Health Policy Commons^™

Influence Of Household Environment And Maternal Behaviors To Upper Respiratory Infection Among Toddlers, Reny Fahdiyani, Ardini S. Raksanagara, Hadyana Sukandar

Kesmas

Infeksi saluran pernapasan akut atas (ISPA atas) di negara berkembang menyebabkan morbiditas tinggi pada anak bawah usia lima tahun (balita). Kementerian Kesehatan Republik Indonesia melaporkan bahwa ISPAnonpneumonia meningkat 2,6% dari tahun 2007 ke 2011. Faktor risiko yang dapat berkontribusi termasuk lingkungan dan perilaku. Penelitian ini bertujuan untuk menyelidiki faktor perilaku dan lingkungan dengan ISPA atas pada balita. Studi kasus kontrol ini dilakukan dari Februari-April 2015 pada balita di Tamansari yang merupakan daerah kumuh di Kota Bandung. Kasus adalah 55 ibu dengan balita menderita ISPA atas yang datang ke puskesmas, sedangkan kontrol dua kali lebih besar dari kasus dipilih dari lingkungan …

Predisposing Factors With Complementary Feeding Practices Among 9-11 Month-Old Infants In Jakarta Urban Slum Area, Septriana Septriana, Gita Ardelia Suhartono

Kesmas

Penyebab utama kekurangan gizi selain dari penyakit infeksi adalah pola asuh yang tidak sesuai dan pemberian makan yang optimal menjadi salah satu cara untuk mengatasi konsekuensi jangka panjang dari kekurangan zat gizi. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor pendukung praktik pemberian makanan pendamping air susu ibu (MPASI) pada bayi usia 9 - 11 bulan di daerah kumuh perkotaan Jakarta. Penelitian potong lintang ini melibatkan 50 orang pengasuh bayi usia 9 – 11 bulan. Data dikumpulkan melalui wawancara menggunakan kuesioner. Tidak terdapat hubungan yang bermakna antara usia pengasuh dengan praktik pemberian makan (nilai p = 0,645). Demikian juga dengan …

Residential Density, Parents’ Sexual Activity And Teenage Sexual Behavior In Yogyakarta, Luluk Rosida, Evi Martha, Besral Besral

Kesmas

Pada daerah kumuh dan padat, orangtua sering terpaksa harus berbagi ruang tidur dengan anak-anaknya sehingga anak-anaknya sudah terpapar dengan aktivitas seksual sejak dini. Penelitian ini bertujuan mengetahui kepadatan hunian, aktivitas seksual orangtua, dan efeknya terhadap perilaku seksual remaja di Yogyakarta. Penelitian ini menggunakan desain potong lintang dengan mewawancarai 268 keluarga yang memiliki anak remaja yang dipilih secara acak di daerah kumuh perkotaan dan daerah pedesaan pada bulan Maret – Mei 2015. Analisis data dilakukan menggunakan uji kai kuadrat dan regresi-cox multivariat. Hasil penelitian ini menunjukkan bahwa orangtua yang tinggal di hunian padat memiliki risiko dua kali lebih besar untuk melakukan …

Effects Of Mothers’ Attitude As Breeders And Distance Of Stockyard Toward Diarrhea Incidence Among Toddlers, Yarmaliza Yarmaliza, Sugito Sugito, Teuku Reza Ferasyi, Nurliana Nurliana, Razali Razali

Kesmas

Diare merupakan penyakit dengan perubahan bentuk dan konsentrasi tinja yang melembek sampai mencair, dan bertambahnya frekuensi buang air besar lebih dari biasanya (tiga kali atau lebih dalam sehari). Di Provinsi Aceh, terdapat kasus diare sebanyak 48/1.000 kelahiran hidup pada 2013. Di Kabupaten Aceh Barat, pada tahun 2014 terdapat 1.071 kasus, sedangkan di Kecamatan Meureubo terdapat sebanyak 70 kasus pada anak bawah lima tahun (balita). Penelitian ini bertujuan untuk mengetahui hubungan sikap ibu sebagai peternak dan jarak kandang ternak terhadap kejadian diare pada balita di wilayah kerja Puskesmas Kecamatan Meureubo. Penelitian ini dilakukan secara potong lintang pada bulan Juli – September …

Knowledge And Behavior Change Of People Living With Hiv Through Nutrition Education And Counseling, Fitri Hudayani, Ratu Ayu Dewi Sartika

Kesmas

HIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan …

Strengthening The Health Workforce In Lmics: Global Innovations Driving Quality Improvement, Zohray Talib

Health Workforce Speaker Series

No abstract provided.

The Impact Of Reimbursement Policies And Practices On Healthcare Technology Innovation, Brian K. Bruen, Elizabeth Docteur, Ruth Lopert, Joshua Cohen, Joseph Dimasi, Avi Dor, Peter Neumann, Regina Desantis, Chuck Shih

Health Policy and Management Faculty Publications

No abstract provided.

How Narrative Focus And A Statistical Map Shape Health Policy Support Among State Legislators, Jeff Niederdeppe, Sungjong Roh, Caitlin Dreisbach

Research Collection Lee Kong Chian School Of Business

This study attempts to advance theorizing about health policy advocacy with combinations of narrative focus and a statistical map in an attempt to increase state legislators’ support for policies to address the issue of obesity by reducing food deserts. Specifically, we examine state legislators’ responses to variations in narrative focus (individual vs. community) about causes and solutions for food deserts in U.S. communities, and a statistical map (presence vs. absence) depicting the prevalence of food deserts across the United States. Using a Web-based randomized experiment (N = 496), we show that narrative focus and the statistical map interact to produce …

The Emerging Zika Pandemic: Enhancing Preparedness, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The Zika virus (ZIKV), a flavivirus related to yellow fever, dengue, West Nile, and Japanese encephalitis, originated in the Zika forest in Uganda and was discovered in a rhesus monkey in 1947. The disease now has “explosive” pandemic potential, with outbreaks in Africa, Southeast Asia, the Pacific Islands, and the Americas. Since Brazil reported Zika virus in May 2015, infections have occurred in at least 20 countries in the Americas. Puerto Rico reported the first locally transmitted infection in December 2015, but Zika is likely to spread to the United States. The Aedes species mosquito (an aggressive daytime biter) that …

Physician Assisted Dying: A Turning Point?, Lawrence O. Gostin, Anna E. Roberts

Georgetown Law Faculty Publications and Other Works

Physician Assisted Dying (PAD) has been lawful in some countries since the 1940s and in the United States since 1997. There is a body of social and scientific research that has focused on whether the practice has been misused and whether gaps exist in legislative safeguards. There are multiple concerns with physicians assisting patients to die: incompatibility with the physician’s role as a healer, devaluation of human life, coercion of vulnerable individuals (e.g., the poor and disabled), and the risk that PAD will be used beyond a narrow group of terminally ill individuals. Statutes in the United States have been …

Teams In Cancer Care, Stephen Taplin

Health Workforce Speaker Series

No abstract provided.

A Public Health Framework For Screening Mammography: Evidence-Based Versus Politically Mandated Care, Lawrence O. Gostin, Kenneth W. Lin Md

Georgetown Law Faculty Publications and Other Works

This Viewpoint highlights the societal risks of politically motivated mandates relating to public health guidelines. Although the Affordable Care Act mandated insurance coverage for U.S. Preventive Services Task Force (USPSTF)-recommended preventive services, it went further for mammography screening. Instead of relying on the most recent USPSTF guidelines, Congress amended the ACA to require the Department of Health and Human Services (DHHS) to use its 2002 guidelines, which recommended screening every 1-2 years starting at age 40. The FY 2016 Consolidated Appropriations Act instructs DHHS to interpret any reference to “current” USPSTF breast cancer screening recommendations to mean those issued “before …

Use Of Pooled State Administrative Data For Mental Health Services Research., Kimberly Eaton Hoagwood, Susan Essock, Joseph Morrissey, Anne Libby, Sheila Donahue, Benjamin Druss, Molly Finnerty, Linda Frisman, Meera Narasimhan, Bradley D Stein, Jennifer P. Wisdom, Judy Zerzan

Health Policy and Management Faculty Publications

State systems are a rich, albeit challenging, laboratory for policy-relevant services research studies. State mental health authorities routinely devote resources to collect data for state planning and reporting purposes. However, these data are rarely used in cross-state comparisons to inform state or federal policy development. In 2008, in response to key recommendations from the National Institute of Mental Health (NIMH) Advisory Council’s “The Road Ahead: Research Partnership to Transform Services,” (http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/road-ahead.pdf), NIMH issued a request for applications (RFA) to support studies on the impact of state policy changes on access, cost, quality and outcomes of care for individuals …

The Impact Of Hearing Impairment And Noise-Induced Hearing Injury On Quality Of Life In The Active-Duty Military Population: Challenges To The Study Of This Issue, Hasanat Alamgir, Caryn A. Turner, Nicole J. Wong, Sharon P. Cooper, Jose A. Betancourt, James Henry, Andrew J. Senchak, Tanisha Hammill, Mark D. Packer

NYMC Faculty Publications

The objectives of this research were to 1) summarize the available evidence on the impact of hearing loss on quality of life (QOL) among U.S. active-duty service members, 2) describe the QOL instruments that have been used to quantify the impact of hearing loss on quality of life, 3) examine national population-level secondary databases and report on their utility for studying the impact of hearing loss on QOL among active-duty service members, and 4) provide recommendations for future studies that seek to quantify the impact of hearing loss in this population. There is a lack of literature that addresses the …

Bridging The Divide White Paper: Long-Acting Reversible Contraception (Larc) In The United States, Julia Strasser, Liz Borkowski, Megan Couillard, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates.

Decades of research have shown that current LARC methods are highly safe and effective, …

Emergency Room Utilization Disparities Among Older Adults Treated By Rural Health Clinics, Matt Bagwell

Electronic Theses and Dissertations

Examining the persistence of disparities over time is an important obligation in terms of rectifying, maintaining, and improving community health and social well-being for all. This study analyzed the individual factors of (a) race/ ethnicity and (b) dual eligibility, as a proxy measure of socioeconomic status, as well as the environmental factor of (c) place of residence, and the organizational factor of (d) Rural Health Clinic (RHC) type on emergency room (ER) utilization of older adult Medicare patients treated by RHCs within the Department of Health and Human Services' (DHHS) Region 4. A prospective, multi-level, longitudinal design was employed to …

Best Practices To Increase Efficacy Of Graduate School Admissions Communications At Clark University, Diana Curran, Nikki Feinberg, Mitchell Kelley, Ruiqi Li, Anning Zhou

School of Professional Studies

Within the period of time that a graduate student deposits and subsequently arrives at their academic institution, receiving timely information is important for their preparation. This process has been deemed by the Deans of the Enterprise Schools at Clark University as one that needs further investigation. As such, this Capstone looks at the array of communication that goes out to each graduate student during this four-month period. The purpose of examining this communication is to analyze its effectiveness in engaging students. To analyze the effectiveness of this communication, surveys were distributed to current students in these schools to gather data …

Beyond Baby Steps An Empirical Study Of The Impact Of Environmental Justice Executive Order 12898, Elizabeth Ann Glass Geltman, Gunwant Gill, Miriam Jovanovic

Publications and Research

This study evaluated the impact of Executive Order (EO) 12898 to advance environmental justice. We conducted a review evaluating the frequency and effective use of EO 12898 since execution with particular focus following President Obama’s Plan EJ 2014. We found that both EO 12898 and Plan EJ 2104 had little, if any, impact on federal regulatory decision making. To the extent federal agencies discussed EO 12898, most did so in boilerplate rhetoric that satisfied compliance but was devoid of detailed thought or analysis. In the 21st year, with the exception of the Environmental Protection Agency, very little federal regulatory activity …

Drilling For Common Ground: How Public Opinion Tracks Experts In The Debate Over Federal Regulation Of Shale Oil & Gas Extraction, Elizabeth Ann Glass Geltman

Publications and Research

Public interest in environmental and health impacts from shale oil and gas extraction (what the public calls “fracking”) is growing. Industry claims the public outcry against the new technology is not grounded in science. In February 2013, Resources for the Future (“RFF”) published a list of high priority “risk pathways” that experts from NGOs, academia, government, and industry all agreed were real concerns about fracking. This article used the risk matrix to evaluate whether public comments in dockets of federal agencies that proposed regulation concerning hydraulic fracturing tracked expert concern. The article found that the public tracked many of the …

Oil & Gas Drilling In National Parks, Elizabeth Ann Glass Geltman

Publications and Research

While a great deal of public attention addresses the Halliburton loophole of the Energy Policy Act of 2005 and Bureau of Land Management efforts to regulate hydraulic fracturing on public lands, less attention has been paid to the National Park Service “9B Regulations,” which provide a national regulatory framework governing the exercise of nonfederal oil and gas rights in national parks. This article begins with a review of law pertaining to oil and gas drilling in national parks. The article examines the tension in striking a balance between environmental protection, conservation of national lands and achieving energy independence, including National …

Evaluation Of Financial Trends And Fundraising Program Of Stap, Jay Mcmahon

Capstone Projects 2015-Present

Every non-profit organization faces challenges with funding. This project examines fundraising trends and threats facing the Southern Tier AIDS Program (STAP). The project began out of concerns about the impact changes in Medicaid legacy rates and Governor Cuomo’s plan for the end of AIDS 2020. Government grants and Medicaid are the largest revenue streams for the organization, changes in these streams could have a devastating impact on the organization. Along with identifying the impact of the funding changes I will evaluate the current fundraising programs and make recommendations based on the past trends and projections of the impact of funding …

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc., Hildi J Hagedorn, Randall Brown, Michael Dawes, Eric Dieperink, Donald Hugh Myrick, Elizabeth M Oliva, Todd H Wagner, Jennifer P. Wisdom, Alex H S Harris

Health Policy and Management Faculty Publications

BACKGROUND: Only 7.8 % of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation …

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc., Hildi Hagedorn, Randall Brown, Michael Dawes, Eric Dieperink, Donald Hugh Myrick, Elizabeth Oliva, Todd Wagner, Jennifer P. Wisdom, Alex Harris

Health Policy and Management Faculty Publications

BACKGROUND: Only 7.8 % of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation …

Building Capacity In Implementation Science Research Training At The University Of Nairobi., George O Osanjo, Julius O Oyugi, Isaac O Kibwage, Walter O Mwanda, Elizabeth N Ngugi, Fredrick C Otieno, Wycliffe Ndege, Mara Child, Carey Farquhar, Jeremy Penner, Zohray Talib, James N Kiarie

Health Policy and Management Faculty Publications

BACKGROUND: Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science.

METHODS: This paper describes how the University of Nairobi leveraged resources from the Medical Education Partnership to develop an institutional program that provides training …

Workforce Planning And Development In Times Of Delivery System Transformation, Patricia Pittman, Ellen Scully-Russ

Health Policy and Management Faculty Publications

Background

As implementation of the US Affordable Care Act (ACA) advances, many domestic health systems are considering major changes in how the healthcare workforce is organized. The purpose of this study is to explore the dynamic processes and interactions by which workforce planning and development (WFPD) is evolving in this new environment.

Methods

Informed by the theory of loosely coupled systems (LCS), we use a case study design to examine how workforce changes are being managed in Kaiser Permanente and Montefiore Health System. We conducted site visits with in-depth interviews with 8 to 10 stakeholders in each organization.

Results

Both …

Local Health Departments’ Activities To Address Health Disparities And Inequities: Are We Moving In The Right Direction?, Gulzar H. Shah, John P. Sheahan

Health Policy & Management: Faculty Publications (2006-2018)

Context: Health disparities are among the critical public health challenges.

Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement.

Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities.

Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four …

Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.

Health Care Limitations Available To Transgender Teenagers: A Systematic Review Of The Literature, Yessenia Madrigal, Michael Curtis

McNair Poster Presentations

This systematic review of literature explores the current academic literature that is available in regards to transgender teenagers, their healthcare options and the services that are available to these teenagers and any obstacles they face when seeking and obtaining healthcare services. This review specifically focuses on transgender teenagers and their family’s experiences and the lack of support given to them at different levels in different healthcare facilities. For this review a total of 29 articles were included in the final literature review and were categorized into different areas: the detrimental effects of non-accepting parents are explained healthcare options available, the …

When You Need More Than Just An Apple A Day: A Review Of The Empirical Evidence Relating To Disparities In Access To Health Care And A Preliminary Perspective On The Effects Of The Patient Protection And Affordable Care Act, Alexis Coulis

Undergraduate Honors Thesis Collection

The concept of medical care is twofold, made up of both prevention and treatment. Prevention itself consists of three distinct levels: primary, secondary, and tertiary. Primary prevention includes actions protecting healthy people from developing a disease in the first place. Secondary goes on to refer to management of a diagnosed condition that works to keep symptoms at a minimum. Finally, tertiary prevention encompasses measures taken in an attempt to control an existing disease. Three individual case studies – the influenza vaccine, asthma management, and control of congestive heart failure – exemplify these primary, secondary, and tertiary preventive measures. Together, they …

The Double-Edged Sword Of Health Care Integration: Consolidation And Cost Control, Erin C. Fuse Brown, Jaime S. King

Indiana Law Journal

The average family of four in the United States spends $25,826 per year on health care. American health care costs so much because we both overuse and overpay for health care goods and services. The Affordable Care Act’s cost control policies focus on curbing overutilization by encouraging health care providers to integrate to pro-mote efficiency and eliminate waste, but the cost control policies largely ignore prices. This article examines this overlooked half of health care cost control policy: rising prices and the policy levers held by the states to address them. We challenge the conventional wisdom that reducing overutilization through …