Public Health Reports最新文献

In response to the COVID-19 pandemic, a multidisciplinary team at the University of Kentucky developed an interdisciplinary science, technology, engineering, and mathematics and environmental health unit-the Wastewater Assessment for Coronavirus in Kentucky: Implementing Enhanced Surveillance Technology (WACKIEST) Unit-for high school students in summer 2022. This case study outlines the WACKIEST Unit, which focused on wastewater surveillance and COVID-19, the obstacles faced during development and recruitment, and implementation of the WACKIEST Unit in conjunction with a rural wastewater surveillance initiative. The unit was implemented in spring 2023 at a rural high school in Kentucky, spanning 12 days and engaging 190 students. Lessons emphasized the importance of wastewater testing in public health decision-making, particularly in the context of COVID-19. A mobile laboratory provided students with hands-on experience in conducting preliminary analyses of wastewater, and a field trip to the local wastewater treatment plant allowed them to observe real-world wastewater management practices. At the unit's conclusion, students created a public health report aligned with the Evidence-Informed Decision Making in Public Health model, reinforcing the goal of fostering community health resilience. The initiative's success-measured by the unit's completion and positive feedback from students and teachers-supports the creation of online modules for broader dissemination. This case study demonstrates how adaptable interdisciplinary approaches can integrate real-world scientific issues into secondary education, offering valuable insights for future efforts in public health education.

Objectives: US community pharmacies are a unique and underused health service setting for identifying and potentially intervening with patients at risk of opioid overdose or opioid use disorder with evidence-based practices such as screening, brief intervention, and referral to treatment (SBIRT). The aim of our study was to assess the feasibility of implementing SBIRT in community pharmacies in an urban county in terms of engagement, reach, and equity across the cascade of pharmacy screening and care.

Methods: Patients aged 18 years or older receiving a schedule II or III opioid prescription at 1 of 17 participating community pharmacies in Allegheny County, Pennsylvania, were invited to engage in SBIRT as part of Project Lifeline-II from June 2020 through January 2023. Participants completed a prescreen and/or a full screen. We calculated the percentage of patients who participated across the cascade of pharmacy screening and care, overall and by sex (male and female) and race (Black and White).

Results: During the study period, 1952 unique adults (79.6%) were screened at least once (52.1% female; 58.0% White, 30.7% Black). Patients who identified as male (vs female) and Black (vs White) were more likely to have a positive prescreen (14.7% male vs 9.8% female; 16.4% Black vs 9.5% White), receive and complete a full screen (82.7% male vs 80.0% female; 83.6% Black vs 78.4% White), and score positively on the full screen (26.6% male vs 20.4% female; 26.8% Black vs 21.9% White).

Conclusion: Although additional research is needed to characterize the full effect of Project Lifeline-II on patient outcomes, our findings help reinforce the benefits of multipronged public health initiatives that include community pharmacists to address the substance use disorder crisis in the United States.

Cervical screening is crucial for early detection of and ultimately eliminating cervical cancer. Conventional methods for cervical screening that rely on clinician collection of specimens encounter barriers, including embarrassment, discomfort, accessibility, and cultural concerns. Self-collection offers a promising solution to promote cervical screening among underscreened populations. Both methods are available to screen eligible patients since changes to the Australian screening program in 2022. We surveyed Australian health care workers at medical practices in an area with low screening rates on their views about self-collection from July through November 2023. Findings revealed gaps in knowledge about appropriate test use and test accuracy. In addition, findings showed a preference for clinician collection and perceptions that their patients lack confidence in self-collection and lack the willingness to learn about self-collection for cervical screening. Lack of up-to-date information on self-collection logistics and accuracy and pessimistic views on the ability of patients to perform self-collection can hinder the use of self-collection for cervical screening. Addressing these concerns through comprehensive education, easy-to-access guidelines, and interventions designed to support self-collection as part of routine practice is essential, especially for improved participation among under- or never-screened patients.

Objectives: Communication plays a pivotal role in addressing modern and complex public health challenges. Our study assessed the extent to which communication-related course outlines in Canadian master of public health (MPH) programs aligned with national and international public health competency frameworks in their coverage of communication competencies.

Methods: We conducted an environmental scan and content analysis of MPH courses relevant to public health communication in 2022 and 2023. We used university and program websites and Google to conduct initial searches and obtain course outlines, supplementing these searches with a survey. We developed a codebook based on public health competencies and pedagogical best practices, capturing variables for communication competencies, audiences, channels, tools, and techniques. Two researchers independently coded course outlines. Descriptive statistics evaluated how these courses address communication-related public health competencies.

Results: We obtained 11 course outlines offered from 2010 through 2023. The focus of the included courses varied, with health communication (n = 3), knowledge mobilization (n = 3), and risk and/or crisis communication (n = 2) being the most common. All courses broadly aligned with communication competencies related to communication with different audiences (n = 11), and mobilizing (n = 9), interpreting (n = 11), tailoring (n = 9), and facilitating (n = 9) communication. Using technology (n = 4) and media (n = 6), addressing mis/disinformation (n = 1), and communicating with diverse audiences (n = 3) had less alignment.

Conclusions: Findings revealed gaps in the coverage of key competencies, particularly in addressing mis/disinformation, leveraging technology and media, communicating with diverse populations, health literacy, and crisis communication. Ongoing review of curriculum would ensure alignment with evolving competencies and public health demands.

Objectives: We evaluated the data quality, acceptability, sensitivity, simplicity, and representativeness of the surveillance system for suspected human rabies exposure in Washington State to understand current surveillance practices and areas for improvement.

Methods: We conducted a mixed-methods evaluation of the state's surveillance system for suspected rabies exposures. Specifically, we compared the number of suspected rabies exposures in the Washington Disease Reporting System (WDRS) with (1) the number of possible rabies exposures captured by syndromic surveillance (Rapid Health Information NetwOrk [RHINO]) and (2) the number of rabies postexposure prophylaxis administrations in the Washington Immunization Information System (WA IIS) from January 2018 through May 2023. We interviewed local health jurisdiction (LHJ) representatives about investigation and reporting of suspected rabies exposure.

Results: From January 2018 through May 2023, there were 1766 reports of suspected rabies exposure in WDRS, 5054 events in RHINO, and 2378 events in WA IIS; we found substantial differences among LHJs in the ratio of WDRS reports to events in RHINO and WA IIS. Interview data confirmed variability in reporting practices and data management. LHJ partners identified common barriers and weaknesses of the surveillance system, including staff turnover, system complexity, and a lack of resources for data modernization.

Conclusions: Suspected rabies exposures may not be consistently captured by the existing surveillance system. Variation among data entry procedures and storage systems across LHJs could be attributed to resource availability, population size, and capacity for data modernization. These data will be used to develop recommendations for improvements in rabies exposure surveillance in Washington State.

Objectives: Revised accreditation criteria from the Council on Education for Public Health (CEPH) in 2016 prompted schools and programs of public health to shift their master of public health (MPH) core curricula. Our objective was to provide data on revisions to MPH core curricula at CEPH-accredited schools and programs of public health and other descriptive statistics on the MPH core curriculum and required courses as of 2023.

Methods: We analyzed data from 67 accredited schools of public health and 130 accredited public health programs to assess changes from 2016 to 2023 in the MPH core curriculum. We examined the number of courses, the proportion of credit hours in the core curriculum, core curriculum composition, and course types.

Results: Almost half (49.2%) of schools, but only 16.9% of programs, made extensive changes to their MPH core curricula, an overall increase of 153.6% from 2020 to 2023. Approximately one-fifth of schools and programs made few to no changes to their core curricula and retained core courses in the 5 former core disciplines. On average, core curriculum credit hours comprised 37.8% of total credit hours for schools and 51.7% for programs. Half (50.0%) of all programs in the sample offered single-concentration MPH degrees. Schools and programs were more likely to continue requiring traditional biostatistics (81.7%) and epidemiology (81.2%) courses in the core curriculum compared with environmental health (69.0%), social and behavioral health (61.9%), and health policy and management (42.1%).

Conclusions: Most schools and programs modified their MPH core curricula, reflecting a departure from traditional public health courses toward innovative approaches to ensure knowledge and skill proficiency of graduates. Future research will determine if these curricular changes improve the knowledge and skill proficiency of public health graduates and the workforce.

Nicotine pouches are noncombustible products that contain nicotine but no tobacco plant material. With rising popularity and increased media attention surrounding ZYN and other nicotine pouch brands, questions remain about whether empirical evidence exists on the public health effects of these products. This review highlights how nicotine pouches, including ZYN, are rising in appeal and prevalence of use, particularly among adolescents and young adults. The use of nicotine pouches is also more prevalent among people who use other tobacco products (vs those who do not), including electronic cigarettes (e-cigarettes), and some people report using nicotine pouches to help reduce or quit the use of e-cigarettes or combustible tobacco products. Nicotine pouches deliver amounts of nicotine similar to other tobacco products and do so at a rate similar to other oral nicotine products, including some US Food and Drug Administration (FDA)-approved nicotine replacement therapies. In addition, nicotine pouches have the potential to be tobacco harm-reduction products if unintended harms can be minimized, although more research is needed to determine the health effect profile of nicotine pouches under naturalistic use conditions. Overall, additional research is needed to verify the results from industry-funded studies, further understand product characteristics that influence nicotine delivery and health effects, and translate findings to real-world use behaviors. This additional research could help determine whether nicotine pouches have a robust evidence base to meet the public health standard by which FDA evaluates new tobacco products.

Vulvovaginal candidiasis (VVC) is an infection caused by the yeast Candida that affects more than 50% of women in their lifetime. We aimed to describe VVC among American Indian/Alaska Native (AI/AN) girls and women who were receiving care in the Indian Health Service (IHS) system during 2016-2022. We calculated the annual VVC prevalence per 1000 IHS user population and examined underlying medical conditions, previous diagnoses, and antifungal treatment. Among 6 million female patient-years, 70 766 patients had ≥1 VVC diagnosis code (2022 prevalence: 14.2 per 1000 IHS user population). Frequent previous or concurrent diagnoses included diabetes (24.8%), urinary tract infection (13.6%), screening for sexually transmitted infection (13.2%), and unspecified acute vaginitis or vulvitis (13.0%). Approximately one-third (33.1%) of patients received fluconazole, and 25.7% received prescription topical antifungal medication. VVC was a common condition among AI/AN patients who accessed care in the IHS health care system. VVC prevalence among AI/AN patients was similar to the prevalence among the broader US population. These data provide a baseline for future studies to evaluate diagnostic and treatment practices for VVC among AI/AN people.