to water quality. The purpose of the study is to investigate the current pharmaceutical disposal practices of hospice nurses, the attitudes of hospice nurses regarding current pharmaceutical disposal practices, and explore ways to educate the hospice community about the concerns associated with flushing pharmaceuticals. The study consisted of reviewing secondary research, completing a survey, forming a focus group, implementing a pilot study, and developing an education plan and outreach materials.

The researchers partnered with two local nonprofit organizations, Georgia Association of Water Professionals …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

La Operación Y Estructura De Salud Familiar Comunitaria Intercultural En El Caso De Achocalla, Dominic Strada

Independent Study Project (ISP) Collection

Esta investigación se centra en la nueva política sanitaria del programa Salud Familiar Comunitaria Intercultural, su nueva administración y su aplicación en Bolivia. La Salud Familiar Comunitaria Intercultural es una política de salud social que décadas después del proceso de descentralización del poder ha puesto la responsabilidad sanitaria en manos de las comunidades. Este estudio se centra en las estructuras de Salud Familiar Comunitaria Intercultural desde el nivel municipal, hasta un total de ocho estructuras, en el municipio de Achocalla. Achocalla es un caso interesante ya que es a la vez una localidad urbana, por formar parte de los suburbios …

Riesgo De Exposición A Los Plaguicidas En Familias Con Niños Menores De 6 Años De Azapa Y Lluta, Andrew Wilbur

Independent Study Project (ISP) Collection

This study aims to characterize the risk of pesticide exposure for children under the age of 6 who live in the rural, agricultural communities of the Azapa and Lluta valleys in Region Arica and Parinacota in northern Chile. To achieve this objective, it seeks to understand current perceptions held by parents or guardians with respect to risk of pesticide exposure within their families and identify practices and living circumstances that contribute to this risk. In environmental health, children are an especially vulnerable population as a result of their distinct characteristics. Their exploratory behavior and naivety contribute to their risk of …

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

Intimate Partner Violence In Urban Pakistan: Prevalence, Frequency, And Risk Factors, Tazeen S. Ali, Nargis Asad, Ingrid Mogren, Gunilla Krantz

School of Nursing & Midwifery

Background: Intimate partner violence (IPV) is an important public health issue with severe adverse consequences. Population-based data on IPV from Muslim societies are scarce, and Pakistan is no exception. This study was conducted among women residing in urban Karachi, to estimate the prevalence and frequency of different forms of IPV and their associations with sociodemographic factors.
Methods: This cross-sectional community-based study was conducted using a structured questionnaire developed by the World Health Organisation for research on violence. Community midwives conducted face-to-face interviews with 759 married women aged 25-60 years.
Results: Self-reported past-year and lifetime prevalence of physical violence was 56.3 …

Developing Countries, Vaccine Access And Influenza Outbreaks: Ethics And Global Health Governance When Facing A Pandemic, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

The threat posed by influenza pandemics raises serious ethical issues, as well as questions of global health governance. In order to create pre-pandemic vaccines, global health authorities need access to virus from regional outbreaks. But because the countries where these outbreaks occur are unlikely to benefit from the vaccine, they are sometimes reluctant to share this seed stock, and may try to make proprietary arrangements with pharmaceutical companies, as briefly occurred in Indonesia. Although these arrangements may increase developing countries' access to vaccine, they hamper the global cooperation necessary to prepare for influenza outbreaks. Developing countries, in contrast, point to …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Combating Biological Terrorism From Imported Food, Jeffrey S. Nelson

Theses and Dissertations

There is a threat that a terrorist or terrorist organization will use access to the US food supply to kill or sicken Americans by contaminating imported food products from Mexico. The food that Americans eat is coming more and more often from foreign countries such as Mexico. Foodborne diseases infect nearly fifty million people in the US each year, resulting in over three thousand deaths. There are many terrorist organizations that would like to deliberately contaminate American food. Drug cartels and terrorist organizations currently operate in Mexico, one of the leading food importers into the US. The purpose of this …

Organs Watch: Possibilities And Perils For Public Anthropology, Roberto Abadie

Department of Sociology: Faculty Publications

Recent technological advances in biomedicine have introduced new therapeutic possibilities but have also contributed to the emergence of a global market for human bodies and body parts. For example, artificial modes of human reproduction created a market for eggs, semen, and surrogate wombs. In addition, organ transfer generated a demand for kidneys and half livers. The whole body has become a valuable commodity as professional research subjects venture into the economy of Phase I Clinical Trials, testing drug safety for pharmaceutical companies. In the process, the trade has become a deeply unequal one in which poor, vulnerable, and easily exploited …

Prevalence Of Herpes Simplex Virus 1 And 2 In A Sexually Transmitted Disease Clinic In Miami, Maya Morrison-Bryant, Maria Alcaide, Khaled Deeb, Jose G. Castro

Florida Public Health Review

The Prevalence of HSV-1 and HSV-2 among STD clinics in Miami is not known. The objective of this study was to evaluate infection rates of HSV 1 and 2, and to describe the socio-demographic characteristics, sexual orientation and co-infection with HIV and other STIs, in individuals attending a Sexually Transmitted Diseases (STD) clinic in Miami. A cross-sectional study of 663 patients tested for HSV type-specific serology or herpes culture during the year 2007 was performed. An overall infection rate of HSV-1 was 42.1% and 36.7% for HSV-2. Statistically higher infection rates for HSV-1and 2 were seen among Hispanics (56.7%, 54.4%) …

Who Are The Health Center Patients Who Risk Losing Care Under The House Of Representatives' Proposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On February 20, 2011, the United States House of Representatives approved more than $61 billion in discretionary spending reductions for the remainder of FY 2011. The legislation includes $1.3 billion in direct spending cuts for community health centers. Using the NACHC patient estimates, we present evidence on the characteristics of patients whose continuing access to health center services is at risk. We arrived at these estimates using data from the Uniform Data System (UDS), the federal reporting system in which all health centers must participate, as well as national estimates from the Medical Expenditure Panel Survey (MEPS), and published reports …

Who Are The Health Center Pati Ents Who Risk Losing Care Under The House Of Representatives’ Pr Oposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

An Update On Red Light Camera Research: The Need For Federal Standards In The Interest Of Public Safety, Barbara Langland-Orban, John T. Large, Etienne E. Pracht

Florida Public Health Review

Since publishing our critique of red light camera (RLC) studies in 2008, we have gained increased insights on the controversy over RLCs. Herein we provide additional information on RLCs, and use a question-and-answer format to address frequently asked questions. This update includes the rationale given for ignoring fatalities at RLC sites, the convergence in findings from the National Highway Traffic Safety Administration's compendium of best RLC studies, common violations of research methods in RLC evaluations, the RLC cost-to-benefit implications for motorists, an explanation for the increase in rear-end crashes at RLC sites, and why RLCs may be ineffective in reducing …

Decreasing Unwanted Pregnancies By Increasing Use Of Emergency Contraceptive Pills (Ecps): A Leadership Approach, Kara Mcginnis

Florida Public Health Review

Unwanted pregnancies burden the U.S. healthcare system, as well as create challenges for women, families, and children. Emergency contraceptive pills (ECPs) can prevent a large percentage of unwanted pregnancies if used appropriately. Factors contributing to non-use of ECPs include the negative social environment created by views on sexual health, misunderstanding concerning the mechanism ofaction, women’s misperceptions oftheir risks ofgetting pregnant and how ECPs work, barriers to obtaining ECPs, and lack of counseling about ECPs from healthcare providers. Leadership is needed to address these factors contributing to the problem. Health educators are in a unique position to lead the field in …

A Study Of Riders' Noise Exposure On Bay Area Rapid Transit Trains, Alexis Dinno, Cynthia Powell, Margaret Mary King

Community Health Faculty Publications and Presentations

Excessive noise exposure may present a hazard to hearing, cardiovascular and psychosomatic health. Mass transit systems, such as the Bay Area Rapid Transit (BART) system, are potential sources of excessive noise. The purpose of this study was to characterize transit noise and riders' exposure to noise on the BART system using three dosimetry metrics. We made 268 dosimetry measurements on a convenience sample of 51 line segments. Dosimetry measures were modeled using linear and non-linear multiple regression as functions of average velocity, tunnel enclosure, flooring, and wet weather conditions, and presented visually on a map of the BART system. This …

Being Surveyed Can Change Later Behavior And Related Parameter Estimates, Alix Peterson Zwane, Jonathan Zinman, Eric Van Dusen, William Pariente

Dartmouth Scholarship

Does completing a household survey change the later behavior of those surveyed? In three field studies of health and two of microlending, we randomly assigned subjects to be surveyed about health and/or household finances and then measured subsequent use of a related product with data that does not rely on subjects' self-reports. In the three health experiments, we find that being surveyed increases use of water treatment products and take-up of medical insurance. Frequent surveys on reported diarrhea also led to biased estimates of the impact of improved source water quality. In two microlending studies, we do not find an …