Health Policy Commons^™

Of Rats And Men, Thomas S. Walsh

Capstones

This capstone is a data-driven investigation into New York City's rat problem. By using publicly available government data to map rat activity in NYC, I identified several socio-economic variables that correlate with rat populations at the community district, borough, and city-scale. I used these findings (mainly that rat problems are linked to lower incomes) as the basis of an investigation, which includes interviews with residents, experts, and city officials. Prof. Bobby Corrigan, urban rodentologist and formerly with the NYC Department of Health criticizes the city's efforts for the first time on the record.

https://thomasseiyawalsh.wixsite.com/ratstone

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. …

Mental Hell, Jesenia De Moya, Hanaa' Tameez, Maritza Villela

Capstones

Mental Hell explores how difficult it is for low-income Latinos in New York City to access mental health care. Through explanations from experts and the personal stories of three Latinas New Yorkers who have gone through the process of trying to get the care they need, the story guides the reader through the many roadblocks this demographic encounters specifically under the insurance of Medicaid.

This is an extremely important topic that affects many New Yorkers, and we believe something needs to be done to make this type of healthcare more accessible for Latinos. New York City has a very high …

Hunger Games: Policies To Address Food Deserts In Rhode Island's Low Income Communities, Jessi Mcneill

Pell Scholars and Senior Theses

This policy paper examines the global, health, and social implications of food deserts in the state of Rhode Island. This paper assesses the inception of the food desert phenomenon and draws attention to three policy options for the state. While there is sufficient research on food deserts in large cities like New York and Philadelphia, little information is available regarding the implications of food deserts and policy options available to provide low-income Rhode Islanders with healthy, affordable food. Research methodology consists of site visits and interviews, as well as research courtesy of the 2017 Rhode Island Food Strategy and nonprofit …

Canines For Disabled Kids, Erin Jerrett, Margarita Mnatsakanyan, Colleen Reynolds, Yin Wang

School of Professional Studies

Canines for Disabled Kids have been working on behalf of children and their families to educate communities and promote service dog partnerships for almost twenty years. Their advocacy with local legislatures, business owners, and community leaders highlighted the difficulties encountered when differentiating service dogs from emotional support/comfort dogs. Service dogs are entitled to access by the Americans with Disabilities Act (ADA), while emotional support/comfort dogs are not protected under the federal statute or to the same rights. Canines for Disabled Kids proposed a study to obtain a current count of licensed service dogs in the Commonwealth and investigate the feasibility …

Let Them Eat Lunch: The Impact Of Universal Free Meals On Student Performance, Amy Ellen Schwartz, Michah W. Rothbart

Center for Policy Research

This paper investigates the impact of extending free school lunch to all students, regardless of income, on academic performance in New York City middle schools. Using a difference-in-difference design and unique longitudinal, student level data, we derive credibly causal estimates of the impacts of “Universal Free Meals” (UFM) on test scores in English Language Arts (ELA) and mathematics, and participation in school lunch. We find UFM increases academic performance by as much as 0.059 standard deviations in math and 0.083 in ELA for non-poor students, with smaller, statistically significant effects of 0.032 and 0.027 standard deviations in math and ELA …

Financial Exploitation Of Maine's Older Adults: An Analysis Of Maine Adult Protective Services And Legal Services For The Elderly Case Records, State Fiscal Years 2010-2016, Eileen Griffin Jd, Catherine Mcguire Bs, Kimberly I. Snow Mhsa, Ba

Disability & Aging

The goal of this study was to capture information about the amount of money Maine’s older adults have lost to financial exploitation, along with information about those exploited, the perpetrators of financial exploitation, the type of loss, and amount of money lost. This report summarizes key findings emerging from this analysis. In particular, we found that, when compared to Maine’s general population of adults age 60 and older, the victims of financial exploitation served by Maine's Adult Protective Services (APS) and Legal Services for the Elderly (LSE) are more likely to be age 80 and older, female; and widowed, single, …

Suicide Prevention: Do San Francisco Afsp Community Walks Reduce Hopelessness?, Tyson Peltz

Master's Projects

Community-based outreach programs have been found to be effective, helping to educate people, and reduce suicide through outreach and peer group support. The American Foundation for Suicide Prevention (AFSP) has been at the forefront of the battle to reduce suicide through education, fund raising, lobbing, and support efforts to those in need of suicide prevention services, as well as those who have lost someone. One of the ways they have done this is through community walks and fundraising throughout the nation for anyone affected by suicide. These events are called Out of the Darkness Walks, which allow the community to …

Improving Service Delivery Through Provider Training: A Process Evaluation Of The Veterans Affairs Palo Alto Health Care System “Commitment To Serve” Workshop, Ismael Barrera

Master's Projects

As the customer-focused management strategies gradually advances into all of the VISNs [Veterans Integrated Service Networks], the Veterans Health Administration in Palo Alto, California implemented a customer service training program for employees to meet the diverse and complex needs of its customers. This research will analyze whether participants in this training, known as Commitment to SERVE, believe that it is achieving its goal. In other words, does the Veterans Affairs Palo Alto Health Care System (VAPAHCS) staff perceive the Commitment to SERVE workshop as a beneficial customer service training program?

Consult Management At The Va Palo Alto Health Care System: Has The Implementation Of Business Rules Improved Consult Management, And Did It Help Measure Performance For Select Services?, Christine Poblete

Master's Projects

This research project was developed to determine whether the new business rules implemented at the VA Palo Alto Health Care System have resulted in an improvement in the delivery of critical health care services through consults; and whether this process can be used as a Key Performance Indicator (KPI) for measuring performance of clinical services by health care administrators.

Access To Healthy Foods: A Descriptive Analysis Of Farmers’ Markets, Food Deserts & Usda Food Assistance Programs In Tennessee Census Tracts, Twanda D. Wadlington

Electronic Theses and Dissertations

Food deserts are a growing problem in the United States, and occur in areas of low-income where people have limited access to healthy foods. In response, the presence of farmers’ markets has grown exponentially, and improved healthy food access. Additionally, the USDA has strived to connect families to healthy foods through food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Senior Farmers’ Market Nutrition Program (SFMNP). This study investigated the relationship between farmers’ markets, their acceptance of food assistance benefits, and their locations within Tennessee …

Santa Clara County Senior Nutrition Program Evaluation Report, Tae Hwan Ihm

Master's Projects

Santa Clara County conducts a Senior Nutrition Program (SNP) in conjunction with the City of San Jose, the Outreach Paratransit Program and local community-based organizations (CBOs) like Sourcewise (Lam, 2015). These programs combined represent a significant investment of public funds, with more than 45% of the SNP program’s funding coming from the county General Fund (Lam, 2015). Such a large financial commitment needs to demonstrate some benefit to the participants, and some positive outcomes from the current program design. This study evaluated the SNP’s effectiveness in achieving its primary goals. Primary goals of the SNP are to promote senior citizens’ …

Increasing Use Of Research Findings In Improving Evidence-Based Health Policy At The National Level, Meiwita Budiharsana

Kesmas

In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program …

The Change In Mental Health Status Of Indonesian Health Care Migrant Worker In Japan, Susiana Nugraha, Yuko Hirano, Honda Sumihisha

Kesmas

Under the Japan – Indonesia Economic Partnership Agreement, more than 1,000 of Indonesian health care workers have migrated to Japan. Social adjustment during the process of migration is linked to mental health changes. This study aimed to figure out the strongest predictor that influences the change in mental health status as a result of migration. Baseline data were collected in Jakarta in 2013 during pre-departure orientation. Follow-up study was conducted one year after the study participants migrated to Japan in 2014. Using longitudinal design, this study employed 92 participants consisting of nurse and certified care worker candidates. The multiple linear …

Husband’S Education Level And Alcohol Drinking Habit As Risk Factors Of Hiv Infection Among Housewives In Pati District, Nurul Aeni, Annemarie Westendorp

Kesmas

Cases of Human Immunodeficiency Virus (HIV) infection in Pati District increase, particularly among housewives. The aim of this study was to analyse the risk factors of HIV infection among housewives in Pati District using case-control study design. The respondents were 90 housewives divided into case and control group. The case group consisted of 30 housewives living with HIV, while the control group comprised 60 housewives living in the similar area of the counterparts. The data collection was focused on demographic, sexual behaviour, and sociocultural variables possessed by housewives and their husbands. The study resulted that the risk factors of HIV …

Implementation Of Cigarette Excise Policy Against Cigarette Consumption Reduction Among Adolescent In Kuningan, Indonesia, Jani Ramjani, Fitri Kurnia Rahim, Icca Stella Amalia, Wahyu Manggala Putra

Kesmas

Indonesia has the highest prevalence of smoking (50.68%) compared to other ASEAN countries. On January 1st, 2017, the Indonesian government raised cigarette excise taxes. The purpose of this study was to analysis the impact of cigarette excise increase on cigarette consumption among adolescents aged 17 to 25 years. The study design used cross-sectional survey. A total of 153 adolescents were recruited in this study through simple random sampling technique. Questionnaires and observation papers were used in this study. A face-to-face interview was conducted to fulfill the data collection through home visit for each respondent. The data were obtained during May …

Spatial Analysis Of Determinants Of Filariasis-Endemic Areas In West Sumatra, Masrizal Masrizal, Fivi Melva Diana, Rosfita Rasyid

Kesmas

West Pasaman District and Agam District are filariasis-endemic areas in West Sumatra with prevalence of 12.40 per 100,000 cases and 11.27 per 100,000 cases respectively. This study aimed to determine risk factors associated with the prevalence of filariasis and mapping the vulnerability of the area in West Sumatra. A case control study design was conducted in the West Pasaman District and Agam District. The study used a sample of 74 cases and 74 controls taken by simple random sampling for the case and purposive random sampling for control. Data analysis used univariate, bivariate, multivariate and spatial. The results in Agam …

Effect Of Health Education On Community Participation To Eradicate Aedes Aegypti-Breeding Sites In Buahbatu And Cinambo Districts, Bandung, Zahratul Elsa, Uun Sumardi, Lia Faridah

Kesmas

Dengue hemorrhagic fever (DHF) is still a major public health problem in many regions in Indonesia including Bandung City. Community participation in implementing Eradication of Mosquito-Breeding Sites is still needed as it is considered the most effective method in controlling the dengue fever. This study aimed to determine the influence of health education towards community participation to eradicate mosquito-breeding sites, which was measured by knowledge level and larva index conducted in Bandung, specifically in two different locations with the highest and the lowest incidence rates of DHF. This study used quasi-experimental method. Samples were 100 people living in Cijawura and …

Maternal Energy Intake At The Sixth Month As Dominant Factor Of Exclusive Breastfeeding Success, Devi Suryanti Sihite, Sandra Fikawati, Ahmad Syafiq

Kesmas

Breastfeeding mothers needed adequate energy intake to provide 6-month exclusive breastfeeding that is necessary for infant growth and development. This study aimed to investigate real intake at the first and sixth month of breastfeeding and determine the dominant factor affecting 6-month exclusive breastfeeding provision. The design of this study was cross-sectional conducted in March-April 2015 among 109 mothers with 6-12- month-old infant living and registered at integrated health care in Kalangan Primary Health Care area. Data were collected through interview using questionnaires. Breastfeeding mothers’ intake was asked using Semi-Quantitative Food Frequency Questionnaire. The study found that 6-month exclusive breastfeeding proportion …

Equity Level Of Health Insurance Ownership In Indonesia, Risky Kusuma Hartono

Kesmas

Social health insurance from government program are expected to be able to reduce inequalities access to health services in the middle of rising of health care cost, while private health insurance is still limited for up and middle class population. This study aimed to analyze the equity level of health insurance ownership including social and private health insurance in Indonesia. This study examined the condition of Indonesia in the middle of entering National Health Insurance (NHI) era. This study used data of Indonesian Socio-Economic Survey 2012. Data were analyzed by using econometric approach through multinomial logit analysis. The results showed …

Engaging Human Rights Norms To Realize Universal And Equitable Health Care In Massachusetts, April Jakubec, Mariah Mcgill, Gillian Macnaughton

Biennial Conference: The Social Practice of Human Rights

Massachusetts health care law served as the model in 2010 for the federal Patient Protection and Affordable Care Act (PPACA). In 2006, Massachusetts adopted sweeping health care reforms. The law sought to increase health care insurance coverage for residents of Massachusetts by:

(1) Mandating that all adults in the state have health care insurance unless an affordable option was not available;

(2) Expanding Medicaid;

(3) Creating a new program of subsidized private insurance for low- and moderate-income residents; and

(4) Establishing a transparent health care insurance market exchange.

Previous studies on the Massachusetts health care reforms of 2006 have analyzed …

Patient Experience In The Behavioral Health Setting: Key Best Practices Throughout An Organizational Journey, Mark L. D'Agostino, Tena Vizner, Daniel Wald, Linda Espinosa, Rick Evans

Patient Experience Journal

NewYork-Presbyterian/Westchester Division, a clinical affiliate of Weill Cornell Medicine, is a 260-bed hospital providing inpatient and outpatient behavioral health care for children, adolescents, adults and older adults. From 2004-2010 the hospital’s patient experience scores on the Press Ganey® Inpatient Psychiatry Survey improved from the 14th to 53rd percentile nationally. We primarily attribute this to joining the Planetree® Affilliate Network. Planetree is a mission based not-for-profit organization that partners with healthcare organizations around the world and across the care continuum to represent the patient voice and advance how professional caregivers engage with patients and families. In 2011, hourly rounding was redesigned …

“We Were Learning Together And It Felt Good That Way.” A Case Study Of A Participatory Group Music Program For Cancer Patients, Laurie Sadowski

Patient Experience Journal

Though there are similarities to music therapy, the field of community music in healthcare, while in its infancy, is steadily growing. This case study explored how semi-formal, active music-making can play a role in illness and recovery and provide patients with a sense of voice, connection, and community, and the efficacy of community music programming in a hospital. Six participants began and three participants completed a 6-week music class learning the ukulele. Interpretative Phenomenological Analysis (IPA) was used as a method for data analysis from semi-structured pre-questionnaires, transcribed classes, transcribed post-interviews, and weekly questionnaires from both the participants and the …

Using Appreciative Inquiry As A Framework To Enhance The Patient Experience, Kerry Moorer Mba, Schawan Kunupakaphun, Elilzabeth Delgado, Matthew Moody, Christina Wolf Msn, Rn, Cnl, Karen Moore Rn, Ms, Fache, Pracha Eamranond Md, Mph

Patient Experience Journal

The following case depicts the journey of a non-profit hospital in an under-served community and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project.

Patient Experiences In Intensive Care Units: A Systematic Review, Serpil Topçu, Şule Ecevit Alpar, Bilgi Gülseven, Ayda Kebapçı

Patient Experience Journal

The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998 – April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: “remembering the intensive care period” and “recalled experiences” of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive …

Operationalizing Person-Centered Care Practices In Long-Term Care: Recommendations From A “Resident For A Day” Experience, Jennifer L. Johs-Artisensi

Patient Experience Journal

As the senior population continues to age, long-term care is positioned for growth and care recipients are demanding more person-centered care. While long-term care leaders may understand and believe in the value of person-centered care, sometimes operationalizing practices to ensure its delivery can be challenging. Using an ethnographic approach, over three years, 159 long-term care administrator-in-training practicum students each lived as a resident for 24 hours in a nursing home. Following the experience, using the Picker Institute’s framework, each participant identified and justified an Always Experience® – an optimal experience they believed should routinely occur for every long-term care resident. …

The Impact Of Provider Service Networks In Florida Medicaid Managed Care On Enrollees’ Satisfaction, Sinyoung Park, Jeffrey S. Harman, Allyson G. Hall

Patient Experience Journal

Two counties in Florida were selected as pilots in 2006 for the Medicaid Demonstration Program. In reform counties, Medicaid enrollees were required to pick a managed care plan; either a Health Maintenance Organization or a Provider Service Network (PSN). PSNs are a form of managed care that provides health care services directly through a provider or network of organizations to a defined population without an intermediary. There are two types of PSNs: Physician-based PSNs and Healthcare system-based PSNs. The objective of this study is to find the differences in enrollees’ satisfaction between two different types of PSNs. To assess the …

Maintaining Public Health Insurance Benefits: How Primary Care Clinics Help Keep Low-Income Patients Insured, Rose L. Harding, Jennifer D. Hall, Jennifer Devoe, Heather Angier, Rachel Gold, Christine Nelson, Sonja Likumahuwa-Ackman, John Heintzman, Aleksandra Sumic, Deborah J. Cohen

Patient Experience Journal

Low-income families struggle to obtain and maintain public health insurance. We identified strategies used by Community Health Centers (CHCs) to assist patients with insurance applications, and assessed patients’ receptivity to these efforts. Observational cross-case comparative study with four CHCs in Oregon. We observed insurance assistance processes, and interviewed 26 clinic staff and 18 patients/family members. Qualitative data were analyzed using a grounded theory approach. Patients’ understanding of eligibility status, reapplication schedules, and how to apply, were major barriers to insurance enrollment. Clinic staff addressed these barriers by reminding patients when applications were due, assisting with applications as needed, and tracking …

Patient Safety: Just Ask. Patients As Reporters Of Real-Time Safety Data; A Pilot Project To Improve Patient Safety In Secondary Care, Thomas A. Cairns Dr, Iain Mccallum Mr

Patient Experience Journal

The Berwick review into patient safety recommended ‘involving patients in the healthcare organisation and seeking out the patient voice as an essential asset to monitor safety.’ (1) However routine data collection from patients in our institution is retrospective and doesn't focus on safety. Our objective was to create a patient-centred mechanism to monitor patient-perceived safety concerns and provide immediate resolution of highlighted issues. A pragmatic 6-question questionnaire was developed containing 4 scored and 2 free text questions. This questionnaire was piloted and adjusted before being administered to all inpatients meeting the inclusion criteria in our institution on one day. Safety …

Patient And Provider Experiences With Relationship, Information, And Management Continuity, Jeanette Jackson, Gail Mackean, Tim Cooke, Markus Lahtinen

Patient Experience Journal

From 2003 to 2014, the Health Quality Council of Alberta (HQCA) monitored patient experiences with healthcare services through a biennial Satisfaction and Experience with Healthcare Services (SEHCS) survey. The findings consistently showed a direct link between coordination of care, an aspect of continuity of care, and healthcare outcomes. Specifically, it showed that better coordination is linked to positive outcomes; the reverse is also true. Given the critical role continuity of care plays in the healthcare system, the HQCA conducted in-depth interviews, interactive feedback sessions and focus groups with patients and providers to explore factors that influence both seamless and fragmented …