Public Health Commons^™

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

The Influence Of Family Dynamics On Contraceptive Use In Madagascar And The Ensuing Impact On Family Well-Being, Joel Zafitandra Hajason, Kayla Piña, Joel L. Raveloharimisy

Faculty Publications

While studies have shown a relationship between family dynamics and contraceptive use and between contraceptive use and family well-being, no empirical study has been conducted to test whether a relationship exists between family influence on contraceptive use and family wellbeing. The objective of this study is to explore whether there is such a relationship between family influence on contraceptive use and family well-being.

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

Balancing The Presentation Of Information And Options In Patient Decision Aids: An Updated Review, Purva Abhyankar, Robert J. Volk, Jennifer Blumenthal-Barby, Paulina Bravo, Angela Buchholz, Elissa Ozanne, Dale C. Vidal, Nananda Col, Peep Stalmeier

Dartmouth Scholarship

Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options.

Estimating The Costs Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

Electronic Word Of Mouth On Twitter About Physical Activity In The United States: Exploratory Infodemiology Study, Ni Zhang, Shelly Campo, Kathleen F. Janz, Petya Eckler, Jingzhen Yang, Linda G. Snetselaar, Alessio Signorini

Faculty Research, Scholarly, and Creative Activity

Background:
Twitter is a widely used social medium. However, its application in promoting health behaviors is understudied.
Objective:
In order to provide insights into designing health marketing interventions to promote physical activity on Twitter, this exploratory infodemiology study applied both social cognitive theory and the path model of online word of mouth to examine the distribution of different electronic word of mouth (eWOM) characteristics among personal tweets about physical activity in the United States.
Methods:
This study used 113 keywords to retrieve 1 million public tweets about physical activity in the United States posted between January 1 and March 31, …

How Medicaid Expansions And Future Community Health Center Funding Will Shape Capacity To Meet The Nation's Primary Care Needs, Leighton C. Ku, Julia Zur, Emily Jones, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

A new report by Drs. L. Ku, J. Zur, E. Jones, P. Shin and S. Rosenbaum examines the impact of federal and state policy decisions on community health centers and their ability to continue providing primary care to the nation's poorest residents. The report estimates that under a worst-case scenario the nation's health centers would be forced to contract, leaving an estimated 1 million low-income people without access to health care services by 2020.

Strengths And Limitations Of The Design Of Helen Keller International’S Childsight® Program Based On Lessons Learned Through The Implementation In Vietnam, 2011-2013, Bradley J. Owen

Capstone Collection

The ophthalmology sector in Vietnam currently faces many challenges. The Asia- Pacific Region, including Vietnam, is reported to have the most cases of uncorrected refractive error in the world at approximately 62 million people. A 2009 study implemented by the World Health Organization also concluded that the Western Pacific region, including Southeast Asia, has 3.98% of the population suffering from uncorrected refractive error, with an estimated cost to the region’s GDP of 111 billion dollars, or .86% of regional GDP (Smith, et al. 2009). In Vietnam alone it is estimated that one in five children suffer from some form of …

New Health Delivery Networks: Merging Public Health And Health Care Systems, Glen P. Mays

Health Management and Policy Presentations

Incomplete coordination between medical care and public health delivery systems can result in significant missed opportunities for improving population health and constraining overall resource use. This lecture uses insight from the field of public health services and systems research (PHSSR) to examine: (1) why medical care and public health systems often fail to connect; (2) what are the potential health and economic consequences of these failures; and (3) what are the opportunities for connecting medical care and public health delivery to improve population health.

Recessions, Risks And Reforms: Changes In Inter-Organizational Activities To Improve Public Health, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, with a focus on hospitals, insurers, employers, and primary …

Who Benefits From Public Health Spending And How Long Does It Take: Estimating Community-Specific Spending Effects, Glen P. Mays

Health Management and Policy Presentations

Objectives: Spending on public health and prevention strategies varies widely across states and communities. The Patient Protection and Affordable Care Act of 2010 (ACA) authorized the largest expansion in federal public health spending in decades, with the goals of improving population health and helping to moderate growth in medical care spending. To produce evidence needed to inform these investments, this study (1) estimates the effects of public health spending patterns within communities on preventable mortality and subsequent medical care spending; and (2) uses the methods of local instrumental variables developed by Heckman and Vytlacil and Basu to estimate how the …

Update On Public Health Financing & Economic Studies From The Phssr And Pbrn Programs, Glen P. Mays

Health Management and Policy Presentations

As part of the Public Health Financing Roundtable at APHA, this session provides an update on public health financing and economics studies underway through the Public Health Services and Systems Research (PHSSR) Program and the Public Health Practice-Based Research Networks (PBRN) Program, supported by the Robert Wood Johnson Foundation.

The Need To Include Animal Protection In Public Health Policies, Aysha Akhtar

Animal Welfare Collection

Many critical public health issues require non-traditional approaches. Although many novel strategies are used, one approach not widely applied involves improving the treatment of animals. Emerging infectious diseases are pressing public health challenges that could benefit from improving the treatment of animals. Other human health issues, that overlap with animal treatment issues, and that warrant further exploration, are medical research and domestic violence. The diverse nature of these health issues and their connection with animal treatment suggest that there may be other similar intersections. Public health would benefit by including the treatment of animals as a topic of study and …

Willow: Reaching Hiv-Positive African-American Women Through A Computer-Delivered Intervention, Charles H. Klein

Anthropology Faculty Publications and Presentations

This study evaluates the efficacy of Multimedia WiLLOW in enhancing HIV-protective sexual behaviors and psychosocial outcomes among HIV-positive African American women, including condom use for vaginal and anal sex, and psychosocial mediators associated with risk reduction practices. Using a community-based randomized controlled design, 168 participants completed a baseline and follow-up assessment as well as an exit satisfaction survey. Intervention participants reported significantly higher proportions of condom protected sex acts in the past 30 days (p=.002), with both HIV-negative (p=.040) and HIV-positive (p=.003) partners. They were also more likely to report 100% condom use (OR = .10; p=.030); a lower adjusted …

Health Promotions 2.0: The Future Of Wellness Programs In America, Rajiv Kumar

Center for Policy Research

In no small part because of technology, the way we live and work is being transformed. I believe that those of us who are interested in health policy can play an important role in guiding that transformation. I submit to you that unhealthy living is a social issue; that conditions such as obesity and diabetes are social diseases and that their prevalence is a social problem. If we have a social problem, then we need a social solution. I believe part of that solution can be found in the worksite health promotion and wellness programs that have taken root across …

The Population Health Revolution, Drew Harris Dpm, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Public Health Services & Systems Research: Building The Science Of Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

The extreme heterogeneity in how public health activities are organized, financed, and implemented across U.S. states and communities provides compelling opportunities for research on the comparative effectiveness and efficiency of public health delivery. This talk highlights some of the most compelling and policy-relevant opportunities for research on public health organization and financing issues, and examines some of the ongoing studies in the field.

Preliminary Findings From An Interventional Study Using Network Analysis To Support Management In Local Health Departments In Florida, Chin S. Park, Hado Byon, Jonathan W. Keeling, Leslie M. Beitsch, Jacqueline A. Merrill

Frontiers in Public Health Services and Systems Research

Management is the core service that integrates and coordinates essential public health services. Managers of local health departments (LHDs) are experts in practice but may not have expertise in organizational management. We conducted an evidence-based training intervention in 10 LHDs in Florida to support managers’ decision-making on organizational integration and coordination. We deployed a standard survey to collect organizational network measurements pre and post intervention. We presented results as evidence-based performance feedback and interviewed managers to document how they used the results in the context of each organization. Post intervention we found unexpected, significantly higher network centralization in daily work. …

Characteristics Of A Local Health Department Associated With The Use Of The Health Equity Index, Moira A. Lawson, Sharon Mierzwa, Michael Knapp

Frontiers in Public Health Services and Systems Research

Local health departments are tasked with understanding and addressing health inequities in the populations they serve. To meaningfully address health inequities, local health departments have identified the need for credible local data to better understand the relationship between community conditions and health outcomes. Yet, when given access to these data, we observe a very large variation in the level of interest between local health departments.

In this study, we offered Connecticut’s Local health departments access to the Health Equity Index, a web based tool that provides data on health outcomes and community conditions at the state, municipal or neighborhood levels. …

Evaluating Use Of Custom Survey Reports By Local Health Departments, Nadya M. Belenky, Christine A. Bevc, Elizabeth Mahanna, Carol Gunther-Mohr, Mary V. Davis

Frontiers in Public Health Services and Systems Research

This report demonstrates how providing survey feedback, like comparative reports, to survey respondents can result in improvement activities. For each of the past three years (2010-2013), the North Carolina Institute for Public Health (NCIPH) has invited local health departments (LHDs) from 40 states to participate in a preparedness capacities survey. In addition, NCIPH fielded a six-question evaluation survey to a subset of LHDs (n=70) to determine how LHDs use these reports. LHDs that reported using their custom reports compared their preparedness capacities to other LHDs, conducted strategic planning (e.g., benchmarking, setting preparedness goals), planned staff trainings, and disseminated the report …

The Relationship Between Quality Improvement And Health Information Technology Use In Local Health Departments, Kendra Johnson, Kim K. Nguyen, Shimin Zheng, Robin P. Pendley

Frontiers in Public Health Services and Systems Research

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use …

Commentary: The Road To Quality In Public Health, A Long But Important Journey, F. Douglas Scutchfield, Glen Mays, Marylou Wallace

Frontiers in Public Health Services and Systems Research

Quality improvement (QI) in public health departments is a focus in this sixth issue of Frontiers. Data is important to the development of quality improvement efforts. As we see growth of and meaningful use of electronic health records, the health department is in a position to take the lead as a data hub and to use this information wisely to both improve their QI efforts and link that QI to outcomes.

Frontiers Of The New Social Marketing, R. Craig Lefebvre

GW Health Communication and Marketing Symposium Series

No abstract provided.

Personal Characteristics And Learning Preference In End-Of-Life Decision Making Of Chronically Ill Community Dwelling Elders, Leigh Ann Bonney

Theses and Dissertations

Leigh Ann Bonney, RN, MSN; Susan Kossman, RN, PhD; MyoungJin Kim, PhD; Wendy Woith, PhD, Caroline Mallory, PhD

Illinois State University, Mennonite College of Nursing

Personal Characteristics and Learning Preference in End-of-Life Decision Making of

Chronically Ill Community Dwelling Elders

Purpose and Background: Clear decision-making (DM) about end-of-life [EOL] contributes to a good death This requires knowledge of life-sustaining treatment with lack of knowledge contributing to feelings of decisional conflict Decision aids can increase knowledge, but elders' preferred learning methods are unknown. Identifying characteristics associated with preferred learning method and decisional conflict can help nurses tailor information to assist in …

Assessing The Potential Impact Of The Affordable Care Act On Uninsured Community Health Center Patients: A Nationwide And State-By-State Analysis, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In this brief, we estimate the number of uninsured community health center (CHC) patients who would gain coverage under the Affordable Care Act using data from the 2009 HRSA Survey of CHC patients and 2011 Uniform Data System. We find that were all states to implement the Affordable Care Act Medicaid expansion, an estimated 5 million uninsured health center patients – or two-thirds of all uninsured patients served by CHCs nationally – would be eligible for coverage. However, over one million uninsured patients – 72% of whom live in southern states – who would have been eligible for coverage will …

Visiting Lecturer Will Link Public Health Risks To Climate Change, Public Affairs & News Bureau, Old Dominion University

News Items

No abstract provided.

Illusion Or Ununderstood Reality: Spiritual Or Psychic Healing And Protection In Southern Madagascar, Henri Lucien Sandifer

Independent Study Project (ISP) Collection

Far from the hospital room and its doctor, the medicine and philosophies of Lakazy and its Ombiasa pertain to a domain largely untouched by western logic and science. Their practices appear to be effective and unique enough to have survived the advent of compelling new theological and scientific belief systems and the vastly different perspectives on community health and stability which these systems have brought to Madagascar. The prime examples of these new arrivals are Christianity and modern medicine, respectively. Within and without their sacred space, the mission of the true Ombiasa is to support their community and for this …

The Mosakowski Institute For Public Enterprise Five Year Report, Mosakowski Institute

Mosakowski Institute for Public Enterprise

This report contains the highlights of the first five years of Clark University’s Mosakowski Institute for Public Enterprise. It includes a description of the Institute’s founding, its commitment to use-inspired research, transformational educational experiences, and community connectedness, the Institute’s leadership and finances, and a listing of projects undertaken and faculty partners.

Hiv/Aids In Yunnan Province: A Study Of Stigma And Support, Sofia Haile

Independent Study Project (ISP) Collection

I conducted a qualitative study on the ability of peer-HIV-support groups in Kunming, China to lessen the effects stigma. There is a lack of quantitative studies of stigma in Yunnan, and no studies that address the ability of Kunming peer-groups to lessen the effects of stigma. Over the course of one month, I collected data via questionnaire, individual interviews, group interviews, and scholarly research. My study had sixteen participants (five female sex workers, seven former intravenous drug users, and four men who have sex with men).

My scholarly research revealed that peer-groups are an effective way to: disseminate knowledge to …

La Situación De Las Cataratas En La Ciudad De Buenos Aires: Un Estudio De Caso En El Hospital Ramos Mejía / The Situation Of Cataracts In The City Of Buenos Aires: A Case Study In Ramos Mejía Hospital, Katie Elizabeth Kessler

Independent Study Project (ISP) Collection

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual …