Health Services Research Commons^™

Tingkat Pengetahuan Dan Persepsi Terhadap Shisha Pada Mahasiswa, Dhimas Nirwana Yudha, Yayi Suryo Prabandari, Purwanta Purwanta

Kesmas

Isu yang berkembang terkait pengetahuan dan persepsi seorang calon tenaga kesehatan memengaruhi keberhasilan pelayanan kesehatan dalam menjawab tantangan di masyarakat nantinya. Shisha (rokok dari Timur Tengah) mulai marak di Yogyakarta. Tujuan penelitian ini untuk memperoleh gambaran tentang tingkat pengetahuan dan persepsi terhadap shisha pada mahasiswa reguler tahap akademik Fakultas Kedokteran Universitas Gadjah Mada. Penelitian ini merupakan penelitian deskriptif menggunakan rancangan potong lintang. Sampel penelitian adalah mahasiswa dari tiga program studi yang dilakukan pada bulan September - Oktober 2013. Jumlah responden sebanyak 72 mahasiswa ilmu keperawatan, 74 mahasiswa gizi dan kesehatan dan 258 mahasiswa pendidikan dokter. Pengumpulan data dilakukan dengan kuesioner. …

Pattern Of Household Drug Storage, Retno Gitawati

Kesmas

Household storage of pharmaceutical is world-widely practice, including in Indonesia. The purpose of this study was to obtain the pattern of medicine storage, the sources and reasons of medicine kept in households. Acrosssectional survey was conducted on October 2011, involving 250 adult household respondents, randomly selected from three subdistricts in North Jakarta, and have approved the written consents, and interviewed with structured questionnaire. Data were performed in univariate and bivariate analysis with chi square test. The majority of household (82%) stored drugs at home; analgesic-antipyretic nonsteroidal anti-inflammatory was the type of drugs kept by mostly (76.1%) of household. Out of …

Diagnosis Dini Tuberkulosis Pada Kontak Serumah Dengan Penderita Tuberkulosis Paru Melalui Deteksi Kadar Ifn-Γ, Sri Andarini Indreswari, Suharyo Suharyo

Kesmas

Tuberkulosis paru masih merupakan masalah dunia. Indonesia menempati peringkat ke tiga di dunia pada tahun 2012. Target nasional Case Detection Rate tahun 2012 adalah 70%, sedangkan pencapaian Jawa Tengah sebesar 58,48%. Penelitian ini bertujuan untuk memperoleh batas kadar interferon (IFN) γ pada orang kontak serumah dengan penderita tuberkulosis paru sebagai dasar diagnosis dini penyakit tuberkulosis. Penelitian dilakukan secara kohort selama dua tahun (2011 - 2013) di Balai Kesehatan Masyarakat Paru Semarang. Pada akhir penelitian, terdapat 12 responden kontak dan 13 tidak kontak serumah. Uji Wilcoxon menunjukkan perbedaan bermakna rerata kadar IFN-γ antara kelompok kontak dengan kelompok tidak kontak serumah (nilai …

Peningkatan Determinan Sosial Dalam Menurunkan Kejadian Tuberkulosis Paru, Dyah Wulan Sumekar Rengganis Wardani

Kesmas

Upaya pengendalian tuberkulosis paru oleh World Health Organization telah meningkatkan angka kesembuhan dan menyelamatkan banyak jiwa, tetapi kurang berhasil dalam menurunkan insiden tuberkulosis. Oleh karena itu, pengendalian tuberkulosis akan lebih menekankan pada kebijakan determinan sosial karena determinan sosial secara langsung maupun melalui faktor risiko tuberkulosis berpengaruh terhadap tuberkulosis. Di Bandar Lampung, angka notifikasi tuberkulosis dari tahun 2009 – 2010 mengalami peningkatan walaupun angka kesembuhan sudah lebih dari 85%. Bandar Lampung juga merupakan bagian dari salah satu provinsi termiskin di Indonesia. Penelitian ini bertujuan untuk mempelajari pengaruh determinan sosial (yang diukur melalui indikator pendidikan, pendapatan dan kelas sosial) terhadap kejadian tuberkulosis. …

Pertumbuhan Dan Perkembangan Anak Usia 3-24 Bulan Di Daerah Konflik, Hastuti Usman, Hadyana Sukandar, Ma’Mun Sutisna

Kesmas

Lima tahun pertama adalah masa penting dalam proses tumbuh kembang anak. Anak lahir dan tinggal di daerah rawan bencana (bencana alam, perang, atau konflik bersenjata) berisiko mengalami kegagalan pertumbuhan dan keterlambatan perkembangan. Penelitian ini bertujuan mengukur perbedaan pertumbuhan dan perkembangan anak usia 3 - 24 bulan antara yang tinggal di daerah konflik dan bukan konflik dan menganalisis korelasi tempat tinggal daerah konflik dengan pertumbuhan serta perkembangan anak usia 3 - 24 bulan. Metode penelitian secara potong lintang dilakukan di Kabupaten Poso periode Februari - Maret 2014 terhadap 40 anak usia 3 - 24 bulan di daerah konflik dan bukan konflik. …

Malnutrisi Akut Berat Dan Determinannya Pada Balita Di Wilayah Rural Dan Urban, Titih Huriah, Laksono Trisnantoro, Fitri Haryanti, Madarina Julia

Kesmas

Malnutrisi akut berat merupakan malnutrisi yang paling serius yang memengaruhi balita dan merupakan masalah kesehatan utama di negara-negara berkembang. Malnutrisi telah meluas baik di perkotaan maupun perdesaan. Akar permasalahan malnutrisi di negara berkembang salah satunya adalah faktor sosial demografi. Tujuan penelitian untuk melihat perbedaan kejadian malnutrisi dan determinannya di area perkotaan dan pedesaan di Yogyakarta. Penelitian menggunakan desain potong lintang dengan responden adalah semua balita malnutrisi akut berat di Kabupaten Sleman (23 balita) dan Kota Yogyakarta (33 balita). Analisis data menggunakan statistik deskriptif dan inferensial. Penelitian dilaksanakan pada Bulan Desember 2012 - Februari 2013. Prevalensi balita malnutrisi akut lebih banyak …

Family Role Towards Smoking Behaviour Among Children In Jakarta, Wahyu Septiono, Dan Wolf Meyrowitsch

Kesmas

In Indonesia, the prevalence of smoking among 5 – 9 years old children has increased from 0.4% in 2001 to 2% in 2007. Among present adults smokers (>20 years), 17% started to smoke before the age of 13 years. This study identified factors related to smoking behaviour among 8 – 12 years old children in Jakarta, Indonesia using a questionnaire based cross sectional survey to obtain smoking status and possible predictors towards smoking habit. The total sample size was 1,097 students among 3rd - 7th grade students from schools in Jakarta. Self-reported smoking status was defined as whether the …

Evaluasi Pelaksanaan Konseling Menyusui, Ika Murtiyarini, Dewi Marhaeni Diah Herawati, Irvan Afriandi

Kesmas

Salah satu upaya pemerintah dalam meningkatkan pemberian ASI di Indonesia adalah dengan memberikan konseling menyusui di pelayanan kesehatan. Penelitian perlu dilakukan untuk mengevaluasi pelaksanaan konseling menyusui di Kota Jambi dengan mengeksplorasi komponen input, activity, output, dan outcome. Penelitian ini merupakan penelitian kualitatif menggunakan strategi studi kasus. Penelitian dilakukan di empat puskesmas Kota Jambi pada bulan Desember 2013 sampai dengan Februari 2014. Pengumpulan data dilakukan dengan studi dokumen, observasi pelaksanaan konseling menyusui dan sarana prasarana, wawancara mendalam, serta focus group discussion. Analisis data yang digunakan adalah analisis tematik. Hasil penelitian menunjukkan bahwa komponen input dan activity kurang optimal seperti kurangnya sumber …

Asupan Vitamin D Rendah Dan Keparahan Demam Berdarah Dengue Pada Anak Usia 1-14 Tahun, Nur Siyam, Siswanto Agus Wilopo, Mohammad Hakimi

Kesmas

Demam berdarah dengue (DBD) menimbulkan syok dan kematian. Penderita DBD di Yogyakarta sebagian besar usia 1 - 12 tahun dengan DBD parah. Asupan vitamin D rendah diasumsikan penyebab DBD parah. Asumsi ini perlu dibuktikan dengan menganalisis pengaruh asupan Vitamin D dan keparahan DBD. Rancangan penelitian adalah studi kasus kontrol. Penelitian di bangsal rawat inap anak dan instalasi catatan medik RS Jogja dan RSUP Dr. Sardjito. Kasus adalah anak usia 1 - 14 tahun dengan DBD grade III & IV, kontrolnya DBD grade I & II. Data asupan vitamin D diambil dengan food frequency questionnaire (FFQ). Variabel luar adalah indeks massa …

Racial Disparities In Access To Community Water Supply Service In Wake County, North Carolina, Jacqueline Macdonald Gibson, Nicholas Defelice, Daniel Sebastian, Hannah Leker

Frontiers in Public Health Services and Systems Research

Anecdotal evidence suggests that historically African American communities on the fringes of cities and towns in North Carolina have been systematically denied access to municipal drinking water service. This paper presents the first statistical analysis of the role of race in determining water access in these fringe areas, known as extraterritorial jurisdictions. Using publicly available property tax data, we quantified the percentage of residences with municipal water service in each census block in Wake County (the second-largest by population in North Carolina). Using the resulting water service maps plus 2010 U.S. Census data, we employed a logistic regression to assess …

Economies Of Scale And Scope In Public Health: An Analysis Of Food Hygiene Services Provided By Local Health Departments In Florida, Simone Singh, Patrick M. Bernet

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) across the United States deliver a range of essential public health services, yet little is known about the costs that LHDs incur in providing these services and the factors that may cause costs to vary both within and across health departments. This report first describes the variations in the costs of one core public health activity commonly provided by LHDs: food hygiene services. It then analyzes the factors that drive LHDs' cost of service provision focusing on the role of economies of scale and economies of scope. Using data for all LHDs in Florida for 2008 …

Editorial Comment: Temporal Trends In Preparedness Capacity, Gulzar H. Shah

Frontiers in Public Health Services and Systems Research

In view of the critical role local health departments (LHDs) play among agencies responsible for responding to natural and man-made emergencies, Bevc et al. examined the LHDs’ emergency preparedness and capacity. They compared LHDs in North Carolina with those across the country for preparedness along eight domains. Significant declines in emergency preparedness were noted from 2010 to 2012 for five out of eight domains, raising questions about our national priority concerning this important function of public health agencies. These findings have numerous implications, some of which are covered in this commentary.

Temporal Trends In Local Public Health Preparedness Capacity, Christine A. Bevc, Mary V. Davis, Anna P. Schenck

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) are essential to emergency preparedness and response activities. Since 2005, LHD resources for preparedness, including personnel, are declining in the face of continuing gaps and variation in the performance of preparedness activities. The effect of these funding decreases on LHD preparedness performance is not well understood. This study examines the performance of preparedness capacities among NC LHDs and a matched national comparison group of LHDs over three years. We observe significant decreases in five of eight preparedness domains from three years of survey data collected from 2010 through 2012. Most notably, we observe significant decreases in …

Measures Of Highly Functioning Health Coalitions: Corollaries For An Effective Public Health System, Priscilla A. Barnes, Paul C. Erwin, Ramal Moonesinghe

Frontiers in Public Health Services and Systems Research

In Tennessee, health coalitions provide guidance in conducting community assessments, health improvement plans and policies and delivering of health and human services, which are considered core functions of public health. In fact, it has been postulated that these coalitions may serve as the organizational embodiment of the local public health system (LPHS). This study identifies functional characteristics of 63 Tennessee County Health Councils (CHCs), advisory councils to local and regional governmental public health agencies on broad issues of health, that contribute to its ability to operate as the primary advising entity of the LPHS. Exploratory factor analysis was conducted on …

Black Is Decidedly Not Just Black: A Case Study On Hiv Among African-Born Populations Living In Massachusetts, Chioma Nnaji, Nzinga Metzger

Trotter Review

Black or African American is a racial category that includes the descendants of enslaved Africans as well as members of foreign-born black communities who migrated to the United States from places abroad, such as Africa, the Caribbean, and Latin America. Grouping native-born and foreign-born blacks into a single homogeneous racial category may make it easier to track disease and health outcomes; however, it masks the different cultural experiences, histories, languages, social and moral values, and expectations that influence health beliefs, attitudes, practices, and behaviors. It also ignores such factors as migration, which forces foreign-born populations to examine both their traditional …

Social Actors Fight The Rising Tide Of Hiv In U.S. Southern Poor, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

The greatest number of persons living with HIV in the United States are now living in the South, and they face poorer health outcomes and increased AIDS-related deaths as compared to the rest of the country. The southern United States has a disproportionate share of low-income individuals, with many lacking access to health care and health insurance. Health facilities are also comparatively fewer and more difficult to reach than in other areas of the United States. The impacts of this already poor health infrastructure on low-income people living with HIV in the South can be life-threatening.

This policy brief summarizes …

Factors Associated With Quality Of Life Among Mothers Of Children With Autism Spectrum Disorder, Marian Marconyak

Health Services Research Dissertations

The increasing prevalence of Autism Spectrum Disorder (ASD) has levied associated effects upon the quality of life (QOL) of mothers of children with ASD. These mothers are subjected to various influences upon their lives as a result of their role as caregivers to children with ASD. The purpose of this study was to assess the International Classification of Functioning, Disability and Health (ICF) Body Functions and Structures, Activities, Participation, Environmental, and Personal Factors associated with QOL among mothers of children with ASD.

English literate, inhabitants of the United States, mothers over the age of 18, of children with ASD were …

Modeling Solutions For Prevention Of Medicare Insolvency For The Baby Boomer Generation (Born 1946 - 1964), Gregory Thomas Scott

Health Services Research Dissertations

Medicare, a United States social insurance program operated by the United States federal government, began operating in a deficit in the year 2010. More funding was expended than revenue received for medical care, creating significant shortfalls for the Medicare Trust Fund. This study examined possible initiatives to describe Medicare funding related to issues as financial shortfalls utilizing mathematical modeling and simulation. The Park Conceptual Model is a framework created to identify internal and external changes that influence bankruptcies related to municipalities, and this Model served as the theoretical basis for this study.

The following study addressed insolvency as negative cash …

How Medicaid Expansions And Future Community Health Center Funding Will Shape Capacity To Meet The Nation’S Primary Care Needs: A 2014 Update, Leighton Ku, Julia Zur, Emily Jones, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Learning From Networks: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays

Health Management and Policy Presentations

Social network analysis methods offer many avenues of inquiry for studying new developments in health policy and health care delivery. The expanding availability of large linkable electronic clinical and administrative data sources allows for novel SNA applications with dependent data structures. Opportunities include the study of delivery patterns within accountable care organizations (ACOs), and other multi-provider networks, price and quality competition within new health insurance exchanges, and population health effects attributable to complex community-level interventions.

Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …

Congestive Heart Failure Self-Management Among Us Veterans: The Role Of Personal And Professional Advocates, Eleni Skaperdas, Anaïs Tuepker, Christina Nicolaidis, Jessica K. Robb, Devan Kansagara, David H. Hickam

School of Social Work Faculty Publications and Presentations

Objective: Understand patients’ experiences with primary care services for congestive heart failure (CHF) and explore the relationship between health services and self-management.

Methods: We conducted semi-structured interviews with thirty-nine patients with CHF receiving care at one Veterans Affairs Medical Center (VA). We analyzed data using thematic content analysis.

Results: Participants acknowledged the importance of ongoing engagement in the plan of care for CHF. They attributed success in this effort to be greatly influenced by personal advocates. The advocates included both members of the healthcare team with whom they had a continuity relationship and friends or family members who assisted on …

Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays

Health Management and Policy Presentations

This session reviews progress in the field of public health services & systems research (PHSSR), with a specific focus on findings that can inform the implementation and impact of health reform strategies on the U.S. public health system.

Using Chipra Immunization Measures For Primary Care Quality Improvement: Leveraging Registry Data From The State Of Maine’S Immunization Information System To Calculate Practice-Level Quality Measures, Kyra Chamberlain

Muskie School Capstones and Dissertations

This report describes key challenges and successes of a federally-funded, cross-organizational effort to use registry data from the State of Maine’s Immunization Information System to calculate childhood and adolescent immunization measures in support of a nine-month, multi-practice learning collaborative which resulted in significant increases in immunization rates and adoption of recommended immunization-related office system procedures. Also highlighted are lessons learned about promoting the use of standardized immunization measures for quality improvement (QI), supporting primary care practices in using and understanding data for QI activities, and emphasizing the value of public-private collaboration in achieving shared goals.

Assessing The Potential Impact Of The Affordable Care Act On Uninsured Community Health Center Patients: An Update, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Producing Population Health: Collective Action Requires Infrastructure, Incentives & Evidence, Glen P. Mays

Health Management and Policy Presentations

Population health improvement strategies are collective action problems that require targeted infrastructure, incentives, and information to succeed. Research on collective action problems and solutions in public health and other spheres of practice offer insight for the successful scale and spread of population health innovations.

Latinas And The Traditional Genetic Counseling Model: A Qualitative Study, Stephanie Thompson

Dissertations and Theses (Open Access)

The traditional genetic counseling model reflects an individualized counseling session that includes the presentation of information about genes, chromosomes, personalized risk assessment, and genetic testing and screening options. Counselors are challenged to balance providing educational information with discussion of implications of this information in an allotted amount of time. The aim of this study was to explore the perceptions of pregnant Latinas on the benefits and limitations of the traditional prenatal genetic counseling model and to determine the specific preferences for receiving prenatal genetic counseling. Data were collected through focus groups and one-on-one, semi-structured interviews of twenty-five Spanish speaking Latinas …

Caregiving And The Experience Of Health And Illness In Children Living With Hiv/Aids In Gulu District Northern Uganda: An Ethnographic Research Narrative, Constantine S.L. Loum Phd

Patient Experience Journal

In this paper we discuss the experience of caregiving for children living with HIV in a resource poor environment in Gulu municipality in northern Uganda; the main research questions of the study were: what are the perceptions of caregivers on the care of children with HIV, and what barriers and enablers exist that undermine or promote better care for children respectively? The experience of caregivers and their perceptions on managing HIV in children is believed to shape the health seeking behaviour towards treatment and efforts to cope with its negative impact on the body. Women and children are the greatest …

The Role Of Governing Boards In Improving Patient Experience: Attitudes And Activities Of Health Service Boards In Victoria, Australia, Marie Bismark, Susan Biggar, Catherine Crock, Jennifer M. Morris, David M. Studdert

Patient Experience Journal

The authors sought to determine the attitudes of public health service board members and senior executives toward patient experience and to describe the governance activities of the boards in this area. The study was based on an online survey of 322 board members from 85 public health services and semi-structured interviews with 35 board members and senior executives from 13 public health services in Victoria, Australia. The results showed that while some health service boards had high aspirations and clear plans for improving patient experience, others remained sluggish or even cynically resistant to changing their existing models of care. Interviewees …

Patients’ Experiences In The Uk: Future Strategic Directions, Sophie Staniszewska, Neil Churchill

Patient Experience Journal

Over the last decade policy has emphasised the importance of a good patient experience as a cornerstone of high quality health and social care in the UK, with many initiatives attempting to develop patient-centred practice. More recently, the Francis Inquiry has addressed the significant failings in care identified at Mid Staffordshire NHS Foundation Trust in England and has been pivotal in raising the importance of patient experience.¹ The Francis report made 290 recommendations, with many emphasizing the importance of patient experience through their focus on specific ways in which the quality of experiences can be enhanced, for example, by …