Health Services Research Commons^™

Factors Affecting The Utilization Of Antenatal Care Among Married Women Of Reproductive Age In The Rural Thatta, Pakistan: Findings From A Community-Based Case-Control Study, Sumera Aziz Ali, Savera Aziz Ali, Anam Feroz, Sarah Saleem, Zafar Fatmi, Muhammad Masood Kadir

Community Health Sciences

Background: There are differences in antenatal care (ANC) utilization between urban and rural areas of Pakistan. Although multiple factors have been studied affecting the utilization of general health care services, the effect of road network distance particularly on the utilization of ANC has not been assessed. Therefore, this study aimed to determine the association between road network distance from a health care facility and utilization of the ANC among women of reproductive age in Thatta Pakistan.
Methods: A community-based case-control study was conducted in district Thatta, Pakistan. Women who did not utilize ANC services during their last pregnancy were considered …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training To The Fee-For-Service Medicare Population, Christian Rhudy, Aric Schadler, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2016, rural fee-for-service (FFS) Medicare beneficiaries represented 21.7% of the population diagnosed with diabetes, but only 2.7% of the population utilizing Diabetes Self-Management Training.
• Utilization of DSMT services in 2016 occurred in 76 rural counties and 309 urban counties.
• Average utilization rates of DSMT services were greater in rural counties than urban counties (5.5% vs. 2.5%).

Rural/Urban Disparities In The Utilization Of Health And Behavioral Assessments/Interventions In The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2016, rural county residents represented 21.8% of the fee-for-service (FFS) Medicare population, but only 1.6% of rural FFS beneficiaries live in a county with local utilization of Health and Behavioral Assessments and Interventions (HBAI) services.
• Utilization of HBAI services in 2016 occurred in 19 (9.7%) rural counties and 176 (90.3%) urban counties.
• Average utilization rates of HBAI services were higher in rural counties than urban counties (0.7% vs. 0.4%).

Rural/Urban Disparities In Utilization Of Medical Nutrition Therapy To The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2016, 21.8% of the fee-for-service (FFS) Medicare population resided in a rural county, but only 3.7% of enrollees residing in a county with utilization of Medical Nutrition Therapy (MNT) services were rural county residents.
• Utilization of MNT services in 2016 occurred in 92 rural counties and 388 urban counties.
• Average utilization rates of MNT services were greater in rural counties than urban counties (3.1% vs. 1.9%).

Major Depression, Treatment Receipt, And Treatment Sources Among Non-Metropolitan And Metropolitan Adults, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• 7.8% of non-metropolitan (weighted number of persons=2,755,020) and 7.1% of metropolitan (weighted number of persons=14,868,655) adults had past year major depression.
• Treatment receipt (seeing a health professional or using prescription medication for depressive feelings) was similar among non-metropolitan (68.0%) and metropolitan (64.6%) adults.
• A closer examination of the type and source of treatment revealed the following:

• Rates of seeing a health professional were similar among non-metropolitan (60.8%) and metropolitan (58.4%) adults, but rates of using prescription medication for depressive feelings were higher among non-metropolitan (58.2%) than metropolitan (48.6%) adults.
• Rates of visiting a general practice/family doctor …

Nih Funding For Research Underlying New Cancer Therapies, Ekaterina Galkina Cleary, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Contemporary discovery and development of cancer drugs are based on the model that investments in basic biomedical science will provide insights that can be translated into new cures. In the USA, basic research is primarily funded by the National Institutes of Health (NIH),1 which allocates half of its research budget to basic science,2 with smaller amounts contributed by philanthropy, academics, or industry.1 Basic science is formally defined as the “systematic study directed toward fuller knowledge or understanding of the fundamental aspects of phenomena and observable facts without specific application towards processes or products in mind”.3 However, science is often useinspired,4 …

Costs Of Maternity Leave To Support Breastfeeding; Brazil, Ghana And Mexico, Mireya Vilar-Compte, Graciela M. Teruel, Diana Flores-Peregrina, Grace J. Carroll, Gabriela S. Buccini, Rafael Perez-Escamilla

Department of Public Health Scholarship and Creative Works

Objective To develop a method to assess the cost of extending the duration of maternity leave for formally-employed women at the national level and apply it in Brazil, Ghana and Mexico. Methods We adapted a World Bank costing method into a five-step method to estimate the costs of extending the length of maternity leave mandates. Our method used the unit cost of maternity leave based on working women’s weekly wages; the number of additional weeks of maternity leave to be analysed for a given year; and the weighted population of women of reproductive and legal working age in a given …

Provision Of Mental Health Services By Critical Access Hospital-Based Rural Health Clinics, John A. Gale Ms, Zachariah T. Croll Mph, Nathan First Lcsw, Msw, Ma, Sara Kahn-Troster Mph

Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural …

The Reproductive Health And Academic Impact Of The New York City School-Based Health Center Reproductive Health Project For Adolescents, Michelle Silverio

Dissertations and Theses

Background: Gaining an understanding of how school reproductive health policies impact adolescent sexual health and academic outcomes is a public health priority in the United States (U.S.) since it has the highest rates of adolescent pregnancy and sexually transmitted infections among developed nations. Adolescence is a critical developmental period and influences in this period affect reproductive health and social well-being over a person’s entire lifespan. Almost all adolescents spend the majority of their time in school settings; therefore local school reproductive health policies may have substantial lifetime impacts. Policies such as providing comprehensive sexual health education and contraceptive access in …

Renal And Cardiovascular Outcomes Associated With Cannabis Use In Veterans With Advanced Chronic Kidney Disease Transitioning To Dialysis, Praveen Kumar Potukuchi

Theses and Dissertations (ETD)

Background: Legalization of cannabis and its constituents may lead to increased exposure of a higher number of consumers to cannabis use, including those with chronic kidney disease (CKD). We expect increase in cannabis use, especially, in patients with compromised kidney function. However, there is sparse literature on the effects of cannabis use on cardiorenal and mortality outcomes among patients with advanced CKD. Objectives: The main goal of the current study was to examine the effect of cannabis use on renal and cerebrovascular outcomes as well as mortality in patients with advanced CKD. Using a nationwide cohort of US veterans with …

Effects Of Climbing Choice, Demographic, And Climate On Walking Behavior, Febriani Fajar Ekawati, Frank Francis Eves

Kesmas

Walking is a public health recommendation to increase physical activity. Although walking for transport is associated with health benefits, it is frequently avoided when a mechanized alternative is available and when the weather or individuals’ available resources are unfavorable. The present quasi-experimental study used chosen walking speed to estimate the use of resources by pedestrians and investigated 730 pedestrians’ behavior when approaching a choice point between a short stair and a ramp at an exit from a university campus toward the local train station on six separate days. Results revealed that individuals who climbed the stairs walked faster than those …

Religious Leader’S Support Toward Individual At Risk Ofhiv/Aids To Attend Voluntary Counselling And Testing Service, Imelda Februati Ester Manurung, Chatarina Umbul Wahyuni, Ari Probandari

Kesmas

Religious leader is a figure who is believed to have the gift of healing. A person with illness will follow any advice the religious leader gives for his/her recovery.Based on the phenomenon, religious leader is a potential local figure to give support for individuals at risk of human immunodeficiency virus (HIV) andacquired immune deficiency syndrome (AIDS). This study aimed to determine factors related to religious leader’s support toward individuals at risk of HIV andAIDS to attend voluntary counselling and testing (VCT) service. This study was an observational analytical with cross-sectional design. The population of thisstudy was religious leader in Kupang …

Adaptation And Validation Of The Tamil (Sri Lanka) Version Ofthe Montreal Cognitive Assessment, Pethirupillai Amal Dinesh Coonghe, Pushpa Fonseka, Sampasivamoorthy Sivayogan, Ajantha Keshavaraj, Rahul Malhotra, Truls Ostbye

Kesmas

The study aimed to develop the Tamil (Sri Lanka) version of the Montreal Cognitive Assessment (MoCA) and investigate its reliability and validity as a briefscreening tool for mild cognitive impairment (MCI). Tamil-speaking Sri Lankan elderly with normal cognition and MCI were recruited from a neurology clinic.Adaptation of the English MoCA to the Tamil (Sri Lanka) involved context-specific content modification and translation. The content validity, reliability, sensitivity,and specificity of the tool were evaluated. Study participants were 184 older adults, comprising 85 with normal cognition and 99 neurologist-diagnosed MCI.The tool had high internal consistency (Cronbach's alpha = 0.83). Receiver operating characteristic curve …

Identifying The Weak Foundation Of Public Health Resilience Fornational Disaster Policy In Indonesia’S Mid-Term Developmentagenda 2015–2019: A Policy Content Analysis, Gita Miranda Warsito, Meiwita Budiharsana, Sharyn Burns

Kesmas

Indonesia is one of the most susceptible nations toward natural disasters in the world. Since 1992, approximately 37 tsunami incidents have occurred inIndonesia, with at least 1,244 cases of natural disasters during 2018. Despite the overwhelming impact of disasters on Indonesia, Public Health Resilience,as an approach to disaster countermeasures, has been poorly elaborated in Indonesia’s development agenda (National Mid-term Development Plan (NMDP),or Rencana Pembangunan Jangka Menengah Nasional (RPJMN), 2015 - 2019). By utilizing the method of policy content analysis, this study aimed to analyzethe policy background of Public Health Resilience against disasters in the NMDP 2015 - 2019 and National …

Benson's Relaxation Therapy And Sleep Quality Among Elderlyat A Social Institution In Inakaka, Indonesia, Nur Baharia Marasabessy, Lucky Herawati, Irhamdi Achmad

Kesmas

Serious sleep disturbances among elderlies include attention or memory disorders, depression and often fall. A quasi experimental study design with pre-posttest with control group was performed to determine effect of Benson’s relaxation therapy on sleep quality among the elderly, and influences of sex, age anddisease suffered differences. Of a total of 46 elderlies from a Social Institute in Ambon, 29 were taken for the treatment group and 19 for the control group.The treatment group was interfered with Benson’s breathing relaxation for 14 days. Sleep quality was measured using Pittsburg sleep quality index form. Datawere analyzed using independent t-test and multivariate …

Myths About Menstrual Personal Hygiene Among Female Adolescents, Tyas Diah Palupi, Terry Y.R. Pristya, Randy Novirsa

Kesmas

Poor personal hygiene during menstruation among adolescents can lead to urinary tract infection, reproductive tract infection, and skin irritation. This studyaimed to determine the relationship between belief in myths and personal hygiene during menstruation. Cross-sectional quantitative study was conductedusing a sample of 119 10th grade female students from Tangerang 13 State Senior High School selected through purposive sampling. Logistic regressionanalysis was used in this study to determine the relationship between myths and personal hygiene after age of menarche, attitude, socioeconomic status,information, and maternal education were controlled. In the bivariate selection, modeling was completed by entering confounding and interaction variablesthen reducing …

Adverse Effect Of Aerosol Pesticide On Lung Dysfunction Amongpaddy Farmers In Purworejo, Central Java, Indonesia, Fajaria Nurcandra, Renti Mahkota, Tri Yunis Miko Wahyono

Kesmas

The World Health Organization estimated that chronic obstructive pulmonary disease (COPD) will be the highest non-communicable disease worldwide by2030, and pesticide exposure is one of major risk factors. This study aimed to determine effect of pesticide exposure on lung dysfunction among paddyfarmers. A case-control study was performed on April - May 2016 in Purworejo. The case group comprised 66 farmers suffering from lung dysfunction during2015 based on medical records, while the control group comprised 59 neighboring farmers showing normal lung function. Both case and control groups weretested using a spirometer and COPD assessment test (CAT) questionnaire. Logistic regression analysis of …

Correlation Of Knowledge And Beliefs To Adherence With Antibiotic Use In Adult Patients At A Private Hospital In Sidoarjo, Muhammad Hasan Wattiheluw, Fauna Herawati, Setiasih Setiasih, Rika Yulia

Kesmas

Infectious diseases are one of the top ten causes of death in the world. Antibiotic therapy is administered for infectious diseases, but if bacteria are exposed to antibiotics continuously, then the bacteria are able to adapt to the medication, thereby resulting in antibiotic resistance. This condition results in an increase in mortality, long hospitalization period, and increased cost of antibiotic therapy and health services. Adherence to using antibiotics may be influenced by knowledge and beliefs about them. This study aimed to understand correlation between knowledge and belief with adherence to antibiotic use at a private hospital in Sidoarjo. This cross-sectional …

Barriers To Covid-19 Rt-Pcr Testing In Indonesia: A Health Policy Perspective, Purwa Kurnia Sucahya

Journal of Indonesian Health Policy and Administration

Indonesia has been facing a hard time accelerating the number of laboratory capacity. This study provides an overview of the data on daily tests, confirmed cases, and the challenge of Covid-19 control associated with government policy. This study utilizes data reported from 2 March to 29 April 2020 by online official sources and regulations. Initially, the government only trusted one lab for the Covid-19 test. As the number of cases increased, referral labs were increased, until 29 April 2020, there were 89 officially appointed laboratories. The daily number of testing results fluctuated and unstable, although the number of reference labs …

Impact Analysis Of The Large-Scale Social Restrictions (Psbb) Policy Implementation In Jakart, Hikmahwati Hikmahwati, Ekasafitri A.S Sangadji, Raden Roro Mega Utami

Journal of Indonesian Health Policy and Administration

Jakarta is the province with the highest population density in Indonesia and is also one of the main international gateways to enter Indonesia. These conditions cause a high risk of transmission COVID-19 in Jakarta. One of the government's decisions was applying the Large Scale Social Restrictions (PSBB) policy in Jakarta. This study is a documentation study with Sabatier and Mazmanian's top-down approach that aims to analyze the extent impact of policy implementation, in terms of the policy objectives and community compliance. Compliance analysis uses the results of the Covid-19 Outbreak Survey and Google mobility index. The result shows the compliance …

Effectiveness Of Large-Scale Social Restrictions (Psbb) Toward The New Normal Era During Covid-19 Outbreak: A Mini Policy Review, Helen Andriani

Journal of Indonesian Health Policy and Administration

The government of Indonesia has not used lockdown or quarantine as an option to tackle the spread of Coronavirus, as the impact of lockdown on small communities in the informal sector that lives from daily income will be severe. Alternatively, the government is enforcing Large-Scale Social Restrictions (Pembatasan Sosial Berskala Besar or "PSBB") to respond to the state of emergency in public health. Starting in June 2020, the government has implemented transitional PSBB in some red zone areas, including the capital Jakarta and East Java province, despite the surge in case numbers. This paper aims to investigate the effectiveness of …

Local Initiatives In Preventing Coronavirus Based On Health Policy Perceptive, Dumilah Ayuningtyas, Misnaniarti Misnaniarti, Siti Khodijah Parinduri, Fitria Aryani Susanti, Ni Nyoman Dwi Sutrisnawati,

Journal of Indonesian Health Policy and Administration

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The Effectiveness Of Covid-19 Countermeasure Policy Implementation In Seven Asean Countries, Wahyu Sulistiadi, Sri Rahayu

Journal of Indonesian Health Policy and Administration

COVID-19, which has spread to almost all countries in the world, force country's leaders to issue COVID-19 countermeasures policy that is the most effective and suitable for their country. The various ways to implement the policy depend on the COVID-19 impact that arises in the country. This study describes the implications of national policies related to COVID-19 case fatality rates up to 29 April 2020 in 7 ASEAN countries. We use analytical descriptive method on COVID-19 data that has been published in online media. The achievement on the implementation of national policy in overcoming COVID-19 in some countries provide new …

Association Between Racial Discrimination And Health‐Related Quality Of Life And The Impact Of Social Relationships, Sze Yan Liu, Genevieve Bergeron, Nneka Lundy De La Cruz, L. Hannah Gould, Amber Levanon Seligson

Department of Public Health Scholarship and Creative Works

Purpose: Interpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the overall New York City (NYC) adult residential population and by four main race/ethnicity groups and explored whether social relationships moderated health effects of discrimination.

Methods: We analyzed cross-sectional survey data from 2335 adults weighted to be representative of the NYC population. We measured exposures to lifetime interpersonal racial discrimination in nine domains using a modifed version …

Private Insurance Reimbursements For Newborn Hearing Screening In The United States, 2013-2014, Thuy Quynh Do, Winnie Chung, Scott Grosse

Journal of Early Hearing Detection and Intervention

The purpose of this study was to describe private insurance reimbursements for newborn hearing screening (NBHS) in the United States. Data from the MarketScan® Commercial Databases were used to estimate reimbursement for privately insured infants born between January 1, 2013–December 31, 2014. Estimates were based on billed claims for hearing-related services during infancy (71,820 infants with inpatient NBHS, 1,104 with outpatient NBHS). Median reimbursement for NBHS performed in a hospital setting was $148.00 (range $113.51–$196.02) when billed as an inpatient service and $136.48 (range $86.08–$220.15) when billed as an outpatient service. Both reimbursement amounts were three times greater than the …

Black Women Survive Breast Cancer With Community-Based Care, Shelley I. White-Means, Jill Dapremont, Barbara D. Davis, Tronlyn Thompson

Faculty Presentations

PURPOSE Community-based breast cancer support agencies who address non-medical, social determinants of health needs that serve as barriers to maximizing breast health outcomes may play a vital role in mitigating breast cancer mortality. They share a common emphasis on addressing social, economic, and psychological needs of breast cancer survivors and those at risk of breast cancer. This paper is third in a series of papers exploring why the rate of breast cancer mortality is two times higher for African American women than white women in Memphis. We sought insights from community-based breast cancer support agencies because they have a close-up …

Costing Of Actions To Safeguard Vulnerable Mexican Households With Young Children From The Consequences Of Covid-19 Social Distancing Measures, Mireya Vilar-Compte, Víctor Pérez, Graciela Teruel, Aranzazu Alonso, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

COVID-19 has imposed unprecedented challenges to society. As the pandemic evolves, the social distancing measures that have been globally enforced, while essential, are having undesirable socioeconomic side effects particularly among vulnerable populations. In Mexico, families who depend upon informal employment face increased threats to their wellbeing, and households who in addition have young children may face long-term consequences. The Mexican government has not yet taken actions, but a coalition of non-governmental organizations is advocating in partnership with academic institutions for social protection actions such as a cash transfer and basic services subsidies for families with young children, subsisting from the …

The Need For Leadership During Public Health Crises, Tanisha Adams

2020 Symposium Posters

This research is intended to educate the public health industry on the need for better crisis leadership preparations. The National Incident Management System (NIMS) is a national training program mandated by the Post-Katrina Emergency Management Reform Act of 2006. The program focuses primarily on Preparedness, Communications and Information Management, Resource Management, and Command and Management. NIMS is formatted in a way that the information can be used across a wide array of organization types. The Incident Command System (ICS) of NIMS has a "military-style, command-and-control model traditionally seen in emergency services and not in public health” (Kohn, Barnett, Galastri, Semon, …

Understanding Elements Involved In Active Racial And Ethnic Minority Recruitment Practices For Biopharmaceutical-Sponsored Clinical Trials: A Socio-Ecological Qualitative Inquiry, Rebecca Rae Johnson

Seton Hall University Dissertations and Theses (ETDs)

Inequitable participation in clinical trials continues to be a problem, and trial populations do not always reflect the demographics of the population that the investigational product will ultimately be treating. Because genetic differences between racial and ethnic groups affect the safety and efficacy of new treatments, it is important that standard of care decisions are made based on a representative population. The purpose of this study is to understand the socio-ecological elements that are involved in the active implementation of racial and ethnic minority recruitment practices for biopharmaceutical-funded trials in the United States. This general qualitative study was both descriptive …