Pub Date : 2024-09-13DOI: 10.1097/phh.0000000000002067
Meron Siira,Kristin R V Harrington,Kwardel Lewis,Elizabeth Rothschild,Tracie Graham,Sharon R Rabinovitz,Samuel Shartar,Theresa Milazzo,Monica Crubezy,Aaron Olsen,David Clark,Alexander Isakov,Allison Chamberlain,Enku Gelaye,Minzhi Xing,Calvin Patimeteeporn,J Peter Cegielski,Neel R Gandhi
CONTEXTThe coronavirus disease 2019 (COVID-19) pandemic devastated societies and economies worldwide. Given the major disruptions to higher education, reflection on university responses to the COVID-19 pandemic may provide insights for future outbreaks.OBJECTIVEHere, we describe the epidemiology of COVID-19 on the Emory University campus during the 2020-2021 academic year and provide an evaluation of the performance of a university-led program with the purpose of describing the effectiveness of efforts to augment the public health authority's case investigation and contact tracing efforts during a public health emergency.DESIGNEvaluation of a case investigation and contact tracing program regarding operations, timeliness, and performance.MAIN OUTCOME MEASURESWe analyzed quality metrics to determine the proportion of cases and contacts interviewed and the time to completion of each step from case diagnosis to testing of contacts.RESULTSDuring the 2020-2021 academic year, 1267 COVID-19 cases among Emory students, faculty, and staff were confirmed by polymerase chain reaction, with 1132 reported close contacts. Among cases, the median test turnaround time was 1 day (interquartile range: 1, 2). Among both cases and close contacts, 98% were successfully interviewed. The team called a majority of cases on the same day as their test result was reported to the program (87%; n = 1052). Almost all (98%; n = 1247) cases completed isolation or were advised to isolate during the review period. Close to half (46%; n = 513) of contacts interviewed began quarantine before their interview. Among close contacts interviewed, 13% (n = 145) subsequently converted to an index case.CONCLUSIONSThe impact and performance of Emory's program may provide useful and actionable data for future university-led infectious disease outbreak response programs. The program structure, performance metrics, and information collected via interviews provide practical implications and an organized structure to guide other programs during future outbreaks.
{"title":"Impact of a University-Led COVID-19 Case Investigation and Contact Tracing Program.","authors":"Meron Siira,Kristin R V Harrington,Kwardel Lewis,Elizabeth Rothschild,Tracie Graham,Sharon R Rabinovitz,Samuel Shartar,Theresa Milazzo,Monica Crubezy,Aaron Olsen,David Clark,Alexander Isakov,Allison Chamberlain,Enku Gelaye,Minzhi Xing,Calvin Patimeteeporn,J Peter Cegielski,Neel R Gandhi","doi":"10.1097/phh.0000000000002067","DOIUrl":"https://doi.org/10.1097/phh.0000000000002067","url":null,"abstract":"CONTEXTThe coronavirus disease 2019 (COVID-19) pandemic devastated societies and economies worldwide. Given the major disruptions to higher education, reflection on university responses to the COVID-19 pandemic may provide insights for future outbreaks.OBJECTIVEHere, we describe the epidemiology of COVID-19 on the Emory University campus during the 2020-2021 academic year and provide an evaluation of the performance of a university-led program with the purpose of describing the effectiveness of efforts to augment the public health authority's case investigation and contact tracing efforts during a public health emergency.DESIGNEvaluation of a case investigation and contact tracing program regarding operations, timeliness, and performance.MAIN OUTCOME MEASURESWe analyzed quality metrics to determine the proportion of cases and contacts interviewed and the time to completion of each step from case diagnosis to testing of contacts.RESULTSDuring the 2020-2021 academic year, 1267 COVID-19 cases among Emory students, faculty, and staff were confirmed by polymerase chain reaction, with 1132 reported close contacts. Among cases, the median test turnaround time was 1 day (interquartile range: 1, 2). Among both cases and close contacts, 98% were successfully interviewed. The team called a majority of cases on the same day as their test result was reported to the program (87%; n = 1052). Almost all (98%; n = 1247) cases completed isolation or were advised to isolate during the review period. Close to half (46%; n = 513) of contacts interviewed began quarantine before their interview. Among close contacts interviewed, 13% (n = 145) subsequently converted to an index case.CONCLUSIONSThe impact and performance of Emory's program may provide useful and actionable data for future university-led infectious disease outbreak response programs. The program structure, performance metrics, and information collected via interviews provide practical implications and an organized structure to guide other programs during future outbreaks.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CONTEXTTraining developers and educators play a crucial role in building strategic skills among the public health workforce. They prepare the workforce to respond to and address emerging concerns and priorities, including on the topics of health equity and diversity, equity, inclusion, and accessibility (DEIA).OBJECTIVEThe purpose of this semisystematic literature review was to identify current evidence-based methods that training developers and educators can apply when teaching DEIA and health equity principles to public health practitioners from various disciplines in the workforce.DESIGNWe conducted a semisystematic literature review because this methodology's purpose is to extract rich, in-depth descriptions that matched the aim to find evidence-based teaching methods to apply.RESULTSSix methods that hold promise for effective teaching health equity and DEIA principles emerged as themes: Critical Reflection, Service Learning, Case Studies, Peer-Learning/Dialogue, Workshops, and Simulation Learning.CONCLUSIONSConsiderations for best practice identified in this literature review include using multimodal approach to support different learning styles among diverse audiences, tailoring content based on training needs analysis recommendations, and considering onus placed on instructors and learners depending on the content and setting.
{"title":"Methods for Teaching Health Equity and Diversity, Equity Inclusion, and Accessibility to Public Health Practitioners: A Semisystematic Review of the Literature.","authors":"Brianne Bostian Yassine,Kaila Graham,Sierra Sledge,Michelle Carvalho","doi":"10.1097/phh.0000000000002063","DOIUrl":"https://doi.org/10.1097/phh.0000000000002063","url":null,"abstract":"CONTEXTTraining developers and educators play a crucial role in building strategic skills among the public health workforce. They prepare the workforce to respond to and address emerging concerns and priorities, including on the topics of health equity and diversity, equity, inclusion, and accessibility (DEIA).OBJECTIVEThe purpose of this semisystematic literature review was to identify current evidence-based methods that training developers and educators can apply when teaching DEIA and health equity principles to public health practitioners from various disciplines in the workforce.DESIGNWe conducted a semisystematic literature review because this methodology's purpose is to extract rich, in-depth descriptions that matched the aim to find evidence-based teaching methods to apply.RESULTSSix methods that hold promise for effective teaching health equity and DEIA principles emerged as themes: Critical Reflection, Service Learning, Case Studies, Peer-Learning/Dialogue, Workshops, and Simulation Learning.CONCLUSIONSConsiderations for best practice identified in this literature review include using multimodal approach to support different learning styles among diverse audiences, tailoring content based on training needs analysis recommendations, and considering onus placed on instructors and learners depending on the content and setting.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-13DOI: 10.1097/phh.0000000000001983
Zoe Lindenfeld,Amanda I Mauri,Ji E Chang
CONTEXTPrior studies have examined the social determinants of health (SDOH) characteristics of counties with elevated rates of overdose deaths. However, this research often ignores variation in upstream governmental investment in these SDOH categories.OBJECTIVETo examine the association of local governmental investments in SDOH with drug overdose mortality at the county level, controlling for demographic and socioeconomic characteristics.DESIGNLongitudinal analysis from 2017 to 2020.SETTINGUnited States counties.PARTICIPANTS3126 counties.MAIN OUTCOME AND MEASURESThe primary study outcome was county overdose death rates per 100 000 population taken from the Centers for Disease Control and Prevention. The main predictor of interest was the per capita average of local governmental expenditures in public health, social service, and education drawn from the U.S. Census of Governments, categorized into quartiles. Covariates included county-level socioeconomic and demographic characteristics as well as county-level SUD services from the AHRQ SDOH Database.RESULTSIn longitudinal multivariate linear regression models with state and year fixed effects, counties in the highest 3 quartiles of SDOH spending had significantly lower rates of overdose deaths compared with counties in the lowest quartile of SDOH spending; in particular, counties in quartile 2 had an average of 9.09 fewer overdose deaths per 100 000 population (95% CI: -12.58, -5.60), counties in quartile 3 had an average of 13.18 fewer deaths per 100 000 population (95% CI: -17.56; -8.80), and counties in quartile 4 had an average of 13.92 deaths per 100 000 population (95% CI: -19.16, -8.68).CONCLUSIONSOur findings demonstrate that higher levels of local governmental investments in SDOH were associated with significantly lower rates of overdose death in U.S. counties after controlling for socioeconomic and demographic characteristics. Going forward, research should focus on determining causality in this relationship, the mechanisms through which this relationship occurs, as well as assess the impact of local public health expenditures allocated toward SUD prevention and treatment specifically on substance use outcomes at the local level.
{"title":"Examining the Relationship Between Local Governmental Expenditures on the Social Determinants of Health and County-Level Overdose Deaths, 2017-2020.","authors":"Zoe Lindenfeld,Amanda I Mauri,Ji E Chang","doi":"10.1097/phh.0000000000001983","DOIUrl":"https://doi.org/10.1097/phh.0000000000001983","url":null,"abstract":"CONTEXTPrior studies have examined the social determinants of health (SDOH) characteristics of counties with elevated rates of overdose deaths. However, this research often ignores variation in upstream governmental investment in these SDOH categories.OBJECTIVETo examine the association of local governmental investments in SDOH with drug overdose mortality at the county level, controlling for demographic and socioeconomic characteristics.DESIGNLongitudinal analysis from 2017 to 2020.SETTINGUnited States counties.PARTICIPANTS3126 counties.MAIN OUTCOME AND MEASURESThe primary study outcome was county overdose death rates per 100 000 population taken from the Centers for Disease Control and Prevention. The main predictor of interest was the per capita average of local governmental expenditures in public health, social service, and education drawn from the U.S. Census of Governments, categorized into quartiles. Covariates included county-level socioeconomic and demographic characteristics as well as county-level SUD services from the AHRQ SDOH Database.RESULTSIn longitudinal multivariate linear regression models with state and year fixed effects, counties in the highest 3 quartiles of SDOH spending had significantly lower rates of overdose deaths compared with counties in the lowest quartile of SDOH spending; in particular, counties in quartile 2 had an average of 9.09 fewer overdose deaths per 100 000 population (95% CI: -12.58, -5.60), counties in quartile 3 had an average of 13.18 fewer deaths per 100 000 population (95% CI: -17.56; -8.80), and counties in quartile 4 had an average of 13.92 deaths per 100 000 population (95% CI: -19.16, -8.68).CONCLUSIONSOur findings demonstrate that higher levels of local governmental investments in SDOH were associated with significantly lower rates of overdose death in U.S. counties after controlling for socioeconomic and demographic characteristics. Going forward, research should focus on determining causality in this relationship, the mechanisms through which this relationship occurs, as well as assess the impact of local public health expenditures allocated toward SUD prevention and treatment specifically on substance use outcomes at the local level.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVETo summarize and examine data collected from the first-ever Public Health Workforce Interests and Needs Survey Maternal and Child Health (MCH) module.DESIGN, SETTING, AND PARTICIPANTSResponses from MCH governmental public health employees in 47 state health departments and 288 local health departments (LHDs) in the United States.MAIN OUTCOME MEASUREDemographic characteristics; 4 measures from the MCH module: the importance of and skill level in 5 MCH competencies in daily work, growth and leadership development opportunities, and additional workforce development needs.RESULTSThe MCH workforce predominantly self-identified as women (91.2%) and as White, non-Hispanic (55.2%). At least 70% of respondents reported MCH competencies as important in their daily work, but only 44% to 57% reported being proficient in those competencies. The MCH workforce in LHDs were less likely than those in state health departments to report being proficient in MCH competencies (adjusted prevalence rate ratio range: 0.83-0.92) or have growth and leadership development opportunities (adjusted prevalence rate ratio range 0.76-0.90).CONCLUSIONThe MCH module highlights a need to further prioritize workforce development efforts for governmental public health staff, especially in LHDs. There is an ongoing need to meet public health professionals where they are and to tailor training models and workforce development plans to account for new and ongoing stressors faced by the workforce.
{"title":"The Maternal and Child Health Workforce: A Snapshot of Current and Future Needs From Public Health WINS 2021.","authors":"Michelle Menser Tissue,Julie Fife Donney,Amy Mullenix,Kay Schaffer,Caroline Stampfel,Lauren Raskin Ramos,Dorothy Cilenti","doi":"10.1097/phh.0000000000002020","DOIUrl":"https://doi.org/10.1097/phh.0000000000002020","url":null,"abstract":"OBJECTIVETo summarize and examine data collected from the first-ever Public Health Workforce Interests and Needs Survey Maternal and Child Health (MCH) module.DESIGN, SETTING, AND PARTICIPANTSResponses from MCH governmental public health employees in 47 state health departments and 288 local health departments (LHDs) in the United States.MAIN OUTCOME MEASUREDemographic characteristics; 4 measures from the MCH module: the importance of and skill level in 5 MCH competencies in daily work, growth and leadership development opportunities, and additional workforce development needs.RESULTSThe MCH workforce predominantly self-identified as women (91.2%) and as White, non-Hispanic (55.2%). At least 70% of respondents reported MCH competencies as important in their daily work, but only 44% to 57% reported being proficient in those competencies. The MCH workforce in LHDs were less likely than those in state health departments to report being proficient in MCH competencies (adjusted prevalence rate ratio range: 0.83-0.92) or have growth and leadership development opportunities (adjusted prevalence rate ratio range 0.76-0.90).CONCLUSIONThe MCH module highlights a need to further prioritize workforce development efforts for governmental public health staff, especially in LHDs. There is an ongoing need to meet public health professionals where they are and to tailor training models and workforce development plans to account for new and ongoing stressors faced by the workforce.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12DOI: 10.1097/phh.0000000000002011
Emily Yette,Rachel Marusinec,Craig Conlon,Thi T Hang Pham,Mehlika Toy,Samuel So,Robert J Wong,Amit S Chitnis
CONTEXTIn the United States, chronic hepatitis B (CHB) virus infection predominantly affects ethnic minorities and vulnerable populations.OBJECTIVEWe analyzed surveillance data to describe CHB epidemiology to guide hepatitis B virus (HBV) elimination efforts in Alameda County.DESIGNPersons with CHB during 2017-2021 were identified by ≥2 positive HBV tests (ie, HBsAg, HbeAg, and HBV DNA) ≥180 days apart using data from California Reportable Disease Information Exchange. Persons with CHB were stratified by age, race/ethnicity, zip code-based Healthy Places Index (HPI), and federally designated Medically Underserved Areas (MUA). Comparisons of reported CHB prevalence between groups utilized z test; comparisons between MUA regions utilized chi-square testing.RESULTSA total of 8122 persons with CHB were identified; reported 5-year CHB prevalence was 0.53% (95% confidence interval: 0.52%-0.54%). Reported CHB 5-year prevalence was significantly higher among persons aged 50 to 69 years old than persons aged 30 to 49 years old (0.99%, 0.78%; P < .001) and Asians, Native Hawaiian/Pacific Islanders, African Americans compared to Whites (1.22%, 0.56%, 0.18%, 0.06%; P < .001). Reported CHB 5-year prevalence in the 2 lowest and most disadvantaged HPI quartiles was significantly higher than the 2 highest quartiles (0.55%, 0.68%, 0.37%, 0.42%; P < .001). The 1918 persons with CHB in MUA, compared to 5859 non-MUA persons, were significantly more likely to be African American (7%, 3%; P < .001) and from the lowest HPI quartile (79%, 19%; P < .001).CONCLUSIONSReported CHB 5-year prevalence in Alameda County was 1.5 times the national prevalence estimates, and reported prevalence was highest among Asians and persons in more disadvantaged areas. Analysis of local CHB surveillance data can guide public health efforts toward HBV elimination.
在美国，慢性乙型肝炎（CHB）病毒感染主要影响少数民族和弱势群体。OBJECTIVEWe analyzed surveillance data to describe CHB epidemiology to guide hepatitis B virus (HBV) elimination efforts in Alameda County.DesignPersons with CHB during 2017-2021 were identified by ≥2 positive HBV tests (ie, HBsAg, HbeAg, and HBV DNA) ≥180 days apart using data from California Reportable Disease Information Exchange.CHB 患者按年龄、种族/民族、基于邮政编码的健康场所指数 (HPI) 和联邦指定的医疗服务不足地区 (MUA) 进行了分层。结果共发现 8122 名 CHB 患者；报告的 5 年 CHB 患病率为 0.53%（95% 置信区间：0.52%-0.54%）。报告的 CHB 5 年流行率中，50 至 69 岁人群明显高于 30 至 49 岁人群（0.99%，0.78%；P < .001），亚裔、夏威夷原住民/太平洋岛民、非裔美国人明显高于白人（1.22%，0.56%，0.18%，0.06%；P < .001）。报告的 CHB 5 年患病率中，HPI 最低和最弱势的 2 个四分位数明显高于最高的 2 个四分位数（0.55%、0.68%、0.37%、0.42%；P < .001）。结论阿拉米达县报告的 5 年慢性阻塞性肺病患病率是全国患病率估计值的 1.5 倍，报告的患病率在亚裔和较贫困地区的人群中最高。对当地 CHB 监测数据的分析可指导公共卫生工作，以消除 HBV。
{"title":"Epidemiology of Chronic Hepatitis B Virus Infection, Alameda County, California, 2017-2021.","authors":"Emily Yette,Rachel Marusinec,Craig Conlon,Thi T Hang Pham,Mehlika Toy,Samuel So,Robert J Wong,Amit S Chitnis","doi":"10.1097/phh.0000000000002011","DOIUrl":"https://doi.org/10.1097/phh.0000000000002011","url":null,"abstract":"CONTEXTIn the United States, chronic hepatitis B (CHB) virus infection predominantly affects ethnic minorities and vulnerable populations.OBJECTIVEWe analyzed surveillance data to describe CHB epidemiology to guide hepatitis B virus (HBV) elimination efforts in Alameda County.DESIGNPersons with CHB during 2017-2021 were identified by ≥2 positive HBV tests (ie, HBsAg, HbeAg, and HBV DNA) ≥180 days apart using data from California Reportable Disease Information Exchange. Persons with CHB were stratified by age, race/ethnicity, zip code-based Healthy Places Index (HPI), and federally designated Medically Underserved Areas (MUA). Comparisons of reported CHB prevalence between groups utilized z test; comparisons between MUA regions utilized chi-square testing.RESULTSA total of 8122 persons with CHB were identified; reported 5-year CHB prevalence was 0.53% (95% confidence interval: 0.52%-0.54%). Reported CHB 5-year prevalence was significantly higher among persons aged 50 to 69 years old than persons aged 30 to 49 years old (0.99%, 0.78%; P < .001) and Asians, Native Hawaiian/Pacific Islanders, African Americans compared to Whites (1.22%, 0.56%, 0.18%, 0.06%; P < .001). Reported CHB 5-year prevalence in the 2 lowest and most disadvantaged HPI quartiles was significantly higher than the 2 highest quartiles (0.55%, 0.68%, 0.37%, 0.42%; P < .001). The 1918 persons with CHB in MUA, compared to 5859 non-MUA persons, were significantly more likely to be African American (7%, 3%; P < .001) and from the lowest HPI quartile (79%, 19%; P < .001).CONCLUSIONSReported CHB 5-year prevalence in Alameda County was 1.5 times the national prevalence estimates, and reported prevalence was highest among Asians and persons in more disadvantaged areas. Analysis of local CHB surveillance data can guide public health efforts toward HBV elimination.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12DOI: 10.1097/phh.0000000000002046
Ashlyn Burns,Haleigh Kampman,Harshada Karnik,Jonathon P Leider,Valerie A Yeager
OBJECTIVEWhen pursuing accreditation by the Public Health Accreditation Board, local health departments (LHDs) must submit a workforce development plan (WDP). The purpose of this study was to examine LHD characteristics associated with workforce gaps identified and strategies implemented by LHDs.DESIGNWe conducted a qualitative content analysis of all WDPs submitted to the Public Health Accreditation Board between March 2016 and November 2021.SETTINGWe examined WDPs from all accredited LHDs (n = 183) at the time of data collection in January 2022. A majority of LHDs had more than 50 staff members (n = 106, 57.9%), had a decentralized governance structure (n = 164, 89.6%), had county-level jurisdictions (n = 99, 54.1%), and served rural populations (n = 146, 79.8%).MAIN OUTCOME MEASURESFor each overarching theme, we constructed 2 binary variables indicating whether the LHD identified a workforce gap or strategy among any subthemes within each overarching theme. Logistic regressions were used to examine relationships between LHD characteristics and identification of a workforce gap or strategy for each theme.RESULTSFew LHD characteristics were significantly associated with gaps identified or strategies implemented by LHDs. LHDs applying for reaccreditation had higher odds (adjusted odds ratio [AOR], 2.44; confidence interval [CI], 1.04-5.83) of identifying a leadership gap and of identifying a recruitment gap (AOR, 2.94; CI, 1.11-7.52) compared to LHDs applying for accreditation for the first time. LHDs serving urban populations had higher odds (AOR, 2.83; CI, 1.32-6.25) of identifying a recruitment strategy compared to LHDs that only served suburban/rural populations.CONCLUSIONSOverall, many workforce gaps reported by LHDs were universally observed irrespective of LHD characteristics. While most LHDs identified strategies to address gaps, our findings also reveal workforce areas where LHDs reported gaps without an accompanying strategy, indicating areas where LHDs could use more technical assistance and support.
{"title":"Accredited Public Health Department Characteristics Associated With Workforce Gaps Identified in Workforce Development Plans.","authors":"Ashlyn Burns,Haleigh Kampman,Harshada Karnik,Jonathon P Leider,Valerie A Yeager","doi":"10.1097/phh.0000000000002046","DOIUrl":"https://doi.org/10.1097/phh.0000000000002046","url":null,"abstract":"OBJECTIVEWhen pursuing accreditation by the Public Health Accreditation Board, local health departments (LHDs) must submit a workforce development plan (WDP). The purpose of this study was to examine LHD characteristics associated with workforce gaps identified and strategies implemented by LHDs.DESIGNWe conducted a qualitative content analysis of all WDPs submitted to the Public Health Accreditation Board between March 2016 and November 2021.SETTINGWe examined WDPs from all accredited LHDs (n = 183) at the time of data collection in January 2022. A majority of LHDs had more than 50 staff members (n = 106, 57.9%), had a decentralized governance structure (n = 164, 89.6%), had county-level jurisdictions (n = 99, 54.1%), and served rural populations (n = 146, 79.8%).MAIN OUTCOME MEASURESFor each overarching theme, we constructed 2 binary variables indicating whether the LHD identified a workforce gap or strategy among any subthemes within each overarching theme. Logistic regressions were used to examine relationships between LHD characteristics and identification of a workforce gap or strategy for each theme.RESULTSFew LHD characteristics were significantly associated with gaps identified or strategies implemented by LHDs. LHDs applying for reaccreditation had higher odds (adjusted odds ratio [AOR], 2.44; confidence interval [CI], 1.04-5.83) of identifying a leadership gap and of identifying a recruitment gap (AOR, 2.94; CI, 1.11-7.52) compared to LHDs applying for accreditation for the first time. LHDs serving urban populations had higher odds (AOR, 2.83; CI, 1.32-6.25) of identifying a recruitment strategy compared to LHDs that only served suburban/rural populations.CONCLUSIONSOverall, many workforce gaps reported by LHDs were universally observed irrespective of LHD characteristics. While most LHDs identified strategies to address gaps, our findings also reveal workforce areas where LHDs reported gaps without an accompanying strategy, indicating areas where LHDs could use more technical assistance and support.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1097/phh.0000000000002065
Brooke A Levandowski,Susan Rietberg-Miller,Brytelle Walton
Workplace tokenism, the use of superficial efforts to appear equitable, which often leads to burnout of marginalized groups, is pervasive, even in health and human service organizations dedicated to improving their community's health and well-being. An original research project to identify interventions addressing tokenism within Lesbian, Gay, Bisexual, Transgender, Queer plus serving health and human service agencies in New York was unable to engage staff in focus groups. A follow-up survey with 41 potential participants reported burnout as the main reason for nonparticipation. Qualitative data revealed desired aftercare for the retraumatizing nature of sharing individual experiences. Utilizing a community-based participatory research approach with an antiracism lens may mitigate challenges addressing tokenism, thereby increasing workplace inclusion of our Lesbian, Gay, Bisexual, Transgender, Queer plus community.
{"title":"Why Won't Anyone Talk? Challenges Naming and Addressing Tokenism Within Health and Human Service Agencies Serving the LGBTQ+ Community.","authors":"Brooke A Levandowski,Susan Rietberg-Miller,Brytelle Walton","doi":"10.1097/phh.0000000000002065","DOIUrl":"https://doi.org/10.1097/phh.0000000000002065","url":null,"abstract":"Workplace tokenism, the use of superficial efforts to appear equitable, which often leads to burnout of marginalized groups, is pervasive, even in health and human service organizations dedicated to improving their community's health and well-being. An original research project to identify interventions addressing tokenism within Lesbian, Gay, Bisexual, Transgender, Queer plus serving health and human service agencies in New York was unable to engage staff in focus groups. A follow-up survey with 41 potential participants reported burnout as the main reason for nonparticipation. Qualitative data revealed desired aftercare for the retraumatizing nature of sharing individual experiences. Utilizing a community-based participatory research approach with an antiracism lens may mitigate challenges addressing tokenism, thereby increasing workplace inclusion of our Lesbian, Gay, Bisexual, Transgender, Queer plus community.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CONTEXTSchools vary in their capacity to implement recommended strategies to prevent infectious diseases, such as COVID-19. Professional development (PD) and technical assistance (TA) are well-established tools used to strengthen school capacity and infrastructure for healthier school environments.OBJECTIVEThe authors examined the relationship between PD and TA received by districts and schools and their implementation of COVID-19 prevention strategies during the 2020-2021 school year.DESIGN AND SETTINGWe conducted a descriptive analysis of survey responses collected during Spring 2021 from selected districts and schools in 9 participating states. The survey assessed the implementation of 10 COVID-19 prevention strategies recommended by the Centers for Disease Control and Prevention and whether district or school staff received PD and/or TA on topics related to COVID-19 during the same year.PARTICIPANTSSurvey responses were received from designated contacts in 310 districts and 931 schools across 9 states.MAIN OUTCOME MEASURESThe dependent variable was the number of COVID-19 prevention strategies that were reported as "in place" by each district and school ranging from 0 to 10.RESULTSOn average, districts and schools reported implementing 7 of 10 recommended COVID-19 prevention strategies during the 2020-2021 school year. Schools that received PD on at least 1 of 12 topics reported implementing 7.61 COVID-19 prevention strategies, whereas schools that did not receive PD reported implementing 6.34 strategies. Similarly, schools that received TA on at least 1 topic reported higher COVID-19 implementation scores (7.51) than schools that did not receive any TA (7.20).CONCLUSIONSFindings reveal a positive relationship between receiving PD and/or TA and implementation of COVID-19 prevention strategies in school settings.
{"title":"The Role of Professional Development and Technical Assistance in Supporting Implementation of COVID-19 Prevention Strategies in K-12 Schools.","authors":"Syreeta Skelton-Wilson,Sarah Lee,Jessica Potts,Chloe Chung,Seraphine Pitt-Barnes,Melissa Fahrenbruch,Forest Ogunyankin,Dana Keener Mast","doi":"10.1097/phh.0000000000001964","DOIUrl":"https://doi.org/10.1097/phh.0000000000001964","url":null,"abstract":"CONTEXTSchools vary in their capacity to implement recommended strategies to prevent infectious diseases, such as COVID-19. Professional development (PD) and technical assistance (TA) are well-established tools used to strengthen school capacity and infrastructure for healthier school environments.OBJECTIVEThe authors examined the relationship between PD and TA received by districts and schools and their implementation of COVID-19 prevention strategies during the 2020-2021 school year.DESIGN AND SETTINGWe conducted a descriptive analysis of survey responses collected during Spring 2021 from selected districts and schools in 9 participating states. The survey assessed the implementation of 10 COVID-19 prevention strategies recommended by the Centers for Disease Control and Prevention and whether district or school staff received PD and/or TA on topics related to COVID-19 during the same year.PARTICIPANTSSurvey responses were received from designated contacts in 310 districts and 931 schools across 9 states.MAIN OUTCOME MEASURESThe dependent variable was the number of COVID-19 prevention strategies that were reported as \"in place\" by each district and school ranging from 0 to 10.RESULTSOn average, districts and schools reported implementing 7 of 10 recommended COVID-19 prevention strategies during the 2020-2021 school year. Schools that received PD on at least 1 of 12 topics reported implementing 7.61 COVID-19 prevention strategies, whereas schools that did not receive PD reported implementing 6.34 strategies. Similarly, schools that received TA on at least 1 topic reported higher COVID-19 implementation scores (7.51) than schools that did not receive any TA (7.20).CONCLUSIONSFindings reveal a positive relationship between receiving PD and/or TA and implementation of COVID-19 prevention strategies in school settings.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1097/phh.0000000000001982
Enbal Shacham,Stephen E Scroggins,Adam Gilmore,Jane Cheng,Rosalinda Nava
BACKGROUNDPediatric asthma remains one of the most prominent chronic health conditions among US youth. Geographic determinants such as air pollutants have been identified as playing a role in asthma development and exacerbation. The purpose of this study was to determine geospatial predictors of pediatric asthma exacerbation events and to prioritize housing remediation resources.METHODSElectronic medical records were abstracted from a health plan in Southern California. The inclusion criteria that created a sample of 51 557 members were those aged 21 years and younger, who had at least 1 asthma-related encounter between January 2019 and December 2021. Diagnoses, age, number of clinic and emergency department visits, and home addresses were included. The air quality index from the closest monitoring station during the study period, residential distance from a primary roadway, and residential distance from manufacturing sites were included in the spatial analysis.RESULTSThe average number of asthma-related clinic visits was 2 across the sample. Individuals with more asthma-related clinic visits residing in public housing were more likely to live within 4 km of industrial manufacturing locations (P < .001), reside closer to a major roadway (P < .001), and experience a higher number of poor air quality days (P < .001). Modeling results show these factors were also significantly predictive of an increase of asthma-related health care encounters.CONCLUSIONSThe findings of this study were consistent with previous studies linking asthma and poor air quality and further highlighted some of the additive and potentially exponential challenges that public housing, major roadways, and manufacturing sites provide communities in their proximity. This research can guide environmental interventions, including the frequency of public housing inspections, community outreach, and the development of communication strategies, to reduce asthma-related experiences across neighborhoods.
{"title":"Predictors of Pediatric Asthma Management: Identifying Actionable Results With Geographic Determinants.","authors":"Enbal Shacham,Stephen E Scroggins,Adam Gilmore,Jane Cheng,Rosalinda Nava","doi":"10.1097/phh.0000000000001982","DOIUrl":"https://doi.org/10.1097/phh.0000000000001982","url":null,"abstract":"BACKGROUNDPediatric asthma remains one of the most prominent chronic health conditions among US youth. Geographic determinants such as air pollutants have been identified as playing a role in asthma development and exacerbation. The purpose of this study was to determine geospatial predictors of pediatric asthma exacerbation events and to prioritize housing remediation resources.METHODSElectronic medical records were abstracted from a health plan in Southern California. The inclusion criteria that created a sample of 51 557 members were those aged 21 years and younger, who had at least 1 asthma-related encounter between January 2019 and December 2021. Diagnoses, age, number of clinic and emergency department visits, and home addresses were included. The air quality index from the closest monitoring station during the study period, residential distance from a primary roadway, and residential distance from manufacturing sites were included in the spatial analysis.RESULTSThe average number of asthma-related clinic visits was 2 across the sample. Individuals with more asthma-related clinic visits residing in public housing were more likely to live within 4 km of industrial manufacturing locations (P < .001), reside closer to a major roadway (P < .001), and experience a higher number of poor air quality days (P < .001). Modeling results show these factors were also significantly predictive of an increase of asthma-related health care encounters.CONCLUSIONSThe findings of this study were consistent with previous studies linking asthma and poor air quality and further highlighted some of the additive and potentially exponential challenges that public housing, major roadways, and manufacturing sites provide communities in their proximity. This research can guide environmental interventions, including the frequency of public housing inspections, community outreach, and the development of communication strategies, to reduce asthma-related experiences across neighborhoods.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1097/phh.0000000000001938
Karl Johnson,Nidhi Oruganti,Dorothy Cilenti,John Wiesman,Todd Jensen,Kristen Hassmiller
CONTEXTThe Public Health 3.0 (PH3.0) framework encourages local health departments (LHDs) to address the social determinants of health (SDOHs) that impact health equity.OBJECTIVEThis study sought to understand how often LHDs are working to address SDOH, which SDOHs are most often being addressed, as well as the mix of strategies that have been proposed to address this work.DESIGNWe reviewed recent Community Health Improvement Plans (CHIPs) to analyze the current involvement of LHDs in addressing SDOH.SETTINGCHIPs published from 2020.PARTICIPANTSAccredited LHDs from across the United States (n = 80).MAIN OUTCOME MEASURESWe developed a qualitative guidebook to characterize CHIP strategies based on the SDOH domain they addressed and the strategic mechanism they proposed.RESULTSAcross our entire sample, CHIPs were roughly 1.5 times more likely to address Health Care Access than Food Insecurity and Access to Healthy Food (65%), Neighborhood Infrastructure (61%), or Affordable Housing (65%), and they were 3 to 4 times more likely to address Health Care Access than Safe Housing (23%), Education Access and Quality (31%), or Economic Stability (24%). Across all major domains, a few concerned policy changes and a handful focused on improving systems or developing the built environment. Most strategies focused on service provision through events or the education of the public and professionals on health-related topics.CONCLUSIONSThe results of this study demonstrate that not all SDOHs are addressed equally by LHDs within their CHIPs. There is significant variation in how SDOHs are addressed along at 2 dimensions: first, in the likelihood that a CHIP addresses the domain and, second, in the mechanism by which each domain is addressed. Practically, the list of strategies we documented from the 80 CHIPs included in our sample may serve as the basis for strategies that other communities may wish to consider when addressing SDOH.
{"title":"Local Public Health Strategies for Addressing Social Determinants of Health-Analysis of Recent Community Health Improvement Plans.","authors":"Karl Johnson,Nidhi Oruganti,Dorothy Cilenti,John Wiesman,Todd Jensen,Kristen Hassmiller","doi":"10.1097/phh.0000000000001938","DOIUrl":"https://doi.org/10.1097/phh.0000000000001938","url":null,"abstract":"CONTEXTThe Public Health 3.0 (PH3.0) framework encourages local health departments (LHDs) to address the social determinants of health (SDOHs) that impact health equity.OBJECTIVEThis study sought to understand how often LHDs are working to address SDOH, which SDOHs are most often being addressed, as well as the mix of strategies that have been proposed to address this work.DESIGNWe reviewed recent Community Health Improvement Plans (CHIPs) to analyze the current involvement of LHDs in addressing SDOH.SETTINGCHIPs published from 2020.PARTICIPANTSAccredited LHDs from across the United States (n = 80).MAIN OUTCOME MEASURESWe developed a qualitative guidebook to characterize CHIP strategies based on the SDOH domain they addressed and the strategic mechanism they proposed.RESULTSAcross our entire sample, CHIPs were roughly 1.5 times more likely to address Health Care Access than Food Insecurity and Access to Healthy Food (65%), Neighborhood Infrastructure (61%), or Affordable Housing (65%), and they were 3 to 4 times more likely to address Health Care Access than Safe Housing (23%), Education Access and Quality (31%), or Economic Stability (24%). Across all major domains, a few concerned policy changes and a handful focused on improving systems or developing the built environment. Most strategies focused on service provision through events or the education of the public and professionals on health-related topics.CONCLUSIONSThe results of this study demonstrate that not all SDOHs are addressed equally by LHDs within their CHIPs. There is significant variation in how SDOHs are addressed along at 2 dimensions: first, in the likelihood that a CHIP addresses the domain and, second, in the mechanism by which each domain is addressed. Practically, the list of strategies we documented from the 80 CHIPs included in our sample may serve as the basis for strategies that other communities may wish to consider when addressing SDOH.","PeriodicalId":520109,"journal":{"name":"Journal of Public Health Management & Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142214330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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