Public Health Commons^™

Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act and larger economic forces are leading both health care providers and public health agencies to renegotiate their roles and responsibilities within the U.S. health system. This session reviews major changes occurring in both health care and public health delivery systems, with a focus on the implications for cancer prevention and control. The information infrastructure created by cancer registries and other health information systems are increasingly important for enabling greater coordination, alignment and accountability within the nation's changing delivery systems.

The National Health Security Preparedness Index: Proposed Updates For 2015-16, Glen P. Mays

Health Management and Policy Presentations

The U.S. Centers for Disease Control and Prevention (CDC) initiated development of the National Health Security Preparedness Index in 2012 to create a platform for measuring the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. As a measurement tool, the Index is designed to summarize levels of preparedness achieved within individual states and for the nation as a whole. This session summarizes proposed updates to the Index for 2015-16 that are designed to improve the validity and reliability of Index measures and …

Assessment Of Nutrition Information System Using Health Metrics Network Framework, Mochamad Iqbal Nurmansyah, Catur Rosidati, Riastuti Kusuma Wardani, Badra Al-Aufa

Kesmas

Sistem informasi gizi (Sigizi) dikembangkan oleh Direktorat Bina Gizi Kementerian Kesehatan sejak 2011. Data Sigizi mencakup data penimbangan balita di posyandu, kasus gizi buruk, cakupan pemberian tablet Fe pada ibu hamil, konsumsi garam beryodium, pemberian vitamin A, dan ASI eksklusif. Penelitian ini bertujuan untuk mengukur kinerja pengelolaan Sigizi di Dinas Kesehatan Kota Tangerang Selatan menggunakan kerangka Health Metrics Network yang dikeluarkan oleh WHO tahun 2008. Sigizi merupakan sistem informasi yang diaplikasikan pada tingkat nasional dengan mekanisme pelaporan berjenjang, dari 508 kabupaten/kota menuju 34 provinsi dan bermuara di tingkat nasional. Di Provinsi Banten, terdapat delapan kabupaten/kota yang menjalankan Sigizi. Informan penelitian …

Sikap Remaja Terhadap Keperawanan Dan Perilaku Seksual Dalam Berpacaran, Desi Rusmiati, Sutanto Priyo Hastono

Kesmas

Laporan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007 dan 2012 menunjukkan terjadinya penurunan jumlah remaja yang memiliki sikap positif terhadap pentingnya mempertahankan keperawanan bagi seorang perempuan. Dari laporan yang sama juga diketahui adanya peningkatan perilaku seksual remaja dalam hal berpegangan tangan, berciuman bibir, petting, dan melakukan hubungan seksual. Penelitian ini bertujuan untuk membuktikan adanya hubungan antara sikap remaja terhadap keperawanan dengan perilaku seksual dalam berpacaran dengan melibatkan usia, jenis kelamin, pendidikan, tempat tinggal, usia pertama kali pacaran, pengetahuan, dan pengaruh teman sebaya sebagai variabel perancu. Penelitian ini merupakan penelitian kuantitatif dengan rancangan potong lintang menggunakan model faktor risiko dari …

Sociodemographic Factors To Dengue Hemmorrhagic Fever Case In Indonesia, Desy Nuryunarsih

Kesmas

Demam berdarah dengue (DBD) adalah penyebab utama rawat inap dan kematian pada anak-anak. Indonesia adalah salah satu negara yang oleh WHO dikategorikan hyperendemicity dengan empat serotipe virus tersebar di daerah perkotaan. Faktor sosiodemografi dianggap sebagai faktor pendukung terjadinya DBD di Indonesia. Studi ini menggunakan data sekunder yang diunduh dari Basis Data Kesehatan Provinsi tahun 2010 Kementerian Kesehatan Republik Indonesia untuk menentukan korelasi antara ketiga faktor sosiodemografi dengan insiden DBD. Penelitian ini menggunakan metode kuantitatif deskripsi korelasi. Hasil penelitian menunjukkan bahwa dua faktor sosiodemografi terpilih memiliki korelasi linier dengan insiden DBD. Analisa regresi multivariat menunjukkan kecilnya korelasi antara insiden DBD dengan …

Penerapan Sistem Remunerasi Dan Kinerja Pelayanan, Tri Wisesa Soetisna, Dumilah Ayuningtyas, Misnaniarti Misnaniarti

Kesmas

Remuneration can influence worker`s motivation, and improve their performance. Likewise in hospital as capital-intensive, human resources-intensive as well as knowledge and technology-intensive health care institution. This study aimed to analyze employee’s perception of remuneration system implementation and adult cardiac surgery services unit’s performance at hospital. This study used a mixed method approach (quantitative and qualitative). Quantitative study design was cross-sectional using questionnaire for self-assesment. Meanwhile, qualitative study design was descriptive conducted through focus group discussion and document review on data in forms of schedule book, registration book, nursing notes and medical records. Data collection was conducted in 2013 at one …

Analisis Sif Kerja, Masa Kerja, Dan Budaya K3 Dengan Fungsi Paru Pekerja Tambang Batu Bara, Qomariyatus Sholihah, Aprizal Satria Hanafi, Wanti Wanti, Ahmad Alim Bachri, Sutarto Hadi

Kesmas

Penambangan batu bara merupakan salah satu sumber pencemaran udara berupa partikel debu batu bara yang dapat mengganggu kesehatan pernapasan bila terhirup manusia. Risiko kerja yang sering terjadi dapat berasal dari faktor pekerjaan atau perilaku pekerja sendiri, di antaranya sif kerja dan masa kerja. Tujuan penelitian adalah untuk mengetahui hubungan sif kerja, masa kerja, dan budaya keselamatan dan kesehatan kerja (K3) dengan fungsi paru pekerja tambang batu bara. Penelitian ini merupakan desain kasus kontrol dengan jumlah masing-masing sampel untuk kasus dan kontrol sebesar 178 responden. Penelitian dilakukan pada bulan Oktober November 2014 di PT. X Kalimantan Selatan. Hasil penelitian berdasarkan uji …

Tradisi Dan Lingkungan Sosial Memengaruhi Dukungan Menyusui Pada Bayi Berat Badan Lahir Rendah Di Kota Malang, Muladefi Choiriyah, Elsi Dwi Hapsari, Wiwin Lismidiati

Kesmas

Berat badan lahir rendah (BBLR) merupakan salah satu penyebab utama kematian bayi di dunia. World Health Organization tahun 2003 telah merekomendasikan menyusui sebagai salah satu penanganan BBLR. Namun, ibu yang memiliki bayi BBLR mengalami kesulitan di awal persalinan. Selain itu, menyusui di Indonesia juga dipengaruhi oleh sosial dan budaya yang dipercayai sehingga memengaruhi keputusan ibu untuk memilih tetap menyusui atau tidak sama sekali di periode awal postpartum. Tujuan penelitian ini untuk mengeksplorasi makna pengalaman ibu untuk tetap menyusui bayi dengan BBLR. Penelitian kualitatif ini dengan pendekatan fenomenologi. Tujuh orang partisipan adalah ibu yang pernah menyusui bayi BBLR. Pengumpulan data dilakukan …

Pendidikan Kesehatan Reproduksi Formal Dan Hubungan Seksual Pranikah Remaja Indonesia, Anggriyani Wahyu Pinandari, Siswanto Agus Wilopo, Djauhar Ismail

Kesmas

Transisi demografi kedua akan terjadi di Indonesia dan ditandai dengan revolusi seksual dan reproduksi. Masalah potensial di masa ini adalah peningkatan perilaku seksual pranikah, kehamilan yang tidak diinginkan, infeksi menular seksual dan penyalahgunaan obat. Penelitian ini bertujuan untuk menguji pengaruh pendidikan kesehatan reproduksi formal terhadap penundaan hubungan seksual pranikah pada remaja dan dewasa muda Indonesia. Penelitian potong lintang yang dianalisis sebagai kohort retrospektif menggunakan data Survei Kesehatan Reproduksi Remaja Indonesia tahun 2012 (10.980 laki-laki dan 8.902 perempuan). Efek pendidikan kesehatan reproduksi formal terhadap penundaan perilaku hubungan seksual dianalisis menggunakan kurva kaplan meier, uji log-rank, dan uji chi square, sedangkan analisis …

The Stephen Klein Wellness Center As A Community-Centered Health Home - A Partnership Between Jefferson And Project Home, James D. Plumb Md, Mph, Lara Weinstein Md, Mph, Monica Mccurdy Pa-C, Mhs

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Health Hub Program Evaluation, Natalie Macias

Master's Projects and Capstones

This paper examines and evaluates the work of LIFT-Levántate a non-profit organization in San Rafael, California on their school-based nutritional education “health hub,” through health promotion interventions with adolescents. The James B. Davidson Middle School health hub educates students on topics related to nutrition and physical activity with the goal of providing access and increasing consumption of fruits and vegetables while lowering students’ intake of high-fat and sugary processed foods. Through research and observations of the students and families in this community, the data seems to indicate apparent disparities which vary by ethnicity, socioeconomic status and access. Underserved populations, including …

Using Research And Roi To Drive Partnerships In Public Health Delivery Systems, Glen P. Mays

Health Management and Policy Presentations

Stimulating public-private partnerships (PPP) for health and economic development initiatives requires research that can answer key questions: (1) what are the health and economic returns likely to be realized; (2) over what time frames and with what certainty; (3) what investments are required to achieve results; and (4) what are the implementation strategies most likely to succeed. This presentation reviews ongoing research on the PPPs used to deliver public health services in the U.S., and explores the lessons this research offers PPPs in low and middle income countries. We examine how scientific evidence on public health delivery systems and their …

How Has The Affordable Care Act Benefitted Medically Underserved Communities? : National Findings From The 2014 Community Health Centers Uniform Data System, Jessica Sharac, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers represent the single largest comprehensive primary health care system serving medically underserved communities, operating in more than 9,000 urban and rural locations. Newly-released data for 2014 from the Uniform Data System (UDS; the federal health center reporting system) shed important light on the impact of the Affordable Care Act in its first full year of implementation in medically underserved urban and rural communities across the U.S. These communities experience elevated poverty, heightened health risks, lack of access to primary health care, and a significantly greater likelihood that residents will be uninsured.

The UDS data show the ACA’s …

Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays

Health Management and Policy Presentations

Health services researchers face growing clinical and policy imperatives for estimating how the effectiveness of medical and public health interventions vary across patients, population groups, and community settings. Recent advances in local instrumental variables estimation techniques allow for the estimation of person-specific and community-specific treatment effects in the presence of unobserved heterogeneity. This presentation explores examples from both medicine and public health following the local IV methods developed by Basu et al. (2013).

National Advisory Council On The National Health Service Corps (Nhsc), Sara J. Rosenbaum

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

The Impact Of Gasoline Prices On Medical Care And Costs Of Motor Vehicle Injuries, He Zhu

Theses & Dissertations

Background Traffic safety has placed a tremendous economic and social burden on individuals and nations. Gasoline prices have been linked to traffic safety in the recent studies. Higher gasoline price may prompt people to reduce expenses by changing travel distance and frequency, transportation mode, or driving behaviors.

Objective This study aims to examine the relationship of gasoline prices to hospital utilization and cost for motorcycle and non-motorcycle motor vehicle injuries in the United States.

Methods Data on inpatient hospitalization for motor vehicle injuries were obtained from the 2001-2010 Nationwide Inpatient Sample, which is part of the Healthcare Costs and Utilization …

Understanding Access To Health Information: The Role And Measurement Of Social Location, Megan S. Kelley

Theses & Dissertations

The purpose of this research is to explore how application of social location theory may improve data collection on health information access in order to better inform and improve the effectiveness of health communication and messaging. This dissertation proposes a framework to understand how people obtain health information based on the idea of social location, Ritzer and Bell’s (1981) levels of social reality, and Dahlberg & Krug’s (2002) social ecological model. This research addressed the extent to which three studies of health information access support the use of such a framework, and if so, how its application could improve our …

Foundational Public Health Services And Health System Reform, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril

Health Management and Policy Presentations

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.

Economic Evaluation Of Fungal Meningitis Outbreak Response In New River Valley: Local Health Department Perspective, Kaja M. Abbas, Nargesalsadat Dorratoltaj, Margaret L. O’Dell, Paige Bordwine, Thomas M. Kerkering, Kerry J. Redican

Frontiers in Public Health Services and Systems Research

Background: The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.

Purpose: The objective of this study was to conduct an economic evaluation of the fungal meningitis outbreak response in New River …

Measuring Changes In Local Surveillance And Investigation Capacity, Christine A. Bevc, Mary V. Davis, Anna P. Schenck

Frontiers in Public Health Services and Systems Research

Background: The outbreak of Ebola virus disease in West Africa and confirmation of the first cases in the United States highlight the need for robust and responsive public health surveillance system. With a 25% decline in funding since 2007, the impact on local surveillance capacities has not previously been described.

Purpose: The Surveillance & Investigation domain of the Local Health Department Preparedness Capacities Survey (PCAS) was reweighted to reflect the national profile of LHDs. Changes in subdomain performance of capacities and the effect of population size on subdomain capacity performance were examined over time.

Methods: Participating LHDs (n=208) …

Implementing Shared Decision-Making: Consider All The Consequences, Glyn Elwyn, Dominick L. Frosch, Sarah Kobrin

Dartmouth Scholarship

The ethical argument that shared decision-making is “the right” thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The …

Paleoepidemiology Of Intestinal Parasites And Lice In Pre-Columbian South America *, Adauto Araujo, Karl J. Reinhard, Daniela Leles, Luciana Sianto, Alena Iniguez, Martin Fugassa, Berrnardo Arriaza, Nancy Orellana, Luiz Fernando Ferreira

Karl Reinhard Publications

Some human parasites originated in prehominid ancestors in Africa. Nematode species, such as Enterobius vermicularis (pinworm), hookworms and Trichuris trichiura are shared by humans and other close phylogenetic primates (Pan and Gorilla), showing that they infected a common ancestor to this group. When humans migrated from Africa to other continents they carried these parasites wherever climate conditions allowed parasite transmission from host to host. Other parasites, however, were acquired throughout human biological and social evolutive history when new territories were occupied. Paleoparasitology data is a valuable source to recover emergence and disappearance of parasite infections through analysis of archaeological remains. …

Diet And Parasitism At Dust Devil Cave, Karl J. Reinhard, J Richard Ambler, Magdalene Mcguffie

Karl Reinhard Publications

Human parasitism has obvious relationships to group size and composition, mobility, subsistence patterns, and rates of culture change. At their best, human endoparasites may be annoying; at their worst, some can cause death. Thus, an overall view of the parasite load of a prehistoric population can yield insights useful in interpreting past lifeways. With these thoughts in mind, we undertook a study of Desha Complex (6800-4800 B .C.) human feces recovered from Dust Devil Cave in southern Utah.

Do Stress Levels Differ Between First Semester Nursing Student Early In The Semester Vs. The End Of The Semester?, Alissy Heisey

Undergraduate Honors Theses

This study intends to determine how stress levels change over time in nursing students in the Baccalaureate program at East Tennessee State University. The instrument utilized for this survey was the Perceived Stress Scale by Mind Garden, Inc. This survey was passed at the beginning of the semester and at the end of the semester. There was no-significant difference found between the two time spots, leading us to conclude that the level of stress perceived by nursing students is a steady factor during their school semester.

Optimisations And Challenges Involved In The Creation Of Various Bioluminescent And Fluorescent Influenza A Virus Strains For In Vitro And In Vivo Applications, Monique I. Spronken, Kristy Short, Sander Herfst, Theo M. Bestebroer, Vincent P. Vaes, Erin Sorrell, + 9 More

Health Policy and Management Faculty Publications

Bioluminescent and fluorescent influenza A viruses offer new opportunities to study influenza virus replication, tropism and pathogenesis. To date, several influenza A reporter viruses have been described. These strategies typically focused on a single reporter gene (either bioluminescent or fluorescent) in a single virus backbone. However, whilst bioluminescence is suited to in vivo imaging, fluorescent viruses are more appropriate for microscopy. Therefore, the idea l reporter virus varies depending on the experiment in question, and it is important that any reporter virus strategy can be adapted accordingly. Herein, a strategy was developed to create five different reporter viruses in a …

Confidence And Connectedness: A Mixed Methods Study On Patients Managing Co-Occuring Physical And Behavioral Health Conditions, Peter Young Fifield

All Theses And Dissertations

Treating chronic illness is becoming increasingly team based, yet most team building concepts relate to the team as a dichotomous unit: the medical team and the patient. Patients are expected to be “engaged” and “activated” members of the team, yet there is a gap in knowledge regarding how patients most effectively integrate into the team. Exacerbating the complexity of patient as team member is the multifaceted, ever-changing mood state of patients with co-occurring medical and mental health conditions. The medical field is well aware of the correlations between mental health and chronic illnesses. The purpose of this study is to …

Agave Chewing And Dental Wear: Evidence From Quids, Emily E. Hammerl, Melissa A. Baier, Karl Reinhard

Karl Reinhard Publications

Agave quid chewing is examined as a potential contributing behavior to hunter-gatherer dental wear. It has previously been hypothesized that the contribution of Agave quid chewing to dental wear would be observed in communities wherever phytolith-rich desert succulents were part of subsistence. Previous analysis of coprolites from a prehistoric agricultural site, La Cueva de los Muertos Chiquitos in Durango, Mexico, showed that Agave was a consistent part of a diverse diet. Therefore, quids recovered at this site ought to be useful materials to test the hypothesis that dental wear was related to desert succulent consumption. The quids recovered from the …

The Alzheimer’S Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary, Nina Silverstein, Frank Porell, Pamela Nadash

Gerontology Institute Publications

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer's Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance.

In …

Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays

Health Management and Policy Presentations

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …