Public Health Administration Research Articles

‘Hot cities’ and rapid growth; experiences and responses of urban planning departments

AbstractIt is presumed that rapidly growing ‘hot cities’ adapt their planning and operations to meet their evolving population's needs. These presumptions inspired the development of the following mixed‐method, convergent parallel study. Data from urban planning officials across nine rapidly growing ‘hot cities’ were collected through pre‐interview surveys and qualitative key‐informant interviews. Thematic analysis was used to identify salient issues regarding awareness and perception of rapid population growth and the resulting response from their departments. Results indicate two main themes; Multidimensional Strain and Mitigation Strategies describe city experiences with rapid population growth effects and response. Across cities, urban planners expressed similar experiences of stress on land usage, housing, transportation, programing, and service delivery. Similar response patterns included evaluation and innovation of growth management strategies, enhanced collaboration, and equity considerations. This snapshot of rapid population growth repercussions and current city mitigation strategies may have future implications for public health and urban planning administrators in practice. Results shared also indicate how population data use and sharing can support Mitigation Strategies and impact community health.

Panelists Outline How to Address Patients’ Social Determinants of Health, Why It’s Important

Panelists Outline How to Address Patients’ Social Determinants of Health, Why It’s Important

Use of Social Media for Implementing Diagnoses, Consultation, Training, and Case Reporting Among Medical Professionals to Improve Patient Care: Case Study of WeChat Groups Across Health Care Settings.

BackgroundHealth professionals in low- and middle-resource settings have limited access to up-to-date resources for diagnosing and treating illnesses, training medical staff, reviewing newly disseminated guidelines and publications, and preparing data for international disease reporting. A concomitant difficulty in high-resource settings is the need for continuing education and skills up-training in innovative procedures on unfamiliar social media platforms. These challenges can delay both patient care and epidemiological surveillance efforts. To overcome these challenges, health professionals have adapted WeChat Groups to implement timely, low-cost, and high-quality patient care.ObjectiveThe primary study aim was to describe the processes taken by medical professionals across their diverse physical and virtual networks in adapting a bottom-up approach to collectively overcome resource shortages. The secondary study aim was to delineate the pathways, procedures, and resource/information sharing implemented by medical professionals using an international publicly available popular social media app (WeChat) to enhance performance of facility-based procedures and protocols for improved patient care.MethodsIn-depth interviews, observations, and digital ethnography of WeChat Groups communications were collected from medical professionals in interconnected networks of health care facilities. Participants’ WeChat Groups usage and observations of their professional functions in interconnected networks were collected from November 2018 to 2019. Qualitative analysis and thematic coding were used to develop constructs and themes in NVivo. Constructs incorporated descriptions for the implementation and uses of WeChat Groups for professional connections, health care procedures, and patient care. Themes supporting the constructs focused on the pathways and venues used by medical professionals to build trust, to establish and solidify online networks, and to identify requests and resource sharing within WeChat Groups.ResultsThere were 58 participants (males 36 and females 22) distributed across 24 health care settings spanning geographical networks in south China. Analysis yielded 4 constructs and 11 themes delineating the bottom-up usage of WeChat Groups among clinicians, technicians, nurses, pharmacists, and public health administrators. Participants used WeChat Groups for collectively training hospital staff in complex new procedures, processing timely diagnoses of biological specimens, staying abreast of latest trends and clinical procedures and symptoms, and contributing to case reporting for emergent illnesses and international surveillance reporting. An unexpected strength of implementing clinical, training, and research support on a popular app with international coverage is the added ability to overcome administrative and geographic barriers in resource distribution. This advantage increased a network’s access to WeChat Groups members both working within China and abroad, greatly expanding the scope of shared resources.ConclusionsThe organic, bottom-up approach of repurposing extant social media apps is low cost and efficient for timely implementation to improve patient care. WeChat’s international user base enables medical staff to access widespread professional networks across geographic, administrative, and economic barriers, with potential to reduce health disparities in low-resource settings.

Administrative management of nurses in the public sector

Background: For the public sector, administrative management in health is a set of activities that nurses carry out to direct an organization in a conscious and systematic way whenever they are in charge of administrative functions and occupations; they must possess a leadership capacity; They must meet the goals of the organization and the nursing division, enhancing the motivation of service workers. Objective: This study aimed to review the literature regarding the administrative management of nurses in health centers; Said management belongs to the most relevant components when seeking to offer an optimal service since the success of that organization will depend on it. Method: It was based on the bibliographic review, so scientific databases such as Web of Science, ERIC and Scielo were searched. Results: The fundamental functions of nurses in administrative management are of priority, because they contribute to public health policies and administration of the system and these competencies are essential for the achievement of institutional goals.

Job Satisfaction in Public Health Care Sector, Measures Scales and Theoretical Background

Public Health care organizations are the most important social systems in which human resources are the wealth and central factor. This study is a literature review on job satisfaction in the public health care sector, giving tools to prevent with measures scales and information's in theoretical background. Evidence of job satisfaction in the public health care sector is encountered by Greek and Global public health organizations and services. Limited literature in connection and contribution of occupational health and safety with Job Satisfaction in the frame of policy and management. Public health care professionals and Administration managers in the healthcare services need to understand the benefits of adopting effective Job satisfaction. The aim of this research was to identify also analyze the knowledge of job satisfaction in the Public Health Care Sector, Measures Scales necessary to identify and knowledge objective to positively affect Public health professionals’ job satisfaction and therefore health care sector quality services. Information’s and knowledge produced an understanding of the mechanisms that increase job satisfaction and contribute to the improvement of psychosocial risks, and well-being to take appropriate measures and scales to create a Healthy and Hygiene working environment. Affects direct in health economics as well as organizational productivity, and quality of performance. A systematic review was conducted for the last two-year in Scopus, Web of Science, Science Direct, and Scientific Journals. There are very few papers published based on the very contemporary title considered for the article, classified as eligible according to the previously established criteria.

Dynamics of drug overdose in the 20th and 21st centuries: The exponential curve was not inevitable, and continued increases are preventable.

While much has been written about the positive individual and collective effects of Supervised injection services (SIS), notably on health and drug-related harm, little research focuses on their operational context and constraints. Building on Lascoumes and Le Gales's “public policy instrument and instrumentation” framework (2007), this article analyzes the implementation of Montreal SIS and discusses how the organizational aspects of SIS produce the contexts for drug injection.Using an ethnographic approach, this article draws on three types of data: 10 months of participant observation in a SIS (700 h); 19 semi-structured interviews with staff members (social workers, peers, heads of staff, management); and analysis of organizational documents (protocols, staff notebooks).First, this article examines how political context and advocacy coalitions produced Montreal SIS as a public policy instrument, affecting both the philosophy and the implementation of the service. It shows that Montreal SIS were developed under a health care network blueprint rather than a community organization harm reduction framework. Then, it analyzes how SIS as a policy instrument defines what constitutes appropriate injection practices, trying to supervise injection as an individual and technical act, rather than a broader social practice composed of pleasure, rituals, routines, and group dynamics.Montreal SIS were conceptualized under a “health banner” and through alliances between regional public health administration and local well-known community organizations. They were then developed mostly under a health care administration blueprint, although operated at a ground-level by local community organizations. It created tensions between the logics of “zero risk” and “harm reduction”, and ambiguity about how injection should be supervised and what parts of drug use could be managed.

Reply commentary by Jalal and Burke.

While much has been written about the positive individual and collective effects of Supervised injection services (SIS), notably on health and drug-related harm, little research focuses on their operational context and constraints. Building on Lascoumes and Le Gales's “public policy instrument and instrumentation” framework (2007), this article analyzes the implementation of Montreal SIS and discusses how the organizational aspects of SIS produce the contexts for drug injection.Using an ethnographic approach, this article draws on three types of data: 10 months of participant observation in a SIS (700 h); 19 semi-structured interviews with staff members (social workers, peers, heads of staff, management); and analysis of organizational documents (protocols, staff notebooks).First, this article examines how political context and advocacy coalitions produced Montreal SIS as a public policy instrument, affecting both the philosophy and the implementation of the service. It shows that Montreal SIS were developed under a health care network blueprint rather than a community organization harm reduction framework. Then, it analyzes how SIS as a policy instrument defines what constitutes appropriate injection practices, trying to supervise injection as an individual and technical act, rather than a broader social practice composed of pleasure, rituals, routines, and group dynamics.Montreal SIS were conceptualized under a “health banner” and through alliances between regional public health administration and local well-known community organizations. They were then developed mostly under a health care administration blueprint, although operated at a ground-level by local community organizations. It created tensions between the logics of “zero risk” and “harm reduction”, and ambiguity about how injection should be supervised and what parts of drug use could be managed.

Between zero risk and harm reduction: An ethnography of Montreal supervised injection services as a public policy instrument.

While much has been written about the positive individual and collective effects of Supervised injection services (SIS), notably on health and drug-related harm, little research focuses on their operational context and constraints. Building on Lascoumes and Le Gales's "public policy instrument and instrumentation" framework (2007), this article analyzes the implementation of Montreal SIS and discusses how the organizational aspects of SIS produce the contexts for drug injection. Using an ethnographic approach, this article draws on three types of data: 10 months of participant observation in a SIS (700h); 19 semi-structured interviews with staff members (social workers, peers, heads of staff, management); and analysis of organizational documents (protocols, staff notebooks). First, this article examines how political context and advocacy coalitions produced Montreal SIS as a public policy instrument, affecting both the philosophy and the implementation of the service. It shows that Montreal SIS were developed under a health care network blueprint rather than a community organization harm reduction framework. Then, it analyzes how SIS as a policy instrument defines what constitutes appropriate injection practices, trying to supervise injection as an individual and technical act, rather than a broader social practice composed of pleasure, rituals, routines, and group dynamics. Montreal SIS were conceptualized under a "health banner" and through alliances between regional public health administration and local well-known community organizations. They were then developed mostly under a health care administration blueprint, although operated at a ground-level by local community organizations. It created tensions between the logics of "zero risk" and "harm reduction", and ambiguity about how injection should be supervised and what parts of drug use could be managed.

Relationship between Government Financial Grants, Internal Revenue and Maternal Mortality Rate in South Africa

Funding of public hospitals and access to quality health care is a universal problem especially in developing countries. This paper aims to examine the relationship between government financial grants, internal revenue and maternal mortality rate. Previous literature has suggested that to achieve better health outcomes, multiple factors including but not limited to finance must be taken into consideration. Secondary data from audited annual health reports (2014/15 – 2018/19) of the nine South African Provinces was analyzed with the employment of the panel data regression technique. Internal Government Revenue was statistically significant at a 5% level of significance (p < 0.05) and Government Financial Grant was not statistically significant (p >0.05). Maternal mortality rate is therefore dependent on internal revenue and not on government financial grants. The findings change the ancient saying that maternal health outcomes shall improve when the government pumps more finances into the health system. Instead, the study reveals that internal revenue generation has an impact on the maternal mortality rate thus bringing in another approach in the fight against maternal mortality. The study adds value to the public health administration in that it brings a different perspective on the fight against maternal mortality in South Africa.

Lessons Learned: The Varied Responses of Massachusetts' Local Health Departments During the COVID-19 Pandemic.

Context:Massachusetts' decentralized public health model holds tightly to its founding principle of home rule and a board of health system established in 1799. Consequently, Massachusetts has more local health departments (n = 351) than any other state. During COVID-19, each health department, steeped in centuries of independence, launched its own response to the pandemic.Objectives:To analyze local public health resources and responses to COVID-19.Design:Semistructured interviews and a survey gathered quantitative and qualitative information about communities' responses and resources before and during the pandemic. Municipality demographics (American Community Survey) served as a proxy for community health literacy. We tracked the frequency and content of local board of health meetings using minutes and agendas; we rated the quality of COVID-19 communications on town Web sites.Setting:The first 6 months of the COVID-19 pandemic in Massachusetts: March-August 2020.Participants:Health directors and agents in 10 south-central Massachusetts municipalities, identified as the point of contact by the Academic Public Health Corps.Main Outcome Measures:We measured municipality resources using self-reported budgets, staffing levels, and demographic-based estimates of community health literacy. We identified COVID-19 responses through communities' self-reported efforts, information on town Web sites, and meeting minutes and agendas.Results:Municipalities excelled in communicating with residents, local businesses, and neighboring towns but lacked the staffing and funding for an efficient and coordinated response. On average, municipal budgets ranged from $5 to $16 per capita, and COVID-19 consumed 75% of health department staff time. All respondents noted extreme workload increases. While municipal Web sites received high scores for Accurate Information, other categories (Navigability; Timeliness; Information Present) were less than 50%.Conclusions:Increased support for regionalization and sustained public health funding would improve local health responses during complex emergencies in states with local public health administration.

Examination of Online Interprofessional Education to Develop Graduate Students’ Interprofessional Socialization and Collaborative Competencies

ABSTRACT Interprofessional education (IPE) is important to prepare graduate students for collaborative practice. This mixed methods study sought to evaluate a full-semester, asynchronous online IPE course for graduate students. Thirty-one graduate social work, nursing, public health, and health administration students participated. Interprofessional socialization and collaborative competencies were measured at three points in the semester. There were statistically significant improvements in self-reported socialization and competencies. Qualitative analysis revealed participants experienced new perspectives, developed appreciation of interprofessional collaboration, practiced communication and teamwork skills, and used course lessons in clinical practice. Study findings indicate that online IPE can help improve graduate students’ interprofessional socialization and collaborative competencies. Further, students indicated they applied course lessons to their school and work clinical practice sites.

'Imperfect but useful': pandemic response in the Global South can benefit from greater use of mathematical modelling.

Mathematical modelling has been a helpful resource for planning public health responses to COVID-19. However, there is a need to improve the accessibility of models built within country contexts in the Global South. Immediately following the overwhelming ‘second wave’ of COVID-19 in India, we developed a user-friendly, web-based modelling simulator in partnership with the public health experts and health administrators for subnational planning. The purpose was to help policy-makers and programme officials at the state and district levels, to construct model-based scenarios for a possible third wave. Here, we describe our experiences of developing and deploying the simulator and propose the following recommendations for future such initiatives: early preparation will be the key for pandemic management planning, including establishment of networks with potential simulator users. Ideally, this preparedness should be conducted during ‘peace time’, and coordinated by agencies such as WHO. Second, flexible modelling frameworks will be needed, to respond rapidly to future emergencies as the precise nature of any pandemic is impossible to predict. Modelling resources will, therefore, need to be rapidly adaptable to respond as soon as a novel pathogen emerges. Third, limitations of modelling must be communicated clearly and consistently to end users. Finally, systematic mechanisms are required for monitoring the use of models in decision making, which will help in providing modelling support to those local authorities who may benefit most from it. Overall, these lessons from India can be relevant for other countries in the South-Asian-Region, to incorporate modelling resources into their pandemic preparedness planning.

Community Pharmacists and Influenza Vaccination: Opportunities and Challenges From a Public Health Perspective

Context: In Quebec, Bill 31, adopted on March 18, 2020, extended vaccination to pharmacists. Despite many advantages, this new practice comes with public health issues reinforced in the context of COVID-19. Therefore, it is essential to understand the opportunities and challenges of the participation of community pharmacists in influenza vaccination, from a public health perspective by (i) describing the year of 2020-2021 influenza vaccination offer, (ii) its opportunities and challenges, and (iii) its impact on the accessibility of this service newly offered by pharmacists to the most vulnerable people. Methods: This research is a case study from one of the most affected areas by COVID-19 in Canada: Laval. Our method combines documentary analysis and semi-structured interviews with health professionals and public health actors (n = 23). Researchers used a thematic analysis to analyze these results. Results: Most partners (pharmacists, public health administrators) underlined multiple opportunities of this new practice, ie, pharmacists who can vaccinate, particularly for chronically ill patients. However, structural and strategical challenges remain. More specifically, vaccination seemed to only rely on a “first come, first served” basis, which questions public health objectives of vaccination, such as equitable access. Conclusion: The introduction of new actors, such as pharmacists, represents a major opportunity to improve vaccination coverage and reduce the burden of COVID-19 on the health system. However, this delegation of a public health activity to the private sector undoubtedly requires closer coordination with public health institutions.

Anticorruption Measures in the Healthcare System During the Pandemic

This article aims to analyze anti-corruption measures in the healthcare system during a pandemic. During this study, the problem of corruption was studied as a subject of interdisciplinary analytical discourse in the global and domestic expert space. Also, based on the results of the content analysis of critical analytical documents from leading international anti-corruption organizations, specific health problems during the pandemic, typical for all countries of the world, were identified. As a result of the analysis of international documents, Kazakhstani scientific and analytical articles, leading state initiatives of Kazakhstan in the field of reforming the country, key conclusions were drawn regarding the understanding of strategic ways of sustainable development through the introduction of an effective and efficient mechanism for adapting world standards to the Kazakhstani field of combating corruption in general and to the system public administration in the healthcare system in particular. The study was carried out based on a comparative analysis of expert assessments of corruption in the healthcare sector. To determine the adaptive effectiveness of applying the recommendations of the global anti-corruption expertise in Kazakhstani practices of combating corruption in the public health administration system, an empirical study of institutional aspects in anti-corruption international analytics was undertaken. This made it possible to see the significance of local features and systemic prerequisites that determine the success of anti-corruption actions in Kazakhstan. During the preparation of the article, the following sources were used: socio-economic expertise of Interpol; National Report on Combating Corruption; analytics from a global anti-corruption NGO.

Resilience and entrepreneurship: a systematic review

Background: The concept of resilience runs through an array of disciplines, consisting of engineering, public health, ecology, psychology, sociology, disaster management, and business administration. Researchers have tries to explain the relationship amongst connected ideas such as resiliency, adaptability, transformability, and vulnerability but their varied definitions and differences between them remain fuzzy. There are two reasons why resilience theory is important in entrepreneurship. Firstly, researchers generally employ the term resilience to mean consciousness, determination, perseverance, or self-value to justify why some entrepreneurs and their firms achieve better results than their non-resilient counterparts. Secondly, there are cognitive and behavioral entrepreneurial traits that strengthen a firm’s capability to adapt to varying conditions. The aim of this study is to review the literature that intercepts resilience and entrepreneurship. The study will attempt to identify scholarly conversations to construct notions of resilience and entrepreneurship. Therefore, limitations in the current literature will be examined and directions for future studies would be highlighted. Methods: This paper adopted a systematic interdisciplinary review of relevant studies that is patterned using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: The scholarly works selected from the literature portrayed six emerging colloquies or research tributaries that intercept entrepreneurship and resilience: Resilience as a function of entrepreneurial individuals or firms,Resilience generating entrepreneurial intentions,Entrepreneurial behavior boosting organizational resilience and,Resilience in the framework of entrepreneurial failure,Entrepreneurship and culture,Resilience as a process of recovery and transformation. Conclusions: This study serves as a backdrop for the emergence of more nuanced debates on the relationship that exists between different streams of conversations on resilience. In addition, this paper shows how entrepreneurs contribute towards promoting a constructively sustainable means for socio-economic development.

COVID-19 Response and Preparedness in the Okayama Prefecture

In this article, the authors explain how Division of Health and Welfare, the Okayama Prefectural Government, addressed the COVID-19 pandemic by focusing on the public health administration, policies enforcement, and government measures to ease the burden of people and industry, especially the hospital industry.

Technologies of Expertise: Opioids and Pain Management’s Credibility Crisis

Journalistic accounts of the opioid crisis often paint prescription opioids as the instrument of profit-minded pharmaceutical companies who enlisted pain specialists to overprescribe addictive drugs. Broadening beyond a focus on pharmaceutical power, this article offers a comparative-historical explanation, rooted in inter- and intra-professional dynamics, of the global increase in rates of opioid prescribing. Through archival analysis and in-depth interviews with pain specialists and public-health officials in the United States and France, I explain how and why opioids emerged as the “right tool for the job” of pain relief in the 1980s and 1990s, affecting how pain science is produced, pain management is administered, and a right to pain relief is promised in different national contexts. I argue that opioids, selected and destigmatized as the technology for pain relief, helped establish a global network of pain expertise, linking a fledgling field of pain specialists to the resources of global-health governance, public-health administration, humanitarian organizations, and pharmaceutical companies. I then compare how U.S. and French pain specialists leveraged opioids to strengthen the boundaries of their emergent fields. Pain specialists’ differing degrees of autonomy in each country’s network of pain expertise shaped the extent to which opioids could dominate pain management and lead to crisis. Tracing the relationship between opioids and pain expertise, I show how technologies can drive crises of expert credibility if and when they escape the control of the networked fields that selected them.

Adaptive Scheme for Crowd Counting Using off-the-Shelf Wireless Routers

Since the outbreak of the world-wide novel coronavirus pandemic, crowd counting in public areas, such as in shopping centers and in commercial streets, has gained popularity among public health administrations for preventing the crowds from gathering. In this paper, we propose a novel adaptive method for crowd counting based on Wi-Fi channel state information (CSI) by using common commercial wireless routers. Compared with previous researches on device-free crowd counting, our proposed method is more adaptive to the change of environment and can achieve high accuracy of crowd count estimation. Because the distance between access point (AP) and monitor point (MP) is typically non-fixed in real-world applications, the strength of received signals varies and makes the traditional amplitude-related models to perform poorly in different environments. In order to achieve adaptivity of the crowd count estimation model, we used convolutional neural network (ConvNet) to extract features from correlation coefficient matrix of subcarriers which are insensitive to the change of received signal strength. We conducted experiments in university classroom settings and our model achieved an overall accuracy of 97.79% in estimating a variable number of participants.

Subjective Well-being Among Migrant Workers Residing in a Shelter Home During Lockdown: A Pilot Survey From North India.

Objective: To explore the impact of lockdown due to coronavirus disease 2019 (COVID-19) on the subjective well-being of migrant workers staying in a shelter home in India.Methods: A total of 54 residents of the shelter home participated in this exploratory survey study. Baseline assessments included sociodemographic profile, the Subjective Well-Being Inventory (SUBI), and the Perceived Stress Scale. The participants were reassessed with the SUBI after 2 weeks of staying in the shelter home. The survey was administered April 11 to May 10, 2020.Results: The mean ± SD age of the participants was 23.54 ± 11.68 years, and the majority were men and in the age group 21-30 years (45%). At baseline assessments, the mean ± SD stress level score was 17.39±4.62. The mean ± SD SUBI score was 81.44 ± 4.62 at baseline and increased to 100.65±5.95 after 2 weeks of staying in the shelter home.Conclusions: The survey findings demonstrate that the levels of subjective well-being among participants improved after their physical and mental health needs were met during their stay in the shelter home. The findings could help policy planners and senior public health administrators minimize gaps to better understand the multiple issues related to the subjective well-being of this population.

Pivoting Community-Based Educational Programming for Formal and Informal Caregivers During COVID-19

The Utah Geriatric Education Consortium provides community-based education about Age-Friendly Health Care and Dementia-Friendly Communities targeted towards informal and professional caregivers. As such, we have collaborated with our community partners to host a series of “Fireside Chats”. Since March of 2020, we have hosted 17 Fireside Chats. Our attendance has exceeded our expectations, with over 500 attendees (average of 32 attendees per session). The professional attendees come from a variety of interdisciplinary backgrounds including nursing, medicine, public health, allied health, aging services, and health and long-term care administration. Our non-professional attendees include family caregivers, students, and older adults in the community. This session will address: a) the logistical steps we took (and lessons learned) as we “pivoted” our Fireside Chats into a virtual video-conference format, b) how we redesigned the curriculum to address topics related to COVID-19, and c) will review our evaluation feedback.