Health Services Research Commons^™

Competition And Collaboration, Chicago-Style, Laura A. Dummit, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to Chicago, Illinois, March 16-18, 2008 to consider how competition and collaboration have shaped Chicago?s health care market. Chicago is a study of contrasts between wealth and poverty and between large, internationally known facilities and struggling community hospitals. The stressed state of the county health system concerned all of the stakeholders and may be an impetus for increased cooperation among the haves and the have nots. No longer waiting for state health reform efforts, key players were working to shore up needed providers and develop a more equitable distribution of resources, …

Completing The Recipe For Children's Health: New Variations On Key Ingredients: A Report From The Workshop On June 28, 2007, Jennifer Ryan

National Health Policy Forum

This paper offers a broad overview of the issues surrounding the social and environmental determinants of children’s health. These issues were explored during a discussion convened by the National Health Policy Forum on June 28, 2007, among a group of individuals concerned about the influences beyond medical care on the health of children. The paper considers the policy and financing tensions that exist across programs and populations that make addressing the full range of influences challenging. It also highlights some of the community-based initiatives that have been successful in providing services to children and families, as described during the workshop. …

Finding Order In Complexity: A Typology Of Local Public Health Delivery Systems, Glen P. Mays, F. Douglas Scutchfield, Michelyn Bhandari, Sharla A. Smith

Health Management and Policy Reports

Public health decision-makers and researchers currently lack an evidence-based framework for describing, classifying, and comparing public health delivery systems based on their organizational components, operational characteristics, and division of responsibility. Related typologies developed in the health services sector have proven extremely valuable for policy and administrative decision-making as well as for ongoing research. Performance assessment, quality improvement, and accreditation activities are now blossoming in public health—adding urgency to the need for classification and comparison frameworks. This brief describes a newly-developed empirical typology for local public health systems and highlights its policy and managerial applications.

Pharmacogenomics: A Primer For Policymakers, Leslie Tucker

National Health Policy Forum

Researchers are exploring how genetic variations among individuals may help explain why a drug can work well in some people and poorly (or not at all) in others, including those who appear to have the same disease. Pharmacogenomics, as this new field is called, aims to help physicians make use of genetic tests to distinguish among patients whose genetic characteristics predispose them to respond in certain ways to certain medicines. If physicians can use this information to quickly and reliably choose the appropriate drug at the most effective dose for each patient, they may produce better patient outcomes and save …

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Management Faculty Research

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …

The Relationship Between Agency Characteristics And Quality Of Home Care, Dawn M. Dalby, John P. Hirdes

Kinesiology and Physical Education Faculty Publications

ABSTRACT. Background. This project assessed the relationship between home care quality indicators HCQIs) and agency characteristics. Methods. Twelve agencies completed a mailed survey on a variety of characteristics, including size of their caseload and for-profit (FP) status of contracted service providers. The HCQIs were derived from standardized assessments completed voluntarily for home care clients in Ontario and in Manitoba, Canada. Results. The average caseload was 121.3 clients per case manager, and over 40% of nursing, personal support and therapy providers were considered FP. For individual HCQIs, few correlations were statistically significant. An overall summary measure of quality was …

Informed Consent In Hiv Prevention Trials: Highlights From An International Workshop, Population Council

HIV and AIDS

Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Consentement Éclairé Dans Les Essais De Prévention Du Vih: Points Saillants D'Un Atelier International, Population Council

HIV and AIDS

Résumé adapté du rapport de l'atelier co-organisé par le Population Council et Family Health International en mai 2005. Le résumé se concentre spécifiquement sur les outils et stratégies présentés lors de l'atelier qui sont utilisés dans les essais de prévention du VIH pour faciliter le consentement éclairé, expliquer concepts difficiles et évaluer la compréhension parmi les participants à l'essai. Des exemples illustratifs d'essais achevés et en cours sont mis en évidence. Ce résumé sera utile à un public de chercheurs locaux, d'avocats et de membres du personnel des essais cliniques.

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Brief adapted from the report of a workshop co-hosted …

Consentimiento Informado En Ensayos De Prevención Del Vih: Aspectos Destacados De Un Taller Internacional, Population Council

HIV and AIDS

Resumen adaptado del informe del taller organizado conjuntamente por el Population Council y Family Health International en mayo de 2005. El resumen se centra específicamente en las herramientas y estrategias presentadas en el taller que se están usando en ensayos de prevención del VIH para facilitar el consentimiento informado, explicar conceptos difíciles, y evaluar la comprensión entre los participantes del ensayo. Se destacan ejemplos ilustrativos de ensayos concluidos y en curso. Este resumen será útil para una audiencia de investigadores locales, defensores y personal de ensayos clínicos.

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Brief adapted from the report of a workshop co-hosted by the Population …

Consentimento Informado Nos Ensaios De Prevenção Do Hiv: Pontos Altos Dum Workshop Internacional, Population Council

HIV and AIDS

Resumo adaptado do relatório do workshop organizado pelo Population Council e Family Health International em maio de 2005. O resumo se concentra especificamente nas ferramentas e estratégias apresentadas no workshop que estão sendo usadas em testes de prevenção do HIV para facilitar o consentimento informado, explicar conceitos difíceis e avaliar a compreensão entre os participantes do estudo. Exemplos ilustrativos de ensaios concluídos e em andamento são destacados. Este resumo será útil para um público de investigadores locais, advogados e equipe de ensaios clínicos.

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Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health …

Sharing Experiences With Comprehensive Responses To Adolescent Reproductive Health Needs In Africa, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

In 1999, the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) project, began a three-year collaboration in Senegal on an adolescent reproductive health (ARH) pilot project that showed that a multisectoral, multidisciplinary approach can increase knowledge, enhance attitudes, and foster positive behaviors for reproductive health. Following requests from several neighboring countries, and given the long collaboration with WHO, FRONTIERS initiated efforts in 2007 to enable utilization of these findings in other African countries. The purpose of this report is to promote the utilization of multisectoral approaches for improving ARH programming by governments, donors, and national and international agencies in francophone …

A Situation Analysis Of Care And Support For Rape Survivors At First Point Of Contact In India And Bangladesh, M.E. Khan, Aruna Bhattacharya, Ismat Bhuiya, Aditi Aeron

Reproductive Health

A situation analysis of post-rape care services available at the first point of contact was conducted in three cities in India and four cities in Bangladesh. The aim of this investigation was to gather information that could be used in the development of a comprehensive care and support system for the rape survivor. Secondarily, the study field-tested sensitive and practical tools that could be used in the future for large-scale situation analyses of the rape survivor services. The results demonstrated that there is no uniform service provision protocol to follow for managing rape survivors at health facilities in India or …

Sexual Behavior And Sti/Hiv Status Among Adolescents In Rural Malawi: An Evaluation Of The Effect Of Interview Mode On Reporting, Barbara Mensch, Paul C. Hewett, Richard Gregory, Stephane Helleringer

Poverty, Gender, and Youth

This paper presents the results from an interview-mode experiment conducted by the Population Council with unmarried young women in rural southern Malawi. To collect data on sexual behavior and the dynamics of HIV transmission, respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. Clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity, yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode, whereas, when …

Childhood Lead Poisoning Prevention Program: 2007-2008 Annual Report, Southern Nevada Health District

Nevada Institute for Children's Research and Policy Reports

The goal of the Southern Nevada Health District Childhood Lead Poisoning Prevention Program (CLPPP) is to eliminate lead poisoning as a significant health risk for children living in the state of Nevada. These efforts started in Clark County, where over 70 percent of the state’s population resides and will expand to Northern and rural Nevada by the end of the grant term.

Managing And Preventing Female Genital Cutting (Fgm/C) Among The Somali Community In Kenya, Maryam Sheikh Abdi, Guyo W. Jaldesa, Ian Askew

Reproductive Health

This report details the Council’s innovative work with religious leaders to reduce the practice of FGM/C in the Somali community in Northern Kenya. In the mid to late 2000s, through the USAID Frontiers project, the Council successfully engaged religious leaders and scholars as community educators to correct the customary misconception that FGM/C is a requirement of Islam. Through sermons and training sessions, these leaders were able to dis-associate FGM/C from Islam, raise public awareness about the harms associated with the practice, and encourage its abandonment.

Technical Assistance To The Interagency Coordination Group Seeking To Reduce Female Genital Mutilation/Cutting, Nafissatou J. Diop

Reproductive Health

This report documents technical assistance provided by FRONTIERS to the Interagency Coordination Group seeking to reduce female genital mutilation/cutting (FGM/C) in sub-Saharan Africa. In particular, staff assisted the group in networking, learning to talk to each other, setting up an operational way of functioning, and influencing key international policy and programmatic documents. Lessons learned through operations research on FGM/C were disseminated widely through the group’s activities and FRONTIERS technical assistance influenced several plans of action and implementation programs. The report notes that in addition to better networking for presenting a common regional vision during the development of policy and programmatic …

Creating The Conditions For Scaling Up The Integration Of Reproductive Health Services For Men In Health And Family Welfare Centers In Bangladesh, M.A. Mannan, Jafar Ahmad Hakim, Syeda Tazneen Waris, Ashraf Ali, Akm Nurul Hakim, Abdul Hannan, Sameena Chowdhury, Saria Tasnim, Saiful Islam, Aqm Rezaul Karim, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan

Reproductive Health

An operations research study, supported by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, showed that reproductive health services for men could be feasibly and acceptably integrated within the Health and Family Welfare Centres in Bangladesh, which have been primarily women-centered health facilities. Given these findings, a follow-up study was implemented to create the conditions for scaling up the model through identifying and piloting the operational details to consider when taking the intervention to scale. The findings presented in this report suggest that this model of service delivery and training can be scaled up countrywide, preferably in stages. To …

Strengthening The Financial Sustainability Of Two Population Services And Training Center (Pstc) Clinics (Bangladesh), Population Services And Training Center (Pstc), Frontiers In Reproductive Health

Reproductive Health

The Population Services and Training Center of Bangladesh (PSTC) operates 15 clinics and 150 satellite posts that provide an Essential Services Package (ESP) to the poor, consisting of child health, family planning, maternal health, communicable disease treatment, and limited curative care. The objective of this study was to conduct an operations research study to determine the feasibility of improving cost recovery in two clinics by raising prices. It appears that the study design was too ambitious for PSTC, a service delivery organization with no prior research experience. Lack of experience was compounded by the resignation of all three PSTC research …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In The Dominican Republic, Gisela Quiterio, Maritza Molina, Marija Miric, Ricardo Vernon, M. Estela Rivero-Fuentes

Reproductive Health

A diagnostic study of the provision and use of contraception in postpartum, postabortion, and prevention of mother-to-child transmission (PMTCT) programs in the Dominican Republic was conducted with funding from USAID. The objectives of the study were to assess the contraceptive knowledge, attitudes, and behaviors of providers and clients; the degree to which information, counseling, and delivery are implemented in postpartum, postabortion, and PMTCT services; the quality of these services; and the readiness of postpartum, postabortion, and PMTCT services to offer contraceptive services. The report finds that family planning services are linked to antenatal, delivery, and postpartum care in most of …

Helping Egyptian Women Achieve Optimal Birth Spacing Intervals Through Fostering Linkages Between Family Planning And Maternal/Child Health Services, Nahla G. Abdel-Tawab, Sarah Loza, Amal Zaki

Reproductive Health

The Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Egyptian Ministry of Health and Population and the NGO Social Planning, Analysis and Administration Consultants, conducted an operations research study to measure the acceptability and effectiveness of two birth spacing message models in Upper Egypt. Overall, the study found that providing birth spacing messages to low-parity women during antenatal and postpartum care and also to husbands through community awareness activities was feasible and acceptable. As a result, birth spacing messages have been integrated into service delivery guidelines for antenatal and postpartum care, and IEC materials on …

Enhancing Utilization Of The Findings From The Youth Reproductive Health Project In Senegal, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

This operations research (OR) study focused on providing information appropriate to the cultural context of Senegalese adolescents on a variety of reproductive health issues including: knowledge of the human body; puberty; sexuality; gender roles; different cultural, familial, and peer values regarding sexual and reproductive behavior; contraception; responsible parenthood; STIs and AIDS; and sources of help and services. The study was undertaken in three urban communities in northern Senegal and had an overall positive result on young people's reproductive health knowledge, enhanced community understanding of youth reproductive health needs, and showed that a multisectoral approach is vital to supporting young people’s …

Strengthening Health And Family Planning Services In Low Performing And Hard-To-Reach Areas Of Bangladesh: Workshop Report, Ubaidur Rob, Md. Noorunnabi Talukder

Reproductive Health

Although Bangladesh has established a comprehensive physical infrastructure to deliver health and family planning services with a network of primary health care facilities in rural areas, the impact of this health service network has been much less than expected because services do not reach all regions effectively. Two divisions, Sylhet and Chittagong, remain the most disadvantaged in terms of health and population outcomes and access to services, compounded by poor utilization of facilities in these areas. Moreover, the current health and population sector programs are beset with human resources and infrastructural problems. The Population Council organized a workshop to find …

Operations Research For Managers Of Reproductive Health Programs, James R. Foreit, M.E. Khan

Reproductive Health

The course presented in this publication defines operations research (OR) as the study of factors under the control of health program managers and other decision-makers. The purpose of OR is to improve programs and provide information for management decision-making. Successful OR is characterized by a close collaboration between program managers and researchers throughout the study. The course focuses on OR as a branch of the behavioral sciences and deals with formative research and field experiments. It concentrates on improving the research knowledge of managers who have had little or no training in research. The focus of this interactive course is …

India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council

Reproductive Health

A quality assurance (QA) procedure was pilot-tested and subsequently scaled up throughout the state of Gujarat, India, after demonstrating that a 65-item checklist is an efficient tool for identifying and remedying gaps in service delivery. From 2004–06, FRONTIERS developed and tested a standardized QA procedure. The State Ministry of Health and Family Welfare (MOHFW) used the procedure to assess health-care services in rural clinics in two pilot districts each in the states of Gujarat and Maharashtra. Based on positive results, the State MOHFW expanded the QA procedure in a phased manner throughout all 25 districts of Gujarat. The model is …

Clark County Child Death Review: 2008 Annual Report, Nevada Institute For Children’S Research And Policy, Tara Phebus, Denise Tanata Ashby, Karen Z. Silcott

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

Snapshot 2008: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Modeling Physical Activity In Working Adults: How Suitable Is The Expanded Parallel Process Model?, Adwoa B-H-Sam

Health Services Research Dissertations

This study is an assessment of the usefulness of the Expanded Parallel Process Model in predicting health enhancing physical activity as an outcome variable. The theory is tested in the context of risk for coronary heart disease and involves secondary analyses of a dataset from a group of working adults. These individuals had elected first to participate in a health plan ‘Quality Improvement Study’ and were then randomly selected to receive an intervention program designed to get people to be more active.

Data on self-reported demographics, physical activity levels, health status characteristics and perceptions measured on a Likert-type scale known …