Public Health Commons^™

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Expanding The Evidence Base For Accreditation And Qi: Progress In Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Studies that examine the implementation and impact of quality improvement strategies in public health are underway through the Public Health Practice-Based Research Networks.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

School Day Segmented Physical Activity Patterns Of High And Low Active Children, Stuart J. Fairclough, Aaron Beighle, Heather Erwin, Nicola D. Ridgers

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: Variability exists in children's activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.

METHODS: Two hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or …

Treatment Outcomes Of A Tailored Smoking Cessation Programme For Individuals Accessing Addiction Treatment Services, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

Background: Individuals with substance use disorders (SUD) have disproportionately higher smoking prevalence and tobacco-related mortality than the general population. This high prevalence of smoking warrants a need for targeted tobacco treatment efforts.

Objectives: To examine smoking cessation outcomes and predictors of successful smoking cessation among individuals with SUD accessing a tobacco dependence clinic (TDC) within Addiction Services.

Methods: Based on clinical guidelines, participants of the TDC received behavioural therapy combined with tailored pharmacotherapy for tobacco treatment (at no cost). A retrospective chart review from 678 participants enrolled in the TDC between Sept 2007 and Dec 2011 was analyzed. 7-day point-prevalence …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

Investing In A Healthier Future: Iom Dissemination Workshop, Glen P. Mays

Health Management and Policy Presentations

This session discusses strategies for implementing new financing strategies and funding mechanisms for public health services.

Patterns Of Interaction In Public Health Research Networks: Insight From Network Analysis, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Studies from the past three decades have found evidence of wide variation in public health practices and policies across states and communities despite an expanding evidence base of efficacious public health strategies, suggesting gaps in implementation and translation processes. Practice-based research networks (PBRNs) are expected to accelerate research participation and translation. This study uses social network analysis methods with twelve Public Health PBRNs to study processes influencing the implementation and translation of research within diverse public health settings.

DATA and METHODS: A cross-sectional network analysis survey was validated and fielded with participants in two cohorts of public health PBRNs …

Editorial Comment: Patterns Of Interaction Among Local Public Health Officials And The Adoption Of Recommended Practices, Glen P. Mays

Frontiers in Public Health Services and Systems Research

No abstract provided.

Patterns Of Interaction Among Local Public Health Officials And The Adoption Of Recommended Practices, Jacqueline A. Merrill, Kathleen M. Carley, Mark G. Orr, Christie Y. Jeon, Jonathon Storrick

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues contains two groups of LHDs that are influential for either their ability to spread information or to innovate. Both groups are more likely to conduct community health assessments and develop health improvement plans. Since these activities are fundamental aspects of accreditation and health reform, the findings may present an early indication that these initiatives are having an effect on the public health system.

Editorial Comment: Public Health Governance And Population Health Outcomes, F. Douglas Scutchfield, Elizabeth Harper

Frontiers in Public Health Services and Systems Research

No abstract provided.

Public Health Governance And Population Health Outcomes, Scott P. Hays, Janine Toth, Matthew J. Poes, Peter F. Mulhall, David M. Remmert, Thomas W. O'Rourke

Frontiers in Public Health Services and Systems Research

Research reviews have identified a gap in understanding the diversity of health department governance structures and in understanding how the variations in governing relates to health outcomes. This report details the categorization of local public health governance and reveals that certain governance types may be better suited to achieve better population health outcomes. State systems achieve the poorest health outcomes, but the best health outcomes are achieved when the political branches have a key role in local public health governance. Public health systems should consider greater local control and involvement in governance; but local governance should include the political branches …

Editorial Comment: Local Health Department Provision Of Wic Services Relative To Local Need – Examining 3 States And 5 Years, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

No abstract provided.

Local Health Department Provision Of Wic Services Relative To Local “Need”— Examining 3 States And 5 Years, Betty Bekemeier, Matthew Bryan, Matthew D. Dunbar, Chris Fowler

Frontiers in Public Health Services and Systems Research

Great variation exists in the nature of LHD service delivery and it varies, in part, relative to jurisdiction population size. Larger LHD jurisdictions may achieve an economy of scale in WIC service delivery that is not matched in smaller areas. Overall, we found that WIC service provision appears relatively consistent across study states and in the presence of increasing need, with greater responsiveness to need in urban areas. As demand for some preventive services increases LHDs in rural areas may need greater support than LHDs in large jurisdictions for meeting local demand. Unlike WIC, LHD-provided services that have less consistently …

Accelerating The Production And Application Of Evidence For Public Health System Improvement: The Search For New Frontiers, Glen P. Mays, Paul Halverson, William Riley, Peggy Honoré, F. Douglas Scutchfield

Frontiers in Public Health Services and Systems Research

The new journal Frontiers in Public Health Services and Systems Research provides a platform for rapidly and widely communicating emerging findings and lessons learned from studies of public health services and delivery systems.

Using State And Local Health Survey Data To Advance Phssr, Glen P. Mays

Health Management and Policy Presentations

State and local health survey data can be used to evaluate the implementation and impact of public health delivery innovations in real-world practice settings.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Sex And Gender In Tobacco Reduction - The State Of The Evidence, Iris Torchalla, Chizimuzo T.C. Okoli

Nursing Presentations

• Global prevalence, risk, and mortality from smoking

• Gender/Sex specific diseases associated with tobacco use

• Gender/Sex specific reasons for smoking

• Gender/Sex specific factors in treating tobacco use

The Tobacco Dependence Clinic: Gender Issues And Possibilities In Cessation Treatment, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

• The Tobacco Dependence Clinic (TDC) is a program that provides behavioural counselling and up to 6-7months of no-cost pharmacotherapy for clients through VCH Mental Health and Addiction Services

• Program is run with a team of nurses, counsellors, respiratory therapists, and a physician.

• Currently in 7 Addictions services located in community health centres in Vancouver.

Special Ops: Vulnerable Populations And Tobacco Treatment, Chizimuzo T.C. Okoli, Audrey Darville

Nursing Presentations

• Reasons for Smoking among individuals with co-morbid substance use (SUD)and/or psychiatric disorders (PD)

• Smoking cessation treatment for individuals with co-morbid substance use (SUD) and/or psychiatric disorders (PD)

• Smoking among the Homeless population

Semi Tractor-Trailer Driver Dies In Median Crossover Crash; 10 Others Die, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

At approximately 5:00 AM on a spring morning, a 45 year-old male semi-tractor trailer driver headed south on an interstate highway with a back-haul of brake drums. He crossed a 60’ grass depressed median, drove over a cable barrier, was struck by a northbound 15-passenger van with 12 occupants, hit a cut rock wall and caught fire. The semi truck driver and 10 occupants within the van died.

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

Recommendation No. 1: Commercial vehicle carriers should establish and implement an appropriate comprehensive safety and driver training program that …

Steel Worker Falls From Highway Bridge And Dies, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

On a fall day in 2010, a 49 year-old steel worker fell from a highway bridge he was working from and died. The steel worker was in the process of leveling jacks for concrete forms. He had donned a fall protection harness with an attached lanyard then stepped outside the lifeline onto a 10”x2” wooden board to verify the jacks were level. As the steel worker stepped over the lifeline, he did not attach the lanyard and fell approximately 28 feet onto the railroad tracks below. He was taken to a nearby hospital where he died in surgery approximately two …

Fibrinogen, Chronic Obstructive Pulmonary Disease (Copd) And Outcomes In Two United States Cohorts, Deepa Valvi, David M. Mannino, Hana Müllerova, Ruth Tal-Singer

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Fibrinogen is a marker of systemic inflammation and may be important in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD).

METHODS: We used baseline data from Atherosclerosis Risk in Communities and Cardiovascular Health Studies to determine the relation between fibrinogen levels and COPD and to examine how fibrinogen levels at baseline affected outcomes of death, development of COPD, lung function decline, and COPD-hospitalizations.

RESULTS: Our study sample included 20,192 subjects, of whom 2995 died during the follow-up period. The mean fibrinogen level was 307.6 mg/dL and 10% of the sample had levels >393.0 mg/dL. Subjects with Stage …

Smoking On The Margins? Assessing The Effects Of A Smoke-Free Law In Parks And On Beaches, Ann Pederson, Chizimuzo T.C. Okoli, Wendy Rice, Steve Chasey, Arezu Moshrefzadeh, Joan L. Bottorff, Natalie Hemsing, Lorraine Greaves, Nancy Poole

Nursing Presentations

This study uses a health equity lens to examine the development, adoption and implementation of an outdoor smoke-free bylaw in Vancouver, BC, Canada. The study aims to:

• Understand the health and health equity effects of a new outdoor smoke-free policy in parks and on beaches;

• Assess the differential impacts of the policy for diverse groups of women and men, in particular those with a high prevalence and susceptibility to smoking and those who are exposed to secondhand smoke (SHS);

• Develop recommendations to enhance the effectiveness of future smoke-free policies to reduce any unintended contributions to health inequities arising from their …

Effects Of A Smoke-Free Law In Parks And Beaches On Smoking Behaviour: Methods To Determine Effectiveness, Chizimuzo T.C. Okoli, Ann Pederson, Steve Chasey, Anna Liwander, Andrew Johnson

Nursing Presentations

OVERVIEW

As part of a comprehensive approach to tobacco control, smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessations in various jurisdictions.

Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g. restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces.

On September 1^st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect.

The aims of this study are …

Equity, Evidence & Ethics: Assessing The Implications Of Outdoor Smoke-Free Policies For Vulnerable Populations, Natasha Jategaonkar, Ann Pederson, Chizimuzo T.C. Okoli, Wendy Rice, Phoebe M. Long, Joan L. Bottorff, Natalie Hemsing, Lorraine Greaves

Nursing Presentations

Smoke-free policies in outdoor settings are becoming increasingly common. Economic and social conditions tend to influence tobacco use patterns as well as exposure to secondhand smoke. Thus, active and passive smoking are both health equity and social justice concerns.

Smoking on the Margins is a multi-component,mixed-methods project that applies an ethical framework to outdoor smoke-free policies in order to identify both concerns and opportunities to promote health and health equity.

Justification for smoke-free policies

Smoke-free spaces are primarily justified on the basis of three goals:

1) Reducing exposure to secondhand smoke;

2) Encouraging people to quit smoking; and

3) Preventing …

Outcomes Of A Tailored Smoking Cessation Program For Individuals With A Substance Use And/Or Psychiatric Disorder, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

BACKGROUND: Tobacco use remains a significant cause of morbidity and mortality globally. Although there has been a steady decline in the overall smoking prevalence in North America during the last decade some subsets of the population continue to smoke at high rates, particularly individuals with a history of substance use disorders (SUD) and/or psychiatric disorders (PD). Studies suggest that individuals with SUD’s and PD’s often have disproportionately higher smoking-related mortality. Studies further suggest that in clinical samples an estimated 75% of individuals with PD and up to 90% of individuals with PD concurrently smoke. This high prevalence of smoking among …

The Economic, Institutional, And Political Determinants Of Public Health Delivery System Structures, Richard C. Ingram, F. Douglas Scutchfield, Glen P. Mays, Michelyn W. Bhandari

Preventive Medicine and Environmental Health Faculty Publications

OBJECTIVES: A typology of local public health systems was recently introduced, and a large degree of structural transformation over time was discovered in the systems analyzed. We present a qualitative exploration of the factors that determine variation and change in the seven structural configurations that comprise the local public health delivery system typology.

METHODS: We applied a 10-item semistructured telephone interview protocol to representatives from the local health agency in two randomly selected systems from each configuration--one that had maintained configuration over time and one that had changed configuration over time. We assessed the interviews for patterns of variation between …

Gender Identity, Ethnic Identity, And Smoking Among First Nations Adolescents, Lorraine Greaves, Joy Johnson, Annie Qu, Chizimuzo T.C. Okoli, Natalie Hemsing, Lucy Barney

Nursing Faculty Publications

Smoking rates among Aboriginal adolescents are the highest of any population group in British Columbia, Canada. Recent studies suggest that substance use is affected by gender and ethnic identity among youth. The purpose of our study was to explore the association of gender and ethnic identity with smoking behaviour among First Nations adolescents. This study is based on a convenience sample (i.e., an on-hand, readily available sample) of 124 youth (123 First Nations and 1 Métis) recruited at youth drop-in centres, health fairs, and cultural activities. We obtained information on demographics, smoking history, Bem Sex Role Inventory (BSRI), composite measure …

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.