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Experience of Public Health Departments in Implementation of COVID-19 Case Investigation and Contact Tracing Programs. 公共卫生部门实施 COVID-19 病例调查和接触者追踪计划的经验。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-05-23 DOI: 10.1177/00333549241239556
Colleen Staatz, Penny S Loosier, Ruth Hsu, Michelle Fiscus, Reena Gupta, E Rain Sabin, Divya Vohra, Holly Matulewicz, Melanie M Taylor, Elise C Caruso, Nickolas DeLuca, Patrick K Moonan, John E Oeltmann, Phoebe Thorpe

Objective: Case investigation and contact tracing (CI/CT) are fundamental public health efforts widely used during the COVID-19 pandemic to mitigate transmission. This study investigated how state, local, and tribal public health departments used CI/CT during the COVID-19 pandemic, including CI/CT methodology, staffing models, training and support, and efforts to identify or prioritize populations disproportionately affected by COVID-19.

Methods: During March and April 2022, we conducted key informant interviews with up to 3 public health officials from 43 state, local, and tribal public health departments. From audio-recorded and transcribed interviews, we used the framework method to analyze key themes.

Results: Major adjustments to CI/CT protocols during the pandemic included (1) prioritizing populations for outreach; (2) implementing automated outreach for nonprioritized groups, particularly during COVID-19 surges; (3) discontinuing contact tracing and focusing exclusively on case investigation; and (4) adding innovations to provide additional support. Key informants also discussed the utility of having backup staffing to support overwhelmed public health departments and spoke to the difficulty in "right-sizing" the public health workforce, with COVID-19 surges leaving public health departments understaffed as case rates rose and overstaffed as case rates fell.

Conclusions: When addressing future epidemics or outbreaks, public health officials should consider strategies that improve the effectiveness of CI/CT efforts over time, such as prioritizing populations based on disproportionate risk, implementing automated outreach, developing models that provide flexible additional staffing resources as cases rise and fall among local public health departments, incorporating demographic data in laboratory reporting, providing community connections and support, and having a system of self-notification of contacts.

目的:病例调查和接触者追踪(CI/CT)是在 COVID-19 大流行期间为减少传播而广泛使用的基本公共卫生工作。本研究调查了各州、地方和部落公共卫生部门在 COVID-19 大流行期间如何使用 CI/CT,包括 CI/CT 方法、人员配备模式、培训和支持,以及如何识别或优先考虑受 COVID-19 影响过大的人群:2022 年 3 月和 4 月期间,我们对来自 43 个州、地方和部落公共卫生部门的多达 3 名公共卫生官员进行了关键信息访谈。通过对访谈的录音和转录,我们使用框架法分析了关键主题:大流行期间对 CI/CT 协议的主要调整包括:(1) 确定外展人群的优先顺序;(2) 对非优先人群实施自动外展,尤其是在 COVID-19 激增期间;(3) 停止接触者追踪,将重点完全放在病例调查上;(4) 增加创新以提供额外支持。主要信息提供者还讨论了配备后备人员以支持不堪重负的公共卫生部门的效用,并谈到了 "合理调整 "公共卫生队伍规模的困难,COVID-19 的激增使公共卫生部门在病例率上升时人员不足,而在病例率下降时人员过剩:在应对未来的流行病或疫情爆发时,公共卫生官员应考虑能够提高 CI/CT 工作长期有效性的策略,如根据过高的风险确定优先人群、实施自动外联、开发可根据当地公共卫生部门的病例增减情况灵活提供额外人力资源的模式、将人口统计学数据纳入实验室报告、提供社区联系和支持以及建立接触者自我通知系统。
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引用次数: 0
Evaluation of Mpox Exposures and Outcomes in Workplaces, 6 Jurisdictions, June 1-August 31, 2022. 2022 年 6 月 1 日至 8 月 31 日,在 6 个辖区对工作场所的麻风腮暴露和结果进行评估。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-05-24 DOI: 10.1177/00333549241245655
Marie A de Perio, Libby Horter, William Still, Ie Meh, Nancy Persson, Abby L Berns, Andrea Salinas, Katherine Murphy, Allison G Lafferty, Daniel Daltry, Skyler Mackey, Denise C Sockwell, Jeremy Adams, Jenniffer Rivas, Nicholas J Somerville, Diana Valencia

Objectives: The risk for mpox virus (MPXV) transmission in most workplaces has not been thoroughly assessed in the context of the 2022 global mpox outbreak. Our objectives were to describe mpox case patients who worked while infectious and the subsequent workplace contact tracing efforts, risk assessments, and outcomes.

Methods: The Centers for Disease Control and Prevention requested information from health departments in the United States in September 2022 to identify people with confirmed or probable mpox who worked outside the home while infectious, either before or after diagnosis, from June 1 through August 31, 2022. We collected and summarized data on demographic, clinical, and workplace characteristics of case patients and workplace contact investigations. We stratified data by industry and occupation categories.

Results: In total, 102 case patients were reported by 6 jurisdictions. The most common industries were accommodation and food services (19.8%) and professional business, management, and technical services (17.0%). Contact investigations identified 178 total contacts; 54 cases (52.9%) had no contacts identified. Of 178 contacts, 54 (30.3%) were recommended to receive postexposure prophylaxis (PEP) and 18 (10.1%) received PEP. None of the contacts developed a rash or were tested for orthopox or mpox, and none were reported to have confirmed or probable mpox.

Conclusion: Data from 6 jurisdictions suggest that the risk of MPXV transmission from workers to others in workplace settings in many industries is low. These findings might support future updates to exposure risk classifications and work activity recommendations for patients. These findings also demonstrate the importance of collecting and analyzing occupation and industry data in case reports to better understand risks in workplaces.

目标:在 2022 年全球麻疹疫情爆发的背景下,大多数工作场所的麻疹病毒(MPXV)传播风险尚未得到全面评估。我们的目标是描述在感染期间工作的水痘病例患者以及随后的工作场所接触者追踪工作、风险评估和结果:美国疾病控制与预防中心于 2022 年 9 月要求美国卫生部门提供信息,以确定在 2022 年 6 月 1 日至 8 月 31 日期间,确诊或可能患有水痘的患者在确诊前或确诊后曾外出工作。我们收集并汇总了病例患者的人口统计学、临床和工作场所特征数据以及工作场所接触调查数据。我们按行业和职业类别对数据进行了分层:结果:6 个辖区共报告了 102 例病例患者。最常见的行业是住宿和餐饮服务业(19.8%)以及专业商业、管理和技术服务业(17.0%)。接触调查共确定了 178 名接触者;54 例病例(52.9%)未确定接触者。在 178 名接触者中,54 人(30.3%)被建议接受接触后预防 (PEP),18 人(10.1%)接受了 PEP。所有接触者均未出现皮疹或接受正痘或水痘检测,也没有报告确诊或可能感染了水痘:来自 6 个辖区的数据表明,在许多行业的工作场所,工人将 MPXV 传播给他人的风险很低。这些研究结果可能会支持未来对暴露风险分类和患者工作活动建议的更新。这些发现还表明,收集和分析病例报告中的职业和行业数据对于更好地了解工作场所的风险非常重要。
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引用次数: 0
Community Engagement, Equity, and Cross-Sector Public Health Practice. 社区参与、公平和跨部门公共卫生实践。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-05-23 DOI: 10.1177/00333549241249671
Patricia M Nickel, Cerise Hunt

In this topical review, we integrate 3 concepts-public health practice, community engagement, and cross-sector governance-to consider the following question: What is the underlying relationship between public health and cross-sector governance according to which the field can understand the role of community engagement in achieving health equity? We begin with an overview of public health practice and the practice of community engagement. Next, we position these practices in the broader turn toward cross-sector governance. The integration of these themes reveals that common tools for community engagement fail to address questions about how services should be funded, how resources should be distributed, and which members of the community have a claim to services. We therefore suggest that distinguishing between community engagement for equity and equitable community engagement is a first step toward deepening dialogue about the role of public health in achieving health equity.

在这篇专题综述中,我们整合了三个概念--公共卫生实践、社区参与和跨部门治理--来思考以下问题:公共卫生与跨部门治理之间的基本关系是什么?据此,该领域可以理解社区参与在实现健康公平中的作用吗?我们首先概述了公共卫生实践和社区参与实践。接下来,我们将这些实践置于跨部门治理的大背景下。通过整合这些主题,我们发现社区参与的常用工具未能解决以下问题:如何资助服务、如何分配资源以及哪些社区成员有权获得服务。因此,我们建议,区分社区参与促进公平和公平社区参与,是深化关于公共卫生在实现健康公平中的作用的对话的第一步。
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引用次数: 0
The Effectiveness of Face Mask Mandates on COVID-19 Transmission in Utah. 在犹他州强制使用口罩对 COVID-19 传播的效果。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-30 DOI: 10.1177/00333549241290676
Alicia C Horn, Holly E Shoemaker, Lindsay T Keegan

Objective: Throughout the COVID-19 pandemic, the effectiveness of face mask mandates was intensely debated. The objective of this study was to describe how face mask mandates at the state, county, and local levels differed in their effectiveness in reducing the number of COVID-19 cases in the jurisdiction where the mandate was implemented and throughout Utah.

Methods: We used publicly available data from the Utah Department of Health and Human Services. We calculated the effectiveness of face mask mandates (EFm) in each local health district after 3 key mandates: the enactment of face mask mandates in Salt Lake and Summit counties (SLSC) on June 28, 2020, and June 27, 2020, respectively; the enactment of a statewide face mask mandate on November 9, 2020; and the lifting of the statewide face mask mandate on April 10, 2021.

Results: Most counties in Utah had a reduction in the growth rate of COVID-19 cases after enactment of face mask mandates. We found an average 11.9% reduction in EFm after the introduction of the SLSC face mask mandates, with 8 of 13 local health districts experiencing a reduction, and an average 12.7% reduction after introduction of the statewide mandate, with 12 of 13 local health districts experiencing a reduction. After mandates were lifted, many counties had an increase in EFm.

Conclusion: Face mask mandates were an effective way to reduce transmission of COVID-19 in local jurisdictions and in neighboring jurisdictions in Utah. Our evidence supports the use of face mask mandates as a way to prevent disease transmission and be better equipped to respond to future pandemics.

目的:在 COVID-19 大流行期间,人们对口罩强制措施的有效性进行了激烈的讨论。本研究旨在描述州、县和地方各级口罩强制措施在减少强制措施实施辖区和整个犹他州 COVID-19 病例数量方面的效果有何不同:我们使用了犹他州卫生与公众服务部公开提供的数据。我们计算了 3 项关键任务后每个地方卫生区的口罩任务有效性(EFm):盐湖郡和高峰郡(SLSC)分别于 2020 年 6 月 28 日和 2020 年 6 月 27 日颁布口罩任务;2020 年 11 月 9 日颁布全州口罩任务;2021 年 4 月 10 日取消全州口罩任务:结果:犹他州大多数县在颁布口罩规定后,COVID-19病例的增长率都有所下降。我们发现,在引入 SLSC 口罩强制规定后,EFm 平均下降了 11.9%,13 个地方卫生区中有 8 个出现下降;在引入全州强制规定后,EFm 平均下降了 12.7%,13 个地方卫生区中有 12 个出现下降。任务取消后,许多县的 EFm 有所上升:在犹他州的地方辖区和邻近辖区,口罩强制措施是减少 COVID-19 传播的有效方法。我们的证据支持使用口罩强制措施来预防疾病传播,并更好地应对未来的流行病。
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引用次数: 0
Evaluation and Revision of Historical ESSENCE Syndromic Surveillance Definition Used to Identify Work-Related Emergency Department Visits. 评估和修订用于识别与工作有关的急诊就诊的历史性 ESSENCE 综合症监测定义。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-26 DOI: 10.1177/00333549241287929
Laurel Harduar Morano, Aaron Kite Powell, Sara E Luckhaupt

Objectives: Occupational health surveillance programs have rarely incorporated syndromic surveillance. We documented a process for evaluating and revising syndromic surveillance definitions, using the example of work-related emergency department (ED) visits.

Materials and methods: Of 140 331 481 ED visits in the National Syndromic Surveillance Program from May 15, 2016, through October 31, 2017, we extracted 391 827 records for phase 1 that met the previously unevaluated original work-related definition or included a work-related employment status ICD-10-CM code (Y99.0/Y99.1; International Classification of Diseases, Tenth Revision, Clinical Modification). Also for phase 1, we evaluated the performance of the original work-related definition using ICD-10-CM work-related employment status codes as a reference standard. In phase 2, we extracted 99 109 records containing candidate work-related keywords. Finally, in phase 3, we examined individual keywords and developed and evaluated a revised definition.

Results: The revised work-related definition identified 259 153 visits by keyword alone, 104 342 visits by ICD-10-CM work-related employment status codes alone, and 16 385 ED visits by both methods. Sensitivity (13.6% vs 11.3%) and positive predictive value (5.9% vs 4.8%) were higher for the revised definition than for the original work-related definition. Manual review indicated that 91.3% (95% CI, 89.6%-93.0%) of visits identified by the revised definition keywords met the study criteria for work-related visits as compared with 75.5% (95% CI, 73.0%-78.4%) of visits for the original work-related definition.

Practice implications: The original work-related definition performed suboptimally because keywords were not sufficiently specific. The revised definition is an improvement but requires testing in real-world scenarios. The presented methods for developing a syndromic surveillance definition are useful, not only for occupational health, but for identification of other subpopulations treated in the ED.

目的:职业健康监测计划很少纳入综合征监测。我们以与工作相关的急诊科(ED)就诊为例,记录了评估和修订症候群监测定义的过程:从 2016 年 5 月 15 日到 2017 年 10 月 31 日,在国家症候群监测计划的 140 331 481 次急诊就诊中,我们在第一阶段提取了 391 827 条记录,这些记录符合之前未经评估的与工作相关的原始定义,或包含与工作相关的就业状况 ICD-10-CM 代码(Y99.0/Y99.1;国际疾病分类,第十版,临床修正版)。在第 1 阶段,我们还使用 ICD-10-CM 工作相关就业状况代码作为参考标准,评估了原始工作相关定义的性能。在第 2 阶段,我们提取了 99 109 条包含候选工作相关关键词的记录。最后,在第 3 阶段,我们检查了各个关键词,并制定和评估了修订后的定义:修订后的工作相关定义仅通过关键词就识别出 259 153 人次,仅通过 ICD-10-CM 工作相关就业状态代码就识别出 104 342 人次,通过两种方法识别出 16 385 人次。修订后定义的灵敏度(13.6% 对 11.3%)和阳性预测值(5.9% 对 4.8%)均高于最初的工作相关定义。人工审核显示,在修订后的定义关键词中,91.3%(95% CI,89.6%-93.0%)的就诊符合工作相关就诊的研究标准,而在最初的工作相关定义中,75.5%(95% CI,73.0%-78.4%)的就诊符合工作相关就诊的研究标准:实践意义:最初的工作相关定义不够理想,因为关键词不够具体。修订后的定义有所改进,但需要在实际场景中进行测试。所介绍的制定综合征监测定义的方法不仅对职业健康有用,而且对识别在急诊室接受治疗的其他亚人群也很有用。
{"title":"Evaluation and Revision of Historical ESSENCE Syndromic Surveillance Definition Used to Identify Work-Related Emergency Department Visits.","authors":"Laurel Harduar Morano, Aaron Kite Powell, Sara E Luckhaupt","doi":"10.1177/00333549241287929","DOIUrl":"https://doi.org/10.1177/00333549241287929","url":null,"abstract":"<p><strong>Objectives: </strong>Occupational health surveillance programs have rarely incorporated syndromic surveillance. We documented a process for evaluating and revising syndromic surveillance definitions, using the example of work-related emergency department (ED) visits.</p><p><strong>Materials and methods: </strong>Of 140 331 481 ED visits in the National Syndromic Surveillance Program from May 15, 2016, through October 31, 2017, we extracted 391 827 records for phase 1 that met the previously unevaluated original work-related definition or included a work-related employment status ICD-10-CM code (Y99.0/Y99.1; <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i>). Also for phase 1, we evaluated the performance of the original work-related definition using ICD-10-CM work-related employment status codes as a reference standard. In phase 2, we extracted 99 109 records containing candidate work-related keywords. Finally, in phase 3, we examined individual keywords and developed and evaluated a revised definition.</p><p><strong>Results: </strong>The revised work-related definition identified 259 153 visits by keyword alone, 104 342 visits by ICD-10-CM work-related employment status codes alone, and 16 385 ED visits by both methods. Sensitivity (13.6% vs 11.3%) and positive predictive value (5.9% vs 4.8%) were higher for the revised definition than for the original work-related definition. Manual review indicated that 91.3% (95% CI, 89.6%-93.0%) of visits identified by the revised definition keywords met the study criteria for work-related visits as compared with 75.5% (95% CI, 73.0%-78.4%) of visits for the original work-related definition.</p><p><strong>Practice implications: </strong>The original work-related definition performed suboptimally because keywords were not sufficiently specific. The revised definition is an improvement but requires testing in real-world scenarios. The presented methods for developing a syndromic surveillance definition are useful, not only for occupational health, but for identification of other subpopulations treated in the ED.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506721","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}
引用次数: 0
Steps Toward Decreasing Maternal Alcohol Consumption in Israel: Nationwide Trends During a Decade. 以色列减少产妇饮酒量的措施:十年间的全国趋势》。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-25 DOI: 10.1177/00333549241289035
Yehuda Senecky, Noam Zrubavel Yaaron, Gabriel Chodick, Andrea Berger, Liat Hen-Herbst, Ilana Barta Fund, Manal Massalha, Ran Matot, Esther Ganelin-Cohen

Objectives: Prenatal alcohol exposure poses a substantial risk to fetal development. Efforts were made in 2011-2020 to increase public awareness of and prevent alcohol consumption during pregnancy. We conducted a cross-sectional survey in Israel of pregnant women's alcohol consumption from January 2021 through June 2023 and compared our results with the results of a survey conducted during 2009-2010 to assess changes over time.

Methods: We conducted cross-sectional surveys at 3 public hospitals in central and northern Israel. Surveyors visited hospitals twice weekly and used a questionnaire consistent with one used in 2009-2010 that focused on alcohol consumption 3 months before pregnancy and during pregnancy. We conducted a stratified analysis of the prevalence of alcohol consumption during pregnancy by demographic characteristics. We also used a multivariable logistic regression model to examine variables associated with receiving guidance on alcohol consumption during pregnancy.

Results: Of 1915 women in the 2021-2023 survey (mean [SD] age, 30.8 [5.6] y), 1204 (62.9%) reported never consuming alcohol before pregnancy and 1708 (89.2%) reported no alcohol consumption during pregnancy. During pregnancy, 157 (8.2%) women reported consuming alcohol weekly or less, 12 (0.6%) more frequently, and 52 (2.7%) binge drinking. We found a significant decrease in alcohol consumption during pregnancy in 2021-2023 as compared with 2009-2010 (odds ratio, 0.68; 95% CI, 0.52-0.88; P = .03). Predictors of alcohol consumption during pregnancy included alcohol consumption before pregnancy, parity, and smoking. Significantly more women in the 2021-2023 sample (n = 569; 29.7%) than in the 2009-2010 sample received guidance on alcohol consumption during pregnancy (P < .001).

Conclusions: Educational efforts should continue to increase awareness of the risks of prenatal alcohol exposure in the general population and among health professionals.

目的:产前接触酒精对胎儿发育有很大风险。2011-2020 年,以色列努力提高公众对孕期饮酒的认识,并预防孕期饮酒。我们在以色列对 2021 年 1 月至 2023 年 6 月期间孕妇的饮酒量进行了横断面调查,并将调查结果与 2009-2010 年期间的调查结果进行了比较,以评估随时间推移发生的变化:我们在以色列中部和北部的 3 家公立医院进行了横断面调查。调查人员每周访问医院两次,所使用的问卷与 2009-2010 年使用的问卷一致,重点关注孕前 3 个月和孕期的饮酒情况。我们根据人口统计学特征对孕期饮酒率进行了分层分析。我们还使用多变量逻辑回归模型研究了与接受孕期饮酒指导相关的变量:在 2021-2023 年调查的 1915 名妇女(平均 [SD] 年龄为 30.8 [5.6] 岁)中,有 1204 人(62.9%)表示在怀孕前从未饮酒,有 1708 人(89.2%)表示在怀孕期间没有饮酒。在怀孕期间,157 名妇女(8.2%)称每周饮酒一次或更少,12 名妇女(0.6%)称饮酒更频繁,52 名妇女(2.7%)称酗酒。我们发现,与 2009-2010 年相比,2021-2023 年孕期饮酒量明显下降(几率比,0.68;95% CI,0.52-0.88;P = .03)。孕期饮酒量的预测因素包括孕前饮酒量、胎次和吸烟。与 2009-2010 年样本相比,2021-2023 年样本(n = 569;29.7%)中接受过孕期饮酒指导的女性人数显著增多(P 结论:孕期饮酒的预测因素包括孕前饮酒、足月和吸烟:应继续开展教育工作,提高普通人群和医疗专业人员对产前酒精暴露风险的认识。
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引用次数: 0
Data Improvement: A Strategy to Improve Understanding of Violence Against Transgender Populations. 数据改进:提高对变性人暴力问题认识的战略》(A Strategy to Improve Understanding of Violence Against Transgender Populations)。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-25 DOI: 10.1177/00333549241291711
Symphony Fletcher, Kieran Todd
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引用次数: 0
An Immediate but Fleeting Interest in MPH Programs After the Onset of COVID-19: An Interrupted Time-Series Analysis. COVID-19 爆发后,人们对 MPH 计划的兴趣一触即发,但稍纵即逝:中断时间序列分析
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-22 DOI: 10.1177/00333549241288140
Jemar R Bather, Emily M Burke, Christine M Plepys, Janani Rajbhandari-Thapa, Debra Furr-Holden, Melody S Goodman

Objectives: The relationship between the onset of the COVID-19 pandemic and interest in master of public health (MPH) programs is unknown. We examined trends in MPH application rates for 31 MPH concentrations and specifically for the MPH concentration in epidemiology and differences by race and ethnicity before and after the onset of the COVID-19 pandemic.

Methods: We constructed a quasi-experimental design to examine trends in MPH application rates from academic years 2015-2016 through 2022-2023 by using Centralized Application Service for Schools and Programs of Public Health data. We used an interrupted time-series analysis to test whether application rates surged after the pandemic's onset (academic years 2019-2020 through 2020-2021) and whether this increase persisted during the pandemic (academic years 2020-2021 through 2022-2023). We fit models for the overall sample, a combined racially and ethnically minoritized sample, each racial and ethnic group separately, and a non-US citizen sample.

Results: The pandemic's onset correlated with an immediate increase in application rates across most samples: overall (38%) and among American Indian/Alaska Native/Native Hawaiian/Pacific Islander (91%), Asian (35%), Black (42%), Hispanic (60%), multiracial (30%), racially and ethnically minoritized (44%), and White (53%) samples. However, this trend was not sustained; application rate trends during the pandemic were significantly lower than prepandemic trends. Application rate trends for all MPH concentrations and the MPH in epidemiology concentration among non-US citizens were significantly higher during the pandemic than prepandemic.

Conclusions: Our results highlight the need for innovative strategies to sustain MPH degree interest and a diverse applicant pool.

目的:COVID-19 大流行的爆发与人们对公共卫生硕士 (MPH) 项目的兴趣之间的关系尚不清楚。我们研究了 31 个公共卫生硕士专业的申请率趋势,特别是流行病学公共卫生硕士专业的申请率趋势,以及 COVID-19 大流行前后不同种族和民族的差异:我们采用准实验设计,利用公共卫生学校和专业集中申请服务数据,研究了从 2015-2016 学年到 2022-2023 学年 MPH 申请率的变化趋势。我们使用间断时间序列分析法来检验申请率是否在大流行开始后(2019-2020 学年至 2020-2021 学年)激增,以及这种增长是否在大流行期间(2020-2021 学年至 2022-2023 学年)持续。我们对总体样本、少数种族和族裔的综合样本、每个种族和族裔群体的单独样本以及非美国公民样本进行了模型拟合:在大多数样本中,大流行病的爆发与申请率的立即上升相关:总体样本(38%)、美国印第安人/阿拉斯加原住民/夏威夷原住民/太平洋岛民样本(91%)、亚裔样本(35%)、黑人样本(42%)、西班牙裔样本(60%)、多种族样本(30%)、少数种族和族裔样本(44%)以及白人样本(53%)。然而,这一趋势并没有持续下去;大流行期间的应用率趋势明显低于大流行前的趋势。在大流行期间,非美国公民中所有 MPH 专业和流行病学 MPH 专业的申请率趋势明显高于大流行前:我们的研究结果表明,有必要采取创新策略来保持对公共卫生硕士学位的兴趣和多元化的申请者群体。
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引用次数: 0
A Shift in Approach to Addressing Public Health Inequities and the Effect of Societal Structural and Systemic Drivers on Social Determinants of Health. 转变应对公共卫生不平等问题的方法,以及社会结构和系统驱动因素对健康的社会决定因素的影响。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-11 DOI: 10.1177/00333549241283586
Carla I Mercado, Kai McKeever Bullard, Michele L F Bolduc, Courtni Alexis Andrews, Zoe R F Freggens, Grace Liggett, Desmond Banks, Shanice Battle Johnson, Ana Penman-Aguilar, Rashid Njai

Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age that influence health outcomes, and structural and systemic drivers of health (SSD) are the social, cultural, political, and economic contexts that create and shape SDOH. With the integration of constructs from previous examples, we propose an SSD model that broadens the contextual effect of these driving forces or factors rooted in the Centers for Disease Control and Prevention's SDOH framework. Our SSD model (1) presents systems and structures as multidimensional, (2) considers 10 dimensions as discrete and intersectional, and (3) acknowledges health-related effects over time at different life stages and across generations. We also present an application of this SSD model to the housing domain and describe how SSD affect SDOH through multiple mechanisms that may lead to unequal resources, opportunities, and consequences contributing to a disproportionate burden of disease, illness, and death in the US population. Our enhanced SDOH framework offers an innovative and promising model for multidimensional, collaborative public health approaches toward achieving health equity and eliminating health disparities.

健康的社会决定因素(SDOH)是指人们出生、成长、生活、工作和衰老时所处的影响健康结果的环境,而健康的结构性和系统性驱动因素(SSD)是指创造和形成 SDOH 的社会、文化、政治和经济环境。通过整合前述实例中的建构,我们提出了一个 SSD 模型,该模型以美国疾病控制和预防中心的 SDOH 框架为基础,扩大了这些驱动力或因素的环境效应。我们的 SSD 模型(1) 将系统和结构视为多维的,(2) 将 10 个维度视为离散和交叉的,(3) 承认在不同的生命阶段和不同的世代,健康相关的影响随着时间的推移而变化。我们还介绍了这一 SSD 模型在住房领域的应用,并描述了 SSD 如何通过多种机制影响 SDOH,从而可能导致资源、机会和后果的不平等,造成美国人口不成比例的疾病、患病和死亡负担。我们的增强型 SDOH 框架为多维度、协作性的公共卫生方法提供了一个创新且前景广阔的模型,以实现健康公平并消除健康差异。
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引用次数: 0
COVID Just-in-Time Extension for Community Health Outcomes: A Collaborative Information-Sharing Platform for a School Health Community. COVID 社区健康成果的及时推广:学校健康社区的协作信息共享平台。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-07 DOI: 10.1177/00333549241283173
Priya Chopra, Alethea Chiappone, Susan Goldenstein, Therese Pilonetti, Roberta Gillis, Daniel Dodson, Shuyuan Tan, John F Thomas, Jessica R Cataldi

The COVID-19 pandemic challenged school health professionals to navigate a dynamic public health emergency and to stay aware of changing recommendations. This study aimed to determine the value of the COVID Just-in-Time ECHO (Extension for Community Health Outcomes) Learning Series for Schools among participating school health personnel and to describe their ongoing information needs during the pandemic. School health, public health, and education professionals across Colorado participated in this ECHO series. Participants attended 1-hour sessions every 2 to 4 weeks from March 2020 through December 2021 for a total of 34 sessions. Data collection included postsession and postseries surveys assessing what participants found most valuable and what additional information they needed. School nurses represented 113 of 224 participants (50%). ECHO content noted as being the most valuable included epidemiology updates and special topics as chosen by participant input. Postseries surveys identified the value of experiencing shared knowledge among Just-in-Time ECHO participants. Participants identified ongoing needs for information about COVID-19 guidance and risk mitigation in schools throughout the sessions. In postseries surveys, participants reported additional ongoing information needs related to COVID-19 outside schools. This ECHO series delivered reliable and time-sensitive information for school health personnel and school leaders and may provide a useful model for information sharing among education and public health professionals.

COVID-19 大流行对学校卫生专业人员提出了挑战,他们需要驾驭动态的公共卫生紧急事件,并随时了解不断变化的建议。本研究旨在确定 COVID 及时 ECHO(社区卫生成果推广)学校学习系列在参与学校卫生人员中的价值,并描述他们在大流行期间的持续信息需求。科罗拉多州的学校卫生、公共卫生和教育专业人员参加了 ECHO 系列学习。从 2020 年 3 月到 2021 年 12 月,参与者每 2 到 4 周参加一次 1 小时的课程,总共参加了 34 次课程。数据收集包括会后和系列活动后调查,评估参与者认为最有价值的内容以及他们需要的其他信息。在 224 名参与者中,学校护士占 113 人(50%)。ECHO 最有价值的内容包括流行病学的最新进展和参与者选择的特别主题。会后调查显示,"及时 ECHO "参与者之间的知识共享很有价值。在整个培训过程中,参与者发现了学校对 COVID-19 指南和降低风险信息的持续需求。在会后调查中,参与者还报告了与 COVID-19 相关的校外持续信息需求。该 ECHO 系列为学校卫生人员和学校领导提供了可靠且时效性强的信息,可为教育和公共卫生专业人员之间的信息共享提供一个有用的模式。
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