Schools Of Public Health Research Articles

168 Modeling biomedical graduate student career development needs and training contexts

Objectives/Goals: To design and implement programming that better prepares graduate students for diverse roles in a variety of workforce environments, our study models the training landscape and programming needs of graduate students in behavioral, clinical, and biomedical graduate programs at a large Midwestern school of medicine and public health. Methods/Study Population: We conducted six focus groups (two graduate program manager focus groups and four graduate student focus groups), to assess the programming, career development, and training needs of graduate students. Using a grounded theory approach, we first engaged in open coding of a sample of transcripts. After developing a codebook, we continued with an iterative coding process interspersed with coder meetings to discuss emerging and changing codes. Using the framework of landscape analysis allowed our coding and modeling to go beyond graduate student needs and study the varying relationships and contexts that impact graduate students throughout their training, such as relationship to supervisor or institutional policies. Results/Anticipated Results: Preliminary results indicate that students wrestle with their status as both students and workers. Specifically, conflict arises between graduate and supervisor expectations around time spent in class, lab, and other career development activities based on these divergent roles. Students and program managers also note the disparities that arise from the university’s lack of standard, formalized policy on labor issues, such as paid leave. Data also suggest that students on training grants note the difference in access to career development resources compared to colleagues. In many cases, students themselves coordinate ad hoc programming to better suit their career and professional development needs, although this work is not a required aspect of their training. Discussion/Significance of Impact: We characterize current graduate training landscapes, which continue to shift as graduate student bodies diversify, unionize, and express interest in increasingly varied biomedical careers. Data from multiple perspectives facilitate creating, implementing, and evaluating supportive training programs that meet identified student needs.

261 Driving community health and mental health programming through collaborative, ongoing community health needs assessments

Objectives/Goals: The Research Education and Community Health (REACH) coalition proposes to develop the infrastructure for continuous and comprehensive collection of community health data to drive programs, education, and funding priorities across municipal agencies, institutions, and nonprofit organizations in Galveston County. Methods/Study Population: The workgroup through REACH will organize and adopt a comprehensive community health needs assessment that 1) accumulates existing, readily available data for shared use (e.g., Center for Health Care Data at the UT School of Public Health, the Texas Department of State Health Services Center for Health Statistics, and Epic Cosmos, a data aggregation tool, used by UTMB and other health systems to improve patient care); 2) utilizes data collected throughout the community (i.e. non-profits, municipal agencies, and law enforcement); and 3) applies qualitative data from focus groups and/or key informant interviews, so we can hear directly from community members about what their needs are. By doing so, we hope all can benefit from having access to current and relevant data to drive our programs, education, and funding. Results/Anticipated Results: This Community Health Needs Assessment is being coordinated by a diverse workgroup including community organizations, researchers, and policy makers who will benefit from access to current and relevant data. The Galveston Youth Risk Student Survey, completed every three years and most recently in 2024, revealed lingering health and mental health effects of the COVID-19 pandemic on County youth. This highlighted the need for community access to current, accurate, and ongoing data to drive programming, interventions, and education. The REACH Coalition, made up of 23 UTMB Centers and Institutes and 39 community organizations, is spearheading this effort as a part of its mission to facilitate collaborative research, service, and educational efforts. Discussion/Significance of Impact: Collected data will be used to establish and support ongoing, coordinated interventions in response to identified needs. Shared ownership of data and project implementation optimizes resources and reduces gaps and/or redundancy in community programming.

Accuracy of Large Language Models for Literature Screening in Thoracic Surgery: Diagnostic Study.

Systematic reviews and meta-analyses rely on labor-intensive literature screening. While machine learning offers potential automation, its accuracy remains suboptimal. This raises the question of whether emerging large language models (LLMs) can provide a more accurate and efficient approach. This paper evaluates the sensitivity, specificity, and summary receiver operating characteristic (SROC) curve of LLM-assisted literature screening. We conducted a diagnostic study comparing the accuracy of LLM-assisted screening versus manual literature screening across 6 thoracic surgery meta-analyses. Manual screening by 2 investigators served as the reference standard. LLM-assisted screening was performed using ChatGPT-4o (OpenAI) and Claude-3.5 (Anthropic) sonnet, with discrepancies resolved by Gemini-1.5 pro (Google). In addition, 2 open-source, machine learning-based screening tools, ASReview (Utrecht University) and Abstrackr (Center for Evidence Synthesis in Health, Brown University School of Public Health), were also evaluated. We calculated sensitivity, specificity, and 95% CIs for the title and abstract, as well as full-text screening, generating pooled estimates and SROC curves. LLM prompts were revised based on a post hoc error analysis. LLM-assisted full-text screening demonstrated high pooled sensitivity (0.87, 95% CI 0.77-0.99) and specificity (0.96, 95% CI 0.91-0.98), with the area under the curve (AUC) of 0.96 (95% CI 0.94-0.97). Title and abstract screening achieved a pooled sensitivity of 0.73 (95% CI 0.57-0.85) and specificity of 0.99 (95% CI 0.97-0.99), with an AUC of 0.97 (95% CI 0.96-0.99). Post hoc revisions improved sensitivity to 0.98 (95% CI 0.74-1.00) while maintaining high specificity (0.98, 95% CI 0.94-0.99). In comparison, the pooled sensitivity and specificity of ASReview tool-assisted screening were 0.58 (95% CI 0.53-0.64) and 0.97 (95% CI 0.91-0.99), respectively, with an AUC of 0.66 (95% CI 0.62-0.70). The pooled sensitivity and specificity of Abstrackr tool-assisted screening were 0.48 (95% CI 0.35-0.62) and 0.96 (95% CI 0.88-0.99), respectively, with an AUC of 0.78 (95% CI 0.74-0.82). A post hoc meta-analysis revealed comparable effect sizes between LLM-assisted and conventional screening. LLMs hold significant potential for streamlining literature screening in systematic reviews, reducing workload without sacrificing quality. Importantly, LLMs outperformed traditional machine learning-based tools (ASReview and Abstrackr) in both sensitivity and AUC values, suggesting that LLMs offer a more accurate and efficient approach to literature screening.

Study of characteristics of faculty of high-level public health schools in China based on internet information

Objective: To understand the characteristics of faculty in high-level public health schools in China, and analyze the differences in age, area and school level. Methods: Based on the internet information, the faculty information of 18 high-level public health schools was collected for a descriptive analysis on faculty characteristics. Results: There were 1 642 faculty members in the schools of public health in China, in whom 51.8% were women, 92.8% had doctorate, 32.4% had postdoctoral experience and 56.8% were former students staying to teach. The average age of the faculty members was (45.6±9.8) years. Meanwhile the top three study subjects were epidemiology and health statistics (31.0%), occupational health and environmental sanitation (16.5%), and health toxicology (16.3%). In the faculty members aged >40 years, 90.2% had doctorate, 62.6% were former students staying to teach, and 24.7% had no educational background of public health. The proportions of faculty members aged ≤40 years in the three groups mentioned above were 98.2%, 45.8% and 39.1% respectively. In terms of study subject, big data study were mainly conducted in the schools with top subject ranking and the schools in developed areas. Conclusions: The public health faculty was characterized by cross education background and high capability. The study subjects and sub-disciplines varied with schools and areas.

Exploration and practice of the collaborative education mode integrating full-time master of public health postgraduates with standardized public health physician training

To enhance the practical ability and job competency of full-time master of public health (MPH) postgraduates and explore a collaborative training mode that integrates medical education with a prevention-and-control approach, in line with standardized public health physician training, the Beijing Center for Disease Control and Prevention, in collaboration with the School of Public Health affiliated to Capital Medical University, had recruited full-time MPH postgraduates since 2015. These students were trained and assessed through a collaborative training mode based on the Beijing public health physician training mechanism. Through the introduction and analysis of the training objectives, training process, practical assessment methods, training quality, and results, this article suggests that the construction of a collaborative training mode integrating MPH postgraduate education of public health professionals and standardized public health physician training has explored a new pathway for cultivating "four-certification integration" public health professionals. This aligns with the Chinese national strategy for public health talent development and can alleviate the problems of "contradictions between work and study", including the current shortage of public health physicians at present and the difficulties in standardized training enrollment. In addition, this collaborative training mode provides valuable experience for other medical schools in training applied public health professionals who meet national public health standards and combine prevention with treatment.

Acetylsalicylic acid and subarachnoid hemorrhage in the Nurses' Health Study.

Acetylsalicylic acid (aspirin) is known to increase the risk of bleeding throughout the body. However, there is also evidence to suggest that acetylsalicylic acid may have a protective role in the formation and rupture of intracranial aneurysms. Previous studies investigating acetylsalicylic acid and subarachnoid hemorrhage (SAH) have so far provided conflicting results. The aim of this study was to analyze the Nurse's Health Study (NHS) using serial assessments to evaluate differences in rates of SAH in those participants taking acetylsalicylic acid and those not taking acetylsalicylic acid while considering dose, frequency, and duration as well as different types of SAH. The NHS is a prospective population-based cohort study of female nurses. Information on acetylsalicylic acid was first reported in 1980 until 2016 and included acetylsalicylic acid use, dose, frequency, and duration. All stroke cases were classified by physicians. Cox proportional-hazards regression models were used to estimate the hazard ratio (HR) associated with acetylsalicylic acid use. A total of 117,648 NHS participants were eligible for analysis with 357 cases of SAH observed over 4,091,239 years of follow-up. There was no association between acetylsalicylic acid use and SAH (HR = 1.02; 95% confidence interval (CI) = [0.82, 1.28], p = 0.85), aneurysmal SAH (1.04; 95% CI = [0.78, 1.39], p = 0.78), or idiopathic SAH (HR = 0.94; 95% CI = [0.65, 1.34], p = 0.72). The number of acetylsalicylic acid tablets per week was associated with SAH (HR = 1.03; 95% CI = [1.00, 1.06], p = 0.02), specifically fatal SAH (HR = 1.04 [1.00, 1.08], p = 0.03). There was no association between frequency and SAH (HR = 1.06; 95% CI = [0.99, 1.13], p = 0.07). There was no evidence to support a protective association between acetylsalicylic acid and either SAH or aneurysmal SAH in female participants. In fact, there was some evidence to suggest increased SAH risk with increased acetylsalicylic acid dose in some but not all analyses. Data are available by request from the Brigham and Women's Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health.

Gun Violence, Physician Leadership, and a Public Health Perspective with Dr. Megan Ranney

In this compelling episode of SoundPractice, host Mike Sacopulos engages in a thought-provoking conversation with Megan Ranney, MD, MPH, FACEP, dean of the Yale School of Public Health and a distinguished professor of emergency medicine. Ranney, a renowned expert on gun violence, delves into the intricate intersection of healthcare, public health, and gun violence in the United States. She shares her unique career journey from a Peace Corps volunteer to an emergency medicine physician and public health leader. The discussion highlights the profound individual and public health consequences of gun violence, emphasizing the necessity of a public health approach to this pervasive issue. This episode offers valuable insights and actionable strategies for physician leaders and healthcare professionals committed to addressing gun violence and improving public health outcomes.

Prevalence, disparities, and trends in intimate partner violence against women living in urban slums in 34 low-income and middle-income countries: a multi-country cross-sectional study.

Prevalence, disparities, and trends in intimate partner violence against women living in urban slums in 34 low-income and middle-income countries: a multi-country cross-sectional study.

Association between depression and vitamin D3 among the people attending private clinic in Ernakulam, Kerala, India

ABSTRACT Background: Depression is a serious global public health issue due to its significant impact on well-being and quality of life. Since vitamin D3 is involved in more than simply bone health, there has been discussion over its potential link to depression. Despite growing evidence that there is a connection between vitamin D3 deficiency and depression, there is a lack of evidence from India. So this study aims to evaluate vitamin D deficiency and depression among patients attending private clinics in Ernakulam, Kerala, India. Methods: The cross-sectional study investigated the association between vitamin D3 levels and depression. This study was approved by the institutional ethical committee of SRM School of Public Health, SRMIST, Kattankulathur, and Tamil Nadu. After getting informed consent from the patients the data regarding socio-demographic profile, Vitamin D and depression was acquired from the patients during their next consecutive follow-up. Participants without significant psychiatric problems or chronic illnesses between the ages of 18 and 49 were enrolled. Serum 25 (OH) D levels were tested, and depression was evaluated using the modified Beck Depression Inventory (BDI-II). Descriptive, Chi-square, and logistic regression analyses were done. Results: The study was among the 126 participants. Depression was more common in those with low vitamin D3 levels than in those without it (67.2% vs. 32.8%). There is a significant association between depression and demographic variables such as age, gender, and occupation. Under logistic regression, age was found to be a significant predictor, the odds ratios showed that older adults had 12 times the odds of developing depression than younger adults. Males have 2.9 times the odds of developing depression than females. Conclusion: This study shows that there is an association between vitamin D insufficiency and increased depression in Ernakulam, Kerala, India. The identification and treatment of depression should take into account vitamin D3 status since treating vitamin D3 insufficiency may have an impact on mental health outcomes. Prospective investigations ought to delve into longitudinal associations and encompass a range of demographics to reinforce causal deductions and overall applicability.

Perceptions and attitudes of medical students toward opioid education: A qualitative study.

Perceptions and attitudes of medical students toward opioid education: A qualitative study.

Career Trends of University of Minnesota School of Public Health Alumni: Baseline Survey Results for a Longitudinal Study.

This work describes baseline results of the University of Minnesota (UMN) School of Public Health (SPH) Career Trends Survey (CTS), allowing for comparison to future CTS data. The UMN SPH CTS was fielded using multiple methods, including paper and online, from January to March 2021. All US-based (at time of survey) UMN SPH alumni for whom the school maintained contact information were eligible to complete the survey. In total, 8817 alumni received the survey and 1966 responded (22% response rate). We examined the proportion of graduates' first jobs by job sector over time, the proportion of graduates who switched job sectors over time, and how closely graduates' first jobs related to public health over time. Graduates overwhelmingly reported that their first jobs were either "somewhat related" or "strongly related" to public health, but a smaller proportion of graduates in the 2010s reported their first jobs being "strongly related" to public health compared to graduates from the first decades for which we have data. Data suggest a noteworthy trend: proportionally fewer of our recent public health graduates are going into governmental public health. Though a more nationally representative dataset is still needed, our results are a crucial step forward in determining how to mitigate the staffing up difficulties faced by many public health agencies.

Quality of Information on Medication Abortion in Private Pharmacies: Results from a Mystery Client Study in Kinshasa, Democratic Republic of Congo

Introduction: Pharmacies are important points of access and information for women seeking medication abortion. In the context of the Democratic Republic of Congo [DRC], where the legal conditions for abortion have expanded in recent years and now allow pharmacies to dispense medication abortion with a prescription, little is known about medication abortion counseling and care offered by pharmacy staff. The aim of this study was to explore the quality of information provided by pharmacy staff to customers seeking medication abortion in Kinshasa. Methodology: A cross-sectional study using the mystery client (MC) approach was conducted in 480 pharmacies between April and May 2023. Trained female (n = 9) and male (n = 3) investigators played the role of mystery clients seeking abortion medication for themselves (or their partner or relative), and they asked questions to assess the performance of pharmacy staff and the quality of the provided information. The MCs recorded the results of their visits immediately after they left the pharmacy. Data were analyzed using Stata 17.0 and QGIS. The research protocol received ethical approval from the Kinshasa School of Public Health, and the need for informed consent was waived as pharmacy providers were being observed acting in their professional capacity. Results: Misoprostol was available at 40% of pharmacies visited, while mifepristone–misoprostol was available at less than 2%. Correct dosage information for misoprostol was provided by only 23% of the providers, with the lowest proportion observed in interactions involving male partners (2.4%). During discussions, only 10.6% of the providers explained what to expect during the abortion process. The quality of information differed according to the client profile, the district, and whether the client had a prescription. Conclusions: While medication abortion can provide a safe option for women seeking to manage their own abortion, the lack of adequate information on the correct dosage and administration can hinder the effectiveness of this regimen. To fully realize the potential of this medication for reducing unsafe abortion, it is essential that pharmacy staff are trained and supported to provide high-quality information and services, and that inequities in access to medications are addressed.

Distribution and Specialties of Broadly Versus Narrowly Defined Public Health Nurses Working in Government Settings in the United States, 2022.

Objectives. To estimate the size of the US governmental public health nurse (PHN) workforce by setting and specialty, including those working outside of health departments. Methods. We used 2022 data from the National Council of State Boards of Nursing, representing 2846 registered nurses (RNs) in almost all states, with weights applied. We examined "setting" and "specialty" of PHNs according to broad and more restricted definitions. Results. Using a broad definition, PHNs in government settings made up 3.7% of the RN workforce, and 1.8% when specialty areas were narrowly defined. These percentages varied by state. PHNs working in public health, school health, and correctional health settings largely indicated their specialty practice areas as public health, school health, and "unspecified" rather than more narrow specialty areas. Conclusions. PHNs are a small proportion of the RN workforce. They consider themselves generalists and can be identified by specialty and when working in governmental settings outside of health departments. Public Health Implications. States with few PHNs may be underserving their communities. Better data are needed to understand specific functions and activities of the PHN workforce. (Am J Public Health. Published online ahead of print February 13, 2025:e1-e10. https://doi.org/10.2105/AJPH.2024.307950).

Fine particulate matter and nonaccidental and cause-specific mortality: Do associations vary by exposure assessment method?

There is considerable heterogeneity in fine particulate matter (PM2.5)-mortality associations between studies, potentially due to differences in exposure assessment methods. Our aim was to evaluate associations of PM2.5 predicted from different models with nonaccidental and cause-specific mortality. We followed 107,906 participants of the Nurses' Health Study cohort from 2001 to 2016. PM2.5 concentrations were estimated from spatiotemporal models developed by researchers at the University of Washington (UW), Pennsylvania State University (PSU), and Harvard TH Chan School of Public Health (HSPH). We calculated 12-month moving average concentrations and we used time-varying Cox proportional hazard ratios (HRs). There were 30,242 nonaccidental deaths in 1,435,098 person-years. We observed high correlations and similar temporal trends between the PM2.5 predictions. We found no associations of UW, PSU, or HSPH PM2.5 with nonaccidental mortality, but suggestive positive associations with cancer, cardiovascular, and respiratory disease mortality. There were small differences in HRs between the PM2.5 predictions. All three predictions showed the strongest associations with cancer mortality: HRs (95% confidence interval, expressed per 5 µg/m3 increase) were 1.06 (1.01, 1.12) for UW, 1.08 (1.03, 1.13) for PSU, and 1.05 (1.00, 1.10) for HSPH. In a subset restricted to participants who were always exposed to PM2.5 below 12 µg/m3, we observed positive associations with nonaccidental mortality. We found that differences between PM2.5 exposure assessment methods could lead to minor differences in strengths of associations between PM2.5 and cause-specific mortality in a population of US female nurses.

P-963. Development, Delivery, and Evaluation of the Texas Epidemic Public Health Institute (TEPHI) Infection Control Lecture Series

Abstract Background The Texas Epidemic Public Health Institute (TEPHI) is a state agency of higher education headquartered at UTHealth Houston School of Public Health. With a mission to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak, TEPHI’s Small Rural Healthcare Preparedness working group developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health organizations.Table 1:Modular Registration, Attendance, and YouTube Views Methods Pilot data was collected from year one of the Infection Control series. Data sources included series attendee registration forms and attendance records (stored in WebEx Webinar Platform) and from post-lecture evaluation surveys using Qualtrics. These data were analyzed using Qualtrics software.Table 2:Infection Control series attendee demographic and occupational characteristics Results A total of 1105 individuals attended or viewed the Infection Control series. Overall, response rate to the evaluation surveys, in general, was low. Even so, feedback was consistently very positive, noting a “high likelihood of future TEPHI infection prevention and control lecture attendance”. Additionally participant feedback was used to guide the active improvements for year two of the series.Table 3:Infection Preventionist Module Registration Demographics Conclusion Infection Control series attendees obtained a deeper understanding of relevant policies, procedures, components, and practices. By offering essential, accessible education on infection prevention and control at no cost to healthcare systems, administrators and healthcare providers working in these systems have gained the knowledge necessary to establish and sustain a safe environment for patients and staff in healthcare settings.Table 4:Modular Post-Survey Evaluations Disclosures Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA, FECMM, CMQ, Cidara: Advisor/Consultant|Enanta: Advisor/Consultant|F2G: Advisor/Consultant|Gilead: Advisor/Consultant|GSK: Advisor/Consultant|Melinta: Advisor/Consultant|Octapharma: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pulmocide: Grant/Research Support|Scynexis: Grant/Research Support|Viracor: Advisor/Consultant

Creating codes of ethics for public health professionals and institutions.

The World Health Organization and the Association of Schools of Public Health in the European Region called for the professionalization of the public health workforce, including the creation of codes of ethics. In this article, the Public Health Ethics and Law Network provides guidance on creating such codes, based on values and principles commonly identified for public health. Our interest was in codes addressing public health broadly rather than disciplines within public health. Public Health codes of ethics are typically published on agency and organization websites rather than peer-reviewed literature. We searched several online databases, such as PubMed; United States government websites; Spanish language websites; and English language websites for public health organizations. We synthesized the principles found into 10 adjectives-such as caring, responsive, and trustworthy-with short elaborations. These terms are practical, for non-philosophers, and provide flexibility for adaptation to country contexts. The creation of a code of ethics should be followed by the identification and building of ethical competencies and capacity for public health professionals and institutions. There are plans to collaborate with pilot sites in the use and generation of further learning, and additional assistance for competencies and other resources to support a code of ethics and competencies.

The Pull of Tradition: The Restoration of a Department Structure in a School of Public Health.

The Pull of Tradition: The Restoration of a Department Structure in a School of Public Health.

Nursing Partnerships Are Crucial for Bridging Education and Public Health.

Public health nurses (PHNs) and school nurses are integral in addressing health disparities, managing chronic illnesses, preventing and controlling communicable diseases, and promoting wellness within communities. Schools serve as pivotal platforms for implementing health initiatives and providing opportunities for disease prevention and health promotion. School nurses identify and address health risks, including chronic conditions, communicable diseases, substance abuse, and mental health concerns, and often act as knowledgeable authorities to access community resources. PHNs perform a vital role in communicating the health experiences of diverse and sometimes vulnerable individuals and families to health planners and policymakers. They also empower community members to articulate concerns and goals, promoting a collaborative approach to public health development. Collaboration between PHNs and school nurses enhances community health through joint efforts in screenings, health education, and community-wide interventions. However, barriers, such as isolated strategic planning, siloed funding, and inadequate information systems, hinder effective collaboration. The authors advocate for joint strategic planning, integrated funding, and interoperable health information systems that may now be fragmented to strengthen these partnerships in order to improve population health. Enhancing these collaborations is vital for creating supportive environments where students can thrive academically and health-wise, ensuring a sustainable impact on community health.

We are not doing enough: Truth-telling and Aboriginal and Torres Strait Islander history in Australian Public Health.

Most public health practitioners and researchers in Australia acknowledge the poorer health and wellbeing of Aboriginal and Torres Strait Islanders peoples relative to non-Indigenous Australians; some work with Aboriginal and Torres Strait Islander communities; however, few acknowledge the role that public health itself has played in the plight of Aboriginal and Torres Strait Islanders peoples throughout Australia's colonial history. In this essay, we - Aboriginal, Torres Strait Islander, and non-Indigenous scholars at the Sydney School of Public Health (SSPH) - argue that truth-telling, which is critical for reconciliation, can only truly begin in Australian public health circles when we listen to the stories and truths of Aboriginal and Torres Strait Islander peoples as it relates to the colonial history of public health in Australia. Herein we give a brief outline of that history and provide some recommendations on ways forward; we also describe the successes and failures at SSPH in hopes that our story can help the broader Australian public health community on their truth-telling journeys. Although our story is about public health in Australia, we believe that its resonance lies everywhere public health has been explicit or implicit in its colonialism toward Indigenous peoples.

Micronutrient dose response (MiNDR) study among women of reproductive age and pregnant women in rural Bangladesh: study protocol for double-blind, randomised, controlled trials

IntroductionOptimising the micronutrient status of women before and during reproduction confers benefits to them and their offspring. Antenatal multiple micronutrient supplements (MMS), given as a daily tablet with nutrients at...