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Sight for All United: Five Year Impact of a Vision Foundation on its Community 团结所有人的视力:视力基金会对其社区的五年影响
Pub Date : 2021-06-21 DOI: 10.18061/ojph.v4i1.8074
Ankur Parikh, Meredith Spitz, Cooper T. Johnson, S. Erzurum
Background: In 2016, Sight for All United (SFAU) was founded in the Mahoning Valley of Ohio with the mission of improving access to care and maximizing the visual potential of the underserved. Methods: A retrospective chart review was conducted on patients served by SFAU from January 2016 through August 2020. Socioeconomic information, type of service, cost, and dollar amount paid were collected for patients. The data were analyzed with descriptive statistics and mapped with Esri ArcGIS. Results: A total of 1327 patients received assistance through the medical assistance and school vision programs. In the medical assistance program, 222 patients (mean age 50 years, 57% female) completed applications and 37% (83 patients) were in a household of 3 or more people. Median yearly income was $18 504, 134% above the federal poverty level by household size. The most common surgical services were cataract surgery (101) and vitreoretinal care (17). The most common medical services were eye exams (79) and spectacles (76). Estimated value of medical services provided was $367 249; actual cost was $93 746. The school vision program provided 1105 eye exams, 1514 pairs of spectacles, and 1 cataract surgery with an estimated value of $133 692. Conclusion: Sight for All United provided $500 941 of vision services to its patients since 2016 while dispersing less than $100 000 of donated dollars through collaboration with eye care providers, community resources, and national foun-dations. This study demonstrates the impact vision foundations managed by local eye care providers can have on the needs in their community in a cost-effective and efficient way.
背景:2016年,“全民视力联盟”(Sight for All United,简称SFAU)在俄亥俄州的Mahoning山谷成立,其使命是改善医疗服务的可及性,并最大限度地发挥服务不足人群的视觉潜力。方法:对2016年1月至2020年8月接受SFAU治疗的患者进行回顾性图表分析。收集患者的社会经济信息、服务类型、费用和支付金额。数据采用描述性统计分析,Esri ArcGIS制图。结果:共有1327名患者通过医疗援助和学校视力计划获得了帮助。在医疗援助方案中,222名患者(平均年龄50岁,57%为女性)完成了申请,37%(83名患者)在三人或三人以上的家庭中。年收入中位数为18504美元,按家庭规模计算比联邦贫困水平高出134%。最常见的手术是白内障手术(101例)和玻璃体视网膜护理(17例)。最常见的医疗服务是眼科检查(79)和眼镜(76)。提供的医疗服务估计价值为367 249美元;实际费用为93 746美元。学校视力项目提供了1105次眼科检查、1514副眼镜和1次白内障手术,估计价值为133 692美元。结论:自2016年以来,全美视力联盟为患者提供了500 941美元的视力服务,而通过与眼科保健提供者、社区资源和国家基金会合作,分发了不到10万美元的捐赠美元。本研究表明,由当地眼科保健提供者管理的视力基金会能够以经济有效的方式对社区需求产生影响。
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引用次数: 0
Disproportionate Impact of COVID-19 on Lower-Income, Minority Populations 新冠肺炎对低收入少数民族人口的不成比例的影响
Pub Date : 2020-12-18 DOI: 10.18061/ojph.v3i3.8034
N. Singer
No abstract available.
没有可用的摘要。
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引用次数: 3
Racism Measurement Framework: A Tool for Public Health Action and Accountability 种族主义衡量框架:公共卫生行动和问责制的工具
Pub Date : 2020-12-18 DOI: 10.18061/ojph.v3i3.8037
Saira Nawaz, Kyle J. Moon, E. Seiber, Anne Trinh, Sue Bennett, Joshua J. Joseph
Racism is a principal determinant of health inequity, but recent events have galvanized local and state leaders across Ohio to declare racism a public health emergency. In addition to the renewed call to racial justice, sustained progress will require ongoing measurement to determine which anti-racist efforts are working, and why. In this review, we present existing measures categorized by 3 dimensions of racism that interact and build off of one another: (1) systemic racism, considering the health effects of policies in housing, voting, criminal legal system, economic opportunity, and health care; (2) interpersonal racism, and measures of provider bias and cultural competency; (3) internalized racism, measured as allostatic stress and heightened vigilance in distinct contexts. After identifying knowledge gaps, we developed a racism measurement framework that more comprehensively depicts the disparities caused by racism within Ohio and can be used to monitor and evaluate the effectiveness of anti-racist efforts implemented across the state. As such, this framework provides not only a call for action against racism in Ohio, but an opportunity for organizations to measure the extent to which efforts have intervened on supposedly entrenched pathways to health inequities and disparities caused by racism.
种族主义是健康不平等的主要决定因素,但最近的事件促使俄亥俄州各地的地方和州领导人宣布种族主义是公共卫生紧急情况。除了再次呼吁种族正义之外,持续的进步还需要不断衡量,以确定哪些反种族主义的努力正在起作用,以及为什么起作用。在这篇综述中,我们提出了根据种族主义的三个维度进行分类的现有措施,这些维度相互作用并相互建立:(1)系统性种族主义,考虑住房、投票、刑事法律制度、经济机会和医疗保健等政策对健康的影响;(2)人际种族主义,以及提供者偏见和文化能力的测量;(3)内化种族主义,表现为适应压力和不同背景下的高度警惕。在确定了知识差距之后,我们开发了一个种族主义衡量框架,该框架更全面地描述了俄亥俄州种族主义造成的差异,并可用于监测和评估全州反种族主义工作的有效性。因此,该框架不仅呼吁在俄亥俄州采取行动反对种族主义,而且为各组织提供了一个机会,以衡量在何种程度上对种族主义造成的卫生不平等和不平等的假定根深蒂固的途径进行了干预。
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引用次数: 5
Benefits of Understanding Systemic Racism in Forming Clinician-Patient Relationships to Reduce Black Infant Mortality 理解系统性种族主义在形成医患关系以降低黑人婴儿死亡率中的益处
Pub Date : 2020-12-18 DOI: 10.18061/ojph.v3i3.8036
M. Gotto, Laura Morello, Marsha Michie
Background: The United States lags far behind other developed nations in our overall infant mortality rate. Public health researcher Arline Geronimus has described a "weathering" effect of chronic racial stress among Black women that contributes to high rates of preterm birth, the leading cause of infant death. Trusting relationships between clinicians and patients may play a role in reducing infant mortality for Black mothers. Based on a social-ecological model of health care communication around infant mortality, we focus here on doctor-patient communication and correlations between clinicians' understandings of systemic racism and their communication with Black pregnant patients.Methods: This paper reports the findings from interviews with 5 maternal health clinicians (prior to recruitment being temporarily paused due to COVID-19) practicing at Cuyahoga County hospitals that serve large populations of Black women. Qualitative coding methods based in grounded theory were used to draw out themes from interview transcripts.Results: Doctor-patient communication was an emergent theme in these interviews. Results suggest an association between clinicians' understanding of the impact of systemic racism and their ability to communicate successfully and form positive bonds with pregnant mothers who are at higher risk of infant mortality.Conclusion: Acknowledging systemic racism as the cause of poor social determinants of health, which in turn contribute to higher rates of infant mortality, may provide clinicians a pathway to more positive communication and higher levels of trust with their patients, which in turn may play a role in reducing infant mortality in the Black community. Further research should investigate these associations.
背景:美国的婴儿死亡率远远落后于其他发达国家。公共卫生研究人员Arline Geronimus描述了黑人女性长期种族压力的“风化”作用,这种影响导致早产率高,早产是婴儿死亡的主要原因。临床医生和患者之间的信任关系可能在降低黑人母亲的婴儿死亡率方面发挥作用。基于围绕婴儿死亡率的医疗保健沟通的社会生态模型,我们在这里重点关注医患沟通以及临床医生对系统性种族主义的理解与他们与黑人孕妇沟通之间的相关性。方法:本文报道了对凯霍加县医院为大量黑人妇女服务的5名孕产妇健康临床医生(在因新冠肺炎暂停招聘之前)的采访结果。基于扎根理论的定性编码方法被用于从访谈记录中提取主题。结果:医患沟通是这些访谈中的一个新兴主题。结果表明,临床医生对系统性种族主义影响的理解与他们成功沟通并与婴儿死亡率较高的孕妇建立积极联系的能力之间存在联系。结论:承认系统性种族主义是健康的不良社会决定因素的原因,这反过来又导致婴儿死亡率上升,这可能为临床医生提供一条与患者进行更积极沟通和更高信任水平的途径,这反过来可能在降低黑人社区婴儿死亡率方面发挥作用。进一步的研究应该调查这些关联。
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引用次数: 0
Addressing Racism as a Public Health Crisis in Ohio 将种族主义视为俄亥俄州的公共卫生危机
Pub Date : 2020-12-18 DOI: 10.18061/ojph.v3i3.8032
A. Ferketich
No abstract available.
没有可用的摘要。
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引用次数: 2
Perceived Racial Discrimination and the Health of Black Youth in Ohio 俄亥俄州黑人青年的种族歧视与健康
Pub Date : 2020-12-18 DOI: 10.18061/ojph.v3i3.8035
Kenneth J Steinman, T. Price‐Spratlen, Christopher Browning
Background: Perceived racial discrimination (PRD) is known to harm youth, yet few studies use large, representative samples or study caregivers' perceptions of their children's experiences with unjust treatment. We examined how such a measure of PRD was associated with demographic characteristics as well as with physical and mental health outcomes for Black youth across Ohio.Methods: The 2019 Ohio Medicaid Assessment Survey was a complex telephone survey with a representative sample of 31 558 adults, 907 of whom completed a proxy interview for a youth in the household who was Black and age 6 to 18 years. One item from an Adverse Childhood Experiences (ACEs) scale assessed PRD: "To the best of your knowledge, has [name] ever experienced any of the following? Treated or judged unfairly because of [her/his] race or ethnic group."Results: Weighted analyses found that PRD was more common among Black youth who were older, from higher income families, and lived in rural counties. Perceived racial discrimination was also associated with frequent mental distress and with having an emotional or behavioral problem that needs treatment or counseling. It was not associated with any physical health outcomes measured.Conclusion: Our findings resemble those from other studies that use more extensive measures of PRD. While no substitute for extensive measures, the ACEs single-item measure may expand opportunities to study PRD in subgroup analyses of larger, representative samples. Yet our findings and those from other studies already provide considerable evidence that efforts to improve Black youth's mental health should consider their experience with PRD.
背景:众所周知,感知种族歧视会伤害年轻人,但很少有研究使用具有代表性的大样本或研究照顾者对其子女遭受不公正待遇的看法。我们研究了这种PRD指标与俄亥俄州黑人青年的人口特征以及身心健康结果之间的关系。方法:2019年俄亥俄州医疗补助评估调查是一项复杂的电话调查,有代表性样本,共有31558名成年人,其中907人完成了家庭中一名6至18岁黑人青年的代理面试。儿童不良经历量表中的一项评估了PRD:“据你所知,[姓名]是否经历过以下任何情况?由于[她/他的]种族或民族而受到不公平的对待或评判。”结果:加权分析发现,PRD在年龄较大、收入较高、生活在农村县的黑人青年中更为常见。感知到的种族歧视也与频繁的精神痛苦以及需要治疗或咨询的情绪或行为问题有关。它与任何测量的身体健康结果无关。结论:我们的研究结果与其他使用更广泛的PRD测量方法的研究结果相似。虽然不能替代广泛的测量,但ACE的单项测量可能会扩大在更大、有代表性的样本的亚组分析中研究PRD的机会。然而,我们和其他研究的发现已经提供了大量证据,证明改善黑人青年心理健康的努力应该考虑他们在PRD方面的经历。
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引用次数: 0
Developing Continuing Education for Ohio’s Local Boards of Health 发展俄亥俄州地方卫生委员会的继续教育
Pub Date : 2020-10-01 DOI: 10.18061/ojph.v3i2.9015
Diana M. Kingsbury, M. Stefanak, Ken Slenkovich
Background: Public health functions at the county level and city level through the work of local health departments (LHDs). Local boards of health (LBoHs) work closely with LHDs as an administrative oversight body. In 2013, legislation was passed in the state of Ohio pertaining to the accreditation of LHDs, which included a provision requiring that Ohio’s LBoH members engage in 2 hours of continuing education (CE) per year. To assist LBoHs in fulfilling these requirements, a partnership was developed between the Ohio Association of Boards of Health (OABH) and the Kent State University College of Public Health (KSU-CPH) to deliver CE content. Methods: The process for developing the CE modules encompasses 3 steps: (1) needs assessment, (2) module development and delivery, and (3) evaluation. Feedback was solicited from Ohio’s LBoH members to determine topics of interest for CE modules. Taking this feedback, a curated set of 8 modules will be developed. Module content will be derived from graduate courses within KSU-CPH as well as from subject matter experts. The modules will be delivered online to LBoH members during their regularly scheduled meetings. Results: This program proposes to fulfill state requirements that LBoH members regularly engage in CE. Partner-ing with KSU-CPH allows for the use of academic content in these trainings. Conclusion: An adequately trained public health workforce is essential for a well-functioning public health system, which includes governing entities like LBoHs. There is limited understanding of how workforce development can be targeted specifically to LBoHs. This CE program contributes to current efforts to promote workforce development within the field of public health.
背景:县级和市级的公共卫生职能是通过地方卫生部门(lhd)的工作实现的。地方卫生委员会作为一个行政监督机构与地方卫生部门密切合作。2013年,俄亥俄州通过了一项关于lhd认证的立法,其中包括要求俄亥俄州lhd成员每年参加2小时的继续教育(CE)的规定。为了帮助lboh满足这些要求,俄亥俄州卫生委员会协会(OABH)和肯特州立大学公共卫生学院(KSU-CPH)之间建立了伙伴关系,以提供CE内容。方法:开发CE模块的过程包括三个步骤:(1)需求评估,(2)模块开发和交付,(3)评估。向俄亥俄州的LBoH成员征求反馈,以确定CE模块感兴趣的主题。根据这些反馈,我们将开发一套由8个模块组成的精选集。模块内容将来自KSU-CPH的研究生课程以及主题专家。这些模块将在LBoH成员定期会议期间在线交付给他们。结果:该计划旨在满足LBoH成员定期参与CE的国家要求。与KSU-CPH的合作允许在这些培训中使用学术内容。结论:一支训练有素的公共卫生人力队伍对于一个运转良好的公共卫生系统至关重要,其中包括像LBoHs这样的管理实体。人们对劳动力发展如何专门针对lboh的理解有限。这一行政长官方案有助于目前在公共卫生领域促进劳动力发展的努力。
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引用次数: 0
Opioid Dispensing Practices in the Acute Care Setting: A Retrospective Study 阿片类药物在急性护理环境中的配药实践:一项回顾性研究
Pub Date : 2020-10-01 DOI: 10.18061/ojph.v3i2.9011
Mohamad Moussa, Lekha Vemuru, Robert Dohar, D. Lubarsky, S. Khuder
Background: Ohio remains one of the most afflicted states nationally with 46.3 per 100 000 deaths due to drug overdose. Opioids are commonly administered in emergency departments for the management of pain. Given the high volume of patients presenting with pain, emergency clinicians must be cognizant of responsible opioid dispensing practices. Ohio established guidelines in April 2012 to provide a general approach for responsible opioid prescribing practices in the emergency setting. The purpose of this study assesses clinician opioid dispensing before and after the implementation of the Ohio Opioid Prescribing Guidelines. Methods: The study design used retrospective data analysis of opioid medications ordered by emergency clinicians to be administered in the emergency room between January 1, 2007, to December 31, 2017, at the University of Toledo Medical Center. A segmented regression analysis with an interrupted time series was used to determine impact. Results: All opioid medication usage showed a significant decrease after guideline implementation except for morphine and fentanyl which showed statistically significant increases in administration over time (P < 0.05). Conclusion: There was a significant decrease in the use of opioids since the implementation of the Ohio Opioid Prescribing Guidelines, yet morphine and fentanyl use has generally increased across all age groups. Age demographics frequently receiving opioids in the emergency room have seemed to shift over time as well as specific opioid drugs dispensed for the management of pain in certain age groups. Further study is needed to evaluate the use of opioids prescribed by emergency physicians after discharge from the emergency department.
背景:俄亥俄州仍然是全国疫情最严重的州之一,每10万人中有46.3人死于药物过量。阿片类药物通常在急诊科用于治疗疼痛。鉴于大量患者出现疼痛,急诊临床医生必须认识到负责任的阿片类药物配药实践。俄亥俄州于2012年4月制定了指导方针,为在紧急情况下负责任的阿片类药物处方做法提供了一种通用方法。本研究的目的是评估临床医生在实施俄亥俄州阿片类药物处方指南前后的阿片类处方。方法:研究设计使用了2007年1月1日至2017年12月31日在托莱多大学医学中心急诊室由急诊临床医生订购的阿片类药物的回顾性数据分析。使用具有中断时间序列的分段回归分析来确定影响。结果:除吗啡和芬太尼外,所有阿片类药物的使用量在指南实施后均显著下降,吗啡和芬太尼的使用量随着时间的推移呈统计学显著增加(P<0.05),然而,吗啡和芬太尼的使用在所有年龄组中普遍增加。随着时间的推移,经常在急诊室接受阿片类药物治疗的年龄人口结构似乎发生了变化,在某些年龄组,为治疗疼痛而分配的特定阿片类药品也发生了变化。需要进一步的研究来评估急诊科医生出院后开具的阿片类药物的使用情况。
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引用次数: 0
Detecting Environmental Contamination of MRSA in Ambulances: A Novel and Efficient Sampling Methodology 检测救护车中MRSA的环境污染:一种新颖有效的采样方法
Pub Date : 2020-10-01 DOI: 10.18061/ojph.v3i2.9012
R. Orellana, A. Hoet, J. V. van Balen, Bo Lu, Christina Kelley, K. Stevenson
Background: Methicillin-resistant Staphylococcus aureus (MRSA) can be found in emergency medical services (EMS) ambulances. This poses an occupational risk and patient safety hazard. Screening for environmental contamination is often not performed due to limited resources and logistical challenges. This study’s objective was to compare traditional screening of individual surfaces versus “pooled sampling” to efficiently identify contamination. Methods: A cross-sectional study, conducted among 145 Ohio EMS ambulances from 84 agencies, tested a novel pooled sampling methodology to detect MRSA contaminated ambulances. For ambulances screened using pooled sampling, 3 samples were collected within each ambulance. Pool One included cabinets, doorways, and ceiling bar. Pool Two included cot, seats, and backboard. Pool Three included steering wheel, kits, and clipboard. For ambulances screened with the traditional detection technique, each of the 9 aforementioned surfaces were sampled individually. Descriptive statistics and unadjusted and adjusted odds ratios (OR) were calculated to compare the 2 methods. Results: Forty-seven of 145 ambulances (32.4%) had at least 1 of the 9 locations contaminated with MRSA. When comparing the 2 screening methodologies, no significant difference was observed regarding the overall detection of MRSA contaminated ambulances (24/60 [40%] versus 23/85 [27.6%], P value: 0.1000). This indicates that pooled sampling appears as an efficient method for identification of MRSA contaminated ambulances. Conclusion: One-third of Ohio ambulances had MRSA contamination in this study. Therefore, an efficient methodology to identify contaminated ambulances with hazardous pathogens is incredibly valuable. Pooling can help save resources and simplify sampling logistics, all which could positively impact infection control practices in emergency medical services.
背景:耐甲氧西林金黄色葡萄球菌(MRSA)可在紧急医疗服务(EMS)救护车中发现。这构成了职业风险和患者安全隐患。由于资源有限和后勤方面的挑战,通常不进行环境污染筛查。本研究的目的是比较传统的单个表面筛选与“集中采样”,以有效地识别污染。方法:对来自84家机构的145辆俄亥俄州EMS救护车进行了一项横断面研究,测试了一种新的汇集抽样方法来检测MRSA污染的救护车。对于采用集中抽样筛选的救护车,每辆救护车内采集3个样本。一号泳池包括橱柜、门廊和天花板酒吧。二池包括帆布床、座椅和篮板。第三组包括方向盘、套件和剪贴板。对于使用传统检测技术筛选的救护车,分别对上述9个表面进行采样。计算描述性统计和未调整和调整的优势比(OR)来比较两种方法。结果:145辆救护车中有47辆(32.4%)至少有1处感染了MRSA。在比较两种筛查方法时,MRSA污染救护车的总体检出率无显著差异(24/60 [40%]vs 23/85 [27.6%], P值:0.1000)。这表明,集中抽样似乎是一种有效的方法,以确定MRSA污染的救护车。结论:在这项研究中,俄亥俄州三分之一的救护车被MRSA污染。因此,一种有效的方法来识别有危险病原体的污染救护车是非常有价值的。集中可以帮助节省资源和简化采样后勤,所有这些都可以对紧急医疗服务中的感染控制实践产生积极影响。
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引用次数: 0
Eight Months and Counting 八个月及以后
Pub Date : 2020-10-01 DOI: 10.18061/ojph.v3i2.9008
Amy K Ferketich
No abstract available.
没有摘要。
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引用次数: 0
期刊
Ohio journal of public health
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