Public Health Commons^™

Health Insurance Coverage In The Gulf Coast States After Affordable Care Act By Rural And Urban Area Between 2009 And 2017, Hosik Min, Kenneth Hudson

Florida Public Health Review

Background: Although health insurance coverage for adults in each of the Gulf Coast States and the rest of the country increased after implementing the Affordable Care Act, the coverage rates in the Gulf Coast region remained lower to rural residents, compared to those in the rest of the Nation. Purpose: This study aimed to update the changes of health insurance coverage in all states and the Gulf Coast states, confirm the significance of the health policy on insurance coverage by analyzing Louisiana, and examine the relationships between socio-demographic variables and rural/urban area by using interaction variables. Methods: …

Epidemiology Of Enforcing Travel Restrictions In Us Peninsular Regions During The Covid-19 Pandemic, Kathleen Kelly, Sebastian Coupe, Cynthia Kelly

Florida Public Health Review

No abstract provided.

Cultivating Healthy Schools: The Feasibility Of An Outdoor Classroom In A Public Elementary School, Erin Largo-Wight, Caroline A. Guardino, Katrina W. Hall

Florida Public Health Review

Background: Nature contact and time outdoors is critical for healthy child development and well-being and a disconnect from nature may be problematic. Purpose: This study was designed to evaluate the feasibility of a nature contact intervention for children – an outdoor classroom - in a public school. Methods: Two kindergarten classes participated in this mixed-methods case study (N=2 teachers, n=36 children aged 5-6) and used an outdoor classroom every other day for language arts lesson over a six weeks observation period. The two teachers in this case study completed a survey that assessed perceived practicality and feasibility of using the …

Photovoice And Youth On Violence And Related Topics: A Systematic Review, Yingwei Yang, Andrew C. Lim, Renée E. Wallace, Stephanie Marhefka-Day, Karen D. Liller

Florida Public Health Review

Background and Purpose: Photovoice is a qualitative method that empowers youth to identify community issues and assets through photo-taking and photo discussions. The purpose of this systematic review was to explore the characteristics of studies using photovoice in violence and related topics among youth, and the rationale, strengths and limitations of the photovoice methodology when applied to youth.

Methods: Inclusion criteria, search strategy, and data extraction and analysis plan were specified in advance and documented in a protocol (Registration: PROSPERO-CRD42018087290). The search strategy included three search concepts: photovoice, youth, and violence-related topics. Two rounds of formal searches were executed across …

Structural And Social Determinants Of Opioid Abuse Among Florida-Based Hospitals, Donald R. Haley, Hanadi Hamadi, Jing Xu, Mei Zhao, Anh Viet Tran Nguyen, Dayana Martinez

Florida Public Health Review

Background: With over two million people suffering from opioid abuse disorders, the Centers for Medicare and Medicaid Services has identified opioid abuse as a key priority. Florida is one of eight states labeled as a high-burden opioid abuse and is an “epicenter” for opioid use and misuse.

Purpose: The purpose of this study was to discover potential predictors of opioid abuse in Florida by exploring specific healthcare delivery, geographic, and patient demographic factors.

Methods: A retrospective longitudinal study design was used to examine four years (2014-2017) of Florida inpatient administrative discharge data across 173 hospitals of opioid abuse rate. …

Changing The Culture Of Opioid-Related Messaging In Florida: A Formative Research Approach, Laura Boutemen, Lindsay Neuberger, Chad Collins, Chandler Dobiyanski, Bethany Richardson, Emily Knapp

Florida Public Health Review

Though expanding in negative impact for decades, the opioid epidemic, including heroin use, has reached public health emergency status in the United States. Heroin is not used only by the most intense drug users, but becoming more common place (Hirschfeld Davis, 2017). It is essential to better understand how young adults perceive heroin prevention, intervention, and treatment so the most effective campaign messages can be constructed to assist them. This paper presents data from four focus groups (N=24) in Orlando, Florida to better gauge young adult knowledge regarding heroin and obtain specific recommendations to successfully inform future messaging. Results suggest …

Understanding Pediatric Injury In Collier County, Florida: A Mixed Methods Analysis, Carmen T. Ramos-Irizarry

Florida Public Health Review

Background: The current trauma system in Collier County disperses injured pediatric patients to trauma centers outside the County. There is a critical gap in knowledge in the epidemiology of the County’s pediatric trauma patients.

Purpose: To understand injury patterns in children ages 0-17 years in Collier County and identify challenges in transporting injured children to definitive care.

Methods: This is a cross sectional, descriptive study using a sequential mixed-methods design. A thorough review of the literature and interviews of key stakeholders were conducted in August 2017. Data obtained from the interviews was used to develop a causal loop diagram …

Youth Violence Prevention In Florida: A Commentary, Yingwei Yang

Florida Public Health Review

No abstract provided.

Comorbidities Of Medicare Beneficiaries With Alzheimer's Disease In Florida, 2010, Tingting Hu, Henry J. Carretta

Florida Public Health Review

Comorbidity associated with Alzheimer’s Disease (AD) is highly prevalent but largely understudied. In this study, we sought to determine 1) the prevalence of AD by race (White, African American, and Hispanics); 2) 20 chronic conditions’ commonly comorbid with AD and the prevalence, mortality rate, and health care expenditure of common AD and comorbid condition by race. A sample of 86,875 Florida 2010 Medicare beneficiaries aged 65 and older with 12 months of fee-for-service (FFS) enrollment were used in this study. In the present analysis, the prevalence of AD was highest among elderly Hispanic beneficiaries. Among 20 chronic diseases, heart disease …

Rates Of Benign Heart Tumors Diagnosed In Florida Hospitals: 1988-2012, Robert B. Hood, Elliott Smith, Richard B. Early, Zachary Weber, Sharona B. Ross, Alexander S. Rosemurgy Ii, Randall E. Harris

Florida Public Health Review

No abstract provided.

Building The Hiv Public Health Service Structure By Quality Improvement, Graham F. Watts Sr

Florida Public Health Review

Quality improvement (QI) is a tool in the public health inventory. It has value in that it provides a modality for accelerating science-based intervention into routine public health practice. In doing so, it holds promise to make transparent how care and service systems demonstrate efficiencies in the structure, operations, and outputs that should translate into improvements in population health outcomes. One HIV health services grant in Northeast Florida touches the lives of over 4,200 persons. How to render services so that it maximally benefits all clients is ongoing work. Service recipients engage nine HIV care funded providers, who differentiate on …

Medical Marijuana Policy Reform Reaches Florida: A Scoping Review, Khadesia Howell, Alexandria Washington, Paula M. Williams, Arlesia L. Mathis, John S. Luque

Florida Public Health Review

Background: Florida became the first state in the U.S. South to legalize the use of medical marijuana to treat a variety of health conditions including chronic pain, epilepsy, and spasticity symptoms from multiple sclerosis. While there are over 200,000 medical marijuana patients in Florida, there remain financial, psychological, and insurance coverage barriers which reduce access for many patients. Purpose: This scoping review, with a focus on state health policy, first describes some clinical studies examining the therapeutic benefits of medical marijuana. Next, there is a discussion of the Florida regulatory environment and major legislation. Also, the review describes how the …

Social Determinants Of Health And Hiv/Aids In Florida, Alane C. Ertel, Robert J. Zeglin

Florida Public Health Review

As of 2016, there were reported to be 135,986 people living with HIV/AIDS (PLWH) in Florida alone, and its cities lead the nation’s incidence rates at around 5,000 new HIV diagnoses annually. Using a few social determinants of health (SDH) associated with deaths of despair (DOD), this paper aims to connect HIV rates to SDH to gain more understanding of how SDH can aid in the alleviation of HIV through public health policy and social change. Methods: This analysis evaluated the predictive ability of the SDH: Education, Insurance, Race, and RaceXEducation for HIV incidence in Florida using regression analysis. Results: …

Evaluation Of Rapid Syphilis Testing Using The Syphilis Health Check In Florida, 2015–2016, Jennifer Richards, James Matthias, Charlotte Baker, Craig Wilson, Thomas A. Peterman, C Perry Brown, Matthew T. Dutton, Yussif Dokurugu

Florida Public Health Review

The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) …

Lessons From The Field: A Systems Thinking Approach For Case Management Documentation, Graham F. Watts Sr, Angela E. Prince, Heather Vaughan, Porschia Mccray Watts, Beth Parker

Florida Public Health Review

Case management is a core HIV health service that focuses on service coordination—the seamless access to an array of integrated services. Integration aims to reduce barriers to medical care. In the busy HIV health services environment, inadequate documentation of case management activities limits the capacity of stakeholders to know what happens during care encounters. This study used theory and qualitative inquiry to uncover best practices that support optimal case management documentation. Two research questions guided the inquiry: What principles should arise in higher order cognitive functioning among case managers during client encounters? What characteristics of a system level approach to …

Efforts Targeting Factors Of Health Disparities That Impair Hiv Treatment Engagement, Graham F. Watts Sr, Heather Vaughan

Florida Public Health Review

Health disparities exist in Northeast Florida. Some locations experience morbidities at higher rates than others. Health zone 1 is a prime example. Differences in disease rates are interlaced with the social determinants of health, (SDOH). Long-standing social and structural influences of disparities are beyond the scope of Ryan White programs. However, empowerment for health promotion is a strategy for targeting health disparities. The Theory of Health Empowerment targets sense of agency and offers some leverage for helping people living with HIV/AIDS, (PLWHA) despite environments blemished by SDOH. Eclectic leadership occurring in a climate of respectful point-counter point discussions established the …

Understanding Motivations For Sti Testing: Comparing Presenters And Non-Presenters Using The Theory Of Planned Behavior And Health Belief Model, Lindsay Neuberger, Megan Pabian

Florida Public Health Review

Sexually transmitted infections (STIs) are a leading health risk to the college-aged population with young adults age 15- 24 accounting for half the new STI diagnoses in the United States (Centers for Disease Control and Prevention, 2018). Despite these alarming numbers, approximately 50-70% of college students have not been tested for STIs (Barth, Cook, Downs, Switzer, & Fischhoff, 2002; Bontempi, Mugno, Bulmer, Danvers, & Vancour, 2009; Boudewyns & Paquin, 2011). The current manuscript draws on the Theory of Planed Behavior and the Health Belief Model to explore how attitudes, norms, perceived behavioral control, and barriers contribute to STI testing intentions. …

After Implementation Of The Aca – Coverage Gaps Among Rural Latinos Still Remain, Arlesia L. Mathis, Matthew Dutton, Ivette A. López, Alan Becker, C Perry Brown

Florida Public Health Review

In this study, we assessed health needs and insurance coverage among a rural Latino population. A health needs survey was conducted in 2015 with approximately 100 Latino residents living in a rural Florida county. The survey included questions on socio-economic characteristics, type of insurance coverage, lapses in coverage, delays in care and satisfaction with health services. Only 15% of respondents had insurance through their employer, and 11% had Medicaid. Over 45% of participants had no health insurance, and 20% had no insurance for more than three years. One in ten had a medication delay due to lack of coverage/money, and …

The Importance Of Revising Florida’S Motorcycle Helmet Laws To Prevent Traumatic Brain Injury – A Commentary, Mohammed S. Uddin, Iveris L. Martinez

Florida Public Health Review

No abstract provided.

Epidemiology And Ideology: Why Health Equity Is Problematic In The United States, Cynthia R. Hall

Florida Public Health Review

Health and healthcare are central elements to the achievement of social justice. Braveman and Gruskin are proponents of health equity as a means to realize social justice. They define health equity as the “absence of systemic barriers to health” that are derived from the unequal power, influence, and capital of marginalized groups within societies (2003, p. 254). John Rawls and Norman Daniels have theorized that social justice requires a fair distribution of goods in a society and that good health is of moral importance to this effort, respectively. Thus, having fair access to a healthy life is a crucial element …

Community-Based Participatory Research: An Ethical And Practical Model For Academic Public Health And Clinical Research, Cynthia R. Hall

Florida Public Health Review

Community-based participatory research (CBPR) is a strategy for performing health-related research in vulnerable communities that have been exploited by traditional research in the past. CBPR focuses on mutual collaboration between the community and the researchers involved. This form of research is ethically compelled to instill transparency and trust into the research enterprise. CBPR envisions the involvement of the community in all aspects of the research: design, implementation and dissemination of research results. This collaborative process necessitates an analysis of ethical considerations because it implies additional moral principles beyond the traditional ethics enunciated in the Belmont Report, the foundational guideline for …

Public Opinion Report Of Nutrition Education And Nutrition-Related Behaviors, Kristen Hicks-Roof, Robert J. Zeglin, Daniel Manson, Corinne A. Labyak

Florida Public Health Review

Objectives: Sources of obtaining credible evidence-based nutrition knowledge appears to be more and more limited as nutrition information becomes widespread. The purpose of this study was to determine sources of nutrition information and corresponding nutrition-related behaviors among Florida residents. Study Design: A cross-sectional study.

Methods: A telephone survey was conducted using probability sampling with residents of Florida in October 2017.Results: A total of 611 respondents completed the survey from 45 different counties across Florida. A significant relationship was established between age and primary source of obtaining nutrition information. Young, middle age and elderly adults preferred media, registered dietitians and physicians/nurses …

A Cross-Sectional Questionnaire-Based Descriptive Study Exploring The Presence Of Behavioral Risk Factors For Infection With Zika Virus Among Students And Employees At An Institution Of Higher Education In South Florida., Dorothy Contiguglia-Akcan, Shasank Chennupati, Sebastian Cuitiva, Christian-Immanuel Oliveros, Carol Marie Fraley, Tiffany Race, Daniel Garrido

Florida Public Health Review

In 2016 and 2017, South Florida was involved in an outbreak of locally-transmitted Zika virus. This questionnaire- based descriptive pilot study demonstrated the presence of behaviors that may be associated with increased risk of Zika transmission in a sample of respondents selected from an institution of higher education in the region. The majority of the 101 respondents living in Miami-Dade County reported inconsistent or no use of mosquito bite prevention methods, over one third (38.6%) traveled to local areas of active transmission, and almost two thirds (64.7%) of those reporting that their sexual partners traveled to local zones of viral …

Sociodemographic Correlates Of Bariatric Surgery By Procedure Type Among A Statewide Ethnically Diverse Patient Population, Alisha Monnette, Tulay Koru-Sengul, Nadia L. Fleurantin, Sarah E. Messiah, Wayway M. Hlaing

Florida Public Health Review

Florida Agency for Health Care Administration (AHCA) 2013 inpatient data was used to conduct a retrospective review using International Classification of Diseases 9th edition (ICD-9) procedure codes to examine the sociodemographic correlates of three bariatric procedures [Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy (SG)]. Race-ethnic groups included non-Hispanic white (NHW), non- Hispanic black (NHB), Hispanic, and other. The sample (n=6,424, mean age 46 years) was predominantly NHW (57.4%), female (74.9%), commercial-insurance carriers (51.2%), and severely obese (98.8%). SG was the most common procedure (57.9%) followed by RYGB (39.3%), and LAGB (2.8%). Regardless of bariatric …

Differences In Current Hookah And Cigarette Smoking Status Attitudes And Beliefs At A Florida University: A Discriminant Analysis, Gail Castañeda, Tracey E. Barnett, Sergio Romero, Mi Jung Lee, Jann Macinnes

Florida Public Health Review

Rising college hookah use, in the absence of cigarettes, suggests attitudinal differences among both forms of tobacco consumption. This study examines which smoking attitudes/beliefs are most distinguishing across current non-smokers, cigarette smokers, hookah smokers, and dual (cigarette and hookah-only) smokers at a Florida university. Self- administered questionnaire data from 373 university students were categorized into four groups based on self-reported 30-day smoking status. Discriminant analysis was used to examine maximal differences between groups across perceived peer acceptability of cigarette smoking, peer acceptability of hookah smoking, hookah smoking harmfulness, and attitude toward peer hookah smoking. Descriptive analyses indicated an overall awareness …

Changes In Hiv Related Risk Behaviors: A Comparative Analysis Of Florida’S 2013 And 2016 Behavioral Risk Factor Surveillance System Survey., Daniel Diyaolu

Florida Public Health Review

Background: Identifying changes in HIV related risk factors is essential to reducing HIV rates in Florida. This study examines if changes occurred in HIV risk factors between 2013 and 2016. Methods: The study utilized secondary data from the Behavioral Risk Factor Surveillance System from 2013 and 2016. A logistic regression analysis was conducted to examine the changes between the years regarding health care coverage and routine HIV testing. Additionally, a separate analysis was performed for the 2016 dataset analyzing if HIV risk behaviors varied by gender, race, age, insurance coverage and HIV testing.

Results: The findings of this study suggest …

Work-Related And Non-Work-Related Lead Poisoning Among Adults In Florida, Babajide Sadiq

Florida Public Health Review

The aim of this study was to identify whether adults with lead poisoning (blood lead level ≥10μg/dL) due to exposure to lead at their workplace have higher blood lead concentration levels compared to persons with lead poisoning who are not occupationally exposed. Data for this study were collected from the Florida Blood Lead Epidemiology Surveillance (ABLES) Program from 2008 to 2010 (n = 2246 adults). The demographic characteristics used for this study included age, gender, race, and ethnicity. The population shows that adults 47years of age have the highest number of cases of blood lead level ≥10μg/dL. In addition, male, …

Incidences Of School-Based Anti-Gay And Gender-Related Bullying: Differences Across Levels Of Education, Evan Mcewing, Joseph M. Zolobczuk, Kiet D. Huynh, Ariel A. Gonzalez, Debbiesiu L. Lee

Florida Public Health Review

Anti-gay and gender-related bullying and harassment are pervasive public health problems found in schools and are correlated with negative mental health and educational outcomes for students. This study examines the differences in the forms and prevalence of anti-gay and gender-related bullying with students from middle school, secondary, and post-secondary institutions. This information can assist researchers and practitioners in better understanding the prevalence of anti-gay verbal versus physical harassment at particular education levels. The sample comprised 7,007 participants. Multivariate analysis of variance was used to examine differences across levels of education, race/ethnicity, and gender on the 9-item Gender and Orientation Attitudes …

Community-Based Participatory Research At Jacksonville, Florida Superfund Ash Site: Toxicology Training To Improve The Knowledge Of The Lay Community, Alan Becker, Sandra Suther, Cynthia Harris, Grazyna Pawlowicz, Gale Disney-Tucker, Matthew Dutton, Fran Close, Aaron Hilliard, Richard Gragg

Florida Public Health Review

Until the late 1960’s, Jacksonville, Florida incinerated its solid waste with the resultant ash deposited in landfills or used to fill flood-prone areas. These filled areas were later developed into parks, school sites and residential areas. Lead in soil at these sites was the major toxicant of concern and driver of clean-up actions. During the period of assessment of lead-levels in soil, there were no established lines of communication between the City and residents of affected neighborhoods resulting in mistrust in the community. To address communication issues, a community-based, culturally sensitive Community Environmental Toxicology Curriculum (CETC) and a short video …

Obstructive Sleep Apnea Disparity Among Truck Drivers: Danger On American Roads, Felicia N. Green, Ivette A. López, Mary Simmons

Florida Public Health Review

Obstructive sleep apnea (OSA), a common sleep disorder, can cause perilous levels of fatigue that impact commercial drivers who operate vehicles such as tow trucks, tractor trailers, and buses. In this study, we explored this population for its awareness of obstructive sleep apnea, the risk factors, and its impact on health for all. We conducted a qualitative study using 33 semi-structured in-depth interview questions with 12 male commercial truck drivers ages 28 to 44 years old, who were Florida residents. Participants had basic knowledge of OSA, minimal awareness of the underlying risk factors that impact their overall health, and of …