Enhancing Local Health Department Disaster Response Capacity with Rapid Community Needs Assessments: Validation of a Computerized Program for Binary Attribute Cluster Sampling

2006 ◽  
Vol 21 (01) ◽  
pp. 32-39 ◽  
Author(s):  
Matthew R. Groenewold

AbstractIntroduction:Local health departments are among the first agencies to respond to disasters or other mass emergencies. However, they often lack the ability to handle large-scale events. Plans including locally developed and deployed tools may enhance local response. Simplified cluster sampling methods can be useful in assessing community needs after a sudden-onset, short duration event.Methods:Using an adaptation of the methodology used by the World Health Organization Expanded Programme on Immunization (EPI), a Microsoft Access-based application for two-stage cluster sampling of residential addresses in Louisville/Jefferson County Metro, Kentucky was developed. The sampling frame was derived from geographically referenced data on residential addresses and political districts available through the Louisville/Jefferson County Information Consortium (LOJIC). The program randomly selected 30 clusters, defined as election precincts, from within the area of interest, and then, randomly selected 10 residential addresses from each cluster.The program, called the Rapid Assessment Tools Package (RATP), was tested in terms of accuracy and precision using data on a dichotomous characteristic of residential addresses available from the local tax assessor database. A series of 30 samples were produced and analyzed with respect to their precision and accuracy in estimating the prevalence of the study attribute. Point estimates with 95% confidence intervals were calculated by determining the proportion of the study attribute values in each of the samples and compared with the population proportion. To estimate the design effect, corresponding simple random samples of 300 addresses were taken after each of the 30 cluster samples.Results:The sample proportion fell within ±10 absolute percentage points of the true proportion in 80% of the samples. In 93.3% of the samples, the point estimate fell within ±12.5%, and 96.7% fell within ±15%. All of the point estimates fell within ±20% of the true proportion. Estimates of the design effect ranged from 0.926 to 1.436 (mean = 1.157, median = 1.170) for the 30 samples.Conclusions:Although prospective evaluation of its performance in field trials or a real emergency is required to confirm its utility, this study suggests that the Rapid Assessment Tools Package, a locally designed and deployed tool, may provide populationbased estimates of community needs or the extent of event-related consequences that are precise enough to serve as the basis for the initial post-event decisions regarding relief efforts.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.


Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 404
Author(s):  
Alejandro José Casanova-Rosado ◽  
Juan Fernando Casanova-Rosado ◽  
Mirna Minaya-Sánchez ◽  
José Luís Robles-Minaya ◽  
Juan Alejandro Casanova-Sarmiento ◽  
...  

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 576-577
Author(s):  
Maximilian Haas ◽  
Sascha Zuber ◽  
David Framorando ◽  
Elissa El Khawli ◽  
Susanne Scheibe ◽  
...  

Abstract As the population ages, risks for cognitive decline threaten independence and quality of life for older adults. Classically, psychological assessment tools to evaluate cognitive functioning are administered in face-to-face laboratory sessions, which is time- and resource-consuming. With the aim of reducing such costs, the present study set out to develop and validate two new online tools, allowing a rapid assessment of general cognitive abilities and of prospective memory. We collected data from 250 participants equally spread across the adult lifespan (aged 18 – 86). Results suggest that performance assessed via these newly developed online tools is comparable to performance in face-to-face laboratory settings. Our findings thereby indicate that these online tools can reliably measure cognitive functioning across the lifespan at a reduced cost, which may help detect individuals at risk of developing age-related cognitive disorders.


Author(s):  
David Callaway ◽  
Jeff Runge ◽  
Lucia Mullen ◽  
Lisa Rentz ◽  
Kevin Staley ◽  
...  

Abstract The United States Centers for Disease Control and Prevention and the World Health Organization broadly categorize mass gathering events as high risk for amplification of coronavirus disease 2019 (COVID-19) spread in a community due to the nature of respiratory diseases and the transmission dynamics. However, various measures and modifications can be put in place to limit or reduce the risk of further spread of COVID-19 for the mass gathering. During this pandemic, the Johns Hopkins University Center for Health Security produced a risk assessment and mitigation tool for decision-makers to assess SARS-CoV-2 transmission risks that may arise as organizations and businesses hold mass gatherings or increase business operations: The JHU Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19 (Toolkit). This article describes the deployment of a data-informed, risk-reduction strategy that protects local communities, preserves local health-care capacity, and supports democratic processes through the safe execution of the Republican National Convention in Charlotte, North Carolina. The successful use of the Toolkit and the lessons learned from this experience are applicable in a wide range of public health settings, including school reopening, expansion of public services, and even resumption of health-care delivery.


Author(s):  
Sariyamon Tiraphat ◽  
Vijj Kasemsup ◽  
Doungjai Buntup ◽  
Murallitharan Munisamy ◽  
Thang Huu Nguyen ◽  
...  

Active aging is a challenging issue to promote older population health; still, there is little clarity on research investigating the determinants of active aging in developing countries. Therefore, this research aimed to examine the factors associated with the active aging of the older populations in ASEAN’s low and middle-income countries by focusing on Malaysia, Myanmar, Vietnam, and Thailand. The study is a cross-sectional quantitative research study using multi-stage cluster sampling to randomize the sample. The sample consists of 2031 older people aged 55 years and over, including 510 Thai, 537 Malaysian, 487 Myanmar, and 497 Vietnamese. We collected a quantitative questionnaire of age-friendly environmental scale and active aging scale based on the World Health Organization (WHO) concept. The predictors of active aging include age-friendly environments, lifestyles, and socioeconomic factors; the data are analyzed by using multiple logistic regression. After adjusting for other factors, we found that older people living in a community with higher levels of age-friendly environments are 5.52 times more active than those in lower levels of age-friendly environments. Moreover, the older population with healthy lifestyles such as good dietary intake and high physical activity will be 4.93 times more active than those with unhealthy lifestyles. Additionally, older adults with partners, higher education, and aged between 55 and 64 years will be 1.70, 2.61, and 1.63 times more active than those with separate/divorce/widow, primary education, and age at 75 years or higher, respectively. Our results contribute considerable evidence for ASEAN policy-making to promote active aging in this region.


1987 ◽  
Vol 17 (2) ◽  
pp. 295-326 ◽  
Author(s):  
Uriel Kitron

The author presents in this article a historical-epidemiological evaluation of several anti-malaria campaigns and of the relative contribution of various direct measures employed and indirect factors operating during these campaigns. Approaches and factors that may be essential or at least useful for successful malaria control are identified. The malaria story in Palestine/Israel and the experience of the Tennessee Valley Authority are analyzed in some detail. In both cases, direct anti-malaria measures were versatile and based mostly on reduction of mosquito breeding and elimination of Anopheles larvae. Efficient organization and coordination of anti-malaria efforts, strenuous research and understanding of the vector biology, and accompanying socioeconomic and agricultural development contributed to successful campaigns. Malaria control in other parts of the United States and in Italy is also considered. The World Health Organization global anti-malaria campaign is discussed in the light of these earlier experiences. The study concludes that no single measure is sufficient to control malaria and that future anti-malaria campaigns need to adopt strategies that are flexible, incorporated into local health services, and interrelated with agricultural practices. Moreover, a certain threshold of socioeconomic development, health services infrastructure, and educational level may have to be reached for the successful application and maintenance of direct anti-malaria measures.


2020 ◽  
Author(s):  
Daniel J. Arenas ◽  
Dania D. Hallak ◽  
Rommell Noche ◽  
Gilberto Vila-Arroyo ◽  
Swathi Raman ◽  
...  

ABSTRACTBackgroundWhile Community Needs Assessments (CNAs) are an important tool for Student-Run Clinics (SRCs) to understand local communities’ healthcare needs, few studies have evaluated CNAs and their impact on care provided at SRCs.ObjectiveEvaluate results from two CNAs of an SRC in East Parkside, Philadelphia to better comprehend (1) community awareness and opinions regarding the SRC and (2) local healthcare concerns and access.Methods58 and 105 East Parkside residents were surveyed in 2011 and 2015 respectively. The results were analyzed to quantify various health-related measures in the community.ResultsResults showed high rates of hypertension, asthma, and diabetes. Rates of pap-smear and hypertension screening matched national averages while mammograms and colonoscopies were below national rates. Both CNAs showed that less than 40% of community members were aware of the clinic’s existence.ConclusionsCNAs can provide valuable insights regarding local health needs which can inform future healthcare interventions.


2020 ◽  
Author(s):  
Leila Jahangiry ◽  
Raziollah Bagheri ◽  
Fatemeh Darabi ◽  
Parvin Sarbakhsh ◽  
Mohammad Mehdi Naghibi Sistani ◽  
...  

Abstract Background: Poor oral hygiene can lead to serious diseases, such as periodontitis, tooth decay, pain and discomfort in teeth or gums, infections, and loss of teeth. In Iran, adults aged 50 y and older are a high-risk group for oral health problems, and this age group will grow in the coming decades. Despite increasing attention on healthy aging, there is relatively less emphasis on oral hygiene and health-related problems. The present study investigated the oral health status of Iranian adults using the oral health self-assessment questionnaire (OHQ) developed by the World Health Organization (WHO). Methods: A population-based household survey of a sample of adults aged 18–65 y was conducted. In this study, the participants were recruited between May and October 2016 in Tabriz, Iran, and the study population was sampled using a multi-stage cluster sampling design. The WHO’s OHQ for adults was used for measuring oral health status and oral hygiene behavior. Results: In total, 2,310 respondents completed the survey. The mean age (SD) of the participants was 41.6(23.4) y. Males accounted for 48.8% of the participants. Of the 2,310 respondents,187 (8.1%) individuals were edentulous, 152(20.7%) of whom were aged 51–65 y. Furthermore, 72.3% of those aged 51–65 y were dentate, and 50% of adults aged 51–65 y said they had 20 or more teeth. About one-third of the participants reported that they did not brush their teeth daily (23% of those aged 18–35 y,35.9% of those aged 36–50 y, and 44.6% for those aged 51–65 y). In the sample, 39.4% of individuals aged 18–35 y, 34.1% of individuals aged 36–50 y, and 26.6% of individuals aged 51–65 y had visited a dentist less than 6 month ago. One-third of the participants consumed sweets and sugary drinks daily. Conclusions: Although the majority of Iranian adults considered their oral health status good, only a small percentage of the sample visited their dentist regularly. Furthermore, visits to the dentist declined in accordance with increasing age, a time when the incidence of oral health problems may increase. Poor oral health may increase the risk of adverse health outcomes, particularly among the aging population.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwa Summaka ◽  
Hayat Harati ◽  
Salem Hannoun ◽  
Hiba Zein ◽  
Nour Koubaisy ◽  
...  

Abstract Background Non-progressive dysarthria is an acquired motor speech disorder resulting from neurological diseases such as stroke and traumatic brain injury. The evidence base for the assessment of non-progressive dysarthria remains limited with professional practices relying mainly on therapists’ clinical experience. Limited information on the assessment practices of Lebanese speech and language therapists (SLTs) is available. Such information is crucial for the development of adequate therapy services for clients with non-progressive dysarthria. This study aims to explore the assessment practices and attitudes of Lebanese SLTs working with adults with non-progressive dysarthria and to investigate their adherence to the framework of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Methods A cross-sectional study was conducted in Lebanon between March and May 2021. Data was collected through an online survey that included information on socio-demographic characteristics, practices, and attitudes of SLTs who assess adults with non-progressive dysarthria. Results A total of 50 Lebanese SLTs responded to the survey. The majority of SLTs (78%) assessed clients with non-progressive dysarthria across all ICF domains. SLTs reported dissatisfaction with the available assessment tools (64%) and reliance on informal tools (84%). In addition, 68% of the SLTs suggested the crucial need for the development of Arabic formal assessments that can quantitatively evaluate dysarthria and determine severity. The survey also showed that the respondents demonstrated a preference for the use of impairment-based tools. Conclusion It can be concluded that the assessment practices of Lebanese SLTs, generally, follow the international trend and the recommended professional guidelines. Further research initiatives should be held to develop Arabic formal assessment tools for non-progressive dysarthria.


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