Department Of Health Research Articles

A Health Department Perspective for Sexually Transmitted Infection Prevention and Control.

A Health Department Perspective for Sexually Transmitted Infection Prevention and Control.

Barriers and facilitators of translating doctoral research findings into policy: The case of a selected health sciences school in a South African university

BackgroundAlthough the barriers and facilitators of translating health research into policy are generally well documented, not much has been reported for universities in low-and middle-income countries. We identified and analyzed barriers and facilitators of translating doctoral research findings into policy in a selected health sciences school in a South African university. MethodsThe study adopted a quantitative descriptive research design. We conveniently collected data through an online questionnaire administered to 47 PhD graduates, 11 PhD final year students and 21 PhD supervisors of the School of Nursing and Public Health. Descriptive statistics was performed, and data were summarized using percentages. ResultsMore than half (72.4 %) of the students reported not involving Department of Health during formulation of research questions for their projects and 62.1 % reported not directly sharing research findings with the Department of Health. 53.4 % of the students indicated that they attended Department of Health research days and only 39.7 % said they presented research findings at the meetings. Only 39.7 % of the students who shared their research results to the Department of Health received feedback. About 52.4 % of the academic supervisors believed the introduction of the quartile system as a measure of impact of publications may reduce policy impact. An individual PhD supervisor supervises an average of 6 PhD students at any given time. 85.7 % of PhD supervisors reported that they consider stakeholders needs/interests when assisting students to identify research topics. ConclusionThe study revealed the need for universities to make policymakers aware of available evidence, conduct research that is informed by the Department of Health's research agenda, involve the Department of Health in identifying research projects, and disseminate findings using platforms accessible to policymakers. Other key considerations are political will to utilize evidence, packaging evidence in a user-friendly manner and building the capacity of policymakers to use evidence.

How ‘Ethical Leadership and Work Climate’ Drive Job Satisfaction: Insights from Banjarmasin’s Health Department

This research aims to analyze the influence of ethical leadership (X1) and ethical work climate (X2) on job satisfaction (Y) in employees of the Banjarmasin City Health Service, South Kalimantan Province, Indonesia. This quantitative research used a structural equation modeling (SEM) approach using SmartPLS. The population in this study was all employees of the Banjarmasin City Health Service, totaling 92 people. The total sampling technique of non-probability sampling was used. Findings showed that ethical leadership positively affects job satisfaction among Banjarmasin City Health Service employees. Furthermore, it showed that ethical work climate positively affects job satisfaction among Banjarmasin City Health Service employees.

Application of a high-performance grey prediction model to predict the cardiovascular disease mortality in elderly Chinese residents

With the acceleration of urbanization and aging process, an increasing number of Chinese senior citizens are suffering from cardiovascular diseases (CVDs). Therefore, reducing the prevalence and mortality of CVD has become one of the priorities of the public health department. And the scientific prediction of CVD morality is of great significance in the prevention and treatment of CVD among the elderly. Given the characteristics of “small sample, complex causes and long duration” of CVD among the senior citizens, grey prediction models which aim at handling the data with “small sample, poor information” are more feasible in forecasting its developing trend. In this paper, a new discrete grey prediction model is designed to forecast the CVD morality among Chinese senior citizens, in which a non-linear function is introduced to expand the model structure and the order and background value coefficient are optimized. In all the three sets of experiments, the errors of the new model are close to but smaller than those of the other three mainstream grey prediction models, indicating that the simulation and prediction performance of the new model is more accurate and stable. The research provides a new modelling approach to predicting the CVD mortality among Chinese senior citizens, which is conducive to the prevention of CVD prevalence and the sustainable development of public health.

Critical success factors in the maintenance strategies of public healthcare facilities

PurposeThe United Nations' Sustainable Development Goal of ensuring healthy lives and promoting well-being for people of all ages underscores the vital role of public healthcare facilities (PHFs) in delivering essential healthcare services. However, these facilities often suffer from inadequate maintenance, exacerbated by the insufficient implementation of maintenance strategies. Recognizing the importance of PHFs in enhancing healthcare services, this paper investigates the Critical Success Factors (CSFs) in the maintenance strategies of PHFs in South Africa.Design/methodology/approachThrough semi-structured interviews with nineteen purposively selected maintenance personnel from the Limpopo Department of Health (DoH), this study identified and analyzed the CSFs to enhance maintenance operations in PHFs. Thematic content analysis was employed to derive key insights from the collected data.FindingsThe study's findings highlight adequate maintenance planning and effective leadership as the two overarching CSFs in the maintenance of PHFs. These factors play a pivotal role in addressing challenges that hinder the current maintenance team from meeting maintenance requirements to the satisfaction of both staff and patients within PHFs.Originality/valueThe study offers valuable insights for policymakers to improve the effectiveness of maintenance operations in PHFs. By addressing the identified CSFs, policymakers can enhance maintenance operations in PHFs, positively impacting healthcare service delivery and the well-being of both staff and patients.

Spatial Clustering of Rabies by Animal Species in New Jersey, United States, from 1989 to 2023.

Identifying spatial clusters of rabies in animals aids policymakers in allocating resources for rabies prevention and control. This study aimed to investigate spatial patterns and hotspots of rabies in different animal species at the county level in New Jersey. Data on animal rabies cases from January 1989 to December 2023 were obtained from the New Jersey Department of Health and aggregated by county. Global Moran's index (I) statistics were computed for each species to detect global spatial clustering (GeoDa version 1.22). Local Moran's indicators of spatial association (LISA) were computed to identify local clusters of rabies. The results from the LISA analysis were mapped using ArcGIS Pro to pinpoint cluster locations. A total of 9637 rabies cases were analyzed among raccoons (n = 6308), skunks (n = 1225), bats (n = 1072), cats (n = 597), foxes (n = 225), and groundhogs (n = 210). A global Moran's test indicated significant global spatial clustering in raccoons (I = 0.32, p = 0.012), foxes (I = 0.29, p = 0.011), and groundhogs (I = 0.37, p = 0.005). The LISA results revealed significant spatial clustering of rabies in raccoons and foxes in southeastern New Jersey and in groundhogs in northern New Jersey. These findings could guide the development of targeted oral rabies vaccination programs in high-risk New Jersey counties, reducing rabies exposure among domestic animals and humans.

Relationship Between Community-Based Total Sanitation and Stunting Incidence in Medan City

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Stunting remains a significant public health issue in Indonesia, particularly in Medan City. Poor sanitation has been identified as one of the key contributing factors to stunting. This study aims to analyze the relationship between community-based total sanitation and stunting incidence in Medan City. The research is a comparative study with a case-control design. It was conducted in five sub-districts with high stunting rates among the fourteen sub-districts in Medan City that have received community-based total sanitation interventions. The study was carried out from November 2023 to February 2024. The study population included all mothers with children age 0-59 months living in sub-districts that received community-based total sanitation interventions. There were 165 participants in the stunting and 49,676 in the not stunting. The sample size was calculated using the Lemeshow formula, resulting in 50 mothers for the stunting group. The not stunting group was matched to the case group in a 1:1 ratio, making the total sample size 100 mothers. Purposive sampling was used to select participants who met the inclusion and exclusion criteria.</em><em> </em><em>Data analysis was performed using SPSS software version 27, employing the chi-square test with a 95% confidence level (α = 0.05). The results showed that three pillars of community-based total sanitation were significantly related to stunting incidence: relationship between handwashing with soap and stunting incidence was significant (p=0.005; OR=4.125), relationship between household Latrine and stunting incidence was significant (p=0.001; OR=7.211), and relationship between household solid waste management and stunting incidence was significant (p=0.027; OR=2.681). The overall relationship between community-based total sanitation and stunting incidence was significant (p=0.015; OR=6.769). Recommendations for the Health Department and Community Health Centers in Medan City include enhancing the achievement of the five STBM pillars within the community through health promotion activities.</em></p><p><em> </em></p></td></tr></tbody></table></div><p><strong><em>Keyword: Child, Hygiene, Mother, Sanitation, Stunting</em></strong></p>

Fostering Trust in Public Health Messaging: Tailoring Communication for Rural Parents.

As pandemic-related mistrust of public health recommendations in rural communities may compound gaps in pediatric immunizations, our team explored parents' perceptions of trustworthiness in messaging. Qualitative study using 4 virtual focus groups. Rural Wisconsin. Participants (n = 25) were parents or guardians of children recruited through our contacts with community-based organizations serving rural communities. Researchers used task-oriented elicitation techniques to initiate discussion on the trustworthiness of messengers and messages providing health recommendations. Participants were asked to (1) review existing public health messaging on a range of topics and from a range of sponsors; and (2) rank a list of potential messengers in terms of trustworthiness (eg, local health department, Centers for Disease Control). Discussions were recorded, and audio files transcribed, to facilitate a team-based, thematic analysis. Competency in medical knowledge and parenting experience contributed to estimations of trustworthiness. Participants also responded well to messages and messengers that were able to project recognition of their children's uniqueness and their experience as parents. Participants distrusted messengers who were seen as biased or "one-sided" in their perspectives. For successful health promotion for rural-living parents, messengers must be recognized as "competent" to provide pediatric health advice and to avoid blanket recommendations that may undermine parents' experience and feelings of being "understood" and affect perceptions of trustworthiness.

A model-based assessment of social isolation practices for COVID-19 outbreak response in residential care facilities

BackgroundResidential aged-care facilities (RACFs, also called long-term care facilities, aged care homes, or nursing homes) have elevated risks of respiratory infection outbreaks and associated disease burden. During the COVID-19 pandemic, social isolation policies were commonly used in these facilities to prevent and mitigate outbreaks. We refer specifically to general isolation policies that were intended to reduce contact between residents, without regard to confirmed infection status. Such policies are controversial because of their association with adverse mental and physical health indicators and there is a lack of modelling that assesses their effectiveness.MethodsIn consultation with the Australian Government Department of Health and Aged Care, we developed an agent-based model of COVID-19 transmission in a structured population, intended to represent the salient characteristics of a residential care environment. Using our model, we generated stochastic ensembles of simulated outbreaks and compared summary statistics of outbreaks simulated under different mitigation conditions. Our study focuses on the marginal impact of general isolation (reducing social contact between residents), regardless of confirmed infection. For a realistic assessment, our model included other generic interventions consistent with the Australian Government’s recommendations released during the COVID-19 pandemic: isolation of confirmed resident cases, furlough (mandatory paid leave) of staff members with confirmed infection, and deployment of personal protective equipment (PPE) after outbreak declaration.ResultsIn the absence of any asymptomatic screening, general isolation of residents to their rooms reduced median cumulative cases by approximately 27%. However, when conducted concurrently with asymptomatic screening and isolation of confirmed cases, general isolation reduced the median number of cumulative infections by only 12% in our simulations.ConclusionsUnder realistic sets of assumptions, our simulations showed that general isolation of residents did not provide substantial benefits beyond those achieved through screening, isolation of confirmed cases, and deployment of PPE. Our results also highlight the importance of effective case isolation, and indicate that asymptomatic screening of residents and staff may be warranted, especially if importation risk from the outside community is high. Our conclusions are sensitive to assumptions about the proportion of total contacts in a facility accounted for by casual interactions between residents.

Toward a More Perfect Union.

In this essay, the author, Dr. Louis Sullivan, describes his life experiences, having been born in the American South during the period of legal racial segregation. Despite many obstacles, Dr. Sullivan became a physician who founded the predominantly Black Morehouse School of Medicine and served as Secretary of the United States Department of Health and Human Services.In his efforts to improve the health of people from historically marginalized groups, including Black and Brown people as well as those experiencing poverty, Dr. Sullivan organized the Association of Minority Health Professions Schools. He chaired the Sullivan Commission to evaluate the strategies developed to increase the number of Black physicians in the nation. He supported development of the Office for Women's Health and led efforts to create the National Institute for Minority Health and Health Disparities, both at the National Institutes of Health. When reflecting on his achievements, Dr. Sullivan cites his many mentors and allies who supported him in his career.Despite significant, ongoing resistance to current efforts to advance diversity, equity, and inclusion in our society, Dr. Sullivan is optimistic that progress toward this goal will continue to be made. He imparts lessons about persistence and positivity and reflects on several initiatives to advance diversity, equity, and inclusion in the health professions and in our society more broadly.

Lessons Learned from the Launch and Implementation of the COVID-19 Contact Tracing Program in New York City: a Qualitative Study.

On June 1, 2020, NYC Health + Hospitals, in partnership with the NYC Department of Health and Mental Hygiene, other city agencies, and a large network of community partners, launched the New York City Test & Trace (T2) COVID-19 response program to identify and isolate cases, reduce transmission through contact tracing, and provide support to residents during isolation or quarantine periods. In this paper, we describe lessons learned with respect to planning and implementation of case notification and contact tracing. Our findings are based on extensive document review and analysis of 74 key informant interviews with T2 leadership and frontline staff, cases, and contacts conducted between January and September 2022. Interviews elicited respondent background, history of program development, program leadership and structure, goals of the program, program evolution, staffing, data systems, elements of community engagement, trust with community, program reach, timeliness, equity, general barriers and challenges, general facilitators and best practices, and recommendations/improvement for the program. Facilitators and barriers revealed in the interviews primarily revolved around hiring and managing staff, data and technology, and quality of interactions with the public. Based on these facilitators and barriers, we identify suggestions to support effective planning and response for future case notification and contact tracing programs, including recommendations for planning during latent periods, case management and data systems, and processes for outreach to cases and contacts.

Advancing Equity in Local Health Departments: An Inside-Out Approach.

The North Carolina Division of Public Health, Chronic Disease and Injury Section recommends local health departments (LHDs) adopt an "inside-out" approach to advance health and racial equity. Internally, LHDs must increase their capacity to address equity by establishing LHD policies and practices that prioritize equity and nurture a culture of trust. Externally, LHDs must seek guidance from historically marginalized populations to inform LHD policy changes and community-based public health approaches affecting these populations for greater engagement in LHD programs. (Am J Public Health. 2024;114(S7):S554-S557. https://doi.org/10.2105/AJPH.2024.307719).

The Use of Nursing Theory and Model in Mental Health and Psychiatric Nursing Doctoral Theses: Turkiye Sample

Aim: The aim of this study is to identify nursing models used in doctoral theses in psychiatric and mental health nursing. Material and Methods: In this descriptive-type retrospective document analysis study, theses in mental health and psychiatric nursing departments of health sciences institutes were reviewed at the National Thesis Center of the Council of Higher Education on from September to October 2023. The study was completed with 14 doctoral theses. Word and Excel programs were used to record and analyze data. Results: The Roy Adaptation Model and then the Neuman Systems Model were mostly used in doctoral theses. It was determined that four theses were randomized controlled, and six theses were done within the scope of community mental health nursing when the sample group was examined. Conclusions: The Roy Adaptation Model has positive effects on issues such as emotional expression, self-esteem, and treatment areas. As a sample group, there was a tendency towards preventive mental health services. Experimental designs with control groups were used in doctoral theses, and four theses were determined to be randomized controlled.

The COVID-19 Disparities Grant: A Lesson in Radical Place-Based Investment to Overcome COVID-19-Related Health Disparities.

The COVID-19 pandemic highlighted and exacerbated health inequities in New York City (NYC) given the disproportionate risk, morbidity, and mortality related to COVID-19 experienced by communities of color with lower household income. To facilitate long-term community recovery from COVID-19, the NYC Department of Health and Mental Hygiene established the Public Health Corp, a partnership with community-based organizations staffed by community health workers in neighborhoods disproportionately impacted by COVID-19. (Am J Public Health. 2024;114(S7):S566-S569. https://doi.org/10.2105/AJPH.2024.307766).

State Department of Health's Equitable Funding Allocation Methodology to Address COVID-19 Health Disparities Among High-Risk and Underserved Populations.

The Washington State Department of Health developed an equitable funding allocation methodology incorporating quantitative and qualitative decision-making components. We describe the methodology and an implementation evaluation performed by an external evaluation team using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) evaluation framework. The evaluation team concluded that the methodology was developed in a way that used a racial equity lens and prioritized intersectionalities in the communities that the funding was intended to serve. (Am J Public Health. 2024;114(S7):S575-S579. https://doi.org/10.2105/AJPH.2024.307833).

Evaluating County Health Department Infrastructure Changes Intended to Improve Access to Federal Funding for Community-Based Organizations, Maricopa County, Arizona.

In 2021, the Maricopa County Department of Public Health in Maricopa County, Arizona, modified its subcontracting process to engage more community-based organizations that serve populations disproportionately affected by COVID-19. The change allowed subrecipients to receive 40% of grant funding up front. An evaluation found that providing up-front funding engaged smaller-budget organizations. However, factors such as administrative requirements and formal policies associated with government partnerships limited the perceived benefits of up-front funding. These findings are relevant for entities seeking to improve access to federal funding. (Am J Public Health. 2024;114(S7):S562-S565. https://doi.org/10.2105/AJPH.2024.307740).

Community-Engaged Survey Approach to Pandemic Impacts on Marginalized Communities, Massachusetts, 2020-2021.

Objectives. To describe how an innovative, community-engaged survey illuminated previously unmeasured pandemic inequities and informed health equity investments. Methods. The methodological approach of Massachusetts' COVID-19 Community Impact Survey, a cross-sectional online survey, was driven by key health equity principles: prioritizing community engagement, gathering granular and intersectional data, capturing root causes, elevating community voices, expediting analysis for timeliness, and creating data-to-action pathways. Data collection was deployed statewide in 11 languages from 2020 to 2021. Results. The embedded equity principles resulted in a rich data set and enabled analyses of populations previously undescribed. The final sample included 33 800 respondents including unprecedented numbers of populations underrepresented in traditional data sources. Analyses indicated that pandemic impacts related to basic needs, discrimination, health care access, workplace protections, employment, and mental health disproportionately affected these priority populations, which included Asian American/Pacific Islanders and parents. Conclusions. Equity-centered data approaches allow for analyses of populations previously invisible in surveillance data, enable more equitable public health action, and are both possible and necessary to deploy in state health departments. (Am J Public Health. 2024;114(S7):S599-S609. https://doi.org/10.2105/AJPH.2024.307800).

Promoting Equitable Access to COVID-19 Vaccinations in Rural and Underserved Arizona: Experiences From Three County Health Departments.

Promoting Equitable Access to COVID-19 Vaccinations in Rural and Underserved Arizona: Experiences From Three County Health Departments.

Project SIGNAL: A Dashboard for Supporting Community Confidence in Making Data-Driven Decisions.

Data dashboards have emerged as critical tools for surveillance and informing resource allocation. Despite their utility and popularity during COVID-19, there is a growing need to understand what tools and training are tailored to nonprofit community-based organizations that may partner with public health officials. In June 2021, the Rhode Island Department of Health and Brown University partnered to create Project SIGNAL (Spatiotemporal Insights to Guide Nuanced Actions Locally), which utilizes spatiotemporal analytics to identify Rhode Island's largest disparities in COVID-19-related outcomes (eg, testing, diagnosis, vaccinations) at the neighborhood level. Results were hosted in an interactive online dashboard (signal-ri.org) designed using principles of the CDC Clear Communication Index. The target audience included a network of 15 geographic areas called Health Equity Zones, funded by the health department to provide critical grassroots public health programs to address social, health, and economic outcomes in their communities. To disseminate the dashboard, a 6-hour virtual workshop series was created to train leaders to use the dashboard and increase their confidence in understanding common public health data terminology and concepts and better prepare attendees for rapid decision making during future public health emergencies. The Project SIGNAL dashboard was launched in August 2022 and has been accessed over 7500 times. A total of 84 community leaders were trained to use this dashboard, increasing their confidence in applying common public health metrics to make decisions about their COVID-19-related activities. While several studies have outlined best practices for data dashboards, this is among the first to examine incorporating these practices into a spatiotemporal decision tool designed specifically for community organizations. Project SIGNAL demonstrates that by incorporating design best practices and pairing data dashboards with hands-on training, we can empower community leaders to utilize advanced spatiotemporal methods to identify health disparities and take localized action.

Examining rurality and social determinants of health among women with GDM: a 15-year comprehensive population analysis

BackgroundGestational diabetes mellitus (GDM) is a common pregnancy complication with long-term health consequences for mothers and their children. The escalating trends of GDM coupled with the growing prevalence of maternal obesity, a significant GDM risk factor projected to approach nearly 60% by 2030 in Kansas, has emerged as a pressing public health issue.MethodsThe aim of this study was to compare GDM and maternal obesity trends in rural and urban areas and investigate maternal demographic characteristics influencing the risk of GDM development over a 15-year period. Trend analyses and a binary logistic regression were employed utilizing 2005 to 2019 de-identified birth record vital statistics from the Kansas Department of Health and Environment (N = 589,605).ResultsOver the cumulative 15-year period, a higher prevalence of GDM was observed across age, race/ethnicity, education, and insurance source. Throughout this period, there was an increasing trend in both GDM and obese pre-pregnancy BMI age-adjusted prevalence, with noticeable rural-urban disparities. From 2005 to 2019, women, including Asians (OR: 2.73, 95% CI 2.58%-2.88%), American Indian or Alaskan Natives (OR: 1.58, 95%, CI 1.44-1.73%), Hispanics (OR: 1.42, 95% CI 1.37%-1.48%), women residing in rural areas (OR: 1.09, 95%, CI 1.06-1.12%), with advanced maternal age (35–39 years, OR: 4.83 95% CI 4.47%-5.22%; ≥40 years, OR: 6.36 95%, CI 5.80-6.98%), with lower educational status (less than high school, OR: 1.15, 95% CI 1.10%-1.20%; high school graduate, OR: 1.10, 95% CI 1.06%-1.13%), Medicaid users (OR: 1.10, 95% CI 1.06%-1.13%), or with an overweight (OR: 1.78, 95% CI 1.72%-1.84%) or obese (OR: 3.61, 95% CI 3.50%-3.72%) pre-pregnancy BMI were found to be at an increased risk of developing GDM.ConclusionsThere are persistent rural-urban and racial/ethnic disparities present from 2005 to 2019 among pregnant women in Kansas with or at-risk of GDM. There are several socioeconomic factors that contribute to these health disparities affecting GDM development. These findings, alongside with prominent rising maternal obesity trends, highlight the need to expand GDM services in a predominantly rural state, and implement culturally-responsive interventions for at-risk women.