American journal of public health
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Historical Article
A tale of two global health programs. Smallpox eradication's lessons for the antipolio campaign in India.
India provided one of the most challenging chapters of the worldwide smallpox eradication program. The campaign was converted from a project in which a handful of officials tried to impose their ideas on a complex health bureaucracy to one in which its components were constantly adapted to the requirements of a variety of social, political, and economic contexts. ⋯ However, this lesson appears to have been largely forgotten by those currently managing the Global Polio Eradication Initiative. We hope to show ways in which contemporary efforts to eliminate polio worldwide might profitably draw on historical information, which can indicate meaningful ways in which institutional adaptability is likely to help counter the political and social challenges being encountered in India.
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We identified factors associated with testing HIV positive in a prison system performing voluntary HIV testing on inmates and estimated the number of undetected HIV cases to evaluate the efficacy of risk-factor-based HIV testing. ⋯ The associations between HIV serostatus and a variety of factors highlight the potential limitations of risk-factor-based HIV testing in prisons, as do the high number of potential undetected HIV cases.
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We investigated whether maternal attitude toward prevention, as indicated by history of seeking Papanicolaou (Pap) tests and contracting sexually transmitted infections, influenced human papillomavirus (HPV) vaccine uptake among their adolescent daughters. ⋯ Mothers' attitude toward prevention may influence HPV vaccine uptake among adolescent girls. The impacts of targeting mothers should be considered by HPV vaccination programs and investigated by further research.
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Comparative Study
Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women.
We tested the effectiveness of a lay health worker intervention to increase breast and cervical cancer screening among low-income Hispanic women. ⋯ Our results add to the evidence concerning the effectiveness of lay health worker interventions for increasing Pap test screening and mammography. Future research should explore the effectiveness of CLS in other Hispanic groups, the mechanisms through which interpersonal communication influences decisions about screening, and how effective interventions such as CLS can best be adopted and implemented in community-based organizations or other settings.
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Comprehensive data on the public health workforce are fundamental to workforce development throughout the public health system. Such information is also a critical data element in public health systems research, a growing area of study that can inform the practice of public health at all levels. ⋯ A 2006-2007 Association of State and Territorial Health Officials workforce enumeration pilot project demonstrated the issues involved in collecting workforce data. This project illustrated key elements of an institutionalized national system of workforce enumeration, which would be needed for a robust, recurring count that provides a national picture of the public health workforce.