scholarly journals Predictors of HIV Preexposure Prophylaxis Initiation Among Public Health Clients in Rural and Small Urban Areas in Iowa

2020 ◽  
pp. 003335492096602
Author(s):  
M. Bryant Howren ◽  
Shelby L. Francis ◽  
Linnea A. Polgreen ◽  
Cody Shafer ◽  
Angela Hoth ◽  
...  
Keyword(s):  
Public Health ◽  
Urban Areas ◽  
Health Department ◽  
Sexual History ◽  
Baseline Survey ◽  
Public Health Departments ◽  
Preexposure Prophylaxis ◽  
Intervention Specialist ◽  
Disease Intervention Specialist

Objective Preexposure prophylaxis (PrEP) is a safe and effective method for HIV prevention, but little is known about PrEP uptake in rural and small urban areas. We described rates and predictors of HIV PrEP initiation among public health clients in rural and small urban areas in Iowa. Methods This was a prospective cohort study of clients with PrEP indications served by HIV testing and disease intervention specialist/partner services (DIS/PS) programs in public health departments in Iowa from February 1, 2018, through February 28, 2019. Eligible participants were aged 18-70 and referred for PrEP by public health personnel. Participants completed surveys at enrollment addressing demographic characteristics; sexual history; previous drug use; PrEP experiences; and knowledge, attitudes, and beliefs about PrEP. A follow-up survey assessed PrEP initiation at 30 days. We compared baseline characteristics of PrEP initiators and non-initiators. Results Two hundred thirty-four public health clients consented to participate in the study; 189 completed the baseline survey, and 117 (61.9%) completed the follow-up survey. The mean age of participants in the baseline survey was 30 (range, 18-68); 109 (57.7%) were male, 127 (67.2%) were White, and 169 (89.4%) lived in a rural or small urban area. Of 117 participants in the follow-up survey, those who initiated PrEP were significantly more likely than those who did not initiate PrEP to be referred by DIS/PS programs (46.7% vs 7.8%, P < .001) and to recognize that PrEP was ≥90% effective (86.7% vs 35.3%, P = .001). No PrEP initiators and 8 PrEP non-initiators agreed that PrEP is for promiscuous people (0% vs 7.8%, P = .04). Perceived PrEP stigma was low and not associated with PrEP initiation. Conclusions PrEP initiation rates were low among rural and small urban health department clients. Interventions are needed to improve linkage to PrEP among rural and small urban public health clients.

scholarly journals Disease Intervention Specialist Education for the Future: An Analysis of Public Health Curricula

2018 ◽  
Vol 133 (6) ◽  
pp. 738-748 ◽  
Author(s):  
William A. Mase ◽  
Andrew R. Hansen ◽  
Stacy W. Smallwood ◽  
Gulzar Shah ◽  
Angela H. Peden ◽  
...  
Keyword(s):  
Public Health ◽  
Core Curriculum ◽  
Public Health Education ◽  
Workforce Training ◽  
Academic Program ◽  
Master Of Public Health ◽  
Job Tasks ◽  
Intervention Specialist ◽  
Knowledge Competencies ◽  
Disease Intervention Specialist

Objectives: The objectives of this study were to (1) determine the degree of alignment between an existing public health curricula and disease intervention specialist (DIS) workforce training needs, (2) assess the appropriateness of public health education for DISs, and (3) identify existing curriculum gaps to inform future DIS training efforts. Methods: Using the iterative comparison analysis process of crosswalking, we compared DIS job tasks and knowledge competencies across a standard Council on Education for Public Health (CEPH)-accredited bachelor of science in public health (BSPH) and master of public health (MPH) program core curricula offered by the Georgia Southern University Jiann-Ping Hsu College of Public Health. Four researchers independently coded each DIS task and competency as addressed or not in the curriculum and then discussed all matches and non-matches between coders. Researchers consulted course instructors when necessary, and discussion between researchers continued until agreement was reached on coding. Results: The BSPH curriculum aligned with 75% of the DIS job tasks and 42% of the DIS knowledge competencies. The MPH core curriculum aligned with 55% of the job tasks and 40% of the DIS knowledge competencies. Seven job tasks and 9 knowledge competencies were considered unique to a DIS and would require on-the-job training. Conclusions: Findings suggest that an accredited public health academic program, grounded in CEPH competencies, could address multiple components of DIS educational preparation. Similar analyses should be conducted at other CEPH-accredited schools and programs of public health to account for variations in curriculum.

scholarly journals Electronic data sharing between public health department and clinical providers improves accuracy of HIV retention data

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S421-S422
Author(s):  
Jessica P Ridgway ◽  
Jessica Schmitt ◽  
Ellen Almirol ◽  
Monique Millington ◽  
Erika Harding ◽  
...  
Keyword(s):  
Public Health ◽  
Data Sharing ◽  
Retention In Care ◽  
Health Department ◽  
Birth Date ◽  
Hiv Positive ◽  
Public Health Department ◽  
Grant Recipient ◽  
Lost To Follow Up

Abstract Background Retention in care is critical for treatment and prevention of HIV. Many HIV care clinics measure retention rate, but data are often incomplete for patients who are classified as lost to follow-up but may be actually in care elsewhere, moved, or died. The Data to Care (D2C) initiative supports data sharing between health departments and HIV providers to confirm patient care status and facilitate reengagement efforts for out of care HIV patients. Methods The University of Chicago Medicine (UCM) provided an electronic list to the Chicago Department of Public Health (CDPH) of adult HIV-positive patients whose retention status was not certain. Retention in care was defined as at least 2 visits &gt;90 days apart within the prior 12 months. CDPH matched this list of patients with data from the Chicago electronic HIV surveillance database. Matches were based on patient name, including alternative spellings and phonetics, and birth date. CDPH also cross-checked patient names with the CDC’s national enhanced HIV-AIDS Reporting System (eHARS) database. CDPH provided UCM with patient current care status, i.e., patient was in care elsewhere (as verified by lab data), moved out of state, or deceased. Results 780 HIV-positive patients received care in the UCM adult HIV clinic from January 1, 2013 to March 31, 2017. Of these, 360 were retained in care as of March 2017. We shared data with CDPH for 492 patients. Of these, 294 (59.8%) were matched, and 168 (34.1%) had a date of last medical care provided. See Table 1 for patient dispositions, before and after data sharing. 24 (13.4%) of patients believed to be lost to follow up according to UCM records were confirmed either transferred care or deceased according to health department data. Conclusion Data sharing between the health department and HIV providers can improve data accuracy regarding retention in care among people living with HIV. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient

scholarly journals Creating Customized Workforce Development Plans for Medium-to-Large Public Health Departments

2019 ◽  
Vol 134 (4) ◽  
pp. 395-403
Author(s):  
Brandon Grimm ◽  
Christine Arcari ◽  
Athena Ramos ◽  
Tricia LeVan ◽  
Kathleen Brandert ◽  
...  
Keyword(s):  
Public Health ◽  
Workforce Development ◽  
Health Department ◽  
Training Needs ◽  
Public Health Workforce ◽  
Health Departments ◽  
Public Health Departments ◽  
Percentage Points ◽  
Development Plans ◽  
County Health Department

Objectives: The objectives of our study were to (1) illustrate a public health workforce assessment process in a medium-sized city or county health department and (2) demonstrate the insights gained by moving from the use of aggregate department-level and competency domain-level training needs results to more granular division-level and skills-level results when creating a workforce development plan. Methods: We used a 130-question needs assessment to guide the creation of a workforce development plan for the Lincoln Lancaster County Health Department (LLCHD) in Nebraska and its 7 divisions. Using SurveyMonkey, we administered the survey to 128 (of the 129) LLCHD public health staff members in June 2015. Using a Likert scale, respondents indicated (1) the importance of the skill to their work and (2) their capacity to carry out 57 skills in 8 domains of the core competencies for public health professionals. We identified training needs as those for which the percentage of respondents who perceived moderate-to-high importance was at least 15 percentage points higher than the percentage of respondents who perceived moderate-to-high capacity. Results: LLCHD as a department had training needs in only 2 competency domains: financial planning and management (importance-capacity difference, 15 percentage points) and policy development and program planning (importance-capacity difference, 19 percentage points). The Health Promotion and Outreach division had training needs in all 8 domains (importance-capacity difference range, 15-45 percentage points). Of the 57 skills, 41 were identified by at least 1 of the LLCHD divisions as having training needs. In 24 instances, a division did not qualify as having training needs in the overall domain yet did have training needs for specific skills within a domain. Conclusions: When performing public health workforce assessments, medium-to-large public health departments can obtain detailed workforce training needs results that pertain to individual skills and that are tailored to each of their divisions. These results may help customize and improve workforce development plans, ensuring that the workforce has the necessary skills to do its job.

Dissemination of Information About Climate Change by State and Local Public Health Departments: United States, 2019–2020

2020 ◽  
Vol 110 (8) ◽  
pp. 1184-1190 ◽  
Author(s):  
Karen Albright ◽  
Pari Shah ◽  
Melodie Santodomingo ◽  
Jean Scandlyn
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Web Sites ◽  
Health Department ◽  
Health Departments ◽  
Local Public Health ◽  
Public Health Departments ◽  
Climate Change Information ◽  
State And Local ◽  
Local Public Health Departments

Objectives. To determine if and how state and local public health departments present information about climate change on their Web sites, their most public-facing platform. Methods. We collected data from every functioning state (n = 50), county (n = 2090), and city (n = 585) public health department Web site in the United States in 2019 and 2020. We analyzed data for presence and type of climate-related content and to determine whether there existed clear ways to find climate change information. We analyzed Web sites providing original content about climate change for explanatory or attributional language. Results. Fewer than half (40%) of state health department Web sites, and only 1.6% of county and 3.9% of city Web sites, provided clear ways to find climate change information, whether through provision of original content or links to external agencies’ Web sites. Among Web sites providing original content, 48% provided no explanation of climate change causes. Conclusions. National and global public health associations have identified climate change as a public health emergency, but most state and local public health departments are not delivering that message. These departments must be better supported to facilitate dissemination of reliable, scientific information about climate change and its effects on health.

scholarly journals Public Health Informatics Workforce Skills and Needs: A Descriptive Analysis using the 2017 PH WINS

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B E Dixon ◽  
T D McFarlane ◽  
S J Grannis ◽  
P J Gibson
Keyword(s):  
Public Health ◽  
United States ◽  
Health Workforce ◽  
Urban Areas ◽  
Health Department ◽  
The United States ◽  
Skill Level ◽  
Public Health Workforce ◽  
Local Health ◽  
Nationally Representative

Abstract In 2017, the Association of State and Territorial Health Officials fielded the Public Health Workforce Interests and Needs Survey (PH WINS), a nationally representative sample of state-level (SHA) and local health department (LHD) public health workers in the United States. The survey was an opportunity to measure the PHI workforce as well as assess the informatics needs of the broader PH workforce. We performed a cross-sectional study using the nationally representative 2017 PH WINS. A total of 17,136 SHA and 26,533 LHD employees participated in the survey. Respondents were asked to rate selected PH competencies with respect to the importance to their day-to-day work (i.e., not important to very important) and their current skill level (e.g., unable to perform, beginner, proficient, expert). We examined skill gaps, defined as discordance between self-reported importance (i.e., need) and skill level, for example, those reporting the competency as “somewhat important” or “very important” and “unable to perform” or “beginner.” Informaticians accounted for 1.1% of SHA respondents and 0.5% of LHD respondents working in a Big City Health Coalition agency, those that serve the top 30 most populous urban areas in the United States. While informaticians generally reported having the skills they needed for their jobs, other PH roles identified gaps. For example, 22.9% of clinical and laboratory workers felt the ability to “identify appropriate sources of data and information to assess the health of a community” was an important skill but they currently possessed low competency. This group similarly identified a gap with respect to collecting ‘valid data for use in decision making.' An informatics-savvy health department requires PHI competencies not just among PHI specialists but also among front line workers, program area managers, and executive leadership. Discordance suggests that agencies should examine ways to enhance training for PHI-related competencies for all PH workers. Key messages The informatics specialists’ role is rare in public health agencies. Significant data and informatics skills gaps persist among the broader public health workforce.

Public health-specific personal disaster preparedness training: An academic-practice collaboration

2014 ◽  
Vol 12 (1) ◽  
pp. 55 ◽  
Author(s):  
Sivan Kohn, MPH ◽  
Natalie Semon, MSEd ◽  
Haley K. Hedlin, PhD ◽  
Carol B. Thompson, MS, MBA ◽  
Felicity Marum, MHS ◽  
...  
Keyword(s):  
Public Health ◽  
Disaster Preparedness ◽  
Process Model ◽  
Health Workers ◽  
Health Department ◽  
Baseline Survey ◽  
Local Health ◽  
Convenience Sample ◽  
Face To Face ◽  
Threat Categories

Objectives: To measure the following three relevant outcomes of a personal preparedness curriculum for public health workers: 1) the extent of change (increase) in knowledge about personal preparedness activities and knowledge about tools for conducting personal preparedness activities; 2) the extent of change (increase) in preparedness activities performed post-training and/or confidence in conducting these tasks; and 3) an understanding of how to improve levels of personal preparedness using the Extended Parallel Process Model (EPPM) framework. Design: Cross-sectional preinterventional and postinterventional survey using a convenience sample. Setting: During 2010, three face-to-face workshops were conducted in three locations in West Virginia.Participants: One hundred thirty-one participants (baseline survey); 69 participants (1-year resurvey)—representing West Virginia local health department (LHD) and State Health Department employees.Interventions: A 3-hour interactive, public health-specific, face-to-face workshop on personal disaster preparedness.Main outcome measure(s): Change in 1) knowledge about, and tools for, personal preparedness activities; 2) preparedness activities performed post-training and/or confidence in conducting these activities; and 3) the relationship of EPPM categories to personal preparedness activities.Results: One year postworkshop, 77 percent of respondents reported having personal emergency kits (40 percent at baseline) and 67 percent reported having preparedness plans (38 percent at baseline) suggesting some participants assembled supply kits and plans postworkshop. Within the context of EPPM, respondents in high-threat categories agreed more often than respondents in low-threat categories that severe personal impacts were likely to result from a moderate flood. Compared to respondents categorized as low efficacy, respondents in high-efficacy categories perceived confidence in their knowledge and an impact of their response on their job success at higher rates.Conclusions: Personal disaster preparedness trainings for the LHD workforce can yield gains in relevant preparedness behaviors and attitudes but may require longitudinal reinforcement. The EPPM can offer a useful threat and efficacy-based lens to understand relevant perceptions surrounding personal disaster preparedness behaviors among LHD employees.

scholarly journals Newborn Screening

2011 ◽  
Vol 29 (1) ◽  
pp. 113-132 ◽  
Author(s):  
Rebecca Anderson ◽  
Erin Rothwell ◽  
Jeffrey R. Botkin
Keyword(s):  
Public Health ◽  
Newborn Screening ◽  
Health Department ◽  
The United States ◽  
Rapid Expansion ◽  
Endocrine Disorders ◽  
Social Challenges ◽  
Public Health Departments ◽  
Lack Of Information ◽  
Technological Advances

Newborn Dried Blood Spot Screening (NBS) is a core public health service and is the largest application of genetic testing in the United States. NBS is conducted by state public health departments to identify infants with certain genetic, metabolic, and endocrine disorders. Screening is performed in the first few days of life through blood testing. Several drops of blood are taken from the baby's heel and placed on a filter paper card. The dried blood, on the filter cards, is sent from the newborn nursery to the state health department laboratory, or a commercial partner, where the blood is analyzed. Scientific and technological advances have lead to a significant expansion in the number of tests—from an average of 6 to more than 50—and there is a national trend to further expand the NBS program. This rapid expansion has created significant ethical, legal, and social challenges for the health care system and opportunity for scholarly inquiry to address these issues. The purpose of this chapter is to provide an overview of the NBS programs and to provide an in-depth examination of two significant concerns raised from expanded newborn screening, specifically false-positives and lack of information for parents. Implications for nursing research in managing these ethical dilemmas are discussed.

Survey of State Public Health Department Resources for Men and Boys: Identification of an Inadvertent and Remediatable Service and Health Disparity

2010 ◽  
Vol 4 (4) ◽  
pp. 344-352 ◽  
Author(s):  
Scott Williams ◽  
Salvatore Giorgianni
Keyword(s):  
Public Health ◽  
Health Disparity ◽  
Survey Methodology ◽  
Health Department ◽  
Men’S Health ◽  
Men's Health ◽  
Specific Information ◽  
Public Health Department ◽  
Public Health Departments ◽  
Access To Health

State Public Health Departments (SPHDs) provide critical access to health outreach and services. Important strides have been made in these areas for broad ranges of populations; however, many men’s health advocates believe that services to achieve similar goals for men and boys have inadvertently declined creating an unintended, but remediatable, service and health disparity. In 2008, the Men’s Health Network completed a benchmarking survey of SPHDs to investigate the validity of concerns about this disparity, characterize the range and nature of existing SPHD resources for men and boys, and establish a survey methodology. Validated data were obtained from 49 states and Washington, D.C. Analysis indicates that there are few state resources dedicated to the health of men and boys, such resources are significantly less than for other populations, few states have population-specific information for men and boys, and most such information was subsumed in women’s health information sites. This study validates concerns that a health disparity has developed; highlights the need for better planning, resourcing, and outreach specific to men and boys; and indicates the imperative to perform a regular comprehensive environmental scan to guide policy.

An analysis of state health department COVID-19 information for the public (Preprint)

2020 ◽  
Author(s):  
Nandita S. Mani ◽  
Terri Ottosen ◽  
Megan Fratta ◽  
Fei Yu
Keyword(s):  
Public Health ◽  
Health Literacy ◽  
Health Information ◽  
Health Department ◽  
Health Departments ◽  
The Public ◽  
Public Health Departments ◽  
Material Type ◽  
The Mean ◽  
Clear Communication

BACKGROUND In response to the current COVID-19 crisis, public health departments across the U.S. have created, distributed, and shared COVID-19 health information. The extent to which information is understandable and actionable can be examined by use of validated health literacy and readability tools. Health information must be actionable, simple, and straightforward, particularly for health messages in times of urgency or during a health crisis. OBJECTIVE This study aimed (1) to use three validated health literacy tools to assess the understandability, actionability, clarity, and readability of COVID-19 health information created for the public by U.S. state public health departments; (2) to examine the correlations between understandability, actionability, clarity, readability, and material types; (3) to propose potential strategies to improve public health messaging. METHODS Based on CDC statistics on June 30, 2020, we identified the top 10 U.S. states with the highest number of COVID-19 cases. We visited the 10 state public health department websites and selected materials related to COVID-19 prevention according to a pre-defined eligibility criteria. Two raters independently assessed the materials by Patient Education and Materials Assessment Tool (PEMAT) and Clear Communication Index (Index). One rater generated the Flesch-Kincaid Grade Level (FKGL) score. Statistical analyses included (1) interrater reliability (IRR) by Cohen’s kappa; (2) the mean, median, standard deviation, range, minimum, maximum, and frequency scores associated with PEMAT, Index, and FKGL; (3) statistical significance of the correlation between PEMAT, Index, FKGL, and Material Type. RESULTS Of 42 materials in this study, (1) inter-rater reliability was 0.94. (2) The mean PEMAT (n=42) understandability was 88.67% (SD±17.69%), with a media of 94% and a range between 21% and 100%; the mean of PEMAT actionability was 88.48% (SD±14.3%), with a media of 100% and a range between 40% and 100%; the mean Index scores was 78.32 (SD±13.03), with a media of 78.35 and a range between 50 and 100. The mean of FKGL of the materials (n=34) was 7.11 (SD±2.60), with a media of 7.3 and a range between 1.7 and 12.5. (3) Correlations were significant (P<0.01) and positive between PEMAT understandability and actionability, PEMAT understandability and Index scores, PEMAT actionability and Index scores, PEMAT understandability and Material Type, PEMAT actionability and Material type. Correlations were significant (P<0.01) and negative between PEMAT understandability and FKGL scores, PEMAT actionability and FKGL scores, Index and FKGL scores, and FKGL and Material Types. No correlation was detected between Index scores and Material types (P>0.05). CONCLUSIONS COVID-19 health information provided by states for the public were easy to understand and act upon but could be improved in terms of readability and clear communication. The positive correlation identified between material types and PEMAT understandability/PEMAT actionability/Index scores respectively led to our recommendation on using more infographics and video format for public health messaging. CLINICALTRIAL N/A

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