scholarly journals Using RE-AIM to examine the potential public health impact of an integrated collaborative care intervention for weight and depression management in primary care: Results from the RAINBOW trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248339
Author(s):  
Megan A. Lewis ◽  
Laura K. Wagner ◽  
Lisa G. Rosas ◽  
Nan Lv ◽  
Elizabeth M. Venditti ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Collaborative Care ◽  
Health Impact ◽  
Public Health Impact ◽  
Integrative Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Intervention ◽  
The Impact

Background An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential. Methods The trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Results At baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance. Conclusions RE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.

Interactive Media for Diabetes Self-Management: Issues in Maximizing Public Health Impact

2010 ◽  
Vol 30 (6) ◽  
pp. 745-758 ◽  
Author(s):  
Russell E. Glasgow
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Interactive Media ◽  
Health Impact ◽  
Self Management ◽  
Public Health Impact ◽  
Shared Decision

Background . Diabetes self-management presents a series of challenging tasks, and primary care, where the majority of cases of adult diabetes are treated, is hard-pressed to address these issues given competing demands. This article discusses how interactive media (IM) can be used to support diabetes self-management. Methods . Following a brief review of the literature, the 5 As framework for enhancing the effectiveness of health behavior counseling and the RE-AIM model for estimating and enhancing public health impact are used to frame discussion of the strengths and limitations of IM for diabetes shared decision making and self-management support. Results . Data and lessons learned from a series of randomized trials of IM for diabetes self-management education are summarized around 2 key issues. The first is enhancing patient engagement in decision making and includes enhancing user experience and engagement, improving quality of care, and promoting collaborative action planning and follow-up. The second is getting such resources into place and sustaining them in real-world primary care settings and involves enhancing participation at patient, clinician, and health care system levels and enhancing the generalizability of results. Conclusions . Key opportunities for IM to support diabetes self-management include assessment of information for shared decision making, assistance with problem-solving self-management challenges, and provision of follow-up support. A key current challenge is the linkage of IM supports to the rest of the patient’s care, and collection of cost-effectiveness data is a key need for future research.

scholarly journals Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis

2021 ◽  
Author(s):  
Charles Whittaker ◽  
Oliver Watson ◽  
Carlos Alvarez-Moreno ◽  
Nasikarn Angkasekwinai ◽  
Adhiratha Boonyasiri ◽  
...  
Keyword(s):  
Public Health ◽  
Supportive Care ◽  
Low Income ◽  
Clinical Care ◽  
Health Impact ◽  
Public Health Impact ◽  
Hospitalised Patients ◽  
Potential Impact ◽  
The Impact ◽  
Potential Therapeutics

Background The unprecedented public health impact of the COVID-19 pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the potential impact of different treatments, and consequently research and procurement priorities, have not been clear. Methods and Findings We develop a mathematical model of SARS-CoV-2 transmission, COVID-19 disease and clinical care to explore the potential public-health impact of a range of different potential therapeutics, under a range of different scenarios varying: i) healthcare capacity, ii) epidemic trajectories; and iii) drug efficacy in the absence of supportive care. In each case, the outcome of interest was the number of COVID-19 deaths averted in scenarios with the therapeutic compared to scenarios without. We find the impact of drugs like dexamethasone (which are delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R=1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalisation) could have much greater benefits, particularly in resource-poor settings facing large epidemics. Conclusions There is a global asymmetry in who is likely to benefit from advances in the treatment of COVID-19 to date, which have been focussed on hospitalised-patients and predicated on an assumption of adequate access to supportive care. Therapeutics that can feasibly be delivered to those earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority.

scholarly journals Evaluating the Impact of Nicotine Regulatory Policies in a Rapidly Changing Market: Findings From the ITC Project in the United States, Canada, United Kingdom, and Australia

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 22-22
Author(s):  
K. Michael Cummings ◽  
Geoffrey T. Fong ◽  
Ron Borland ◽  
Ann McNeill ◽  
Richard J. O’Connor ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
United Kingdom ◽  
Research Program ◽  
Health Impact ◽  
The United States ◽  
Public Health Impact ◽  
Global Changes ◽  
Regulatory Policies ◽  
The Impact

PURPOSE Tobacco smoking is the leading preventable cause of death, projected to claim up to one billion deaths in the 21st century. Smoking is the leading cause of cancer, accounting for approximately 30% of cancer cases globally. The recent surge in nicotine vaping products (NVPs), such as e-cigarettes, has led to astounding global changes in the tobacco/nicotine landscape, prompting vigorous debate about whether these products represent a positive or negative public health impact. METHODS In 2016, the International Tobacco Control (ITC) Project created a multimethod program of 5 linked projects to examine NVP design/content, the interplay between NVPs and cigarettes in adults and youth, the impact of NVP regulations, and implications of NVPs on public health in 4 countries that vary in regulatory approach to NVPs: the United States, United Kingdom, Canada, and Australia—the first ever multicountry longitudinal study of e-cigarettes and other NVPs. RESULTS This presentation will describe the overall research program and then review key findings from these 5 linked international projects: the ITC Four-Country Adult Smoking and Vaping Survey, the ITC International Youth Smoking and Vaping Survey, the ITC product testing project, the experimental marketplace project, and the simulation study estimating the impact of different parameters, including the prevalence of NVP use and restrictiveness of policies on NVPs. The overall objective of these ITC projects was to evaluate and understand the impact of different policies on the uptake, use, reasons for use, and impact of use among youth and among adults over time and across countries. CONCLUSION The ITC project’s multimethod, multicountry research program illustrates the unique value of cross-country research to examine the public health impact of the evolving nicotine marketplace and of regulations on the broadening array of nicotine products throughout the world.

scholarly journals Public health impact model estimating the impact of introducing an adjuvanted recombinant zoster vaccine into the UK universal mass vaccination programme

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025553
Author(s):  
Desirée A M van Oorschot ◽  
Manjit Hunjan ◽  
Benjamin Bracke ◽  
Stéphane Lorenc ◽  
Desmond Curran ◽  
...  
Keyword(s):  
Public Health ◽  
Health Impact ◽  
Sensitivity Analyses ◽  
Public Health Impact ◽  
Base Case ◽  
Complication Rates ◽  
Zoster Vaccine ◽  
Recombinant Zoster Vaccine ◽  
The Uk ◽  
The Impact

ObjectivesIn 2013, the herpes zoster (HZ) immunisation programme was introduced in the UK, recommending vaccination of adults 70 years of age (YOA) with the zoster vaccine live (ZVL), the only vaccine available at the time. The recently approved adjuvanted recombinant zoster vaccine (RZV) has a substantially different clinical profile that may offer additional benefits.This study aimed to 1) assess the public health impact (PHI) of introducing RZV in the UK compared with the current vaccination strategy and 2) explore via scenario analyses the optimal age group of vaccination in terms of PHI.DesignA previously developed health economic model was adapted to the UK setting.SettingCalculations were based on efficacy data from pivotal clinical trials, HZ incidence and postherpetic neuralgia (PHN) probability from a UK study and HZ-associated complication rates from published literature.PopulationThe base-case population considered a 2018-projected UK vaccination cohort of individuals 70 YOA.InterventionsVaccination with ZVL or RZV, assuming a first-dose coverage of 48.3% for both vaccines and 70% compliance for the second dose of RZV.Outcome measuresOutcomes included reduction of HZ and PHN cases, complications and the use of healthcare resources over a life-time horizon. The impact of coverage and second-dose compliance was also explored.ResultsCompared with no vaccination, RZV would lead to a reduction of 30 262 HZ and 5409 PHN cases while ZVL would lead to a reduction of 7909 HZ and 3567 PHN cases. The number needed to vaccinate to prevent 1 HZ case is 12 with RZV and 45 with ZVL. The highest PHI with RZV could be achieved in individuals 60 or 65 YOA.ConclusionUnder the model assumptions, RZV is predicted to avert more HZ and PHN cases compared with ZVL. Results were robust under different scenario and sensitivity analyses.

scholarly journals Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis

2021 ◽  
Author(s):  
Charles Whittaker ◽  
Oliver J Watson ◽  
Carlos Alvarez-Moreno ◽  
Nasikarn Angkasekwinai ◽  
Adhiratha Boonyasiri ◽  
...  
Keyword(s):  
Public Health ◽  
Supportive Care ◽  
Low Income ◽  
Health Impact ◽  
Public Health Impact ◽  
The Public ◽  
Hospitalised Patients ◽  
Potential Impact ◽  
The Impact ◽  
Potential Therapeutics

Abstract Background The public health impact of the COVID-19 pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the potential impact of different treatments, and consequently research and procurement priorities, have not been clear. Methods Using a mathematical model of SARS-CoV-2 transmission, COVID-19 disease and clinical care, we explore the public-health impact of different potential therapeutics, under a range of scenarios varying healthcare capacity, epidemic trajectories; and drug efficacy in the absence of supportive care. Results The impact of drugs like dexamethasone (delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R=1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalisation) could have much greater benefits, particularly in resource-poor settings facing large epidemics. Conclusions Advances in the treatment of COVID-19 to date have been focussed on hospitalised-patients and predicated on an assumption of adequate access to supportive care. Therapeutics delivered earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority.

DAMPAK PENGELOLAAN SAMPAH PADA KESEHATAN MASYARAKAT DI TPA

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Emilda Emilda
Keyword(s):  
Public Health ◽  
Hand Hygiene ◽  
Waste Management ◽  
Qualitative Data ◽  
Water Storage ◽  
Health Impact ◽  
Clean Water ◽  
The People ◽  
Clean Environment ◽  
The Impact

The limitations of waste management in the Cipayung Landfill (TPA) causing a buildup of garbage up to more than 30 meters. This condition has a health impact on people in Cipayung Village. This study aims to analyze the impact of waste management at Cipayung Landfill on public health in Cipayung Village, Depok City. The research is descriptive qualitative. Data obtained by purposive sampling. Data was collected by interviews, observation and documentation. Based on interviews with 30 respondents, it was found that the most common diseases were diarrhea, then other types of stomach ailments, subsequent itching on the skin and coughing. This is presumably because the environmental conditions in the form of unhealthy air and water and clean and healthy living behaviors (PHBS) have not become the habit of the people. The results indicated that there were no respondents who had implemented all of these criteria. In general respondents have implemented  3 criteria, namely maintaining hair hygiene, maintaining skin cleanliness, and maintaining hand hygiene. While maintaining clean water storage is the most often overlooked behavior. To minimize this health impact, improvements in waste management in Cipayung landfill are needed along with continuous socialization and education to develop PHBS habits and the importance of maintaining a clean environment.

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