Public Health Commons^™

Opinions Of Individuals In The Greater Durban Area Concerning Government Healthcare, Alexander Braun

Independent Study Project (ISP) Collection

One important determinant of health in South Africa is how government entities, from the local level to the national level, use their health budgets. A complex system of organizations involving many government employees at the various levels are involved in the process of turning a budget allocation of Rand into healthcare services and goods that make their way to the South African people. What do individuals in the greater Durban area think about that process as it exists currently, and what do they think of the services that are eventually delivered to them? This is an important question, especially in …

Cost Estimation Methods And Foundational Public Health Capabilities, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medine recently recommended that the federal government identify the components and costs of a "minimum package of public health services" and "foundational public health capabilities" that should be universally available across the U.S. This presentation reviews costing methods that can be used for identifying the costs required to establish "foundational public health capabilities" at state and local levels within the U.S. public health system.

Accreditation And Standardization In Local Public Health, Glen P. Mays

Health Management and Policy Presentations

Reducing harmful, wasteful, and inequitable variation in public health delivery is a central objective for administrative and policy decision-makers in public health, and is embedded in the national accreditation movement. The challenge lies in accomplishing this objective while preserving the benefits of customization in public health delivery that accrue through tailoring and targeting of resources to unique community needs and risks. Public health services and systems research (PHSSR) can help determine the optimal balance between standardization and customization in public health delivery.

Strengthening The Evidence Base For Accreditation: Progress In Phssr And Pbrns, Glen P. Mays

Health Management and Policy Presentations

With the launch of a voluntary national accreditation program for public health agencies, the field requires an expanding evidence base concerning which public health strategies work best, for which populations, and under what circumstances. The field of public health services and systems research (PHSSR) and practice-based research networks (PBRNs) are producing applied studies that can inform the future development and implementation of accreditation standards, and evaluate the impact of accreditation on the field of practice.

Health System Contributions To Public Health Activities Amid Policy And Economic Change: Estimating Complementarities, Substitutions, And Network Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury, potentially changing the structure of public health delivery systems and expanding the delivery of strategies that improve population health. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and …

Frontiers In Public Health Services And Systems Research: Accelerating And Expanding Knowledge Transfer In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

As part of the "Meet the Editors" panel on publishing health services research, this presentation discusses the new open-access journal Frontiers in Public Health Services and Systems Research. This journal serves as a vehicle for rapidly disseminating newly emerging and preliminary findings from studies that examine the organization, financing, and delivery of public health services. The goal is to stimulate research collaboration and accelerate knowledge transfer from research projects to policy and administrative decision-makers within the public health system.

Impact Of Storm Events On Water Quality Of A Karst Stream And Implications For Public Health Protection At A Historic Landmark, Ellen R. Barringer

Mahurin Honors College Capstone Experience/Thesis Projects

A water quality study was conducted on Lost River near Bowling Green, Kentucky. The emphasis of the study was to assess the influence of storm events on water quality and E. coli (cfu/100ml) levels. Lost River is a karst stream and flows underground for much of its course through Warren County and Bowling Green, Kentucky. The Lost River watershed is approximately 55 square miles and receives surface runoff from rural and urban land uses. Within the watershed exists the Lost River Cave and Valley, which receives secondary contact use throughout the year. A water quality assessment of multiple parameters was …

The Value Of Public Health Financial Data, Glen P. Mays

Health Management and Policy Presentations

Effective policy and administrative decision-making in public health requires reliable information on the amount of resources invested in governmental public health programs and how these resouces are allocated and used across the U.S. public health system. This session examines current and potential uses of public health financial data in the U.S., and considers expanded roles for research in informing policy and administrative decisions.

Vital Statistics: The State Of The Public Health Pbrn Program, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Public Health PBRN Program has continued to expand during the 2013 program year with new networks, new research projects, and expanded translation and dissemination initiatives. The program plays an increasingly powerful role in helping to transform the U.S. public health enterprise into a rapid-learning system for health improvement.

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

Monitoring Qi Maturity Of Public Health Organizations And Systems In Minnesota: Promising Early Findings And Suggested Next Steps, Kimberly J. Miner Gearin, M. Elizabeth Gyllstrom, Brenda M. Joly, Renee S. Frauendienst, Julie Myhre, William Riley

Frontiers in Public Health Services and Systems Research

Public health departments and systems are increasing investments in quality improvement. This paper presents methods used to identify a select number of items from a previously validated QI Maturity Tool as the basis for calculating organizational and system-level QI maturity scores that could be followed over time. Findings suggest that the abbreviated tool measures variation in QI maturity across LHDs, and differences in scores among divisions within a state health department. Minnesota has incorporated the abbreviated tool into an annual reporting system for the MN Local Public Health Act, thereby enabling stakeholders to monitor a system median score and distribution …

Accelerating And Expanding Knowledge Transfer In Public Health Settings: Frontiers In Phssr, Glen P. Mays

Health Management and Policy Presentations

Creating a "rapid-learning" system in public health requires mechanisms for the continuous exchange of knowledge and evidence among researchers, practice settings, and policy decision-makers. The open-access platform Frontiers in Public Health Services and Systems Research provides a new mechanism for this exchange.

A Patient-Centered Approach For Evaluating Public Health Roles Within Systems Of Care For Children With Special Healthcare Needs, Danielle M. Varda, Ayelet Talmi

Frontiers in Public Health Services and Systems Research

Despite the apparent success that local and state health departments have had integrating a public health approach to provide programs and services for families with children who have complex health needs, there continues to be mixed results in terms of satisfaction and degree of support from this system. Current evaluations collect performance data from system stakeholders, rarely including the patient perspective. Examining the system holistically using Social Network Analysis, to include both the stakeholder and patient perspectives of how well the system is functioning affords greater understanding of how a public health approach to systems of care leads to more …

The Children And Parents In Focus Project: A Population-Based Cluster-Randomised Controlled Trial To Prevent Behavioural And Emotional Problems In Children, R. Salari, H. Fabian, Ron Prinz, S. Lucas, I. Feldman, Amanda Fairchild, A. Sarkadi

Faculty Publications

Background: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. Methods/Design: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in …

The Core Competencies For Public Health Professionals, Center For Leadership In Public Health Practice

Florida Public Health Training Center

Core competencies for public health professionals are competencies that represent a set of skills, knowledge, and attitudes necessary for the broad practice of public health, as they apply to front-line staff, senior-level staff, and supervisory and management staff. We will describe the Core Competencies for Public Health Professionals by defining the related key terminology, reviewing how the Core Competencies are designed for all public health professionals at the various stages of their career, and presenting the Domains of the Core Competencies.

Relationship Between Nonmedical Benzodiazepine Use And Psychiatric Disorders Among Rural Appalachian Drug Abusers, Derek Szesny

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Background: Inhabitants of Appalachian Kentucky are encumbered by tremendous health disparities, exhibit high rates of prescription drug abuse, and often co-present with psychiatric disorders. Compared to opioids, little research has focused on the nonmedical use of benzodiazepines.

Objective: To examine the association between nonmedical benzodiazepine use and major depressive disorder (MDD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and anti-social personality disorder (ASPD) in a population of opioid drug abusers.

Methods: Data for this cross-sectional study was obtained from the Social Networks among Appalachian People (SNAP) study. Contingency tables analysis and the

X2statistic were used to …

The Effect Of State Expansion Of Medicaid Eligibility On Uninsurance Rates And Health Outcomes Of Nonelderly Adulst, Lazarus Ude Eze

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Background:

Arizona, New York, and Maine expanded Medicaid eligibility to include nonelderly non-disabled childless adults between 2001 and 2002. This study examines whether this policy affects the percentage of uninsured nonelderly adult population and years of potential life lost in the state.

Methods

I compared the three states with Medicaid expansion with three other states with similar demographic characteristics but without expansions. The study population consists of uninsured adults between ages of 19 and 64 years of income equals or below 138% federal poverty level. I carried out a paired-samples t-test on the data and also plotted a line …

Health Status And Care Access Of The Uninsured In Kentucky, Douglas Keith Branham

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

ABSTRACT/EXECUTIVE SUMMARY

With the individual mandate of the Patient Protection and Affordable Care Act (ACA) set to go into effect in 2014, as well as the Medicaid expansion in some states, the federal and state governments have a difficult road ahead planning how to respond to the anticipated increase in health services use. Kentucky is an undecided state regarding the Medicaid expansion and as one of the more impoverished states in the U.S. potentially has much to gain from the new law.

Many studies have focused on the U.S. as a whole in describing the health status of the uninsured. …

The Impact Of Discontinuing Coverage Of Second Generation Antihistamines In A Managed Care Organization, Matthew D. Harman

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

ABSTRACT Background: Second generation antihistamines (SGAs) are approved to treat seasonal and/or perennial allergic rhinitis (AR) and chronic idiopathic urticaria (CIU). It is estimated that 82% of Americans with AR use antihistamines, with the majority using SGAs due to their low side effect profile. As policy, over-the-counter (OTC) SGAs were not covered in this health plan population (cetirizine and loratadine products were available OTC prior to the study period, while fexofenadine products became available OTC during the study period). On January 1, 2012, the policy was extended to remove coverage of prescription-only SGAs (included desloratadine and levocetirizine products). Objectives: To …

Family-Focused Physical Activity, Diet, And Obesity Interventions In African-American Girls: A Systematic Review, Daheia J. Barr-Anderson, Alexis W. Adams-Wynn, Katherine I. Disantis, Shiriki Kumanyika

Faculty Publications

Obesity interventions that involve family members may be effective with racial/ethnic minority youth. This review assessed the nature and effectiveness of family involvement in obesity interventions among African-American girls aged 5-18 years, a population group with high rates of obesity. Twenty-six databases were searched between January 2011 and March 2012, yielding 27 obesity pilot or full-length prevention or treatment studies with some degree of family involvement and data specific to African-American girls. Interventions varied in type and level of family involvement, cultural adaptation, delivery format, and behavior change intervention strategies; most targeted parent-child dyads. Some similarities in approach based on …

Social And Behavioral Sti Risk Factors: Comparing A Two-Year Community College Setting To A Four-Year University Setting, Oswald M. Attin

Faculty Publications and Presentations

No abstract provided.

Tackling Overweight And Obesity: Does The Public Health Message Match The Science?, Katherine Hafekost, David Lawrence, Francis Mitrou, Therese O'Sullivan, Stephen Zubrick

Research outputs 2013

Background: Despite the increasing understanding of the mechanisms relating to weight loss and maintenance, there are currently no validated public health interventions that are able to achieve sustained long-term weight loss or to stem the increasing prevalence of obesity in the population. We aimed to examine the models of energy balance underpinning current research about weight-loss intervention from the field of public health, and to determine whether they are consistent with the model provided by basic science. EMBASE was searched for papers published in 2011 on weight-loss interventions. We extracted details of the population, nature of the intervention, and key …

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Elite Athletes' Survival Advantage: Could Be Shared By All Through Physical Activity, Adrian E. Bauman, Steven N. Blair

Faculty Publications

No abstract provided.

Smokers’ Vs. Non-Smokers’ Attitudes Toward Tobacco Usage, Jeff W. Totten, Betty J. Cayton

Atlantic Marketing Journal

The purpose of the study was to collect attitudinal and behavioral data on a sample of college students from a Southern state university regarding tobacco usage. The sample was designed to include both smokers and non-smokers. A non-probability sample of 508 college students was collected by handing out surveys in classes and in campus buildings. The questionnaire was designed by the students and the authors and included half of Pechmann and Shih’s (1999) smoking perceptions scale items. Users made up 36.6% of the sample. The average length of time reported using tobacco products was five years, with 78.3% stating they …

Expanding Delivery System Research In Public Health Settings: Lessons From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg

Health and Clinical Sciences Faculty Publications

BACKGROUND: Delivery system research to identify how best to organize, finance, and implement health improvement strategies has focused heavily on clinical practice settings, with relatively little attention paid to public health settings-where research is made more difficult by wide heterogeneity in settings and limited sources of existing data and measures. This study examines the approaches used by public health practice-based research networks (PBRNs) to expand delivery system research and evidence-based practice in public health settings.

METHODS: Practice-based research networks employ quasi-experimental research designs, natural experiments, and mixed-method analytic techniques to evaluate how community partnerships, economic shocks, and policy changes impact …

Body Mass Index Trajectories From Adolescence To Midlife: Differential Effects Of Parental And Respondent Education By Race/Ethnicity And Gender, Katrina M. Walsemann, Jennifer A. Ailshire, Bethany A. Bell, Edward A. Frongillo

Faculty Publications

Objectives: Race/ethnicity and education are among the strongest social determinants of body mass index (BMI) throughout the life course, yet we know relatively little about how these social factors both independently and interactively contribute to the rate at which BMI changes from adolescence to midlife. The purpose of this study is to 1) examine variation in trajectories of BMI from adolescence to midlife by mothers' and respondents' education, and 2) determine if the effects of mothers' and respondents' education on BMI trajectories differ by race/ethnicity and gender.

Design: We used nationally representative data from the National Longitudinal Survey of Youth …

The Effect Of Exercise Training Modality On Serum Brain Derived Neurotrophic Factor Levels In Individuals With Type 2 Diabetes, Damon L. Swift, Neil M. Johannsen, Valerie H. Myers, Conrad P. Earnest, Jasper A. J. Smits, Steven N. Blair, Timothy S. Church

Faculty Publications

Introduction: Brain derived neurotrophic factor (BDNF) has been implicated in memory, learning, and neurodegenerative disease. However, the relationship of BDNF with cardiometabolic risk factors is unclear, and the effect of exercise training on BDNF has not been previously explored in individuals with type 2 diabetes.

Methods: Men and women (N=150) with type 2 diabetes were randomized to an aerobic exercise (aerobic), resistance exercise (resistance), or a combination of both (combination) for 9 months. Serum BDNF levels were evaluated at baseline and follow-up from archived blood samples.

Results: Baseline serum BDNF was not associated with fitness, body composition, anthropometry, glucose control, …

Dose-Response Effects Of Exercise Training On The Subjective Sleep Quality Of Postmenopausal Women: Exploratory Analyses Of A Randomised Controlled Trial, Christopher E. Kline, Xuemei Sui, Martica H. Hall, Shawn D. Youngstedt, Steven N. Blair, Conrad P. Earnest, Timothy S. Church

Faculty Publications

Objective: To investigate whether a dose-response relationship existed between exercise and subjective sleep quality in postmenopausal women. This objective represents a post hoc assessment that was not previously considered.

Design: Parallel-group randomised controlled trial.

Setting: Clinical exercise physiology laboratory in Dallas, Texas.

Participants: 437 sedentary or overweight/obese postmenopausal women.

Intervention: Participants were randomised to one of four treatments, each of 6 months of duration: a non-exercise control treatment (n=92) or one of three dosages of moderate-intensity exercise (50% of VO_2peak), designed to meet 50% (n=151), 100% (n=99) or 150% (n=95) of the National Institutes of Health Consensus Development …