Health Policy Commons^™

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Bridging Fiscal Sustainability And Health Equity: A Policy Analysis Of California’S Healthcare Coverage Safeguards, Guadalupe Castaneda Martinez

Master's Projects and Capstones

Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. …

Graduate Student Paper: Aging In A Changing Japan: Gendered Adaptation To Changing Family Structure, Miki Izu, Clayton Chalmers

Asia Pacific Perspectives

Although Japanese seniors are very healthy, research shows that they are not very happy. Compared to seniors in other developed countries, Japanese elders have lower ratings of subjective well-being and are increasingly alone. This paper argues that changes to Japanese family life help explain why Japanese elders are struggling with low subjective well-being. Specifically, declining marriage rates and declining rates of elders living with their children (co-residency) have made it harder for elders to get the support they need. Moreover, the effect and the adaptations to these changes are not equal between men and women. While elderly Japanese men are …

Indigenous Water Rights: Navigating Sovereign Waters, Cynthia N. Pina

Master's Projects and Capstones

The issue of Native American water rights and the sovereignty of their land on reservations is gaining increasing prominence, making it the focal point of this thesis as an environmental justice concern. Native Americans face disproportionate public health challenges related to water accessibility, contamination, sanitation, outdated infrastructure, and other social determinants of health. The legal framework that governs the coexistence of Native Americans in the United States is rooted in a settler colonial perspective. Consequently, this has created a dependent relationship between Native Americans and the United States federal government. Despite the long-standing advocacy of Tribes for sovereignty since the …

The Association Between High Medical Costs & Migration In The United States, Zuriel Sanders

Master's Theses

In the United States, the current medical system has been controversial due to its non-universal design. Typically those who’re employed and middle or upper class have the most access to health care due to this design. Even among those with access to health insurance the amount of out-of-pocket medical expenses that families are exposed to after insurance can cause a burden in itself for staying financially afloat that year, especially when paired with the increasing cost of living in the U.S. from 2009-Present. For the purpose of this paper, we’ll be examining the relationship between migration & high medical expenses …

Whistleblowing As An Anti-Corruption Strategy In Health And Pharmaceutical Organizations: A Scoping Review Protocol., Taryn Vian, Brianna Agnew Mph, Keith Mcinnes Jr

Nursing and Health Professions Faculty Research and Publications

Background

Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector.

Objective

The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organizations in low- and middle-income countries (LMICs).

Methods

This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organizations for policy documents, guidance …

Observational Study Of The Clinical Performance Of A Public-Private Partnership National Referral Hospital Network In Lesotho: Do Improvements Last Over Time?, Nancy A. Scott, Jeanette L. Kaiser, Brian W. Jack, Elizabeth L. Nkholongo, Allison Juntunen, Tshema Nash, Mayowa Alade, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Public-private partnerships (PPP) may increase healthcare quality but lack longitudinal evidence for success. The Queen ‘Mamohato Memorial Hospital (QMMH) in Lesotho is one of Africa’s first healthcare PPPs. We compare data from 2012 and 2018 on capacity, utilization, quality, and outcomes to understand if early documented successes have been sustained using the same measures over time. In this observational study using administrative and clinical data, we assessed beds, admissions, average length of stay (ALOS), outpatient visits, and patient outcomes. We measured triage time and crash cart stock through direct observation in 2013 and 2020. Operational hospital beds increased from 390 …

What’S Lunch Got To Do With It?: A Case Study Of California Policy, Educational Equity, And The First Statewide Universal School Meals Program, Rebecca Murillo

Master's Projects and Capstones

In July 2021, California became the first state to pass a program which guarantees two meals a day to all K-12 students at no cost. This project examines California’s journey to pass this Universal School Meals Program (USMP) and explores how such a program can provide equity for students. I produce a legislative history which traces how school meals are funded and regulated at the federal level, California’s public education funding system, their state meal program, the policies which created changes that allowed the USMP to pass, and the legislation of the program itself. Framework presented by Tyack and Cuban …

Translatina Immigrant Mental Health Wellness: Suggestive Intervention Strategies The City Of San Francisco Should Consider Adopting, Valeria Vera

Master's Theses

Translatina immigrants in the United States often suffer from intersectional traumas due to their race, gender, sexual orientation, religion, and immigration status — putting them in a vulnerable position socially, psychologically, economically, and medically. Due to their positionality in the intersections of migration, criminalization, cissexism, and mental health, they are often more marginalized and have greater needs than communities with privileged sociocultural identities. As a particularly vulnerable group, they need guaranteed access to gender-affirming healthcare that is inclusive of mental health services. Despite Translatinas’ need for mental health services, there exist many barriers making services inaccessible and insufficient in San …

Job Satisfaction And Stressors: The Direct Support Professional's Experience, Saralynn Emery

Master's Theses

The current service system for individuals with intellectual and developmental disabilities is provided in the form of community-based support. This support is carried out by Direct Support Professionals (DSPs) who provide one-on-one services to individuals in their homes, workplaces, and communities. The current system is undergoing a turnover crisis and there is an enormous need for a quality and reliable workforce of DSPs to continue to carry out services. Previous research has explored factors that contribute to DSP burnout and ultimately turnover. By researching the DSP role from the DSP experience directly, this study examines other factors that contribute to …

Con Confianza: Using Community-Based Participatory Research Principles To Inform Community-Academic Partnership Practices And Build Trust In Hispanic Communities, Sharon Tafolla

Master's Projects and Capstones

Hispanic communities are at disproportionate risk for chronic diseases and researchers have cited the need for further community and culturally informed studies to improve research outcomes to either make treatments and interventions more generalizable or modify them to the needs of Hispanic communities. However, many of the same linguistic and cultural barriers to health care access and utilization also impact the ability for Hispanic groups to participate in research studies. Community Academic Partnerships (CAPs) are positioned to conduct culturally and linguistically competent research in Hispanic communities. For research in Hispanic communities to be effective, CAPs must prioritize practices that build …

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 …

Black Pregnancy Matters: Racial Reproductive Bias In African American Maternal Mortality, Juhi Khemani

Master's Projects and Capstones

This semester-long research project uncovers how racial biases demonstrated in the reproductive health field, and specifically before, during, and after childbirth, affect the rate of maternal mortality and morbidity for African American mothers in the United States. The rate of maternal mortality for this specific racial group is four times greater as compared to Caucasian women and this discrepancy will be investigated and analyzed throughout this capstone thesis. Interviews were conducted with key figures in the obstetric and gynecological field as well as with Black mothers themselves in an effort to uncover what factors, aside from medical anomalies, are leading …

Anti-Corruption, Transparency And Accountability In Health: Concepts, Frameworks, And Approaches, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: As called for by the Sustainable Development Goals, governments, development partners and civil society are working on anti-corruption, transparency and accountability approaches to control corruption and advance Universal Health Coverage.

Objectives: The objective of this review is to summarize concepts, frameworks, and approaches used to identify corruption risks and consequences of corruption on health systems and outcomes. We also inventory interventions to fight corruption and increase transparency and accountability.

Methods: We performed a critical review based on a systematic search of literature in PubMed and Web of Science and reviewed background papers and presentations from two …

Promoting Anti-Corruption, Transparency And Accountability To Achieve Universal Health Coverage, Theadora Koller, David Clarke, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Anti-corruption, transparency and accountability measures are often missing from efforts to promote universal health coverage. Yet, if unchecked, corruption represents a significant drain on domestic health resource and a major barrier to achieving universal health coverage and the sustainable development goals. The World Health Organization is promoting a coordinated public health approach to anti-corruption, transparency and accountability, working with global partners to create new internal control and assurance models, increase monitoring and evaluation; develop capacity for multiple stakeholders to address corruption; and strengthen normative guidance to integrate anti-corruption, transparency and accountability into WHO’s work on health systems strengthening. The articles …

Leveraging The Power Of Mutual Aid, Coalitions, Leadership, And Advocacy During Covid-19, Daniela Domínguez, Dellanira García, David A. Martínez, Belinda Hernandez-Arriaga

Psychology

The COVID-19 pandemic has shed light on the norms, patterns, and power structures in the United States that privilege certain groups of people over others. This manuscript describes COVID-19 as an unprecedented catalyst for social transformation that underscores the need for multi-level and cross-sectoral solutions to address systemic changes to improve health equity for all. The authors propose that the American Psychological Association and its membership can initiate systemic change, in part, by: (a) supporting mutual aid organizations that prioritize the needs of vulnerable communities; (b) leveraging the efforts and strides APA psychologists have already made within the association, in …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Health Starts In The Home: An Assessment Of Efforts To Improve Occupant Health Through Healthy Building Materials In San Francisco’S Affordable Housing, Staci Hoell

Master's Projects and Capstones

Americans spend 90% of their lives indoors, and much of this time is spent at home, surrounded by building materials that typically have added chemicals like flame retardants, highly fluorinated compounds, and antimicrobials. Recent research has linked these chemicals to adverse health outcomes such as asthma, endocrine disruption, cancer, neurodevelopmental issues, and reproductive problems (Bayer et al., n.d.; Green Science Policy Institute). Furthermore, these chronic health conditions disproportionately affect low-income populations. Fortunately, substantial efforts in research, practice, and policy are working to reduce the use of these potentially harmful chemicals in building materials, particularly in San Francisco’s affordable housing sector. …

San Francisco's Response To Sexual Assault: Pathways To Creating A Survivor-Centered Criminal Justice System, Bianca Rosen

Master's Projects and Capstones

This research examines the process when adult sexual assault survivors in San Francisco decide to pursue legal justice and how survivors experience the local criminal justice system. My analysis exposes the mistreatment of survivors who participate with local law enforcement and recommends survivor-centered policies that could support the wellbeing of survivors pressing charges. The purpose of this research is to encourage law enforcement practices that prioritize survivors’ self-determination and welfare.

Do Marketing Strategies Impact Condom Sales In Uganda?, Meyhar Mohammed

Master's Theses

What attracts people to buy condoms? HIV/AIDS remain one of the biggest health dangers of the world, especially in Sub-Saharan Africa. A lot of efforts have been pursued in the past two decades to drastically reduce prevalence of HIV and increase awareness about preventive mechanisms. In order to prevent relapse of success achieved so far, it is important to recognize transformation of consumer behavior due to growth in social networks, education and awareness over time. There are a lot of behavioral triggers captured by social marketing interventions in the field of public health. In an attempt to investigate the role …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

“Mexico, Public Policy And Obesity In A Global Context”, Daniela Carina Bermudez

Master's Theses

Mexico has one of the most obese populations in the world. A country known for its diversity of rich flavorful food is drowning in low nutritional food products. This thesis examines Mexico’s obesity epidemic within the larger global context of international economic trade policies, public policies and Mexico’s health policies. The key research questions are 1) why is there an obesity epidemic in Mexico? and 2) what remedies should Mexico implement to control it? This thesis contributes to a viable policy strategy for the Mexican government to control and prevent the further increase of this obesity epidemic. Reviewing both the …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

Combating Hiv/Aids In Marginalized Communities: Papua And West Papua Provinces, Indonesia, Bani Cheema

Master's Theses

My study focuses on foreign aid and local initiatives for HIV/AIDS prevention in eastern Indonesia using the provinces of Papua and West Papua as a case study. The two provinces are home to indigenous tribal groups that are socioeconomically marginalized and most affected by the epidemic. My research investigates behavior change communication as a principal strategy undertaken by multiple organizations for HIV/AIDS prevention in this region. I take a qualitative approach by examining the effectiveness of this strategy in local communities and by revealing social and cultural barriers that impede success. Obstacles that negatively impact prevention efforts include structural violence, …

County Of San Mateo Adolescent Report 2014-2015 Youth And Adults Working Together For A Healthy Future, Vanessa D. Bolton

Master's Projects and Capstones

The purpose of this paper is to highlight my fieldwork experience with the County of San Mateo Health System’s Health Policy and Planning Unit. Under the guidance of a Community Health Planner, my scope of work was within the area of school wellness, ranging from an adolescent report publication to researching breakfast in the classroom models to attending district wellness policy meetings. The San Mateo County Adolescent Report took precedence over most of the school wellness projects and initiatives because it was seeking to identify the needs of the County’s youth using evidence from various data sources and to develop …

Improv To Improve Interprofessional Communication, Team Building, Patient Safety, And Patient Satisfaction, Candace A. Campbell

Doctor of Nursing Practice (DNP) Projects

The purpose of this process improvement project was to implement a test of change within a healthcare team utilizing applied improvisational exercises (AIEs), and to lay the groundwork for more effective inter- and intra-professional communication.

Literature review: AIEs have been shown to facilitate individual participant communication strengths through a process of un-learning certain common behavioral habits, and learning new habits that assist in creating and expanding closed-loop communication. Such un-learning and learning enriches the participant’s awareness of the environment and encourages participant adaptability through positive group interactions.

Method: An all-day AIE seminar/workshop was conducted with members of two healthcare teams …