Public Health Implementation Considerations for State-Level Ebola Monitoring and Movement Restrictions

2020 ◽  
pp. 1-6
Author(s):  
Tara Kirk Sell ◽  
Matthew P. Shearer ◽  
Diane Meyer ◽  
Mary Leinhos ◽  
Erin Thomas ◽  
...  
Keyword(s):  
Public Health ◽  
Policy Development ◽  
State Level ◽  
The United States ◽  
Structured Interviews ◽  
Movement Restriction ◽  
Implementation Processes ◽  
Cdc Guidelines ◽  
Control And Prevention ◽  
Substantial Resource

ABSTRACT Objective: This article describes implementation considerations for Ebola-related monitoring and movement restriction policies in the United States during the 2013–2016 West Africa Ebola epidemic. Methods: Semi-structured interviews were conducted between January and May 2017 with 30 individuals with direct knowledge of state-level Ebola policy development and implementation processes. Individuals represented 17 jurisdictions with variation in adherence to US Centers for Disease Control and Prevention (CDC) guidelines, census region, predominant state political affiliation, and public health governance structures, as well as the CDC. Results: Interviewees reported substantial resource commitments required to implement Ebola monitoring and movement restriction policies. Movement restriction policies, including for quarantine, varied from voluntary to mandatory programs, and, occasionally, quarantine enforcement procedures lacked clarity. Conclusions: Efforts to improve future monitoring and movement restriction policies may include addressing surge capacity to implement these programs, protocols for providing support to affected individuals, coordination with law enforcement, and guidance on varying approaches to movement restrictions.

scholarly journals Policy Inertia on Regulating Food Marketing to Children: A Case Study of Malaysia

2021 ◽  
Vol 18 (18) ◽  
pp. 9607
Author(s):  
SeeHoe Ng ◽  
Bridget Kelly ◽  
Heather Yeatman ◽  
Boyd Swinburn ◽  
Tilakavati Karupaiah
Keyword(s):  
Public Health ◽  
Policy Development ◽  
Self Regulation ◽  
Food Marketing ◽  
Policy Reforms ◽  
Structured Interviews ◽  
Implementation Processes ◽  
Global Standards ◽  
Marketing To Children

Unhealthy food marketing shapes children’s preference towards obesogenic foods. In Malaysia, policies regulating this food marketing were rated as poor compared to global standards, justifying the need to explore barriers and facilitators during policy development and implementation processes. The case study incorporated qualitative methods, including historical mapping, semi-structured interviews with key informants and a search of cited documents. Nine participants were interviewed, representing the Federal government (n = 5), food industry (n = 2) and civil society (n = 2). Even though the mandatory approach to government-led regulation of food marketing to children was the benchmark, more barriers than facilitators in the policy process led to industry self-regulations in Malaysia. Cited barriers were the lack of political will, industry resistance, complexity of legislation, technical challenges, and lack of resources, particularly professional skills. The adoption of industry self-regulation created further barriers to subsequent policy advancement. These included implementer indifference (industry), lack of monitoring, poor stakeholder relations, and policy characteristics linked to weak criteria and voluntary uptake. These underlying barriers, together with a lack of sustained public health advocacy, exacerbated policy inertia. Key recommendations include strengthening pro-public health stakeholder partnerships, applying sustained efforts in policy advocacy to overcome policy inertia, and conducting monitoring for policy compliance and accountability. These form the key lessons for advocating policy reforms.

Vaccine Administration by Paramedics: A Model for Bioterrorism and Disaster ResponsePreparation

2003 ◽  
Vol 18 (4) ◽  
pp. 321-326
Author(s):  
Bruce J. Walz ◽  
Richard A. Bissell ◽  
Brian Maguire ◽  
James A. Judge
Keyword(s):  
Public Health ◽  
United States ◽  
Patient Education ◽  
Emergency Services ◽  
The United States ◽  
Specific Training ◽  
Vaccination Programs ◽  
Emergency Services Personnel ◽  
Cdc Guidelines ◽  
Control And Prevention

AbstractThe events of 11 September 2001 have had a profound effect on disaster planning efforts in the United States. This is true especially in the area of bioter-rorism. One of the major tenets of bioterrorism response is the vaccination of at-riskpopulations. This paper investigates the efficacy of training emergency medical services paramedics to administer vaccines in public health settings as preparation for and response to bioterrorism events and other disaster events.The concept of vaccination administration by specially trained paramedics is not new. Various programs to provide immunizations for emergency services personnel and at-risk civilian populations have been reported.Vaccination programs by paramedics should follow the guidelines of the National Vaccine Advisory Committee of the Centers for Disease Control and Prevention (CDC). Thispaper compares the seven standards of the CDC guidelines to routine paramedic practice and education. It is concluded that paramedics are adequately trained to administer vaccines. However, specific training and protocols are needed in the areas of administrative paperwork and patient education. A proposed outline for a paramedic-training program is presented.

Vaccine Administration by Paramedics: A Model for Bioterrorism and Disaster Response Preparation

2003 ◽  
Vol 18 (4) ◽  
pp. 321-326 ◽  
Author(s):  
Bruce J. Walz ◽  
Richard A. Bissell ◽  
Brian Maguire ◽  
James A. Judge
Keyword(s):  
Public Health ◽  
Disaster Response ◽  
Emergency Services ◽  
The United States ◽  
Specific Training ◽  
Response Preparation ◽  
Vaccination Programs ◽  
Emergency Services Personnel ◽  
Cdc Guidelines ◽  
Control And Prevention

AbstractThe events of 11 September 2001 have had a profound effect on disaster planning efforts in the United States. This is true especially in the area of bioter-rorism. One of the major tenets of bioterrorism response is the vaccination of at-riskpopulations. This paper investigates the efficacy of training emergency medical services paramedics to administer vaccines in public health settings as preparation for and response to bioterrorism events and other disaster events.The concept of vaccination administration by specially trained paramedics is not new. Various programs to provide immunizations for emergency services personnel and at-risk civilian populations have been reported.Vaccination programs by paramedics should follow the guidelines of the National Vaccine Advisory Committee of the Centers for Disease Control and Prevention (CDC). Thispaper compares the seven standards of the CDC guidelines to routine paramedic practice and education. It is concluded that paramedics are adequately trained to administer vaccines. However, specific training and protocols are needed in the areas of administrative paperwork and patient education. A proposed outline for a paramedic-training program is presented.

Can increases in Twitter posts predict increases in cumulative incidence of COVID-19 in the United States? Evidence that social media can inform epidemic surveillance. (Preprint)

2020 ◽  
Author(s):  
Ruoyan Sun ◽  
Henna Budhwani
Keyword(s):  
Public Health ◽  
United States ◽  
Cumulative Incidence ◽  
Hot Spots ◽  
Adult Population ◽  
State Level ◽  
The United States ◽  
Education Attainment ◽  
Public Health Systems ◽  
Per Capita

BACKGROUND Though public health systems are responding rapidly to the COVID-19 pandemic, outcomes from publicly available, crowd-sourced big data may assist in helping to identify hot spots, prioritize equipment allocation and staffing, while also informing health policy related to “shelter in place” and social distancing recommendations. OBJECTIVE To assess if the rising state-level prevalence of COVID-19 related posts on Twitter (tweets) is predictive of state-level cumulative COVID-19 incidence after controlling for socio-economic characteristics. METHODS We identified extracted COVID-19 related tweets from January 21st to March 7th (2020) across all 50 states (N = 7,427,057). Tweets were combined with state-level characteristics and confirmed COVID-19 cases to determine the association between public commentary and cumulative incidence. RESULTS The cumulative incidence of COVID-19 cases varied significantly across states. Ratio of tweet increase (p=0.03), number of physicians per 1,000 population (p=0.01), education attainment (p=0.006), income per capita (p = 0.002), and percentage of adult population (p=0.003) were positively associated with cumulative incidence. Ratio of tweet increase was significantly associated with the logarithmic of cumulative incidence (p=0.06) with a coefficient of 0.26. CONCLUSIONS An increase in the prevalence of state-level tweets was predictive of an increase in COVID-19 diagnoses, providing evidence that Twitter can be a valuable surveillance tool for public health.

scholarly journals Users’ Beliefs Toward Physical Distancing in Facebook Pages of Public Health Authorities During COVID-19 Pandemic in Early 2020

2021 ◽  
pp. 109019812110144
Author(s):  
Soon Guan Tan ◽  
Aravind Sesagiri Raamkumar ◽  
Hwee Lin Wee
Keyword(s):  
Public Health ◽  
Health Belief Model ◽  
United States Public Health ◽  
Health Belief ◽  
The United States ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Control And Prevention ◽  
Belief Model ◽  
The Health Belief Model

This study aims to describe Facebook users’ beliefs toward physical distancing measures implemented during the Coronavirus disease (COVID-19) pandemic using the key constructs of the health belief model. A combination of rule-based filtering and manual classification methods was used to classify user comments on COVID-19 Facebook posts of three public health authorities: Centers for Disease Control and Prevention of the United States, Public Health England, and Ministry of Health, Singapore. A total of 104,304 comments were analyzed for posts published between 1 January, 2020, and 31 March, 2020, along with COVID-19 cases and deaths count data from the three countries. Findings indicate that the perceived benefits of physical distancing measures ( n = 3,463; 3.3%) was three times higher than perceived barriers ( n = 1,062; 1.0%). Perceived susceptibility to COVID-19 ( n = 2,934; 2.8%) was higher compared with perceived severity ( n = 2,081; 2.0%). Although susceptibility aspects of physical distancing were discussed more often at the start of the year, mentions on the benefits of intervention emerged stronger toward the end of the analysis period, highlighting the shift in beliefs. The health belief model is useful for understanding Facebook users’ beliefs at a basic level, and it provides a scope for further improvement.

scholarly journals Patterns and correlates of mis-implementation in state chronic disease public health practice in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Margaret M. Padek ◽  
Stephanie Mazzucca ◽  
Peg Allen ◽  
Emily Rodriguez Weno ◽  
Edward Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Public Health Practice ◽  
State Level ◽  
The United States ◽  
Organizational Level ◽  
Effective Programs

Abstract Background Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Methods A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation. Results Half (50.7%) of respondents were chronic disease program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40). Conclusion The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.

scholarly journals Tracking U.S. Pertussis Incidence: Correlation of Public Health Surveillance and Google Search Data Varies by State

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Christopher H. Arehart ◽  
Michael Z. David ◽  
Vanja Dukic
Keyword(s):  
Public Health ◽  
Linear Models ◽  
State Level ◽  
Individual State ◽  
Control And Prevention ◽  
Search Data ◽  
State Models ◽  
Uniform Manner ◽  
Google Search ◽  
The U.S

AbstractThe Morbidity and Mortality Weekly Reports of the U.S. Centers for Disease Control and Prevention document a raw proxy for counts of pertussis cases in the U.S., and the Project Tycho (PT) database provides an improved source of these weekly data. These data are limited because of reporting delays, variation in state-level surveillance practices, and changes over time in diagnosis methods. We aim to assess whether Google Trends (GT) search data track pertussis incidence relative to PT data and if sociodemographic characteristics explain some variation in the accuracy of state-level models. GT and PT data were used to construct auto-correlation corrected linear models for pertussis incidence in 2004–2011 for the entire U.S. and each individual state. The national model resulted in a moderate correlation (adjusted R2 = 0.2369, p < 0.05), and state models tracked PT data for some but not all states. Sociodemographic variables explained approximately 30% of the variation in performance of individual state-level models. The significant correlation between GT models and public health data suggests that GT is a potentially useful pertussis surveillance tool. However, the variable accuracy of this tool by state suggests GT surveillance cannot be applied in a uniform manner across geographic sub-regions.

scholarly journals Patterns and Correlates of Mis-implementation in State Chronic Disease Public Health Practice in the United States

2021 ◽  
Author(s):  
Margaret Padek ◽  
Stephanie Mazzucca ◽  
Peg Allen ◽  
Emily Rodriguez Weno ◽  
Edward Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Public Health Practice ◽  
State Level ◽  
The United States ◽  
Organizational Level ◽  
Effective Programs

Abstract Background: Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Methods: A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation. Results: Half (50.7%) of respondents were chronic disease program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40). Conclusion: The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.

scholarly journals Feeding the disparities: the geography and trends of breastfeeding in the United States

2018 ◽  
Author(s):  
Romain Garnier ◽  
Ana I. Bento ◽  
Pejman Rohani ◽  
Saad B. Omer ◽  
Shweta Bansal
Keyword(s):  
Public Health ◽  
United States ◽  
Breast Milk ◽  
Low Income ◽  
Temporal Trends ◽  
State Level ◽  
The United States ◽  
Poverty Level ◽  
Future Health ◽  
Breastfeeding Rates

AbstractThere is scientific consensus on the importance of breastfeeding for the present and future health of newborns, in high- and low-income settings alike. In the United States, improving breast milk access is a public health priority but analysis of secular trends are largely lacking. Here, we used data from the National Immunization Survey of the CDC, collected between 2003 and 2016, to illustrate the temporal trends and the spatial heterogeneity in breastfeeding. We also considered the effect sizes of two key determinants of breastfeeding rates. We show that, while access to breast milk both at birth and at 6 months old has steadily increased over the past decade, large spatial disparities still remain at the state level. We also find that, since 2009, the proportion of households below the poverty level has become the strongest predictor of breastfeeding rates. We argue that, because variations in breastfeeding rates are associated with socio-economic factors, public health policies advocating for breastfeeding are still needed in particular in underserved communities. This is key to reducing longer term health disparities in the U.S., and more generally in high-income countries.

scholarly journals Age-Standardized Mortality of Persons on Probation, in Jail, or in State Prison and the General Population, 2001-2012

2019 ◽  
Vol 134 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Christopher Wildeman ◽  
Alyssa W. Goldman ◽  
Emily A. Wang
Keyword(s):  
Public Health ◽  
United States ◽  
Age Distribution ◽  
Correctional Facility ◽  
Well Being ◽  
The United States ◽  
Mortality Rates ◽  
State Prison ◽  
Control And Prevention ◽  
Standardized Mortality Ratios

Objectives: The number of adults in the United States being held on probation—persons convicted of crimes and serving their sentence in the community rather than in a correctional facility—approached 4 million at the end of 2016 and continues to grow, yet little is known about the health and well-being of this population. We compared the standardized mortality ratios of persons on probation in the United States with persons in jail, persons in state prison, and the general US population. Methods: We used administrative data from 2001-2012 from the Bureau of Justice Statistics and the Centers for Disease Control and Prevention WONDER database and indirect standardization techniques to compare the mortality rates of persons on probation in 15 states with the mortality rates of persons in jail, persons in state prison, and the general US population. We applied the age-specific mortality rates of 3 populations (general US population, persons in jail, and persons in state prison) to the age distribution of persons on probation to estimate standardized mortality ratios. Results: Persons on probation died at a rate 3.42 times higher than persons in jail, 2.81 times higher than persons in state prison, and 2.10 times higher than the general US population, after standardizing the age distribution of persons on probation relative to the other 3 groups. Conclusions: Public health interventions should target persons on probation, who have received less attention from the public health community than persons serving sentences in jails and prisons.

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