From Tobacco to Obesity Prevention Policies: A Framework for Implementing Community-Driven Policy Change

2018 ◽  
Vol 19 (6) ◽  
pp. 856-862 ◽  
Author(s):  
Lauren Walter ◽  
Kelly Dumke ◽  
Ariana Oliva ◽  
Emily Caesar ◽  
Zoë Phillips ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Tobacco Control ◽  
Policy Change ◽  
Obesity Prevention ◽  
Los Angeles County ◽  
Local Level ◽  
Evidence Based ◽  
Prevention Policies ◽  
Community Residents

Efforts to reverse the obesity epidemic require policy, systems, and environmental (PSE) change strategies. Despite the availability of evidence-based and other promising PSE interventions, limited evidence exists on the “how-to” of transitioning them into practice. For the past 13 years, the Los Angeles County Department of Public Health has been building capacity among community residents and other stakeholders to create effective community coalitions and to implement well-designed policy strategy campaigns using an evidence-based approach to policy change, the policy adoption model (PAM). Implementing a phase-based approach to policy change, the PAM was initially used to support the passage of over 140 tobacco control and prevention policies in Los Angeles County. Following these successes, Los Angeles County Department of Public Health applied the PAM to obesity prevention, operationalizing the policy process by training community residents and other stakeholders on the use of the model. The PAM has shown to be helpful in promoting PSE change in tobacco control and obesity prevention, suggesting a local-level model potentially applicable to other fields of public health seeking sustainable, community-driven policy change.

scholarly journals Public Health Efforts Can Impact Adoption of Current Susceptibility Breakpoints, but Closer Attention from Regulatory Bodies Is Needed

2018 ◽  
Vol 57 (3) ◽  
Author(s):  
James A. McKinnell ◽  
S. Bhaurla ◽  
P. Marquez-Sung ◽  
A. Pucci ◽  
M. Baron ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Los Angeles ◽  
Antimicrobial Susceptibility ◽  
Los Angeles County ◽  
Susceptibility Testing ◽  
Clinical Care ◽  
Public Health Intervention ◽  
Antimicrobial Susceptibility Testing ◽  
Outreach Program

ABSTRACT Microbiological testing, including interpretation of antimicrobial susceptibility testing results using current breakpoints, is crucial for clinical care and infection control. Continued use of obsolete Enterobacteriaceae carbapenem breakpoints is common in clinical laboratories. The purposes of this study were (i) to determine why laboratories failed to update breakpoints and (ii) to provide support for breakpoint updates. The Los Angeles County Department of Public Health conducted a 1-year outreach program for 41 hospitals in Los Angeles County that had reported, in a prior survey of California laboratories, using obsolete Enterobacteriaceae carbapenem breakpoints. In-person interviews with hospital stakeholders and customized expert guidance and resources were provided to aid laboratories in updating breakpoints, including support from technical representatives from antimicrobial susceptibility testing device manufacturers. Forty-one hospitals were targeted, 7 of which had updated breakpoints since the prior survey. Of the 34 remaining hospitals, 27 (79%) assumed that their instruments applied current breakpoints, 17 (50%) were uncertain how to change breakpoints, and 10 (29%) lacked resources to perform a validation study for off-label use of the breakpoints on their systems. Only 7 hospitals (21%) were familiar with the FDA/CDC Antibiotic Resistance Isolate Bank. All hospitals launched a breakpoint update process; 16 (47%) successfully updated breakpoints, 12 (35%) received isolates from the CDC in order to validate breakpoints on their systems, and 6 (18%) were planning to update within 1 year. The public health intervention was moderately successful in identifying and overcoming barriers to updating Enterobacteriaceae carbapenem breakpoints in Los Angeles hospitals. However, the majority of targeted hospitals continued to use obsolete breakpoints despite 1 year of effort. These findings have important implications for the quality of patient care and patient safety. Other public health jurisdictions may want to utilize similar resources to bridge the patient safety gap, while manufacturers, the FDA, and others determine how best to address this growing public health issue.

Incidentally Detected SARS-COV-2 Among Hospitalized Patients in Los Angeles County, August to October 2020

2021 ◽  
Vol 16 (8) ◽  
Author(s):  
Jennifer Tsai ◽  
Elizabeth Traub ◽  
Kymberly Aoki ◽  
Kelsey Oyong ◽  
Heidi Sato ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Emergency Preparedness ◽  
Medical Records ◽  
Confidence Limit ◽  
Los Angeles County ◽  
Resource Planning ◽  
Hospital Discharges ◽  
Hospitalization Rates ◽  
Test Result

We aimed to determine the percentage of COVID-19–associated hospitalizations reported to Los Angeles County (LAC) Public Health that might have been misclassified because of incidentally detected SARS-CoV-2. We retrospectively reviewed medical records from a randomly selected set of hospital discharges reported to LAC Public Health from August to October 2020 for a clinical diagnosis of COVID-19 or a positive SARS-CoV-2 test result. Among the 13,813 discharges from 85 hospitals reported to LAC Public Health as COVID-19–associated hospitalizations from August to October 2020, 346 were randomly selected and reviewed. SARS-CoV-2 detection was incidental to the reason for hospitalization in 12% (95% confidence limit, 9%-16%) of COVID-19 classified hospital discharges. Adjusting COVID-19–associated hospitalization rates to account for incidental SARS-CoV-2 detection could help public health policymakers and emergency preparedness personnel improve resource planning.

Introduction and History of Public Health in Los Angeles County

2012 ◽  
pp. 1-12
Author(s):  
Jonathan E. Fielding ◽  
Jonathan Freedman ◽  
Stephanie N. Caldwell
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Los Angeles County ◽  
History Of Public Health ◽  
History Of

Case Study: Nontraditional Partners in the Case of Kansas City

2019 ◽  
pp. 445-450
Author(s):  
Scott Hall ◽  
Rex Archer
Keyword(s):  
Public Health ◽  
Policy Change ◽  
Kansas City ◽  
Local Level ◽  
Health Department ◽  
Chamber Of Commerce ◽  
Working Together ◽  
Multiple Jurisdictions

This chapter demonstrates the power of non-traditional partnerships to achieve policy change at the local level. The chapter's review of the work of the Kansas City Chamber of Commerce and the KCMO Health Department to motivate adoption of Tobacco 21 initiatives in multiple jurisdictions highlights the importance of business and public health working together.

Using decision analysis to select alternate modes of dispensing: An example from Los Angeles County Public Health

2009 ◽  
Vol 7 (2) ◽  
pp. 39
Author(s):  
Sinan Khan, MPH, MA ◽  
Anke Richter, PhD
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Decision Analysis ◽  
Los Angeles County ◽  
Relative Effectiveness ◽  
Health Maintenance Organization ◽  
Sensitivity Analyses ◽  
Health Maintenance ◽  
Response Planning ◽  
The Many

Objective: To comply with the Center for Disease Control’s mass prophylaxis mandates, many public health jurisdictions must supplement their existing Points of Dispensing (POD)-based system. Because of limited budgets and personnel availability, only one or two alternatives out of the many potential options can be implemented.Design: Multicriteria decision analysis is a powerful tool that allows public health officials to assess the relative effectiveness of alternate modes of dispensing while incorporating the opinions of their multidisciplinary emergency response planning teams.Setting: This process was utilized to analyze the effectiveness of alternate modes of dispensing that could be used to supplement the existing POD system within the Los Angeles County (LAC) Department of Public Health (DPH).Results: The top two options for LAC were prepositioning for civil service and partnership with a major Health Maintenance Organization. These choices were stable under a variety of sensitivity analyses, and the differences in opinion between the agencies and other stakeholders do not change them.Conclusions: The transparency of the model and analysis may allow decision makers and planners in the LAC DPH to garner support for their alternate modes of dispensing plans. By making the decision criteria clear and demonstrating the robustness of the results in the sensitivity analyses, public health partners gain a deeper understanding of the issues and their potential roles. The process can be repeated by any jurisdiction, but definition of “best” will rely on the issues and gaps that are identified with the jurisdiction’s POD plan for mass prophylaxis.

scholarly journals A Framework for Mobilizing Communities to Advance Local Tobacco Control Policy: The Los Angeles County Experience

2012 ◽  
Vol 102 (5) ◽  
pp. 785-788 ◽  
Author(s):  
Mark D. Weber ◽  
Paul Simon ◽  
Monty Messex ◽  
Linda Aragon ◽  
Tony Kuo ◽  
...  
Keyword(s):  
Los Angeles ◽  
Tobacco Control ◽  
Los Angeles County ◽  
Control Policy ◽  
Tobacco Control Policy

scholarly journals A Tale of Two Institutions: COVID-19 Positive Rates in Asymptomatic Patients Pre-Screened for Spine Procedures and Surgeries in Los Angeles, California

2021 ◽  
pp. 219256822110574
Author(s):  
Allen S. Chen ◽  
Matthew Brown ◽  
Anush Arekelyan ◽  
Sophie Wennemann ◽  
Nick Shamie ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Los Angeles County ◽  
Data Sets ◽  
Global Public Health ◽  
Rt Pcr ◽  
Asymptomatic Patients ◽  
Time Period ◽  
Chi Squared ◽  
Using Data

Study Design Retrospective cohort study. Objectives The coronavirus disease (COVID-19), caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented global public health emergency. The aim of the current study was to report on COVID-19 rates in an asymptomatic population prior to undergoing spine procedures or surgeries at two large Los Angeles healthcare systems. Methods Elective spine procedures and surgeries from May 1, 2020 to January 31, 2021 were included. Results from SARS-CoV-2 virus RT-PCR nasopharyngeal testing within 72 hours prior to elective spine procedures were recorded. Los Angeles County COVID-19 rates were calculated using data sets from Los Angeles County Department of Public Health. Chi-squared test and Stata/IC were used for statistical analysis. Results A total of 4,062 spine procedures and surgeries were scheduled during this time period. Of these, 4,043 procedures and surgeries were performed, with a total of 19 patients testing positive. Nine positive patients were from UCLA, and 10 from USC. The overall rate of positive tests was low at .47% and reflected similarities with Los Angeles County COVID-19 rates over time. Conclusions The current study shows that pre-procedure COVID-19 testing rates remains very low, and follows similar patterns of community rates. While pre-procedure testing increases the safety of elective procedures, universal COVID-19 pre-screening adds an additional barrier to receiving care for patients and increases cost of delivering care. A combination of pre-screening, pre-procedure self-quarantine, and consideration of overall community COVID-19 positivity rates should be further studied.

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