Health Policy Commons^™

No More Mind Games: Content Analysis Of In-Game Commentary Of The National Football League’S Concussion Problem, Jeffrey Parker

Theses and Dissertations (Comprehensive)

American (gridiron) football played at the professional level in the National Football League (NFL) is an inherently physical spectator sport, in which players frequently engage in significant contact to the head and upper body. Until recently, the long-term health consequences associated with on the field head trauma were not fully disclosed to players or the public, potentially misrepresenting the dangers involved in gameplay. Crucial to the dissemination of this information to the public are in-game televised commentators of NFL games, regarded as the primary conduits for mediating in-game narratives to the viewing audience. Using a social constructionist theoretical lens, this …

Political, Economic, And Health Determinants Of Tuberculosis Incidence, Ashley Rutherford

Electronic Theses and Dissertations

The epidemiologic transition has shifted major causes of mortality from infectious disease to chronic disease; however, infectious diseases are again re-emerging as a major global concern (Diamond, 1997; Karlen, 1995; McNeil, 1976). This research aimed to identify potential areas of infectious disease influence that are not health-related in order to help governments and policymakers establish new policies, correct current policies, or further address these issues in order to effectively prevent and combat infectious disease. This study employed a retrospective, cross-sectional, non-experimental design via structural equation modeling (SEM) and examined tuberculosis incidence rates at the country-level. Secondary data from open-source, international …

A Cross-Sectional Study On Patients' Access To Healthcare In A Developing Nation, Pawan Bhandari

All Graduate Theses, Dissertations, and Other Capstone Projects

The objective of this research study was to gauge the current status of patients' access to health care services in a developing nation or least-developed country (as defined by the World Bank and United Nations), Nepal. Many patients are not privileged to have a hospital at a close proximity in Nepal. They are also forced to travel and wait for long hours due to their inability to pay for services offered by private healthcare institutions. A survey questionnaire was developed to get a snapshot of how long patients travel to get to a public hospital for an outpatient service. The …

Depression Intervention Programs In Low-Income High Schools, Gopika Hari

UROP Posters

It is estimated that 2.6 million adolescents suffer from major depressive episodes each year. Research has noted that symptoms in youth have become indicators of mental health complications later in life. Studies reveal that low income is a risk factor for depression and that socioeconomically-disadvantaged teenagers are more than twice as likely to develop mental illnesses. Only roughly 25% of children with mental illnesses receive adequate help and 80% of these resources come from schools. This study focuses on establishing the importance of depression intervention programs in low-income high schools and on designing novel guidelines for effective protocols. A compilation …

Implementation Of Self-Directed Supports For Individuals With Intellectual And Developmental Disabilities: A Political Economy Analysis, Matthew P. Decarlo

Theses and Dissertations

Self-directed supports, as a method of service delivery, have grown from small pilot programs in a handful of states to at least one program in every state. For individuals with intellectual and developmental disabilities (IDD), self-direction presents unique opportunities to engage in self-determined behavior and shape the services upon which they rely. Although the evidence base for self-direction is relatively robust, there is a significant lack of information on how implementation of self-direction is faring on the national level. The purpose of this study is to understand how the political and economic factors within and across states have impacted the …

Policies And Clinical Practices Regarding Candidacy And Auditory Treatment For Hispanic Pediatric Patients In Cochlear Implant Centers In The United States, Matthew Ehrenburg

Senior Independent Study Theses

This research sought to investigate the policies and clinical practices regarding candidacy and auditory treatment for Hispanic pediatric cochlear implant patients at cochlear implant centers in the United States. More specifically, the study investigated treatment services provided to pediatric patients who are raised in monolingual Spanish, English as a second language (ESL), and bilingual English-Spanish speaking homes. The study made use of survey research to examine cochlear implant centers regarding their policies, clinical practices, and their referral processes for this specific group of cochlear implant recipients. The survey was distributed electronically through the online survey software Qualtrics via email to …

Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica, Mark Gordon

Journal of Sustainable Social Impact

Food policy has a unique role for public, nonprofit, private, and academic stakeholders. Growing food in the city is a challenge worldwide. Food systems can be destroyed by external (weather extremes) and internal (zoning regulations) forces. This study explores urban farms as a secondary food source and their common themes across four sectors. A Northeastern U.S. city was the case study to examine how it implemented its formal urban agriculture program. The positive social change implications of urban farms include greater food visibility and food access in low-income areas and more consumer awareness about growing fresh food. This study contributes …

Experiences Of Victimization And Health Care Access Among Non-Metropolitan Lgbtq+ Individuals, Ashley-Ann Marcotte

Theses and Dissertations (Comprehensive)

Lesbian, gay, bisexual, trans, and queer (LGBTQ+) individuals report substantial rates of violence, discrimination, and negative life events due to homophobia and transphobia and these experiences impact access to health care services and programs (Bauer et al, 2009; Grant, Mottet, Tanis, Harrison, & Keisling, 2010) These experiences result in LGBTQ+ communities needing services, programs, and social supports to provide safer spaces. Although it is well recognized that health care services are not a major determinant of health outcomes and yet use more than 60% of health spending (Canadian Institute for Health Information, 2014; Muzyka, Hodgson, & Prada, 2012). As such, …

Neoliberalism Redux: The Global Health Policy Agenda And The Politics Of Cooptation In Latin America And Beyond, Anne E Birn, Laura Nervi, Carlos Eduardo Siqueira

Gastón Institute Publications

This article explores the neoliberal cooptation of social justice-oriented global health policies over the last three decades, from primary health care and ‘health for all’ to various contemporary so-called ‘health equity’ initiatives, such as Universal Health Coverage and ‘health convergence’. The authors illustrate and contextualize the different periods and approaches with examples from a range of Latin American countries, drawing on diverse political experiences and social struggles in the health arena. The analysis concludes with reflections about the region’s experiences of resisting and challenging the neoliberal health agenda, in spite of domestic and global environments that have constrained these efforts, …

Food Insecurity And Housing Instability In Vulnerable Families, Christian King

Department of Nutrition and Health Sciences: Faculty Publications

Reducing the prevalence of household food insecurity has been a long-standing objective of the federal government. Previous research has found many negative consequences of food insecurity for families and households but has not examined its relationship with housing instability. Using longitudinal data from the Fragile Families and Child Wellbeing Study, difference-in-difference models show that food insecurity is associated with housing instability. The association remains statistically significant after accounting for potential selection and unobserved heterogeneity using propensity score matching and excluding households that experienced prior housing instability from the sample. Examining potential mediating factors, I find that material hardship explains about …

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan

Senior Honors Projects, 2010-2019

Primary care physicians operate on the front lines of health care. Although primary care physicians play a critical role in improving health outcomes, workforce trends in the United States show a growing shortage of primary care physicians as demand for primary care rises. In conveying the importance of primary care physicians, the worsening physician shortage, the inequitable distribution of providers, and the lackluster institutional response thus far, this paper calls into question the effectiveness of current indicators used to identify underserved areas and provide appropriate government assistance. Through the use of data from the 2010 census and American Medical Association …

Advocacy In Action: A Framework For Implementation Of The American Counselors Association Advocacy Competencies On A Local Level, Jeffrey M. Lown

Educational Specialist, 2009-2019

Despite calls from within the professional field and external forces, counselors have faced ongoing challenges in their efforts to be effective advocates for their clients and themselves. A review of the literature reveals that throughout the history of the profession, prominent figures have called on counselors to assume advocacy roles, and that some initiatives have been successful in fostering lasting change. However, as counselors and their clients’ needs continue to evolve, so too must strategies to address these needs be reevaluated and new initiatives put into place.

In this paper, I have outlined a committee structure and agenda that seeks …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Puerto Rico’S Community Health Centers In A Time Of Crisis, Peter Shin, Jessica Sharac, Marie Nina Luis, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2014, Puerto Rico’s twenty federally funded community health centers, operating in 71 sites located throughout the Commonwealth, served 330,736 patients, approximately one in ten Commonwealth residents. Compared to other Puerto Rico residents, health center patients are less likely to be insured. Despite considerable growth in Medicaid as a result of the supplemental funding provided under the Affordable Care Act, in 2014, 12.2% of health center patients remained uninsured.

Compared to health centers outside Puerto Rico, Puerto Rico’s health centers show a greater proportion of Medicaid patients served (69% compared to 46% outside Puerto Rico), a greater dependence on physician …

Workforce Innovations In Oral Health, Jean Moore, Margaret Langelier, Bridget Baker

Health Workforce Speaker Series

No abstract provided.

The Challenges Of Leading Change In Health-Care Delivery From The Frontline, Vivienne Byers

Articles

Aim: The public sector is facing turbulent times and this challenges nurses, who are expected to serve both patient interests and the efficiency drives of their organisations. In the context of implementing person-centred health policy, this paper explores the evolving role of front-line nurses as leaders and champions of change.

Background: Nurses can be seen to have some autonomy in health-care delivery. However, they are subject to systems of social control. In implementing person- centred policy, nurses can be seen to be doing the best they can within a constrained environment.

Method: A survey of nursing practice in person-centred health-policy …

Health Center Trends: Recent Experience In Medicaid Expansion And Non-Expansion States., Peter Shin, Jessica Sharac, Julia Zur, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In thousands of medically underserved communities across the U.S., community health centers enroll lowincome people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and service capacity, comparing states that implemented the ACA Medicaid expansion in 2014 and states that did not expand Medicaid in 2014. The study is based …

Capstone Revival, Mary Mesele, Ruochen Lu, Quilin Jiang

School of Professional Studies

The capstone project is a culminating experience whereby students choose to research a topic that is relevant in their field of study and have been highly regarded as important learning activities. The capstone allows students to use research, analytical, problem solving and evaluation skills they have learned in the course of the graduate program. McGill indicates the benefit of the completion of a capstone project not only in gaining knowledge in capstone but also in learning how to apply the knowledge gained in other courses in the major (McGill, 2012). Currently, COPACE (College of Professional and Continuing Education) has three …

Bridging The Divide White Paper On Medication Abortion: Overview Of Research & Policy In The United States, Liz Borkowski, Julia Strasser, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Medication abortion (also called medical abortion) is a safe method of abortion available for the past 15 years in the US. The Bridging the Divide white paper summarizes the scientific evidence related to the current medication abortion process and potential changes to the process that could make it even safer and more accessible for patients, as well as policy considerations and directions for future research.

In the fall of 2000, the US Food & Drug Administration (FDA) approved the drug Mifeprex© (generic: mifepristone) for use in medication abortions. That approval included requirements that affect both patients and providers and that …

Quality And Cost Of Diabetes Mellitus Care In Community Health Centers In The United States., Patrick Richard, Peter Shin, Tishra Beeson, Laura S. Burke, Susan F. Wood, Sara Rosenbaum

Health Policy and Management Faculty Publications

OBJECTIVE: To examine variations in the quality and cost of care provided to patients with diabetes mellitus by Community Health Centers (CHCs) compared to other primary care settings.

RESEARCH DESIGN AND METHODS: We used data from the 2005-2008 Medical Expenditure Panel Survey (N = 2,108). We used two dependent variables: quality of care and ambulatory care expenditures. Our primary independent variable was whether the respondent received care in a Community Health Centers (CHCs) or not. We estimated logistic regression models to determine the probability of quality of care, and used generalized linear models with log link and gamma distribution to …