The Kentucky Diabetes Control Program and the Feasibility of the Pyramidal Model for Public Health Intervention in Diabetes Mellitus

1988 ◽  
Vol 14 (3) ◽  
pp. 218-222 ◽  
Author(s):  
Steven B. Leichter ◽  
Carlos Hernandez ◽  
Charlotte Harvill ◽  
George Rice ◽  
Charles Gollmar

The Kentucky Diabetes Control Program was the first statewide program to use an indirect, "pyramidal" model to achieve desired changes in health care delivery for diabetes. This model leverages the expertise of sub- specialists through regional sub specialty teams (RDTs) of allied health professionals to primary health professionals for use with their patients. It has the advantage of yielding geometric increases in the numbers of patients affected while utilizing the existing primary care system. The model was implemented throughout Kentucky over four years and now includes an admin istrative core, two subspecialty resource centers, and 18 RDTs, with a registered nurse and dietitian in each. During its first five years of operation, the program providedformal, continuing education in diabetes to 16, 035 health professionals. They, in turn, provided formal patient education to 20, 866 patients and family members. These results suggest the feasi bility of the indirect, pyramidal model as afunctional public health intervention in diabetes.

2021 ◽  
Vol 32 (7) ◽  
pp. 282-287
Author(s):  
Alison While

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.


2021 ◽  
Vol 26 (6) ◽  
pp. 278-282
Author(s):  
Alison While

Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations. A second article will review the evidence relating to strategies to address vaccine hesitancy and promote vaccination acceptance.


2005 ◽  
Vol 09 (22) ◽  
pp. 1185-1198

Community-Based Dengue Control Program. Dengue: An Update. Dengue Epidemic Modeling: Stakes and Pitfalls. Dengue: Translating Scientific Progress into Public Health Intervention.


2020 ◽  
Vol 15 (4) ◽  
pp. 33-62
Author(s):  
Sara Swenson

In this article, I explore how Buddhist charity workers in Vietnam interpret rising cancer rates through understandings of karma. Rather than framing cancer as a primarily physical or medical phenomenon, volunteers state that cancer is a product of collective moral failure. Corruption in public food production is both caused by and perpetuates bad karma, which negatively impacts global existence. Conversely, charity work creates merit, which can improve collective karma and benefit all living beings. I argue that through such interpretations of karma, Buddhist volunteers understand their charity at cancer hospitals as an affective and ethical form of public health intervention.


2021 ◽  
Vol 104 ◽  
pp. 742-745
Author(s):  
Hye Seong ◽  
Hak Jun Hyun ◽  
Jin Gu Yun ◽  
Ji Yun Noh ◽  
Hee Jin Cheong ◽  
...  

Author(s):  
Mark E. Keim ◽  
Laura A. Runnels ◽  
Alexander P. Lovallo ◽  
Margarita Pagan Medina ◽  
Eduardo Roman Rosa ◽  
...  

Abstract Objective: The efficacy is measured for a public health intervention related to community-based planning for population protection measures (PPMs; ie, shelter-in-place and evacuation). Design: This is a mixed (qualitative and quantitative) prospective study of intervention efficacy, measured in terms of usability related to effectiveness, efficiency, satisfaction, and degree of community engagement. Setting: Two municipalities in the Commonwealth of Puerto Rico are included. Participants: Community members consisting of individuals; traditional leaders; federal, territorial, and municipal emergency managers; municipal mayors; National Guard; territorial departments of education, health, housing, public works, and transportation; health care; police; Emergency Medical Services; faith-based organizations; nongovernmental organizations (NGOs); and the private sector. Intervention: The intervention included four community convenings: one for risk communication; two for plan-writing; and one tabletop exercise (TTX). This study analyzed data collected from the project work plan; participant rosters; participant surveys; workshop outputs; and focus group interviews. Main Outcome Measures: Efficacy was measured in terms of ISO 9241-11, an international standard for usability that includes effectiveness, efficiency, user satisfaction, and “freedom from risk” among users. Degree of engagement was considered an indicator of “freedom from risk,” measurable through workshop attendance. Results: Two separate communities drafted and exercised ~60-page-long population protection plans, each within 14.5 hours. Plan-writing workshops completed 100% of plan objectives and activities. Efficiency rates were nearly the same in both communities. Interviews and surveys indicated high degrees of community satisfaction. Engagement was consistent among community members and variable among governmental officials. Conclusions: Frontline communities have successfully demonstrated the ability to understand the environmental health hazards in their own community; rapidly write consensus-based plans for PPMs; participate in an objective-based TTX; and perform these activities in a bi-lingual setting. This intervention appears to be efficacious for public use in the rapid development of community-based PPMs.


2010 ◽  
Vol 16 (6) ◽  
pp. 1166-1173 ◽  
Author(s):  
Sylvie Miaux ◽  
Louis Drouin ◽  
Patrick Morency ◽  
Sophie Paquin ◽  
Lise Gauvin ◽  
...  

Author(s):  
Kenton Kroker

Historians have clearly articulated the ways in which sleeplessness has long been part of the human condition. As an object of medical expertise and public health intervention, however, insomnia is a much more recent invention, having gained its status as a pathology during the 1870s. But while insomnia has attracted considerable and concerted attention from public health authorities allied with sleep medicine specialists, this phenomenon is not well explained by classical medicalization theory, in part because it is the sleepless sufferers, not the medical experts, who typically have the authority to diagnose insomnia. The dynamics of insomnia’s history are better described as those of a boundary object, around which concepts and practices of biomedicine and psychology coalesce to frame contemporary notions of self-medicalization and self-experiment.


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