Journal of Public Health Management & Practice最新文献

{"title":"Visualizing Neighborhood COVID-19 Levels, Trends, and Inequities in Wastewater: An Equity-Centered Approach and Comparison to CDC Methods.","authors":"Tori L Cowger,Nicholas B Link,Justin D Hart,Madeline T Sharp,Shoba Nair,Ruchita Balasubramanian,Soroush Moallef,Jarvis Chen,William P Hanage,Loni Philip Tabb,Kathryn T Hall,Bisola O Ojikutu,Nancy Krieger,Mary T Bassett","doi":"10.1097/phh.0000000000002049","DOIUrl":"https://doi.org/10.1097/phh.0000000000002049","url":null,"abstract":"CONTEXTMonitoring neighborhood-level SARS-CoV-2 wastewater concentrations can help guide public health interventions and provide early warning ahead of lagging COVID-19 clinical indicators. To date, however, U.S. Centers for Disease Control and Prevention's (CDC) National Wastewater Surveillance System (NWSS) has provided methodology solely for communicating national and state-level \"wastewater viral activity levels.\"PROGRAMIn October 2022, the Boston Public Health Commission (BPHC) began routinely sampling wastewater at 11 neighborhood sites to better understand COVID-19 epidemiology and inequities across neighborhoods, which vary widely in sociodemographic and socioeconomic characteristics. We developed equity-centered methods to routinely report interpretable and actionable descriptions of COVID-19 wastewater levels, trends, and neighborhood-level inequities.APPROACH AND IMPLEMENTATIONTo produce these data visualizations, spanning October 2022 to December 2023, we followed four general steps: (1) smoothing raw values; (2) classifying current COVID-19 wastewater levels; (3) classifying current trends; and (4) reporting and visualizing results.EVALUATIONCOVID-19 wastewater levels corresponded well with lagged COVID-19 hospitalizations and deaths over time, with \"Very High\" wastewater levels coinciding with winter surges. When citywide COVID-19 levels were at the highest and lowest points, levels and trends tended to be consistent across sites. In contrast, when citywide levels were moderate, neighborhood levels and trends were more variable, revealing inequities across neighborhoods, emphasizing the importance of neighborhood-level results. Applying CDC/NWSS state-level methodology to neighborhood sites resulted in vastly different neighborhood-specific wastewater cut points for \"High\" or \"Low,\" obscured inequities between neighborhoods, and systematically underestimated COVID-19 levels during surge periods in neighborhoods with the highest COVID-19 morbidity and mortality.DISCUSSIONOur methods offer an approach that other local jurisdictions can use for routinely monitoring, comparing, and communicating neighborhood-level wastewater levels, trends, and inequities. Applying CDC/NWSS methodology at the neighborhood-level can obscure and perpetuate COVID-19 inequities. We recommend jurisdictions adopt equity-focused approaches in neighborhood-level wastewater surveillance for valid community comparisons.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Systemic Inequities: An Evaluation of the Resilience Catalysts in Public Health Program.","authors":"Wendy Ellis,Kristen Hayes,Esmeralda Salas,Stephanie A Bultema,Tahlia Gousse,Kuan-Lung Daniel Chen","doi":"10.1097/phh.0000000000002053","DOIUrl":"https://doi.org/10.1097/phh.0000000000002053","url":null,"abstract":"CONTEXTResilience Catalysts (RC) in Public Health provides local health departments (LHDs) with a process and technical assistance (TA) to operationalize the Community Health Strategist (CHS) role, foster equity, and support community resilience through policy, practice, and program change across multiple sectors.OBJECTIVESThis evaluation sought to (1) identify essential elements of the RC process and TA that help LHDs address the systemic drivers of adversity and inequity, and (2) expand understanding of RC's preliminary impact and inform implications for theory, practice, and funding in the post-COVID context.DESIGNThe mixed-methods evaluation incorporated online surveys and semi-structured interviews. Key themes and takeaways were identified using framework analysis, constant comparison analysis, and descriptive statistics.SETTINGThe evaluation was conducted in 12 cities and counties across the United States, including California, Colorado, Florida, Iowa, Kentucky, Maryland, Massachusetts, New Jersey, North Carolina, Ohio, Tennessee, and Washington.PARTICIPANTSSurvey participants consisted of 29 representatives of 11 RC sites. Interview participants included 33 individuals: 19 representatives of 9 RC sites and 14 individuals representing RC TA providers and funders.MAIN OUTCOME MEASURESThe evaluation measured outcomes related to collaborative engagement, addressing inequity, systems change, knowledge change, ability to work within a local political and community context, sustainability, and scalability.RESULTSEvaluation results demonstrate outcomes related to community engagement, expansion of system-level thinking, advancing health and racial equity, clarity and understanding of RC process, building LHD and partners' capacity and skills needed to embody the CHS role.CONCLUSIONSThe RC process prepared LHDs to operationalize the CHS role by providing the knowledge, skills, and capacities needed to understand root causes of adversity and inequity, address structural racism as a public health issue, and develop collaborative plans for addressing root causes.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Quality Improvement to Expand and Align State Public Health Long-Term Follow-up Data Collection Across Newborn Screening Conditions.","authors":"Kristi Bentler,Lexie Barber,Anna K Lintelmann,Darcia M Dierking,Abby C Meyer,Ashley Comer,Jennifer Hauser","doi":"10.1097/phh.0000000000002056","DOIUrl":"https://doi.org/10.1097/phh.0000000000002056","url":null,"abstract":"CONTEXTDespite the undeniable success of newborn screening (NBS), numerous barriers exist regarding long-term follow-up (LTFU) of children with conditions included in NBS. Furthermore, there is a focus on condition-specific follow-up with no national guidelines for standard quality measures collected by state public health LTFU programs.PROGRAMMinnesota Department of Health (MDH) Longitudinal Follow-up for NBS.IMPLEMENTATIONA state public health LTFU for NBS quality improvement (QI) project was carried out with collaboration between MDH project team members and a QI Steering Team who provided clinical, public health, education, caregiver, and community perspectives and expertise to MDH. Relevant measures were selected from existing data elements, and additional measures were developed based on exchange between MDH project team and the QI Steering Team. Potential data sources were explored and prioritized. Processes for querying existing data sources such as death records were refined, new sources such as electronic health records and paper/PDF health records were established, and data collection was piloted. The Minnesota Electronic Disease Surveillance System was modified, and an electronic data form was created to promote consistent data abstraction from sources. Throughout the project, progress was evaluated and shared. At project conclusion, MDH project team and the QI Steering Team reviewed project outcomes and approaches to evolve the project into ongoing surveillance.EVALUATIONFive common public health LTFU measures were determined. Overall, 77% of attempted measures were successfully collected. Primary and secondary data sources were adopted. In addition, collected data resulted in 7% of cases that were closed to further public health LTFU, often related to a move out of state.DISCUSSIONThis project established the feasibility of state public health LTFU surveillance of outcomes and health care use by collecting a common data set applicable across NBS conditions.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using National Public Health Accreditation to Explore Quality Improvement and Performance Management in Small Local Health Departments.","authors":"Matthew Fifolt,Peg Allen,Andrew Crenshaw,Paul C Erwin,Britt Lang,Amy Belflower Thomas,Ross C Brownson","doi":"10.1097/phh.0000000000002062","DOIUrl":"https://doi.org/10.1097/phh.0000000000002062","url":null,"abstract":"CONTEXTThis article focuses on 4 small local health departments (LHDs) that were in the process of seeking Public Health Accreditation Board (PHAB) reaccreditation or Pathways Recognition using PHAB Standards & Measures Version 2022.OBJECTIVEThe objective of this study was to explore the experiences of 4 small LHDs related to Quality Improvement (QI) and Performance Management (PM) in their pursuit of PHAB reaccreditation or Pathways Recognition.DESIGNA team of researchers conducted 22 qualitative interviews with health department leaders and staff. Findings relative to QI/PM represent an embedded case study since they were part of a larger investigation.SETTINGThe research team conducted interviews remotely with health departments located in the West and Midwest.PARTICIPANTSParticipants included adults at least 18 years old and employed in 1 of 4 health departments.MAIN OUTCOME MEASURESEmergent themes from this qualitative investigation included using QI/PM tracking systems, building staff buy-in for QI/PM, integrating QI/PM into daily work, and advice for other health departments regarding QI/PM.RESULTSParticipants suggested that tracking systems helped them manage QI/PM processes. Staff buy-in for QI/PM was strengthened by building a sense of ownership of the process and connecting improvement processes to outcomes. Health departments integrated QI/PM into daily work by leadership modeling and communicating expectations. Advice for other health departments included finding a QI system that was easy to follow and recognizing the role of QI/PM in improving performance to better support the wellbeing of the community.CONCLUSIONSQI/PM are important tools for health department effectiveness. Participants affirmed that the primary purposes of QI/PM are to enhance internal processes and improve community health outcomes. Study findings demonstrate how 4 small health departments integrated QI/PM into their public health practice.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}