Sexually Transmitted Diseases Among Residents in Nursing Homes: The Nurses' Perspective

Background: Examining registered nurses' perceptions of sexually transmitted disease (STD) education among residents in nursing homes allows for broader insight into why STDs continue to increase among older adults. Methods: A 4-page pilot survey was mailed to nursing home directors of nursing in Northwest Ohio (n=99) with a response rate of 32%. Directors of nursing were the target population as they are the most likely employee to hold registered nurse licensure. The health belief model formed the basis for the survey. Results: Most nurses did not see STDs or human immunodeficiency virus (HIV) as problems among their residents (100% and 96%, respectively) yet support for sex among residents was high. All (100%) agreed sex among married residents should be supported, while 77% agreed sex among nonmarried residents should be supported. Most nurses stated they were comfortable discussing HIV risk (84%), STD risk (84%), erectile dysfunction (75%), sexual desire and intimacy (72%), and correct condom use (66%). The most commonly reported perceived barriers to STD education were family opposition (63%), resident embarrassment (56%), and lack of education regarding the prevalence of STDs in older adults (53%). The most commonly reported perceived benefits to STD education were being seen as a leading facility for healthy initiatives (66%) and promotion of healthy sexual relationships among residents (56%). Conclusion: There was strong support for STD education among nurses though implementation remains rare. Addressing the most commonly perceived barriers and benefits may prove beneficial in increasing the number of LTCFs that provide STD education to residents.

Ohio Journal of Public Health Vol. 4, Issue 1 (June 2021): Full Issue

No abstract available.

Using Social Determinants Screening/Mapping Tools to Identify Needs and Resources for Student-Run Free Clinic Patients

Background: Social determinants of health have been well accepted as contributing to health outcomes. They are a vital aspect of health care delivery and must be a consideration, especially among free clinic populations. Social determinants of health have also become a required element of medical school curricula. The Student Outreach to Area Residents Student-Run Free Clinic based out of Northeast Ohio Medical University piloted a student-led program that implemented social determinants of health screening and community resource referral as a part of integrated health care delivery for all its patients. Methods: We described the development of a screening tool, protocol, and creation of community resource referral materials. We also described the tracking of patient-reported needs and mapping of location and accessibility of community resources. One hundred patients were surveyed through convenience sampling, and results were used for program improvement. Results/Conclusion: After collecting and analyzing survey results, it was found that the 2 most frequently requested determinants were mental health and utilities services, and the most available community resource was emergency food services. We also mapped these results by zip code and found gaps between need and distribution of services. We demonstrated the utility of mapping to identify points of improvement for the future. We also provided lessons learned related to effective social determinants of health screening, community resource referral, and overall program implementation in student-run free clinics. We further explained the benefits of including similar student-led programs as a way for students to gain practical experience related to social determinants of health.

Unintended Consequences: Social Isolation in the Elderly During COVID-19

No abstract available.

Sight for All United: Five Year Impact of a Vision Foundation on its Community

Background: In 2016, Sight for All United (SFAU) was founded in the Mahoning Valley of Ohio with the mission of improving access to care and maximizing the visual potential of the underserved. Methods: A retrospective chart review was conducted on patients served by SFAU from January 2016 through August 2020. Socioeconomic information, type of service, cost, and dollar amount paid were collected for patients. The data were analyzed with descriptive statistics and mapped with Esri ArcGIS. Results: A total of 1327 patients received assistance through the medical assistance and school vision programs. In the medical assistance program, 222 patients (mean age 50 years, 57% female) completed applications and 37% (83 patients) were in a household of 3 or more people. Median yearly income was $18 504, 134% above the federal poverty level by household size. The most common surgical services were cataract surgery (101) and vitreoretinal care (17). The most common medical services were eye exams (79) and spectacles (76). Estimated value of medical services provided was $367 249; actual cost was $93 746. The school vision program provided 1105 eye exams, 1514 pairs of spectacles, and 1 cataract surgery with an estimated value of $133 692. Conclusion: Sight for All United provided $500 941 of vision services to its patients since 2016 while dispersing less than $100 000 of donated dollars through collaboration with eye care providers, community resources, and national foun-dations. This study demonstrates the impact vision foundations managed by local eye care providers can have on the needs in their community in a cost-effective and efficient way.

The Design and Methodology of the Ohio COVID-19 Survey

Background: Governments worldwide are balancing contrasting needs to curtail the toll that coronavirus disease 2019 (COVID-19) takes on lives and health care systems and to preserve their economies. To support decisions, data that simultaneously measure the health status of the population and the economic impact of COVID-19 mitigation strategies are needed. In the United States, prior to the onset of COVID-19, surveys or tracking systems usually focused on public health or economic indicators, but not both. However, tracking public health and economic measures together allow policy makers and epidemiologists to understand how policy and program decisions are associated. The Ohio COVID-19 Survey (OCS) attempts to track both measures in Ohio as one of the first statewide population surveys on COVID-19. To achieve this there are several methodological challenges which need to be overcome. Methods: The OCS utilizes a representative panel offering both cross-sectional and longitudinal analyses. It targets 700 to 1000 respondents per week for a total of 12 600 to 18 000 respondents over an 18-week period. Leveraging a sample of 24 000 adult Ohioans developed from a statewide population health survey conducted in fall 2019, the OCS produces weekly economic and health measures that can be compared to baseline measures obtained before the COVID-19 pandemic began. Results: The OCS was able to quickly launch and achieve high participation (45.2%) and retention across waves. Conclusion: The OCS demonstrates how it is possible to leverage an existing health-based survey in Ohio to generate a panel which can be used to quickly track fast-breaking health issues like COVID-19.

Keeping the Public Healthy During a Global Pandemic

No abstract available.

Leveraging Local and Regional Partners to Implement Hospital Closed Point of Dispensing Sites

Background: Point of dispensing (POD) sites are critical to local public health agencies (LPHA) when an emergen-cy occurs requiring medications or vaccinations. Delivering medical countermeasures (MCM) ensures community support mechanisms and the general public are provided with a pharmaceutical intervention to limit untoward outcomes caused by the emergency. While LPHAs are required to have an MCM response plan, these plans vary based on jurisdictional size and geographical location in Ohio. This study evaluated the implementation potential of an MCM toolkit developed for LPHAs and hospitals across Ohio. Methods: An MCM toolkit was created consisting of planning resources, training modules, sample exercises, and custom graphics. The toolkit was evaluated using Consolidated Framework for Implementation Research constructs by public health, hospital, hospital association, and emergency management professionals across Ohio by an electronic sur-vey and phone interview. Qualitative and quantitative data were collected to determine overall implementation potential. Results: Thirty-eight (n=38) respondents with jurisdictional influence over 44 Ohio counties participated. Electronic survey results demonstrated high implementation potential for the MCM toolkit (weighted average 4.71/5.00). Phone interviews highlighted: (1) jurisdictional and regionalized planning approaches were necessary for MCM delivery, and (2) hospitals should function as closed POD sites for jurisdictional LPHAs. Conclusion: This work demonstrates the importance of MCM response planning for LPHAs and hospitals. Imple-mentation and planning materials for this work could be adopted into practice by LPHAs and hospitals across the United States to further assist in emergency preparedness planning.

Toledo Naloxone Outreach Program: Patient and Health Care Professional Student Education

Background: In 2016, Ohio was home to 2 of the top 10 cities with opioid overdoses in the United States. Dayton ranked first, and Toledo held the tenth slot. In response to the opioid epidemic, the Toledo Naloxone Outreach Program (TNOP) was developed to provide naloxone to underserved patients at a student-run free clinic.Methods: The TNOP takes place weekly at 2 locations in the greater Toledo area. Patients are asked to fill out an anonymous survey and given a brief training session by a health care professional student. Patients are then sent home with a free naloxone kit. Additionally, health care professional students were surveyed on their confidence of acquiring a substance use history and knowledge of local services for patients and family members of those experiencing addiction during the "train the trainer" event. The health care professional student survey utilized a 1-5 Likert scale and was analyzed using paired student t tests.Results: Survey results from patients indicate that a majority had not received nalox one prior to the training, indicating the service was expanding access to an otherwise underserved population. Results from the survey administered before and after health care professional student training sessions reflect a significant increase in confidence eliciting a substance abuse history and providing patients and/or family members with addiction resources in the community.Conclusion: The TNOP has provided the community of Toledo with 2 additional outreach locations for receiving free naloxone kits with proper education. Currently, TNOP is in the process of expanding the outreach program to additional student-run free clinics in Ohio.

The Ohio COVID-19 Survey: Preliminary Findings and Their Use During the Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic has created exceptional health and economic uncertainty for Ohioans in 2020. In the spring of 2020, the state commissioned the Ohio COVID-19 Survey (OCS) to ask residential Ohio adults about how the pandemic was affecting them. The purpose of this research is to provide state leadership with real-time information about the effects of the pandemic and concurrent recession on Ohio households.Methods: The OCS is a special supplement to the Ohio Medicaid Assessment Survey (OMAS), a stratified random digit dial, cell phone and landline telephone survey. This study includes data collected weekly between April 20, 2020, and August 24, 2020. We conducted descriptive time-series analysis of the survey data and provided updates to the state's COVID-19 Response Team throughout the survey period.Results: Preliminary findings from the OCS reflect 3 themes among respondents: 1) elevated levels of concern over health and household economics; 2) disproportionate effects that exacerbate existing inequities; and 3) majority adjustment to "new normal" and acceptance of public health guidelines .Conclusion: Preliminary findings indicate that groups that were struggling before the pandemic have faced the biggest challenges with regard to health and household economics since it began. Data from the OCS enabled us to provide real-time analysis to state leadership regarding Ohioans' experience during the first 6 months of the COVID-19 pandemic. Further analysis and integration of additional data will allow us to provide deeper insights as Ohio seeks to move into recovery.