scholarly journals Evaluation of a Program to Reduce Home Environment Risks for Children with Asthma Residing in Urban Areas

2021 ◽  
Vol 19 (1) ◽  
pp. 172
Author(s):  
Brandon Workman ◽  
Andrew F. Beck ◽  
Nicholas C. Newman ◽  
Laura Nabors
Keyword(s):  
Health Professionals ◽  
Urban Areas ◽  
Medical Center ◽  
Home Visits ◽  
Health Department ◽  
Evidence Base ◽  
Program Improvement ◽  
Housing Quality ◽  
Local Health ◽  
Asthma Triggers

Pediatric asthma morbidity is often linked to challenges including poor housing quality, inability to access proper medical care, lack of medications, and poor adherence to medical regimens. Such factors also propagate known disparities, by race and income, in asthma-related outcomes. Multimodal home visits have an established evidence base in support of their use to improve such outcomes. The Collaboration to Lessen Environmental Asthma Risks (CLEAR) is a partnership between the Cincinnati Children’s Hospital Medical Center and the local health department which carries out home visits to provide healthy homes education and write orders for remediation should code violations and environmental asthma triggers be identified. To assess the strengths and weaknesses of the program, we obtained qualitative feedback from health professionals and mothers of children recently hospitalized with asthma using key informant interviews. Health professionals viewed the program as a positive support system for families and highlighted the potential benefit of education on home asthma triggers and connecting families with services for home improvements. Mothers report working to correct asthma triggers in the home based on the education they received during the course of their child’s recent illness. Some mothers indicated mistrust of the health department staff completing home visits, indicating a further need for research to identify the sources of this mistrust. Overall, the interviews provided insights into successful areas of the program and areas for program improvement.

scholarly journals HIV and infant feeding – one step forward, two steps back

2011 ◽  
Vol 12 (4) ◽  
pp. 6 ◽  
Author(s):  
H Saloojee ◽  
G Gray ◽  
J A McIntyre
Keyword(s):  
South African ◽  
Health Professionals ◽  
Health Department ◽  
Evidence Base ◽  
African Health ◽  
One Step ◽  
Free Replacement ◽  
Hiv Exposed ◽  
Adequate Evidence ◽  
South African Health

The recent decision by the South African Health Department to withdraw the provision of free replacement (formula) feeds to HIV-exposed infants has hardly evoked any response from clinicians, health professionals or civil society groups. This paper argues that the decision is short-sighted, lacks an adequate evidence base, and is retrogressive and unconstitutional. Nine supporting arguments are presented and an alternative policy proposed.

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.

Integrated care: learning from East London

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697265
Author(s):  
Sonia Bussu
Keyword(s):  
Integrated Care ◽  
Evidence Base ◽  
Community Health Services ◽  
Health Economy ◽  
Local Health ◽  
Frontline Staff ◽  
Care Community ◽  
Organisation Development ◽  
Integrated Care Pathways ◽  
Local Health System

BackgroundDespite a growing body of literature on integrated, there remains a relatively small evidence base to suggest which elements of integrated care are most effective and how to implement them successfully. This might also be due to the fact that policy thinking around integrated care is struggling to translate into organisation change at the point of delivery. Better understanding of patterns of collaborations and integrated pathways is crucial to understand frontline staff’s OD needs and provide adequate support.AimThis paper focuses on the frontline level to assess progress towards integrated care in East London.MethodWe use admission avoidance (Rapid Response service) and discharge services (Discharge to Assess) as a lens to examine how frontline staff from secondary care, community health services and social service work together to deliver more integrated care. The study uses the Researcher in Residence (RiR), where the researcher is embedded in the in the organisations she is evaluating, as a key member of the delivery team.ResultsInitial findings suggest that while work on integrated care has enabled some level of collaborative working at strategic levels in partner organisations, on the frontline professionals are grappling with issues such as professional identity, professional boundaries, mutual trust and accountability, as new services and roles struggle to be fully embedded within the local health system.ConclusionThe paper sheds light on to the complexity on integrated care at the point of delivery. Better understanding of integrated care pathways is crucial to evidence patterns of collaboration across organisations; assess how these new roles and teams are embedding themselves within the local health economy; identify organisation development needs; and provide adequate support to frontline staff.

scholarly journals Geographies of Doing Nothing–Internal Displacement and Practices of Post-Disaster Recovery in Urban Areas of the Kathmandu Valley, Nepal

2021 ◽  
Vol 10 (3) ◽  
pp. 110
Author(s):  
Alexandra Titz
Keyword(s):  
Urban Areas ◽  
Evidence Base ◽  
Internal Displacement ◽  
Kathmandu Valley ◽  
Reconstruction Process ◽  
Internally Displaced ◽  
Secondary Displacement ◽  
Displaced People ◽  
Durable Solutions ◽  
Post Disaster

Disaster-related internal displacement is on the rise in many countries and is increasingly becoming an urban phenomenon. For many people, as in the case of the earthquake disaster 2015 in Nepal, protracted or multiple disaster displacements are a lived reality. While the drivers of displacement are relatively well understood, significant uncertainties remain regarding the factors that trigger prolonged or secondary displacement and impede ending of displacement or achieving durable solutions. The purpose of this article is to illustrate and theorise the discourse of reconstruction and return that shapes experiences, strategies, and policies in order to gain a better understanding of the obstacles to pursuing durable solutions that are still shaping the reality of life for urban internally displaced people (IDPs) in Kathmandu Valley. I use the concepts of ‘fields of practice’ and ‘disaster justice’ to provide insights into the theorisation of the links between social inequality, structural forms of governance, and the reconstruction process itself. Findings demonstrate that the application of these concepts has great potential to expand our understanding of ‘realities of life’ and practices of IDPs, and thus contribute to a more differentiated evidence base for the development and implementation of appropriate disaster risk reduction policies and practices.

Expanding Support Services for Adults Born With Cleft Lip and/or Palate in the United Kingdom: An Exploratory Evaluation of the Cleft Lip and Palate Association Adult Services Programme

2021 ◽  
pp. 105566562110254
Author(s):  
Kenny Ardouin ◽  
Nicky Davis ◽  
Nicola Marie Stock
Keyword(s):  
Health Professionals ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Evidence Base ◽  
Psychosocial Needs ◽  
For Profit ◽  
Adult Services ◽  
The United Kingdom ◽  
Not For Profit ◽  
Valuable Adjunct

Background: The largest group of people living with repaired cleft lip and/or palate (CL/P) are adults. Previous research has identified unmet treatment and psychosocial needs, yet few interventions exist. This article outlines 3 interventions developed by the Cleft Lip and Palate Association as part of its 3-year community-based Adult Services Programme; an Adults Conference, a series of panel discussions (“Cleft Talk”) streamed in podcast/video format, and a Leaver’s Pack of resources for adults wishing to return to cleft care. Methods: Feedback from attendees of the Adults Conferences (2018-2019) was collected using specifically developed evaluation forms. Streaming metrics and social media interactions were extracted for Cleft Talk panel discussions (2019-2020). The Leaver’s Pack was piloted in 2020, using an online evaluation form. Specialist health professionals were invited to provide feedback or participate in a one-to-one interview regarding their perceived impact of the program. Results: All 3 interventions across the different modalities received support from participating adults, demonstrating potential to meet adults’ needs across the life span. Health professionals also offered support for the program, viewing the interventions as a valuable adjunct to formal medical CL/P services. Conclusions: This exploratory evaluation indicates that peer- and community-led interventions, in combination with ongoing access to specialist medical care, can have a range of positive impacts for adults with CL/P. There is scope for similar initiatives to be developed internationally and for individuals with other craniofacial conditions. Not-for-profit organizations are encouraged to routinely evaluate their interventions to create a stronger evidence base for their valuable work.

scholarly journals A Web-Based Tool for Quantification of Potential Gains in Life Expectancy by Preventing Cause-Specific Mortality

2021 ◽  
Vol 9 ◽  
Author(s):  
Aruna Chandran ◽  
Churong Xu ◽  
Jonathan Gross ◽  
Kathryn M. Leifheit ◽  
Darcy Phelan-Emrick ◽  
...  
Keyword(s):  
Heart Disease ◽  
Life Expectancy ◽  
Health Department ◽  
Local Health ◽  
Web Based ◽  
Baltimore City ◽  
Scarce Resources ◽  
Disease Mortality ◽  
Specific Mortality ◽  
Neighborhood Level

Introduction: Local health departments are currently limited in their ability to use life expectancy (LE) as a benchmark for improving community health. In collaboration with the Baltimore City Health Department, our aim was to develop a web-based tool to estimate the potential lives saved and gains in LE in specific neighborhoods following interventions targeting achievable reductions in preventable deaths.Methods: The PROLONGER (ImPROved LONGEvity through Reductions in Cause-Specific Deaths) tool utilizes a novel Lives Saved Simulation model to estimate neighborhood-level potential change in LE after specified reduction in cause-specific mortality. This analysis uses 2012–2016 deaths in Baltimore City residents; a 20% reduction in heart disease mortality is shown as a case study.Results: According to PROLONGER, if heart disease deaths could be reduced by 20% in a given neighborhood in Baltimore City, there could be up to a 2.3-year increase in neighborhood LE. The neighborhoods with highest expected LE increase are not the same as those with highest heart disease mortality burden or lowest overall life expectancies.Discussion: PROLONGER is a practical resource for local health officials in prioritizing scarce resources to improve health outcomes. Focusing programs based on potential LE impact at the neighborhood level could lend new information for targeting of place-based public health interventions.

scholarly journals Health Care Professionalism Without Doctors

2018 ◽  
Vol 5 (2) ◽  
pp. 72-94 ◽  
Author(s):  
Marie Østergaard Møller
Keyword(s):  
Health Professionals ◽  
Qualitative Data ◽  
Nationwide Survey ◽  
Relational Theory ◽  
Local Health ◽  
Medical Field ◽  
Data Set ◽  
The Individual ◽  
The Relationship ◽  
Larger Sample

The article uses the organization of health houses in Denmark as a case to study the relationship between spatial surroundings and professionalization. The question is whether these new local health houses comprise an alternative to the medical view on health or ––even in the absence of the hospital–– script the professionals to identify themselves as agents from the medical field? In this article, macro-structural theory is combined with micro-relational theory in order to identify how macro structures such as professionalization nest the way social interaction takes place in concrete spatial situations and surroundings. The argument put forward is that we need to identity this process at the level of the individual in order to qualify and anchor our understanding of professionalization as a macro phenomenon. The empirical basis is two dissimilar locations (health houses), selected from a larger qualitative data set of interviews with health professionals and citizens and observations of health houses, originally selected from a nationwide survey. The presented analysis zooms in on selected places and situations and relates analyses to the overall picture of differences and similarities identified in the larger sample. The analysis shows how entrances, receptions, information screens and coffee tables not only design houses, but also script styles of interaction between health professionals and citizens as well as they work as signs creating expectations about professional roles and how to reflect and act as a professional in a given physical and social setting. The main finding is that spatial surroundings facilitate processes of identification and counter-identification crucial to a new kind of health professionals such as the ones under study here.

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