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Heitkemper E, Hulse S, Bekemeier B, Schultz M, Whitman G, Turner AM. The Solutions in Health Analytics for Rural Equity Across the Northwest (SHARE-NW) Dashboard for Health Equity in Rural Public Health: Usability Evaluation. JMIR Hum Factors 2024; 11:e51666. [PMID: 38837192 PMCID: PMC11187519 DOI: 10.2196/51666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 03/24/2024] [Accepted: 04/18/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Given the dearth of resources to support rural public health practice, the solutions in health analytics for rural equity across the northwest dashboard (SHAREdash) was created to support rural county public health departments in northwestern United States with accessible and relevant data to identify and address health disparities in their jurisdictions. To ensure the development of useful dashboards, assessment of usability should occur at multiple stages throughout the system development life cycle. SHAREdash was refined via user-centered design methods, and upon completion, it is critical to evaluate the usability of SHAREdash. OBJECTIVE This study aims to evaluate the usability of SHAREdash based on the system development lifecycle stage 3 evaluation goals of efficiency, satisfaction, and validity. METHODS Public health professionals from rural health departments from Washington, Idaho, Oregon, and Alaska were enrolled in the usability study from January to April 2022. The web-based evaluation consisted of 2 think-aloud tasks and a semistructured qualitative interview. Think-aloud tasks assessed efficiency and effectiveness, and the interview investigated satisfaction and overall usability. Verbatim transcripts from the tasks and interviews were analyzed using directed content analysis. RESULTS Of the 9 participants, all were female and most worked at a local health department (7/9, 78%). A mean of 10.1 (SD 1.4) clicks for task 1 (could be completed in 7 clicks) and 11.4 (SD 2.0) clicks for task 2 (could be completed in 9 clicks) were recorded. For both tasks, most participants required no prompting-89% (n=8) participants for task 1 and 67% (n=6) participants for task 2, respectively. For effectiveness, all participants were able to complete each task accurately and comprehensively. Overall, the participants were highly satisfied with the dashboard with everyone remarking on the utility of using it to support their work, particularly to compare their jurisdiction to others. Finally, half of the participants stated that the ability to share the graphs from the dashboard would be "extremely useful" for their work. The only aspect of the dashboard cited as problematic is the amount of missing data that was present, which was a constraint of the data available about rural jurisdictions. CONCLUSIONS Think-aloud tasks showed that the SHAREdash allows users to complete tasks efficiently. Overall, participants reported being very satisfied with the dashboard and provided multiple ways they planned to use it to support their work. The main usability issue identified was the lack of available data indicating the importance of addressing the ongoing issues of missing and fragmented public health data, particularly for rural communities.
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Affiliation(s)
| | - Scott Hulse
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Betty Bekemeier
- School of Nursing, University of Washington, Seattle, WA, United States
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Melinda Schultz
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Greg Whitman
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Anne M Turner
- School of Public Health, University of Washington, Seattle, WA, United States
- School of Medicine, University of Washington, Seattle, WA, United States
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Hall K, Royster J. Opportunities to Support Secondary Data Access Needs Among Local Health Departments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:753-756. [PMID: 37478097 DOI: 10.1097/phh.0000000000001798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Affiliation(s)
- Kellie Hall
- National Association of County and City Health Officials, Washington, District of Columbia
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Bekemeier B, Heitkemper E, Backonja U, Whitman G, Schultz M, Jiang Y, Baquero B, Turner AM. Rural Public Health Data Challenges During the COVID-19 Pandemic: The Case for Building Better Systems Ahead of a Public Health Crisis. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:496-502. [PMID: 36867496 DOI: 10.1097/phh.0000000000001726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
CONTEXT Rural public health personnel serve communities that have been particularly susceptible to COVID-19 and yet faced the pandemic with far less well-resourced capacity than their urban counterparts. A critical aspect of addressing local health inequities is access to high-quality population data and the capacity to effectively use data to support decision making. However, much of the data required to investigate inequities are not readily available to rural local health departments and the tools and training to analyze data are often lacking. PROGRAM The purpose of our effort was to explore rural data challenges related to COVID-19 and provide recommendations for improving rural data access and capacity ahead of future crises. IMPLEMENTATION We gathered qualitative data in 2 phases, more than 8 months apart, from rural public health practice personnel. Initial data were gathered in October-November 2020 regarding rural public health data needs during the COVID-19 pandemic and then to later identify whether the same findings held true in July 2021 or whether access to and capacity to use data to address the pandemic and related inequities improved as the pandemic progressed. EVALUATION In our 4-state exploration focused on access and use of data among rural public health systems to promote health equity in the Northwest United States, we found tremendous and ongoing unmet data needs, challenges with communicating data, and a lack of capacity to meet this public health crisis. DISCUSSION Recommendations for addressing these challenges include increasing dedicated resources specifically to rural public health systems, improving data access and infrastructure, and providing dedicated data-related workforce development.
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Affiliation(s)
- Betty Bekemeier
- Schools of Nursing (Drs Bekemeier and Backonja and Mr Whitman), Public Health (Drs Bekemeier, Baquero, and Turner), and Medicine (Drs Backonja and Turner), University of Washington, Seattle, Washington; School of Nursing, University of Texas, Austin (Dr Heitkemper); University of Wisconsin-Madison, Madison, Wisconsin (Ms Schultz); School of Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington (Dr Backonja); and Carnegie Mellon University, Pittsburgh, Pennsylvania (Ms Jiang)
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Petrovskis A, Bekemeier B, van Draanen J, Heitkemper E. Grouping Public Health Skills to Facilitate Workforce Development: A Factor Analysis of PH WINS. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:E79-E89. [PMID: 36731059 DOI: 10.1097/phh.0000000000001613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions. DESIGN Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives). SETTING Data for this study come from the 2017 PH WINS, which assessed public health workforce perceptions of training needs, workplace environment, job satisfaction, perceptions about national trends, and demographics. The analysis included 22 items. PARTICIPANTS All public health staff in participating agencies were eligible to complete the survey. The national data set included participants from 47 state health agencies, 26 large local health departments (LHDs), and 71 mid-sized LHDs across all 10 Health and Human Services regions in the United States (including LHDs from all states). The analytic sample was n = 9630 in tier 1, n = 4829 in tier 2, and n = 714 in tier 3 staff. MAIN OUTCOME MEASURE Three factors were identified within the skills portion of PH WINS, using exploratory factor analysis. To interpret retained factors, the following parameters were used: factor loadings greater than 0.4, factor cross-loadings less than 0.4 or higher than loadings on other factors, and communalities greater than 0.5. RESULTS Factors included (1) data and systems thinking, (2) planning and management, and (3) community collaboration, with slight variation in item loadings between tier 1 and tier 2 and 3 staff analyses. CONCLUSION This study was the first known factor analysis of the training needs and workforce skills portion of PH WINS in the published literature. This study advances our conceptualization of public health workforce skills and has the potential to shape future critical workforce training development.
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Affiliation(s)
- Anna Petrovskis
- School of Nursing, University of Washington, Seattle, Washington (Dr Petrovskis and Drs Bekemeier and van Draanen); and School of Nursing, University of Texas at Austin, Austin, Texas (Dr Heitkemper)
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Orr JM, Leider JP, Kuehnert P, Bekemeier B. COVID-19 Revealed Shortcomings Of The US Public Health System And The Need To Strengthen Funding And Accountability. Health Aff (Millwood) 2023; 42:374-382. [PMID: 36877906 DOI: 10.1377/hlthaff.2022.01234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
The US governmental public health system, which includes federal, state, and local agencies, is seen by many observers as having a money problem, stemming from a lack of resources. During the COVID-19 pandemic, this lack of resources has had unfortunate consequences for the communities that public health practice leaders are expected to protect. Yet the money problem is complex and involves understanding the nature of chronic public health underinvestment, identifying what money is spent in public health and what the country gets for it, and determining how much money is needed to do the work of public health in the future. This Commentary elucidates each of these issues and provides recommendations for making public health services more financially sustainable and accountable. Well-functioning public health systems require adequate funding, but a modernized public health financial data system is also key to the systems' success. There is a great need for standardization and accountability in public health finance, along with incentives and the generation of research evidence demonstrating the value of and most effective delivery for a baseline of public health services that every community should expect.
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Affiliation(s)
- Jason M Orr
- Jason M. Orr, University of Minnesota, Minneapolis, Minnesota
| | | | - Paul Kuehnert
- Paul Kuehnert, Public Health Accreditation Board, Alexandria, Virginia
| | - Betty Bekemeier
- Betty Bekemeier , University of Washington, Seattle, Washington
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Petrovskis A, Bekemeier B, Heitkemper E, van Draanen J. The DASH model: Data for addressing social determinants of health in local health departments. Nurs Inq 2023; 30:e12518. [PMID: 35982547 DOI: 10.1111/nin.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023]
Abstract
Recent frameworks, models, and reports highlight the critical need to address social determinants of health for achieving health equity in the United States and around the globe. In the United States, data play an important role in better understanding community-level and population-level disparities particularly for local health departments. However, data-driven decision-making-the use of data for public health activities such as program implementation, policy development, and resource allocation-is often presented theoretically or through case studies in the literature. We sought to develop a preliminary model that identifies the factors that contribute to data-driven decision-making in US local health departments and describe relationships between them. Guided by implementation science literature, we examined organizational-level capacity and individual-level factors contributing to using data for decision-making related to social determinants of health and the reduction of county-level disparities. This model has the potential to improve implementation of public health interventions and programs aimed at upstream structural factors, by elucidating the factors critical to incorporating data in decision-making.
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Affiliation(s)
- Anna Petrovskis
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Betty Bekemeier
- School of Nursing, University of Washington, Seattle, Washington, USA
| | | | - Jenna van Draanen
- School of Nursing, University of Washington, Seattle, Washington, USA
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Kulik PKG, Leider JP, Rogers M, Karnik H, Power LE, Schaffer K, Bekemeier B. PH WINS for All: The Critical Role of Partnerships for Engaging All Local Health Departments in the Public Health Workforce Interests and Needs Survey. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:S48-S53. [PMID: 36223512 PMCID: PMC10573110 DOI: 10.1097/phh.0000000000001635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The 2021 "PH WINS for All" pilot sought to address a rural research gap by including small local health departments in the Public Health Workforce Interests and Needs Survey (PH WINS) for the first time. To do so, the de Beaumont Foundation partnered with the Public Health Training Centers in Health and Human Services Regions V and X. This article describes the collaborative efforts that made the PH WINS for All pilot successful, presents respondent demographics by agency size, and discusses the importance of gathering such data to address the unique needs of the workforce in small local health departments.
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Affiliation(s)
- Phoebe K. G. Kulik
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
| | - Jonathon P. Leider
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
| | - Megan Rogers
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
| | - Harshada Karnik
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
| | - Laura E. Power
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
| | - Kay Schaffer
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
| | - Betty Bekemeier
- Region V Public Health Training Center and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan (Ms Kulik and Dr Power); Region V Public Health Training Center and Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota (Drs Leider and Karnik); de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer); and Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, Washington (Ms Rogers and Dr Bekemeier)
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Prochnow T, Umstattd Meyer MR, Bridges Hamilton CN, Wilkins E, Pollack Porter KM. Real-Time Video Scan Method for Community Partner Use to Inform Play Streets Implementation. Health Promot Pract 2022; 23:944-949. [PMID: 33969724 DOI: 10.1177/15248399211009789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
System for Observing Play and Recreation in Communities (SOPARC) can provide accurate assessment of physical activity; however, the skills, time, and human resources necessary to collect/interpret SOPARC data can be challenging for community organizations. This article describes a more accessible adaptation of SOPARC using video recordings for community organizations to obtain physical activity feedback at Play Streets. Narrated panoramic video scans occurred every 30 minutes at each Play Street using an iPad. Videographers narrated: (1) sex, (2) age group (child, teen, adult, senior), and (3) activity level (sedentary, walking, vigorous) for everyone recorded. SOPARC video scans, in-person iSOPARC observations, and interviews were conducted with Play Streets implementors to determine validity and feasibility. Validity was examined using Lin's concordance correlation coefficient (CCC). In-person and video scans showed near perfect agreement for sedentary individuals (CCC = .95) and substantial agreement for active individuals (CCC = .72). Overall, community partners felt that they "could see how [the scans] could be useful" and "help[ed] see a bit more clearly what's happening." The method described here is a more accessible systematic observation approach to measure physical activity for communities implementing Play Streets. Further, this method can be used without research training while still providing valuable activity feedback.
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Vo MV, Ebi KL, Busch Isaksen TM, Hess JJ, Errett NA. Addressing Capacity Constraints of Rural Local Health Departments to Support Climate Change Adaptation: Action Is Needed Now. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13651. [PMID: 36294229 PMCID: PMC9602968 DOI: 10.3390/ijerph192013651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Looming climate change health impacts among rural communities will require a robust health system response. To reduce health inequities and promote climate justice, rural local health departments (LHDs) must be adequately resourced and supported to engage in climate change mitigation and adaptation policy and program development and implementation. In the United States, small local tax bases, overreliance on revenue from fee-based services, and limited federal funding to support climate change and health programming, have left rural LHDs with limited and inflexible human, financial, and political capital to support engagement in local climate change activities. Because of the urgent demands stemming from climate change, additional investments and supports are needed to rapidly build the capacity and capability of rural LHDs. Federal and state approaches to public health funding should consider the unique climate change and health risks of rural communities. Further, cross-jurisdictional shared service arrangements and state-level support to build rural LHDs' technical capacity, and research on local impacts and culturally appropriate solutions, must be prioritized.
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Affiliation(s)
- Matthew V. Vo
- Public Health–Global Health, University of Washington School of Public Health, Seattle, WA 98195, USA
| | - Kristie L. Ebi
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98105, USA
- Department of Global Health, University of Washington School of Public Health, Seattle, WA 98195, USA
- Center for Health and the Global Environment (CHanGE), University of Washington School of Public Health, Seattle, WA 98195, USA
| | - Tania M. Busch Isaksen
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98105, USA
- Center for Health and the Global Environment (CHanGE), University of Washington School of Public Health, Seattle, WA 98195, USA
| | - Jeremy J. Hess
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98105, USA
- Department of Global Health, University of Washington School of Public Health, Seattle, WA 98195, USA
- Center for Health and the Global Environment (CHanGE), University of Washington School of Public Health, Seattle, WA 98195, USA
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Nicole A. Errett
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98105, USA
- Center for Health and the Global Environment (CHanGE), University of Washington School of Public Health, Seattle, WA 98195, USA
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Supporting rural public health practice to address local-level social determinants of health across Northwest states: Development of an interactive visualization dashboard. J Biomed Inform 2022; 129:104051. [DOI: 10.1016/j.jbi.2022.104051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 01/24/2023]
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Petrovskis A, Baquero B, Bekemeier B. Involvement of Local Health Departments in Obesity Prevention: A Scoping Review. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E345-E353. [PMID: 33729187 PMCID: PMC8781226 DOI: 10.1097/phh.0000000000001346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Local health department (LHD) obesity prevention (OP) efforts, particularly by rural LHDs, are seemingly uncommon, in part, due to limited infrastructure, workforce capacity, accessible data, and available population-level interventions aimed at social determinants of health (SDOH). METHODS We conducted a scoping review to determine LHD roles in OP efforts and interventions. Inclusion criteria were articles including evidence-based OP and LHD leaders or staff. Articles were coded by type of LHD involvement, data use, intervention characteristics, use of an SDOH lens, and urban or rural setting. RESULTS We found 154 articles on LHD OP-52 articles met inclusion criteria. Typically, LHDs engaged in only surveillance, initial intervention development, or evaluation and were not LHD led. Data and SDOH lens use were infrequent, and interventions typically took place in urban settings. CONCLUSION LHDs could likely play a greater role in OP and population-level interventions and use data in intervention decision making. However, literature is limited. Future research should focus on LHD capacity building, including academic-public health partnerships. Studies should include rural populations, data, and SDOH frameworks addressing "upstream" factors.
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Affiliation(s)
- Anna Petrovskis
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| | - Barbara Baquero
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| | - Betty Bekemeier
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
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Schenkelberg MA, Essay AM, Rosen MS, Bavari AE, Norgelas SJ, Rosenkranz RR, Welk GJ, Dzewaltowski DA. A protocol for coordinating rural community stakeholders to implement whole-of-community youth physical activity surveillance through school systems. Prev Med Rep 2021; 24:101536. [PMID: 34976611 PMCID: PMC8683876 DOI: 10.1016/j.pmedr.2021.101536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/09/2021] [Accepted: 08/22/2021] [Indexed: 12/28/2022] Open
Abstract
Accurate and effective local data collection systems are needed to inform community change on youth health behaviors such as physical activity (PA). Systematic methods are particularly important for understanding PA behaviors that may be influenced by individual, interpersonal, organizational, and regional factors. The purpose of this study was to describe a protocol for coordinating community stakeholders to implement an online youth PA surveillance instrument. The research team collaborated with local health departments (LHDs) from two rural communities to coordinate schools in implementing school-wide youth PA surveillance. A data sharing agreement was established between all partners. School administrators and teachers attended in-person training sessions for an online PA survey and how to use the data. Following the training, students were provided individualized logins to complete the survey once a semester over a two-year academic period. Across both communities, 23 teachers and administrators attended the training sessions that were facilitated by the LHDs and research team. In Year 1 (Y1), a total of 465 3rd through 6th grade students were enrolled in the participating schools (community 1 = 227; community 2 = 238). Survey response rates ranged from 86.1% to 95.4% completion, depending on the community and semester. In Year 2 (Y2), a total of 501 3rd through 6th grade students were enrolled (community 1 = 260; community 2 = 241). Response rates ranged from 86.3% to 89.6% in the fall term. A protocol for coordinating LHD and community stakeholders was an effective strategy for implementing population-level youth PA surveillance with high levels of reach.
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Affiliation(s)
| | - Ann M. Essay
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Marisa S. Rosen
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Arissa E. Bavari
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Sara J. Norgelas
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Richard R. Rosenkranz
- College of Health & Human Sciences, Kansas State University, Manhattan, KS 66506, USA
| | - Gregory J. Welk
- College of Human Sciences, Iowa State University, Ames, IA 50011, USA
| | - David A. Dzewaltowski
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Sainkhuu S, Cunha-Cruz J, Rogers M, Knerr S, Bekemeier B. Evaluation of Training Gaps Among Public Health Practitioners in Washington State. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:473-483. [PMID: 32810065 DOI: 10.1097/phh.0000000000001184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Identifying training gaps in public health competencies and skills is a first step in developing priorities for advancing the workforce. OBJECTIVE Our purpose was to identify training gaps in competencies and skills among local, state, and nonjurisdictional public health employees in Washington State. Our secondary aim was to determine whether training gaps differed by employees' work-related and demographic characteristics. DESIGN We used data from our training needs assessment of the public health workforce, conducted as an online cross-sectional survey in Spring/Summer of 2016. RESPONDENTS AND SETTING Employees from governmental local, state, and nonjurisdictional public health departments in Washington State. MAIN OUTCOME MEASURES Training gaps were calculated for 8 public health competencies and 8 skills, using a composite score of respondents' ratings of their "training confidence" and "training need." For each domain and skill area, we calculated the percentage of associated items, where respondents rated their training needs as high and their confidence as low to create scores ranging from 0% to 100%. RESULTS The largest training gaps in public health competencies were in the Financial Planning and Policy Development domains. For skills, Quality Improvement and Developing Effective Communication Campaigns had the largest training gaps. In adjusted models, female employees or employees working in local health departments in select Washington State regions had higher training gaps in Financial Planning, Policy Development, and Quality Improvement, relative to male or state health department employees. Employees who worked in specialized programs, such as Communicable Disease Control, and Maternal, Child, and Family Health, had higher training gaps in Financial Planning and Developing Effective Communication Campaigns than those who worked in Administrative and Support Services. CONCLUSIONS We identified important training gaps in several competency domains and skills. Findings are informing decisions about tailoring training opportunities for public health practitioners in Washington and other states.
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Affiliation(s)
- Solongo Sainkhuu
- Departments of Oral Health Sciences, School of Dentistry (Dr Cunha-Cruz) and Health Services, School of Public Health (Drs Cunha-Cruz, Knerr, and Bekemeier and Ms Rogers), University of Washington, Seattle, Washington; and Northwest Center for Public Health Practice, University of Washington, Seattle, Washington (Ms Rogers and Dr Bekemeier)
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Ryan-Ibarra S, Nishimura H, Gallington K, Grinnell S, Bekemeier B. Time to Modernize: Local Public Health Transitions to Population-Level Interventions. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:464-472. [PMID: 31834010 DOI: 10.1097/phh.0000000000001100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify facilitating factors that guide local health departments (LHDs) in their transition from direct clinical service provision to population-level interventions addressing the social determinants of health. DESIGN Key informant interviews with LHD leaders and their staff were conducted using a semistructured interview guide. Thematic qualitative analysis was used to identify common characteristics and strategies among the LHD leaders and staff. PARTICIPANTS LHDs represented both rural and urban communities with population sizes from 9746 to 919 628 and agencies in Illinois, Montana, North Carolina, Oregon, Tennessee, Washington, and West Virginia. OUTCOME MEASURE The impetus and facilitators for transitioning health department services from clinical to population health. RESULTS Leaders from 7 LHDs emphasized that an impetus for their transition from direct clinical services to population-level interventions was that it was "time to modernize." Among LHDs interviewed, most included the 10 Essential Public Health Services or Public Health 3.0 in their strategic plan. Adding this focus to their strategic plan facilitated buy-in from local government and the ability to maintain the LHDs' focus on population-level interventions. We found that strong relationships and open communication with community members and partner organizations (eg, federally qualified health centers) were critical facilitators of transition. Themes from interviews were used to identify an initial set of 8 key elements of an effective transition: partnership/leadership, vision/goals, communication, community engagement, interventions, data/evaluation, workforce issues, and sustainability. CONCLUSIONS Prevention systems suffer from a lack of adequate health promotion and access to quality care for their community's residents. There is a need for LHDs to access technical support to strategically address complexity and ensure core population-focused prevention. The results shared provide replicable solutions, practices, and methods that enable successful transitions of LHDs toward maximizing their role in population health.
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Affiliation(s)
- Suzanne Ryan-Ibarra
- Survey Research Group (Dr Ryan-Ibarra and Mss Nishimura and Gallington) and Population Health Innovation Lab (Ms Grinnell), Public Health Institute, Oakland, California; and Northwest Center for Public Health Practice, Seattle, Washington (Dr Bekemeier)
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15
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Veinot TC, Ancker JS, Bakken S. Health informatics and health equity: improving our reach and impact. J Am Med Inform Assoc 2021; 26:689-695. [PMID: 31411692 DOI: 10.1093/jamia/ocz132] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Health informatics studies the use of information technology to improve human health. As informaticists, we seek to reduce the gaps between current healthcare practices and our societal goals for better health and healthcare quality, safety, or cost. It is time to recognize health equity as one of these societal goals-a point underscored by this Journal of the American Medical Informatics Association Special Focus Issue, "Health Informatics and Health Equity: Improving our Reach and Impact." This Special Issue highlights health informatics research that focuses on marginalized and underserved groups, health disparities, and health equity. In particular, this Special Issue intentionally showcases high-quality research and professional experiences that encompass a broad range of subdisciplines, methods, marginalized populations, and approaches to disparities. Building on this variety of submissions and other recent developments, we highlight contents of the Special Issue and offer an assessment of the state of research at the intersection of health informatics and health equity.
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Affiliation(s)
- Tiffany C Veinot
- School of Information, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica S Ancker
- Division of Health Informatics, Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York, USA
| | - Suzanne Bakken
- School of Nursing, Columbia University, New York, New York, USA.,Department of Biomedical Informatics, Columbia University, New York, New York, USA.,Data Science Institute, Columbia University, New York, New York, USA
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16
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Ward TM, Skubic M, Rantz M, Vorderstrasse A. Human-centered approaches that integrate sensor technology across the lifespan: Opportunities and challenges. Nurs Outlook 2020; 68:734-744. [PMID: 32631796 PMCID: PMC8104265 DOI: 10.1016/j.outlook.2020.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 01/22/2023]
Abstract
Children, parents, older adults, and caregivers routinely use sensor technology as a source of health information and health monitoring. The purpose of this paper is to describe three exemplars of research that used a human-centered approach to engage participants in the development, design, and usability of interventions that integrate technology to promote health. The exemplars are based on current research studies that integrate sensor technology into pediatric, adult, and older adult populations living with a chronic health condition. Lessons learned and considerations for future studies are discussed. Nurses have successfully implemented interventions that use technology to improve health and detect, prevent, and manage diseases in children, families, individuals and communities. Nurses are key stakeholders to inform clinically relevant health monitoring that can support timely and personalized intervention and recommendations.
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Affiliation(s)
- Teresa M Ward
- School of Nursing, University of Washington, Seattle, WA.
| | - Marjorie Skubic
- Electrical Engineering and Computer Science, University of Missouri, Columbia, MO
| | - Marilyn Rantz
- Sinclair School of Nursing, University of Missouri, Columbia, MO
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17
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Brewer LC, Fortuna KL, Jones C, Walker R, Hayes SN, Patten CA, Cooper LA. Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health. JMIR Mhealth Uhealth 2020; 8:e14512. [PMID: 31934874 PMCID: PMC6996775 DOI: 10.2196/14512] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 09/05/2019] [Accepted: 10/16/2019] [Indexed: 12/12/2022] Open
Abstract
The rapid proliferation of health informatics and digital health innovations has revolutionized clinical and research practices. There is no doubt that these fields will continue to have accelerated growth and a substantial impact on population health. However, there are legitimate concerns about how these promising technological advances can lead to unintended consequences such as perpetuating health and health care disparities for underresourced populations. To mitigate this potential pitfall, it is imperative for the health informatics and digital health scientific communities to understand the challenges faced by disadvantaged groups, including racial and ethnic minorities, which hinder their achievement of ideal health. This paper presents illustrative exemplars as case studies of contextually tailored, sociotechnical mobile health interventions designed with community members to address health inequities using community-engaged research approaches. We strongly encourage researchers and innovators to integrate community engagement into the development of data-driven, modernized solutions for every sector of society to truly achieve health equity for all.
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Affiliation(s)
- LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States
| | | | | | - Robert Walker
- Massachusetts Department of Mental Health, Boston, MA, United States
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Lisa A Cooper
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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18
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Lee EWJ, Viswanath K. Big Data in Context: Addressing the Twin Perils of Data Absenteeism and Chauvinism in the Context of Health Disparities Research. J Med Internet Res 2020; 22:e16377. [PMID: 31909724 PMCID: PMC6996749 DOI: 10.2196/16377] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/11/2019] [Accepted: 11/11/2019] [Indexed: 01/03/2023] Open
Abstract
Recent advances in the collection and processing of health data from multiple sources at scale-known as big data-have become appealing across public health domains. However, present discussions often do not thoroughly consider the implications of big data or health informatics in the context of continuing health disparities. The 2 key objectives of this paper were as follows: first, it introduced 2 main problems of health big data in the context of health disparities-data absenteeism (lack of representation from underprivileged groups) and data chauvinism (faith in the size of data without considerations for quality and contexts). Second, this paper suggested that health organizations should strive to go beyond the current fad and seek to understand and coordinate efforts across the surrounding societal-, organizational-, individual-, and data-level contexts in a realistic manner to leverage big data to address health disparities.
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Affiliation(s)
- Edmund W J Lee
- Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard TH Chan School of Public Health, Boston, MA, United States
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Kasisomayajula Viswanath
- Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard TH Chan School of Public Health, Boston, MA, United States
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BeLue R, Wirth L, Steormer A, Alexander S. The Community Analytics Academy Pilot: A Community-Academic Partnership for Building Community Health Care Analytic Capacity. J Prim Care Community Health 2020; 11:2150132720932408. [PMID: 32508202 PMCID: PMC7281603 DOI: 10.1177/2150132720932408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The ability to analyze data to identify best practices is key to improving quality of care for community-based health care organizations (CBOs). Leading commercial statistical software remains too costly for many CBOs operating in underserved communities. The St Louis Integrated Health Network (IHN) collaborates with CBOs to increase access to health care. IHN and a local university developed the Community Analytics Academy (CAA), a training collaborative designed to meet the need for data-informed decision making among CBOs. Establishing analytics training collaboratives for CBOs empowers organizations to respond to the ever-growing amounts of health care data and the need for data-driven decision making.
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