Public Health Commons^™

Best Practice Use To Address Tobacco-Related Disparities By California Community Coalitions, Rodney K. Mccurdy

Frontiers in Public Health Services and Systems Research

Tobacco-related disparities (TRDs) are a major public health concern. This study surveyed community tobacco coalition project directors in California to determine the usage of 11 CDC-published best practices to address TRDs. Response rate was 80 percent. Communities had implemented, on average, one-half of the 11 practices surveyed. Differences were observed between rankings for best practice implementation and perceived level of importance in addressing TRDs in the community. Resource constraints and community context were the highest reported barriers to best practice use. Study findings could assist tobacco program officials and local coalitions in addressing TRDs in their communities.

Support For A Smoke-Free Bylaw In Parks And On Beaches, Chizimuzo T.C. Okoli, Ann Pederson, Wendy Rice

Nursing Faculty Publications

BACKGROUND: In September 2010, Vancouver, Canada enacted a smoke-free bylaw in parks and on beaches.

OBJECTIVE: To examine demographic and attitudinal factors associated with the public opinion on Vancouver's outdoor smoke-free bylaw.

METHODS: From 496 randomly selected Vancouver residents, information on demographics, smoking status, and opinions and support for or opposition to the smoke-free bylaw were obtained by telephone surveys.

RESULTS: Approximately 84.2% of the sample endorsed the legislation; a greater proportion of non-smokers supported the bylaw than smokers (88.6% vs. 52.0%). In multivariate analysis, demographic variables significantly associated with supporting the smoke-free bylaw were being female, having completed community …

Factory Laborer Dies When A Car Driven By Coworker Crashes Into Him In Parking Lot, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On a summer day, a 29-year-old male manufacturing laborer was outside under a small metal stairway in the loading dock area of the manufacturing plant during his lunch break. Another employee entered her car in the employee parking lot to leave on her lunch break. Her car unexpectedly malfunctioned when in reverse, sped backward, and crashed into the stairway under which the worker was taking a break. The collision pushed the metal stairway along the wall of the factory, crushing the worker between the building and the passenger side of the car. Emergency medical services arrived and transported the worker …

Health System Contributions To Public Health Activities Amid Policy And Economic Change: Estimating Complementarities, Substitutions, And Network Effects, 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, potentially changing the structure of public health delivery systems and expanding the delivery of strategies that improve population health. 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 …

Day Care Monitor Dies After Crash Of 15-Passenger Van, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the late afternoon of a spring day, a day care van operator and a monitor loaded 16 children into a 15-passenger van. Carrying a total of 18 passengers in the 15-passenger van, the operator and the monitor proceeded to transport the children to their homes. After dropping off two children at their residences, the van was traveling 46-50 mph in the left hand lane headed east in a 35 mph zone on a non-divided four-lane state road. As the van approached a side street on the right, the right rear tire blew out and the van veered sharply to …

Hospital Contributions To Public Health Activities Before And After Aca: Incentives, Constraints & Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created enhanced IRS requirements for not-for-profit hospitals regarding the provision of community benefits, potentially stimulating new approaches to community health needs assessment, priority setting, and engagement with public health agencies and other community stakeholders. Yet the economic downturn has constrained hospital earnings and increased demand for uncompensated care, potentially crowding out hospital contributions to public health activities. This study uses data from 1998-2012 on a national cohort of communities to examine: (1) the extent and nature of change in hospital contributions to public health activities; and (2) the economic, institutional, and policy-related factors that …

Frontiers In Public Health Services And Systems Research: Accelerating And Expanding Knowledge Transfer In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

As part of the "Meet the Editors" panel on publishing health services research, this presentation discusses the new open-access journal Frontiers in Public Health Services and Systems Research. This journal serves as a vehicle for rapidly disseminating newly emerging and preliminary findings from studies that examine the organization, financing, and delivery of public health services. The goal is to stimulate research collaboration and accelerate knowledge transfer from research projects to policy and administrative decision-makers within the public health system.

Biomarkers For Ovarian Cancer, Eric T. Fung, Frederick Ueland, J. R. Van Nagell, Paul D. Depriest, Andre T. Baron

Epidemiology and Environmental Health Faculty Patents

The present invention provides protein-based biomarkers and biomarker combinations that are useful in qualifying ovarian cancer status in a patient. In particular, the biomarkers of this invention are useful to classify a subject sample as ovarian cancer, ovarian cancer of low malignant potential, benign ovarian disease or other malignant condition. The biomarkers can be detected by SELDI mass spectrometry.

From The Frontier: Translating Research To Practice…Qi As The Hinge Point, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

This article is number three in the series From the Frontier: Translating Research to Practice. The narrative describes the work of a practice-academic network in Minnesota which explored the degree to which having a culture of quality at the local health department level influenced the capacity to implement a new statewide initiative. The network conducted a mixed-methods study of grantees funded to develop and implement local policy, systems, and environmental change strategies to promote nutrition, increase activity, and reduce tobacco use and exposure. The results of their study indicated that grantees with higher performance levels in Quality Improvement (QI) …

Access To Primary Care: Comparing Driving Distance From Health Professional Shortage Area (Hpsa) Counties Versus Non-Hpsa Counties, Molly Cashion, Stephanie Jilcott-Pitts, Doyle Cummings, Christopher Duffrin, John Jones, Qiang Wu

Frontiers in Public Health Services and Systems Research

The criteria used to identify Health Professional Shortage Areas dates back to the 1970’s and very little has changed since then. This study examined driving distance from patient address to provider address as one component of a geographical HPSA. Primary care-related services located in adjacent areas to whole-county HPSAs are considered excessively distant when travel time exceeds 30 minutes or the equivalent of 20 miles in this study. We found similarities in travel distance to primary care-related services from patients living in HPSA counties compared to those living in non-HPSA counties. This could indicate the need to re-examine HPSA definitions …

Addressing Health Inequalities In The United States: Key Data Trends And Policy Action, Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell, Thomas A. Laveist

Frontiers in Public Health Services and Systems Research

Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting in the form of national objectives or goals to address health inequalities. More research and better methods are needed to precisely measure relationships between stated …

Analyzing Return On Investment In Public Health: Implications And Future Directions, Glen P. Mays

Health Management and Policy Presentations

Return on investment (ROI) analyses of public health programs, policies, and services are being undertaken with increasing frequency to provide assessments of the value of these activities. This presentation reviews current initiatives and future directions for improving the quality of ROI studies and their application to real-world public health policy and administrative decisions.

The Public Health Pbrn Program: Building The Science Of Public Health Delivery, Glen P. Mays, Anna Goodman Hoover

Health Management and Policy Presentations

This session describes public health practice-based research networks (PBRNs) and emerging opportunities for collaboration with injury control research centers to advance the science of injury prevention practice.

Harnessing The Power Of Public Health Systems For Injury Prevention & Control, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.

Public Health Delivery Systems And Population Health, Glen P. Mays

Health Management and Policy Presentations

Despite high overall health expenditures, the U.S. continues to fall behind other high-income countries on many measures of population health. While health care delivery systems are now studied intensively for solutions to U.S. cost and quality problems, the nation's delivery systems for public health programs and policies are only now becoming the subject of rigorous empirical study. This presentation examines recent studies of public health delivery systems and important directions for future inquiry.

Tobacco Treatment Outcomes From A Specialist Smoking Cessation Clinic Based Within Cardiology Services, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

BACKGROUND: Populations with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening cardiac events. The purpose of our study is to examine pilot treatment outcomes of an outpatient Smoking Cessation Clinic (SCC) provided within Cardiology Services.

METHODS: This study is based on a retrospective review of the charts of 118 participants of the SCC (between Sept 2010 and May 2012). The primary components of intervention include tailored pharmacotherapy and behavioural counselling. The main outcome of interest is self-reported 7-day point-prevalence of smoking abstinence verified by expired CO level (when available).

RESULTS: 34.7% …

Estimating Return On Investment: Approaches And Methods, Glen P. Mays

Health Management and Policy Presentations

Continuing fiscal constraints in the public sector and large-scale policy changes associated with health reform implementation in the U.S. are giving heightened attention to questions about the health and economic value of public health programs, services, and policies -- strategies designed to protect health and prevent disease and injury on a population-wide basis. This session provides an overview of approaches for conducting return-on-investment (ROI) analyses and related economic evaluation studies in public health settings in order to inform policy and administrative decision-making. New opportunities and resources created through CDC's National Public Health Improvement Initiative (NPHII) and RWJF's Public Health Practice-based …

Optimizing The Value Of Public Health Services: Lessons From Research & Practice, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health programs and policies holds considerable potential for improving population health and constraining the growth in health care spending. Achieving such expansions efficiently, particularly in low-resource settings, requires careful attention to interorganizational and intergovernmental relationships in public health delivery.

Significant Sequelae After Bacterial Meningitis In Niger: A Cohort Study, Jean-François Jusot, Zilahatou Tohon, Abdoul Aziz Yazi, Jean-Marc Collard

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Beside high mortality, acute bacterial meningitis may lead to a high frequency of neuropsychological sequelae. The Sahelian countries belonging to the meningitis belt experience approximately 50% of the meningitis cases occurring in the world. Studies in Africa have shown that N. meningitidis could cause hearing loss in up to 30% of the cases, exceeding sometimes measles. The situation is similar in Niger which experiences yearly meningitis epidemics and where rehabilitation wards are rare and hearing aids remain unaffordable. The aim of this study was to estimate the frequency of neuropsychological sequelae after acute bacterial meningitis in four of the …

National Estimates Of Emergency Department Visits For Pediatric Severe Sepsis In The United States, Sara Singhal, Mathias W. Allen, John-Ryan Mcannally, Kenneth S. Smith, John P. Donnelly, Henry E. Wang

Emergency Medicine Faculty Publications

Objective. We sought to determine the characteristics of children presenting to United States (US) Emergency Departments (ED) with severe sepsis.

Study design. Cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Using triage vital signs and ED diagnoses (defined by the International Classification of Diseases, Ninth Revision codes), we identified children(triage fever or ICD-9 infection) and organ dysfunction (triage hypotension or ICD-9 organ dysfunction).

Results. Of 28.2 million pediatric patients presenting to US EDs each year, severe sepsis was present in 95,055 (0.34%; 95% CI: 0.29-0.39%). Fever and respiratory infection were the most common indicators of …

Truck Driver Dies When Tractor-Trailer Overturns After Leaving Road, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a spring day around 5:45 a.m., a 55-year-old male truck driver was driving south on an interstate transporting sheet metal. It is unknown how long he had been driving when he exited from the highway, traveled partially up the ramp, and struck the left side guard rail. The truck left the road, traveled down an embankment and overturned onto its roof. A passing motorist called emergency medical services. The driver was extricated by mechanical means and declared dead at the scene.

To prevent future occurrences of similar incidents, the following recommendations have been made: …

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Health Management and Policy Presentations

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

The Value Of Public Health Financial Data, Glen P. Mays

Health Management and Policy Presentations

Effective policy and administrative decision-making in public health requires reliable information on the amount of resources invested in governmental public health programs and how these resouces are allocated and used across the U.S. public health system. This session examines current and potential uses of public health financial data in the U.S., and considers expanded roles for research in informing policy and administrative decisions.

Vital Statistics: The State Of The Public Health Pbrn Program, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Public Health PBRN Program has continued to expand during the 2013 program year with new networks, new research projects, and expanded translation and dissemination initiatives. The program plays an increasingly powerful role in helping to transform the U.S. public health enterprise into a rapid-learning system for health improvement.

Testing Integrated Primary Care And Public Health Models For Prevention Delivery, Glen P. Mays

Health Management and Policy Presentations

Improving the delivery of evidence-tested prevention interventions to populations at greatest risk requires strong coordination between primary care providers and public health organizations. This presentation reviews current research on models for integrated delivery of primary care and public health services, and identifies emerging research needs and opportunities. Of particular interest are the roles that practice-based research networks (PBRNs) can play in building this evidence.

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

Workers Killed Due To Driver Distraction, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To Prevent Driver Distraction,

Employers should:

• Provide training on the importance of being attentive and not engaging in distracting tasks or behaviors while driving
• Develop policies that minimize or eliminate the use of in-vehicle devices while driving

Employees should:

• Not use dispatching devices while driving
• Not text or manually dial a cell phone while driving
• Refrain from activities such as reading, writing or map reading while driving

Transforming Our Parks And Beaches, Chizimuzo T.C. Okoli

Nursing Presentations

This presentation covers a study that examines the health and health equity impact of the newly implemented smoke-free policy for Vancouver’s parks and beaches.

Cost Estimation Methods: Strategies And Examples For Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

This webinar reviews methods for conducting cost studies in public health settings, including strategies for estimating the financial and ecnomic costs of delivering public health services, and analytic approaches to identifying factors that influence delivery costs. These types of studies are of increasing importance to policy and practice stakeholders given the need for evidence about the return-on-investment (ROI) generated through public health delivery.

Community Asset Identification In Support Of A Place-Based, Early Childhood Obesity Prevention And School Readiness Initiative, Cristi Carman, Bernice Raveche Garnett, Josefine Wendel, Justeen Hyde, Virginia Rall Chomitz

Frontiers in Public Health Services and Systems Research

Despite extensive community efforts that have resulted in obesity decreases in Cambridge, MA over the last decade, obesity among Black youth remains disproportionately high. Likewise, racial/ethnic academic achievement disparities persist and are evident at early ages.

Prior research and emerging national policy recommendations confirm the need for place-based, early childhood interventions to address persistent racial/ethnic disparities in obesity and school readiness. A community-based participatory research initiative is developing an intervention targeted to pre-kindergarten children and their families in a diverse Cambridge neighborhood. The intervention will partner with a Cambridge Public Schools (CPS) program designed to support school readiness through extended …