Journal of Public Health Management and Practice最新文献

{"title":"Rural-Urban Differences in Self-Reported Participation in Diabetes Self-Management Education.","authors":"Emma Boswell, Jan Probst, Peiyin Hung, Laura Herbert, Elizabeth Crouch","doi":"10.1097/PHH.0000000000001928","DOIUrl":"10.1097/PHH.0000000000001928","url":null,"abstract":"<p><strong>Context: </strong>Rural America faces a dual challenge with a higher prevalence of diabetes mellitus (hereafter, diabetes) and diabetes-related mortality. Diabetes self-management education (DSME) can improve glucose control and reduce adverse effects of diabetes, but certified DSME programs remain disproportionately limited in rural counties than in urban counties.</p><p><strong>Objective: </strong>The goal of this study is to examine the proportion of urban and rural adults who report having received DSME using a nationwide, 29-state survey while considering the potential consequences of lower service availability.</p><p><strong>Design: </strong>This cross-sectional study used data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS). Residence was defined as urban (metropolitan county) vs rural (non-metropolitan county). Logistic regression, incorporated survey weights, was used to determine the odds of having received DSME by residence.</p><p><strong>Setting: </strong>BRFSS is a nationally representative survey, and this study included participants from 29 states that were distributed throughout all regions of the United States.</p><p><strong>Participants: </strong>The study sample consisted of 28,179 adults who reported having diabetes, lived in one of the states that administered the diabetes module in 2019, and answered all relevant questions.</p><p><strong>Main outcome measures: </strong>The main outcome measure was whether a participant had ever received DSME. Participants were considered to have received DSME if they self-reported having ever taken a class on how to manage diabetes themselves.</p><p><strong>Results: </strong>Overall, 54.5% of participants reported having received DSME; proportionately fewer rural residents (50.4%, ±1.1%) than urban residents (55.5%, ±1.0%) reported DSME. Rural disparities persisted after adjusting for demographic, enabling, and need factors (Adjusted Odds Ratio  = 0.79; CI, 0.71-0.89). By sociodemographic factors, Hispanic persons vs non-Hispanic White persons and single vs married/coupled individuals were less likely to report DSME receipt (both 0.76 [0.62-0.94]).</p><p><strong>Conclusions: </strong>Ongoing national efforts addressing rural disparities in diabetes-related complications should target individuals most at risk for missing current diabetes educational programming and design appropriate interventions.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"805-817"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaching Public Health Issues Among People Who Use Drugs Through a Syndemic Lens.","authors":"Julia Greenspan, Victoria Pless, Ramya Dronamraju, Amelia Poulin","doi":"10.1097/PHH.0000000000002058","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002058","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"30 6","pages":"913-918"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four Years of Supporting Health in All Policies Initiatives at the Local Level: 2018-2022.","authors":"Rachel Siegel, Sukeshi Roberts, Hope Roobol, Bhawna Sharma, Geoffrey Mwaungulu","doi":"10.1097/PHH.0000000000002059","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002059","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"30 6","pages":"919-923"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Process Evaluation of a Pilot Food Insecurity Resource Navigation Program Integrated Within Pediatric Primary Care: Utilizing RE-AIM to Inform Program Scale-up.","authors":"Mackenzie Stuenkel, Caitlin Koob, Emily Richardson, Nicole Smolens, Meredith Eicken, J Blakely Amati, Kerry Sease","doi":"10.1097/PHH.0000000000002038","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002038","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to examine the implementation and effectiveness of a novel pediatric food navigation program through a structured, comprehensive evaluation using the RE-AIM framework.</p><p><strong>Design and participants: </strong>Data were collected from October 2021 through August 2022 for 166 pediatric patients and their families who were screened as food insecure or high-risk for food insecurity and were referred to this pilot food resource navigation program (FRNP). A total of 88 patients' guardians consented to participate in this FRNP, receiving initial service connection. Participants were contacted via telephone by trained navigators within this health system to assess food security status across three time points (baseline, follow-up 1 [1- <3 months], and follow-up 2 [3-6 months]) and facilitate connection to appropriate community-based resources related to food assistance.</p><p><strong>Results: </strong>In this sample, we had an overrepresentation of Hispanic patients and an underrepresentation of Non-Hispanic Black and White patients relative to the available clinic population. Patients participating in the navigation program showed incremental shifts toward food security from baseline to two follow-up points. Integration within primary care was supported by physician champions across participating clinics and alignment with systemwide, updated universal screening guidelines to support projected increases in families requiring connecting to assistance programs. Through this evaluation, a comprehensive list of community-based food resource programs related to food assistance was integrated into electronic documentation for navigators to alleviate navigator burden and sustain the effect of this FRNP's implementation.</p><p><strong>Conclusions: </strong>These findings may be used to inform expansion of current programming efforts within this FRNP and to clarify process evaluations of broader health system-based programming. Further research, building on the findings of this pilot study, is needed to examine the longitudinal, causal effect of FRNPs in pediatric food security and long-term health outcomes for replication across health systems nationwide.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"30 6","pages":"E344-E352"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Unusual Patterns of Cancer and Environmental Concerns: The Importance of Community Input and Engagement.","authors":"Stephanie L Foster, Suzanne K Condon, Amy M Lavery, Alisha A Etheredge, Brian S Kennedy, Erik R Svendsen, Patrick N Breysse","doi":"10.1097/PHH.0000000000001963","DOIUrl":"https://doi.org/10.1097/PHH.0000000000001963","url":null,"abstract":"<p><strong>Context: </strong>In fiscal year 2019, the Department of Health and Human Services (DHHS) received an appropriation from Congress specifically to update guidelines for investigating community cancer concerns. This resulted in the DHHS directing the Centers for Disease Control and Prevention (CDC) to fulfill this responsibility.</p><p><strong>Program: </strong>The CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) provide guidance to state, tribal, local, and territorial (STLT) health departments and play important roles in supporting STLT programs in addressing community cancer concerns.</p><p><strong>Implementation: </strong>The updated guidelines offer enhancements addressing limitations and challenges regarding the process for investigating cancer clusters as expressed by STLT programs responsible for responding to inquiries and by communities impacted by unusual patterns of cancer. Additionally, the updated guidelines offer new tools and approaches associated with scientific advancements. Issues associated with improving communications and community engagement were a priority. Details in the updated guidelines provide suggestions for building and maintaining trust; provide resources via additional tools, templates, and methodology to facilitate sharing of information; provide suggestions for identifying agency and community points of contacts; and provide suggestions for establishing a community advisory committee.</p><p><strong>Conclusion: </strong>Enhancements to the previous guidelines were included to address advancements in statistical approaches and methods for understanding exposure pathways and also to respond to limitations described in the previous guidelines. Furthermore, these enhancements ensure communities have a voice in the process and offer methods to enhance transparency throughout the investigative process. Ultimately, the 2022 Guidelines are designed to ensure that community engagement, community input, and communication remains paramount to the process of assessing unusual patterns of cancer and environmental concerns.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"30 6","pages":"879-886"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintaining and Improving Virtual Call Centers for Public Health: The CUNY Recovery Corps Experience.","authors":"Srividhya Sharma, Valerie El-Alfi, Danielle Greene","doi":"10.1097/PHH.0000000000001959","DOIUrl":"10.1097/PHH.0000000000001959","url":null,"abstract":"<p><strong>Context: </strong>In the early stages of the COVID-19 pandemic in New York City, individuals who tested positive, exposed contacts, and their families faced significant challenges in accessing essential resources for successful quarantine and isolation. These resources included alternative housing, food access, grocery delivery, missed wage assistance, transportation for household members, medical care, and more.</p><p><strong>Program: </strong>The City University of New York (CUNY) Recovery Corps emerged as an innovative virtual resource navigation service to connect New Yorkers to essential resources and later to vaccinations, treatment, and services for Long COVID. The program prioritized reaching people living in underserved and under-resourced neighborhoods. Over 3 years, it made a substantial impact, reaching 374 728 New Yorkers and connecting 135 147 to crucial resources.</p><p><strong>Implementation: </strong>Implementing a successful virtual navigation center amidst a global pandemic posed unique challenges. It required well-established systems to provide services, manage staff, build community, and both assure and improve service quality.</p><p><strong>Evaluation: </strong>Continuous quality assurance and process improvement efforts resulted in a nearly 10-point increase in successful client-resource connections program-wide, with individual navigators showing improvements of up to 20%. Staff-led initiatives, such as population-specific resource guides and incentive awards, boosted morale and cohesion. Providing continuous professional development opportunities and requested training including trauma-informed care, self-care, and strategies for managing grief contributed to staff retention and improved client interactions.</p><p><strong>Discussion: </strong>The CUNY Recovery Corps provides a blueprint for setting up navigation services for emergency response and supporting health and social services. The current paper delves into the intensive quality improvement efforts, program management infrastructure, and staff support that made this program a success. By applying these lessons on establishing and maintaining a virtual call center prioritizing the client's well-being and staff strengths, policymakers and social service leaders can effectively address various health and social service needs proactively rather than rebuilding after each disaster.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"869-878"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Down Silos in the Workplace: A Framework to Foster Collaboration.","authors":"Anita A Jones, Justin Uhd, Charlotte D Kabore, Kelly A Cornett","doi":"10.1097/PHH.0000000000002007","DOIUrl":"10.1097/PHH.0000000000002007","url":null,"abstract":"<p><strong>Introduction: </strong>Employees are often placed within an organization based on their respective roles or duties, which can lead to vertical and horizontal organizational silos. Organizational silos may restrict information, resources, and stymie progress and innovation. This analysis presents a framework to mitigate silos and overcome communication barriers within an organization by increasing collaboration.</p><p><strong>Methods: </strong>The project team examined results from the Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) 2020 Employee Viewpoint Survey Results and conducted 19 key informant discussions with NCCDPHP employees. Participants were asked to provide feedback on (1) understanding silos in the workplace and (2) best practices for reducing silos and fostering collaboration. A thematic analysis was conducted to understand organizational silos, the motivation to reduce silos, and identify best practices and strategies.</p><p><strong>Results: </strong>Respondents felt that siloing exists at the division and branch levels; however, 95% of respondents were motivated to reduce silos. Fifty-eight percent of respondents identified that institutional factors such as the organizational structure (n = 8) and red tape/bureaucracy (n = 3) contribute to siloing. Additional behaviors and actions that perpetuate silos were identified, and efforts to reduce silos were categorized to propose a model: Framework to Foster Collaboration for improving organizational collaborative efforts.</p><p><strong>Discussion and conclusion: </strong>Key themes included inclusion, shared goals and vision, bi-directional communication, and relationship building and developing trust as critical elements for improving collaboration and creating synergy across teams in efforts to reduce silos in the workplace.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E306-E311"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cluster Analysis Methods to Support Population Health Improvement Among US Counties.","authors":"Elizabeth A Pollock, Ronald E Gangnon, Keith P Gennuso, Marjory L Givens","doi":"10.1097/PHH.0000000000002034","DOIUrl":"10.1097/PHH.0000000000002034","url":null,"abstract":"<p><strong>Context: </strong>Population health rankings can be a catalyst for the improvement of health by drawing attention to areas in need of relative improvement and summarizing complex information in a manner understood by almost everyone. However, ranks also have unintended consequences, such as being interpreted as \"hard truths,\" where variations may not be significant. There is a need to improve communication about uncertainty in ranks, with accurate interpretation. The most common solutions discussed in the literature have included modeling approaches to minimize statistical noise or borrow strength from covariates. However, the use of complex models can limit communication and implementation, especially for broad audiences.</p><p><strong>Objectives: </strong>Explore data-informed grouping (cluster analysis) as an easier-to-understand, empirical technique to account for rank imprecision that can be effectively communicated both numerically and visually.</p><p><strong>Design: </strong>Cluster analysis, specifically k-means clustering with Wasserstein (earth mover's) distance, was explored as an approach to identify natural and meaningful groupings and gaps in the data distribution for the County Health Rankings' (CHR) health outcomes ranks.</p><p><strong>Setting: </strong>County-level health outcomes from the 2022 CHR.</p><p><strong>Participants: </strong>3082 counties that were ranked in the 2022 CHR.</p><p><strong>Main outcome measure: </strong>Data-informed health groups.</p><p><strong>Results: </strong>Cluster analysis identified 30 health groupings among counties nationwide, with cluster size ranging from 9 to 184 counties. On average, states had 16 identified clusters, ranging from 3 in Delaware and Hawaii to 27 in Virginia. Number of clusters per state was associated with number of counties per state and population of the state. The method helped address many of the issues that arise from providing rank estimates alone.</p><p><strong>Conclusions: </strong>Public health practitioners can use this information to understand uncertainty in ranks, visualize distances between county ranks, have context around which counties are not meaningfully different from one another, and compare county performance to peer counties.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E319-E328"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ODMAP: Stakeholder Perspectives on a Novel Public Health and Public Safety Overdose Surveillance System.","authors":"Bennett Allen, Julian Cohen-Serrins","doi":"10.1097/PHH.0000000000002035","DOIUrl":"10.1097/PHH.0000000000002035","url":null,"abstract":"<p><p>This pilot study explores the utilization of the Overdose Detection Mapping Application Program (ODMAP) as a tool for enhancing collaboration between the public health and public safety sectors to address the overdose epidemic in the United States. Through qualitative interviews with ODMAP users, key themes emerged, including the role of data sharing in facilitating collaboration, challenges posed by divergent data privacy standards, and the need for clearer guidance on cross-sector data sharing. Findings highlight ODMAP's potential to integrate data for targeted interventions at individual and population levels. Future research directions include overcoming data sharing barriers, strategically utilizing data across sectors, and rigorously evaluating the impact of cross-sector partnerships on overdose morbidity and mortality. Overall, this study underscores the importance of ODMAP in fostering coordinated responses to the overdose crisis and provides valuable insights for improving overdose surveillance and intervention efforts.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E329-E334"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Statewide Physician Champion Initiative to Prevent Diabetes: Lessons Learned from North Carolina.","authors":"Tamkeen Khan, Nar Ramkissoon, Siga Vasaitis, Franklin Walker, Shivajirao Patil, Neha Sachdev","doi":"10.1097/PHH.0000000000002040","DOIUrl":"10.1097/PHH.0000000000002040","url":null,"abstract":"<p><p>The North Carolina Medical Society (NCMS) and American Medical Association (AMA) collaborated to support diabetes prevention efforts in North Carolina (NC) with a physician champion initiative focused on tracking and increasing referrals to the National Diabetes Prevention Program (DPP). Three focus areas to effectively engage and utilize physician champions included: (1) self-adoption within their practice, (2) engagement and outreach with other healthcare leaders, and (3) influence to peers and colleagues. Six NC physician champions were selected to support the work from January 2020 to January 2023. This resulted in increased outreach to physicians about Diabetes Free NC , increased materials/education for physicians on prediabetes identification and management, and 1943 referrals to the National DPP. This work can be further translated and applied to other states to aid prevention efforts. Physician champions' expertise coupled with adequate resources can allow them to play a key role in chronic disease prevention and management.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"818-822"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}