Health Policy Commons^™

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Health Policy & Community Health: Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Health Policy & Community Health: Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

“Take My Word For It”: Group Texts And Testimonials Enhance State And Federal Student Aid Applications', Jason Jabbari, Stephen Roll, Sam Bufe, Jessica Mckay

Social Policy Institute Research

"As the cost of college continues to rise, it has become increasingly important for students to apply for financial aid. However, many students are unaware of the benefits of FAFSA. We launched a field experiment with a non-profit organization to explore the impact of text message interventions on FAFSA application rates. 2,236 potential students were randomized into three groups: a control group that focused on reminders for upcoming deadlines, a treatment group that focused on benefits-framed messaging, and a second treatment group that added social proofing and norming. Each group received 8 text messages from late September 2020 to early …

Spatio-Temporal Analysis Of The Roadside Transportation Related Air Quality (Startraq) And Neighborhood Characterization, Jaymin Kwon, Yushin Ahn, Steve Chung

Mineta Transportation Institute

To promote active transportation modes (such as bike ride and walking), and to create safer communities for easier access to transit, it is essential to provide consolidated data-driven transportation information to the public. The relevant and timely information from data facilitates the improvement of decision-making processes for the establishment of public policy and urban planning for sustainable growth, and for promoting public health in the region. For the characterization of the spatial variation of transportation-emitted air pollution in the Fresno/Clovis neighborhood in California, various species of particulate matters emitted from traffic sources were measured using real-time monitors and GPS loggers …

The Impact Of Covid-19 On Church Gatherings In The Philippines: A Policy Analysis, Grace Zurielle Malolos, Joseph Christian Obnial, Rena Mallillin, Pamela Bianca Pasco, Erika Ong, Arianne Andes, Faith Ann Apat, Emma Teresa Carmela Aportadera, Rafael Valencia, Don Eliseo Lucero-Prisno Iii

Ateneo School of Medicine and Public Health Publications

The Philippines is the largest Christian-majority country in Asia. With church gatherings playing a vital role in the nature of Christianity in the Filipino culture, the advent of the coronavirus disease (COVID-19) pandemic in the Philippines posed challenges to public religious practices amid efforts to mitigate COVID-19 community transmission. Various policy pronouncements from both the government-led Inter-Agency Task Force (IATF) on Emerging Diseases and the church-led Catholic Bishops’ Conference of the Philippines (CBCP) were issued. These guidelines were implemented in order to address the two-pronged problem on healthcare and religious obligations. While these guidelines were initially contributory to the mitigation …

Food Insecurity In Detroit: Exploring The Relationship Between Patient-Reported Food Insecurity And Proximity To Healthful Grocery Stores, Sara Santarossa, Alex B. Hill, Alexandra R. Sitarik, Mackenzie Taylor, Susan Hawkins, Katherine Scher, Aaron Sohaski, Mohammed Baseer, Rachael Dombrowski, Alexander Plum, Christine Lm Joseph

Urban Studies and Planning Faculty Research Publications

Objective:
The objective of the current study was to determine if patients of a large health care system in Detroit who self-identify as food insecure live further away from healthy grocery stores compared with food secure patients. Second, we explored whether food insecurity and distance to healthy grocery stores are related to ecological measures of vehicle availability in the area of residence.

Design:
A secondary data analysis that uses baseline data from a pilot intervention/feasibility study.

Setting:
Detroit, Michigan, USA.

Participants:
Patients of Henry Ford Health System were screened for food insecurity to determine eligibility for a pilot intervention/feasibility study …

Assessment Of The Financial Health Of Rural Hospitals After Implementation Of The Georgia Rural Hospital Tax Credit Program, Bettye A. Apenteng, Samuel T. Opoku, Charles Owens, Emmanuel Akowuah, Linda Kimsey, Angela Peden

Health Policy & Community Health: Faculty Publications

Importance In 2016, Georgia implemented the Rural Hospital Tax Credit Program, which allows taxpayers to receive a tax credit for contributions to qualifying rural hospitals in the state. Empirical evidence of the program’s association with the viability of the state’s rural hospitals is needed.

Objective To examine the association of the tax credit program with the financial health of participating rural hospitals.

Design, Setting, and Participants This longitudinal cross-sectional study used hospital financial data from the Centers for Medicare & Medicaid Services for 2015 to 2019. A difference-in-differences analytic approach was used to examine the association of the tax credit …

Timely And Well-Targeted Financial Assistance During Covid-19, Mathieu Despard, Selina Miller, Katie Kristensen

Social Policy Institute Research

The Social Policy Institute (SPI) at Washington University in St. Louis partnered with PerkUp Financial Health LLC, a financial services technology company, to study an emergency financial assistance program offered to employees of three hotels in New Orleans, LA who have been affected by the COVID-19 pandemic. PerkUp serves as a technology hub for a collaboration of non-profit partners that deliver financial support services and innovative products to employees of participating companies. The array of financial health services available through the PerkUp platform provides a financial safety net for the most financially vulnerable employees.

The Disproportionate Impact Of Toxins In Consumer Products, Meredith Bollheimer, Elissa Reitz

The Seneca Falls Dialogues Journal

The number of chemicals used in everyday products has grown exponentially over the last century. Many of these chemicals are known endocrine disrupting compounds (EDC’s) and they have not been proven to be safe for humans or for the environment. Rather, many of these chemicals have been linked to negative human health outcomes and damage to the environment. Corporate America is responsible for the production and liberal use of these chemicals in consumer and personal care products. The federal government has failed to provide effective or meaningful standards or regulations for the myriad chemicals of concern that make their way …

Review Of Sexual Health Issues Linked With Cardiovascular Disease And Type 2 Diabetes Mellitus In Aboriginal And Torres Strait Islander Males, Veronica Collins, Tamara J. Swann, Jane Burns, Tim Moss, Mick Adams

Australian Indigenous HealthBulletin

There are well established links between male sexual health conditions and chronic disease, particularly cardiovascular disease (CVD) and type 2 diabetes (T2DM). Erectile dysfunction (ED) and low testosterone are two sexual health conditions that are relatively common among the wider male population. However, there is a lack of data specifically about these sexual problems among Aboriginal and Torres Strait Islander males.

One of the most important findings of research regarding the links between sexual health and chronic disease is that ED can be a risk marker for future CVD or undiagnosed T2DM. Understanding these links can lead to more holistic …

Support For Me Assessment Of Substance Use Treatment And Recovery Services Current Infrastructure And Future Needs: Summary Of Feedback From The Support For Me Community Focus Groups (Condensed), Katie Rosingana Ba, Mary Lindsey Smith Phd, Evelyn Ali Bs, Karen Pearson Mlos, Ma, Tyler Egeland Ba, Mark Richards Bs

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. In collaboration with Maine DHHS, the Cutler Institute conducted a series of virtual focus groups in Maine as part of a needs assessment for the SUPPORT for ME initative. These focus groups were conducted regionally by Public …

Support For Me Assessment Of Substance Use Treatment And Recovery Services Current Infrastructure And Future Needs: Findings From The Support For Me Youth Survey (Condensed), Evelyn Ali Bs, Katie Rosingana Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. In collaboration with Maine DHHS, the Cutler Institute conducted a survey for youth and young adults in Maine as part of a needs assessment for the SUPPORT for ME initative. The data collection goals of the survey …

Travelling For Abortion Services In Mexico 2016–2019: Community-Level Contexts Of Mexico City Public Abortion Clients, Laura E. Jacobson Mph, Biani Saavedra-Avendano, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To describe the community context of women who travel to access Mexico City’s public sector abortion programme and identify factors associated with travelling from highly marginalised settings.

Methods: We used data from the Interrupción Legal de Embarazo (ILE) programme (2016–2019) and identified all abortion clients who travelled from outside Mexico City. We merged in contextual information at the municipality level and used descriptive statistics to describe ILE clients’ individual characteristics and municipalities on several measures of vulnerability. We also compared municipalities that ILE clients travelled from with those where no one travelled from. We used logistic regression to identify …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Ensuring Equitable Access: Theory And Methodology On Future Grant Application Design For The City Of Bloomington's John M. Scott Health Care Commission, Zachary Fabos

Student Research – Stevenson Center

This research utilizes qualitative and quantitative methods to analyze perception and opinion of the City of Bloomington’s John M. Scott Health Care Commission’s grants program and its application process among recipient agencies and other participants. Data, gathered through surveys and semi-structured interviews, in 2020 and 2021, between representatives of each agency and the researcher are meant to inform the development of new approaches encouraging a wider reach of the Commission’s grants program in McLean County, Illinois. Questioning the theoretical purpose of merit, bureaucracy, and performance in an application process, this research aims to create a more accessible program for agencies …

Personal Mastery And All-Cause Mortality Among Older Americans Living With Diabetes, Ho-Jui Tung, Ming-Chin Yeh, Randall Ford, Gulzar H. Shah

Health Policy & Community Health: Faculty Publications

Introduction: Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time.
Methods: A total of 1,779 participants were identified from an off-year survey of the Health and Retirement Study. Proportional Hazard Models were used to evaluate the significance of selected variables in predicting the survival of participants over a 13-year period.
Results: A substantial proportion (46.7%) of the diabetic patients had survived by the end of 2016. Adults with lower mastery …

Perceived Benefits Matter The Most In Covid-19 Preventive Behaviors: Empirical Evidence From Okara District, Pakistan, Gulzar H. Shah, Ansar Ali Faraz, Hina Khan, Kristie Cason Waterfield

Health Policy & Community Health: Faculty Publications

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a faceto- face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara …

Student Loans And Health-Related Financial Hardship, Sophia T. Anong, Robin Henager

Journal of Student Financial Aid

Research has shown that student loan borrowers in repayment exhibit physical and mental health problems. These can be exacerbated by and contribute to health-related financial hardship. We use the 2015 U.S. National Financial Capability Study to examine the likelihood of having past due medical bills and of avoiding health care services by not purchasing prescribed medication, skipping tests or follow-up with a doctor or not seeking care for a medical problem. Borrowers on income-driven repayment plans and those who made late payments are found to be more likely to have unpaid medical bills and to have avoided required medical attention. …

Evidence On Child Nutrition Recommendations And Challenges In Crisis Settings: A Scoping Review, Aniqa Islam Marshall, Gideon Lasco, Mathudara Phaiyarom, Nattanicha Pangkariya, Phetdavanh Leuangvilay, Pigunkaew Sinam, Rapeepong Suphanchaimat, Sataporn Julchoo, Watinee Kunpeuk, Yunting Zhang

Development Studies Faculty Publications

Adequate child nutrition is critical to child development, yet child malnutrition is prevalent in crisis settings. However, the intersection of malnutrition and disasters is sparse. This study reviews existing evidence on nutrition responses and outcomes for infants and young children during times of crisis. The scoping review was conducted via two approaches: a systematic search and a purposive search. For the systematic search, two key online databases, PubMed and Science Direct, were utilized. In total, data from 32 studies were extracted and included in the data extraction form. Additionally, seven guidelines and policy documents were included, based on relevance to …

Pregnant Women With Substance Use Disorders Deserve Plans Of Safe Care, Alexandra E. Punch, Monika Taylor

Population Health Research Brief Series

Substance use among women who are pregnant is a growing U.S public health issue. Approximately 340,000 infants are affected by prenatal exposure to illicit drugs annually, leading to an increase in Neonatal Abstinence Syndrome (NAS), and Child Protective Services involvement. This issue brief describes the current state of prenatal substance use and provides guidance on the use of federally mandated Plans of Safe Care to help mothers prepare for the arrival of their baby while navigating their substance use disorder.

Experiences Of Nonbinary And Gender Nonconforming Individuals Within The Healthcare System, Chloe B. Lacey

Intuition: The BYU Undergraduate Journal of Psychology

Though nonbinary and gender nonconforming people are becoming increasingly recognized in North America, specialized healthcare—specifically gender-affirming procedures—are not becoming available to them. Researchers have examined the subjective experiences of these individuals as they have navigated the healthcare system in order to further understand possible limitations for nonbinary and gender nonconforming populations. Methods include assessing the procedures available to participants and their interpersonal experiences with healthcare professionals and family members. Scientific resources on this topic are limited, and the results are overwhelmingly represented by self-report. Furthermore, the content of the results is majorly negative toward the participants’ experiences. Participants report verbal …

The Use Of Mobile Apps To Increase Physical Activity Level: A Systematic Review, Dziyana Nazaruk, Kelli Rouser

Health Policy & Community Health: Faculty Publications

Background: About 82% of the U.S. adult population owns a smartphone. More than half of that population downloaded a fitness or health app to increase the physical activity level. The current review included studies that have utilized mobile apps in conjunction with other intervention strategies to increase physical activity levels. Methods: The search was conducted in five electronic databases. Studies were included if they were randomized controlled trials, utilized mobile apps, physical activity was the primary outcome, written in English, and conducted between the years of 2007 and 2019. Results: Thirteen studies were included in the final review. Results indicated …

Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Ghana is working toward achieving universal health coverage (UHC). This is driven, in part, by the Sustainable Development Goals (SDGs), specifically SDG 3—Good Health and Well-Being, which seeks to ensure healthy lives and promote well-being for all at all ages. Achieving this feat will improve equity of access as people, especially the poor can access quality health services without financial hardships. Ensuring equitable access to family planning (FP) is essential to securing the well-being of women and supporting the health and development of communities. One pathway to ensuring equity is the inclusion of FP in affordable insurance. While the inclusion …

Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana

Reproductive Health

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased …

The Essence Of Telemedicine For Bridging The Gap In Health Services, Budi Wiweko, Sarah Chairani Zakirah, Atha Luthfi

Kesmas

This study aimed to review the essence of telemedicine in this modern era of technology and innovation, especially in developing countries. It also investigated the regulation aspect as the main component for healthcare services. There were five main categories of telemedicine: revenue stream and technology literacy, health facilities, human resources, data authorization and security, and health protocol. Furthermore, when combined with wearable devices, it enhanced healthcare delivery opportunities. There were two major components of global electronic health, namely telehealth and health informatics, based one-commerce and e-learning systems. The World Health Organization (WHO) has been able to describe the roles of …

The Determinants Of Stunting For Children Aged 24-59 Months In Kulon Progo District 2019, Chatrine Aprilia Hendraswari, Yuliasti Eka Purnamaningrum, Tri Maryani, Yani Widyastuti, Sakinah Harith

Kesmas

This study pertains to stunting in children in Indonesian with z-scores of less than -2 Standard Deviation (SD) and less than -3 SD. The preliminary study results showed the highest prevalence of stunting to be 22.6%, at the Temon II Primary Health Care in Kulon Progo District. The study aimed to assess the determinants of stunting children aged 24–59 months. This study was conducted from September 2018–May 2019. The design of this study was analytical observational with study design case-control. The sample was 60 children aged 24–59 months. The method utilized proportional sampling, whereas the data analysis applied chi-square and …

A Path Analysis Model For Explaining The Factors Influencing Wearing A Mask Among Commuting Workers Using Commuter Line Bogor-Jakarta, David Kusmawan, Shofi Andari, Ira Gustina, Indri Hapsari Susilowati, Mufti Wirawan

Kesmas

Jakarta is one of the most air-polluted cities in the world, which can increase the health risk of commuting workers exposed to pollutants. This study aimed to determine the factors that directly and indirectly affect healthy behavior (wearing a mask) for commuters using the Bogor-Jakarta Commuter Line. Furthermore, a total of 155 respondents participated and the data collected were analyzed using descriptive and path analysis. The commuters aware of the hazard potential related to air pollution during commuting were 137 people (88.4%). While 104 people (67.1%) were aware of the good perception of pollution and 125 uses masks during commuting …

The Effect Of Smoking On Carbon Monoxide Respiration Among Active Smokers In Palembang City, Indonesia, Rico Januar Sitorus, Imelda Gernauli Purba, Merry Natalia, Kraichat Tantrakarnapa

Kesmas

Smoking leads to disease and disability as well as harm nearly every organ of the body. Furthermore, smoking of tobacco is known to cause pulmonary dysfunction and lead to complications, pain, or even death. This study aimed to measure the risk factors for the respiration of carbon monoxide among smokers. A cross-sectional design was implemented by involving 156 smokers in Karyajaya Subdistrict, Palembang City. The dependent variable was carbon monoxide levels (ppm), while the independent variables were smoking frequency, duration, and the last period of smoking. The carbon monoxide levels (ppm) measured with a PiCO + Smokerlyzer® device from Bedfont …

The Significance Of Super Depo Sutorejo: Waste Management Project In Surabaya Municipality, Indonesia, Yohanes Kambaru Windi, Dyah Wijayanti, Eko Rustamaji Wiyatno, Loetfia Dwi Rahariyani

Kesmas

The Super Depo Sutorejo Surabaya (SDSS) Project was created to separate household waste into fractions, but its separation effect is unknown. This study assessed the significance of the project in sorting general waste into biodegradable, non-biodegradable, and assorted. The t-test compared the means of general and biodegradable waste (normally distributed). The non-biodegradable and assorted waste were not significantly distributed; therefore, the Wilcoxon Signed Ranks Test was used to compare their medians against general waste. The multivariate analysis compared the significance level of each waste fraction. Each statistical analysis showed that the SDSS significantly sorts the general waste. The p-values were …

Inter-Related Factors Influencing Sexual Quality Of Life Among Women Living With Hiv In Banten Province, Indonesia: A Mixed Methods Study, Dyah Juliastuti, Judith Dean, Yati Afiyanti, Lisa Fitzgerald

Kesmas

Socio-cultural concerns often restrict women's sexual rights and well-being living with HIV (WLHIV) in developing countries. These convergent parallel mixed methods study combined quantitative and qualitative approaches to explore factors influencing WLHIV sexual quality of life in Banten Province, Indonesia. A 2017 cross-sectional survey of 207 reproductive-aged WLHIV was analyzed using univariate and multivariate logistic regression statistics. Furthermore, in-depth interviews with a sub-sample of survey participants (n = 30) were thematically analyzed. Most of the women (60%) involved reported loss of sexual pleasure and depressed sexual life. Meanwhile, 48% affirmed low sexual quality of life which was associated with unemployment …