Journal of Public Health Management and Practice最新文献

Context: Adverse childhood experiences (ACEs), substance use disorders (SUDs), and overdose are interconnected issues impacting individuals and communities at multiple levels of the social ecology and across generations. Few studies describe approaches that intentionally and simultaneously address these issues.

Program: This paper examines activities of 15 sites across the country that were designed to simultaneously prevent ACEs, SUD, and overdose. This paper describes the work at the intersection as well as gaps and opportunities. Describing ways to implement intersectional programming may assist other organizations in taking similar steps in their communities.

Implementation: From December 2020 through July 15, 2023, funded sites received technical assistance from the National Association of County and City Health Officials and the Centers for Disease Control and Prevention for 18 months to support the implementation, adaptation, and/or expansion of evidence-based programs to address ACEs, SUD, and overdose.

Evaluation: Activities were coded to identify intersectional interventions that addressed ACEs, SUD, and overdose. Most of the ACEs prevention strategies and overdose prevention priority areas/guiding principles from which communities could choose were represented. Most activities were implemented with caregivers and families and addressed ACEs through interventions to lessen harm or to promote social norms. Primary prevention and coordination of resources were the most used overdose prevention priority area/guiding principle.

Discussion: It is possible to address the intersection of ACEs, SUD, and overdose on a local level. Opportunities to further address the intersection include incorporating more secondary and tertiary prevention strategies, expanding economic supports, and increasing the work focused on equity.

Context: The first case of mpox was detected in the United States in a Laboratory Response Network (LRN) laboratory at the Massachusetts Department of Public Health on May 17, 2022. Through previous years of smallpox preparedness efforts by the United States government, testing capacity in LRN laboratories across the United States utilizing the FDA-cleared Centers for Disease Control and Prevention (CDC) Non-variola orthopoxvirus (NVO) test was approximately 6000 tests weekly across the nation prior to the mpox outbreak. By early June 2022, the LRN laboratories had capacity to perform up to 8000 tests per week. As the outbreak expanded, cases were identified in every United States state, peaking at ~3000 cases per week nationally in August 2022.

Objective: Although NVO testing capacity in LRN laboratories exceeded national mpox testing demand overall, LRN testing access in some areas was challenged and test expansion was necessary.

Participants: CDC engaged with partners and select commercial laboratories early to increase diagnostic testing access by allowing these commercial laboratories to utilize the NVO test.

Setting: The expansion of testing to commercial laboratories increased testing availability, capacity, and volume nationwide. This was the first time that CDC shared an FDA 510k-cleared molecular test with commercial laboratories to support a public health emergency.

Design: Extensive efforts were made to ensure the CDC NVO test was used appropriately in the private sector and that the transfer process met regulatory requirements.

Main outcome measures, results, conclusions: These novel methods to expand NVO testing to commercial laboratories increased national testing capacity to 80 000 mpox tests/week. Test volumes among these laboratories never exceeded this expanded capacity. The rapid increase in the nation's testing capacity, in conjunction and coordination with other public and private health efforts, helped to detect cases rapidly. These actions demonstrated the importance of highly functional and efficient public health and private sector partnerships for responding to public health emergencies.

Context: In process evaluation research, secular trends refer to external factors unrelated to an intervention that impact implementation. The COVID-19 pandemic was a secular trend that affected the implementation of the Nutritious Eating with Soul (NEW Soul) study.

Objective: This paper describes steps taken in modifying intervention delivery due to the secular trend of the pandemic. This paper also addresses process evaluation measures of dose delivered, dose received, and satisfaction.

Design: This study is a longitudinal study.

Setting: The study took place in Columbia, SC, from 2018 to 2021.

Participants: African American adults between 18 and 65 years old.

Intervention: The NEW Soul study, a dietary lifestyle intervention, lasted 24 months.

Main outcome measures: Process evaluation variables of dose delivered, dose received, and satisfaction.

Results: The study team shifted intervention delivery and maintained the timeline of classes for participants and intervention activities. Dose delivered was higher in-person (7.0 out of 8) compared to online (6.4 out of 8; t = -3.92, P = .002). Attendance was higher in-person compared to online (t = 2.80, P = .006). Overall, satisfaction of the intervention was favorable in-person and online. Helpfulness of nutrition information in the class was rated lower online compared to in-person (t = 2.05, P = .04).

Conclusions: Even though the study team successfully shifted intervention delivery online, dose delivered was higher in-person. Evaluations of classes remained high across cohorts and for in-person and online classes. Future lifestyle interventions working with African American adults requires consistent flexibility in intervention delivery.

Objective: This study aimed to assess the opinions, attitudes, and behaviors of family physicians in Türkiye regarding mandatory communicable disease notification.

Design: Cross-sectional study.

Setting: A national online survey in Türkiye.

Participants: This study was conducted among 397 family physicians from different geographical regions in Türkiye.

Main outcome measures: Family physicians' opinions, attitudes, and behaviors regarding infectious disease notification.

Results: The majority of family physicians (69.3%) felt inadequate in terms of knowledge about the notification system and 70.3% desired post-graduation training on communicable disease reporting. About one-third of the participants were dissatisfied with the current notification system. Reasons for under-reporting included lack of time, lack of feedback, and uncertainty about post-notification procedures. Factors significantly associated with higher infectious disease notification attitude scores (IDNAS) were receiving training on communicable disease reporting, feeling competent about reporting, and being satisfied with the reporting system (P < .001). However, physicians who admitted choosing a different ICD code to avoid filling out an infectious disease notification form had lower IDNAS scores (P < .001).

Conclusion: This study highlights knowledge gaps and negative attitudes among family physicians in Türkiye regarding infectious disease reporting. Addressing these challenges requires continuous education and training programs. Feedback mechanisms should be improved to enhance physicians' engagement in the notification process. Reducing the workload of family physicians and simplifying the reporting process may also contribute to higher compliance with mandatory communicable disease reporting.

Context: Multisector community partnerships play a pivotal role in public health strategy for understanding and addressing social determinants of health (SDOH) and promoting health equity. The work of these partnerships is well aligned with building community resilience.

Program: The Year 2 Improving Social Determinants of Health-Getting Further Faster (GFF) retrospective evaluation was designed to gather practice-based evidence that can inform future community-driven partnerships to improve chronic disease outcomes and advance health equity by addressing social determinants of health (SDOH).

Implementation: This paper sought to determine how the efforts of multisector community partnerships could also support community resilience. Guided by CDC's Framework for Program Evaluation in Public Health and health equity principles, the GFF evaluation engaged 14 Multisector Community Partnerships to better understand how their SDOH interventions contribute to community changes that improve chronic diseases and advance health equity. Data collection included qualitative discussions along with additional quantitative analyses of SDOH outcomes, costs, and prevention impacts. This paper focuses on insights gathered from qualitative discussions (2 virtual 60-minute discussions with members of each of the 14 Partnerships) around community resilience.

Evaluation: Results from qualitative discussions demonstrate how Partnerships' SDOH efforts created parallel opportunities for nurturing community resilience. For example, Partnerships engaged community members in the design and implementation of SDOH interventions in ways that nurtured a sense of belonging and empowerment to shape their community. To further build community resilience, Partnerships mentioned the importance of sustained and flexible funding, help building stronger partnerships, and a shared goal to build resilience and engage community members.

Discussion: Findings indicate that community partnerships working to address SDOH can drive reciprocal improvements in community resilience-contributions that are critical for advancing health equity. Partnerships suggested that health departments may have opportunities to enhance community resilience through their role as funder, facilitator, and convener.

Objective: This study aimed to assess the quality of community health assessments (CHA) and community health improvement plans conducted by Public Health Accreditation Board (PHAB)-accredited local health departments (LHDs) in Kentucky.

Design: Quality assessment of CHAs and community health improvement plan documents using criteria adapted from Pennel et al (2015).

Setting: PHAB-accredited LHDs in Kentucky.

Participants: Seventeen CHAs and community health improvement plan documents from PHAB-accredited LHD.

Main outcome measures: Quality scores based on 17 evaluation criteria, including stakeholder involvement, data examination, plan feasibility, and LHD-hospital collaboration.

Results: The study found significant variation in the quality of CHAs and community health improvement plan documents. The highest scores were for partner involvement, data examination, and plan feasibility. The lowest scores were for LHD-hospital collaboration, use of evidence-based strategies, and plan evaluation. No community variables significantly predicted overall report scores.

Conclusions: The quality of CHAs and community health improvement plan documents varies among Kentucky LHDs, highlighting the need for more robust guidance and standardized criteria. Strengthening hospital-LHD collaboration and focusing on evidence-based strategies can improve public health outcomes.

Implications for policy and practice: Enhancing CHAs and community health improvement plan processes through legislative changes, better guidance, and improved collaboration between hospitals and LHD can lead to more effective public health interventions and outcomes.

Compared with traditional measures of scientific impact, the CDC Science Impact Framework more broadly, directly, and quickly assesses impact of public health science. For 20 CDC-funded HIV prevention projects that were conducted during 2018-2022, health departments documented impact, based on CDC Science Impact Framework domains: Disseminating Science, Creating Awareness, Catalyzing Action, Effecting Change, and Shaping the Future. Health departments reported 282 impacts: the most common were new partnerships (n = 17, Catalyzing Action), capacity building (n = 16, Effecting Change), new projects or initiatives begun (n = 15, Shaping the Future), new collaborations (n = 14, Catalyzing Action), improved program (n = 13, Shaping the Future), new guidelines or practices (n = 13, Effecting Change), and informed persons affected by work (n = 13, Creating Awareness). Health departments documented substantial impact with a simple, timely, and broad approach. Demonstrating impact is important for community-based organizations, funders, and others interested in public health and helps them better understand the value of public health.

Objectives: To propose a framework for adoption of privacy-preserving record linkage (PPRL) for public health applications.

Methods: Twelve interviews with subject matter experts (SMEs) were conducted virtually and coded using an inductive approach. A collaborative session was conducted with SMEs to identify key steps in the PPRL project lifecycle which informed development of a PPRL implementation checklist.

Results: This framework has 2 decision-making levels: the organization level and the project or program level. Organization-level considerations include PPRL governance, the optimal choice among approved PPRL solutions, the need for longitudinal linkages, the potential issue of vendor lock-in, and costs. Program-level considerations include characteristics of the PPRL use case, linkage quality and accuracy, data privacy and use, security thresholds, compatibility with data owners' data architecture, and trade-offs between open-source and commercial PPRL solutions. A PPRL implementation checklist was developed to guide public health practitioners considering PPRL for data linkage.

Conclusions: The framework may be considered by public health entities to guide adoption and implementation of PPRL in public health research and surveillance. Public health experts may refer to this framework and the PPRL implementation checklist when determining the appropriateness of PPRL for specific use cases and implementation planning.

Objective: State public health departments use federal funding to examine and address social determinants of health (SDOH) within their communities to improve health and advance health equity. Yet, most federal funding is categorical (ie, funding used for a specific program or narrow purpose), which can create barriers to addressing social and structural drivers of inequity. The Preventive Health and Health Services Block Grant (PHHS Block Grant) is a flexible funding mechanism that provides health departments the latitude to identify and fund initiatives that address local public health needs. It is unclear, however, to what extent health departments use this flexible resource to incorporate SDOH into their programs.

Design: Cross-sectional, descriptive analysis of state health department PHHS Block Grant program administrative data.

Setting: This study examined PHHS Block Grant budgets and workplans for the federal Fiscal Year 2021 to assess whether state health departments aligned their grant-funded program with the national objectives associated with the Healthy People 2030 SDOH Framework.

Participants: Forty-seven states and the District of Columbia were included in this study.

Main outcome measures: Percent of states that used PHHS Block Grant funds to address SDOH; proportion of funding allocated to address SDOH; percentage of programs that addressed SDOH.

Results: Three-fourths (75%) of states allocated funds to 97 programs aligning with at least 1 Healthy People 2030 SDOH-related objective. Fifty of the programs were fully or primarily funded by the PHHS Block Grant. Results also show that as the states' PHHS Block Grant funding level increased so did the percent of states that allocated funding toward SDOH programs.

Conclusion: This study shows that state health departments are using the PHHS Block Grant to address SDOH, and that the grant plays an important funding role for these programs. States are incorporating the grant into their funding strategies to address SDOH.