Journal of Public Health Policy最新文献

Health care provider retention is important for mitigating workforce shortages in underserved areas. The National Health Service Corps (NHSC) provides loan repayment for a two or three-year service commitment from clinicians to work in underserved areas. Prior studies have mixed findings as to what influences clinician retention and have focused mainly on individual-level background characteristics. We used measures of NHSC clinicians' work environment during their service experience, in addition to background characteristics, to identify patterns of experiences, and assess whether these patterns were associated with post-service intentions. We observed that technical assistance and job resources were more influential on clinicians' intentions, compared to individual- or community-level characteristics. Organizations with efficient and supportive work environments may help retain clinicians in underserved areas.

This study investigates the prevalence and determinants of readiness for quality antenatal care (ANC) services in Bangladesh using data from the 2017 Bangladesh Health Facility Survey (BHFS). We assessed the association between selected factors and the readiness index using multinomial logistic regression. We identified a significant gap in the availability and quality of ANC services, only 4.26% of health facilities provide quality ANC services, with rural facilities showing lower readiness compared to urban facilities (RRR:0.13; 95% CI: 0.06-0.31; p < 0.001). Community clinics and private hospitals have a lower likelihood of medium or high readiness compared to public hospitals or clinics. Health facilities with specialized care are more likely to demonstrate readiness for quality ANC services. Policy recommendations include increased healthcare funding, implementation of ANC guidelines, strengthened monitoring and evaluation of health facilities, and heightened community awareness. These measures should improve ANC, overall health outcomes, and public health policies.

There is a need for careful examination of large volumes of collected (structured and unstructured) information related to school-based evaluation. There is also no published, comprehensive framework/s for evaluating complex interventions in Irish primary schools. The aim of this paper is to outline a methodology for process evaluation of an Irish primary school-based physical activity (PA) and nutrition intervention. Evaluation followed the three themes outlined by the British Medical Research Council: implementation, context, and mechanism of impact that we further divided into six dimensions. Methodological tools included questionnaires, PA logs, reflective journals, write and draw, and semi-structured interviews. We triangulated findings across these multiple tools to assess each dimension. We designed a unique framework to enable comparisons and offer researchers a template for evaluating complex health promotion interventions in primary schools. We present a methodology for evaluating a complex school-based health promotion intervention. The framework we propose integrates process and outcome data. It aims to enhance future result interpretation and facilitate informed comparisons among intervention schools.

Current evidence implicates educational pressures and reduced outdoor time as major causes of myopia. This paper examines the ongoing battle against the myopia epidemic in East Asia, including its cultural offshoots such as Singapore, where over 80% of young adults are myopic. East Asian societies share deeply rooted Confucian values that attach great importance to education and familial obligations, with heavy parental investment in education and the perception that academic excellence reflects filial piety. Coupled with a strong emphasis on standardised test results, East Asian children face intense educational pressures from a young age. Existing education-based myopia prevention strategies focus either on top-down school reforms to promote more outdoor time for students during school hours or on bottom-up awareness initiatives encouraging lifestyle changes. However, the entrenched Confucian worldview suggests that more extensive top-down reforms aimed at reducing competition in education, combined with widespread bottom-up awareness initiatives targeting the public-particularly parents, given their active involvement in children's education outside of school-may be required to truly turn the tide on myopia.

Armenia's early adoption of telemedicine began with the National Aeronautics and Space Administration (NASA) collaboration following the 1988 Spitak earthquake, providing critical medical support. The 2022 legalization of telemedicine by the Armenian Ministry of Health marked a significant step toward improving healthcare delivery. Current regulations only apply to doctors and lack clear terminology for different telemedicine interactions, highlighting the need for broader and more inclusive policies. Despite regulatory progress, telemedicine adoption in Armenia faces challenges such as insufficient digital literacy, infrastructure, and integration into medical education and practice.

The dramatic growth in the rate of diabetes prompts serious debates about awareness, early diagnosis, and care interventions. This Viewpoint aims to explore, from the perspectives of healthcare sector representatives, what challenges and difficulties they face in dealing with diabetes and how these can be overcome. We applied the World Café method for group discussions, which enabled us to bring together 50 stakeholders. They identified challenges at institutional and structural levels under the concepts of awareness, digitalisation, and new forms of care and shared their suggestions for feasible solutions. We learned there is a need for a diabetes map of Germany to identify risk groups and that hybrid solutions should be implemented for treatment, care, prevention, and early diagnosis, considering digital infrastructure. Also, the demand for digital innovation in the healthcare system raised concerns about information transparency and data management.

Household food insecurity is associated with both low income and high cost of living, it is a potentially better measure for consumption compared to income. We use data on food insecurity and income from 10 years of the Canadian Community Health Survey (2007-2017) of single-person households (n = 145,044) to estimate the probability of being food insecure at the Canadian poverty thresholds (Market Basket Measure thresholds, or MBMs), and determine the income required to reach that probability in each MBM region, aggregated by province and rural/urban status. A regression model shows the probability of being food insecure at the MBM is approximately 30% which we call the Food Insecurity Poverty Line (FIPL). The income required to meet the FIPL is substantially different from the MBM, sometimes 1.25 times the MBM. This implies that food insecurity is a potential sentinel measure for poverty.

Growing debates about algorithmic bias in public health surveillance lack specific examples. We tested a common assumption that exposure and illness periods coincide and demonstrated how algorithmic bias can arise due to missingness of critical information related to illness and exposure durations. We examined 9407 outbreaks recorded by the United States National Outbreak Reporting System (NORS) from January 1, 2009 through December 31, 2019 and detected algorithmic bias, a systematic over- or under-estimation of foodborne disease outbreak (FBDO) durations due to missing start and end dates. For 7037 (75%) FBDOs with complete date-time information, ~ 60% reported that the exposure period ended before the illness period started. For 2079 (87.7%) FBDOs with missing exposure dates, average illness durations were ~ 5.3 times longer (p < 0.001) than those with complete information, prompting the potential for algorithmic bias. Modern surveillance systems must be equipped with investigative capacities to examine and assess structural data missingness that can lead to bias.