Immigrant Communities and COVID-19: Strengthening the Public Health Response

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Immigrant Communities ◽  
Care Providers ◽  
Public Health Response ◽  
The Public ◽  
Public Health Infrastructure ◽  
Health Infrastructure

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

The public’s trust and information brokers in health care, public health and research

2019 ◽  
Vol 33 (7/8) ◽  
pp. 929-948 ◽  
Author(s):  
Jodyn Platt ◽  
Minakshi Raj ◽  
Sharon L.R. Kardia
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Information Sharing ◽  
Health Information ◽  
Health Care Providers ◽  
Care Providers ◽  
Content Type ◽  
The Public ◽  
Information Brokers

Purpose Nations such as the USA are investing in technologies such as electronic health records in order to collect, store and transfer information across boundaries of health care, public health and research. Health information brokers such as health care providers, public health departments and university researchers function as “access points” to manage relationships between the public and the health system. The relationship between the public and health information brokers is influenced by trust; and this relationship may predict the trust that the public has in the health system as a whole, which has implications for public trust in the system, and consequently, legitimacy of involved institutions, under circumstances of health information data sharing in the future. This paper aims to discuss these issues. Design/methodology/approach In this study, the authors aimed to examine characteristics of trustors (i.e. the public) that predict trust in health information brokers; and further, to identify the factors that influence trust in brokers that also predict system trust. The authors developed a survey that was administered to US respondents in 2014 using GfK’s nationally representative sample, with a final sample of 1,011 participants and conducted ordinary least squares regression for data analyses. Findings Results suggest that health care providers are the most trusted information brokers of those examined. Beliefs about medical deceptive behavior were negatively associated with trust in each of the information brokers examined; however, psychosocial factors were significantly associated with trust in brokers, suggesting that individual attitudes and beliefs are influential on trust in brokers. Positive views of information sharing and the expectation of benefits of information sharing for health outcomes and health care quality are associated with system trust. Originality/value This study suggests that demonstrating the benefits and value of information sharing could be beneficial for building public trust in the health system; however, trust in brokers of information are variable across the public; that is, knowledge, attitudes and beliefs are associated with the level of trust different individuals have in various health information brokers – suggesting that the need for a personalized approach to building trust.

The Evolution of a Public Health Policy: Health Care Providers and the Transmission of HIV

1994 ◽  
Vol 24 (3) ◽  
pp. 535-548 ◽  
Author(s):  
Sally Guttmacher
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Public Health Policy ◽  
Health Care Facilities ◽  
Care Providers ◽  
The Public ◽  
Care Facilities ◽  
Potential Benefits ◽  
Spread Of Infection

The single known instance of transmission of HIV from a health care provider to a patient raised issues concerning the responsibility of clinicians to their patients, and sparked debate over policies to prevent the spread of HIV in health care facilities. The intensity and politicization of the debate were reflected in revision of the Centers for Disease Control guidelines to control the spread of infection at health care facilities, and in legislation proposed in Congress. The guidelines and proposed legislation provoked responses by public health and medical organizations, several of which considered the measures to be unnecessarily restrictive and too costly in terms of potential benefits. This article describes the events and responses that took place during 1991–1992 after the public was made aware of the case involving transmission from provider to patient. The author examines the situation in the context of public health efforts to control the spread of HIV.

scholarly journals Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

2021 ◽  
Vol 2 (3) ◽  
pp. 142-145
Author(s):  
Happiness P. Saronga ◽  
Jackline V. Mbishi ◽  
Saidah S. Bakar ◽  
Switbert R. Kamazima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Low Income ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Low Income Countries ◽  
Care Providers ◽  
Public Health Facilities

Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services. Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis. Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities. Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

scholarly journals Detection of SARS-CoV-2 RNA and Antibodies in Diverse Samples: Protocol to Validate the Sufficiency of Provider-Observed, Home-Collected Blood, Saliva, and Oropharyngeal Samples

10.2196/19054 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19054 ◽  
Author(s):  
Patrick Sean Sullivan ◽  
Charles Sailey ◽  
Jodie Lynn Guest ◽  
Jeannette Guarner ◽  
Colleen Kelley ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
The United States ◽  
Alternative Methods ◽  
Nasopharyngeal Swab ◽  
Care Providers ◽  
Public Health Response ◽  
Specimen Collection

Background The response in the United States to the coronavirus disease (COVID-19) pandemic has been hampered by a lack of aggressive testing for the infection. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cornerstone of an effective public health response. However, efforts to test have been hampered by limited reagents, limitations in the availability of swabs used for the collection of nasopharyngeal swab (NPS) specimens, limitations in personal protective equipment (PPE) for health care providers collecting the NPS specimens, and limitations in viral transport media for transporting the specimens. Therefore, more flexible options for screening for SARS-CoV-2 RNA and serologic responses are critical to inform clinical and public health responses. Objective We aim to document the ability of patients to self-collect sufficient specimens for SARS-CoV-2 viral detection and serology. Methods Patient self-collection of samples will be done with observation by a health care provider during a telemedicine session. Participants will be mailed a specimen collection kit, engage in a telehealth session with a provider through a HIPPA (Health Insurance Portability and Accountability Act of 1996)-compliant video meeting, and collect specimens while being observed by the provider. Providers will record whether they are confident in the suitability of the specimen for laboratory testing that would inform clinical decision making. We will objectively assess the sufficiency of biological material in the mailed-in specimens. Results The protocol was approved by the Emory University Institutional Review Board (IRB) on March 30, 2020 (Protocol number 371). To date, we have enrolled 159 participants. Conclusions Defining a conceptual framework for assessing the sufficiency of patient-collected samples for the detection of SARS-CoV-2 RNA and serologic responses to infection is critical for facilitating public health responses and providing PPE-sparing options to increase testing. Validation of alternative methods of specimen collection should include objective measures of the sufficiency of specimens for testing. A strong evidence base for diversifying testing modalities will improve tools to guide public health responses to the COVID-19 pandemic.

scholarly journals Detection of SARS-CoV-2 RNA and Antibodies in Diverse Samples: Protocol to Validate the Sufficiency of Provider-Observed, Home-Collected Blood, Saliva, and Oropharyngeal Samples (Preprint)

2020 ◽  
Author(s):  
Patrick Sean Sullivan ◽  
Charles Sailey ◽  
Jodie Lynn Guest ◽  
Jeannette Guarner ◽  
Colleen Kelley ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
The United States ◽  
Alternative Methods ◽  
Nasopharyngeal Swab ◽  
Care Providers ◽  
Public Health Response ◽  
Specimen Collection

BACKGROUND The response in the United States to the coronavirus disease (COVID-19) pandemic has been hampered by a lack of aggressive testing for the infection. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cornerstone of an effective public health response. However, efforts to test have been hampered by limited reagents, limitations in the availability of swabs used for the collection of nasopharyngeal swab (NPS) specimens, limitations in personal protective equipment (PPE) for health care providers collecting the NPS specimens, and limitations in viral transport media for transporting the specimens. Therefore, more flexible options for screening for SARS-CoV-2 RNA and serologic responses are critical to inform clinical and public health responses. OBJECTIVE We aim to document the ability of patients to self-collect sufficient specimens for SARS-CoV-2 viral detection and serology. METHODS Patient self-collection of samples will be done with observation by a health care provider during a telemedicine session. Participants will be mailed a specimen collection kit, engage in a telehealth session with a provider through a HIPPA (Health Insurance Portability and Accountability Act of 1996)-compliant video meeting, and collect specimens while being observed by the provider. Providers will record whether they are confident in the suitability of the specimen for laboratory testing that would inform clinical decision making. We will objectively assess the sufficiency of biological material in the mailed-in specimens. RESULTS The protocol was approved by the Emory University Institutional Review Board (IRB) on March 30, 2020 (Protocol number 371). To date, we have enrolled 159 participants. CONCLUSIONS Defining a conceptual framework for assessing the sufficiency of patient-collected samples for the detection of SARS-CoV-2 RNA and serologic responses to infection is critical for facilitating public health responses and providing PPE-sparing options to increase testing. Validation of alternative methods of specimen collection should include objective measures of the sufficiency of specimens for testing. A strong evidence base for diversifying testing modalities will improve tools to guide public health responses to the COVID-19 pandemic.

Law, Liability, and Public Health Emergencies

2009 ◽  
Vol 3 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Sharona Hoffman ◽  
Richard A. Goodman ◽  
Daniel D. Stier
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Influenza Pandemic ◽  
Public Health Emergency ◽  
Care Providers ◽  
The Public ◽  
Public Health Emergencies ◽  
Medical Response

ABSTRACTAccording to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts. (Disaster Med Public Health Preparedness. 2009;3:117–125)

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

scholarly journals Innovative COVID-19 Programs to Rapidly Serve New Mexico

2020 ◽  
Vol 136 (1) ◽  
pp. 39-46
Author(s):  
Joanna G. Katzman ◽  
Laura E. Tomedi ◽  
Karla Thornton ◽  
Paige Menking ◽  
Michael Stanton ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Critical Care ◽  
New Mexico ◽  
General Education ◽  
Health Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Project Echo

Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico is a telementoring program that uses videoconferencing technology to connect health care providers in underserved communities with subject matter experts. In March 2020, Project ECHO created 10 coronavirus disease 2019 (COVID-19) telementoring programs to meet the public health needs of clinicians and teachers living in underserved rural and urban regions of New Mexico. The newly created COVID-19 programs include 7 weekly sessions (Community Health Worker [in English and Spanish], Critical Care, Education, First-Responder Resiliency, Infectious Disease Office Hours, and Multi-specialty) and 3 one-day special sessions. We calculated the total number of attendees, along with the range and standard deviation, per session by program. Certain programs (Critical Care, Infectious Disease Office Hours, Multi-specialty) recorded the profession of attendees when available. The Project ECHO research team collected COVID-19 infection data by county from March 11 through May 31, 2020. During that same period, 9765 health care and general education professionals participated in the COVID-19 programs, and participants from 31 of 35 (89%) counties in New Mexico attended the sessions. Our initial evaluation of these programs demonstrates that an interprofessional clinician group and teachers used the Project ECHO network to build a community of practice and social network while meeting their educational and professional needs. Because of Project ECHO’s large reach, the results of the New Mexico COVID-19 response suggest that the rapid use of ECHO telementoring could be used for other urgent national public health problems.

Creating Academic and Health Care Partnerships that Impact Public Health

2015 ◽  
Vol 4 (4) ◽  
pp. 378-384
Author(s):  
Peter W. Grandjean ◽  
Burritt W. Hess ◽  
Nicholas Schwedock ◽  
Jackson O. Griggs ◽  
Paul M. Gordon
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Professional Training ◽  
Local Health ◽  
Care Providers ◽  
Research Partnerships ◽  
Local Health Care ◽  
Training Community ◽  
The University

Kinesiology programs are well positioned to create and develop partnerships within the university, with local health care providers, and with the community to integrate and enhance the activities of professional training, community service, public health outreach, and collaborative research. Partnerships with medical and health care organizations may be structured to fulfill accreditation standards and the objectives of the “Exercise is Medicine®” initiative to improve public health through primary prevention. Barriers of scale, location, time, human resources, and funding can be overcome so all stakeholder benefits are much greater than the costs.

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