Health Policy Commons^™

Public Health Staff Development Needs In Informatics: Findings From A National Survey Of Local Health Departments, Barbara L. Massoudi, Kelley Chester, Gulzar H. Shah

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

Context: Public health practice is information-intensive and information-driven. Public health informatics is a nascent discipline, and most public health practitioners lack necessary skills in this area.

Objective: To describe the staff development needs of local health departments (LHDs) related to informatics.

Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County & City Health Officials.

Participants: A total of 324 LHDs from all 50 states completed the survey (response rate: 50%).

Main Outcome Measure(s): Outcome measures included LHDs' specific staff development needs related to informatics. …

Using Information Systems To Improve A Mid-Sized Local Health Department’S Effectiveness In A Time Of Rapid Change, Kay Lovelace, Gulzar H. Shah

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

Background: Informatics capacity building is resource and personnel intensive. Many local health departments (LHDs) face tradeoffs between using their resources to carry out existing mandates and using resources to build their capacity, for example, through informatics, to deliver essential services in a more effective and efficient manner.

Objective: The purpose of this case study is to describe how a mid-sized LHD built and used information systems to support its strategic objectives, clinical services, and surveillance.

Methods: The mid-sized LHD described here was chosen for its “best practices” in informatics capacity building and use by NACCHO's study advisory committee. To conduct …

An Iterative, Low-Cost Strategy To Building Information Systems Allows A Small Jurisdiction Local Health Department To Increase Efficiencies And Expand Services, Kay Lovelace, Gulzar H. Shah

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

Objective and Methods: The objective of this case study was to describe the process and outcomes of a small local health department's (LHD's) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed.

Results and Conclusions: The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department's success were simple information systems, …

The Health Care Expenditure And Income: A Global Perspective, Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti

Center for Policy Research

This paper investigates the long-run economic relationship between health care expenditure and income in the world using data on 167 countries over the period 1995-2012, collected from the World Bank data set. The analysis is carried using panel data methods that allow one to account for unobserved heterogeneity, temporal persistence, and cross-section dependence in the form of either a common factor model or a spatial process. We estimate a global measure of income elasticity using all countries in the sample, and for sub-groups of countries, depending on their geo-political area and income. Our findings suggest that at the global level, …

Urgent Challenges For Local Public Health Informatics, Joseph P. Gibson, Gulzar H. Shah, Laura C. Streichert, Linda Verchick

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

This editorial highlights the urgent challenges for local public health informatics and provides solutions to face these challenges.

The Methods Behind 2015 Informatics Capacity And Needs Assessment Study, Gulzar H. Shah

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

The 2015 Informatics Needs and Capacity of Local Health Departments (LHDs) survey is the most recent comprehensive source of quantitative data on LHD informatics. Conducted by the National Association of County & City Health Officials (NACCHO), this is the third nationally representative quantitative study of LHD informatics since 2009. The previous 2 comprehensive quantitative assessments were conducted by NACCHO in 2009-2010 and 2011. Given that public health informatics is rapidly evolving, the 2015 Informatics survey is a much-needed country-wide assessment of the current informatics needs and capacities of LHDs. This article outlines detailed methodology used in the 2015 Informatics survey, …

Informatics As A Strategic Priority And Collaborative Processes To Build A Smarter, Forward-Looking Health Department, Kay Lovelace, Gulzar H. Shah

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

This article was published in the Journal of Public Health Management and Practice.

Interoperability Of Information Systems Managed And Used By The Local Health Departments, Gulzar H. Shah, Jonathon P. Leider, Huabin Luo, Ravneet Kaur

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

Background: In the post-Affordable Care Act era marked by interorganizational collaborations and availability of large amounts of electronic data from other community partners, it is imperative to assess the interoperability of information systems used by the local health departments (LHDs).

Objectives: To describe the level of interoperability of LHD information systems and identify factors associated with lack of interoperability.

Data and Methods: This mixed-methods research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling …

Electronic Health Records And Meaningful Use In Local Health Departments: Updates From The 2015 Naccho Informatics Assessment Survey, Karmen S. Williams, Gulzar H. Shah

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

Background: Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data.

Purpose: The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs.

Methods: Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling …

Local Health Departments' Partners And Challenges In Electronic Exchange Of Health Information, Gulzar H. Shah, Joshua Vest, Kay Lovelace, J. Mac Mccullough

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

Background: Unprecedented amounts of data are produced by the health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data. LHDs will need to participate in health information exchange (HIE) with a number of partners in order to benefit from these data resources. LHDs' participation in HIEs with specific partners has not been studied.

Objectives: To describe the level of and challenges in LHD participation in HIE with other partners, and variation by LHD population size and governance type.

Data and Methods: This research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, …

Incentivizing Healthy Eating In Children: An Investigation Of The “Ripple” And “Temporal” Effects Of Reward-Based Interventions, Saied Toossi

Center for Policy Research

Although previous studies have established the effectiveness of using small reward-based incentives in inducing the choice and consumption of healthier foods among children, little is known about their impact outside of experimental settings or their effectiveness over time when administered daily. This paper presents the results of a field experiment conducted to provide insight on these matters. The study employs a pretest-posttest within-subject design and was conducted at a summer program catering to low-income children between the ages of 5 and 12. Corroborating existing studies, the introduction of small reward-based incentives was found to induce large increases in the number …

Does Aco Adoption Change The Health Workforce Configuration In U.S. Hospitals?, Avi Dor, Patricia Pittman, Clese Erikson, Roberto Delhy, Xinxin Han

Health Workforce Research Center Publications

Working with Premier, Inc., this study explored how participation in ACOs affects hospitals’ workforce assignment and configuration. The study 1) describes the differences in workforce characteristics in hospitals adopting versus not adopting an ACO model and 2) determines key changes in workforce before and after a hospital adopts an ACO model. Key Questions

1. Hospitals with what types of workforce configuration are more likely to participate in an ACO?
2. How do hospitals change their workforce after participating in an ACO?
3. Do hospitals not yet participating in ACOs make similar/different changes to workforce as their peers in ACOs?

Smart Cities: Improving The Roadside Environment With Distributed Sensor Systems, Christine M. Kendrick

PSU Transportation Seminars

The City of Portland is exploring how distributed "Internet of Things" (IoT) sensor systems can be used to improve the available data that is usable by city engineers, planners, and the public to help inform transportation operations, enable assessments of public health and equity, advance Portland’s Climate Action Plan goals, and create opportunities for economic development and civic engagement.

The City is currently looking at how low-cost air quality sensors can be used to improve and increase real-time understanding of transportation-related pollutants. However, the state of low-cost air quality sensor technology is not usable off the shelf due to sensitivity …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

How Medicaid And Other Public Policies Affect Use Of Tobacco Cessation Therapy, United States, 2010-2014., Leighton Ku, Erin Brantley, Tyler Bysshe, Erika Steinmetz, Brian K. Bruen

Health Policy and Management Faculty Publications

INTRODUCTION: State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers.

METHODS: We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014.

RESULTS: Medicaid policies that require patients to …

How Do You Know A Labor Shortage When You See One?, Burt Barnow

Health Workforce Speaker Series

No abstract provided.

Community Health Centers And Medicaid Payment Reform: Emerging Lessons From Medicaid Expansion States, Peter Shin, Jessica Sharac, Zoe Barber, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers represent a major source of primary health care for the nation’s Medicaid beneficiaries. Because the Federally Qualified Health Center (FQHC) payment system is encounter-based, health centers and Medicaid agencies in ACA expansion states are actively pursuing payment reforms that will enable health centers to adopt strategies that can more effectively respond to the considerable and complex health and social needs of people served by health centers, and more efficiently address the surging volume of patient care. In five expansion states whose alternative payment experiments are underway, health centers and Medicaid agencies are testing payment alternatives, such as …

Grassroots Community Fundraising And Advocacy To Reduce Breast Cancer Mortality In Ohio Through Patient Navigation And Safety-Net Programs, Julie Mcmahon

Learning Showcase 2016: A Celebration of Discovery, Transformation and Success

Ohio has the third highest breast cancer mortality rate of any state in the U.S. In 2016, 1,700 women will die from breast cancer in Ohio. When diagnosed at early stages, survival and quality of life are improved. Barriers to care like finances, health literacy, insurance coverage, fear and transportation contribute to late-stage diagnoses. A community needs assessment of 30 counties in central and southeast Ohio was conducted to inventory all health system assets, healthy policy impacts, and collect qualitative data to identify local barriers and solutions to reduce mortality. Results were used to develop a multi-level approach to reduce …

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …