Public Health Commons^™

The Public Health Pbrn Program: A Summative Report, Center For Public Health Systems And Services Research

UKCPHSSR Research Briefs and Reports

This program seeks to expand the volume and quality of evidence on how best to organize, finance, and deliver public health services by: (1) helping to organize and develop practice-based research networks (PBRNs) comprised of public health agencies and skilled research institutions; (2) selecting grantees to receive funding and technical assistance for PBRN research projects; and (3) facilitating the successful development, implementation, and translation of research projects through PBRNs by providing technical assistance, fostering peer learning, and leading selected multi-network research activities.

Initial Impact Of Tailored Web-Based Messages About Cigarette Smoke And Breast Cancer Risk On Boys' And Girls' Risk Perceptions And Information Seeking: Randomized Controlled Trial, Chris G. Richardson, Laura L. Struik, Kenneth C. Johnson, Pamela A. Ratner, Carolyn Gotay, Jasmina Memetovic, Chizimuzo T.C. Okoli, Joan L. Bottorff

Nursing Faculty Publications

BACKGROUND: Recent evidence indicates a causal link between both active smoking and secondhand smoke (SHS) exposure and breast cancer (BC).

OBJECTIVE: The objective of the present study was to evaluate the initial reactions of girls and boys to tailored Web-based messages that describe the relationship between SHS and BC, using a parallel, single-blinded cluster randomized controlled trial.

METHODS: This trial was nested within a cycle of an ongoing longitudinal study of 1498 students from 74 secondary schools. Self-reported assessments were used to evaluate the impact of study messages on participants' risk perception and interest in obtaining additional information after participants …

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

Public Health Research Implementation And Translation: Evidence From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg, Doris M. Castellanos-Cruz, Anna G. Hoover, Lizeth C. Fowler

Health and Clinical Sciences Faculty Publications

BACKGROUND: Research on how best to deliver efficacious public health strategies in heterogeneous community and organizational contexts remains limited. Such studies require the active engagement of public health practice settings in the design, implementation, and translation of research. Practice-based research networks (PBRNs) provide mechanisms for research engagement, but until now they have not been tested in public health settings.

PURPOSE: This study uses data from participants in 14 public health PBRNs and a national comparison group of public health agencies to study processes influencing the engagement of public health settings in research implementation and translation activities.

METHODS: A cross-sectional network …

Occupational Injuries On Thoroughbred Horse Farms: A Description Of Latino And Non-Latino Workers' Experiences, Jennifer E. Swanberg, Jessica M. Clouser, Susan C. Westneat, Mary W. Marsh, Deborah B. Reed

Health, Behavior & Society Faculty Publications

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry's workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies …

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.

Truck Driver Dies When Tractor-Trailer Leaves The Road And Plunges Into A Creek-Bed, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a fall day, exact time unknown and the length of time driving unknown, a 28-year-old male truck driver was driving north on an interstate transporting 30,000 lbs. of blue plastic injection molding pellets. The truck driver exited the highway behind a guardrail and traveled 1,320 feet, striking a wire fence and several trees before plummeting into a creek bed, shearing the cab open. At 10:27 a.m., a citizen called in to the fire department to report a mysterious blue substance observed in the creek a couple of miles down from the accident. The fire …

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.

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 …

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 …

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.

Arborists Die After Falling, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To Prevent Arborists Injuries:

• Never allow an aerial lift to be used as a crane or material lifting device.
• All trees and limbs should be inspected for structural weakness such as rot, before work starts.
• Arborists should wear appropriate personal protective equipment while performing tree trimming activities.

Special Factors for Aerial Lifts:

• Do not exceed the boom and basket load limits specified by the manufacturer.
• When working from an aerial lift, use a body harness that is properly attached.

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.

Asthma And Risk Of Non-Respiratory Tract Infection: A Population-Based Case-Control Study, Duk Won Bang, Hyeon J Yang, Eell Ryoo, Majdi N. Al-Hasan, Brian Lahr, Larry M. Baddour, Barbara P. Yawn, Young J. Juhn

Internal Medicine Faculty Publications

OBJECTIVES: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.

DESIGN: The study was designed as a population-based retrospective case-control study.

SETTING: This population-based study was conducted in Olmsted County, Minnesota.

PARTICIPANTS: The study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.

PRIMARY AND SECONDARY OUTCOME MEASURES: Only community-acquired E coli BSI …

The Vancouver General Hospital Smoking Cessation Clinic: Outcomes From A Specialist Cessation Service Within Cardiology, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

PURPOSE: The purpose of our study is to examine pilot treatment outcomes of an outpatient Smoking Cessation Clinic (SCC) provided within Cardiology Services.

RELEVANCE/CONTEXT: Populations with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening cardiac events. Smoking cessation can greatly reduce the risk of further occurrence of a cardiac event and associated mortality. However few Cardiology services in Canada offer smoking cessation services and few Cardiologists refer smoking patients to such services. The Vancouver General Hospital’s SCC is housed within Cardiology Services and offers a longitudinal approach to smoking cessation. This …

Suicide And Suicide Attempts In Kentucky, 2001‐2012, Joshua W. Lambert, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

The data sources, methods, and definitions used in this report are based on the State Injury Indicators report: Instructions for Preparing 2011 Data, Atlanta, Georgia, March 2013, a publication of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Cost Estimation Methods And Foundational Public Health Capabilities, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medine recently recommended that the federal government identify the components and costs of a "minimum package of public health services" and "foundational public health capabilities" that should be universally available across the U.S. This presentation reviews costing methods that can be used for identifying the costs required to establish "foundational public health capabilities" at state and local levels within the U.S. public health system.

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

Health Management and Policy Presentations

Studying variation and innovation in public health delivery can identify pathways for improving the organization, financing, and implementation of programs and policies that protect and promote health.

A Content Analysis Of Media Coverage Of The Introduction Of A Smoke-Free Bylaw In Vancouver Parks And Beaches, Arezu Moshrefzadeh, Wendy Rice, Ann Pederson, Chizimuzo T.C. Okoli

Nursing Faculty Publications

The Board of Parks and Recreation in Vancouver, BC approved a smoke-free bylaw in the city's parks, beaches and recreational facilities, effective 1 September 2010. We analyzed local news coverage and portrayal of the bylaw to understand the potential influence of news media on public perception of the bylaw in order to inform the media advocacy work of public health interest groups. We compiled a data set of newspaper articles (n = 90) and conducted a quantitative content analysis to examine content related to the outdoor smoke-free policy, including article slant, topics related to smoking and tobacco control, and any …

Accreditation And Standardization In Local Public Health, Glen P. Mays

Health Management and Policy Presentations

Reducing harmful, wasteful, and inequitable variation in public health delivery is a central objective for administrative and policy decision-makers in public health, and is embedded in the national accreditation movement. The challenge lies in accomplishing this objective while preserving the benefits of customization in public health delivery that accrue through tailoring and targeting of resources to unique community needs and risks. Public health services and systems research (PHSSR) can help determine the optimal balance between standardization and customization in public health delivery.

Strengthening The Evidence Base For Accreditation: Progress In Phssr And Pbrns, Glen P. Mays

Health Management and Policy Presentations

With the launch of a voluntary national accreditation program for public health agencies, the field requires an expanding evidence base concerning which public health strategies work best, for which populations, and under what circumstances. The field of public health services and systems research (PHSSR) and practice-based research networks (PBRNs) are producing applied studies that can inform the future development and implementation of accreditation standards, and evaluate the impact of accreditation on the field of practice.

Public Health Practice-Based Research Networks: Creating Evidence For Practice, Glen P. Mays

Health Management and Policy Presentations

Powerful opportunities for learning from variation and change in public health delivery now exists across the U.S. health system. Practice-based research networks (PBRNs) provide the vehicles for harvesting evidence from applied, comparative studies -- and for feeding this information back into the delivery system.

Public Health Services & Systems Research: Concepts, Methods, And Emerging Findings, Glen P. Mays

Health Management and Policy Presentations

The field of public health services & systems research (PHSSR) increasingly is addressing the question of how to assess the value of investments in public health programs, infrastructure, and delivery systems. Progress in quasi-experimental research designs, measurement, estimation techniques, and data sources are yielding important insight.

Strengthening The Science Of Public Health Delivery Through Public Health Services Research, Glen P. Mays

Health Management and Policy Presentations

This session notes recent progress from the field of public health services and systems research (PHSSR) concerning the most promising directions for improving the delivery and impact of public health services, programs, and policies.

Application Of Situational Leadership To The National Voluntary Public Health Accreditation Process, Kristina Rabarison, Richard C Ingram, James W. Holsinger Jr.

Health Management and Policy Faculty Publications

Successful navigation through the accreditation process developed by the Public Health Accreditation Board (PHAB) requires strong and effective leadership. Situational leadership, a contingency theory of leadership, frequently taught in the public health classroom, has utility for leading a public health agency through this process. As a public health agency pursues accreditation, staff members progress from being uncertain and unfamiliar with the process to being knowledgeable and confident in their ability to fulfill the accreditation requirements. Situational leadership provides a framework that allows leaders to match their leadership styles to the needs of agency personnel. In this paper, the application of …

Smoking Cessation Outcomes Among Individuals With A History Of Psychotic Disorders As Compared To Those Without, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

Background: Psychotic disorders (e.g., Schizophrenia, schizoaffetive disorder) are associated with a higher smoking prevalence (relative to other psychiatric disorders) and smoking attributable mortality. Until recently, little has been done to address the disproportionate smoking in this population. The objectives of our study are to: 1) describe the characteristics of smokers with a history of psychiatric disorders (i.e., none, psychotic, and depressive/anxiety) and 2) examine smoking cessation/reduction outcomes by history of psychiatric disorders.

Methods: Retrospective analyses were conducted from charts of 982 participants accessing a tailored, evidence-based, tobacco treatment program within mental health and addictions services in Vancouver, Canada. Demographics, tobacco …

Outcomes Of A Smoking Cessation Clinic In Cardiology Services, Vancouver, Canada, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

BACKGROUND: Adults who have experienced cardiac events have a high burden of smoking and are likely to continue post cardiac event. Research in this population suggests that smoking cessation services offered to this population can reduce the re-occurrence of cardiac events by assisting patients in cessation. However, few cardiology clinics offer smoking cessation services and few cardiologists refer patients to such services. The Smoking Cessation Clinic (SCC) provides evidence-based smoking cessation treatment within Cardiology services in Vancouver General Hospital in Vancouver, Canada. The aim of this study was to evaluate the SCC program in terms of its program engagement …

Smoking On The Margins: An Equity Analysis Of Vancouver's Outdoor Smoke-Free Policy In Parks And On Beaches, Chizimuzo T.C. Okoli, Ann Pederson

Nursing Presentations

Background: Increasingly, jurisdictions worldwide are addressing smoking restrictions in outdoor public spaces to reduce secondhand smoke exposure, discourage youth initiation, enhance cessation, and reduce environmental hazards (i.e., fire and cigarette-related litter). However, there is little research on the policy context and health-equity impact of such policies to help guide wider implementation efforts.

Objectives: On September 1, 2010, the Board of Parks and Recreation in Vancouver, Canada, introduced a smoke-free bylaw for the city’s parks and beaches. The Smoking on the Margins project is examining the policy context and potential health-equity impact of this bylaw.

Methods: Applying critical multiplism and equity-focused …

Geomapping Telehealth Access To Developmental-Behavioral Pediatrics, Neelkamal S. Soares, Andrew O. Johnson, Nitish Patidar

Health Management and Policy Faculty Publications

Background: Geographic information systems (GIS) mapping is fairly novel in describing utilization of health services. Our study is the first to use GIS to demonstrate that telehealth pediatric specialty service access would create substantial savings in travel time and distance compared with accessing a tertiary-care center for similar service.

Materials and Methods: A retrospective chart review of telehealth encounters and geocoding of patients' address were done with actual travel along road calculations to estimate travel time and distance for a visit, compared with a hypothetical visit to the nearest tertiary-care site for the similar service.

Results: Over a 2-year period, …

Population Cancer Risks Associated With Coal Mining: A Systematic Review, Wiley D. Jenkins, W. Jay Christian, Georgia Mueller, K. Thomas Robbins

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Coal is produced across 25 states and provides 42% of US energy. With production expected to increase 7.6% by 2035, proximate populations remain at risk of exposure to carcinogenic coal products such as silica dust and organic compounds. It is unclear if population exposure is associated with increased risk, or even which cancers have been studied in this regard.

METHODS: We performed a systematic review of English-language manuscripts published since 1980 to determine if coal mining exposure was associated with increased cancer risk (incidence and mortality).

RESULTS: Of 34 studies identified, 27 studied coal mining as an occupational exposure …