Public Health Commons^™

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …

Stakeholder Recommendations To Refine The Fitness-To-Drive Screening Measure, Sherrilene Classen, Sandra M. Winter, Craig A. Velozo, Elizabeth M. Hannold, Jason Rogers

The Open Journal of Occupational Therapy

In developing the web-based Fitness-to-Drive Screening Measure (FTDS) and keyform (results output) for use to identify at-risk older drivers, we examined the needs, perspectives, and suggestions of three stakeholders groups: occupational therapy practitioners, certified driver rehabilitation specialists (CDRSs), and family members/caregivers. We conducted three focus groups, which were moderated, recorded, transcribed, and analyzed using directed content analysis. Respondents in two focus groups also rated FTDS aspects (e.g., ease of use, format, and relevance), using a visual analog scale (VAS, 0-10 scale with 10 being excellent). All three stakeholder groups contributed to the development of the web-based FTDS. Results from occupational …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Clean Needles And Bad Blood: Needle Exchange As Morality Policy, Elizabeth A. Bowen

The Journal of Sociology & Social Welfare

The morality policy framework is a lens for understanding the unique characteristics of policies that attempt to regulate personal morals and behaviors. Needle exchange, a controversial intervention for reducing the transmission of HIV in injection drug users, shares many of the hallmark characteristics of morality policies. Analyzing needle exchange from a morality policy perspective, focusing on the 21-year ban on federal funding for needle exchange, reveals how value-based arguments have been used in the needle exchange debate and explains why the issue is likely to remain controversial in the United States. This analysis adds to the understanding of moral and …

Local Public Health System Partnerships: A Mixed Methods Multi-State Study, Priscilla A. Barnes

Dissertations

The purpose of this three-paper dissertation was to conduct a mixed methods multi-state examination of specific partnership-related activities among local public health systems (LPHSs) as well as to explore perceptions of LPHS practitioners regarding partnership practices.

In the first paper, secondary data analysis of questions from the National Public Health Performance Standards Program (NPHPSP, n = 110) was used to determine the frequency that partnership activities were conducted optimally (> 75% of the time) and whether any associations existed between three different partnership capacities. Activities were matched with relational, organizational, and programmatic capacities from the Collaborative Capacity Framework. Overall, 86% …

The President's Emergency Plan For Aids Relief (Pepfar): A Social Work Ethical Analysis And Recommendations, Robert J. Barney, Stephan L. Buckingham, Judith M. Friedrich, Lisa M. Johnson, Michael A. Robinson, Bibhuti K. Sar

The Journal of Sociology & Social Welfare

The President's Emergency Plan for AIDS Relief (PEPFAR) is the most recent international social program instituted by the U.S. Government to combat HIV/AIDS. Since its inception in 2003, this foreign policy initiative has dedicated $63 billion for HIV/AIDS prevention and treatment in foreign countries. Despite PEPFAR's many accomplishments, it continues to promote controversial prevention strategies. This paper analyzes these prevention strategies, utilizing social work values as described in the NASW Code of Ethics. Policy, practice, and research implications are discussed.

Ethnicity Matters: The Socioeconomic Gradient In Health Among Asian Americans, Emily S. Ihara

The Journal of Sociology & Social Welfare

This study examines the relationship between socioeconomic indicators and health status among Asian Americans using data from the 2001 California Health Interview Survey (CHIS), a population-based random-digit-dial survey with race-ethnic supplemental samples. Multivariate logistic regression analyses show that the inverse relationship between socioeconomic position and health status is similar for Asian Americans when measured as an aggregate group compared to Whites. However, when specific Asian American ethnic groups are examined, the relationship varies greatly. For example, among Chinese Americans and Vietnamese Americans, education is a significant predictor of poor health status, but household income is more significant among Korean Americans. …

Perceptions Of Quality Of Life Of Latinos With Diabetes Living In The U.S.: Variations By Geographic Region Of Origin, Janice M. Long

Dissertations

The Latino population, the largest ethnic minority in the United States, is a diverse group originating from numerous geographic regions of Latin America. Latinos vary in the risk for type 2 diabetes, a condition that exacts a costly burden on those who suffer with it. With the Latino population diversity, diverse strategies are needed. One strategy is to improve outcomes of life quality by improving knowledge of those who deliver health services to Latinos with type 2 diabetes. Through measurement of quality of life (QOL), the more precious aspects of living, how one feels about living with diabetes, can be …

A Study Of Disaster Preparedness Of Rural Hospitals In The United States, Barbara Cliff

Dissertations

This dissertation examines disaster preparedness in the U.S. and explores the relationships between risk perception, funding from the Health Resources and Services Administration (HRSA), and preparedness. Secondary data analysis was conducted using the National Study of Rural Hospitals from Johns Hopkins University. The study, based on a random sample of rural hospitals, consisted of a mail questionnaire and a follow-up phone interview with the hospital's Chief Executive Officer (n = 134).

A model of disaster preparedness was utilized to examine seven elements of preparedness. Risk perception was examined by seven risk threats, and HRSA funding was examined as a …

Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith

Masters Theses

There have been many anecdotal accounts describing the characteristics of individuals involved in methamphetamine use, trafficking and production. However, prior to the current study there was yet to be a macro-level analysis of methamphetamine use. The extant macro-level literature on drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. It was expected that school-districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural school districts would show higher rates than urban and …

Review Of Children As Partners In Health: A Critical Review Of The Child-To-Child Approach. Pat Pridmore And David Stephens. Review By Terri Combs-Orme, Terri Combs-Orme

The Journal of Sociology & Social Welfare

Pat Pridmore and David Stephens, Children as Partners in Health: A Critical Review of the Child-to-Child Approach. New York: Zed Books, 2000. $ 59.95 hardcover, $22.50 papercover.

Promoting Healthy Behavior Change In Skin Cancer Risk Reduction Using The Transtheoretical Stages Of Change Model, Sherry L. Pagoto

Dissertations

Skin cancer is the most commonly diagnosed cancer in the United States with 20% of people developing some form of skin cancer in their lifetime (American Cancer Society, 1999). In spite of the high incidence of skin cancer, it is highly preventable. Approximately 90% of the cases are caused by exposure to ultraviolet radiation from the sun (Skin Cancer Foundation, 1992). The effect of an intervention aimed at reducing skin cancer risk was compared to a survey only control group in 99 Chicago beach-goers. The intervention was based on the Transtheoretical Stages of Change Model (TTM) and included sun sensitivity …

Behavior And Attitudes Related To The Prevention Of Sexually Transmitted Disease And Unplanned Pregnancy, J. Lee Hoover

Dissertations

A sample of 214 persons was tested to determine the impact of gender role orientation, neuroticism, extraversion, authoritarianism, race, gender, and sexual orientation on attitudes and behavior relevant to the prevention of sexually transmitted disease and unintended pregnancy. Specifically measured was the impact of these factors on attitudes toward the condom as contraceptive, attitudes toward the condom as prophylactic, and reported condom use.

Gender role orientation was measured using the short form of the Bern Sex Role Inventory (BSRI) (Bern, 1978), neuroticism and extraversion were measured using the NEO-Five Factor Inventory (NEO-FFI) (Costa & McCrae, 1992), and authoritarianism was measured …

The Effects Of Organizational Culture On Quality Of Life For Older Veterans, Michelle Diane Stone

Dissertations

The organizational culture in a Veteran's Administration Medical Center (VAMC) was described using triangulated methods which included both secondary quantitative survey data, and internal documentary data sources. The initial survey data collected, from staff and elder veterans revealed an overall positive perception from both samples regarding the quality of life for elder veterans living on extended care wards. The study investigated the extent to which the VAMC's organizational culture affected these perceptions of quality of life.

Documentary data were collected from a variety of VAMC sources regarding behaviors, ideologies, leadership trends, mechanisms of control, and the formal organizational structure. A …

Correlates And Infant Mortality: Sudden Infant Death Syndrome Among Black Women In The United States, Paulette Aubrey

Masters Theses

Often referred to as "cot death" or "crib death," sudden infant death syndrome (SIDS) is the single leading cause of infant death in infants aged 28 days to 1 year of life. Although the exact etiology of SIDS remains unknown, epidemiological studies have identified risk factors associated with higher rates of SIDS. In this study, the relationship between sudden infant death syndrome and maternal education among black women who gave birth in the United States during 1983 was examined.

The population for this study consisted of black infants who were born in 1983 and died before their first birthday. Among …

Structuring Support For Volunteer Commitment: An Aids Services Program Study, Taryn Lindhorst, Ronald Mancoske

The Journal of Sociology & Social Welfare

Since the AIDS epidemic began over a decade ago, the bulk of services for people living with HIV in the community setting have been provided by volunteers. Volunteers are confronted with the stigmatized status of people with HIV and must learn to manage multiple crisis issues. This paper describes research on volunteerism in a buddy program for people living with AIDS and the perceptions of volunteers about the structural supports of the volunteer program. Issues around perceptions of stress and the relationship between bereavement and volunteering are explored.

Home Safety-The Challenge To Public Health, Ray Ranson

The Journal of Sociology & Social Welfare

Home accidents are now a leading cause of death and injury particularly in young children and the elderly. For example, 3.1 million accidents occur in the home every year in the United Kingdom with no signs of diminishment. More effective systems of accident recording, monitoring, investigation, intercollaboration and education are urgently needed to redress this epidemic. More attention needs to be given to preventive safety design in architect training and adoption of home safety design standards and legislation. The major threat to public health which home accidents represent must not go unchallenged.

Aids Prevention Through Printed Media: Knowledge And Communication Behaviors Of Gay College-Aged Males, Cheryl L. Knight

Masters Theses

AIDS prevention research has established the effectiveness of multiple component group interventions. It has not identified whether the effectiveness is due to the format of the intervention (i.e., rehearsal, feedback, etc.) or its instructional content. This study investigates the impact of instructional content delivered in the inexpensive and readily obtained printed medium. Thirteen gay or bisexual college-aged men received an information pamphlet and an AIDS-related communication skills training booklet. Subjects were evaluated on measures of knowledge, safe and risky behaviors, and communication behaviors in each of three assessment sessions. Visual analyses and repeated measures analyses of variance did not support …

The Use Of Musical Wind Instruments As An Expiratory Therapy With Chronic Obstructive Pulmonary Disease Patients, Ellen R. Griggs Drane

Masters Theses

The use of musical wind instruments as an expiratory therapy with Chronic Obstructive Pulmonary Disease (COPD) patients was compared to the traditional inspiratory treatment of the Inspiratory Muscle Trainer (IMT) during a twelve week pre - posttest study. Sixteen subjects, attending an out patient respiratory rehabilitation program, were randomly assigned to either the experimental group, receiving musical wind instruments, or the control group, receiving the IMT.

Measures for the study were: Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC) as measured by the Pulmonary Function Test; physical endurance measured by the Twelve Minute Walk Endurance Test; …

Official Documentation Of A Sexually Transmitted Disease (Std): An Empirical Assessment, Dennis L. Peck, John W. Bardo

The Journal of Sociology & Social Welfare

Using data from clinic records of patients examined and treated at a public health facility, the reporting of unconfirmed cases is examined and the correspondence between public health profiles of patients at risk to sexually transmitted disease and the data are discussed. Implications relating to the findings and to public health policy are also discussed.

The Mexican American Elderly And Barriers To The Utilization Of Health Care Services, Kathleen Anne Hoekstra

Masters Theses

The utilization of health care services by the Mexican American elderly is low compared to the severity of their health problems. This thesis examines the sociocultural factors which affect the interaction of the Mexican American elderly and mainstream health professionals. Included is a brief history detailing discriminatory practices, a description of traditional Mexican cultural practices and attitudes, and an exploration of the cultural barriers which limit access to health care.

Dual-Purpose Activity Versus Single-Purpose Activity In An Institutionalized Geriatric Population, Rita M. Yoder

Masters Theses

The use of purposeful, goal-directed activity has traditionally been a central theme for occupational therapy. In dual-purpose activity the participant has two goals: successful task completion and the making of adaptive responses in the activity process. This study compares the extent to which a dual-purpose activity (stirring for the purpose of exercise and baking cookies) enhances performance in contrast to a single-purpose activity (stirring for the purpose of exercise alone) in an institutionalized geriatric population.

Thirty women between 70 and 92 years of age were randomly assigned to either the single- or dual-purpose activity. Duration, exertion, and discontinuities were measured …

The Use Of Guided Imagery And Progressive Relaxation In Treating Hemodialysis Patients For Dietary Compliance, James B. Morrissey

Dissertations

Studies have confirmed that many hemodialysis patients experience numerous psychological difficulties as a result of their physical illness. One behavioral manifestation of these psychological states is noncompliance to imposed dietary restrictions. In spite of life threatening implications, many hemodialysis patients find it very difficult to maintain dietary compliance.

Recently, guided imagery and progressive relaxation have been used as methods to assist clients to overcome negative psychological states. In most cases, the treatments are adjunctive to on-going counseling or psychotherapy. The purpose of this investigation was to test the idea that guided imagery and progressive relaxation alone can be successfully used …

The Social And The Emotional In The Etiology Of Childhood Lead Poisoning, Harris Chaiklin, Barbara S. Mosher

The Journal of Sociology & Social Welfare

Childhood lead poisoning has been characterized as a silent epidemic. Significant social, emotional, and economic factors play a role in its etiology. Differential intervention in this problem is predicated on understanding the relative role of these causes.

A Study In Self-Defeat: The Public Health Venereal Disease Clinic, Joseph F. Sheley

The Journal of Sociology & Social Welfare

This paper relates the results of three months of participant observation and interviews in a public venereal disease clinic. The research was directed toward assessment of the relationship of clinic efficiency (a smoothly operating bureaucratic clinic) and clinic effectiveness (a major reduction of illness within a community). The venereal disease clinic is described as an efficient and well planned health unit with three major objectives: a) checking the increase of V.D. through preventive medicine; b) detection and treatment of V.D. within the community; and c) provision of health services to lower S.E.S. segments of the population. Research results indicate that …

A Substance Abuse Prevention Plan Proposal For The State Of Michigan, William Lucien Macleod

Masters Theses

No abstract provided.

Maternal/Infant Care: A Systems Approach To Organizational Structures And Services Of Community Agencies, Nancy B. Carlson

Dissertations

No abstract provided.

Transforming The Orientation Of A Health Organization Through Community Involvement, Sharon Pastor Simson, Laura J. Bleiweiss

The Journal of Sociology & Social Welfare

Health organizations have been oriented to meeting needs and fulfilling demands which are perceived and defined by physician providers (Freidson, 1970 Stevens, 1971). Organizational goals, services, structures, and processes of operation were formulated in accordance with the interests, values, and concerns of provider-members. Latent to this provider orientation was the assumption that professional members were the ones most qualified to determine what was best for the organization and for its consumers (Freidson 1971). In recent times, however, numerous social changes have occurred on a societal level and within the institution of medicine (Hepner, 1972; Somers, 1971; Rosengren and Lefton, 1969). …

The Effects Of Dental Hygiene Information And Consequation On Plaque Control, Janel R. Warner

Masters Theses

The research described in the present paper is based upon a parsimonious analysis of behavior which utilizes principles that have been empirically determined. These principles as discussed by Ullmann and Krasner (1966) and Ulrich, Stachnik, and Mabry (1966) have suggested the wide applicability of behavior modification techniques, not only with animals, but with human subjects in diverse settings. One setting that has previously been left unexplored by proponents of behavior modification, which promises to be an area of growing concern, is that of dental hygiene.

The problem that the present study concerns itself with is educating children in the· correct …