Journal of Public Health Management and Practice最新文献

{"title":"Factors Associated with Turnover Intention Among Early-Career US Governmental Public Health Employees and a Moderation Role of Race and Ethnicity.","authors":"In-Gu Kang, Nayoung Kim, Arianna Injeian, Beth H Chaney, Hee Yun Lee","doi":"10.1097/PHH.0000000000002176","DOIUrl":"10.1097/PHH.0000000000002176","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the associations between individual characteristics, organizational environmental perceptions, and turnover intention among early-career US governmental public health employees under 35 years of age.</p><p><strong>Design: </strong>Multivariable logistic regression was used to analyze turnover intention in relation to employee demographics, agency setting, global workplace satisfaction, and organizational environmental perceptions among early-career public health employees from the combined cross-sectional data of the 2017 and 2021 Public Health Workforce Interests and Needs Survey. Moderation effects of race and ethnicity on these relationships were also tested.</p><p><strong>Setting: </strong>US State Health Agency Central Offices and Local Health Departments.</p><p><strong>Participants: </strong>A total of 43 638 US governmental public health employees across state and local health agencies participated in this study.</p><p><strong>Main outcome measures: </strong>Self-reported turnover intention, coded as binary: \"No\" (0) for staying and \"Yes\" (1) for intention to leave within a year, excluding retirement.</p><p><strong>Results: </strong>A 35.7% of early-career US governmental public health employees under 35 years of age reported an intention to leave their agency within a year, exceeding the overall workforce rate of 25.4% ( P < .05). Men, individuals of other gender identities, racial and ethnic minorities, those with higher education, and younger employees were more likely to report turnover intention. In contrast, higher global workplace satisfaction, positive perceptions of talent and expertise utilization, and career development opportunities including training needs assessments and leadership development were associated with lower turnover intention. These relationships were moderated by race and ethnicity, with stronger protective effects for white employees compared to racial and ethnic minoritized employees.</p><p><strong>Conclusions: </strong>Early-career US governmental public health employees face high turnover risks, especially in certain demographic groups. Higher global workplace satisfaction and positive perceptions of skill utilization and career development opportunities reduce the odds of turnover intention, with stronger effects for white employees. Targeted human resource strategies are essential to improving retention in this workforce.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E267-E275"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162938","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":"Innovations and Hiring Improvements to Address Public Health Workforce Recruitment.","authors":"Emilie R Madsen, Paulani Mui, Beth Resnick, Valerie A Yeager","doi":"10.1097/PHH.0000000000002179","DOIUrl":"10.1097/PHH.0000000000002179","url":null,"abstract":"<p><strong>Objectives: </strong>This study engaged state and local health agency employees involved in the hiring process to examine the impact of hiring laws and civil service requirements on recruitment processes. Additionally, we identified innovative approaches to improve recruitment.</p><p><strong>Design: </strong>Key informant cross-sectional qualitative study.</p><p><strong>Setting: </strong>State and local U.S. governmental public health agencies.</p><p><strong>Participants: </strong>Health department hiring managers, human resources/workforce development directors and assistant directors, program managers, deputy commissioners, and other HR representatives.</p><p><strong>Main outcome measures: </strong>Experiences and perceptions of public health hiring approaches, processes, and civil service requirements.</p><p><strong>Results: </strong>Three themes emerged as solutions and innovations for public health agency recruitment: marketing strategies, organizational workforce development changes, and applicant experience improvements. Marketing strategies to improve recruitment included the expanded use of job wrapping and social media platforms. Organizational workforce development for recruitment and retention initiatives included paid fellowship programs, salary comparisons and market adjustments, expanded benefits, and the enhanced role of HR teams. Discussion of civil service requirements and hiring laws revealed that organizational and governance factors, such as hiring authority, were perceived as more consequential to effective recruitment than specific components of the law.</p><p><strong>Conclusions: </strong>Organizations should improve inefficient recruitment and hiring processes and systems where possible. Much of this is achievable through quality improvement initiatives rather than legal or regulatory changes. However, tracking the hiring process to identify inefficiencies is essential, as barriers likely differ across agencies and states. Finding ways to shorten the applicant review timeframe and improve communication with applicants throughout the hiring process may yield more successful recruitment efforts. Lastly, Public Health Infrastructure Grant (PHIG) funding and programming have led to recruitment innovations. Flexibility to adapt recruitment approaches to changing workforce and labor market dynamics is needed for an adequate workforce with the capacity to address foundational needs and public health challenges.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"806-817"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638441","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":"Show Me the Values: Centering Communities and Co-Creation in an Equity-Driven Evaluation.","authors":"Kay Schaffer, Jamila M Porter","doi":"10.1097/PHH.0000000000002187","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002187","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"31 5","pages":"897-898"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676125","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":"Associations of Physical Activity-Related Social Norms and Frequency of Outdoor Walking with Perceived Walkability Among Rural Oregon Adults.","authors":"Cynthia K Perry, Jay E Maddock, Nathan F Dieckmann, Jim Winkle, Heather Franklin, Jessica J Currier, Elena Andreyeva, Rebecca A Seguin-Fowler","doi":"10.1097/PHH.0000000000002164","DOIUrl":"10.1097/PHH.0000000000002164","url":null,"abstract":"<p><strong>Context: </strong>Individuals who walk regularly are more likely to meet recommended physical activity guidelines than non-walkers; however, rural US adults walk less than urban adults. The built and social environment, perceived walkability and walking are bidirectionally related with each other.</p><p><strong>Objective: </strong>This study's purpose was to assess the associations of physical activity-related social norms and frequency of walking in the neighborhood with perceived walkability among rural adults.</p><p><strong>Study design main outcomes: </strong>The data for this cross-sectional analysis comes from a randomized trial with 18 rural Oregon libraries. As part of baseline assessment, participants completed surveys on physical activity-related social norms, perceived walkability, frequency of walking in the neighborhood, and demographic items. We assessed bivariate correlations and ran linear regression models with perceived walkability as the outcome and social norms (social environment) and frequency of walking in the neighborhood (built environment experience) as predictors with covariates of age, gender and income.</p><p><strong>Setting and participants: </strong>Adult residents of 18 rural communities in Oregon.</p><p><strong>Results: </strong>Of the 313 participants who completed the survey, 60% were 65 and older, 92% white and 86% women; 17% reported walking in the neighborhood less than once a month and 5% reported walking 5 or more days/week. We found positive correlations between perceived walkability and frequency of walking in the neighborhood ( r = .23, p < .01), and social norms ( r = .47, p < .01). The linear regression model explained 28% of the variance in perceived walkability (adj r -squared = 0.26). Social norms (unstandardized coefficient = 0.37, 95% CI: 0.28,0.46) and frequency of walking in the neighborhood, (unstandardized coefficient = 0.06, 95% CI: 0.02, 0.10) were positively associated with perceived walkability.</p><p><strong>Conclusions: </strong>Among a group of rural adults social norms had a greater influence on perceived walkability than frequency of walking in the neighborhood. Intervening in the social environment could impact perceived walkability and ultimately walking among rural adults.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"709-715"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035165","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":"Call for Critical System Thinking in Addressing the 2024 Mpox Public Health Emergency.","authors":"","doi":"10.1097/PHH.0000000000002193","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002193","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"31 5","pages":"905"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676123","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":"Use and Characteristics of Clinical Coding for Post-COVID Conditions in a Retrospective US Cohort.","authors":"Nicole D Ford, Sarah Baca, Alexandra F Dalton, Emilia H Koumans, Julia Raykin, Priti R Patel, Sharon Saydah","doi":"10.1097/PHH.0000000000002137","DOIUrl":"10.1097/PHH.0000000000002137","url":null,"abstract":"<p><strong>Context: </strong>Little is known about when and how the ICD-10-CM diagnosis code for Post-COVID Conditions (PCC; U09.9) is being used to document PCC.</p><p><strong>Objectives: </strong>To examine the use and characteristics of clinical coding for PCC.</p><p><strong>Design: </strong>A retrospective cohort.</p><p><strong>Setting: </strong>Transaction-level medical encounters, laboratory testing results, pharmacy claims, and medical claims for inpatient and outpatient care from the HealthVerity database.</p><p><strong>Participants: </strong>382 400 US adults and children with private health insurance, Medicare, and Medicaid who had U09.9 code documented during October 1, 2021-June 30, 2023.</p><p><strong>Outcome measures: </strong>Count of first use of the U09.9 code, (a) overall, over time, and proportion by provider type; (b) prevalence of PCC-associated incident conditions co-documented with U09.9; (c) number of documented SARS-CoV-2 infections preceding U09.9; (d) timing between infection and U09.9; (e) encounters during the 6 months following first use of U09.9.</p><p><strong>Results: </strong>Overall, 0.6% of 65 556 068 patients had a PCC diagnosis code (64.6% female; 6 in 10 had ≥1 preexisting conditions). The highest count of new U09.9 codes occurred during Quarter 1 and Quarter 3 of 2022 and was documented by a variety of provider specialties. The most prevalent co-documented PCC-associated incident conditions were respiratory (13.4%) and malaise and fatigue (7.8%). Only 62% of patients had SARS-CoV-2 infection documented preceding U09.9; median time to PCC documentation was 17.0 days (interquartile range [IQR] = 5.0, 61.0). Patients with ≥1 encounters during which PCC was documented in the 6 months following their index encounter (n = 109 794) had, on average, 25.5 additional encounters (median = 14 [IQR = 7, 29]).</p><p><strong>Conclusions: </strong>Our study describes the sociodemographic characteristics, complex clinical manifestations, and high healthcare use of patients following a PCC diagnosis. These findings may inform efforts to identify and treat PCC, inform healthcare planning, and support efforts to educate clinicians about the definition of PCC and accurate application of the code.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E292-E302"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558361","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":"Ear Care and Hearing Health Awareness Among Female Community Health Volunteers in Nepal.","authors":"Milan Maharjan, Samira Rajbhandari","doi":"10.1097/PHH.0000000000002174","DOIUrl":"10.1097/PHH.0000000000002174","url":null,"abstract":"<p><strong>Objective: </strong>The primary cause of hearing loss in Nepalese children is chronic otitis media. General lack of awareness about ear and hearing health, paired with usage of traditional malpractices to treat common ear problems, has contributed to an increased morbidity of chronic otitis media and consequent hearing loss. The aim is to evaluate the practices and awareness of ear and hearing health among female community health volunteers (FCHVs).</p><p><strong>Design: </strong>Cross-sectional study. Data were collected between January 2021 and January 2023.</p><p><strong>Setting: </strong>Seven municipalities of Kathmandu, Lalitpur, and Bhaktapur districts of Nepal.</p><p><strong>Participants: </strong>2154 female community health volunteers.</p><p><strong>Main outcome measures: </strong>FCHVs were interviewed using structured questionnaire prepared in local language to examine their level of awareness about ear care and hearing health. Demographics of the participants, awareness and common practices in ear and hearing health were documented and studied.</p><p><strong>Results: </strong>A total of 2154 FCHVs, age ranging from 20 to 65 years old participated in the study. The majority of the FCHVs have at least a secondary level education (n = 912, 42.34%) and only 14.21% (n = 306) of FCHVs surveyed are illiterate. Out of 2154 effective responses, 91.36% (n = 1968) reported cleaning their ears regularly using cotton buds, metallic loops and feathers. Sixty-one percent of them accept the traditional method of instilling oil or other home remedies into their ears, and 45.13% (n = 972) report using eardrops without prescription to self-treat ear problems. The majority of participants are aware that loud noise and ear infections may cause hearing loss.</p><p><strong>Conclusions: </strong>There is a poor knowledge about ear and hearing health among FCHVs in Nepal. Health volunteers play an integral role in promoting preventive care at the community level. This study highlights a need for awareness about ear and hearing health among this key demographic in order to prevent avoidable hearing loss in Nepal.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E286-E291"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512610","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":"Trends in Days in Accounts Receivables Across Safety-Net Health Centers, 2019-2023.","authors":"Nicole Cook, Matthew W H Jones, Rae L Crist, Brenda M McGrath, Rose Goueth, Yui Nishiike, James Bindas, Kurt C Stange","doi":"10.1097/PHH.0000000000002211","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002211","url":null,"abstract":"<p><p>Community-based health centers play a crucial role in delivering care to medically under-resourced communities but operate in a state of financial instability exacerbated by the COVID-19 pandemic. To improve understanding of the pandemic on health centers we assessed monthly and annual accounts receivables (AR) data over 5 years (2019-2023) for 81 health centers. Between 2019 and 2023, health centers improved their Days in AR, decreasing from 49.8 in 2019 to 47.5 in 2023, demonstrating financial resilience in the face of a challenging environment. Larger health centers demonstrated the greatest reduction in days in AR, whereas health centers with a lower percentage of uninsured patients experienced an increase in AR. Clinics operating in Medicaid expansion states were largely stable, while clinics in non-expansion states had higher AR through fall 2020, a sharp decrease in early 2021, and then stayed stable throughout the rest of the study period.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974173","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":"Improving the Performance of a Syndromic Surveillance Definition for Sexual Violence.","authors":"Amy Ising, Lucas M Neuroth, Lubna S Hossain, Julie M Kafka, Anna E Waller","doi":"10.1097/PHH.0000000000002217","DOIUrl":"10.1097/PHH.0000000000002217","url":null,"abstract":"<p><strong>Context: </strong>Timely and representative data for sexual violence surveillance in the United States are lacking.</p><p><strong>Objective: </strong>To address this gap, we aimed to improve the identification of sexual violence in syndromic surveillance emergency department (ED) visit data through evaluation of the latest Centers for Disease Control and Prevention (CDC) sexual violence surveillance definition (CDC V3) using North Carolina (NC) syndromic surveillance data and development of an enhanced definition (V4).</p><p><strong>Design: </strong>We created a gold standard dataset of visits representing incident sexual violence, history of sexual violence, or no sexual violence through manual review, developed an enhanced V4 definition based on this review, and then compared the performance of the CDC V3 and V4 definitions against the gold standard.</p><p><strong>Setting: </strong>North Carolina.</p><p><strong>Participants: </strong>Emergency department visits in NC, 1/1/2016-6/3/2024.</p><p><strong>Main outcome measures: </strong>We compared the precision measures (Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and F1) of the CDC V3 and new V4 definitions for sexual violence. We applied both definitions to NC ED visit data for 2019-2023 to compare demographics and crude rates.</p><p><strong>Results: </strong>The CDC V3 sexual violence definition proved highly specific. The V4 definition identified a 6% increase in incident sexual violence ED visits compared to the CDC V3 definition, with additional chief complaint search terms and the selective incorporation of triage notes. Trends in patient sex, age group, race, and ethnicity were similar across both definitions. The F1 score showed improvement for the V4 definition compared to the CDC V3 definition, suggesting that it better optimizes the need to comprehensively identify ED visits for sexual violence while minimizing false positives.</p><p><strong>Conclusions: </strong>Syndromic surveillance ED visit data provide timely, population-based data on this complex topic. Building upon the CDC V3 definition and incorporating triage notes where available allowed us to develop a more sensitive and accurate surveillance definition for incident sexual violence.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974149","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 Novel Application of Statewide Emergency Department Data to Classify Behavioral Health Holds.","authors":"Bradford S Wheeler, Allison R Arellano, Jennifer Bowman, Carrie L Brown, Lana Deyneka, Elliot Krause, Keith McCoy, Hayley Young, Jessica D Tenenbaum","doi":"10.1097/PHH.0000000000002210","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002210","url":null,"abstract":"<p><strong>Context: </strong>Emergency department (ED) \"boarding\" for behavioral health occurs when patients remain in emergency rooms overnight due to a lack of available psychiatric beds. However, quantification of the problem and demographic characterization of affected populations have been limited and manual. When a patient stays in the ED awaiting either an inpatient psychiatric bed or community care, this is known as a behavioral health hold (BHH). Understanding of BHH requires statewide, 'real-time' data collection that does not widely exist.</p><p><strong>Program: </strong>Collaborators leveraged an existing syndromic surveillance system to compile ED data from across North Carolina into an executive BHH dashboard by developing a custom data extract, implementing a BHH case definition, and curating the data in a secure environment. Data come from 131 hospitals submitting ED visit data to NC DETECT, and the resulting extract includes patients with ED encounters lasting at least 24 hours for a behavioral health reason from November 2022 to November 2024.</p><p><strong>Implementation: </strong>The team implemented and evaluated multiple case definitions of BHH based on ICD-10 codes or keywords listed within the free-text encounter chief complaint. One case definition and four metrics were selected for use within a dashboard based on subject matter expert feedback. US Census Bureau data were used to create population denominators and estimate population rates, which are presented in an equity context.</p><p><strong>Evaluation: </strong>This dashboard enabled data-driven funding and policy decisions for additional crisis stabilization resources, including Facility Based Crisis (FBC) facilities, Behavioral Health Urgent Care (BHUC) facilities, and Mobile Response and Stabilization Services.</p><p><strong>Discussion: </strong>A cross-departmental approach provided the necessary expertise for state departments of health to capitalize on an existing syndromic surveillance system to address a behavioral health policy need. This novel approach, encapsulated in a dashboard, places intelligence about the burden of BHH directly in the hands of policy makers.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974151","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}