Health Policy Commons^™

Cues To Cervical Cancer Screening Among U.S.-Hispanic Women, Arelis Moore De Peralta, Bonnie Holaday, Ida Mikisa Hadoto

Arelis Moore de Peralta

Introduction: Hispanic women’s cervical cancer rates are disproportionately high. Cues to cervical cancer screening (Cues to Action) are strategies to activate the decision-making process to get screened for cervical cancer. This study used the health belief model to examine which cues prompt Hispanic women to undergo cervical cancer screening and how perceptions could be potentiated by cues to cervical cancer screening.

Method: A cross-sectional survey was conducted among Hispanic women 18 to 65 years old (n = 220). Generalized linear modeling was used.

Results: Spanish media and reminders by mother and doctors were relevant cues. Generalized linear modeling showed …

Assessing The Causal Impact Of Chinese Aid On Vegetative Land Cover In Burundi And Rwanda Under Conditions Of Spatial Imprecision, Robert Marty, Seth Goodman, Michael Lefew, Carrie B. Dolan, Ariel Benyishay, Daniel Runfola

Carrie Dolan

There has been considerable debate regarding the efficacy of international aid in meeting the dual goals of human development and environmental sustainability. Many donors have sought to engage with this challenge by introducing environmental safeguard and monitoring initiatives; however, evidence on the success of these interventions is limited. Evaluating aid is a particular challenge in the case of donors that do not disclose information on the nature, geographic location, or extents of their interventions. In such cases, new methods that extract and geoparse data on the activities of opaque donors through the manual interpretation of thousands of news and …

Delays In Antiretroviral Therapy Initiation Among Hiv-Positive Individuals: Results Of The Positive Living With Hiv Study, Krishna C. Poudel, David R. Buchanan, Kalpana Poudel-Tandukar

Krishna C. Poudel

Background: Lack of early initiation of antiretroviral therapy (ART) remains a major health concern due to increased risk of premature mortality and further HIV transmission. This study explored CD4+ cell count monitoring in relation to delays in ART initiation among HIV-positive individuals in the Kathmandu Valley, Nepal, where ART coverage was only 23.7% in 2011.

Design: We recruited a total of 87 ART-naïve, HIV-positive individuals aged 18 to 60 years through the networks of five non-government organizations working with HIV-positive individuals. We collected data on the history of ART initiation, CD4+ cell count monitoring, socio-demographic variables, perceived family …

Hospital Mergers And Public Accountability: Tennessee And Virginia Employ A Certificate Of Public Advantage, Erin C. Fuse Brown

Erin C. Fuse Brown

No abstract provided.

Massachusetts Medicaid Members That Smoked In 2008: Characteristics Associated With Smoking Status In 2014, Alexis D. Henry, John Gettens, Judith A. Savageau, Doris Cullen, Anna Landau

Judith A. Savageau

The smoking rate among non-elderly Medicaid enrollees is more than double the rate for those privately insured; smoking-related conditions account for 15% of Medicaid expenditures. Under state health reform, Massachusetts Medicaid (MassHealth) made tobacco cessation treatment available beginning in 2006. We used surveys conducted in 2008 and 2014 to examine changes in smoking abstinence rates among MassHealth members identified as smokers and to identify factors associated with being a former smoker. Members previously identified as smokers were surveyed by mail or phone; 2008 and 2014 samples included 3,116 and 2,971 members, respectively. Surveys collected demographic and health information, asked members …

The Relationship Between Quality Improvement And Health Information Technology Use In Local Health Departments, Kendra Johnson, Kim K. Nguyen, Shimin Zheng, Robin P. Pendley

Shimin Zheng

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use …

Training For Tactical Operations In Tropical Environments: Challenges, Risks, & Strategies For Risk Management, Rodney Pope, Rob Orr, Anthony Walker, Shane D. Irving, Ralph P. Jones, Richard J. Gorey, Scott D. Gayton, Joseph Knapik

Rob Marc Orr

Tactical operators, encompassing military, law enforcement, fire and other emergency personnel, can be found in all climatic zones. These tactical operators may be deployed at short notice to tropical environments, often with limited time to acclimatise if based in more temperate zones. They are then expected to undertake arduous tactical tasks, often repeatedly and for extended periods in the tropical area. These demands combine with harsh environments, personal protective equipment (PPE), tactical loads, threats to life, and responsibility for the safety and survival of others to place immense physical and mental stresses on tactical operators. Managing the resulting risks is …

A Study Of Claim Resolution Structured Settlement Agreements: Final Report, Marcus Dillender, Kevin Hollenbeck, H. Allan Hunt

Kevin Hollenbeck

No abstract provided.

A Study Of Claim Resolution Structured Settlement Agreements: Final Report, Marcus Dillender, Kevin Hollenbeck, H. Allan Hunt

H. Allan Hunt

No abstract provided.

Addressing The Ethical, Legal, And Social Issues Raised By Voting By Persons With Dementia, Jason H. Karlawish, Richard J. Bonnie, Paul S. Appelbaum, Constantine Lyketsos, Bryan James, David Knopman, Christopher Patusky, Rosalie A. Kane, Pamela S. Karlan

Bryan G Kane MD

This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance …

The Problem Of State Intervention In Post-Abolition Slavery: A Critique Of Consensus, Anthony Talbott, David Watkins

David Watkins

Slavery is now illegal by all states and under international law. Contrary to the hopes of abolitionists, this state of affairs has transformed rather than eradicated slavery as an institution. Furthermore, responses by states to post-abolition forms of slavery have often been less than ideal. This paper begins by comparing two state responses to slavery in the early 20th century: the federal peonage trials in Montgomery, Alabama from 1903-1905, and the federal response to an alleged epidemic of “white slavery” from 1909-1910, culminating in the passage of the White Slave-Traffic Act. Taken together, these responses engender pessimism about the state …

When Does Marketisation Lead To Privatisation? Profit-Making In English Health Services After The 2012 Health And Social Care Act, Nick Krachler, Ian Greer

Ian Greer

Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. England’s Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the …

Military Misconduct And Homelessness Among Us Veterans Separated From Active Duty, 2001-2012, Adi V. Gundlapalli, Jamison D. Fargo, Stephen Metraux, Marjorie E. Carter, Matthew K. Samore, Vincent Kane, Dennis P. Culhane

Dennis P. Culhane

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Wendy F. Hensel

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Leslie E. Wolf

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

Allowing Patients To Waive The Right To Sue For Medical Malpractice: A Response To Thaler And Sunstein, Tom Baker, Timothy D. Lytton

Timothy D. Lytton

This essay critically evaluates Richard Thaler and Cass Sunstein’s proposal to allow patients to prospectively waive their rights to bring a malpractice claim, presented in their recent, much acclaimed book, Nudge: Improving Decisions about Health, Wealth and Happiness. We show that the behavioral insights that undergird Nudge do not support the waiver proposal. In addition, we demonstrate that Thaler and Sunstein have not provided a persuasive cost-benefit justification for the proposal. Finally, we argue that their liberty-based defense of waivers rests on misleading analogies and polemical rhetoric that ignore the liberty and other interests served by patients’ tort law rights. …

Global Trade Impacts: Addressing The Health, Social And Environmental Consequences Of Moving International Freight Through Our Communities, Martha Matsuoka, Andrea Hricko, Robert Gottlieb, Juan Delara

Martha Matsuoka

As ports and goods movement activity expands throughout the United States, a major challenge is how to make the adverse impacts of freight transportation a more central part of economic development, policy and planning discussions and transportation decision making. In 2009, faculty and staff from the Urban & Environmental Policy Institute of Occidental College and from the environmental health sciences and regional equity programs of the University of Southern California (USC) began a study of this evolving global trade and freight transportation system, focusing on areas in the United States where the system is expanding and where community, labor and …

Municipal Officials' Participation In Built Environment Policy Development In The United States, Stephenie C. Lemon, Karin V. Goins, Kristin L. Schneider, Ross Brownson, Cheryl A. Valko, Kelly R. Evenson, Amy A. Eyler, Katie M. Heinrich, Jill Litt, Rodney Lyn, Hannah L. Reed, Nancy O'Hara Tompkins, Jay Maddock

Stephenie C. Lemon

Purpose. This study examined municipal officials' participation in built environment policy initiatives focused on land use design, transportation, and parks and recreation. Design. Web-based cross-sectional survey. Setting. Eighty-three municipalities with 50,000 or more residents in eight states. Subjects. Four hundred fifty-three elected and appointed municipal officials. Measures. Outcomes included self-reported participation in land use design, transportation, and parks and recreation policy to increase physical activity. Independent variables included respondent position; perceptions of importance, barriers, and beliefs regarding physical activity and community design and layout; and physical activity partnership participation. Analysis. Multivariable logistic regression models. Results. Compared to other positions, public …

The Role Of Leadership In Creating A Strategic Climate For Evidence-Based Practice Implementation And Sustainment In Systems And Organizations, Gregory Aarons, Mark Ehrhart, Lauren Farahnak, Marisa Sklar

G A Aarons

There is a growing impetus to effectively implement evidence-based practices (EBPs) in health and allied health settings in order to improve the public health impact of such practices. To support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups (3). This article identifies two relevant types of leadership for implementation and recommends steps that leaders can take in developing a strategic climate for EBP implementation and sustainment within the outer and inner contexts of health …

Measure Of Clinical Information Technology Adoption, Jinhyung Lee, Young-Taek Park

Jinhyung Lee

Objectives: The objective of this study was to create a new measure for clinical information technology (IT) adoption as a proxy variable of clinical IT use.

Methods: Healthcare Information and Management Systems Society (HIMSS) data for 2004 were used. The 18 clinical IT applications were analyzed across 3,637 acute care hospitals in the United States. After factor analysis was conducted, the clinical IT adoption score was created and evaluated. Results: Basic clinical IT systems, such as laboratory, order communication/results, pharmacy, radiology, and surgery information systems had different adoption patterns from advanced IT systems, such as cardiology, radio picture …

Increasing Environmental Performance In A Context Of Low Governmental Enforcement: Evidence From China, Mary Alice Haddad

Mary Alice Haddad

Creating Healthy Community In The Postindustrial City, Brian A. Hoey

Brian A. Hoey, Ph.D.

Primary Health Centres And Patients Satisfaction Level In Haripad Community Development Block Of Kerala, India, Pankaj Roy

Pankaj Roy

Desktop Medicine, Jason Karlawish

Jason Karlawish

No abstract provided.

Addressing The Ethical, Legal, And Social Issues Raised By Voting By Persons With Dementia, Jason H. Karlawish, Richard J. Bonnie, Paul S. Appelbaum, Constantine Lyketsos, Bryan James, David Knopman, Christopher Patusky, Rosalie A. Kane, Pamela S. Karlan

Jason Karlawish

This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance …

Voices Of Blackford County: Employing Counter-Normative Pedagogy In Service Learning, Sherrie M. Steiner

Sherrie M Steiner

No abstract provided.

Cultural Competency In New Jersey: Evolution From Planning To Law, Debbie Salas-Lopez, Linda Holmes, Dawne Mouzon, Maria Soto-Greene

Debbie Salas-Lopez MD, MPH

No abstract provided.

Cancer Prevention And Control: A Multidisciplinary Approach, Michael Preston

Michael Preston

The Delta Leadership Institute Executive Academy is a year-long training program in leadership development and advocacy. Over 52 leaders from across the 8 state Delta Regional Authority service area (Illinois, Missouri, Kentucky, Arkansas, Tennessee, Louisiana, Mississippi, and Alabama) who work in the public, private and nonprofit sectors attended this session. At each session, the leaders study best practices in community and economic development, and learn from experts who share resources that these leaders can apply in their communities. This session provided findings on the economic burden of health disparities and interventions being used to address health disparities related to cancer.

Parenting From Prison: Family Relationships Of Incarcerated Women In Massachusetts, Erika Kates, Sylvia Mignon, Paige Ransford

Sylvia I. Mignon

Historically in the United States, there has been little concern about the needs of incarcerated women and their family members, especially children. This began to change with the tremendous increase in the number of incarcerated women. The rate of women’s incarceration increased dramatically during the 1980s and today the number of female inmates continues to rise faster than the number of male inmates. In 1986, 19,812 women were incarcerated in the United States and this number rose in 1991 to 38,796. Today, over 112,000 women are incarcerated in state or federal facilities (Sabol et al., 2007; Snell 1994). While in …

Estimation Of Uninsurance Rate: Comparison Of Four Estimation Methods, Jackie Zhang, Renee Hotchkiss, Thomas Wan

Thomas T.H. Wan

Objective: Although high percentage of the uninsured is an important public policy issue, the discrepancies in both state and national estimates of the numbers of uninsured are reported. This study compares four advanced estimation methods for uninsurance, by using Florida Health Insurance Survey data as an example. Design: The four predictive models include decision tree, neural network, general logistic regression, and two-stage logistic regression. Risk factors to uninsurance are identified. Population: The study sample comes from the Florida Health Insurance Study data collected for the Florida Agency of Health Care Administration in 1999, representing the first large-scale study designed exclusively …