Implementing A Public Health Perspective In Fda Drug Regulation, Patricia J. Zettler, Margaret Foster Riley, Aaron S. Kesselheim

Faculty Publications By Year

There is, without question, a public health crisis in the United States arising from both illicit and prescription opioid misuse, addiction, and overdose. The Food and Drug Administration (FDA) is one regulator with an important role to play in minimizing the harms associated with prescription opioids, while also ensuring that prescription opioids are available for the evidence-based management of pain. One question, however, is to what extent the agency can consider in its decisions to approve opioids and keep existing ones on the market the provider and patient behaviors contributing to the epidemic. This is, in part, because FDA’s approval …

Paid Parental Leave In The United States: Reconciling Competing Demands, Sydney Joseph

CMC Senior Theses

The United States is the only developed nation that fails to provide its citizens with paid parental leave. The lack of parental benefit provision operates to the detriment of individuals and society as a whole by contributing to inequity across gender, race, socioeconomic status, and sexual orientation. As the demographics of the American workforce have changed, public policy has not kept pace. Paid parental leave is associated a number of health, economic, and social benefits. However, the greatest barrier to legislating paid parental leave is the philosophical underpinnings of American politics, specifically the strong current of liberal individualism and absence …

Employee Financial Wellness Programs: Differences In Reach By Race And Ethnicity, Sophia R. Fox-Dichter, Mathieu R. Despard, Ellen Frank-Miller, Geraldine Germain

Social Policy Institute Research

Employee Financial Wellness Programs (EF-WPs) consist of a wide array of workplace-based services and benefits that aim to enhance em-ployees’ financial well-being, such as in-person financial coaching, online financial management tools, and payroll advances or short-term loans. EFWP provision varies across employers with few organizations offering the same set of services. The recently released Employee Financial Well-ness Programs Project: Comprehensive Report of Findings notes that EFWP utilization rates and employee self-reported benefits also vary widely. This report continues the examination of varia-tion in EFWP trends by breaking down measures of EFWP reach by employee race and ethnicity. We examine three …

Making Medicaid Work In The Mountain State? An Assessment Of The Effect Of Work Requirements For Medicaid Beneficiaries In West Virginia, Simon F. Haeder

Faculty & Staff Scholarship

West Virginia is one of the poorest states in the nation, and West Virginians face some of the highest rates of illness and disability. One of the few bright spots for the health of West Virginians have been government-funded programs like Medicaid and the Children’s Health Insurance Program (CHIP). The Affordable Care Act (ACA), including the expansion of Medicaid under Governor Tomblin in 2014, has brought health coverage and access to care to hundreds of thousands of West Virginians. Today, about a third of West Virginians rely on Medicaid, and the program has become the backbone of the state’s health …

Three Essays On Public Finance And Public Policy: Financial Disclosure And Policy Reinvention In U.S. State And Local Governments, Jinhai Yu

Theses and Dissertations--Public Policy and Administration

This dissertation consists of three essays. The first essay, or Chapter 2, advances the literature by examining the conditional effects of lobbying on the relationship between policy learning and policy reinvention. Scholars have consistently shown that learning of successful policies in other states leads to higher likelihood of policy adoption. This essay extends this finding two ways. First, policy learning can also lead to more comprehensive adoption of successful policies. Second, the effect of policy learning on policy comprehensiveness is conditional on lobbying by interest groups, an alternative source of information about policy success. To test these hypotheses, I conduct …

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

Disability & Aging

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

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

Master's Projects

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

Community Paramedicine Pilot Programs: Lessons From Maine, Karen B. Pearson Mlis, Ma, George Shaler Mph

Emergency Medical Services (EMS)

Community paramedicine programs are beginning to flourish across the nation, and the need to provide demonstration or pilot programs is essential to providing a consistent and high-level standard for this model of care. While the overarching goals are to align with the Triple Aim, piloting a community paramedicine program also allows each community to develop and implement a program tailored to the healthcare needs of their specific community. A successful program builds the evidence base that can then be used to create legislative change necessary to financially sustain this model of care across the healthcare delivery system. This article provides …

Food Justice In The Trump Age: Priorities For Urban Food Advocates, Nevin Cohen, Janet Poppendieck, Nicholas Freudenberg

Publications and Research

Every constituency – regardless of political ideology – must analyze the effects of the election of Republican majorities in Congress and Donald J. Trump as President of the United States. This is particularly true for advocates involved in eliminating food insecurity and hunger, fighting malnutrition and health inequality, and ensuring sustainable and fair urban food systems with high quality jobs. Anticipating the new administration’s efforts that may undermine food justice enables advocates, researchers, and policy makers to choose priorities and forge strategic partnerships.

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

The Efficacy Of Public Health Interventions Aimed At Curbing Gun Violence: An Integrative Review, Brian Cook

Grace Peterson Nursing Research Colloquium

Abstract

Background: Gun violence is a pressing public health issue in the United States. Homicide is the second-leading cause of death for 15 to 24 year-old Americans, and the third-leading cause of death for 25 to 34 year-old Americans, and 80% of these homicides are committed via firearm. In recent years, the field of criminology has studied the efficacy of a variety of policing, public health, and public policy interventions that aim to reduce the incidence of gun violence, but many of their findings have yet to be incorporated into the body of nursing literature.

Objective: This project’s objective was …

Mapping The Alignment Of Programmatic Mission, Functions And Outcomes With The Attainment Of Health Equity: An Overview Of The Approach And Initial Outcomes Through The Lens Of The Usda’S Cyfar Scp Program, Onyemaechi Nweke, Kara Ryan, Mpp, Bonita Williams, Phd

Journal of Health Disparities Research and Practice

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an …

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

Theses and Dissertations

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.

Reflecting Back On The Ebola Outbreak And The Future Of Bioterrorism, Christian Pedersen

Pepperdine Policy Review

In the wake of the 2014 Ebola outbreak, policy makers have focused on the public health components which led to the outbreak, the efforts to control it, and mitigate the impact of the outbreak. Some of the most enlightening aspects of the outbreak, pertain to National Security. The crisis demonstrated some crucial challenges the United States would have to plan for to effectively respond to a bioterrorist attack.

Utilizing Title Vi As A Means To Eradicate Health Discrimination, Adrian D. Samuels, Mariah L. Cole

Journal of Health Disparities Research and Practice

Health disparities among people of color are persistent and detrimental to the overall wellness of these groups. Discrimination in the provision of health care services is one of the primary causes of health disparities. Title VI of the Civil Rights Act of 1964’s availability as a tool to prevent discrimination and, in turn, disparities among these groups is underdocumented. The legislative intent of Title VI and the historical context of the law have been helpful in its use outside of the health care arena to prevent discrimination. This sheds light on the ways that the law can influence the health …

Knowledge Of Health Insurance Concepts And The Affordable Care Act Among Rural Residents, Erika C. Ziller Phd

Health System Reform

Health insurance literacy is central to identifying eligibility for coverage and subsidies, choosing a plan, and using optimal healthcare services under the Affordable Care Act (ACA) or other insurance reform initiatives. To fully benefit from policy efforts to improve health insurance access, rural residents must have the ability to select the plan that best meets their healthcare needs. However, a higher proportion of rural residents possess characteristics that may put them at risk of lower health insurance literacy, including lower incomes and educational attainment, less experience with private insurance, and historically higher uninsured rates. Using Health Reform Monitoring Survey data …

Obesity Policy Stringency Over Time: A Four State Policy Design, Luisa M. Lucero

School of Public Service Theses & Dissertations

Over the past several decades obesity rates in the United States have increased exponentially, reaching epidemic proportions and placing heavy financial and health-related burdens on states. States could reduce their obesity-related spending by billions of dollars, however, if they reduced their obesity prevalence by five percent by 2030, which would reduce medical costs, loss of productivity, and loss of life. Despite the incentive to improve obesity rates, not all states are taking advantage of obesity-related policy as a means to combat obesity. Using a multiple case study design and policy design as the theoretical foundation, this study explores whether or …

Social Isolation And Loneliness In Older People: A Closer Look At Definitions, Mary Lou Ciolfi, Frances Jimenez Ba

Disability & Aging

Social isolation and loneliness are related and the terms are often used interchangeably, but they are distinct concepts with different definitions, health impacts, and interventions. Our population is aging and older people are at increased risk for both social isolation and loneliness and the associated negative health consequences. Understanding the important differences between social isolation and loneliness will help us recognize them earlier in vulnerable populations, engage in more meaningful conversations with older adults about their own risks, and will inform the development and delivery of more individualized, meaningful, and cost-effective interventions.

Strategies And Substance Treatment: Perceptions Of Older Adults 60 And Over, Kim Malveo Jones

Electronic Theses, Projects, and Dissertations

The purpose of this study was to gather the perceive strategies and substance treatment needs of adults 60 and over. To examine what recovery treatment models and strategies could be most effective for the age-related complex needs of the 60 and over population who are at risk for substance misuse, use or abuse. In the coming years, there will be a substantial increase in the numbers of older adults with substance misuse and abuse problems. Even though one in five individuals who experience substance abuse are older adults many clinicians remain ill equipped to serve older clientele, and particularly those …

Book Review: Prostitution Narratives: Stories Of Survival In The Sex Trade, Edited By Caroline Norma And Melinda Tankard Reist, Abigail Bray

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

San Francisco's Response To Sexual Assault: Pathways To Creating A Survivor-Centered Criminal Justice System, Bianca Rosen

Master's Projects and Capstones

This research examines the process when adult sexual assault survivors in San Francisco decide to pursue legal justice and how survivors experience the local criminal justice system. My analysis exposes the mistreatment of survivors who participate with local law enforcement and recommends survivor-centered policies that could support the wellbeing of survivors pressing charges. The purpose of this research is to encourage law enforcement practices that prioritize survivors’ self-determination and welfare.

After Closure: Options For Pursuing A High Performance Rural Health System, Andrew F. Coburn Phd

Rural Hospitals (Flex Program)

Presented at the 2017 National Rural Health Association Annual Meeting. Coburn, a member of the Rural Policy Research Institute Panel, discussed the following key questions: What kind of rural health system is possible in places that cannot support a full-service hospital? How does a rural community navigate the transition from hospital-centric care toward new models that deliver high performance? What implementation support will be needed? Coburn noted that there is no single model for re-configuring the rural health system after hospital closure; local assets, affiliations and partnerships, financial and delivery flexibility and capacities must be critically assessed to determine the …

The Role Of Public Versus Private Health Insurance In Ensuring Health Care Access & Affordability For Low-Income Rural Children, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Amanda Burgess Mppm

Access / Insurance

Medicaid and the Children’s Health Insurance Program (CHIP) have played a critical role in ensuring access to health insurance coverage among children and have been particularly important sources of coverage for rural children. More than 35.5 million children were enrolled in Medicaid or CHIP in September 2016—accounting for just over half of total Medicaid and CHIP enrollment. Given the large proportion of rural children covered by public insurance, it is critically important to understand the role of that coverage in ensuring access to affordable healthcare for rural children. Using data from the 2011-2012 National Survey of Children’s Health, this study …

An Evaluation Of Mental Health Resources At Syracuse University, Joyce Lalonde

Renée Crown University Honors Thesis Projects - All

This Honors capstone project discusses mental health at Syracuse University. As identified through quantitative and qualitative research, as well as through personal narratives and experiences, mental health resources and awareness at Syracuse University could be drastically improved. This project’s objective is to evaluate these mental health resources on Syracuse University campus and to offer recommendations to improve said resources and build awareness. This has been done through Mental Health Awareness Week and a Mental Health Report with additive research through an annotated bibliography. Through this, the project outlines the trajectory of mental health on campus. Overall, this project has shifted …

A Guide For Assessing Older Adults’ Needs On Maine Islands, Beatrice Byrne

Muskie School Capstones and Dissertations

This template may help Maine island communities identify older adults’ needs and island resources, in order to allow older adults to age in the island communities.

Three interviews with island health leaders, one community conversation with older islanders, and one pilot test provided information about what to include in the template.

The template includes a demographic survey, guides for conducting semi-structured interviews and group conversations with older adults and caregivers, a guide and worksheet for analyzing the data, a guide for assessing community resources, a guide for dissemination, and a list of additional resources.

The Impact Of Parents Having Health Insurance On Their Children’S Health Care, Andrea Bennett

Graduate Theses, Dissertations, and Capstones

Abstract of the Dissertation

This study examines the impact of parents having health insurance on their children’s health care in Kentucky. Child health insurance status and child a usual source of medical care are the two health care measures analyzed. The author builds on prior research that indicated more children would become insured if parents had access to affordable health insurance options. Through the implementation of the ACA in 2014, Kentucky expanded Medicaid eligibility to low-income adults up to 138% of the federal poverty level (FPL) and offered discounts on private health insurance plans for families in certain income thresholds …

Law-Based Arguments And Messages To Advocate For Later School Start Time Policies In The United States, Clark J. Lee, Dennis M. Nolan, Steven W. Lockley, Brent Pattison

Homeland Security Publications

The increasing scientific evidence that early school start times are harmful to the health and safety of teenagers has generated much recent debate about changing school start times policies for adolescent students. Although efforts to promote and implement such changes have proliferated in the United States in recent years, they have rarely been supported by law-based arguments and messages that leverage the existing legal infrastructure regulating public education and child welfare in the United States. Furthermore, the legal bases to support or resist such changes have not been explored in detail to date. This article provides an overview of how …

Detroit Food Metrics Report 2017, Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Poison In Pink, Sydney V. Cook

Graduate Student Theses, Dissertations, & Professional Papers

Humans slather, spray, mist, and cleanse their bodies with personal care products like lotion, hairspray, cologne, and shampoo every day. Our cupboards are stocked full of them, but few of us understand what is in those jars and bottles. We trust that if it’s on the shelf at the store, it’s safe. However, this is not always the case, and many personal care products contain chemicals that are harmful to human and environmental health.

My multi-disciplinary Environmental Studies thesis project combines evidenced-based research, interviews, nonfiction narrative, and science communication to create part of a book manuscript intended to educate general …

Assessment Of The Use Of Overdose Education And Naloxone Distribution By Maine Buprenorphine/Naloxone Prescribers, Stephen Kirsch

Muskie School Capstones and Dissertations

Background: Overdose deaths, specifically related to opioids, have been identified as a public health problem both nationally and in the state of Maine. Overdose Education and Naloxone Distribution (OEND) is an innovative model of patient education that has been shown to be effective in increasing knowledge of overdose risk and has the potential to help reduce opiate related overdose deaths.

Methods: A 28-item web-based survey examining clinician attitudes, OEND practices and characteristics was distributed to 196 Maine based physicians with a Drug Enforcement Agency waiver to prescribe burprenorphine/naloxone. Facilitators and barriers to the provision of OEND were also assessed. Surveys …