Journal of Public Health Management and Practice最新文献

Naloxone is efficacious at reversing opioid overdoses and appears efficient in mathematical models of its use. State-level, field-based data on naloxone administrations in the New York State Department of Health's Opioid Overdose Prevention Program (OOPP) network, as well as OOPP budgetary data, informed an economic evaluation of these statewide efforts. Results indicated high levels of lives saved, years of life saved, and economic benefits across the time-period April 2023 to March 2025. Given the substantial beneficial impact of naloxone provision and training via the New York OOPP network, continued investment is warranted until all unmet needs are addressed and recent downward trajectories in fatal overdoses are continued.

YMCAs were instrumental in establishing the National Diabetes Prevention Program (NDPP), including a Medicare-covered model of the lifestyle intervention in 2018. Despite this key milestone for sustainability and strong clinical outcomes, reach has been extremely limited. Greater uptake is key to reducing diabetes prevalence and requires more NDPP suppliers. In a mixed-methods evaluation, we found the rate of sustained YMCA adoption declined 63.7% nationally, from 193 NDPP suppliers in 2018 to 70 in 2024. In surveys of YMCAs that had largely sustained delivery ( n = 26), leadership support was cited as a strength, while inadequate resources were a primary challenge. Three in-depth case reports identified strategies for sustainability in resource-limited settings: diversifying funding, identifying cost efficiencies, leveraging incentives to engage participants, and partnering with peer organizations and leadership to address barriers. Findings may inform practice and policy efforts to stabilize NDPP delivery in community settings and support its intended public health impact.

Context: Thousands of lead-based paint (LBP) inspections and risk assessments have been completed by professionals in recent years, but they have not yet been assembled into a suitable database to support a housing surveillance system.

Objective: This study was completed to determine if a database can be developed by uploading results of lead paint risk assessments; inspections; and evaluations of homes of children with elevated blood lead levels to support the creation of a LBP housing surveillance system.

Methods: Working with local private and public lead poisoning prevention professionals and laboratories, data from 2128 pre-1978 dwelling units, comprising 350 104 interior and 45 685 exterior LBP XRF measurements; 12 619 floor dust lead measurements; 8772 windowsill dust lead measurements; and other variables were assembled and analyzed.

Results: Although all reports complied with the US Department of Housing and Urban Development (HUD) guidelines, their report formats varied widely. The percentage of homes with any interior LBP was 62% (28%-88%, depending on risk categorization, that is, homes without or with children with elevated blood lead levels; the percentage with exterior LBP was 63% (28%-88%); and the percentage with both interior and exterior LBP was 51% (8%-86%). Room names, number, and building component naming systems were highly variable, making data cleaning needlessly complex.

Conclusions: Increased standardization of LBP report formats, including standardized room, building component, and surface nomenclature, is needed to create a national housing surveillance system. All current commercially available XRF portable LBP analyzers can download data into electronic files, making handwritten data obsolete. Most labs can provide electronic files with dust and soil data. Improved standardization will help optimal targeting of remediation and future research to ensure children are adequately protected. Such standardization could be accomplished by a revised edition of the HUD lead paint guidelines and/or the establishment of a consensus standard-setting organization, such as the American Society for Testing and Materials (ASTM).

Context objective: Written a decade ago, the 2015 Rural Active Living: A Call to Action (published in 2016) described rural-specific efforts in the fields of active living and physical activity (PA) and identified 8 recommendations to guide rural active living research and practice. Given that rural populations continue to experience a higher burden of PA-related chronic health conditions, the objective of this review was to revisit the 8 Rural Active Living Calls to Action, reassess the evidence base, summarize advances in each area, and identify emerging areas that warrant examination or further study.

Methods: We leveraged expertise from researchers and practitioners within the CDC-funded Physical Activity Policy Research and Evaluation Network Rural Active Living Workgroup and reviewed literature published since the original call to action. Teams were formed for each of the original 8 calls to action. Each team reviewed the literature, synthesized findings, and developed recommendations for future research.

Results: Academic and practice-based progress was evident across multiple of the original calls to action. Despite these findings, the need persists for rural-specific national surveillance data scaled to small geographies (census tract and block group) that accounts for differences within and across rural communities, various forms of rural governance, and how these factors interplay with active living opportunities. Six emerging areas of research (best practices, social issues, COVID-19 effects, collaboration, implementation science, and implications of rural health-related funding changes) are discussed and warrant further study.

Conclusions: In summarizing progress since the original Call to Action, we recommend strategies to continue advancing rural active living and identify emerging focus areas.

This case study examines the challenges and facilitators to implementation and enforcement of Tobacco 21 and Tobacco Retail Licensing policies in Cincinnati, Ohio, from 2019 to 2022. Cincinnati was part of a cohort of communities supported by Interact for Health to develop, implement, and enforce local Tobacco 21 and related policies. The City of Cincinnati policies were initially passed in 2018 after robust coalition-building efforts and the Cincinnati Health Department was tasked with implementation and enforcement. These processes met early challenges including enactment of state and federal Tobacco 21 laws prior to local implementation, the impact of the COVID-19 pandemic and response on local public health efforts, and retailer identification and monitoring limitations. Over time, the Cincinnati Health Department overcame these challenges to successfully implement and enforce the policies through nurturing partnerships with retailers, streamlined retailer tracking, and ongoing education efforts. Adaptability and flexibility were key to gaining traction in a challenging environment. The relationships built with retailers via education and one-on-one support helped ease the transition for local businesses, retailer and public support for the policies grew, and youth reported lower access to and use of tobacco. This case study is based on a 3-year evaluation that highlighted the voices of retailers, an often underrepresented partner in tobacco policy implementation, enforcement, and evaluation.

Context: Efforts in the United States to address the opioid epidemic often include harm reduction approaches. Harm reduction vending machines (HRVMs) are a newer model for distributing harm reduction supplies in the United States, although they have been more widely used for decades in Europe.

Objective: The goal of the current study is to describe the programmatic details and implementation process for a potentially unique HRVM rollout in New York State (NYS), where HRVM implementation was facilitated by a centralized state program (MATTERS). We also describe evaluation data on the experiences of the agencies that agreed to host a machine through the program, to identify the pros and cons of the model and lessons learned for others considering this approach.

Design: Program description and qualitative program evaluation using interviews.

Setting and participants: Fourteen representatives from 12 organizations, collectively hosting 15 vending machines across NYS.

Main outcome: Description of the program structure and process, and identification of themes emerging from the qualitative interviews around the model. A rapid analysis approach was used to identify themes from the data.

Results: Findings revealed: 1) perceptions of how HRVMs fit into overall harm reduction activities; 2) pros (eg, privacy and 24/7 availability) and cons (eg, identifying partners and technological challenges); and 3) lessons learned (eg, thoughtful planning and engagement are critical) that can help inform other organizations considering taking on an HRVM and other entities considering regional or statewide rollout of HRVMs.

Conclusions: Organizations perceived HRVMs as valuable additions to their harm reduction activities and saw few challenges associated with hosting a machine. The centralized rollout process facilitated the ability of individual organizations to implement a machine. Future studies are needed to fully understand the cost-benefit of HRVMs, as well as the impact of HRVMs on key substance use and overdose outcomes.

Developing a skilled governmental public health workforce requires intentional training opportunities that extend beyond foundational skills. Field placement programs, offered through the Public Health Training Center Network, provide students with practical experience while supporting agency capacity. This Practice Brief Report examines governmental public health field placements sponsored by the Region IV Public Health Training Center between 2019 and 2024 (n = 75). Student evaluations showed frequent practice in data analytics and assessment, policy development and program planning, and communication skills, areas reflecting organizational strengths. However, the findings of Public Health Workforce Interest and Needs Survey highlighted critical workforce gaps in higher-level skills such as budget and financial management, policy engagement, and leadership and systems thinking. Field placement experiences offer an opportunity to introduce students to these complex competencies early in their careers. Intentionally integrating higher-level skills into placement design can strengthen student preparation and help ensure a future workforce ready to address evolving public health challenges.