Public Health Commons^™

Equitable Vaccine Access Within An Age-Based Framework, Alan B. Cobo-Lewis

Developmental Disabilities Network Journal

Objectives: When vaccine supply was limited, several states adopted age-based prioritization for Covid-19 vaccine eligibility because it is simple (especially when age is quantized by decade) and age is strongly associated with Covid-19 mortality. But this approach raises equity concerns based in law and ethics. I propose data-driven solutions for equitable policy within an age-based framework. Methods: Using CDC and Census Bureau data, I analyzed 538,627 U.S. Covid-19 deaths by age and race-ethnicity through February 2021 and compared the risk ratios to published data on risk ratios for other conditions. Results: Covid-19 mortality rose 2.56-fold per decade of life. Down …

2022-04-29 Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Examining Social Determinants Of Health During A Pandemic: Clinical Application Of Z Codes Before And During Covid-19, Xueying Yang Ph.D., Brooks Yelton, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Shan Qiao Ph.D., Xiaoming Li Ph.D., Daniela B. Friedman Ph.D.

Faculty Publications

Recognition of the impact of social determinants of health (SDoH) on healthcare outcomes, healthcare service utilization, and population health has prompted a global shift in focus to patient social needs and lived experiences in assessment and treatment. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) provides a list of non-billable “Z codes” specific to SDoH for use in electronic health records. Using population-level analysis, this study aims to examine clinical application of Z codes in South Carolina before and during the COVID-19 pandemic. The study population consists of South Carolina residents who had a healthcare visit and had …

Barriers To Public Health In Latino American Indigenous Communities, Wilzave Quiles Guzman

Honors Program Theses and Research Projects

This paper focuses on barriers to public health in Latino American Indigenous communities. Indigenous people throughout the world are at a public health disadvantage due to a lack of clearly defined practices within the decision-making processes to plan, evaluate, and control finances from governmental and non-governmental entities in charge of managing health services. I argue that political, social, and institutional changes are still needed to achieve health equity in Indigenous communities and that these changes should go beyond implementing a universal health care program. I must recognize improvements made by many Latino American countries like Brazil, which prepared a plan …

A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith

Evidence-Based Practice Project Reports

Obesity is a worsening pandemic that requires immediate action. It is recommended that primary care providers screen patients for obesity and provide multimodal behavioral interventions to their patients to treat and prevent obesity (USPSTF, 2018). The purpose of this evidenced-base practice (EBP) project is to implement a multimodal intervention for weight loss in adults within primary care. Five search engines were utilized, and 16 articles were ultimately selected as evidence. The evidence supported self-monitoring and close follow-up while in active weight loss. The Iowa Model for EBP to promote quality care was used as the framework to guide the project …

Vermont: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika C. Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the Northern …

The Value Of Education: School Policy Decisions During The Covid-19 Pandemic, Elika W. Somani

Individually Designed Interdepartmental Major Honors Project

During the COVID-19 pandemic, lacking national U.S. policies, wide variation and conflict over chosen public school policy decisions emerged. What factors and guidelines informed the decision-making process in K-12 public schools during the COVID-19 pandemic and who were the key stakeholders? This study examines three school district types – a large city, medium city, and small-town – across Minnesota as case studies to unpack how policy decisions were made during the pandemic. Stakeholder interviews uncovered that the school decision-making process was a) connected to a district's political opinions, b) made by the superintendent and school board, c) primarily influenced by …

New Hampshire: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika C. Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the …

Maine: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Yvonne Jonk Phd, Louisa Munk Mph, Erika Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the …

The Northern Border Region: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the Northern …

New York: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the Northern …

Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.

Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.

Advantages Of Early Utilization Of Palliative Care In The Pediatric Icu: A Scoping Review, Shelby Noel Cain Bsn, Rn, Cpn, Dana Pabalate Zimmerman Msn, Rn, Charis Elizabeth Oji Msn, Aprn, Cpnp-Pc/Ac, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative …

Analysis Of Firearm Violence During The Covid-19 Pandemic In The Us, Shengzhi Sun, Wangnan Cao, Yang Ge

Faculty Publications

Importance In the US, the COVID-19 pandemic intensified some conditions that may contribute to firearm violence, and a recent surge in firearm sales during the pandemic has been reported. However, patterns of change in firearm violence in the first year of the COVID-19 pandemic in the US remain unclear.

Objective To quantify the changes in interpersonal firearm violence associated with the pandemic across all 50 US states and the District of Columbia.

Design, Setting, and Participants This population-based cross-sectional study examined 50 US states and the District of Columbia from January 1, 2016, to February 28, 2021. The COVID-19 pandemic …

Parenthood Orientation Among Young Women: Is It Associated With Pregnancy Intention And Unprotected Intercourse?, Nakeisha Blades

Theses and Dissertations

This study explored relationships between parenthood orientation, pregnancy intention, and unprotected intercourse. Nulligravid, sexually active women aged 18-29 (N = 252) were surveyed on these topics in May 2019. There were significant differences in parenthood orientation by past and current pregnancy intention. Higher scores on parenthood orientation were associated with increased odds of past unprotected intercourse and expecting future unprotected intercourse. Only education and contraceptive self-efficacy retained significance in adjusted models. Study results are consistent with prior work on parenthood orientation and pregnancy intention and point to other factors as stronger correlates of contraceptive use.

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Dnp Final Report: Sane Finder: A Web-Based Mobile Solution To Identify The Location Of Currently Available Sexual Assault Nurse Examiners (Sane) For First Responders, Brenda D. Herrmann

DNP Final Reports

Society views sexual assault as one of the most horrific crimes committed by one human being against another, but the “rescue” has the potential to make the experience even more difficult for the victim, in essence re-traumatizing them (Nugent-Borakove et al., 2006). In the United States in 2018, almost 140,000 victims reported being sexually assaulted (U.S. Department of Justice - Federal Bureau of Investigation, 2019). In Texas, over 6 million individuals have been sexually assaulted in their lifetime (Busch-Armendariz et al., 2015). Getting victims to a specially trained sexual assault nurse examiner (SANE) as quickly as possible improves outcomes. SANEs …

The Role Of Socio-Cultural Perspectives And Vaccine Misinformation On The Intention To Receive Covid-19 Vaccination In A Selected Sample Of Georgia Southern Students, Alyssa G. Love-Archey

Honors College Theses

The purpose of the study was to explore sociocultural influences on the intention to receive the Covid-19 vaccination and to measure which sociocultural factor had the greater influence: misinformation about the vaccine or specific cultural beliefs (religion and/or cultural practices) on vaccine intent in Georgia Southern students. An anonymous, exploratory survey was utilized to collect information on these constructs in two selected groups of students: those who had been vaccinated prior to taking the survey and those who had not been vaccinated prior to taking the survey. Subjects of the study were undergraduate, master’s degree, and doctoral students of the …

Perceived Roles, Benefits And Barriers Of Virtual Global Health Partnership Initiatives: A Cross-Sectional Exploratory Study, Lisa Umphrey, George Paasi, William Windsor, Grace Abongo, Jessica Evert, Heather Haq, Elizabeth M Keating, Suet Kam Lam, Megan S Mchenry, Carolyne Ndila, Charles Nwobu, Amy Rule, Reena P Tam, Daniel Olson, Peter Olupot-Olupot

Faculty, Staff and Students Publications

BACKGROUND: Virtual global health partnership initiatives (VGHPIs) evolved rapidly during the COVID-19 pandemic to ensure partnership continuity. However the current landscape for VGHPI use and preference is unknown. This study aimed to increase understanding of GH partners' perspectives on VGHPIs.

METHODS: From 15 October to 30 November 2020, An online, international survey was conducted using snowball sampling to document pandemic-related changes in partnership activities, preferences for VGHPIs, and perceived acceptability and barriers. The survey underwent iterative development within a diverse author group, representing academic and clinical institutions, and the non-profit sector. Participants from their professional global health networks were invited, …

Development Of An Experienced Quality Measure For Clients, Informal And Formal Caregivers In Home Care In The Netherlands: A Participatory Action Research, Roy Haex, Theresa Thoma-Lürken Phd, Anna J.H.M. Beurskens Phd, Sandra M.G. Zwakhalen Phd, Rn

Patient Experience Journal

To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating possible points of improvement for the primary care process. A participatory action research design to develop the measure following three iterative cycles, using various data sources in evaluating requirements related to the goal, feasibility in care setting, and usability in the care process. The final design comprises an …

Resource Utilization Among Informal Caregiver Of Lung Cancer Patients Undergoing Treatment, Charlotte T. Lee, Clarelle L. Gonsalves, Jenny Gao-Kang, Wyatt G. Pickrell, Ruth F. Barker

Patient Experience Journal

The objective of this study is to explore patient and caregiver factors that shape the use of available resources to support caregiving for lung cancer patients undergoing treatment. A mixed-method study was conducted at one regional cancer centre within the Province of Ontario, Canada, using concurrent triangulation design. Adult patients with lung cancer (n=46) and their caregivers (n=42) (37 patient-caregiver dyads) were invited to complete a one-time study survey. Informal caregivers (n=20) also participated in a one-time semi-structured interview. Descriptive statistics and Pearson’s correlation were used to examine patterns of resource utilization and associations among study variables. Content analysis was …

Understanding Patient Experiences Before And During The Covid-19 Pandemic: A Quasi-Experimental Comparison Of In-Person And Virtual Cancer Care, Linda Watson, Claire Link, Siwei Qi, Eclair Photitai, Lindsi Chmielewski, Diane Fode, Andrea Deiure

Patient Experience Journal

The COVID-19 pandemic prompted the immediate widespread implementation of virtual care appointments in Cancer Care Alberta (CCA). This study aimed to compare patient experiences and satisfaction with in-person care provided prior to the pandemic and virtual care provided after the COVID-19 outbreak. Surveys were conducted to compare patient satisfaction, using the Your Voice Matters (YVM) experience survey, between patients in the pre-pandemic in-person (baseline) and post-outbreak (virtual) cohorts. Generalized Linear Models (GLMs) with an ordinal logistic link were used, adjusting for self-reported health status and other covariates, to investigate the association between cohort type and patient satisfaction. Despite having higher …

An Exploration Of Psychological Trauma And Positive Adaptation In Adults With Congenital Heart Disease During The Covid-19 Pandemic, Liza Morton Dr, Calum Calderwood, Nicola Cogan, Claire Murphy, Evan Nix, Jacek Kolacz Dr

Patient Experience Journal

The growing population of adults with congenital heart disease (CHD) often have lifelong experience of dealing with potentially traumatic health crises and medical uncertainty whilst facing increased vulnerability to post-traumatic stress disorder (PTSD). The COVID-19 pandemic presents additional challenges for this population including increased risk of health complications, shielding and strict social distancing, changes to medical care provision and social stigma. Despite such challenges, adults with CHD have the potential to also experience positive changes, yet little is known as to what helps cultivate positive adaptation and post-traumatic growth (PTG) within this context. The current study comprised a cross-sectional, anonymous, …

Consumer Experience Of Mental Health Services During The Covid-19 Pandemic: Evidence From An Australian Mental Health System, Sarah Kelshaw, Jason Boyd, Irene Gallagher, Grant Sara

Patient Experience Journal

COVID-19 has increased the need for mental health care but disrupted its delivery. We examined impacts of the first year of the COVID-19 pandemic on consumer experience of NSW hospital and community mental health services, compared to their pre-COVID baseline. We also examined whether increased telehealth use was associated with changes in the quantity or experience of community mental health care. Data were 73,488 Your Experience of Service (YES) surveys from state mental health services in New South Wales (NSW), Australia, grouped into three periods: pre-COVID (January 2018 to March 2020), early-COVID (April to June 2020) and stable-COVID (July to …

Family’S Sufferings From Asymptomatic Covid: Clinicians’ Perspective, Neha Joshi Dr, Jitender Nagpal Dr, Anand Sinha Dr

Patient Experience Journal

Anticipating dire consequences, in 2020 the world braced itself for the unparalleled pandemic by resorting to unprecedented measures including stringent lockdowns, unforeseen social isolations, spotlight focus, resource diversions besides reorganized healthcare systems to name the quintessential few. Such unifocal convergence enhanced the vulnerabilities of patients dependent on non-COVID healthcare assistance. For a nation with a meagre allocation of 0.7 hospital beds per 1000 people and a lopsided doctor-population ratio of 1:1800, COVID-centric measures created unintended complications. Ironically, many succumbed in myriad ways, not due to the pandemic but due to the attributes of the survival measures. While such consequences cannot …

Current Prom And Prem Use In Health System Performance Measurement: Still A Way To Go, Claudia Bull, Emily J. Callander

Patient Experience Journal

There is a growing impetus to “measure what matters” to enable health systems to optimise value-based, person-centred healthcare. This paper describes the critical importance of patient-reported outcome and experience measures (PROMs and PREMs) in this pursuit and provides an in-depth overview of how PROM and PREM programs differ between England, the United States, and Australia. A comprehensive timeline of PROM, PREM, legislation/policy, and value-based purchasing (pay-for-performance) program implementation accompanies this discussion. Importantly, this paper highlights disparities between these nations’ PROMs and PREMs programs, evidencing that we still have a way to go towards equal health system performance measurement globally.

Experience …

2022-04-27 Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2022-04-27_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …