Health Policy Commons^™

Cigarette Smoking Behaviors And Nicotine Dependence At The Intersection Of Sexual Identity And Sex In The United States: Findings From The National Survey On Drug Use And Health, Ollie Ganz, Jonathan A. Schulz, Sarah J. Ehlke, Jessica L. King Jensen, Andrea C. Villanti

Psychology Faculty Publications

Introduction: Cigarette smoking is disproportionately high among lesbian, gay, and bisexual (LGB) adults. Yet, collapsing these identities into a monolith can disguise important within group disparities (e.g., lesbian/gay versus bisexual female). The purpose of this study is to report recent national prevalence estimates and trends of cigarette smoking behaviors and nicotine dependence by sexual identity and sex. Methods: Data were from the 2015–2019 National Survey on Drug Use and Health (n = 210,392; adults 18+), a nationally representative, repeated cross-sectional study of substance use and mental health in the U.S. We examined bivariate and multivariable associations between sexual identity and …

The Shortfalls Of Vulnerability Indexes For Public Health Decision-Making In The Face Of Emergent Crises: The Case Of Covid-19 Vaccine Uptake In Virginia, Lydia Cleveland Sa, Erika Frydenlund

VMASC Publications

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is …

Use Of The Rasch Model For Fit Statistics And Rating Scale Diagnosis For The Student Perception Appraisal- Revised, Robert J. Hawkins, Janice Hawkins, Beth Tremblay, Lynn Wiles, Karen Higgins

Nursing Faculty Publications

Background and Purpose: Nursing student retention is essential to meet workforce demands. Jeffrey's Nursing Student Retention Student Perception Appraisal-Revised (SPA-R1) has been used extensively to understand factors that impact retention. Psychometric testing of the SPA-R1 contributes to greater confidence in the instrument's reliability and validity.

Methods: Item response theory and specifically, the single parameter polytomous Rasch model was used as a framework for fit statistic testing and rating scale diagnostics of the SPA-R1. This was a secondary analysis of a convenience sample of undergraduate prelicensure nursing students. The setting for the previous study was virtual, and the study period was …

Understanding And Assessing Demographic (In)Equity Resulting From Extreme Heat Exposure Due To Lack Of Tree Canopies In Norfolk, Va Using Agent-Based Modeling, Virginia Zamponi, Kevin O'Brien, Erik Jensen, Brandon Feldhaus, Russell Moore, Christopher J. Lynch, Ross Gore

VMASC Publications

Prolonged exposure to extreme heat can result in illness and death. In urban areas of dense concentrations of pavement, buildings, and other surfaces that absorb and retain heat, extreme heat conditions can arise regularly and create harmful environmental exposures for residents daily during certain parts of the year. Tree canopies provide shade and help to cool the environment, making mature trees with large canopies a simple and effective way to reduce urban heat. We develop a demographically representative 1 (agent): 1 (person) agent-based model to understand the extent to which different demographics of residents in Norfolk, VA are equitably shaded …

Technology Adoption Of Computer-Aided Instruction In Healthcare: A Structured Review, Queenie Kate Cabanilla, Frevy Teofilo-Orencia, Rentor Cafino, Armando T. Isla Jr., Jehan Grace Maglaya, Xavier-Lewis Palmer, Lucas Potter, Dave E. Marcial, Lemuel Clark Velasco

Electrical & Computer Engineering Faculty Publications

Computer-Aided Instruction (CAI) is one of the interactive teaching methods that electronically presents instructional resources and enhances learner performance. In health settings, using CAI is one of the important ways to improve learners' knowledge and usefulness in their healthcare specialization yet there is still a lack of research that offers a comprehensive synthesis of investigating into the adoption of CAI in healthcare. This research aims to provide a comprehensive review of related literatures on the enablers and barriers for technology adoption of CAI in healthcare. 31 journals were analyzed and revealed that several studies were utilizing the Unified Theory of …

Using Adult Learning Characteristics And The Humanities To Teach Undergraduate Healthcare Students About Social Determinants Of Health, Elizabeth A. Brown, Hannah Kinder, Garrett Stang, Wendy Shumpert

Community & Environmental Health Faculty Publications

Authors used an andragogy framework to help undergraduate allied health students better understand social determinants of health (SDOH) using a photo essay assignment. The study examined students’ perceptions of SDOH in various communities, description of health outcomes associated with their chosen SDOH, and lessons learned and suggestions to improve the assignment for future cohorts. Data were extracted from photo essays from 2019–2021 and entered in Microsoft Excel and Word for data analysis after course completion. Conventional qualitative content analysis was used to analyze student evaluation data from open-ended questions. Data were extracted from 53 student essays from 2019 to 2021. …

Experiences With Covid-19 Stress Among Hispanic/Latino Farmworkers, Brenda Berumen-Flucker, Hadiza Galadima, Sylvia Shangani, Michele Kekeh, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: Hispanics/Latinos, particularly those that identify as foreign-born, are overrepresented in the agricultural sector in the U.S. Over the course of the COVID-19 pandemic, this subpopulation of farmworkers was recognized as an invaluable group of essential workers unable to implement COVID-19 protections.

METHODS: Previously validated COVID-19 stress scale measures were identified, adapted, and translated to collect COVID-19 stress data from Hispanic/Latino agricultural workers in two heavily agricultural counties in northeastern North Carolina. Participants were recruited using purposive convenience sampling. Data collection took place from June to November of 2021.

RESULTS: The majority of Hispanic/Latino agricultural workers surveyed reported experiencing worries …

Socioeconomic Status, Cultural Values, And Elderly Care: An Examination Of Elderly Care Preference In Oecd Countries, Fang Fang, Xiao Yang

Psychology Faculty Publications

Background

With the rapid growing of the older population around the world, care for older adults is becoming a pressing public health issue. To find the optimum and sustainable balance of informal and formal involvement in senior care is urgently important. However, it is still unclear how older adults’ preferences for senior care are shaped by a range of factors at individual and country levels. Therefore, the present study aimed to examine the roles of socioeconomic status (SES) and culture values in old adults’ attitude toward senior care.

Methods

The data from the International Social Survey Program 2012: Changing Family …

Investigating Public Support For Biosecurity Measures To Mitigate Pathogen Transmission Through The Herpetological Trade, Elizabeth F. Pienaar, Diane J. Episcopio-Sturgeon, Zachary T. Steele

Biological Sciences Faculty Publications

The expanding global trade in herpetofauna has contributed to new infectious disease dynamics and pathways that allow for the rapid spread of pathogens geographically. Improved biosecurity is needed to mitigate adverse biodiversity, economic and human health impacts associated with pathogen transmission through the herpetological trade. However, general lack of knowledge of the pathogen transmission risks associated with the global trade in herpetofauna and public opposition to biosecurity measures are critical obstacles to successfully preventing pathogen transmission. In 2019 we administered a survey to 2,007 members of the public in the United States of America to ascertain their support for interventions …

Healthcare Transformation In Saudi Arabia: An Overview Since The Launch Of Vision 2030, Ahmed Ali Alasiri, Viqaruddin Mohammed

University Administration Publications

Saudi Arabia’s Vision 2030 has taken a centre stage in the development of its healthcare sector through privatization adopting Public Private Partnerships (PPPs). The objective of this study is to provide an overview of healthcare transformation in Saudi Arabia since the launch of the ambitious Vision 2030, identifying issues those need to be addressed and steps taken towards provision of health systems transformation. Literature review was based on extensive review of published and unpublished articles, where different search engines and databases searched using the key words: ‘Saudi Healthcare’, ‘Healthcare transformation’, ‘Saudi vision: 2030’, ‘Public-Private Partnerships’ and ‘Privatization’, in addition to …

Prevalence Of Mutations In The Pfdhfr, Pfdhps, And Pfmdr1 Genes Of Malarial Parasites Isolated From Symptomatic Patients In Dogondoutchi, Niger, Ibrahima Issa, Mahaman Moustapha Lamine, Veronique Hubert, Amadou Ilagouma, Eric Adehossi, Aboubacar Mahamadou, Neil F. Lobo, Demba Sarr, Lisa M. Shollenberger, Houze Sandrine, Ronan Jambou, Ibrahim Maman Laminou

Biological Sciences Faculty Publications

The effectiveness of artemisinin-based combination therapies (ACTs) depends not only on that of artemisinin but also on that of partner molecules. This study aims to evaluate the prevalence of mutations in the Pfdhfr, Pfdhps, and Pfmdr1 genes from isolates collected during a clinical study. Plasmodium genomic DNA samples extracted from symptomatic malaria patients from Dogondoutchi, Niger, were sequenced by the Sanger method to determine mutations in the Pfdhfr (codons 51, 59, 108, and 164), Pfdhps (codons 436, 437, 540, 581, and 613), and Pfmdr1 (codons 86, 184, 1034, and 1246) genes. One hundred fifty-five (155) pre-treatment samples were …

Planning For Evacuation And Sheltering Of Vulnerable & Medically Fragile Populations During The Post-Vaccine Period Of A Compound Hurricane-Pandemic Threat: After-Action Report (Aar) Summarizing Results Of A Workshop Hosted On September 27, 2021, Wie Yusuf, Converge Covid-19 Working Group, Old Dominion University, University Of South Florida

School of Public Service Faculty Publications

From the Executive Summary:

The CONVERGE COVID-19 Working Group’s Workshop on Planning for Evacuation and Sheltering of Vulnerable and Medically Fragile Populations during the Post-vaccine Period of a Compound Hurricane-Pandemic Threat was held virtually on September 27, 2021. The 137 workshop participants represented federal, state, and local governments, the nonprofit sector and advocacy organizations, businesses, and academic institutions. Participants primarily represented functional areas of emergency management, planning, and public health. Geographically, the workshop participants came from 20 states, primarily along the Eastern seaboard plus the U.S. Virgin Islands and Canada.

Short-Range Forecasting Of Covid-19 During Early Onset At County, Health District, And State Geographic Levels Using Seven Methods: Comparative Forecasting Study, Christopher Lynch, Ross Gore

VMASC Publications

BACKGROUND:

Forecasting methods rely on trends and averages of prior observations to forecast COVID-19 case counts. COVID-19 forecasts have received much media attention, and numerous platforms have been created to inform the public. However, forecasting effectiveness varies by geographic scope and is affected by changing assumptions in behaviors and preventative measures in response to the pandemic. Due to time requirements for developing a COVID-19 vaccine, evidence is needed to inform short-term forecasting method selection at county, health district, and state levels.

OBJECTIVE:

COVID-19 forecasts keep the public informed and contribute to public policy. As such, proper understanding of forecasting purposes …

Raise Your Voice To Promote Childhood Vaccines: Vaccines Save Lives, Janice Hawkins

Nursing Faculty Publications

[First paragraph] The current pandemic has increased our awareness of the importance of vaccines. As COVID-19 spread across the globe, the world raced to fight the disease. Vaccines rolled out in record time, and mass vaccination clinics are underway.

Recent Trends In Heat-Related Mortality In The United States: An Update Through 2018, Scott C. Sheridan, P. Grady Dixon, Adam J. Kalkstein, Michael J. Allen

Political Science & Geography Faculty Publications

Much research has shown a general decrease in the negative health response to extreme heat events in recent decades. With a society that is growing older, and a climate that is warming, whether this trend can continue is an open question. Using eight additional years of mortality data, we extend our previous research to explore trends in heat-related mortality across the United States. For the period 1975–2018, we examined the mortality associated with extreme-heat-event days across the 107 largest metropolitan areas. Mortality response was assessed over a cumulative 10-day lag period following events that were defined using thresholds of the …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Status And Factors Associated With Healthcare Choices Among Older Adults And Children In An Urbanized County: A Cross-Sectional Study In Kunshan, China, Yuxi Zhao, Linqi Mao, Jun Lu, Qi Zhang, Gang Chen, Mei Sun, Fengshui Chang, Xiaohong Li

Community & Environmental Health Faculty Publications

As important unit for regional health planning, urbanized counties are facing challenges because of internal migrants and aging. This study took urbanized counties in China as cases and two key populations as objects to understand different populations’ intentions of choosing corresponding health service resources and to provide support for resource allocation. A cross-sectional study was conducted in Kunshan, a highly urbanized county in China, in 2016, among older adults aged 60 or over and children aged 0–6. Multinomial logistics models were used to identify the factors associated with healthcare choices. In this study, we found that income, distance of the …

Life In Hampton Roads Survey Press Release #2: Policy And Local Response Covid-19, Social Science Research Center, Old Dominion University

Life in Hampton Roads Survey Report

Life in Hampton Roads: Politics, Policy and COVID-19 Response

The survey included several questions that provide a window into the views of Hampton Roads citizens concerning policy choices and leadership during the COVID-19 pandemic response. Overall and on most issues the public was quite divided, with divisions often falling along party lines, but President Trump and the Centers for Disease Control and Prevention (CDC) seemed to elicit the strongest negative and positive responses, respectively. A substantial majority approved of Governor Northam’s timing on the initial stay-at-home order, and respondents leaned toward the view that additional restrictions on public activity should …

Innovative Framework For Academic And Public Health Departments' Partnership On Preparing Future Practitioners- Preliminary Data, Michele Kekeh, Muge Akpinar-Elci, Myngoc Nguyen, Nancy Welch

Community & Environmental Health Faculty Publications

This article presents a model to respond to current public health challenges and transform knowledge into preventive strategies. It also presents an innovative way for academic institutes and public health departments to focus on public health workforce development. Academic institutes partnership with public health departments have started fostering service-learning opportunities to engage students in public health with an emphasis on the specific public health outcomes. However, the benefit of service–learning projects on the health departments and the populations served is largely unknown. Recently, these service-learning opportunities are becoming less sustainable due to the inability of preceptors to provide the necessary …

Fostering University Collaboration And Building Capacity To Respond To Coastal Resilience Challenges In Virginia: Findings From The Rotating Resilience Roundtables Workshop Spring 2019, Wie Yusuf, Michelle Covi, Anamaria Bukvic, Tom Allen, Taiwo Oguntuyo

Presentations, Lectures, Posters, Reports

[from Background and Overview]

Communities in coastal Virginia, particularly in the urban region of Hampton Roads and the rural Eastern Shore peninsula, are experiencing the impacts of climate change as part of everyday life. Among the most apparent impacts are sea level rise and associated flooding, but increasingly residents of the region are observing changing ecosystems, health impacts and complex social challenges are made more difficult. The region is experiencing the fastest rate of relative sea level rise on the U.S. east coast due to interactions between ocean currents, global sea level rise, high-water tables and ground subsidence (Adapt Virginia …

Research Agenda In Developing Core Reference Ontology For Human Intelligence/Machine-Intelligence Electronic Medical Records System, Ziniya Zahedi, Teddy Steven Cotter

Engineering Management & Systems Engineering Faculty Publications

Beginning around 1990, efforts were initiated in the medical profession by the U.S. government to transition from paper based medical records to electronic medical records (EMR). By the late 1990s, EMR implementation had already encountered multiple barriers and failures. Then President Bush set forth the goal of implementing electronic health records (EHRs), nationwide within ten years. Again, progress toward EMR implementation was not realized. President Obama put new emphasis on promoting EMR and health care technology. The renewed emphasis did not overcome many of the original problems and induced new failures. Retrospective analyses suggest that failures were induced because programmers …

Reducing The Rate Of Cesarean Delivery On Maternal Request Through Institutional And Policy Interventions In Wenzhou, China, Yushan Yu, Xiangyang Zhang, Caixia Sun, Huijie Zhou, Qi Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before …

Obesity Policy Stringency Over Time: A Four State Policy Design, Luisa M. Lucero

School of Public Service Theses & Dissertations

Over the past several decades obesity rates in the United States have increased exponentially, reaching epidemic proportions and placing heavy financial and health-related burdens on states. States could reduce their obesity-related spending by billions of dollars, however, if they reduced their obesity prevalence by five percent by 2030, which would reduce medical costs, loss of productivity, and loss of life. Despite the incentive to improve obesity rates, not all states are taking advantage of obesity-related policy as a means to combat obesity. Using a multiple case study design and policy design as the theoretical foundation, this study explores whether or …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Community & Environmental Health Faculty Publications

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Health Care Use, Out-Of-Pocket Expenditure, And Macroeconomic Conditions During The Great Recession, Juan Du, Takeshi Yagihashi

Economics Faculty Publications

We study how macroeconomic conditions during the Great Recession affected health care utilization and out-of-pocket expenditures of American households. We use two data sources: the Consumer Expenditure (CE) Survey and the Survey of Income and Program Participation (SIPP); each has its own advantages. The CE contains quarterly frequency variables, and the SIPP provides panel data at the individual level. Consistent evidence across the two datasets shows that utilization of routine medical care was counter-cyclical, whereas hospital care was pro-cyclical during the Great Recession. When we examine the pre-recession period, the relationship between macroeconomic conditions and health care use was either …

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 …

Perceptions Of The Counseling Profession: From Health Science Graduate Faculty And Students, Kaprea F. Johnson, Christianne Fowler, Karen Kott, Margaret Lemaster

Nursing Faculty Publications

Counseling is considered a newer healthcare profession and possibly unknown to others. This study uses a post-positivist phenomenological approach exploring healthcare faculty and students' perceptions of counseling professionals after participating in a semester long interprofessional health promotions and maintenance course. Results indicated most professions are unaware of counselors, their scope of practice, and their benefit to interprofessional teams. Participants showed growth in their knowledge. Results indicate the importance of interprofessional education and need for advocacy awareness.

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …