Health Policy Commons^™

Out Of Sight, But Not Out Of Mind: Keeping Connections Alive During Covid-19, Katie Braun

Patient Experience Journal

The Veteran Affairs Pittsburgh Healthcare System (VAPHS) completed over 750,000 outpatient appointments during fiscal year 2019. With changes occurring around COVID-19, VAPHS saw a significant decline in veterans on campus. VAPHS employees are strongly connected to the mission of serving our nation’s hero’s, while veterans find trust, support and comradery at the VA. The VAPHS Office of Veterans Experience (OVE) realized the impact that COVID-19 isolation may have on veterans quarantined at home and seized the opportunity to continue to build relationships, develop trust and keep connected through the VAPHS Birthday Club. Over 1,300 calls have been placed to provide …

A Comprehensive Call Center Supporting Safe, Efficient Operations During A Pandemic, Janice P. Finder, Ashlyn Proske, Judy Overton, Elizabeth Comcowich Garcia, Michael Frumovitz

Patient Experience Journal

Research has shown that a comprehensive call center can support a safe, efficient, and quality experience for patients and their families. When a patient receives a cancer diagnosis, the stakes are already high. Add a pandemic to an immunocompromised patient population and fear escalates. In order to accommodate the ever-changing information and ease patients’ anxieties surrounding their cancer diagnoses, it is necessary that an institution be available 24/7 to inform, help navigate systems, and manage symptoms because the emergency room, and many times the clinics, have too many inherent risks.

MD Anderson expanded the hours of operation for askMDAnderson, a …

How University Of Chicago Medicine Designed Virtual Rounding To Maintain Human Connections During Covid-19, Susan M. Murphy

Patient Experience Journal

This story is about how the Patient Experience and Engagement Program (PEEP) team at University of Chicago Medicine adapted our patient rounding program from in-person to virtual during the COVID-19 crisis. With creativity and ingenuity, our team shifted on a dime to ensure that patients received the kind of care and connection that allowed them to start the recovery process from what could otherwise be a traumatizing experience before they even leave the hospital. I will explain the steps we took to quickly transition our rounding program from in-person to virtual. But more than that, I want to convey the …

A Covid-19 Patient’S Experience: Engagement In Disease Management, Interactions With Care Teams And Implications On Health Policies And Managerial Practices, Lihua Dishman, Vicki Schroeder

Patient Experience Journal

This narrative inquiry aimed to explore a COVID-19 patient’s lived experience from contracting the disease to recovery and understand the implications of this unique patient experience on health policies and managerial practices. The personal narrative approach was used to chronicle the patient’s weekly journey in disease management. Best practices emerged from her and her family members’ engagement in managing COVID-19, and interactions with her primary care provider and COVID-19 Response Team. Her COVID-19 patient experience also provided a basis for implications on public health and healthcare policies and managerial practices. Three key dimensions were perceived to have positively impacted the …

Focusing On Positivity During The Covid-19 Crisis: A New York Health System Strategy, Sven Gierlinger, Agnes Barden

Patient Experience Journal

In the midst of the COVID-19 pandemic, spreading positivity has become a core mission of Northwell Health, the largest integrated health system in New York. As a state and community health system, we are forever changed, but our need for compassion, humanism, and connection has never wavered. Creating innovative ways to bring humanity to the forefront, hope and optimism echo across the organization as initiatives, forums, and acts of gratitude have ensued.

Experience Framework

This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework)

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Chronic Pain, Vulnerability And Human Spirit While Living Under The Umbrella Of Covid-19, Richard B. Hovey Dr., Delane Linkiewich Ms., Mary Brachaniec Ms.

Patient Experience Journal

The purpose of writing this article is to describe what added challenges people like us who are living with chronic pain are experiencing during the COVID-19 pandemic. We explore what this challenging time means to us and how it affects our lives, along with providing insight into our experiences. This is not a research study, but instead an article that shares perspectives from people with lived experience of chronic pain. Our narratives are presented to create an awareness of the plight for people already living with challenging health conditions and how the COVID-19 pandemic has added additional layers of vulnerability. …

Caring For Kids In The Time Of Covid-19, Laurie S. Strongin

Patient Experience Journal

The proliferation of COVID-19 has disrupted tens of millions of children’s lives. Aside from the monotony of living indoors for extended periods, being quarantined can cause feelings of helplessness, anxiety, and fear in kids and parents. These feelings are familiar to chronically ill children whose treatment often necessitates years in and out of hospitals, but COVID-19 has made life harsher for these kids. While otherwise healthy children tend to have milder symptoms than adults, the same isn’t true for kids with compromised immune systems. Keeping these children safe requires hospitals to make adjustments that exacerbate their isolation from everything they …

Treading Water: Coping With Uncertainty During A Novel Pandemic, Sachin Patel

Patient Experience Journal

The abruptness with which the COVID-19 pandemic has changed the delivery of healthcare will have a lasting effect on patients and families of intensive care unit survivors. Using the best science and epidemiology healthcare systems developed protocols and policies to implement the highest level of care but mitigate disease spread. Out of these initiatives the “no visitor” policy was born. The impact of COVID-19 causing florid respiratory failure immediately derailed the lives of a happily retired couple. While on mechanical ventilation for sixteen days, Betty was unable to connect with her husband of over 40 years. In that time, the …

Getting Comfortable With Being Uncomfortable: A Conversation With Marsha Sinanan-Vasishta, Jason A. Wolf

Patient Experience Journal

We find ourselves managing two critical moments and a powerful confluence of events, one a crisis in health. We are still facing the COVID crisis, and we are trying very hard to rely on evidence and truth that will lead us forward in addressing that in the best way possible. We are also in a crisis of humanity, one that has been simmering beneath the surface for years, the issue of systemic racism and disparities in healthcare, further highlighted by the COVID crisis. This article shares the conversation I had with Marsha Sinanan-Vasishta, MSN, MBA, RN, NEA-BC, CPXP, Deputy Chief …

Leadership Matters: A Conversation With Dr. James Hildreth, Jason A. Wolf

Patient Experience Journal

I was extremely honored at this moment in the midst of our current health crisis to have a conversation with Dr. James Hildreth, president and chief executive officer of Meharry Medical College. The focus and commitment expressed by Dr. Hildreth reflects the very mission statement of Meharry Medical College itself, to advance health equity through innovative research, transformative education, exceptional and compassionate health services and policy-influencing thought leadership. As equally important is the alignment of Meharry’s purpose with our very own at the Institute, as Meharry’s mission continues to empower diverse populations to improve the well-being of humankind. Dr. Hildreth …

A Commitment To Hope, Jason A. Wolf Phd, Geoffrey A. Silvera

Patient Experience Journal

On April 1, we made the decision to reconfigure our scheduled special issue on Behavioral Health to the topic of this issue - Sustaining a Focus on Human Experience in the Face of COVID-19. In the midst of crisis, we were uncertain how people would respond to this call or even if they could in the face of the realities they were addressing each day. Yet, the research, cases and stories started to arrive. The contributions in this special issue represent a patchwork of powerful insights and a historic record to document this moment. What we have brought together …

Mapping Geographical Inequalities In Oral Rehydration Therapy Coverage In Low-Income And Middle-Income Countries, 2000–17, Kirsten E. Wiens, Robert C. Reiner Jr, Arianna Maever L. Amit, Veincent Christian F. Pepito, Local Burden Of Disease Diarrhoea Collaborators, 702 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative …

Learning From The Past: Distributed Cognition And Crisis Management Capabilities For Tackling Covid-19, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

The outbreak of coronavirus disease 2019 (COVID-19) has presented an unprecedented public health crisis across the globe. Governments have developed different approaches to tackle the complex and intractable challenge, showing variations in their effectiveness and results. South Korea has achieved exceptional performance thus far: It has flattened the curve of new infections and brought the outbreak under control without imposing forceful measures such as lockdowns and travel ban. This commentary addresses the South Korean government’s response to COVID-19 and highlights distributed cognition and crisis management capabilities as critical factors. The authors discuss how the South Korean government has cultivated distributed …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …

Impact Of Lockdown In India: A Case Study Comparing Kanataka With International Model, Stelvin Sebastian, Aby Paul, Jeeva Joseph, Joel Joby, Sanjo Saijan, Jobin Kunjumon Vilapurathu

Kesmas

The COVID-19 was declared a pandemic and a global health emergency by WHO, prompting various countries to implement early and stringent social distancing protocols through lockdown, to flatten the epidemic curve. The objective of the present study was to assess the impacts and effectiveness of the lockdown protocol in Karnataka and Punjab, compared with the implementation of this method in Australia and the UK. This study involved the collection of data from different authorized databases, in two phases. The first phase included the time starting with the first-reported index case through the 14th day after the declaration of lockdown, for …

Pre-Testing Of The Who’S Educational Video: “How To Protect Yourself Against Covid-19”, Hilyatul Fadliyah, Manendra Muhtar, Munih Munih, Sylviasari Risgiantini, Weny Wulandary, Hadi Pratomo

Kesmas

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a public health emergency in many countries, including Indonesia. The World Health Organization (WHO) released an educational video, entitled "How to Protect Yourself Against COVID-19", which explained how to prevent the spread of COVID-19. This study is a qualitative study that aims to pre-test this video, based on the Information, Education, Communication (IEC) theory, by analyzing teenagers’ perceptions of the video. The design used was a Rapid Assessment Procedure (RAP), and the data were collected by conducting in-depth interviews with participants, through …

Review Of Trial Therapies And Treatment For Covid-19: Lessons For Indonesia, Halma Zahro Mukhlida, Hilma Hasro Maulida, Gunanti Khairunnisa, Margaretha Josephine Mantrono, Risky Kusuma Hartono, Rindu Rindu, Eka R W Purnamasari, Rizky Fajar Meirawan

Kesmas

The infectious disease from Coronavirus Disease 2019, or COVID-19, has quickly spread world-wide since 2019. Therapies for managing COVID-19 have yet to be confirmed as medication for the severe sickness that the disease may cause. This study aimed to review the previous research of the efficacy of trial therapy and treatment to the patients in the hospital with COVID-19. Using PRISMA guidelines as a method for conducting a systematic literature review, a total of 67 articles were collected from several online journal databases. Various therapies were found that are effective in the treatment and management of COVID-19. In accordance with …

Understanding Attitudes Toward Healthcare Reform: The Roles Of Self-Interest, Group Identity And Racial Resentment, Maria Beatrice Livaudais

Political Science ETDs

The Patient Protection and Affordable Care Act (ACA) cemented itself as one of the most controversial pieces of legislation of the decade. Public opinion polls find Americans are often evenly split in support of the ACA. This dissertation explores the roles of self-interest, group identity, and racial resentment on attitudes toward the ACA and healthcare reform. The dissertation centers our attention on variation by race and the impact racial tensions beyond the Black-White paradigm on these attitudes. I find group identity shapes attitudes Blacks’ and Latinos’ attitudes toward the ACA but not Whites’ and racial resentment, directed toward Blacks, Latinos …

Publication Of Data Collection Forms From Nhlbi Funded Sickle Cell Disease Implementation Consortium (Scdic) Registry, Jeffrey Glassberg, Elizabeth A. Linton, Katrina Burson, Tabitha Hendershot, Joseph Telfair, Julie Kanter, Victor R. Gordeuk, Allison A. King, Cathy L. Melvin, Nirmish Shah, Jane S. Hankins, Axel Yannick Epié, Lynne D. Richardson

Health Policy & Community Health: Faculty Publications

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into clinical advances. Despite registry initiatives in SCD, the unavailability of descriptions of the selection process and copies of final data collection tools, coupled with incomplete representation of the SCD population hampers further research progress. This manuscript describes the SCDIC (Sickle Cell Disease Implementation Consortium) Registry development and makes the SCDIC Registry baseline …

Detroit Food Metrics Report 2019, Alex B. Hill

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Measuring The Impact Of Covid-19 On Older Adults In Massachusetts, Ceara Somerville, Jan Mutchler, Caitlin Coyle

Center for Social and Demographic Research on Aging Publications

The spread of COVID-19 across the United States has affected every facet of life since early 2020. According to the Centers for Disease Control and Prevention (CDC), there are currently over 4 million cases across the nation and over 146,000 deaths from the virus. Massachusetts has been one of the states hit hardest, with over 100,000 confirmed cases and more than 8,000 deaths to date. The Commonwealth currently trails only New York and New Jersey in number of deaths. While cases surge around the country, Massachusetts has seen some leveling out of positive cases since the beginning of July. Though …

Using Open Public Meetings And Elections To Promote Inward Transparency And Accountability: Lessons From Zambia, Taryn Vian, Rachel M. Fong, Jeanette L. Kaiser, Viviane Sakanga, Melvin Mwansa, Parker S. Chastain, Thandiwe Ngoma, Nancy Scott

Nursing and Health Professions Faculty Research and Publications

Background
Community-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members.

Methods
We applied a principally qualitative …

Formative Research To Design A Culturally-Appropriate Cancer Clinical Trial Education Program To Increase Participation Of African American And Latino Communities, Jennifer Cunningham-Erves, Claudia Barajas, Tilicia Mayo-Gamble, Caree R. Mcafee, Pamela Hull, Maureen Sanderson, Juan Canedo, Katina Beard, Consuelo H. Wilkins

Health Policy & Community Health: Faculty Publications

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program.

Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Toxic Structures: Speculation And Lead Exposure In Detroit's Single-Family Rental Market, Alexa Eisenberg, Eric Seymour, Alex B. Hill, Joshua Akers

Urban Studies and Planning Faculty Research Publications

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor-landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥ 5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity …

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 …

Covid-19 And Latinos In Massachusetts, Lorna Rivera, Phillip Granberry, Lorena Estrada-Martínez, Miren Uriarte, Eduardo Siqueira, Ana Rosa Linde-Arias, Gonzalo Bacigalupe

Gastón Institute Publications

This report focuses on the Latino population of Massachusetts and uses 2014–2018 American Community Survey (ACS) demographic data to explore both Latinos’ vulnerability to COVID-19 infection and the key predictive factors. We explore what is known about the social determinants of health previously identified as critical to understanding the spread and differential infection rates of COVID-19 across populations—for example, opportunities for infection due to employment and housing conditions—and how these apply to the Latino population in Massachusetts. We also briefly explore those factors that lead to COVID-19 severe illness and possibly death from the disease, including the age of the …

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

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 …