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Chae DH, Snipes SA, Chung KW, Martz CD, LaVeist TA. Vulnerability and Resilience: Use and Misuse of These Terms in the Public Health Discourse. Am J Public Health 2021; 111:1736-1740. [PMID: 34554819 PMCID: PMC8561197 DOI: 10.2105/ajph.2021.306413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/04/2022]
Affiliation(s)
- David H Chae
- David H. Chae and Kara W. Chung are with the Department of Social, Behavioral, and Population Sciences and Thomas A. LaVeist is with the Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Shedra A. Snipes is with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Connor D. Martz is with the Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - Shedra A Snipes
- David H. Chae and Kara W. Chung are with the Department of Social, Behavioral, and Population Sciences and Thomas A. LaVeist is with the Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Shedra A. Snipes is with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Connor D. Martz is with the Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - Kara W Chung
- David H. Chae and Kara W. Chung are with the Department of Social, Behavioral, and Population Sciences and Thomas A. LaVeist is with the Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Shedra A. Snipes is with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Connor D. Martz is with the Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - Connor D Martz
- David H. Chae and Kara W. Chung are with the Department of Social, Behavioral, and Population Sciences and Thomas A. LaVeist is with the Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Shedra A. Snipes is with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Connor D. Martz is with the Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - Thomas A LaVeist
- David H. Chae and Kara W. Chung are with the Department of Social, Behavioral, and Population Sciences and Thomas A. LaVeist is with the Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Shedra A. Snipes is with the Department of Biobehavioral Health, Pennsylvania State University, University Park. Connor D. Martz is with the Department of Human Development and Family Science, Auburn University, Auburn, AL
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Wolfenden L, Movsisyan A, McCrabb S, Stratil JM, Yoong SL. Selecting Review Outcomes for Systematic Reviews of Public Health Interventions. Am J Public Health 2021; 111:465-470. [PMID: 33476230 PMCID: PMC7893343 DOI: 10.2105/ajph.2020.306061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/04/2022]
Abstract
For systematic reviews to have an impact on public health, they must report outcomes that are important for decision-making. Systematic reviews of public health interventions, however, have a range of potential end users, and identifying and prioritizing the most important and relevant outcomes represents a considerable challenge.In this commentary, we describe potentially useful approaches that systematic review teams can use to identify review outcomes to best inform public health decision-making. Specifically, we discuss the importance of stakeholder engagement, the use of logic models, consideration of core outcome sets, reviews of the literature on end users' needs and preferences, and the use of decision-making frameworks in the selection and prioritization of outcomes included in reviews.The selection of review outcomes is a critical step in the production of public health reviews that are relevant to those who use them. Utilizing the suggested strategies may help the review teams better achieve this.
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Affiliation(s)
- Luke Wolfenden
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Ani Movsisyan
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Sam McCrabb
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Jan M Stratil
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Sze Lin Yoong
- Luke Wolfenden and Sam McCrabb are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Ani Movsisyan and Jan M. Stratil are with the Institute for Medical Information Processing, Biometry and Epidemiology and the Pettenkofer School of Public Health, Ludwig Maximilian University of Munich, Munich, Germany. Sze Lin Yoong is with the Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
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Wang X, Ren R, Kattan MW, Jehi L, Cheng Z, Fang K. Public Health Interventions' Effect on Hospital Use in Patients With COVID-19: Comparative Study. JMIR Public Health Surveill 2020; 6:e25174. [PMID: 33315585 PMCID: PMC7759508 DOI: 10.2196/25174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 12/06/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Different states in the United States had different nonpharmaceutical public health interventions during the COVID-19 pandemic. The effects of those interventions on hospital use have not been systematically evaluated. The investigation could provide data-driven evidence to potentially improve the implementation of public health interventions in the future. OBJECTIVE We aim to study two representative areas in the United States and one area in China (New York State, Ohio State, and Hubei Province), and investigate the effects of their public health interventions by time periods according to key interventions. METHODS This observational study evaluated the numbers of infected, hospitalized, and death cases in New York and Ohio from March 16 through September 14, 2020, and Hubei from January 26 to March 31, 2020. We developed novel Bayesian generalized compartmental models. The clinical stages of COVID-19 were stratified in the models, and the effects of public health interventions were modeled through piecewise exponential functions. Time-dependent transmission rates and effective reproduction numbers were estimated. The associations of interventions and the numbers of required hospital and intensive care unit beds were studied. RESULTS The interventions of social distancing, home confinement, and wearing masks significantly decreased (in a Bayesian sense) the case incidence and reduced the demand for beds in all areas. Ohio's transmission rates declined before the state's "stay at home" order, which provided evidence that early intervention is important. Wearing masks was significantly associated with reducing the transmission rates after reopening, when comparing New York and Ohio. The centralized quarantine intervention in Hubei played a significant role in further preventing and controlling the disease in that area. The estimated rates that cured patients become susceptible in all areas were small (<0.0001), which indicates that they have little chance to get the infection again. CONCLUSIONS The series of public health interventions in three areas were temporally associated with the burden of COVID-19-attributed hospital use. Social distancing and the use of face masks should continue to prevent the next peak of the pandemic.
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Affiliation(s)
- Xiaofeng Wang
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States
| | - Rui Ren
- Department of Statistics, Xiamen University, Xiamen, China
| | - Michael W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States
| | - Lara Jehi
- Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Zhenshun Cheng
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Kuangnan Fang
- Department of Statistics, Xiamen University, Xiamen, China
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Freckelton Qc I. COVID-19: Fear, quackery, false representations and the law. Int J Law Psychiatry 2020; 72:101611. [PMID: 32911444 PMCID: PMC7351412 DOI: 10.1016/j.ijlp.2020.101611] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 05/12/2023]
Abstract
Fear, anxiety and even paranoia can proliferate during a pandemic. Such conditions, even when subclinical, tend to be a product of personal and predispositional factors, as well as shared cultural influences, including religious, literary, film, and gaming, all of which can lead to emotional and less than rational responses. They can render people vulnerable to engage in implausible conspiracy theories about the causes of illness and governmental responses to it. They can also lead people to give credence to simplistic and unscientific misrepresentations about medications and devices which are claimed to prevent, treat or cure disease. In turn such vulnerability creates predatory opportunities for the unscrupulous. This article notes the eruption of quackery during the 1889-1892 Russian Flu and the 1918-1920 Spanish Flu and the emergence during 2020 of spurious claims during the COVID-19 pandemic. It identifies consumer protection strategies and interventions formulated during the 2020 pandemic. Using examples from the United States, Japan, Australia and the United Kingdom, it argues that during a pandemic there is a need for three responses by government to the risks posed by conspiracy theories and false representations: calm, scientifically-based messaging from public health authorities; cease and desist warnings directed toward those making extravagant or inappropriate claims; and the taking of assertive and well publicised legal action against individuals and entities that make false representations in order to protect consumers rendered vulnerable by their emotional responses to the phenomenology of the pandemic.
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Affiliation(s)
- Ian Freckelton Qc
- Barrister, Castan Chambers, Melbourne, Australia; Supreme Court of Nauru, Nauru; University of Melbourne, Australia; Monash University, Australia; Johns Hopkins University, Baltimore, MD, USA.
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Carter SE, Gobat N, Pfaffmann Zambruni J, Bedford J, van Kleef E, Jombart T, Mossoko M, Bulemfu Nkakirande D, Navarro Colorado C, Ahuka-Mundeke S. What questions we should be asking about COVID-19 in humanitarian settings: perspectives from the Social Sciences Analysis Cell in the Democratic Republic of the Congo. BMJ Glob Health 2020; 5:e003607. [PMID: 32948618 PMCID: PMC7503194 DOI: 10.1136/bmjgh-2020-003607] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
| | - Nina Gobat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | | | | | - Esther van Kleef
- Department of Public Health, Prince Leopold Institute of Tropical Medicine, Antwerpen, Belgium
| | - Thibaut Jombart
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- UK Public Health Rapid Support Team, Public Health England, London, UK
| | - Mathias Mossoko
- Direction Générale de Lutte contre la Maladie/ Direction Surveillance Epidemiologique, Ministere de la Sante Publique, Kinshasa, Congo (the Democratic Republic of the)
| | - Dorothée Bulemfu Nkakirande
- Direction Générale de Lutte contre la Maladie/ Direction Surveillance Epidemiologique, Ministere de la Sante Publique, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Steve Ahuka-Mundeke
- Departement de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)
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Matowo NS, Tanner M, Munhenga G, Mapua SA, Finda M, Utzinger J, Ngowi V, Okumu FO. Patterns of pesticide usage in agriculture in rural Tanzania call for integrating agricultural and public health practices in managing insecticide-resistance in malaria vectors. Malar J 2020; 19:257. [PMID: 32677961 PMCID: PMC7364647 DOI: 10.1186/s12936-020-03331-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/09/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Unrestricted use of pesticides in agriculture is likely to increase insecticide resistance in mosquito vectors. Unfortunately, strategies for managing insecticide resistance in agriculture and public health sectors lack integration. This study explored the types and usage of agricultural pesticides, and awareness and management practices among retailers and farmers in Ulanga and Kilombero districts in south-eastern Tanzania, where Anopheles mosquitoes are resistant to pyrethroids. METHODS An exploratory sequential mixed-methods approach was employed. First, a survey to characterize pesticide stocks was conducted in agricultural and veterinary (agrovet) retail stores. Interviews to assess general knowledge and practices regarding agricultural pesticides were performed with 17 retailers and 30 farmers, followed by a survey involving 427 farmers. Concurrently, field observations were done to validate the results. RESULTS Lambda-cyhalothrin, cypermethrin (both pyrethroids) and imidacloprids (neonicotinoids) were the most common agricultural insecticides sold to farmers. The herbicide glyphosate (amino-phosphonates) (59.0%), and the fungicides dithiocarbamate and acylalanine (54.5%), and organochlorine (27.3%) were also readily available in the agrovet shops and widely used by farmers. Although both retailers and farmers had at least primary-level education and recognized pesticides by their trade names, they lacked knowledge on pest control or proper usage of these pesticides. Most of the farmers (54.4%, n = 316) relied on instructions from pesticides dealers. Overall, 93.7% (400) farmers practised pesticides mixing in their farms, often in close proximity to water sources. One-third of the farmers disposed of their pesticide leftovers (30.0%, n = 128) and most farmers discarded empty pesticide containers into rivers or nearby bushes (55.7%, n = 238). CONCLUSION Similarities of active ingredients used in agriculture and malaria vector control, poor pesticide management practices and low-levels of awareness among farmers and pesticides retailers might enhance the selection of insecticide resistance in malaria vectors. This study emphasizes the need for improving awareness among retailers and farmers on proper usage and management of pesticides. The study also highlights the need for an integrated approach, including coordinated education on pesticide use, to improve the overall management of insecticide resistance in both agricultural and public health sectors.
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Affiliation(s)
- Nancy S Matowo
- Environmental Health & Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania.
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Givemore Munhenga
- Wits Research Institute for Malaria, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Salum A Mapua
- Environmental Health & Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Marceline Finda
- Environmental Health & Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Vera Ngowi
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fredros O Okumu
- Environmental Health & Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
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Kysow K, Bratiotis C, Lauster N, Woody SR. How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver. Health Soc Care Community 2020; 28:1160-1169. [PMID: 31984612 DOI: 10.1111/hsc.12948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 12/13/2019] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
Hoarded homes can pose a threat to public safety, with heightened risks of fire hazards, pest infestations and noxious odours in both the home and neighbouring dwellings. Communities across North America are responding to these public safety concerns through a harm reduction approach. This descriptive study explores the implementation and outcomes of the City of Vancouver's approach involving a partnership between fire prevention and public health. Data were collected from the team's 2016-2018 case tracking systems, consisting of health records and team intervention record, as well as notes taken from case briefing meetings. Study objectives included describing the intervention model, providing descriptive statistics on clients and their clutter volume, the interventions undertaken, and exploring predictors of clutter volume and case outcome through exploratory analyses. The sample included 82 cases involving severely hoarded conditions or more moderate hoarding conditions paired with additional client vulnerabilities (e.g. health conditions, frailty). Results from paired samples t-tests and regression analysis, suggest the Hoarding Action Response Team's (HART) model of a community-based intervention for hoarding was associated with clutter reduction and tenancy preservation. HART successfully maintained engagement with most clients, and most cases were closed within six home visits. Despite these successes, the team dealt with several barriers including client avoidance and limited resources. This paper provides guidance for communities who are working to develop a coordinated response to problems associated with hoarding and begins to establish expectations for what can be achieved through a community-based hoarding intervention model.
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Affiliation(s)
- Kate Kysow
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | | | - Nathanael Lauster
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Sheila R Woody
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Hu H, Allen P, Yan Y, Reis RS, Jacob RR, Brownson RC. Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis. J Public Health Manag Pract 2020; 25:373-381. [PMID: 31136511 PMCID: PMC6269222 DOI: 10.1097/phh.0000000000000821] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners. DESIGN In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use. SETTING The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention. PARTICIPANTS Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872). MAIN OUTCOME MEASURES Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use. RESULTS The optimal model identified 4 latent classes, labeled as "unsupportive workplace," "low agency leadership support," "high agency leadership support," and "supportive workplace." With maximum probability assignment, participants in "high agency leadership support" (odds ratio = 2.08; 95% CI, 1.35-3.23) and "supportive workplace" (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than "unsupportive workplace." The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for "high agency leadership support" and odds ratio = 1.74 (95% CI, 1.07-2.82) for "supportive workplace." CONCLUSIONS Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such as supervisory expectations, access to evidence, and participatory decision making may need leadership support as well to improve research evidence use in public health job tasks.
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Affiliation(s)
- Hengrui Hu
- Division of Biostatistics (Mr Hu and Dr Yan) and Division of Public Health Sciences, Department of Surgery (Drs Yan and Brownson), Washington University School of Medicine, and Prevention Research Center, Brown School (Mr Hu and Ms Jacob and Drs Allen, Reis, and Brownson), Washington University in St Louis, St Louis, Missouri
| | - Peg Allen
- Division of Biostatistics (Mr Hu and Dr Yan) and Division of Public Health Sciences, Department of Surgery (Drs Yan and Brownson), Washington University School of Medicine, and Prevention Research Center, Brown School (Mr Hu and Ms Jacob and Drs Allen, Reis, and Brownson), Washington University in St Louis, St Louis, Missouri
| | - Yan Yan
- Division of Biostatistics (Mr Hu and Dr Yan) and Division of Public Health Sciences, Department of Surgery (Drs Yan and Brownson), Washington University School of Medicine, and Prevention Research Center, Brown School (Mr Hu and Ms Jacob and Drs Allen, Reis, and Brownson), Washington University in St Louis, St Louis, Missouri
| | - Rodrigo S. Reis
- Division of Biostatistics (Mr Hu and Dr Yan) and Division of Public Health Sciences, Department of Surgery (Drs Yan and Brownson), Washington University School of Medicine, and Prevention Research Center, Brown School (Mr Hu and Ms Jacob and Drs Allen, Reis, and Brownson), Washington University in St Louis, St Louis, Missouri
| | - Rebekah R. Jacob
- Division of Biostatistics (Mr Hu and Dr Yan) and Division of Public Health Sciences, Department of Surgery (Drs Yan and Brownson), Washington University School of Medicine, and Prevention Research Center, Brown School (Mr Hu and Ms Jacob and Drs Allen, Reis, and Brownson), Washington University in St Louis, St Louis, Missouri
| | - Ross C. Brownson
- Division of Biostatistics (Mr Hu and Dr Yan) and Division of Public Health Sciences, Department of Surgery (Drs Yan and Brownson), Washington University School of Medicine, and Prevention Research Center, Brown School (Mr Hu and Ms Jacob and Drs Allen, Reis, and Brownson), Washington University in St Louis, St Louis, Missouri
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Abstract
Antimicrobial resistance (AMR) results in drug-resistant infections that are harder to treat, subsequently leading to increased morbidity and mortality. In 2008, we reviewed the problem of AMR in Singapore, limiting our discussion to the human healthcare sector. Ten years later, we revisit this issue again, reviewing current efforts to contain it in order to understand the progress made as well as current and emerging challenges. Although a significant amount of work has been done to control AMR and improve antibiotic prescribing in Singapore, most of it has focused on the hospital setting, with mixed impact. The role of antibiotic use and AMR in food animals and the environment - and the link to human health - is better understood today. This issue of AMR encompasses both human health as well as animal/food safety, and efforts to control it will need to continually evolve to maintain or improve on current gains.
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Affiliation(s)
- Alvin Qijia Chua
- Department of Pharmacy, Singapore General Hospital, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Andrea Lay-Hoon Kwa
- Department of Pharmacy, Singapore General Hospital, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore
| | - Thean Yen Tan
- Duke-NUS Medical School, National University of Singapore, Singapore
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | | | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- National Centre for Infectious Diseases, Singapore
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Chamorro C, Díaz-Echenique L, Oliván J, Villalbí JR. [Local public health services: a descriptive study of the municipalities of Catalonia in 2016]. Rev Esp Salud Publica 2019; 93:e201905026. [PMID: 31038127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/22/2019] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVE The health system in Spain rests mostly in the Autonomous Communities (similar to the states in the US). The public health activities of many local governments are little studied. The objective of this work was to bring knowledge about the public health activities of the municipalities, providing information obtained from a recent survey in Catalonia. METHODS Descriptive study based on a survey to public health officers in the 119 municipalities above 10,000 population in Catalonia, excluding the city of Barcelona. The survey was conducted between May and October 2016, with 103 municipalities (86.6%) reporting on their services in 2015, prior to the survey. Data were collected and descriptive analyses performed. RESULTS A consolidation of both political and professional public health structures of the municipalities was observed. Most frequent activities in health protection were related to legionella control, the control of urban pests and the management of complaints and requests by citizens. Most frequent activities in the field of health promotion were related to physical activity and health, prevention in tobacco and alcohol, food and nutrition. There were relatively few changes reported in public health structures and their officers, as well as in human resources. CONCLUSIONS In Catalonia, municipalities above 10,000 population have a remarkable level of activity in public health. Both the areas of health protection (with mandatory minimum services for local governments) and of health promotion show high levels of activity. The system seems stable regarding political changes and budget constraints. There are opportunities for improvement in the training of professionals and service accreditation. It would be desirable to find ways to improve coordination among these services.
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Affiliation(s)
- Cati Chamorro
- Servei de Salut Pública. Diputació de Barcelona. Barcelona. España
| | | | - Jesús Oliván
- Servei de Salut Pública. Diputació de Barcelona. Barcelona. España
| | - Joan R Villalbí
- Agència de Salut Pública de Barcelona. Barcelona. España
- CIBER de Epidemiología y Salud Pública. Instituto de Salud Carlos III. Madrid. España
- Institut d'Investigació Biomèdica Sant Pau. Barcelona. España
- Departament de Ciències Experimentals i de la Salut. Universitat Pompeu Fabra. Barcelona. España
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11
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Williams AM, Kreisel K, Chesson HW. Impacts of Federal Prevention Funding on Reported Gonorrhea and Chlamydia Rates. Am J Prev Med 2019; 56:352-358. [PMID: 30655083 PMCID: PMC10984145 DOI: 10.1016/j.amepre.2018.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/19/2018] [Accepted: 09/20/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The Centers for Disease Control and Prevention allocates funds annually to jurisdictions nationwide for sexually transmitted infection prevention activities. The objective of this study was to assess the effectiveness of federal sexually transmitted infection prevention funding for reducing rates of reported sexually transmitted infections. METHODS In 2017-2018, finite distributed lag regression models were estimated to assess the impact of sexually transmitted infection prevention funding (in 2016 dollars per capita) on reported chlamydia rates from 2000 to 2016 and reported gonorrhea rates from 1981 to 2016. Including lagged funding measures allowed for assessing the impact of funding over time. Controls for state-level socioeconomic factors, such as poverty rates, were included. RESULTS Results from the main model indicate that a 1% increase in annual funding would cumulatively decrease chlamydia and gonorrhea rates by 0.17% (p<0.10) and 0.33% (p<0.05), respectively. Results were similar when stratified by sex, with significant decreases in rates of reported chlamydia and gonorrhea in males of 0.33% and 0.34% (both p<0.05) respectively, and in rates of reported gonorrhea in females of 0.32% (p<0.05). The results were generally consistent across alternative model specifications and other robustness tests. CONCLUSIONS The significant inverse associations between federal sexually transmitted infection prevention funding and rates of reported chlamydia and gonorrhea suggest that federally funded sexually transmitted infection prevention activities have a discernable effect on reducing the burden of sexually transmitted infections. The reported sexually transmitted infection rate in a given year depends more on prevention funding in previous years than on prevention funding in the current year, demonstrating the importance of accounting for lagged funding effects.
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Affiliation(s)
- Austin M Williams
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kristen Kreisel
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Harrell W Chesson
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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12
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Crizzle AM, Dykeman C, Laberge S, MacLeod A, Olsen-Lynch E, Brunet F, Andrews A. A public health approach to mobilizing community partners for injury prevention: A scoping review. PLoS One 2019; 14:e0210734. [PMID: 30668594 PMCID: PMC6342297 DOI: 10.1371/journal.pone.0210734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/31/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Reducing injuries in adults requires work with diverse stakeholders across many sectors and at multiple levels. At the local level, public health professionals need to effectively bring together, facilitate, and support community partners to initiate evidence-based efforts. However, there has been no formal review of the literature to inform how these professionals can best create action among community partners to address injuries in adults. Thus, this scoping review aims to identify theories, models or frameworks that are applicable to a community-based approach to injury prevention. METHODS Searches of scientific and less formal literature identified 13,756 relevant items published in the English language between 2000 and 2016 in North America, Europe and Australia. After screening and review, 10 publications were included that (1) identified a theory, framework or model related to mobilizing partners; and (2) referred to community-based adult injury prevention. RESULTS Findings show that use of theories, frameworks and models in community-based injury prevention programs is rare and often undocumented. One theory and various conceptual models and frameworks exist for mobilizing partners to jointly prevent injuries; however, there are few evaluations of the processes to create community action. CONCLUSIONS Successful community-based injury prevention must build on what is already understood about creating partnership action. Evaluating local public health professional injury prevention practice based on available theories, models and frameworks will identify successes and challenges to inform process improvements. We propose a logic model to more specifically guide and evaluate how public health can work locally with community partners.
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Affiliation(s)
- Alexander M. Crizzle
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Cathy Dykeman
- Halton Region Health Department, Oakville, Ontario, Canada
| | - Sarah Laberge
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ann MacLeod
- Trent Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada
| | - Ellen Olsen-Lynch
- Trent Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada
| | - France Brunet
- Eastern Ontario Health Unit, Cornwall, Ontario, Canada
| | - Angela Andrews
- Haliburton, Kawartha, Pine Ridge District Health Unit, Port Hope, Ontario, Canada
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Myers AE, Southwell BG, Ribisl KM, Moreland-Russell S, Bowling JM, Lytle LA. State-Level Point-of-Sale Tobacco News Coverage and Policy Progression Over a 2-Year Period. Health Promot Pract 2019; 20:135-145. [PMID: 29338430 DOI: 10.1177/1524839917752108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mass media content may play an important role in policy change. However, the empirical relationship between media advocacy efforts and tobacco control policy success has rarely been studied. We examined the extent to which newspaper content characteristics (volume, slant, frame, source, use of evidence, and degree of localization) that have been identified as important in past descriptive studies were associated with policy progression over a 2-year period in the context of point-of-sale (POS) tobacco control. METHOD We used regression analyses to test the relationships between newspaper content and policy progression from 2012 to 2014. The dependent variable was the level of implementation of state-level POS tobacco control policies at Time 2. Independent variables were newspaper article characteristics (volume, slant, frame, source, use of evidence, and degree of localization) and were collected via content analysis of the articles. State-level policy environment contextual variables were examined as confounders. RESULTS Positive, significant bivariate relationships exist between characteristics of news content (e.g., high overall volume, public health source present, local quote and local angle present, and pro-tobacco control slant present) and Time 2 POS score. However, in a multivariate model controlling for other factors, significant relationships did not hold. DISCUSSION Newspaper coverage can be a marker of POS policy progression. Whether media can influence policy implementation remains an important question. Future work should continue to tease out and confirm the unique characteristics of media content that are most associated with subsequent policy progression, in order to inform media advocacy efforts.
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Affiliation(s)
- Allison E Myers
- 1 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 2 Counter Tools, Inc., Carrboro, NC, USA
| | - Brian G Southwell
- 1 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 3 RTI International, Research Triangle Park, NC, USA
| | - Kurt M Ribisl
- 1 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Leslie A Lytle
- 1 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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14
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Soulimane A, Ben Abdelaziz A, Serhier Z, Dahdi SA, Merbouh MA. Comparative study of post-graduate training programs in public health in the great maghreb countries. Tunis Med 2018; 96:808-815. [PMID: 30746673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Training in public health, an essential lever for the success of health programs, mobilizes several disciplines, from the description of health situations to the study of their determinants, and to health management. OBJECTIVE To compare postgraduate training programs in Public Health, provided in the countries of the Greater Maghreb. METHODS Through a documentary study, various components of post-graduate training in Public Health in the Maghreb have been identified: offers and methods of training, learning objectives, program content and reference skills. RESULTS In the Maghreb, and with the exception of Mauritania, Training offers are limited to teaching in Public Health with a medical orientation, integrated in the university system in the form of residency. Other training (masters ...) are provided in the context of continuing professional development. Areas of competence include, in addition to medical and scientific expertise, communication and interdisciplinary collaboration. The programs focus on methodological aspects in relation to related disciplines such as health promotion, anthropology, sociology and health planning. CONCLUSION The pooling of training experiences in Public Health, in the Maghreb countries, would be essential to launch a quality homogeneous training based on the paradigm of global health.
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15
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Shifa GT, Ahmed AA, Yalew AW. Maternal and child characteristics and health practices affecting under-five mortality: A matched case control study in Gamo Gofa Zone, Southern Ethiopia. PLoS One 2018; 13:e0202124. [PMID: 30110369 PMCID: PMC6093655 DOI: 10.1371/journal.pone.0202124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 07/27/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Though Ethiopia has shown a considerable improvement in reducing under-five mortality rate since 1990, many children still continue to die prematurely. Mixed results have been reported about determinants of under-five mortality. Besides, there is paucity of mortality studies in the current study site. Therefore, this study was conducted to assess maternal and child health related predictors of under-five mortality in Southern Ethiopia. METHODS A matched case control study was conducted in 2014 in Arba Minch Town and Arba Minch Zuria District of Gamo Gofa Zone, Southern Ethiopia. Conditional logistic regression was employed to identify the predictors of under-five mortality. Sampling weight was applied to account for the non-proportional allocation of sample to different clusters. Based on the Mosley & Chen's analytical framework for under-five and infant mortalities, the predictors were organized in to three groups: 1) personal illness control, 2) child feeding and newborn care and 3) other maternal and child related factors. RESULTS Among personal illness control related factors: lack of post-natal care, immunization status of the child and lack of Vitamin A supplementation were significantly associated with higher rate of under-five mortality. Not breastfeeding and delaying first bath at least for 24 hours were child feeding and newborn care related factors which were found to be significantly associated with under-five mortality. Among other maternal and child related factors, shorter previous birth interval, history of death of index child's older sibling, being multiple birth and live birth after the index child were significantly associated with under-five mortality. CONCLUSIONS In order to maintain reduction of under-five mortality during the Sustainable Development Goals era, strengthening of maternal and child health interventions, such as post-natal care, family planning, immunization, supplementation of Vitamin A for children older than six months, breastfeeding and delaying of first bath after delivery at least for 24 hours are recommended.
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Affiliation(s)
- Girma Temam Shifa
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Ahmed Ali Ahmed
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Kurowska P, Królak A, Giermaziak W. Health policy programs realised in Poland in 2016-2017. Rocz Panstw Zakl Hig 2018; 69:209-217. [PMID: 29766700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Health Policy Program (Program Polityki Zdrowotnej – PPZ) is a state policy tool for engaging local government units into the mechanism of granting provision of health services. Authors show areas in which self-governments most often took preventive health care actions and describe legislative changes in the Act on provision of health services. OBJECTIVE The aim of the article is to quantitative and qualitative statement of PPZ prepared in Poland in 2016 and 2017, as well as presenting changing legal situation in the scope of evaluation of these projects. MATERIALS AND METHODS Authors use descriptive method, presenting changes of legal status. The article includes data available in the Bulletin of Public Information by The Agency for Health Technology Assessment. 590 programs were analyzed (239 from 2016 and 351 from 2017). RESULTS In 2016 – 67% of submitted programs were given a positive opinion and in 2017 – 71%. The most of positively evaluated PPZ submitted by local government units (53% in 2016; 47% in 2017) referred to prevention of infectious diseases by vaccines. On the basis of analyses conducted, significant differences were observed in the implementation of the PPZ in various regions of Poland. CONCLUSIONS In the recent years a big improvement in the quality of planned self-government health programs is observed. It is suggested that due to the regulation defining the model of the health policy program and the model of the final report, this trend will continue.
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Affiliation(s)
- Patrycja Kurowska
- The Stanisław Konopka Main Medical Library, Warsaw, Poland
- Department of Pharmacognosy and Molecular Basis of Phytotherapy, Faculty of Pharmacy, Medical University of Warsaw, Poland
| | - Anna Królak
- The Stanisław Konopka Main Medical Library, Warsaw, Poland
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Checchi F, Warsame A, Treacy-Wong V, Polonsky J, van Ommeren M, Prudhon C. Public health information in crisis-affected populations: a review of methods and their use for advocacy and action. Lancet 2017; 390:2297-2313. [PMID: 28602558 DOI: 10.1016/s0140-6736(17)30702-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/27/2017] [Accepted: 02/09/2017] [Indexed: 11/22/2022]
Abstract
Valid and timely information about various domains of public health underpins the effectiveness of humanitarian public health interventions in crises. However, obstacles including insecurity, insufficient resources and skills for data collection and analysis, and absence of validated methods combine to hamper the quantity and quality of public health information available to humanitarian responders. This paper, the second in a Series of four papers, reviews available methods to collect public health data pertaining to different domains of health and health services in crisis settings, including population size and composition, exposure to armed attacks, sexual and gender-based violence, food security and feeding practices, nutritional status, physical and mental health outcomes, public health service availability, coverage and effectiveness, and mortality. The paper also quantifies the availability of a minimal essential set of information in large armed conflict and natural disaster crises since 2010: we show that information was available and timely only in a small minority of cases. On the basis of this observation, we propose an agenda for methodological research and steps required to improve on the current use of available methods. This proposition includes setting up a dedicated interagency service for public health information and epidemiology in crises.
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Affiliation(s)
- Francesco Checchi
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Humanitarian Department, Save the Children, London, UK.
| | | | - Victoria Treacy-Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jonathan Polonsky
- Department of Health Emergency Information and Risk Assessment, World Health Organization, Geneva, Switzerland
| | - Mark van Ommeren
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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18
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Kim HB, Lee SM. When public health intervention is not successful: Cost sharing, crowd-out, and selection in Korea's National Cancer Screening Program. J Health Econ 2017; 53:100-116. [PMID: 28340393 DOI: 10.1016/j.jhealeco.2017.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 02/26/2017] [Accepted: 02/27/2017] [Indexed: 06/06/2023]
Abstract
This study investigates the impact of and behavioral responses to cost sharing in Korea's National Cancer Screening Program, which provides free stomach and breast cancer screenings to those with an income below a certain cutoff. Free cancer screening substantially increases the screening take up rate, yielding more cancer detections. However, the increase in cancer detection is quickly crowded out by cancer detection through other channels such as diagnostic testing and private cancer screening. Further, compliers are much less likely to have cancer than never takers. Crowd-out and selection help explain why the program has been unable to reduce cancer mortality.
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Affiliation(s)
- Hyuncheol Bryant Kim
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY 14853, United States.
| | - Sun-Mi Lee
- National Health Insurance System (NHIS), Seoul, Republic of Korea.
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Lindley MC, Wortley PM, Winston CA, Schwartz B. Programmatic Factors Related to Smallpox Vaccine Uptake by Healthcare Workers and Others. Infect Control Hosp Epidemiol 2016; 27:1242-5. [PMID: 17080383 DOI: 10.1086/508834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Accepted: 08/19/2005] [Indexed: 11/03/2022]
Abstract
We surveyed program coordinators at 106 hospitals and health departments that participated in the National Smallpox Vaccination Program to ascertain how program-level factors affected the rate of smallpox vaccine uptake by staff. In a fully adjusted multivariate model, health departments achieved significantly higher vaccination rates than did hospitals, as did facilities that invited fewer employees to be vaccinated.
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Affiliation(s)
- Megan C Lindley
- Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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20
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Kolasa K, Turlej A, Hermanowski T. Health technology assessment of public health programmes in Poland, years 2010 and 2013. Przegl Epidemiol 2016; 70:77-154. [PMID: 27344479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND In Poland, among other responsibilities, local governments are obliged to organize public health activities for local communities. To fulfill their obligations in this respect, authorities can organize preventive care in the form of health programs. Prior to their implementation, local governments must seek however opinion of the Polish HTA (Health Technology Assessment) agency. HTA recommendations do inform final decision making process but are not obligatory to be followed. OBJECTIVE Firstly, It was to provide an insight into what extend local governments utilize health programs in their endeavors and the scope of health topics included. Secondly, it was to elicit recommendations for future authors of health programs in order to increase the chances of positive HTA recommendation. METHODS The retrospective analysis of HTA recommendations issued by the Polish HTA agency (AHTAPol) in 2010 and 2013 was conducted. RESULTS There were 67 and 294 HTA recommendations issued in 2010 and 2013 respectively of which 47.8% and 34.4% were negative. Among authors, city councils and communes dominated. Vaccinations were the most commonly chosen target health intervention. In total, six key recommendations for local governments interested in the implementation of health programs were elicited. CONCLUSIONS To increase the chances for positive HTA recommendations, the health program has to be designed for health problems supported by sound clinical evidence which is not covered by the scope of reimbursement offered by National Health Fund. The targeted health intervention has to be supported by the evidence of proven clinical efficacy and safety and utilize available epidemiological data.
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Affiliation(s)
| | - Agnieszka Turlej
- Politechnika Warszawska Szkoła Biznesu Studium Farmakoekonomiki, HTA, Marketingu i Prawa Farmaceutycznego
| | - Tomasz Hermanowski
- Politechnika Warszawska Szkoła Biznesu Studium Farmakoekonomiki, HTA, Marketingu i Prawa Farmaceutycznego
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Vynnycky E, Sumner T, Fielding KL, Lewis JJ, Cox AP, Hayes RJ, Corbett EL, Churchyard GJ, Grant AD, White RG. Tuberculosis control in South African gold mines: mathematical modeling of a trial of community-wide isoniazid preventive therapy. Am J Epidemiol 2015; 181:619-32. [PMID: 25792607 PMCID: PMC4388015 DOI: 10.1093/aje/kwu320] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 10/16/2014] [Indexed: 01/22/2023] Open
Abstract
A recent major cluster randomized trial of screening, active disease treatment, and mass isoniazid preventive therapy for 9 months during 2006-2011 among South African gold miners showed reduced individual-level tuberculosis incidence but no detectable population-level impact. We fitted a dynamic mathematical model to trial data and explored 1) factors contributing to the lack of population-level impact, 2) the best-achievable impact if all implementation characteristics were increased to the highest level achieved during the trial ("optimized intervention"), and 3) how tuberculosis might be better controlled with additional interventions (improving diagnostics, reducing treatment delay, providing isoniazid preventive therapy continuously to human immunodeficiency virus-positive people, or scaling up antiretroviral treatment coverage) individually and in combination. We found the following: 1) The model suggests that a small proportion of latent infections among human immunodeficiency virus-positive people were cured, which could have been a key factor explaining the lack of detectable population-level impact. 2) The optimized implementation increased impact by only 10%. 3) Implementing additional interventions individually and in combination led to up to 30% and 75% reductions, respectively, in tuberculosis incidence after 10 years. Tuberculosis control requires a combination prevention approach, including health systems strengthening to minimize treatment delay, improving diagnostics, increased antiretroviral treatment coverage, and effective preventive treatment regimens.
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Affiliation(s)
- Emilia Vynnycky
- Correspondence to Dr. Emilia Vynnycky, Statistics, Modelling and Economics Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom (e-mail: or )
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Abstract
Detection of low-level bed bug, Cimex lectularius L. (Hemiptera: Cimicidae), infestations is essential for early intervention, confirming eradication of infestations, and reducing the spread of bed bugs. Despite the importance of detection, few effective tools and methods exist for detecting low numbers of bed bugs. Scent dogs were developed as a tool for detecting bed bugs in recent years. However, there are no data demonstrating the reliability of trained canines under natural field conditions. We evaluated the accuracy of 11 canine detection teams in naturally infested apartments. All handlers believed their dogs could detect infestations at a very high rate (≥95%). In three separate experiments, the mean (min, max) detection rate was 44 (10-100)% and mean false-positive rate was 15 (0-57)%. The false-positive rate was positively correlated with the detection rate. The probability of a bed bug infestation being detected by trained canines was not associated with the level of bed bug infestations. Four canine detection teams evaluated on multiple days were inconsistent in their ability to detect bed bugs and exhibited significant variance in accuracy of detection between inspections on different days. There was no significant relationship between the team's experience or certification status of teams and the detection rates. These data suggest that more research is needed to understand factors affecting the accuracy of canine teams for bed bug detection in naturally infested apartments.
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Affiliation(s)
- Richard Cooper
- Department of Entomology, Rutgers University, 93 Lipman Drive, New Brunswick, NJ 08901
| | - Changlu Wang
- Department of Entomology, Rutgers University, 93 Lipman Drive, New Brunswick, NJ 08901
| | - Narinderpal Singh
- Department of Entomology, Rutgers University, 93 Lipman Drive, New Brunswick, NJ 08901
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Long T, Murphy M, Fallon D, Livesley J, Devitt P, McLoughlin M, Cavanagh A. Four-year longitudinal impact evaluation of the Action for Children UK Neglect Project: outcomes for the children, families, Action for Children, and the UK. Child Abuse Negl 2014; 38:1358-1368. [PMID: 24238659 DOI: 10.1016/j.chiabu.2013.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 10/09/2013] [Accepted: 10/15/2013] [Indexed: 06/02/2023]
Abstract
Neglect has a devastating impact on children and is the most pervasive form of child maltreatment in the United Kingdom. The study purpose was to establish outcomes for neglected children following structured assessment and intervention to ascertain what worked and why it worked. This prospective cohort study included 85 cases of neglected children under 8 years of age from 7 centers across the United Kingdom. Data were collected between 2008 and 2012 through serial quantitative recording of the level of concern about neglect. Serial review of qualitative case-file data was undertaken for detail of assessment, interventions, and evidence of outcomes for the child. Data analysis was undertaken by paired t-test, Chi Square, descriptive statics for categorical data, and, for narrative data, identification of recurring factors and patterns, with correlation of presenting factors, interventions, and outcomes. Paired t-test demonstrated significant decrease in overall Action for Children Assessment Tool scores between assessment (M=43.77, SD=11.09) and closing the case (M=35.47, SD=9.6, t(84)=6.77, p<0.01). Improvement in the level of concern about neglect was shown in 79% of cases, with only 21% showing no improvement. In 59% of cases, concern about neglect was removed completely. Use of the assessment tool fostered engagement by parents. The relationship between lack of parental engagement and children being taken into care was statistically significant, with a large effect size (χ(2) 10.66, df1, p=0.0001, OR=17.24). When parents refused or were unable to respond positively to the intervention, children benefited from an expedited move into care.
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Affiliation(s)
- Tony Long
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
| | - Michael Murphy
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
| | - Debbie Fallon
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
| | - Joan Livesley
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
| | - Patric Devitt
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
| | - Moira McLoughlin
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
| | - Alison Cavanagh
- School of Nursing, Midwifery & Social Work, University of Salford, Salford M6 6PU, UK
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Brown TT. How effective are public health departments at preventing mortality? Econ Hum Biol 2014; 13:34-45. [PMID: 24239000 DOI: 10.1016/j.ehb.2013.10.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 10/15/2013] [Accepted: 10/15/2013] [Indexed: 06/02/2023]
Abstract
This study estimates the causal impact of variation in the expenditures of California county departments of public health on all-cause mortality rates and the associated value of lives saved. Since the activities of county departments of public health are likely to affect mortality rates with a lag, Koyck distributed lag models are estimated using the Lewbel instrumental variables estimator. The findings show that an additional $10 per capita of public health expenditures reduces all-cause mortality by 9.1 deaths per 100,000. At current funding levels, the long-run annual number of lives saved by the presence of county departments of public health in California is estimated to be approximately 27,000 (26,937 lives, 95% confidence interval: [11,963, 41,911]). The annual value of these lives is estimated to be worth $212.8 billion using inflation-adjusted standard U.S. government estimates of the value of a statistical life ($7.9 million).
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Affiliation(s)
- Timothy Tyler Brown
- School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
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Njomo DW, Mukoko DA, Nyamongo NK, Karanja J. Increasing coverage in mass drug administration for lymphatic filariasis elimination in an urban setting: a study of Malindi Town, Kenya. PLoS One 2014; 9:e83413. [PMID: 24454703 PMCID: PMC3891599 DOI: 10.1371/journal.pone.0083413] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 11/05/2013] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Implementation of Mass Drug Administration (MDA) in urban settings is an obstacle to Lymphatic Filariasis (LF) elimination. No urban-specific guidelines on MDA in urban areas exist. Malindi district urban area had received 4 MDA rounds by the time the current study was implemented. Programme data showed average treatment coverage of 28.4% (2011 MDA), far below recommended minimum of 65-80%. METHODS To identify, design and test strategies for increased treatment coverage in urban areas, a quasi-experimental study was conducted in Malindi urban area. Three sub-locations with lowest treatment coverage in 2011 MDA were purposively selected. In the pre-test phase, 947 household heads sampled using systematic random method were interviewed for quantitative data. For qualitative data, 12 Focus Group Discussions (FGDs) with single sex adult and youth male and female groups and 3 with community drug distributors (CDDs) were conducted. Forty in-depth interviews with opinion leaders and self-administered questionnaires with District Public Health officers purposively selected were carried out. The quantitative data were analyzed using SPSS version 16 and statistical significance assessed by χ(2) test.The qualitative data were analyzed manually according to study's themes. RESULTS AND DISCUSSION The identified strategies were implemented prior to and during 2012 MDA in two sub-locations (experimental) while in the third (control), usual MDA strategies were applied. In the post-test phase, 2012 MDA coverage in experimental and control sub-locations was comparatively assessed for effect of the newly designed strategies on urban MDA. Results indicated improved treatment coverage in experimental sub-locations, 77.1% in Shella and 66.0% in Barani. Central (control) sub-location also attained high coverage, 70.4% indicating average treatment coverage of 71%. CONCLUSION The identified strategies contributed to increased treatment coverage in experimental sites and should be applied in urban areas. Due to closeness of sites, spillover effects may have contributed to increased coverage in the control site.
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Affiliation(s)
- Doris W. Njomo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC) Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Dunstan A. Mukoko
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Nairobi, Kenya
| | - Nipher K. Nyamongo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC) Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Joan Karanja
- Malindi District Hospital, Ministry of Health, Malindi, Kenya
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Hartmann A, Van Dyk L. The utilization of mobile devices for telemedicine services in a South African public healthcare system. Stud Health Technol Inform 2014; 206:20-28. [PMID: 25365668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of this study is to develop an understanding in the use of mobile devices in administering telemedicine services within the public health care sector of South Africa. An online questionnaire was developed and distributed amongst medical officers, specialists, students and medical staff of one of the health districts of South Africa. This paper describes the design of the questionnaire as well as the most significant outcomes. Results are presented in terms of reasons why healthcare workers use mobile devices, as well as perceptions in terms of transmission security and quality of transmitted information.
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Affiliation(s)
- André Hartmann
- Department for Industrial Engineering, Stellenbosch University
| | - Liezl Van Dyk
- Programme for Industrial Engineering, North-West University
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Buxton JA, McIntyre CC, Tu AW, Eadie BD, Remple VP, Halperin B, Pielak KL. Who knows more about immunization?: Survey of public health nurses and physicians. Can Fam Physician 2013; 59:e514-e521. [PMID: 24235210 PMCID: PMC3828113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To report the findings of a knowledge survey of nurse and physician immunization providers. DESIGN Cross-sectional postal survey assessing demographic characteristics and vaccine knowledge. SETTING British Columbia (BC). PARTICIPANTS Nurse and physician immunization providers in BC. MAIN OUTCOME MEASURES Knowledge of vaccine-preventable diseases, vaccines in general, and vaccine administration and handling practices. RESULTS Survey responses were received from 256 nurses and 292 physicians (response rates of 48.6% and 18.3%, respectively). Most nurses (98.4%) reported receiving immunization training outside of the academic setting compared with 55.6% of physicians. Overall, nurse immunizers scored significantly higher than physician immunizers on all 3 domains of immunization knowledge (83.7% vs 72.8%, respectively; P < .001). Physicians scored highest on the vaccine-preventable disease domain and least well on the general vaccine domain. Nurses with more experience as health care providers scored higher. Physicians scored higher if they were female, served patient populations predominantly younger than 5 years, or received immunization training outside of academic settings. CONCLUSION In BC, nurse immunizers appear to have higher overall immunization knowledge than physicians and are more likely to receive immunization training when in practice. Physician immunizers might benefit most from further training on vaccines and vaccine administration and handling.
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Kempe A, Saville A, Dickinson LM, Eisert S, Reynolds J, Herrero D, Beaty B, Albright K, Dibert E, Koehler V, Lockhart S, Calonge N. Population-based versus practice-based recall for childhood immunizations: a randomized controlled comparative effectiveness trial. Am J Public Health 2013; 103:1116-23. [PMID: 23237154 PMCID: PMC3619016 DOI: 10.2105/ajph.2012.301035] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared the effectiveness and cost-effectiveness of population-based recall (Pop-recall) versus practice-based recall (PCP-recall) at increasing immunizations among preschool children. METHODS This cluster-randomized trial involved children aged 19 to 35 months needing immunizations in 8 rural and 6 urban Colorado counties. In Pop-recall counties, recall was conducted centrally using the Colorado Immunization Information System (CIIS). In PCP-recall counties, practices were invited to attend webinar training using CIIS and offered financial support for mailings. The percentage of up-to-date (UTD) and vaccine documentation were compared 6 months after recall. A mixed-effects model assessed the association between intervention and whether a child became UTD. RESULTS Ten of 195 practices (5%) implemented recall in PCP-recall counties. Among children needing immunizations, 18.7% became UTD in Pop-recall versus 12.8% in PCP-recall counties (P < .001); 31.8% had documented receipt of 1 or more vaccines in Pop-recall versus 22.6% in PCP-recall counties (P < .001). Relative risk estimates from multivariable modeling were 1.23 (95% confidence interval [CI] = 1.10, 1.37) for becoming UTD and 1.26 (95% CI = 1.15, 1.38) for receipt of any vaccine. Costs for Pop-recall versus PCP-recall were $215 versus $1981 per practice and $17 versus $62 per child brought UTD. CONCLUSIONS Population-based recall conducted centrally was more effective and cost-effective at increasing immunization rates in preschool children.
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Affiliation(s)
- Allison Kempe
- Children's Outcomes Research Program, The Children's Hospital, Denver, CO, USA.
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Olshtain-Pops K, Maayan S, Shufaro Y, Simon A, Srur A, Mador N, Wolf D, Lorber M. [Fertility treatment options for discordant couples living with HIV]. Harefuah 2013; 152:216-247. [PMID: 23844523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Serodiscordant couples live with the risk of HIV infection of the negative partner when attempting to become pregnant. Using density gradient centrifugation (DGC), spermatozoa can be separated from other seminal compartments. Isolated spermatozoa do not contain detectable HIV RNA. DGC followed by artificial insemination may significantly reduce the risk of infection. The Hadassah AIDS Center (HAC) has recently initiated a fertility center for serodiscordant couples. METHODS Our patient population includes serodiscordant couples in which the male is HIV positive. The male semen is washed using the DGC procedure. Washed semen is tested for HIV by standard PCR methods. Intrauterine insemination (IUI) is attempted using the washed semen. RESULTS A total of 55 couples have registered for this procedure. This includes 16 men who have sex with men, 7 who have hemophilia and 8 couples of Ethiopian origin. The average female age is 33 years. Seven (12%) men had inadequate sperm counts and were referred for IVF. Overall, 34 semen samples were tested for HIV. Only one was found to be positive. During the procedure, 22 couples underwent at least one IUI attempt and 16 (72%) females became pregnant, 3 of them after the first IUI attempt. All women tested for HIV after IUI were found to be negative. CONCLUSIONS The pregnancy success rate during the first year of operation was 72%, similar to that reported by other centers in Europe. There were no seroconversions of the female partner. Serodiscordant couples living with HIV in Israel today may consider starting a family, while significantly reducing the risk of infecting the negative female partner.
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Affiliation(s)
- Karen Olshtain-Pops
- Clinical Microbiology and Infectious Diseases Unit, Hadassah Medical Center.
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Abstract
The accelerating adoption of electronic health record (EHR) systems will have far-reaching implications for public health research and surveillance, which in turn could lead to changes in public policy, statutes, and regulations. The public health benefits of EHR use can be significant. However, researchers and analysts who rely on EHR data must proceed with caution and understand the potential limitations of EHRs. Because of clinicians' workloads, poor user-interface design, and other factors, EHR data can be erroneous, miscoded, fragmented, and incomplete. In addition, public health findings can be tainted by the problems of selection bias, confounding bias, and measurement bias. These flaws may become all the more troubling and important in an era of electronic "big data," in which a massive amount of information is processed automatically, without human checks. Thus, we conclude the paper by outlining several regulatory and other interventions to address data analysis difficulties that could result in invalid conclusions and unsound public health policies.
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Affiliation(s)
- Sharona Hoffman
- Law-Medicine Center at Case Western Reserve University School of Law
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Mulder C, Harting J, Jansen N, Borgdorff MW, van Leth F. Adherence by Dutch public health nurses to the national guidelines for tuberculosis contact investigation. PLoS One 2012; 7:e49649. [PMID: 23166738 PMCID: PMC3498228 DOI: 10.1371/journal.pone.0049649] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 10/11/2012] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess whether public health nurses adhered to Dutch guidelines for tuberculosis contact investigations and to explore which factors influenced the process of identifying contacts, prioritizing contacts for testing and scaling up a contact investigation. Methods A multiple-case study (2010–2012) compared the contact investigation guidelines as recommended with their use in practice. We interviewed twice 14 public health nurses of seven Public Health Services while they conducted a contact investigation. Results We found more individuals to be identified as contacts than recommended, owing to a desire to gain insight into the infectiousness of the index case and prevent anxiety among potential contacts. Because some public health nurses did not believe the recommendations for prioritizing contacts fully encompassed daily practice, they preferred their own regular routine. In scaling up a contact investigation, they hardly applied the stone-in-the-pond principle. They neither regularly compared the infection prevalence in the contact investigation with the background prevalence in the community, especially not in immigrant populations. Nonadherence was related to ambiguity of the recommendations and a tendency to act from an individual health-care position rather than a population health perspective. Conclusions The adherence to the contact investigation guidelines was limited, restraining the effectiveness, efficiency and uniformity of tuberculosis control. Adherence could be optimized by specifying guideline recommendations, actively involving the TB workforce, and training public health nurses.
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Hartwell SW, Deng X, Fisher W, Fulwiler C, Sambamoorthi U, Johnson C, Pinals DA, Sampson L, Siegfriedt J. Harmonizing databases? Developing a quasi-experimental design to evaluate a public mental health re-entry program. Eval Program Plann 2012; 35:461-472. [PMID: 22436598 PMCID: PMC3371126 DOI: 10.1016/j.evalprogplan.2012.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 02/02/2012] [Accepted: 02/14/2012] [Indexed: 05/31/2023]
Abstract
Our study is the first-ever initiative to merge administrative databases in Massachusetts to evaluate an important public mental health program. It examines post-incarceration outcomes of adults with serious mental illness (SMI) enrolled in the Massachusetts Department of Mental Health (DMH) Forensic Transition Team (FTT) program. The program began in 1998 with the goal of transitioning offenders with SMI released from state and local correctional facilities utilizing a core set of transition activities. In this study we evaluate the program's effectiveness using merged administrative data from various state agencies for the years 2007-2011, comparing FTT clients to released prisoners who, despite having serious mental health disorders, did not meet the criterion for DMH services. By systematically describing our original study design and the barriers we encountered, this report will inform future efforts to evaluate public programs using merged administrative databases and electronic health records.
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Affiliation(s)
- Stephanie W Hartwell
- Department of Sociology, University of Massachusetts at Boston, 100 Morrissey Blvd, Boston, MA 02125, United States.
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Abstract
BACKGROUND During the 1990s, Alaskan pilots had one of the most hazardous occupations in the US. In 2000, a multifaceted public health initiative was launched, focusing on Alaskan air taxi/commuter (AT) operations, including risk factor identification, improved weather information, and the formation of an industry-led safety organization. METHODS Effectiveness was assessed by comparing rates of crashes using Poisson regression, comparing trends in annual numbers of crashes, and assessing changes in the number and type of controlled flight into terrain (CFIT) events. RESULTS The greatest improvements were seen in Alaska fatal AT crashes with a 57% decrease in rates between time periods. While the number of AT crashes in the rest of the US steadily declined during 1990-2009, Alaska only showed significant declines after 2000. CFIT crashes declined but remained more deadly than other crashes. CONCLUSIONS This coordinated effort was successful in reducing crashes in the Alaskan AT industry.
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Affiliation(s)
- Nicolle A Mode
- Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health/Alaska Pacific Regional Office, Anchorage, AK 99508, USA
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Welfare WS, Lighton L. Mapping of sexual health promotion in North West England, 2008. Public Health 2011; 125:101-5. [PMID: 21276994 DOI: 10.1016/j.puhe.2010.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Revised: 08/05/2010] [Accepted: 11/02/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To map sexual health promotion activity and resources across North West England. STUDY DESIGN Survey. METHODS A survey of all sexual health promotion activity commissioned by primary care trusts (PCTs) was carried out using a self-completion questionnaire for PCT sexual health commissioners in North West England. RESULTS Sixteen out of 24 PCTs responded. Some PCTs had difficulty in identifying the relevant commissioner. Most activity was focused on young people, especially around the National Chlamydia Screening Programme (NCSP) and teenage pregnancy, and on particular high-risk groups such as lesbian, gay and bisexual people, those living with human immunodeficiency virus and commercial sex workers. All PCTs commissioned education/training and a condom distribution service. Other common activities included outreach work, and producing and disseminating materials. Most services were confined to one PCT. Most PCTs were unable to identify the resources committed to sexual health promotion. The emergent themes in the analysis of service development ideas and comments were all linked to commissioning: commissioning and strategy; funding; needs assessment; service development and provision; contracting and monitoring; evaluation and evidence; and regional perspective. CONCLUSIONS A simple tool to map sexual health promotion activities commissioned by PCTs was developed. Many PCTs could not identify a commissioner for sexual health or the resources committed to sexual health promotion. Sexual health promotion activity focused on young people (linked to the NCSP and teenage pregnancy) and particular high-risk groups, with resultant gaps and a mismatch with the epidemiology. The most frequently commissioned activities were education/training and condom provision (despite the limited evidence base). A series of recommendations to PCTs, sexual health networks and providers are made.
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Affiliation(s)
- W S Welfare
- Greater Manchester Health Protection Unit, Floor 7b, Sentinel House, Albert Road, Eccles, Manchester M30 0NJ, UK
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Joshi M, Sorenson SB. Intimate partner violence at the scene: incident characteristics and implications for public health surveillance. Eval Rev 2010; 34:116-136. [PMID: 20233999 DOI: 10.1177/0193841x09360323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Using data that, to our knowledge, have not been used before for this purpose, we examined 9,231 opposite-sex intimate partner violence (IPV) calls for law enforcement assistance recorded in the Compstat system of a large U.S. city. Although women were the predominant victims, injuries were documented more often for men. Only about 1% of incidents were considered a restraining order violation, although many orders were active in the city at the time. The data appeared to be of good quality and just a few changes in recording procedures would increase Compstat's usefulness for public health in U.S. cities.
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Affiliation(s)
- Manisha Joshi
- School of Social Policy and Practice, University of Pennsylvania, 3815 Walnut Street, Philadelphia, PA 19104, USA.
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Start4Life. Building on the success of Change 4 Life. Pract Midwife 2010; 13:32-3. [PMID: 20162888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Boe DT, Riley W, Parsons H. Improving service delivery in a county health department WIC clinic: an application of statistical process control techniques. Am J Public Health 2009; 99:1619-25. [PMID: 19608964 PMCID: PMC2724451 DOI: 10.2105/ajph.2008.138289] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2008] [Indexed: 11/04/2022]
Abstract
Local public health agencies are challenged to continually improve service delivery, yet they frequently operate with constrained resources. Quality improvement methods and techniques such as statistical process control are commonly used in other industries, and they have recently been proposed as a means of improving service delivery and performance in public health settings. We analyzed a quality improvement project undertaken at a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic to reduce waiting times and improve client satisfaction with a walk-in nutrition education service. We used statistical process control techniques to evaluate initial process performance, implement an intervention, and assess process improvements. We found that implementation of these techniques significantly reduced waiting time and improved clients' satisfaction with the WIC service.
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Martinelli D, Mincuzzi A, Minerba S, Tafuri S, Conversano M, Caputi G, Lopalco PL, Quarto M, Germinario C, Prato R. Malignant cancer mortality in Province of Taranto (Italy). Geographic analysis in an area of high environmental risk. J Prev Med Hyg 2009; 50:181-190. [PMID: 20411653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND A geographic analysis of the causes of death is an important tool for assessing the effectiveness of Public Health initiatives. The aim of this study is to analyse the causes of death between 2000 and 2004, to discover any excess mortality from cancer in Province of Taranto, an area at high environmental risk. METHODS Mortality data from cancer were selected from the Puglia Regional Nominative Causes of Death Registry. Crude and standardized rates and Standardized Mortality Ratios (SMR) were calculated for the five Provinces of the Puglia Region, their capital cities and in four concentric rings around the industrial area located in Province of Taranto. RESULTS . Even if the highest death rate for all tumours resulted in the Province of Lecce (24.9 x 10,000), in the cities of Lecce and Bari (29 x 10,000), the distribution of the SMRs in Province of Taranto showed an excess of mortality (+10%) in the ring next to industrial area. For lung cancer the highest rate was reported in city of Taranto (6 x 10,000) and the highest risk (+24%) in the ring next to industrial area. Moreover, in this area 9 (70%) of the 13 considered malignant tumours types presented an excess of mortality. CONCLUSION The results uphold the data reported in the published literature. It is fundamental to intensify research into other risk factors (exposure at work and aberrant lifestyles). Moreover, there is an increasing need for a Regional Cancer Register.
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Affiliation(s)
- D Martinelli
- Section of Hygiene, Department of Medical and Occupational Science, University of Foggia, Epidemiological Observatory of Puglia Region, Foggia, Italy
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Li W, Land T, Zhang Z, Keithly L, Kelsey JL. Small-area estimation and prioritizing communities for tobacco control efforts in Massachusetts. Am J Public Health 2009; 99:470-9. [PMID: 19150913 PMCID: PMC2642525 DOI: 10.2105/ajph.2007.130112] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2008] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We developed a method to evaluate geographic and temporal variations in community-level risk factors and prevalence estimates, and used that method to identify communities in Massachusetts that should be considered high priority communities for smoking interventions. METHODS We integrated individual-level data from the Behavioral Risk Factor Surveillance System from 1999 to 2005 with community-level data in Massachusetts. We used small-area estimation models to assess the associations of adults' smoking status with both individual- and community-level characteristics and to estimate community-specific smoking prevalence in 398 communities. We classified communities into 8 groups according to their prevalence estimates, the precision of the estimates, and temporal trends. RESULTS Community-level prevalence of current cigarette smoking among adults ranged from 5% to 36% in 2005 and declined in all but 16 (4%) communities between 1999 and 2005. However, less than 15% of the communities met the national prevalence goal of 12% or less. High smoking prevalence remained in communities with lower income, higher percentage of blue-collar workers, and higher density of tobacco outlets. CONCLUSIONS Prioritizing communities for intervention can be accomplished through the use of small-area estimation models. In Massachusetts, socioeconomically disadvantaged communities have high smoking prevalence rates and should be of high priority to those working to control tobacco use.
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Affiliation(s)
- Wenjun Li
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Shaw Building, SH2-230, 55 Lake Ave N, Worcester, MA 01655, USA.
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Pfeiffer J, Johnson W, Fort M, Shakow A, Hagopian A, Gloyd S, Gimbel-Sherr K. Strengthening health systems in poor countries: a code of conduct for nongovernmental organizations. Am J Public Health 2008; 98:2134-40. [PMID: 18923125 PMCID: PMC2636539 DOI: 10.2105/ajph.2007.125989] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2008] [Indexed: 11/04/2022]
Abstract
The challenges facing efforts in Africa to increase access to antiretroviral HIV treatment underscore the urgent need to strengthen national health systems across the continent. However, donor aid to developing countries continues to be disproportionately channeled to international nongovernmental organizations (NGOs) rather than to ministries of health. The rapid proliferation of NGOs has provoked "brain drain" from the public sector by luring workers away with higher salaries, fragmentation of services, and increased management burdens for local authorities in many countries. Projects by NGOs sometimes can undermine the strengthening of public primary health care systems. We argue for a return to a public focus for donor aid, and for NGOs to adopt a code of conduct that establishes standards and best practices for NGO relationships with public sector health systems.
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Affiliation(s)
- James Pfeiffer
- Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195-7660, USA.
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Global measles deaths drop by 74%. Indian J Med Sci 2008; 62:521-3. [PMID: 19402258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Sivak M, Tsimhoni O. Improving traffic safety: conceptual considerations for successful action. J Safety Res 2008; 39:453-457. [PMID: 19010118 DOI: 10.1016/j.jsr.2008.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 07/29/2008] [Accepted: 08/05/2008] [Indexed: 05/27/2023]
Abstract
INTRODUCTION In the early stages of motorization, it did not take rigorous scientific research to achieve major improvements in traffic safety. Instead, early traffic-safety countermeasures were often based exclusively on common sense. Since then, scientific research has gradually increased in importance as the basis for developing successful interventions. This shift was not made by choice but mostly by necessity: many of the "easy" problems have already been addressed, and the remaining problems are generally too complex for an approach based solely on common sense. Fortunately, our understanding of the complexities involved in traffic safety has recently made major gains, and common sense can now be supplemented, to some degree, by valid technical analysis. APPROACH This article discusses major conceptual issues that should be considered in guiding the future development of effective, science-based traffic-safety countermeasures. IMPACT ON INDUSTRY After briefly discussing the conceptual issues, the article offers a list of implications for action.
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Affiliation(s)
- Michael Sivak
- The University of Michigan Transportation Research Institute, Ann Arbor, Michigan 48109-2150, USA.
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S KIK, Chandy SJ, Jeyaseelan L, Kumar R, Suresh S. Antimicrobial prescription patterns for common acute infections in some rural & urban health facilities of India. Indian J Med Res 2008; 128:165-171. [PMID: 19001680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND & OBJECTIVES Irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. This study was undertaken to determine the rate and pattern of antimicrobial prescribing in patients with uncomplicated acute respiratory infections, fever and diarrhoea attending a few rural and urban health settings. METHODS The study was done in primary and secondary health care facilities of public/government and private settings at four sites in India. Patients with fever, cough, diarrhoea or ear, nose or throat infections of < 7 days were included. Pregnant women, lactating mothers, infants, seriously ill patients and patients with bloody diarrhoea or purulent nasal or ear discharge were excluded. RESULTS Overall antimicrobial prescription rate was 69.4 per cent (95% CI 67.1, 71.7). Wide variation was observed (Thiruvananthapuram 47.6%, Lucknow 81.8%, Chennai 73.1% and Vellore 76.5%). Physicians practicing in rural and public/government settings prescribed antimicrobials more frequently than those in urban and private settings (83.8, 81.9, 68.3 and 68.2% respectively). Antimicrobials were more frequently prescribed for patients presenting with fever. Highest rate was noticed for children aged between 6 and 18 yr. Patients of the high-income group received antimicrobials more frequently (72.7%). In both public/ government and private settings, for patients who purchased medicines, the rate was higher (82.4 and 68.9% respectively), vs. those receiving free medicines (70.2 and 46.2% respectively). Two third of all antimicrobials prescribed were penicillins and co-trimoxazole, and > 40 per cent of prescriptions from private sector were quinolones and cephalosporins. INTERPRETATION & CONCLUSIONS Our findings showed that prescription of antimicrobials for acute respiratory infections and diarrhoea was extremely common and warrants interventional strategies.
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Affiliation(s)
- Kumari Indira K S
- Department of Pulmonary Medicine, Amrita Institute of Medical Sciences, Kochi, India.
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Ilangho RP. Review series: lung disease around the world: lung health in India. Chron Respir Dis 2007; 4:107-10. [PMID: 17621579 DOI: 10.1177/1479972307078581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R P Ilangho
- Department of Respiratory Medicine, Apollo Hospitals, Chennai, India.
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Butler J, Tews D, Raevsky C, Canavese J, Wojciehowski K, Michalak C, Thomas M, Brewster J, Mason M, Schmidt R. Accreditation/Performance Assessment On-Site Reviews in Michigan, Missouri, North Carolina, and Washington. Journal of Public Health Management and Practice 2007; 13:395-403. [PMID: 17563629 DOI: 10.1097/01.phh.0000278034.72067.3a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In 1988, the Committee for the Study of the Future of Public Health identified the core functions of assessment, policy development, and assurance as key roles of the public health governmental sector. Some states have developed accreditation or performance assessment programs to measure how state and/or local government carry out these functions. Several of these programs share a common "on-site review" component defined as a site-specific visit to assess, observe, interview, review, evaluate, and/or survey a local/state agency or program regarding its ability to meet a set of public health standards. This article describes the experience of four states-Michigan, Missouri, North Carolina, and Washington-in developing and conducting on-site reviews for accreditation or performance assessment.
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Affiliation(s)
- James Butler
- Michigan Department of Community Health, Lansing, USA.
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Landrum LB, Bassler EJ, Polyak G, Edgar M, Giangreco C, Dopkeen JC. Local Public Health Certification and Accreditation in Illinois. Journal of Public Health Management and Practice 2007; 13:415-21. [PMID: 17563632 DOI: 10.1097/01.phh.0000278037.61765.b9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Funded by the Robert Wood Johnson Foundation through the Multi-State Learning Collaborative, the Illinois Accreditation Development Project is developing a proposal to reengineer the 15-year-old Illinois local health department certification process. The Project is addressing a variety of political, technical, and resource issues in its attempt to develop a new approach to a mature program that will incorporate more meaningful performance and capacity measures for all local public health practice standards. Both statewide strategic planning and the evolving national momentum toward local public health agency accreditation are motivating the enhancements to the Illinois program. A new proposal that blends the current mandatory certification program with a new voluntary local public health accreditation program is discussed. The proposed new structure enhances the state-operated certification program with specific performance measures and creates a three-tiered voluntary accreditation process governed by a third party accreditation board.
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Barometer. Public health April 2007. Health Serv J 2007; 117:23. [PMID: 17511340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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