Community Health and Preventive Medicine Commons^™

Bending The Health Care Cost Curve In North Carolina: The Experience Of Community Health Centers, Patrick Richard, Peter Shin, Kristina Vasilkovska, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

North Carolina is known for innovative practices in primary care delivery and education, and accordingly one might expect to see greater efficiencies overall in care delivery, and less direct, measurable impact by community health centers on cost and outcome. Of interest is whether community health centers (CHCs) are cost effective providers in states with a sophisticated primary care infrastructure and focus on the needs of medically underserved communities. Building on the large body of health services research literature that has documented the quality and cost-effectiveness of federally-funded primary health centers nationwide, as well as estimates of national savings that are …

The Health Status, Concerns, And Reform In Uruguay With An Emphasis On Health Promotion Programs Geared Towards The Care And Development Of The Country's Children And Adolescents, Melissa Raquel Ramírez

Honors Scholar Theses

This study was conducted in Montevideo, Uruguay, where I examined the actions that the country and society as a whole, its various communities, the Uruguayan government, and the people take in order to prevent disease and promote a healthy society. An ethnographic experiential and evidence-based approach, including personal experience, interviews, and official government documents, was used to fully describe the way the system operates. Due to Uruguay's demographic characteristics, particular attention was paid to children and adolescents. For this thesis, Uruguay is described in terms of its history, physical and mental health issues, society's shared health concerns, and its vulnerable …

Comparing Cognitive Functioning And Adverse Metabolic Effects Of Consumers Taking Type 1 Or Type 2 Antipsychotic Medications With Un-Medicated Consumers, Muhammad Puri

Master of Public Health Program Student Publications

Obesity and metabolic side effects such as diabetes mellitus are major concerns in public health. Mentally ill people are a high risk subgroup for obesity and metabolic syndrome because of behavior, non treatment, and medication side effects. In this research, I conducted a retrospective chart review to compare the weight and body mass index of consumers who were prescribed antipsychotic Type 1 or Type 2 medications. The sample was drawn from consumers attending the Consumer Advocacy Model (CAM) program which is an outpatient substance abuse and mental health treatment program in the Wright State University Boonshoft School of Medicine Department …

Idaho Rural Family Physician Workforce Study: The Community Apgar Questionnaire, D. F. Schmitz, E. Baker, A. Nukui, T. Epperly

Public and Population Health Faculty Publications and Presentations

Context: Community factors of varied importance help determine the success of achieving and maintaining a physician workforce. The purpose of this study was to develop an evaluation instrument (Community Apgar Questioinnaire) useful to rural Idaho communities’ in their assessment of the assets and capabilities related to physician recruitment and retention.

Methods: A quantitative scoring interview instrument was developed based on a literature review, site visits and discussions with rural physicians and hospital administrators. A total of 11 rural Idaho communities differing in geography and other known variables were selected, some identified historically to have more success in recruitment and retention …

Toxic Chemicals Transported By Rail And Public Health Safety Using Gis In Montgomery County, Ohio, Jason Lipiec

Master of Public Health Program Student Publications

Hazardous chemicals transported by rail pass directly through urban cities and pose a safety and health threat to the community. Some of these chemicals can be in large quantities, extremely toxic, devastating to the environment and have the potential to cause mass casualties and death. Thousands of people could be in harm’s way. While there is always the possibility for accidental chemical release, they also have the potential to be used in acts of sabotage and terrorism. Evaluation of the rail line in Montgomery County, Ohio using standards in the 2008 Emergency Response Guidebook using geographic information systems (GIS) at …

The Non-Infectious Disease Implications Of Bed Bug Infestations, Christopher T. Balster

Master of Public Health Program Student Publications

The purpose of this study was to determine the prevalence of bed bug infestations throughout Ohio, whether the non-infectious disease implications of infestations are public health concerns, and also determine the perceived ability of public health departments to respond to outbreaks within their jurisdiction. A descriptive study was performed using survey data obtained from 79 local public health departments throughout Ohio. Overall, 79.05% of individuals surveyed agreed that bed bug outbreaks are a public health concern. The mode of responses regarding whether or not the non-infectious disease concerns of infestations are a public health concern was 4 on a scale …

Cultural Conceptions Of Health, Caroline Stephens

Independent Study Project (ISP) Collection

Healthcare is a complicated structure, influenced by multiple economic, social and cultural factors. It is problematic enough to determine how to administer healthcare in countries that rely only on the western healthcare system, but it is even more difficult in places such as Madagascar where multiple healthcare systems exist. Today the Malagasy have a culture that combines the many French practices with the traditional Malagasy beliefs, traditions and values. Many Malagasy chose to utilize allopathic medicine, but many others still prefer to go to a traditional healer. By gaining a better understanding of the average Malagasy person’s perceptions of proper …

Plants, People, And Partnership In Madagascar: How Pharmaceutical Companies And Bioprospecting Ventures Must And May Positively Benefit The Communities Whose Resources They Use, Rebecca Slotkin

Independent Study Project (ISP) Collection

For centuries, traditional medical practitioners around the world have understood the tremendous wealth of medicinal power that can be found in the natural environment. In Madagascar, traditional practitioners have both used and cared for their natural environment, which in turn has given them a wide array of medical knowledge. According to the World Health Organization (WHO), “approximately 80% of the world’s inhabitants rely predominantly on traditional medicines for their primary health care” (Cao et al. 2009). Traditional medical knowledge has relatively recently come to the attention of the international medical market. This “recent ‘rediscovery’ of medicinally useful plants” (Sheldon et …

“Mind The Gap” Addressing The Gap Between Health Care Policy & Health Care Reality In Madagascar & The Way Forward Integrating Traditional Medicine & Ethical Reform Within Health Care, Laura Dillon

Independent Study Project (ISP) Collection

At first glance the health care system in Madagascar looks pretty good. No health care system is perfect, in fact most are far from perfect, but some certainly work better than others. On paper it seems that the current system in Madagascar would be among those that “work better”. Sadly, there is oftentimes a disconnect between what a government writes on paper and what happens in reality; looking around the streets of Antananarivo it quickly became apparent that Madagascar is an example of this disconnect. You do not have to be a health care professional to see the lack of …

How Do Religion And Belief Systems Influence Traditional Medicine And Health Care In Madagascar?, Whitney Franklin

Independent Study Project (ISP) Collection

Religion and beliefs consistently shape social structures, laws, and even medicine. In Madagascar, this is extremely evident when considering traditional medicine but also exists in modern medicine. Christianity and traditional beliefs are the two main systems that have shaped traditional medicine to what it has become today. These opposites function as a duality that becomes apparent when looking at certain events in Madagascar’s history and the examination of the evolution and rituals performed in the different types of traditional medicine. Through the methodology of interviewing traditional healers and gathering historical information from experts in lectures, I can make sure to …

Medical Pluralism In Morocco: The Cultural, Religious, Historical And Political-Economic Determinants Of Health And Choice., Tyler Martinson

Independent Study Project (ISP) Collection

Morocco is a culturally diverse intersection between the African continent, the Arab world and Europe. This multiplicity is mirrored in the country’s pluralistic medical system and beliefs surrounding the concepts of illness and health. Explanations of health are endorsed by culturally specific knowledge and are then naturalized and taken as objective. A synthesis of theoretical descriptions and political-economic of medical pluralism, along with historical analysis, explains the presence of multiple health practices and how a person’s choice of medical practice is heavily influenced by dynamic socio-cultural, religious, historical, political and economic factors. This study will help improve practitioner/client narratives of …

A Pilot Study To Assess The Readiness And Barriers As Correlates To Participation In Rural Worksite Health Promotion Programming, Kayte L. Tranel

College of Education and Human Sciences: Dissertations, Theses, and Student Research

An increased risk of lifestyle-related conditions (hypertension, type 2 diabetes, cardiovascular disease and some forms of cancer) is associated with overweight and obesity, which affect approximately two in three American adults (Centers for Disease Control and Prevention [CDC], 2009). Worksite health promotion programming (WHPP) may be effective for reducing disease risk. Reaching adults in the worksite seems logical considering most spend approximately 40 hours each week in that setting. WHPP is linked to improved effectiveness for promoting healthy lifestyle behaviors, but often struggles with low participation and high attrition rates. Research regarding barriers to WHPP and physical activity is available, …

Appalachian Regional Model For Organizing And Sustaining County-Level Diabetes Coalitions, Richard Crespo, Molly Shrewsberry, Darrlyn Cornelius-Averhart, Henry B. King Jr.

Family and Community Health

This article describes a model for developing diabetes coalitions in rural Appalachian counties and presents evidence of their sustainability. The rural Appalachian coalition model was developed through a partnership between two federal agencies and a regional university. Coalitions go through a competitive application process to apply for one-time $10,000 grants. The project has funded 7 to 9 coalitions annually since 2001, reaching 66 total coalitions in 2008. Sustainability of the coalitions is defined by the number of coalitions that voluntarily report on their programs and services. In 2008, 58 of 66 (87%) coalitions in the Appalachian region continue to function …

Addressing The Challenges Of Reporting On Childhood Asthma In A Changing Health Care System: Building Better Evidence For High Performance, Meagan Lyon, Anne Rossier Markus, Maya Tuchman Gerstein, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and costly chronic disease that burdens children and families as well as the health care systems that serve them. A key element to improving asthma outcomes is access to timely and useful data that can improve the quality of care and inform programs and policies to best serve those communities most burdened by asthma. This Policy Brief examines the nation’s data collection framework for childhood asthma and considers steps that might be taken to strengthen it, including the development, collection and refinement of community-level data to inform local health care systems. Through a review of …

Peer Support In Centers For Independent Living: What Do We Know?, Craig Ravesloot Ph.D., Bob Liston, University Of Montana Rural Institute

Health and Wellness

Peer support is ubiquitous.It is defined as a helping relationship between an individual who has experience living under certain conditions assisting another person to cope with and adapt to similar circumstances.It has been gaining in popularity and use since its early adoption in Alcoholics Anonymous (AA), and has been used widely, and with good effect, with people experiencing a variety of both physical and mental health conditions.

Comparison Of Workplace Protection Factors For Different Biological Contaminants, Kyungmin Jacob Cho, Tiina Reponen, Roy Mckay, Alok Dwivedi, Atin Adhikari, Umesh Singh, Rakesh Shukla, M. Susan Jones, Gordon Jones, Sergey A. Grinshpun

Nursing Faculty Publications

This study compared workplace protection factors (WPFs) for five different contaminants (endotoxin, fungal spores, (1→3)-β-D-glucan, total particle mass, and total particle number) provided by an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR). We previously reported size-selective WPFs for total particle numbers for the ER and FFR, whereas the current article is focused on WPFs for bioaerosols and total particle mass. Farm workers (n = 25) wore the ER and FFR while performing activities at eight locations representing horse farms, pig barns, and grain handling facilities. For the determination of WPFs, particles were collected on filters simultaneously …

Smoking During Pregnancy: Its Effects On The Prevalence Of Low Birth Weight Infants, Lynda M. Colussi

Master of Public Health Program Student Publications

Objective: The purpose of this research was to determine what impact demographic characteristics and the smoking status of mothers had on the prevalence and risk for LBW births. Methods: Birth certificate data from Montgomery County, Ohio from 2006-2009 was analyzed. Among the information collected were the infant's birth weight, the mother's age, marital status, education level, race, payer status at time of delivery, WIC status, and smoking status. The impact demographic characteristics and smoking status had on the prevalence of LBW births was determined by a logistic regression model. The effect of when women smoked during pregnancy had on the …

The Believe In All Your Possibilities Campaign: Updating A Social Marketing Campaign On A Shoe String Budget, Moya L. Alfonso, H. Woodcum, Sherri Reynolds, John S. Luque

Community Health: Faculty Presentations (1993-2018)

The purpose of this presentation is to provide participants with an understanding of how to revamp or refresh a brand on a limited budget using a case study approach. The ‘Believe in All Your Possibilities’ community-based prevention marketing campaign, which was targeted at reducing alcohol and tobacco use among middle school youth, was the result of a long term school-community-university partnership in Southeast Florida. This alcohol campaign has been continuously implemented for eight years. Encouraging evaluation results combined with recently acquired alcohol prevention funding served as the impetus for conducting research to determine if ‘Believe’: a) was still relevant to …

Rocky Mountain Highs And Lows: Efforts To Improve Health And Reduce Costs In Denver, Michele J. Orza, Jessamyn Taylor

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Home, But Not Alone: Evidence-Based Maternal, Infant, And Early Childhood Home Visitation, Eileen Salinsky

National Health Policy Forum

Home visitation services for young and expectant families have the potential to improve child and parent outcomes in a broad variety of ways, but the effectiveness of home visits may depend on the nature, frequency, and duration of these services. The Patient Protection and Affordable Care Act of 2010 (PPACA) created a new federal funding stream to promote the development and implementation of evidence-based home visiting programs. This issue brief provides an overview of the newly established Maternal, Infant, and Early Childhood Home Visiting program, describes existing approaches to home visitation, and discusses the implications of federal funding for state …