Browsing by Subject "public health"
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Item African-American and Latina Women Seeking Public Health Services: Cultural Beliefs regarding Pregnancy, including Medication-taking Behavior(University of Minnesota, College of Pharmacy, 2011) Sanchez, Luz Dalia; Rowles, Joie; Dube, DavidObjective: to describe cultural beliefs and medication-taking-behavior about pregnancy in African-American and Latina women. Design: qualitative study using phenomenological methodology; face-to-face, semi structured interviews and focus group. Thematic analysis was done to obtain themes consistent with the research objective. Setting: Maricopa County, Arizona, Department of Public-health Programs, November 2008 through April 2009. Participants: women seeking public-health services in the greater Phoenix, Arizona. Results: fifteen adult women representing two ethnic groups (seven African-Americans and eight Latinas) participated. Themes derived from the interview data included: “The Dilemma: To Become or Not to Become Pregnant;” “The Ideal Stress-free World: Support System;” “Changing Worlds: Wanting Dependency;” and “The Health care System: Disconnection from Pregnancy to Postpartum.” Conclusions: based on the cultural themes: 1. pregnancies were not planned; 2. healthy life-style changes were not likely to occur during pregnancy; 3. basic facts about the biology of sexual intercourse and pregnancy were not understood, and there was no usage of any preconceptional or prenatal medications; and 4. professional health care was not desired or considered necessary (except during delivery). These cultural beliefs can contribute to negative birth outcomes, and need to be considered by pharmacists and other health-care providers. The information gained from this study can guide the implementation of educational programs developed by pharmacists that are more sensitive to the cultural beliefs and points of view of these particular women. Such programs would thus be more likely to be favorably received and utilized.Item Assessment of Public Health Needs in Four Counties in Western Minnesota(2004) Ghomwari, HassanItem Certificates of Confidentiality: Protecting Human Subject Research Data in Law and Practice(2013-02-12) Wolf, Leslie E.; Patel, Mayank J.; Williams, Brett A.; Austin, Jeffrey L.; Lauren A., DameResearchers often require and collect sensitive information about individuals to answer important scientific questions that impact individual health and well-being and the public health. Researchers recognize they have a duty to maintain the confidentiality of the data they collect and typically make promises, which are documented in the consent form. The legal interests of others, however, can threaten researchers’ promises of confidentiality, if they seek access to the data through subpoena. Certificates of Confidentiality (Certificates), authorized by federal statute, are an important tool for protecting individually identifiable sensitive research data from compelled disclosure. However, questions persist in the research community about the strength of Certificate protections, and the evidence on which to judge the strength is scant. In this article, we address those questions through a careful examination of the legislation and regulations concerning Certificates and the reported and unreported cases we have identified through our legal research and interviews with legal counsel about their experiences with Certificates. We also analyze other statutes that protect research data to compare them to the Certificate’s protections, and we review other legal strategies available for protecting research data. Based on our analysis, we conclude with recommendations for how to strengthen protection of sensitive research data.Item Cluster Evaluation of the Community-Based Public Health Initiative: 1994 Annual Report.(1994) Schmitz, Connie C.Item Cluster Evaluation of the Community-Based Public Health Initiative: 1995 Annual Report.(1995) Schmitz, Connie C.Item Deeply Affordable Housing in the Twin Cities Metro: Who produces it, where, and how?(2024-05-01) Abdullahi, Abdullahi; Koch, James; Maxwell, Harrison; McEnery, GriffinDespite a vibrant affordable housing industry in the seven-county Twin Cities metropolitan area, little research has focused specifically on the challenges in developing deeply affordable housing. This capstone project shines light on the local landscape of deeply affordable housing, through data analysis, mapping, and stakeholder engagement. Over the past decade, deeply affordable housing development in the Twin Cities metro has been concentrated in Minneapolis and Saint Paul, and supply trails far behind demand. Amid a decades-long disinvestment in public housing at the federal level, non-profit developers are overwhelmingly responsible for providing deeply affordable housing. These developers operate on razor-thin margins and rely heavily upon subsidies from all levels of government, including tax credits, project based vouchers, tax increment financing, and various loans and grants. Currently available subsidy is highly competitive and falls short of adequately supporting both new developments with deeply affordable units and preserving already existing deeply affordable units. Further, as construction and operating costs rise and interest rates remain elevated, the subsidy available is stretched thinner still. With little hope for significant investment at the federal level, public entities at all levels of government in the state can enact policy interventions to increase development, which could include state sponsored vouchers, a robust state housing tax credit, inclusionary zoning, and more. To address concerns over the need for sustained investment in housing, a statewide constitutional amendment has been proposed at the legislature. This could provide needed and ongoing funding to meet the metro-wide demand for deeply affordable housing.Item Energy and Equity in the Twin Cities Workshop Summary Report(2022) Ries, Heidi; Nelson, Edwin; Chan, GabrielThe Energy and Equity in the Twin Cities Workshop, jointly convened in November 2021 by the University of Minnesota’s Institute on the Environment (IonE) and Robert J. Jones Urban Research and Outreach-Engagement Center (UROC), fostered dialogue, collaboration, and new partnerships to drive local solutions promoting energy justice. This summary report is for people who are interested in learning about local efforts – including projects developed during the workshop – to build an equitable green energy future. It is also for people who are interested in organizing cross-disciplinary workshops rooted in equity and shared learning. The Energy and Equity in the Twin Cities Workshop sought to engage local organizations and communities that historically have been excluded from conventional energy policy convenings, which tend to cater to established experts rather than community leaders such as activists, artists, and storytellers. It also sought to engage those working to address household wellbeing and security. More specifically, the workshop aimed to advance conversation, connection, and solutions to energy injustice by building bridges between the still largely distinct fields of clean energy policymaking and frontline community advocacy.Item Environmental Health Nexus: Designing Predictive Models for Improving Public Health Interventions(2018-05) Liu, YangThe environment embodies all surroundings of humans, including natural (e.g., climate, rivers, and animals) and built (e.g., roads and buildings) components. The environment is closely related to population health both directly and indirectly. Ambient temperature exposure and air pollution, for example, can directly affect population health through its direct impacts on human cardiovascular and respiratory functions. Rainfall, on the other hand, can indirectly affect population health through its impacts on disease-transmitting vectors, such as mosquitoes. The U.S. Global Change Research Group and the Intergovernmental Panel on Climate Change both highlight the importance of the environment on population health. Environmental health is a challenging research topic for a variety of reasons. First, it is difficult to select the appropriate environmental indicators. Thanks to technological advancements in instrument precision, remote sensing, and many other fields, there is now an unprecedented amount of environmental information available to researchers. Although data availability issues still exist, the bigger question now is how to select information that is most relevant and appropriate to answer research questions. For example, when studying the epidemiological link between ambient temperature and population health, the most fundamental task is to select the appropriate indicator for ambient temperature. Because there are over 60 potential indicators that are all designed to approximate temperature perceived by the human body, this task can be a challenge. Second, along with the wide range of indicators comes a large volume of environmental data that is now available. Some ambient environmental indicators, such as air temperature, are available on a three-hour basis globally with high resolution since the 1980s. Technologies such as geographic information systems (GIS) have empowered public health to access this information. However, extracting this information for public health purpose is not always easy and may involve specialized technical expertise. Furthermore, incorporating this high-granularity data with traditionally scarcer public health data also entails technical difficulties. Last but not least, from a computational standpoint, it is challenging to work with high-dimensional data, especially given different research objectives. Environmental health issues do not usually deal with only a pair of exposure and response factors because no environmental factor exists independently. When studying dengue fever, for example, the link between temperature and disease occurrences is not two-dimensional because climate (e.g., rainfall), environmental (e.g., river network, non-human primates), and societal factors (e.g., human mobility network) are also involved. Reducing high-dimensional data to the essentials in order to meet research objectives is easier said than done. It involves sophisticated quantitative methods such as complexity science. It also largely depends on the specific research questions, e.g., if the model used to study the environmental health issue is for risk assessment, risk comparison, or disease forecast. Despite the technical challenges, environmental information has tremendous potential in terms of ecosystem service for population health research. Existing research has already generated many valuable outcomes with great real-life implications. However, the uptake rates of such knowledge among public health policy- and decision-makers remain low. An important underlying reason is that current knowledge contains little necessary details needed to influence policies and decisions. Moreover, policy- and decision-makers often lack the technical expertise to translate the results from research articles into valuable information to their specific context. The relationship between research and policy is predominantly driven by the research, i.e., the supply-side of epidemiological knowledge. Such supply-driven model has already been proven to be suboptimal in terms of maximizing the impact of research. Targeting the challenges discussed above, this dissertation focuses on designing quantitative predictive models for improving environmental health policy and decisions. More specifically, it generates evidence-based science to improve policies and decisions with respect to risk communication, impact assessment, and intervention planning. Although the end-users of specific studies included are environmental health managers and practitioners, the knowledge generated is also valuable to environmental health and methods researchers. Within the overarching theme, two projects were completed over the course of this dissertation. The first project used environmental information to forecast infectious disease outbreaks. Infectious diseases that rely on vector-borne, water-borne, air-borne, and zoonotic transmissions are all considered environmentally sensitive infectious diseases. Two studies were completed for influenza outbreaks in the U.S. and dengue fever outbreaks in San Juan, Puerto Rico and Iquitos, Peru. The research objective was to design statistical models that maximize forecast accuracy in terms of future outbreak timing and magnitude. Meteorological factors such as temperature, humidity, and precipitation were considered. The end-users in these projects were the U.S. Centers for Disease Control and Prevention, the National Oceanic and Atmospheric Administration, and local public health agencies. The end-goal was to reduce disease burden through preventative intervention planning. The forecasting methods used in these disease forecast models were uniquely designed for environmentally sensitive infectious diseases. Based on the nature of the transmission mechanisms involved, the models considered substantial temporal delays between the environmental exposure and population health responses. Traditionally, researchers have relied on measurements such as auto-correlation and partial auto-correlation coefficients to assess these temporal delays. However, these coefficients are constrained by linear assumptions. In this project, mutual information (a concept in information theory) was adopted as an alternative measure that quantifies the delayed relationship between environmental exposure and health response. The second component was to design evidence-based and policy-oriented models for managing population health risks associated with ambient temperature exposure. This component was a collaborative effort with the Minnesota Department of Health and the U.S. Centers for Disease Control and Prevention. The study site is the Minneapolis-St. Paul Twin Cities Metropolitan Area. The environmental indicator to measure ambient temperature exposure was selected using a data-driven approach. The risk assessment models aim at improving the quality of public health policy and decision-making. This project expands on the existing risk assessment methods by developing various modifications and extensions to meet the needs of risk communication, impact assessment, and intervention planning. In this dissertation, three studies from this second project (ambient temperature) are presented. The work described above has important epidemiological, methodological, and policy implications. It also contributes to a bigger picture, which is to design decision support tools for environmental health management. An ideal decision support tool should combine general and universal patterns in epidemiology with the local public health context to optimize policies and decisions under uncertain scenarios. This type of tool has been developed for ecosystem management (e.g., wetland restoration) and for chronic care. However, for environmental health issues, this type of tool does not yet exist. Currently, environmental health management still largely relies on past experiences of policy and decision makers. Essential knowledge needed for creating such decision support tools is not yet fully available. This dissertation provides some of the missing answers, with the ultimate goal of rationalizing and optimizing public health policies and decisions regarding environmental health intervention.Item Executive Review of the Stevia Food System(2023-06-02) Wibbens, Katie MStevia is an alternative sweetener that provides sweetness to foods without the caloric value of traditional sweeteners such as sucrose. With the rise of an obesity epidemic in the United States, industry is faced with increased pressure to make products with fewer calories, yet with the same or similar palatability as the original product. Alternative sweeteners such as stevia are used to add sweetness without adding calories since the body cannot use the stevia molecule for energy. The gradual introduction of these alternative sweeteners within the American food system could contribute toward greater availability of foods with less caloric density. To increase the feasibility of gradually incorporating alternative sweeteners into common foods traditionally made with sugar ingredients, this paper focuses on four main pillars within the Stevia food system: decreasing the cost of scaling production, improving product formulation, addressing flavor modification, and maintaining consumer acceptability. These four fundamental basic food system functions serve as a guide for scaling-up and gradually introducing non-caloric sweeteners as viable ingredients in traditionally sweetened food products. Addressing our pressing public health issues necessitates a gradual substitution with alternative sweeteners such as stevia. This gradual introduction requires a food systems approach addressing the barriers, challenges and opportunities within our food system while balancing consumer needs, wants, and desires.Item Executive Summary Presented to the School of Public Health: Information Needs Assessment of Public Health Researchers(2017-09) Hunt, Shanda; Bakker, CaitlinA needs assessment was conducted by the University of Minnesota Libraries of School of Public Health faculty researchers. Qualitative analyses revealed unique information science needs, some misunderstandings, and a wealth of challenges. Librarians offered potential solutions to improve research processes.Item Five-County Minnesota Case Study: Rural Roadway Fatal Crash Characteristics and Select Safety Improvement Programs(Center for Excellence in Rural Safety, Hubert H. Humphrey Institute of Public Affairs, University of Minnesota, 2008-12) Patterson, Tyler M.; Munnich, LeeThis second in a series of CERS research reports summarizes the characteristics of the fatal rural roadway crashes within five Minnesota counties and describes some of the safety improvement programs or campaigns being used in this five-county area. Past research has shown that some of the many characteristics of fatal rural roadway crashes include younger drivers, alcohol involvement, lack of seat belt use, and speeding. The crash data summarized in this report were generally obtained from the Minnesota Department of Transportation and Minnesota Department of Public Safety. Several recommendations have been proposed as a result of this case study project that focus on improving rural roadway safety data and analyses. Evaluations of safety improvement programs/campaigns are also proposed. Recommendations include: • Examine more rural roadway crash factors and combinations of factors for additional clarification. • Improve the metrics used to describe or define rural roadways in the United States. • Use the primary characteristics of rural roadway crashes as the basis for safety improvement measures and programs implemented in rural areas. • Include measures and strategies that improve driver decision-making as one of the focus or emphasis areas of a comprehensive safety program. • Fund projects that continue to help upgrade and apply GIS tools to plot and evaluate safety data with respect to driver behavior and roadway conditions. • Scientifically evaluate the impacts of the safety improvement programs described in this report.Item An Information Science Needs Assessment of School of Public Health Researchers at the University of Minnesota: Summary Report(2017-08-04) Hunt, Shanda L; Bakker, Caitlin JItem Information Science Solutions to Communicating Public Health Research Findings to the Public(2018-05) Bakker, Caitlin; Hunt, ShandaWe conducted a needs assessment of public health researchers November 2016 - January 2017. The aims of the study were to capture the evolving needs, opportunities, and challenges of public health researchers in the current environment and provide actionable recommendations. Participants (N=24) were recruited through convenience sampling and one-on-one interviews were audio recorded. Qualitative analyses were conducted using NVivo 11. The data revealed that researchers recognized the need to communicate the significance of public health research findings to the public, yet felt they lacked the skills and resources necessary. Many researchers questioned the value of making articles, research data, and other outputs openly available. They expressed their frustration in trying to make complex data sets and research findings easily digestible by broad audiences. Finally, they did not make the connection between their professional marketing activities and dissemination. Information professionals can assist public health researchers in modernizing and broadening their dissemination practices by considering alternative forums, such as repositories and open education resources, and by utilizing formats, such as data visualizations, that more effectively convey research findings. Libraries can also introduce researchers to plain language summaries of research outputs and ways in which social media is being used to communicate to the public. These strategies could advance public health communication to the public, practitioners, and policymakers, as well as contribute to open science.Item The Institute for Immigrant & Refugee Health and Wellness(2009) Moe, KarenItem Mushrooms, Snacks, and Dairy Foods: Health Impacts, Consumption Patterns, and Dietary Guidance(2018-04) Hess, JulieThe Dietary Guidelines for Americans (DGA) are designed to incorporate current scientific evidence into recommendations for eating patterns to promote health and help prevent chronic diseases, many of which are linked to poor dietary quality, among the American population. Recommendations in the 2015 DGA focus on increasing dietary variety and nutrient-density and shifting to healthier foods, beverages, and eating patterns. However, the typical American diet does not align with these guidelines. The primary aims of this project were to identify strategies to improve the variety and nutrient-density of the American diet and conduct clinical and epidemiological studies to assess their potential impacts on health. Secondary aims were to review topics that warrant attention in the DGA, compare U.S. guidance with recommendations of other countries, and evaluate components of dietary guidance that merit reconsideration. Substituting mushrooms for meat at some meals would increase Americans’ intake of vegetables, fiber, and non-animal protein and help align U.S. diets with DGA recommendations. A clinical intervention study compared the impact on satiety and gut health markers of adding mushrooms or meat to a typical American consumers’ diet. In a randomized open-label crossover study, participants (n=32) consumed protein-matched amounts of mushrooms or meat twice daily for ten days, including at an in-person visit. During the last five days of each diet, participants completed a full fecal sample collection. Mushroom consumption impacted subjective satiety markers but not energy intake and led to few significant differences in gut health markers compared to meat consumption. After a mushroom meal, participants reported less hunger (p= 0.045), greater fullness (p= 0.05), and decreased prospective consumption (p= 0.03) than after the meat meal. There were no statistically significant differences in participant ratings of satisfaction (p= 0.10) or in energy intake at an ad libitum meal. There were also no differences in breath hydrogen and breath methane measurements or with stool frequency, consistency, pH, or short chain fatty acid concentrations between the two diets. Mushroom treatment led to greater overall gastrointestinal symptoms, including gas and flatulence, than the meat diet on days 1 and 2 as well as higher average stool weight (p= 0.002). The higher stool weight and presence of undigested mushrooms in stool suggest that mushroom consumption may impact laxation. Adults and children in the U.S. commonly consume “snacks,” or energy outside of the traditional mealtimes of breakfast, lunch, and dinner. Replacing foods currently selected as snacks with nutrient-dense alternatives could lower the risk of nutrient deficiencies and excess nutrient consumption and improve the quality of the U.S. diet. Yet, while the DGA recommend selecting nutrient-dense foods, they do not provide a metric for evaluating nutrient-density. The Nutrient-Rich Foods (NRF) Index, a nutrient profiling method with scores that positively correlate with the Healthy Eating Index, was used to quantify the nutrient-density of foods frequently selected as snacks. Epidemiological datasets, including the National Health and Nutrition Examination Survey (NHANES) and the School Nutrition Dietary Assessment Study, as well as market research data were used to identify common snacks. Several common snacks, including yogurt, milk, fruit, nuts and seeds, and potato chips had relatively high NRF index scores, indicating nutrient density. Other frequently selected snacks including soft drinks, pies and cakes, ice cream, and cookies had negative NRF scores indicating low nutrient-density. Nutrient-density scores may not provide new information about snacks at either end of a “nutrient-density spectrum,” such as yogurt, fruit, soft drinks, and ice cream. If added to food labels, nutrient-density scores could serve as helpful tools for consumers to identify more nutrient-dense options among the foods located between the extremes. Snacks as an eating occasion also merit attention in dietary guidance. The label ascribed to an eating occasion (i.e. “snack” or “meal”) influences other food choices an individual may make on the same day as well as satiety after consumption. However, the DGA as well as the dietary guidance of several other countries, including Brazil, Canada, Japan, and Oman, do not directly address the healthfulness of additional eating occasions and also vacillate between defining “snacks” as an eating occasion and as a type of food (“snack food”). Dietary guidance could reimage “snack foods” to prevent “snack time” from becoming an occasion for overconsuming nutrient-poor foods. Another component of dietary guidance that warrants reconsideration is the labeling of food groups on USDA’s 2010 MyPlate guide, a visual food guide for educating consumers about dietary guidance. When the previous food guide, MyPyramid (2005), was replaced with MyPlate, the name of the “meat & beans” group was changed to the “protein group.” The exclusion of dairy foods from the “protein foods” group of MyPlate illustrates the shortcomings of the new name. Previous research also shows that that consumers understand food-based terms better than nutrient-based terms. Changing the name of this group back to “meat & beans” group would provide important clarification for consumers and educators regarding the content and dietary role of this group. The DGA incorporate recent scientific evidence into recommendations for the U.S. population, however, these recommendations require more effective translation to the American public to impact public health.Item Patients’ Knowledge of and Practices Relating to the Disposal of Used Insulin Needles(University of Minnesota, College of Pharmacy, 2010) Musselman, Kerri T.; Sicat, Brigitte L.; Thomas, Michelle Herbert; Harpe, Spencer E.Objective: To determine (1) how patients currently dispose of used insulin needles, (2) whether patients were educated about disposal of their used insulin needles, and (3) who educated patients about the disposal of their used insulin needles. Methods: A self-administered questionnaire was designed for this study. The survey assessed patient knowledge about disposal of used insulin needles and the patient-reported source and location of education about disposal techniques. The questionnaire was administered to a convenience sample of patients from four locations in Richmond, Virginia. Any patient who used insulin, was at least 18 years old, and was willing to complete the survey was eligible for inclusion. Results: Fifty responses were received with 40% indicating that education had been received on the disposal of used needles. From that 40%, nurses were identified as the source of education 60% of the time and pharmacists 25% of the time. Approximately 50% of the respondents reported disposing of used needles directly in the trash when at home. While away from home, 22% reported placing used needles in the trash, and 38% took them home for disposal. Conclusion: Patients are not consistently educated regarding the proper disposal of used needles. Health care practitioners should play a larger role in educating patients about the potential risks of inappropriate needle disposal and appropriate disposal methods. Future research is still needed to understand fully the magnitude of the problems associated with inappropriate needle disposal by patients.Item Perceptions of Evaluator Competencies in Public Health(2016-05) Larson, MichelleAbstract Public health is a profession that typically provides services through government and is complex, expensive, and often political. The public health profession usually consists of professionals, such as nurses and health educators. Evaluation is a component of public health services and is often conducted to demonstrate the value of a program’s services. The evaluation field exists as its own practice that also has professionals, competencies, and ethics. Evaluation in public health may be conducted by public health staff or may be contracted to another party. It is important that evaluations of public health programs be conducted with rigor and expertise because of the potential impact to society and the magnitude of costs if they are not. The purpose of this study was to find out what public health professionals think are the most important competencies for those who conduct evaluations for public health programs. The methodology of qualitative inquiry included focus groups of public health professionals in Minnesota with oversight of evaluators and evaluation. The methodology of quantitative inquiry consisted of an electronic survey of members of the Minnesota Public Health Association. Results of this study show varying opinions of what is most important in public health evaluator competency traits and that all are important. The results have implications for public health practice and future research of evaluator competencies.Item Planning for a pandemic influenza outbreak: roles for librarian liaisons in emergency delivery of educational programs(Haworth, 2007) McGuire, LisaIn February 2006, two librarians at the University of Minnesota’s Bio-Medical Library were asked to participate in a task force at the University of Minnesota’s School of Public Health (SPH). The charge from the dean of SPH was to determine how the school could continue to deliver its educational programs in the event of a pandemic influenza outbreak. This paper will outline the work of the task force, discuss its recommendations, and offer ideas on how other librarians can work with their liaison areas to plan for a similar project.Item Public Water Supply Quality in the Rock River Watershed, Southwest Minnesota(Water Resources Research Center, University of Minnesota, 1982-10) Straub, C.P.; Goppers, V.M.; Singer, R.D.Several municipal water supplies in the Rock River watershed in Southwestern Minnesota were tested on approximately a monthly basis for a little over two-years for the anions nitrate-nitrogen, sulfate, chloride, and bicarbonate alkalinity as calcium carbonate, and for total dissolved solids, conductivity, and pH. Anions were selected for analysis because it was felt that they were better descriptors of the effect of land use practices on ground water quality. The ratios of the various anions sulfate/nitrate-nitrogen, chloride/nitrate-nitrogen, sulfate/chloride, and bicarbonate alkalinity as calcium carbonate/sulfate served to identify changes in water quality not associated with dilution. Findings indicated seasonal changes in water quality not necessarily reflected in changes in the ratios, generally increasing concentrations of nitrate-nitrogen in many instances, exceeding permissible concentrations specified in the Interim Primary Drinking Water Standards, and high dissolved solids concentrations generally exceeding recommended levels specified in the Secondary Drinking Water Standards. Groundwater concentrations were compared with surface water samples from the several streams, springs, and lakes in the area. Some relations to land use practice on groundwater quality and precipitation were indicated. The data have been utilized to call attention to deficiencies in water quality to the consumers of the waters in the communities concerned.