Health Policy Commons^™

Creation Of A Global Vaccine Risk Index, Tasmiah Nuzhath, Peter J Hotez, Ashish Damania, P Shuling Liu, Brian Colwell

Center for Medical Ethics and Health Policy Staff Publications

The World Health Organization has identified vaccine hesitancy as one of its top ten global health threats for 2019. Efforts are underway to define the factors responsible for reductions in vaccine confidence. However, as global measles cases accelerated beginning in 2018, it became evident that additional factors were promoting measles re-emergence, including war, political and socio-economic collapse, shifting poverty, and vulnerability to weather events and climate change. Accordingly, we propose a Global Vaccine Risk Index (VRI) to consider these variables as a more comprehensive means to identify vulnerable nations where we might expect measles and other vaccine-preventable diseases to emerge …

Fast Cbt For Pediatric Ocd: A Multiple-Baseline Controlled Pilot Trial Of Parent Training In Exposure And Response Prevention Delivered, Lara J Farrell, Natalja A Nabinger De Diaz, Sharna Mathieu, Matthew L Mckenzie, Taka Miyamoto, Caroline L Donovan, Allison M Waters, Sonja March, Nicole Bothma, Rianca Kroon, Gabrielle Simcock, Robert S Ware, Robert R Selles, Eric A Storch, Thomas Ollendick

Center for Medical Ethics and Health Policy Staff Publications

Objective: The current study utilized a single case series, non-concurrent multiple baseline design to examine the efficacy of training parents via telehealth videoconferencing in exposure and response prevention (ERP) for home delivery of the treatment for their children and adolescents with obsessive compulsive disorder (OCD).

Method: There were nine participants aged 8 to 14 years who had received a primary diagnosis of OCD. The design involved a series of AB replications, whereby following pre-treatment assessments participants were randomly assigned to either a 2-week (n = 4) or 3-week (n = 5) baseline condition with weekly monitoring of their …

Post-Trial Access In Implanted Neural Device Research: Device Maintenance, Abandonment, And Cost, Gabriel Lázaro-Muñoz, Michelle T Pham, Katrina A Muñoz, Kristin Kostick-Quenet, Clarissa E Sanchez, Laura Torgerson, Jill Robinson, Stacey Pereira, Simon Outram, Barbara A Koenig, Philip A Starr, Aysegul Gunduz, Kelly D Foote, Michael S Okun, Wayne Goodman, Amy L Mcguire, Peter Zuk

Center for Medical Ethics and Health Policy Staff Publications

Background: Clinical trial participants who benefit from experimental neural devices for the treatment of debilitating and otherwise treatment-resistant conditions are generally not ensured continued access to effective therapy or maintenance of devices at the conclusion of trials.

Objective/hypothesis: Post-trial obligations have been extensively examined in the context of drug trials, but there has been little empirical examination of stakeholder perspectives regarding these obligations in the rapidly growing field of neural device research.

Methods: This study examined the perspectives of 44 stakeholders (i.e., 23 researchers and 21 patient-participants) involved in implantable neural device trials.

Results: Researchers were concerned about current post-trial …

A Mixed-Methods Protocol To Develop And Validate A Stewardship Maturity Matrix For Human Genomic Data In The Cloud, Vasiliki Rahimzadeh, Ge Peng, Mildred Cho

Center for Medical Ethics and Health Policy Staff Publications

This article describes a mixed-methods protocol to develop and test the implementation of a stewardship maturity matrix (SMM) for repositories which govern access to human genomic data in the cloud. It is anticipated that the cloud will host most human genomic and related health datasets generated as part of publicly funded research in the coming years. However, repository managers lack practical tools for identifying what stewardship outcomes matter most to key stakeholders as well as how to track progress on their stewardship goals over time. In this article we describe a protocol that combines Delphi survey methods with SMM modeling …

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Health Policy & Community Health: Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …

Social Media Usage And Transitioning Into Online Classes During Covid-19- A Survey Of Undergraduate Students In Georgia, United States, Sylvia Ofori, Janet Choongo, Mario Kekop, Gulzar H. Shah, Haresh Rochani, Joseph Telfair

Health Policy & Community Health: Faculty Publications

Previous studies on the use of social media (SM) during the COVID-19 pandemic have focused on the use in sustaining academic communication. This study aimed to assess the association between SM and the ease of transitioning to online classes during the COVID-19 pandemic using survey data from 872 undergraduate students. The findings showed that Snapchat and Instagram were the most preferred social media sites among participants. Compared to students who use SM for < 2 hours a day, use for > 5 hours (AOR= 2.44; 95% CI, 1.13 – 5.25) or 3 to 5 hours a day (AOR = 2.01, 95% CI 1.06-3.81) increased the odds of easily …

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …

American Gun Violence: A Cause To Combat The Epidemic, Colin Fonseca

Health Sciences Student Scholarship

The following paper examines the role assault weapons and high-capacity magazines play in mass shootings within the United States. With reference to compelling statistics, the extent to which political ideology impacts decisions on gun reform is assessed. Specifically, the paper recognizes the stark contrast in opinion between Democrats and Republicans on the severity of the problem of gun violence in America; while Democrats identify gun violence as a public health crisis in need of immediate attention, Republicans express their worry that citizens’ freedoms are being violated if stricter reforms are established. Considering the fact that gun violence has remained an …

Low Acceptance Of Helmet-Use And Injuries From Motorcycle Accidents In Rawalpindi And Abbottabad, Pakistan, Maryam Siddiqa, Gulzar H. Shah, A. Munam

Health Policy & Community Health: Faculty Publications

Background: Motorcycle accidents are a major cause of head injuries and the current study evaluated the beneficial impact and effectiveness of helmet usage among injured Motorcycle users. This study has been performed to observe the Motorcycle collisions within 6 months in Rawalpindi and Abbottabad cities of Pakistan

Objectives: Implications of helmet usage were assessed and the risk factors for severe injury during motorcycle accidents were identified.

Results: The multivariate analysis indicated that riders without a helmet were more likely to experience severe (AOR, 2.216; 95% CI, 2.02 to 10.5) or moderate injury (AOR, 1.215; 95% CI, 0.84 …

Indicadores De Desigualdad Y Mortalidad Por Enfermedades Cardiometabólicas En Guatemala / Inequality Indicators And Cardiometabolic Diseases Mortality In Guatemala, Alejandro Cerón, Gila Y. Goldstein

Anthropology: Faculty Scholarship

La medición de las desigualdades en salud al interior de los países de ingresos bajos y medios es necesaria para la planificación, monitoreo y evaluación de intervenciones de salud pública, especialmente para problemas que contribuyen altamente a la carga de enfermedad, como las enfermedades cardiometabólicas. El objetivo de este estudio fue caracterizar los patrones de desigualdad de las tasas de mortalidad para las principales causas cardiometabólicas en Guatemala. Se usó datos del Censo Nacional de Población, y estadísticas oficiales de defunción de 2018 para calcular tasas crudas de mortalidad para diabetes (DM), infarto agudo de miocardio (IAM), y accidente cerebrovascular …

Reproductive Freedom For All: A Policy Brief, Noa J. Cook

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Reproductive freedom in the United States has been a source of controversy throughout history and current legislation places these rights under attack. Divided into three parts, this policy brief seeks to address the lack of accessible reproductive healthcare for women, with special attention to economic, racial, and ethnic disparities. Part 1 includes a historical overview of abortion access and significant legislation in the U.S., describes the present status of the problem, and the populations affected. In Part 2, the pros and cons of current policies such as the federal contraceptive guarantee of the Affordable Care Act (ACA), Hyde Amendment, and …

Determining The Optimal Healthcare System For America: Comparing The Current American And Universal Healthcare Systems, Tejas Kandharkar

University Honors Program

U.S. citizens ranked healthcare as the most important issue when it comes to voting (Zieff, 2020). The healthcare system’s importance is evident which is why it is important to determine what healthcare system is optimal for America. I used core indicators to compare the current American healthcare system and universal healthcare system and evaluated them for four key parameters. Based on my analysis, I conclusively determined that the universal healthcare system (Score: 8.23/10) is more optimal than the current American healthcare system (Score: 5.10/10). The American system had a somewhat better quality of care but the universal healthcare system was …

Covid-19 Investigated In Terms Of Disparities: An Analysis Of The Past, Present, And Future Of Public Health In Illinois, Hannah Deblock

University Honors Program

As a relatively new topic, previous literature fails to address the relation of social determinants of health to COVID-19. By combining existing knowledge on previous epidemics, information on the role of social determinants of health, and data on COVID-19, conclusions can be made about the path going forward. Historically, nonpharmacologic interventions such as quarantine periods, face coverings, and social distancing have been used in epidemics such as the Spanish Influenza of 1918-19. In terms of social determinants of health, geographical location, educational level, and income level all play a part in the health of an individual. Rather than emphasizing personal …

Senior Center Response To Covid-19: Involvement With Vaccine Distribution, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

In early 2021, access to a COVID-19 vaccine was prioritized for older adults and people with multiple co-morbidities. Between high demand and emerging supply, and new systems for booking a vaccine appointment, many people had challenges getting an appointment. Senior centers across the state became a crucial resource for access to the vaccine and additional information about its efficacy and safety.

Senior Center Response To Covid-19: Mid-Year Operations 2021, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

Senior centers/COAs in Massachusetts remained largely operational through the height of the COVID-19 pandemic, and continued to assist older adults in the community. With the introduction of a vaccine, return to ‘normal’ operations has become more feasible. By mid-2021, senior centers were returning to some in-person operations and continued adaptations for safety, including mask-wearing, limiting capacity, fewer walk-ins, and increased hand sanitization availability.

Gender Identity And Mental Health Among Undergraduate Students In The United States, Mckenzie Mcnamara

All Theses

This study explores the relationship between gender identity, challenges experienced by students, psychological distress, and suicide behavior for undergraduate students in the United States of America. The quantitative analysis utilizing the American College Health Association’s National College Health Assessment from Fall 2019, Spring 2020 and Fall 2020. The sample consisted of 78,296 undergraduate participants of which 65.9% identified as female, 30.5% identified as male, and 3.6% identified as non-binary students. The statistical analysis consisted of a multiple regression model controlling for variables of institution type. The major finding of this study is that non-binary undergraduate students had greater psychological distress …

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.

Responding To Domestic Violence With Transformative Justice And Community Accountability, Anaiis Nysether

Capstone Projects and Master's Theses

Walnut Avenue Family & Women’s Center (WAFWC) wanted to create a survivor-driven transformative justice program for survivors of domestic violence and the people who caused them harm. The program needed to be customizable enough to suit the specific needs and individual safety considerations of the participants, but also needed enough structure that it could be reproducible from case to case. In order to design a program that was based on these ideas and able to be used in the context of a non-profit organization, WAFWC researched ways other communities had been using transformative justice and community accountability to address issues …

J Mich Dent Assoc December 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Two cover stories presenting perspectives from both ends of the practice life continuum: “Starting Your Practice Life” and “Preparing for Retirement”.
• A feature article, “What Happened in Vegas Became ADA Policy”.
• A feature article, “An Oversight Corrected: 2020 MDA Life Members Recognized”.
• The 2021 Author/Title Index to the Journal of the Michigan Dental Association. …

The Healing Landscapes Of Usu: Discovering Spaces Of Potential Mental Restorativeness: A Geospatial Analysis Of Usu Campus, Amelia H. Wilcken

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

This project focuses on understanding an alternative resource that can be intentionally improved upon to help address the mental health crisis on university campuses. With ample research showing how nature and being outside can help improve, or be restorative for, the mental state of individuals, this project developed an analytical method for understanding the restorative potential within the campus landscape as a whole and within districts. The analysis uses nine separate elements that make up the campus landscape: (1) trees, (2) landscape plantings (grass, planters, etc.), (3) art pieces, (4) benches, (5) water features, (6) sidewalks, (7) roads, (8) parking …

From Pandemic Response To Portable Population Health: A Formative Evaluation Of The Detroit Mobile Health Unit Program, Phillip Levy, Erin Mcglynn, Alex B. Hill, Liying Zhang, Steven J. Korzeniewski, Bethany Foster, Jasmine Criswell, Caitlin O'Brien, Katee Dawood, Lauren Baird, Charles J. Shanley

Urban Studies and Planning Faculty Research Publications

This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease “hotspots” based on publicly available SARS-CoV-2 testing data and …

Consistent Snap Participation Increases Preventative Health Care Visits For Infants, Colleen Heflin, Irma A. Arteaga, Julia Stafford

Population Health Research Brief Series

Food insecurity in families with children has increased dramatically during the coronavirus (COVID-19) pandemic. Not only is food insecurity a problem on its own, but it is linked to receiving less preventative medical care in the first year of life—including well-child visits and recommended vaccinations. This brief summarizes findings from research examining the connection between SNAP participation and preventative care in an infant’s first year of life in Missouri. Findings show that infants in households that receive unstable SNAP benefits have a lower likelihood of attending all their well-child visits and receiving routine immunizations. Policymakers should consider interventions to simplify …

Paid Sick Leave Heading Into Covid-19: A Descriptive Account Of Workers Who Lacked Paid Sick Leave, David Rothwell, Sophia Fox-Dichter, Mathieu Despard, Michal Grinstein-Weiss

Social Policy Institute Research

Paid sick leave is vital for controlling the spread of illness in the workplace and an invaluable public health tool, but too few workers have access to it. In this brief, we examine the beginning of the COVID-19 pandemic to assess paid sick leave coverage with a focus on the social and economic characteristics of workers without paid leave.

Using a nationally representative survey with roughly 4,000 working respondents, we found that a third lacked access to paid sick leave. Workers without paid leave were younger, more likely to be female, more likely to be white, and less likely to …

Vaccine Hesitance During Covid-19: Exploring Motivations And Incentives, Laura Brugger, Stephen Roll, Katie Kristensen, Michal Grinstein-Weiss

Social Policy Institute Research

As rates of vaccination have slowed, concerns are growing about how to increase vaccine uptake among those who are vaccine hesitant, particularly with the emergence of new and contagious variants such as Delta. Using our national Socioeconomic Impacts of COVID-19 Survey, we examine the predictors of vaccine hesitance in the U.S. and report on findings from an experiment assessing the potential impacts of vaccine incentive schemes.

Our study points to the difficulties in overcoming vaccine hesitance among the unvaccinated. Vaccine hesitance was common across income levels, and experience with COVID-19-related hardships—such as knowing someone who died of the disease or …

Addressing The Role Of Climate Change In Agriculture And Mexico-Us Immigration, Xiaoxin Liang

Binghamton University Undergraduate Journal

Among the greatest threats of climate change is the significant impact on mass displacement, particularly as it relates to Mexico-US immigration. Low crop yields from worsening climate conditions have been linked to increased migration of Mexican farmers. With a projected 4.2 million additional migrants in the foreseeable future, it poses a contemporary environmental, social, and political dilemma. This policy brief analyzes several provision proposals to be adopted into the United States-Mexico-Canada Agreement (USMCA), as evaluated under economic cost, equity, environmental impact, and feasibility criteria. My research concludes that the most effective and direct provision proposal is the implementation of adaptive …

The Indonesian Strategy To Achieve Universal Health Coverage Through National Health Insurance System: Challenges In Human Resources, Atikah Adyas

Kesmas

Many countries are currently trying to achieve universal health insurance coverage in order to provide health protection for their population. Indonesia has received a strong political commitment to implement national health insurance including government support to finance the poor. The implementation of comprehensive national health insurance requires human resources, each of which has a role in fighting for noble goals for the welfare of all people. This paper is taken from the experience of Indonesia and several other countries as well as guidelines that can be used in exploring the role of human resources for the success of the implementation …

Mental Fatigue And Its Associated Factors Among Coal Mining Workers After One Year Of The Covid-19 Pandemic In Indonesia, Hendra Djamalus, Budi Utomo, I Made Djaja, Sjahrul M. Nasri

Kesmas

Mental fatigue among coal mining operators was related to driving activities that require high concentration. This study aimed to determine factors that contributed to mental fatigue among coal mine operators in Indonesia, specifically in Kalimantan and Sumatra, after a one-year COVID-19 pandemic. This cross-sectional study was conducted among 480 operators from two companies and seven sites. A self-administrated questionnaire in the Google Form was used to measure mental fatigue, the non-work-related factors (age, education, marital status, residence, and stress level), and work-related factors (working periods, shift pattern, type of shift, and work area in mining). The data analyzed using Chi-square …

Breastfeeding Knowledge And Behavior In Lactational Amenorrhea Method (Lam) As A Natural Contraceptive, Mufdlilah Mufdlilah, Reza Bintangdari Johan, Sri Ratna Ningsih

Kesmas

The lactational amenorrhea method (LAM) is a natural contraceptive that is highly effective after the three essential criteria are fulfilled. However, there is a significantly low adoption resulting from poor knowledge and correct practices. This study aimed to determine the correlation between knowledge and behavior of breastfeeding mothers on breastfeeding as a natural contraceptive. This was an analytic observational study with a cross-sectional design involving 89 breastfeeding mothers and was performed from January to March 2018. Furthermore, data were collected using a questionnaire, and the results showed knowledge of breastfeeding mothers to be good (59.6%) and not good (51.7%). However, …

Integrated Model Of A Family Approach And Local Support In Tuberculosis Case Finding Efforts In People With Hiv/Aids, Erni Astutik, Chatarina Umbul Wahyuni, Imelda F E Manurung, Geofrey Ssekalembe

Kesmas

The human immunodeficiency virus (HIV) remains a major global public health problem. People with HIV/acquired immune deficiency syndrome (AIDS) are more susceptible to opportunistic infections such as tuberculosis (TB). Therefore, families and community leaders need to help monitor people living with HIV/AIDS (PLWHA). This study aimed to analyze an integrated family approach and local support model to detect TB cases in PLWHA. This study used a case-control study in Kupang City, East Nusa Tenggara Province, in July 2020. The sample comprised 100 people (50 PLWHA with TB case and 50 controls) using total sampling and random sampling, respectively. The variables …

Predictors Of The Covid-19 Social Distancing Practice Among Undergraduate Health Students In Samarinda City, Indonesia: A Cross-Sectional Study, Siti Hadijah Aspan, Pramon Viwattanakulvanid

Kesmas

Social distancing is a health protocol recommended by the World Health Organization (WHO) for reducing the spread of COVID-19. Undergraduate health students play an important role in the dissemination of accurate information. This study identified predictors that influenced the COVID-19 social distancing practice and examined the sources of social distancing information among undergraduate health students in Samarinda City, Indonesia. This cross-sectionalonline survey study (March-April 2021) involved 422 undergraduate students from medicine, public health, and pharmacy faculties at Mulawarman University. Binary logistic regression was conducted to identify factors associated with the COVID-19 social distancing practice. The results showed that age (AOR …