Journal of community health
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The burden of preventable chronic diseases is straining our nation's health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. ⋯ Within 12 months, communities advanced over one-third of their obesity and tobacco-use prevention strategies. Tobacco interventions appeared to have higher potential population reach than obesity interventions within this initiative. Findings on the progress and potential reach of this major initiative may help inform future chronic disease prevention efforts.
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International health electives offer unique experiences for medical students to develop clinical skills and cultural competencies in unique and diverse environments. Medical students have been increasingly pursuing these learning opportunities despite the challenges. However, their goals in pursuing these opportunities and the relation between their learning objectives and actual experiences have not been studied adequately. ⋯ Program challenges were also identified. Students in a global health elective were able to fulfill self-identified learning objectives, while also gaining other unexpected yet important lessons. Students' learning objectives also should be considered in evaluating learning experiences in international health electives.
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Use of mammograms to detect presence of breast cancer is influenced by many factors, including ability to access mammography services. Access to services is often affected by the capacity of mammography facilities to serve women. We sought to describe the capacity of mammography facilities to conduct mammograms in a largely urban area of Texas. ⋯ Most facilities had only one or two staff to conduct mammograms. The results of this survey indicate that the capacity of mammography facilities vary dramatically across many characteristics of capacity. As these indicators are tied to the ability of women to access necessary preventive services, it is important to determine how these characteristics are associated with mammography utilization.
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This study examines the relationship between rurality as well as the proportion of non-physician clinicians and county rates of ambulatory care sensitive hospitalizations (ACSHs) for pediatric, adult and elderly populations in Nebraska. The study design was a cross-sectional observational study of county level factors that affect the county level rates of ACSHs using Poisson regression models. ⋯ The proportion of primary care providers who are non-physician clinicians does not have a significant association with ACSHs for any of the age groups. The results indicate that rurality may have a greater impact on pediatric and adult ACSHs and the proportion of NPCs in the primary care provider workforce does not significantly impact ACSH rates.
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Influenza can spread quickly among children and caregivers in child day care settings. Vaccination is the most effective method to prevent influenza. We determined 2009 pandemic influenza A (H1N1) (pH1N1) and seasonal influenza vaccination rates during the 2009-2010 influenza season among child care center employees, assessed knowledge and attitudes regarding the vaccines, and determined factors associated with vaccine receipt. ⋯ The most common reasons cited for not getting either vaccine were "I don't think I need the vaccine," "I don't think the vaccine will keep me from getting the flu," and "the vaccine is not safe." Factors independently associated with receipt of either vaccine included belief in its efficacy, having positive attitudes towards it, and feeling external pressure to get it. Child care center employees had low rates of pH1N1 and seasonal influenza vaccination largely due to misconceptions about the need for and efficacy of the vaccine. Public health messages should address misconceptions about vaccines, and employers should consider methods to maximize influenza vaccination of employees as part of a comprehensive influenza prevention program.