Health Policy Commons^™

Learning Before And During The Covid-19 Outbreak: A Comparative Analysis Of Crisis Learning In South Korea And The Us, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

Learning is imperative in government responses to crises like the COVID-19 pandemic. This study examines the South Korean and United States governments’ responses to COVID-19 from a comparative perspective. The analysis focuses on crisis learning conducted before and during the COVID-19 outbreak, using the conceptual categories of intercrisis/intracrisis learning and single-/double-loop learning. The findings suggest that double-loop, intercrisis learning allows for more effective crisis management by (re)developing a common operating framework. The efficacy of learning is enhanced when double-loop learning is followed by single-loop learning that embeds new structures and operational procedures. The findings also suggest that intercrisis learning facilitates …

When Will The Covid-19 Pandemic In Indonesia End?, Dewi Susanna

Kesmas

On January 30, 2020, the World Health Organization(WHO) declared 2019-nCOV to be a Public Health Emergency of International Concern (PHEIC), due to the significant increase in confirmed new cases in various countries.1 In Indonesia, the first confirmed COVID-19 case was a female who had a closed contact with the 24th confirmed case in Malaysia and the second case was the mother of the first case.2 As time goes by, the number of new cases has increased significantly, reaching 160.165 confirmed cases with 6,944 deaths by August 27, 2020.3 The time when the COVID-19 pandemic in Indonesia will end is not …

Policy Implementation: Teachers’ Role As First Responders In Emergencies And Disasters, Shabir Hyder, Adnan Fazal Manzoor, Muhammad Amjad Iqbal

Kesmas

During the past decade, the schoolchildren faced many disasters and emergencies originating from natural and man-made sources. The safety of schoolchildren rests with school management and teachers. This study aimed to assess teachers' awareness with regard to disaster prevention and health, safety, security, and environment (HSSE) policies at primary schools in Pakistan. In addition, it explores the suitability of teachers to perform as emergency handlers in the absence of school nurses and resource officers (SROs). The study involved a qualitative study, based on open-ended interviews from a sample of 25 school teachers. Methodology triangulation was applied to reduce bias. Results …

Using The Reach, Effectiveness, Adoption, Implementation, Maintenance Framework In The Evaluation Of Community-Based Adolescent Care Pilot Program, Badra Al Aufa, Wahyu Sulistiadi, Mochamad Iqbal Nurmansyah, Agung T R Syiroj, Ibrahim Isa Koire

Kesmas

Posyandu Remaja (Posmaja) is a community-based adolescent care service in Indonesia that comprises a group of adolescents working as volunteers and healthcare workers under the guidance and responsibility of the Public Health Centre and City Health Office. The study aims to provide a formative evaluation program of Posmaja using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. This research used a qualitative approach and took place in South Tangerang City, Indonesia. The data were collected from July until December 2018. Nineteen people participated in the study. The study used in-depth interviews and focus group discussions that adopted the RE-AIM …

Association Between Social Media Exposure To Food And Beverages With Nutrient Intake Of Female Adolescents, Cholida Adiba, Siti Fatimah Pradigdo, Martha Irene Kartasurya

Kesmas

Communication technology development has influenced adolescent food choices and intakes. This study aimed to investigate the association between social media exposure to food and beverage content and nutrient intake among female adolescents. The study was conducted in a cross-sectional design. The targeted population was 104 female students aged 14–18 years old at 'XY' High School in Semarang, Central Java, Indonesia. Eighty-one subjects were chosen by clustered random sampling. Data were collected by interviews using structured questionnaires and a 3x24-hour recall method. Data analyses were conducted by chi-square, Fisher exact tests, and logistic regression. The median and standard deviations of social-media, …

Ultraviolet Exposure And Photokeratitis Complaints Among Informal Welding Workers In Depok, West Java, Indonesia, Maria K I J Yustheresani, Fajaria Nurcandra, Azizah Musliha Fitri, Annisa Ika Putri, Dyah Utari

Kesmas

One of the photokeratitis risk factors is acute reversible radiation of ultraviolet (UV) rays, which injure the cornea's epithelial tissue. Informal welding workers are susceptible populations to UV rays exposure. This study aimed to confirm the influence of UV radiation exposure on photokeratitis complaints in welding workers in Cimanggis, Depok, West Java. A cross-sectional study was conducted from February to June 2019 and used to select 100 welding workers purposively. A semi-structured questionnaire was used to determine photokeratitis complaints, age, education level, eye protection, safety knowledge, and work period; the UV radiation measured by A UV meter. Data were analyzed …

Cultural And Religious Belief Approaches Of A Tuberculosis Program For Hard-To-Reach Populations In Mentawai And Solok West Sumatera, Indonesia, Rizanda Machmud, Irvan Medison, Finny Fitry Yani

Kesmas

Tuberculosis (TB) is a leading public health concern in Indonesia. It ranks second on the list of high-burden TB countries. In West Sumatra, 47% of TB cases are undetected, late diagnosed, and received incomplete treatment because of low-level awareness and knowledge and stigma, especially among the hardest to reach populations. The study aims to identify the best communication channel to reach those who live in vulnerable and remote areas. This study was a qualitative study applying in-depth interviews to the informal leaders, health officers, cultural artists, and religious leaders across districts in Mentawai and Solok Districts, which are remote and …

Obesity Indicators And C-Reactive Protein In Indonesian Adults (More Than Equal To 40 Years Old): The Indonesian Family Life Survey 5, Yeni Mahwati, Dieta Nurrika

Kesmas

C-reactive protein (CRP) is the best clinical marker for systemic inflammation. Obesity is associated with increased CRP levels. Systemic inflammation is present before morbidity occurs. Research reveals that the identification of obesity indicators and CRP levels is limited among Indonesians. The present study investigated the associations between obesity indicators (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]) and CRP levels among Indonesian adults. This cross-sectional study based on Indonesian Family Life Survey-5 2014–2015 was conducted among 3,386 adults (≥ 40 years) living in 13 provinces in Indonesia during the study period. All data were collected …

A Study On Knowledge, Attitudes, And Practices On Rabies In The Philippines, Reynaldo Jr Bundalian, Monalisa Lacson, Catherine Bacani, Dinah Rose Soriano, Agnes Garing, Artemio Jr Aquino, Archie Policarpio, Joey Kyle Mallari, Remedios San Jose, Maria Fe Bulao, Neil Tanquilut, Patricia Joy Magsino

Kesmas

In 2007, the Philippine government passed the Anti-Rabies Act to address rabies in the country. However, rabies is still a major public health concern in many provinces. This study aimed to evaluate the knowledge, attitude, and practices (KAP) of residents on rabies, the Anti Rabies Act, and responsible pet ownership (RPO) in Pampanga, Philippines. A cross-sectional survey was done from October 2017 to February 2018 in 92 randomly selected barangays in the province. Questionnaires were adapted from similar studies. Logistic regression was used to identify factors associated with KAP. Results showed that most people have good knowledge of the Anti-Rabies …

Assessment Of Knowledge, Attitudes, And Behaviors Of Turkish Women On Breast And Cervical Cancer In Karabük Province, Turkey, Nergiz Sevinc, Belgin Oral, Burcu Korkut

Kesmas

Breast and cervical cancer incidence and mortality among women have been increasing worldwide. This cross-sectional study aimed to evaluate women's knowledge, attitudes, and behaviors regarding breast and cervical cancers. The sample was composed of 507 women aged 18 years and older who were admitted to a primary health care center in Karabük, Turkey, from October to December 2019. The data was obtained using a questionnaire consisting of 34 questions regarding participants’ socio demographic characteristics, knowledge, attitudes, and behaviors toward breast and cervical cancers. The mean age of the participants was 41.3±12.0 years and 68.4% of them were married. Slightly more …

Who Relocates, Where Do They Move, And Why?, Yung Chun, Jason Jabbari, Pranav Nandan, Andrew Foell, Michal Grinstein-Weiss

Social Policy Institute Research

The lack of socioeconomic mobility among marginalized populations leads to the concentration of poverty, a long-standing issue in American cities. Empirical studies on neighborhood effects have found that poverty concentration adversely affects the socioeconomic mobility of residents—associated with their economic well-being, employment, education, health, and safety—in lower-income neighborhoods. Through a variety of neighborhood revitalization projects, federal, state, and local governments have put enormous efforts into cutting the vicious cycle of poverty while increasing the socioeconomic mobility of lower-income households. One of these projects, the Choice Neighborhood Initiative, is a recent Federal effort to revitalize distressed public housing sites in American …

Generational Impacts Of 1930s Housing Discrimination And The Imperative Need For The Healthy Start Initiative To Address Structural Racism, Brittney Butler, Michael Outrich, Jessica Roach, Arthur James

Journal of Health Disparities Research and Practice

For nearly three decades, Healthy Start Initiative(HSI) has served communities with high rates of adverse pregnancy outcomes--with the goal to lower them by 50%. Despite a large focus on social determinants of health, HSI has narrowly addressed racism. The effects of legal housing discrimination continue to be felt and have profound implications for pregnancy. To understand the historical context of racism in these communities, we geospatially evaluated the relationship between HSI service areas and Home-Owners Loan Corporation(HOLC) graded maps. Using data from John Snow Inc, National Healthy Start Association, and Mapping Inequality we found that 73 of 100 communities served …

Sex Education In The United States: Implications For Sexual Health And Health Policy, Eliana R. Johnson

The Corinthian

There is much disagreement over what constitutes effective sex education in the United States. There are several reasons why America’s sex education system is outdated and problematic. First, it often advocates only for abstinence, which leaves people unprepared and unable to protect themselves if/when they choose to have sex, leading to higher rates of unintended pregnancies, abortions, and sexually transmitted infections in the U.S. than in any other developed nation in the world. In addition, the culture of fear surrounding sex education leads to negative attitudes among young people about sex. This can not only cause sexual dysfunction and strife …

Covid-19 Reduced Outpatient Visits By Up To 70% In The Us, Pinka Chatterji, Yue Li

Population Health Research Brief Series

The COVID-19 pandemic has created new challenges for healthcare providers. Outpatient visits dropped by up to 70% relative to the same weeks in prior years.

The Affordable Care Act And Entrepreneurship Lock: An Updated Examination Of Employer-Based Healthcare’S Effect On Self-Employment By Demographic Group, Sean Ruddy

Undergraduate Economic Review

This paper capitalizes on a natural experiment created by differences in Medicaid expansion under The Patient Protection and Affordable Care Act (ACA). A difference and difference model comparing states that did and did not expand Medicaid is conducted to investigate if providing an alternative and low-cost source of health insurance affects self-employment rates overall and across different demographic groups. The results suggest that living in a state that expanded Medicaid was associated with a 1.4 percent increase in the likelihood that an individual will be self-employed and that this effect is heterogeneous across different demographics, being largest among African Americans.

Child Food Insecurity In Nevada Counties, 2018, Ally Beckwith, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet synthesizes data on the child hunger discrepancies in Nevada counties from the Feeding America 2018 Map the Meal Gap Study. The information focuses on food insecurity experienced by children, and the food budget shortfall in Nevada.

Panda: A Case-Study Examining A Successful Audiology And Otology Patient And Public Involvement And Engagement Research Group, Laura Boddy, Richard Allen, Rosalyn Parker, Margaret E. O'Hara, Amy V. Gosling

Patient Experience Journal

There has been increasing involvement of patients and members of the public in research; however, case studies describing patient research groups with hearing loss are non-existent. Such case studies will be valuable, enabling evidence-based dialogue and promoting best practice in the engagement of patients, the public and researchers. This paper aims to discuss this practice. The absence of such dialogue may hinder initial efforts by researchers to realise the potential of Patient and Public Involvement. The objective of this study was to set up and run a patient and public involvement and engagement group in audiology research, use the lessons …

Addressing Social Disconnection Among Frequent Users Of Community Hospital Emergency Departments: A Statewide Implementation Evaluation, A. Rani Elwy, Elisa Koppelman, Victoria Parker, Chris Louis

Patient Experience Journal

We conducted a qualitative exploration and implementation evaluation of a Massachusetts policy initiative, the Community Hospital Acceleration, Revitalization, and Transformation (CHART) investment program, to examine how CHART innovations aimed at reducing unnecessary emergency department (ED) visits also addressed patients’ social disconnection problems according to a social connection framework (structural, functional, quality or multilevel). We performed interviews with 236 stakeholders (hospital managers, CHART providers, staff, and community partners) one-year post CHART implementation. Interviews were analyzed using a directed content analysis approach. Data were then mapped to levels of the social connection framework. Our results support that social disconnection, described as “loneliness” …

Management Of Frequent Ed Users By Community Paramedics Improves Patient Experiences And Reduces Ems Utilization, Oluwakemi Aiyedun Adio, Laura Ikuma, Sonja Wiley

Patient Experience Journal

This study examined a suburban emergency medical system (EMS)-led community paramedicine (CP) program in terms of adherence to protocol, patient-paramedic interactions, patient experience, and cost. Participants (n=57) are frequent emergency department (ED) users (≥ 4 ED visits/year), with a mean age of 59.8±17.6 years and have multiple chronic conditions. Of these, 36 completed a modified Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey at 3- and 6-months following program enrollment. The main outcome measures were adherence to intake goals; types, modes, and frequencies of CP interventions; CG-CAHPS patient experience scores; and cost savings. Cost savings compared …

Patient Experience In Outpatient Clinics: Does Appointment Time Impact Satisfaction?, Shikha Shah Modi, Jennifer B. Costigan, Mark Lemak, Sue Feldman

Patient Experience Journal

The objective of this study is to understand patient experience by appointment time by analyzing the Consumer Assessment of Hospital Provider and Systems (CAHPS) scores at a granular level across pre-determined time periods (AM and PM). This study utilized quantitative and qualitative methods. A deidentified secondary data set from the University of Alabama at Birmingham’s Press Ganey website was used to analyze the difference in CAHPS scores across AM and PM time periods. Unstructured survey responses were analyzed as a way to further enrich the quantitative findings. The data sample consisted of 821 responses from a dermatology clinic for the …

Patients’ Experience In Hong Kong Hospitals: A Comparison Between South Asian And Chinese People, Nimisha Vandan, Janet Yuen-Ha Wong Dr., Paul Siu-Fai Yip Chair Professor, Daniel Yee-Tak Fong Dr.

Patient Experience Journal

Patient experience in hospital is positively associated with both self-rated and objectively measured health outcomes. In many countries ethnic minority patients have more negative experience and bear a disproportionate burden of disease than their majority counterparts. However, hospital experience of ethnic minority patients in Asia is still unexplored. We aimed to explore the hospital experience of South Asian ethnic minority and compare that with local Chinese patients’ experience in Hong Kong. A cross-sectional study sample comprised of 783 participants (388 South Asian and 395 Chinese). Picker Patient Experience-15 (PPE-15) questionnaire was used for data collection. Simple and multiple regressions were …

Responsiveness Of Primary Health Care Services In Nigeria: The Patients’ Perspective, Daprim S. Ogaji, Chinedu B. Egu, Michael Nwakor-Osaji, Amala C. Smart, Emeka F. Anyiam, Faith C. Diorgu

Patient Experience Journal

Health system responsiveness reflects the extent national health systems meet the legitimate expectations of patients. This study assessed the responsiveness of primary health care services in Nigeria from the clients’ perspective. A cross-sectional survey of 379 participants were randomly selected from 7 centers from a sample frame of 20 primary healthcare centers. Descriptive results were presented in frequencies and percentages. The associations between the importance and performance ranking were examined using the Spearman’s ranked correlation coefficient. Multivariate logistic regression was used to identify predictors of responsiveness with p-values ≤ 0.05 considered statistically significant. There were equal proportion of respondents aged≥30 …

Patient Engagement In Action: Timing And Intensity Of Strategies Used To Engage Low Income Depressed Mothers Of Infants And Toddlers, Maureen J. Baker, Beth Perry Black, Linda S. Beeber

Patient Experience Journal

The purpose of this study was to illuminate the process of patient engagement and to determine how components of patient engagement were operationalized in the nurse-patient interpersonal relationship with low income, depressed mothers, a traditionally underserved population. Using a descriptive quantitative design, we examined how components of patient engagement were executed across three phases of the nurse-patient interpersonal relationship. We assessed for differences in engagement strategies used in different phases of the interpersonal relationship and with mothers with varying levels of engagement. Through this study, we observed that patient engagement has several dynamic components varying in intensity and frequency, depending …

Patient Participation Strategies: The Nursing Bedside Handover, Irene Decelie

Patient Experience Journal

Patient participation is an important goal in today’s health care and considered necessary to achieve safe and quality patient care. The purpose of this paper is to discuss the historical and theoretical background surrounding the concept of patient participation in health care and specifically to examine patient participation strategies which have been reported to be of influence when employed during the nurse to nurse and patient to nurse activities encompassed in the bedside handover. The bedside handover is the nursing activity of transferring primary nursing responsibility of care from one nurse to another. Encouraging patients to participate during this process …

Enhancing Patient Involvement In Quality Improvement: How Complaint Managers See Their Roles And Limitations, Nathalie Clavel, Marie-Pascale Pomey

Patient Experience Journal

Patient involvement is a priority for healthcare organizations seeking to improve the quality of care and services. The contribution that complaint handling can make towards quality improvement has remained underexplored, while healthcare organizations are implementing strategies to effectively involve patients in quality improvement. We conducted a qualitative study to understand how complaint managers see their roles and limitations in enhancing patient involvement in quality improvement. A convenience sample of eleven complaint managers was selected from nine Canadian healthcare organizations with various annual volumes of complaints and situated in different settings (urban, rural, and semi-urban). The data were analyzed using a …

How Information Sharing Can Improve Patient And Family Experience In Critical Care: A Focus Group Study, Jayne Garner, Sioban Kelly, Girendra Sadera, Victoria Treadway

Patient Experience Journal

The experience of being in hospital critical care has major impacts upon the patient, their family and carers. This situation is likely to be stressful, fast changing and challenging for those involved. Crucial to this encounter are factors relating to information sharing between the clinical team, the patient, family and carers. Focus groups at a UK hospital site with former patients, their families and carers provides insight into their journey and the factors that influence this. Issues that emerged included the format of information, how and who delivered this, communication transition out of critical care and leaving hospital. While participants …

Living With Cardiovascular Disease (Cvd): Exploring The Biggest Challenges For People Affected By Cvd In The Uk, And Their Use (Or Not) Of Online Resources, Sarah-Ann Burger, Alan J. Poots, Anna Perris, Helen Crump, Helen Thorne, Sally Hughes, Jacob West

Patient Experience Journal

As death rates decrease, people affected by cardiovascular disease (CVD) continue to live with these diseases and the associated challenges, long-term. We aimed to identify the biggest challenges for people affected by CVD in the UK and explore the sources of support and information used to help manage conditions, to inform future service provision. An online questionnaire was sent and advertised to people over 16 years old in the UK self-identifying as affected by CVD (living with CVD, had risk factors, or a carer). There were 13,885 responses. The top five challenges were: feeling down, sad, or depressed; making changes …

Exploring Peer Mentoring In Pediatric Transition: Perspectives Of Different Stakeholders About Accompanying Patients In Gastroenterology, Guillaume Dumais-Lévesque, Marie-Pascale Pomey

Patient Experience Journal

The literature identifies several issues in the pediatric transition, such as the lack of coordination between pediatric and adult settings and young patients who are not exercising independence in the self-management of their disease. The objective of this study is to explore the potential for a pediatric transition program in gastroenterology, introducing an accompanying patient program to support the transition. A qualitative case study was conducted, including semi-structured focus groups and individual interviews with each group involved in the pediatric transition between two centres in Quebec. A thematic analysis of the collected data was performed using QDA Miner v5.1. In …

Collecting Child-Patient Feedback: A Systematic Review On The Patient-Reported Outcome Measures For Hospitalized Children, Haneen Ali, Astin Cole, Adam Sienkiewicz, Steffie Rosene, Reagan Shaffer, Robert Thames

Patient Experience Journal

Accurate reporting of patient experiences is a crucial resource for hospitals engaged in patient-and-family-centered care (PFCC). However, studies suggest that most children do not respond to patient satisfaction surveys and are instead represented by their parents or guardians. This study reviewed instruments used to obtain feedback from children about their healthcare experiences for two purposes: 1) To understand the limitations of current tools and 2) To determine if creating a new instrument is necessary. A systematic review was performed on PubMed, Medline, CINAHL, and Web of Science to identify peer-reviewed questionnaires designed to collect children's healthcare experiences. Out of the …

The Impact Of Parental Presence In The Nicu On Hospital Alienation And Other Distress Measures, Katherine D. Taylor, Lindsey Mclaughlin, Devon Kuehn, Justin Campbell, John Kohler Sr, Jason Higginson

Patient Experience Journal

Parental presence in the neonatal intensive care unit (NICU) positively impacts infant development. Few studies have examined the impact of presence on parental distress. Alienation, or lack of trust in the healthcare team, may occur independently from other forms of distress. Increased parental presence was hypothesized to reduce alienation by allowing for more positive in-person interaction with hospital staff. Parents of infants born < 28 weeks or < 1000 grams were prospectively enrolled and completed several surveys measuring distress prior to discharge, including a novel hospital alienation questionnaire. Spearman correlation was used to compare distress measures and visitation rates of 68 mothers and 6 fathers. Alienation was rarely reported and was uncorrelated with other distress measures. Maternal presence was most strongly correlated with anxiety, though this was not statistically significant. Fathers who were more alienated were present in the NICU less and correlation between maternal and paternal alienation was strong. These results were not statistically significant, however. Though statistically significant results were not produced in this research, hospital alienation does appear to be a distinct concept that has been unstudied previously.

Experience Framework

This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework)

• Access other PXJ articles related to this lens.
• Access other resources related to this …