Public Health Commons^™

Promise And Perils Of State-Based Road To Universal Health Insurance In The U.S., Carol S. Weissert

Journal of Health Care Law and Policy

No abstract provided.

Unequal Access: The Crisis Of Health Care Inequality For Low-Income African-American Residents Of The District Of Columbia, Robyn Whipple Diaz

Journal of Health Care Law and Policy

No abstract provided.

Maximizing Resources To Meet Client Needs: Evaluation Of A Comprehensive Hiv/Aids Care And Support Model In India, Yrg Care, Horizons Program, International Hiv/Aids Alliance

HIV and AIDS

To examine the benefits and feasibility of service delivery, the Horizons program and the International HIV/AIDS Alliance undertook a multifaceted operations research study of YRG CARE, a nongovernmental organization which offers services to PLHA in southern India. Data from this study suggest that comprehensive care and support services have had a positive impact on perceived quality of life, serostatus disclosure, number of illness episodes, and household expenditures for those patients who participated in the study. The results of this component of the study support the value of scaling-up the YRG CARE service model to other NGOs in India to expand …

Expanding The Care Continuum For Hiv/Aids: Bringing Carers Into Focus, Jessica Ogden, Simel Esim, Caren Grown

HIV and AIDS

This review by the International Center for Research on Women explores the specific issues that cluster around the provision of care in the context of the global HIV/AIDS pandemic. With the support of the Population Council’s Horizons program, this review applies the care economy lens to two key sectors, health and social protection, and finds that while important strides are being made, much more needs to be known and done to enable individuals, families, and households to survive in a world shaken by AIDS. The report documents the challenges faced by family care providers, who are primarily women and unlinked …

Expanding Care And Support In South India: Scaling Up Yrg Care's Patient-Centered Approach, Yrg Care, Horizons Program, International Hiv/Aids Alliance

HIV and AIDS

This study examines the experiences of YRG CARE, a Chennai-based NGO, which provides an integrated continuum of prevention, care, and support services for PLHA in South India. In this Horizons report, the authors examine the process of scaling up YRG CARE’s patient-centered approach and how this led to the enhanced provision of care and support services at four selected sites. Networking and collaboration among providers at all sites were essential parts of the strategy. At the end of project workshop, scale-up participants and YRG CARE affirmed their intention to continue collaboration in order to build on the successes of the …

Succession Planning In Uganda: Early Outreach For Aids-Affected Children And Their Families, Horizons Program, Makerere University Department Of Sociology, Plan Uganda

HIV and AIDS

This publication reports on an intervention study that evaluated the effectiveness of a succession planning (SP) program in Uganda. Unlike most other programs for AIDS-affected children, succession planning reaches children and their families while their HIV-positive parents are still living and in a position to plan for their children’s long-term well-being. Research carried out by the Department of Sociology at Makerere University (Kampala) and the Population Council Horizons program suggests that succession planning is a promising approach: despite AIDS-related stigma and cultural resistance to acknowledging illness and death, qualitative research indicates that the approach met with a high degree of …

Combining Community Approaches And Government Policy To Prevent Hiv Infection In The Dominican Republic, Deanna Kerrigan, Luis Moreno, Santo Rosario, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

A recent Horizons study conducted jointly with two Dominican NGOs assessed the impact of two environmental-structural models in reducing HIV-related risk among female sex workers in the Dominican Republic and compared their cost-effectiveness. In the two cities studied, there were improvements from pre- to post-intervention in the key outcome variables, however the type and level of these changes varied by intervention approach. Based on our findings, program planners and policymakers involved in the study in the Dominican Republic agree that the integrated solidarity and policy model in conjunction with ongoing peer education and community mobilization activities is an appropriate, cost-effective, …

Strengthening Sti Treatment And Hiv/Aids Prevention Services In Carletonville, South Africa, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam

HIV and AIDS

Although knowledge about HIV/AIDS is widespread in South Africa, adult HIV prevalence is high, indicating high levels of risky sexual behavior. Understanding the gap between knowledge and behavior requires an examination of the social context in which the epidemic occurs. The Horizons Program conducted an intervention study in the Carletonville area to study the social determinants of the HIV epidemic and to assess the impact of a targeted program of HIV and STI prevention and service delivery. In 1998, the Mothusimpilo (“Working together for health”) Intervention Project (MIP) was launched to reduce community prevalence of HIV and other STIs and …

Combinando Estrategias Comunitarias Y Política Gubernamental Para Prevenir La Infección Del Vih En La República Dominicana, Deanna Kerrigan, Luis Moreno, Santo Rosario, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

Programas efectivos para evitar nuevas infecciones del VIH entre trabajadoras sexuales y sus parejas, y por lo tanto la población en general, son componentes críticos de estrategias nacionales de prevención del VIH. Un estudio recientemente realizado por Horizons, en conjunto con dos organizaciones no-gubernamentales dominicanas y el Programa Nacional del Control de ITS y SIDA evaluó el impacto de dos modelos ambientales-estructurales en disminuir el riesgo de VIH en trabajadoras sexuales en la República Dominicana y comparó el costo-efectividad de los dos modelos. Los modelos, construidos sobre la base de años de experiencia adquirida a través de programas de educación …

Community Approaches And Government Policy Reduce Hiv Risk In The Dominican Republic, Deanna Kerrigan, Luis Moreno, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

Effective programs that avert new HIV infections among sex workers and their partners, and hence the general population, are critical components of national HIV-prevention strategies. Prevention efforts have frequently relied on interventions that reach members of these vulnerable groups as individuals, such as condom promotion and STI management. Now, many researchers and program implementers are increasingly turning to “environmental-structural” interventions that address the physical, social, and political contexts in which individual behavior takes place. A recent Horizons study conducted jointly with two Dominican NGOs—Centro de Orientación e Investigación Integral and Centro de Promoción e Solidaridad Humana—and the National Program for …

Intervenciones Comunitarias Y Política Gubernamental Reducen El Riesgo Del Vih En La República Dominicana, Deanna Kerrigan, Luis Moreno, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

Programas efectivos para evitar nuevas infecciones del VIH entre trabajadoras sexuales y sus parejas, y por lo tanto la población en general, son componentes críticos de estrategias nacionales de prevención del VIH. Generalmente los esfuerzos de prevención se han concentrado en intervenciones que alcanzan a los miembros de estos grupos vulnerables al nivel individual, tal como promoción de condones y manejo de ITS. Actualmente, muchos investigadores y gerentes de programas se encuentran dirigiéndose a intervenciones “ambientales-estructurales” que toman en cuenta los contextos físicos, sociales y políticos en que el comportamiento individual ocurre. Un estudio reciente realizado por Horizons, en conjunto …

The Role Of Incentives In Promoting Workplace Hiv/Aids Policies And Programs, Simon Baker, Srisuman Sartsara, Patchara Rumakom, Philip Guest, Katie D. Schenk, Anthony Pramualratana, Suparat Suksakulwat, Surachai Panakitsuwan, Sikarat Moonmeung

HIV and AIDS

This brief examines the role of incentives in encouraging companies in Thailand to adopt workplace policies and programs that address AIDS-related stigma and discrimination and respond to the needs of workers for information and services. The research was a collaboration between the Horizons Program, American International Assurance (AIA), the Thailand Business Coalition on AIDS (TBCA), and AusAID. After the initiative was launched (known as the AIDS-response Standard Organization), TBCA staff built relationships with company managers to explain and promote the advantages of joining. Companies agreeing to implement at least three HIV/AIDS workplace policies would receive a reduction of 5–10 percent …

Equitable Access To Hiv Counseling And Testing For Youth In Developing Countries: A Review Of Current Practice, Ann P. Mccauley

HIV and AIDS

While many people get HIV-related counseling and testing, only those who receive pre- and post-test counseling, and test voluntarily, are participating in voluntary counseling and testing (VCT). The high rates of HIV infection among youth make it crucial to find programs to prevent infection. Because there is evidence that many adults benefit from VCT, there is increasing interest in extending these services to young people. VCT counseling helps adolescents evaluate their own behavior and its consequences. A negative test result offers the opportunity to recognize vulnerabilities and develop risk-reduction plans to adopt safe behaviors. Young people who test HIV-positive can …

Paving The Path: Preparing For Microbicide Introduction—Report Of A Qualitative Study In South Africa [Executive Summary], Julie Becker, Rasha Dabash, C. Elizabeth Mcgrory, Diane Cooper, Jane Harries, Margaret Hoffman, Jennifer Moodley, Phyllis Orner, Hillary J. Bracken

HIV and AIDS

With recently accelerated support for the development of microbicides to prevent HIV transmission and the urgency of the global AIDS epidemic, it is important to begin to identify strategies for introducing a microbicide once it is proven safe and effective and is approved for use. This executive summary presents results from a qualitative study that explored a range of issues likely to influence microbicide introduction at the community, health service, and policy levels. The study, which identified critical issues to be addressed in building support for microbicides and facilitating a smooth introduction, was conducted between September 2002 and September 2003 …

Paving The Path: Preparing For Microbicide Introduction—Report Of A Qualitative Study In South Africa, Julie Becker, Rasha Dabash, C. Elizabeth Mcgrory, Diane Cooper, Jane Harries, Margaret Hoffman, Jennifer Moodley, Phyllis Orner, Hillary J. Bracken

HIV and AIDS

With recently accelerated support for the development of microbicides to prevent HIV transmission and the urgency of the global AIDS epidemic, it is important to begin to identify strategies for introducing a microbicide once it is proven safe and effective and is approved for use. This report presents results from a qualitative study that explored a range of issues likely to influence microbicide introduction—positively or negatively—at three levels: community, health service, and policy. The study, which identified critical issues to be addressed in building support for microbicides and facilitating a smooth introduction, was conducted between September 2002 and September 2003 …

Surveillance For Waterborne-Disease Outbreaks Associated With Drinking Water--United States, 2001-2002, Brian G. Blackburn, Gunther F. Craun, Jonathan S. Yoder, Vincent Hill, Rebecca L. Calderon, Nora Chen, Sherline H. Lee, Deborah A. Levy, Michael J. Beach

Journal Articles: Epidemiology

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs). This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States.

REPORTING PERIOD COVERED: This summary includes data on WBDOs associated with drinking water that occurred during January 2001-December 2002 and on three previously unreported outbreaks that occurred during 2000.

DESCRIPTION OF SYSTEM: Public health departments in the states, …

Use Of Erythropoietin In Cancer Patients: Assessment Of Oncologists’ Practice Patterns In The United States And Other Countries, Jared R. Adams, Linda S. Elting, Gary H. Lyman, James N. George, Barry C. Lembersky, James O. Armitage, George D. Demetri, Charles L. Bennett

United States Public Health Resources

PURPOSE: To assess physician use of erythropoietin in cancer patients before publication of the American Society of Clinical Oncology/American Society of Hematology guidelines.
METHODS: Questionnaires about erythropoietin use in practice and 12 hypothetical clinical scenarios involving patients with cancer were mailed to 2000 oncologists/hematologists in the United States and 19 other countries. Response rates were 30% in the United States and 25% internationally. Data on erythropoietin use for ovarian cancer were obtained from one clinical trial. Multivariate regression models assessed predictors of erythropoietin prescription.
RESULTS: Most physicians selected a hemoglobin level ≤10 g/dL as an upper threshold for erythropoietin use …

Medicare At 40: A Mid-Life Crisis?, Nancy-Ann Deparle

Journal of Health Care Law and Policy

No abstract provided.

Medicaid: Issues And Challenges For Health Coverage Of The Low-Income Population, Diane Rowland

Journal of Health Care Law and Policy

No abstract provided.

Information For Authors

International Journal of Global Health and Health Disparities

No abstract provided.

Involving Young People In The Care And Support Of People Living With Hiv/Aids In Zambia, Eka Esu-Williams, Katie D. Schenk, Joseph Motsepe, Scott Geibel, Anderson Zulu

HIV and AIDS

The Population Council, in collaboration with CARE International and Family Health Trust, conducted a study in Zambia to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households. Discussions with caregivers and clients demonstrated that trained youth are able to meet a range of the needs of clients and orphans and vulnerable children, and that their efforts may be …

A Rapid Situation Analysis Of The Access To Care Project In Northern Thailand, Ratana Panpanich

HIV and AIDS

A rapid situation analysis (RSA) study, supported by the Horizons program, was undertaken to understand the strengths and weaknesses of the Thai government’s Access to Care (ATC) project in northern Thailand. The ultimate aim of the study was to make recommendations for action that will improve the quality of the antiretroviral (ARV) therapy that clients receive and to enhance their adherence to HAART. The RSA has shown high levels of support for the ATC project from health providers, HAART clients, their relatives, and even those who had dropped out of the program. However, the RSA has also shown that there …

Adherence To Antiretroviral Therapy In Adults: A Guide For Trainers, Horizons Program, International Centre For Reproductive Health, Mombasa Coast Province General Hospital

HIV and AIDS

Over the last five years, there has been a rapid change in treatment strategies for HIV infection. With the advent of newer antiretrovirals, treatment has moved from mono-therapy and bi-therapy to triple drug therapy or Highly Active Antiretroviral Therapy. One of the foremost concerns of ARV programs is the ability of people living with HIV/AIDS to maintain near perfect adherence over the long term. To achieve the goal of antiretroviral therapy (ART), undetectable levels of the virus in the blood, patients are required to maintain more than 90–95% adherence. Adherence is defined as a patient’s ability to follow a treatment …

Vulnerability And Intervention Opportunities: Research Findings On Youth And Hiv/Aids In South Africa, Population Council

HIV and AIDS

The Nelson Mandela Children’s Fund (NMCF) seeks comprehensive local solutions to address the negative effects of HIV/AIDS on children, adolescents, households, and communities. To this end, NMCF initiated the Goelama Project, which uses a community mobilization strategy to catalyze action by local organizations and government bodies to prevent HIV infection and mitigate the socioeconomic impacts of the disease, particularly as they affect orphans and vulnerable children (OVC). This brief highlights key findings from an assessment of reproductive and sexual health knowledge and behaviors among nearly 5,000 youth from eight districts in three provinces in South Africa where the Goelama Project …

Public Posting As A Strategy To Increase Walking: A Worksite Intervention, Rayleen Earney, Timothy J. Bungum

Environmental & Global Health Faculty Research

Because most American adults do not meet recommended physical activity guidelines, the need for new and innovative strategies is apparent. The current study employed public posting in an attempt to increase walking behavior in a worksite setting. Pedometer generated data was publicly posted in a prominent location in the worksite. In our study that utilized a pre-experimental design, we found that walking steps were statistically higher during the intervention and in a post intervention period as compared to the baseline data. We conclude that the public posting of physical activity data has the potential to increase walking behavior.

Ic107: Program: 9th Biennial Symposium On Minorities, The Medically Underserved & Cancer. From Awareness To Action, The Unequal Burden Of Cancer, Intercultural Cancer Council

Informational and Promotional Materials

Program details the events, speakers, attendees, and discussions during the 9th Biennial Symposium on Minorities, the Medically Underserved & Cancer presented by Intercultural Cancer Council and Baylor College of Medicine. The symposium took place March 24-28, 2004 at the OMNI Shoreham in Washington, DC. See more at Intercultural Cancer Council Records.

Effects And Cost Of Implementing A Gender-Sensitive Reproductive Health Program In Bolivia, Erica Palenque, Lizzy Montano, Ricardo Vernon, Fernando Gonzales Salguero, Patricia Riveros, John H. Bratt

Reproductive Health

The Integral Health Coordination Program (Programa de Coordinación en Salud Integral or PROCOSI), a network of 24 Bolivian NGOs, and the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program evaluated the effects of interventions on clinic clients and their partners, and estimated the costs of incorporating a gender perspective into service delivery. Results show that sexual and reproductive health service organizations can implement action plans to change organizational policies and service delivery practices and to improve their infrastructure and equipment to make them more convenient for clients. The results further show that the intervention made modest but important changes in …

Awareness Of Heart Health Promotion And Heart Disease Prevention Programs Among African, African-American, And Caucasian American Women, Leenghoi Lower

All Graduate Theses, Dissertations, and Other Capstone Projects

The aim of this study was to assess awareness of African, African-American, and Caucasian American women regarding heart health promotion and heart disease prevention programs. A survey consisting of 10 questions was given to 150 women from the Minnesota cities of Mankato, Minneapolis, and Saint Paul. Data was collected from 60 women. Results from this study indicated that 32.45% of women were aware of heart health promotion and heart disease prevention programs while 67.55% were not aware. An investigation was also carried out to determine knowledge of women regarding heart disease as the leading cause of morbidity in women. Results …

A Comparison Of Perceptions Of Students, Parents And School Personnel Regarding Bullying Behavior, Joan Buchar

Masters Theses & Specialist Projects

A COMPARISON OF PERCEPTIONS OF STUDENTS, PARENTS AND SCHOOL PERSONNEL REGARDING BULLYING BEHAVIOR Joan Buchar July 2, 2004 52 Pages Directed by: Richard W. Wilson, J. David Dunn, Lisa L. Lindley Department of Public Health Western Kentucky University Bullying in America's schools is a problem that is, at best, a nuisance and at worst, the suspected cause of school shootings. Bullying is a persistent, physical or psychological abuse of power. It takes many forms from physical assault and name calling to shunning, ridicule or exclusion. The victims are usually powerless to change conditions and often bullying is ignored or dismissed …

Perceptions Of Pediatric Overweight And Weight Management: A Comparison Of Parents And Physicians, Lisa K. Thomason

Masters Theses & Specialist Projects

Pediatric overweight is of paramount importance in Kentucky, as studies show prevalence rates are higher in the state than the national average. Research suggests that comprehensive treatments involving diet training, exercise training, and psychological counseling are most effective at reducing overweight in children. Little research has been done, however, to compare parents' and physicians' perceptions of obesity, its treatment, or barriers to weight management.

The purpose of this study is to examine differences in attitudes toward pediatric obesity and weight management among parents and physicians, specifically related to the importance of diet training, exercise training, and psychological counseling. Surveys were …