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  1. Article ; Online: Equity Work Among Accredited Health Departments in the United States, 2015-2021.

    Lang, Britt / Kronstadt, Jessica / Rich, Naomi

    Public health reports (Washington, D.C. : 1974)

    2023  , Page(s) 333549231210033

    Abstract: Objectives: Minimal research has examined the number of health departments conducting work related to equity and/or the kind of work, if any, they are conducting. We examined the relationship between public health accreditation and work related to ... ...

    Abstract Objectives: Minimal research has examined the number of health departments conducting work related to equity and/or the kind of work, if any, they are conducting. We examined the relationship between public health accreditation and work related to health equity by analyzing accredited health departments' responses to a prompt in the Public Health Accreditation Board's (PHAB's) annual report.
    Methods: We analyzed self-reported responses from accredited health departments to questions about emerging public health issues and innovations in PHAB's annual report. We identified themes using a priori and inductive coding.
    Results: A total of 316 health departments submitted an annual report from January 2015 through December 2021. Of those health departments, 283 (89.6%) stated in their annual report that they engaged in work related to health equity, 50 (17.7%) of which provided a narrative about this work. Of those 50 health departments, the most common theme reported was community partnership, described by 23 (46.0%) health departments. The next most reported themes were COVID-19 vaccine access for racially or socioeconomically marginalized communities (n = 17, 34.0%) and programs related to health equity (n = 16, 32.0%).
    Conclusions: We found that most accredited health departments conduct work related to health equity. Further research is needed to examine characteristics that influence a health department's likelihood of conducting equity work. Models and resources on how health departments, particularly small health departments, can begin equity work would be valuable.
    Language English
    Publishing date 2023-12-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 120953-x
    ISSN 1468-2877 ; 0033-3549
    ISSN (online) 1468-2877
    ISSN 0033-3549
    DOI 10.1177/00333549231210033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Public Health Department Accreditation and Innovation: A Brief Report of the Approaches Used to Promote Innovation.

    Lang, Britt / Rich, Naomi / Kronstadt, Jessica / Harris, April

    Journal of public health management and practice : JPHMP

    2022  Volume 28, Issue 4 Suppl 4, Page(s) S138–S142

    Abstract: To examine the relationship between public health accreditation and innovation, we analyzed accredited health departments' self-reported responses to a prompt within the Public Health Accreditation Board's (PHAB's) Annual Report regarding any approaches ... ...

    Abstract To examine the relationship between public health accreditation and innovation, we analyzed accredited health departments' self-reported responses to a prompt within the Public Health Accreditation Board's (PHAB's) Annual Report regarding any approaches to pursuing innovation within their health department. We found that of the 205 health departments examined, 75 (37%) described elements of the health department's approach to fostering innovation. The most common approaches to innovation included partnerships (59% of those health departments that described their innovation approaches) and leadership (27%). Other common elements, mentioned by at least 20% of health departments that provided their innovation approach, include funding, internal collaboration, training, and devoting time to innovation. Both larger health departments and state health departments were more likely than smaller health departments and local health departments to describe elements of their approach in fostering innovation, suggesting that those types of health departments may have access to resources and flexibility in staffing, both integral elements for promoting innovation.
    MeSH term(s) Accreditation ; Humans ; Leadership ; Local Government ; Public Health ; Public Health Administration ; Self Report ; Workforce
    Language English
    Publishing date 2022-06-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2027860-3
    ISSN 1550-5022 ; 1078-4659
    ISSN (online) 1550-5022
    ISSN 1078-4659
    DOI 10.1097/PHH.0000000000001477
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: What Are Public Health Agencies Planning for Workforce Development? A Content Analysis of Workforce Development Plans of Accredited Public Health Departments.

    Yeager, Valerie A / Burns, Ashlyn B / Lang, Britt / Kronstadt, Jessica / Hughes, Monica J / Gutta, Jyotsna / Kirkland, Chelsey / Orr, Jason / Leider, Jonathon P

    Journal of public health management and practice : JPHMP

    2023  Volume 29, Issue 6, Page(s) 762–774

    Abstract: Objective: Recruiting and retaining public health employees and ensuring they have the skills necessary to respond are vital for meeting public health needs. As the first study examining health department (HD) workforce development plans (WDPs), this ... ...

    Abstract Objective: Recruiting and retaining public health employees and ensuring they have the skills necessary to respond are vital for meeting public health needs. As the first study examining health department (HD) workforce development plans (WDPs), this study presents gaps and strategies identified in WDPs across 201 accredited HDs (168 initial/33 reaccreditation plans).
    Design: This cross-sectional study employed qualitative review and content analysis of WDPs submitted to the Public Health Accreditation Board (PHAB) between March 2016 and November 2021.
    Main outcome measures: Eight overarching workforce themes were examined: planning/coordination, leadership, organizational culture, workplace supports/retention, recruitment, planning for departmental training, delivery of departmental training, and partnership/engagement. Within each theme, related subthemes were identified. Coders indicated whether the WDP (1) identified the subtheme as a gap; (2) stated an intent to address the subtheme; and/or (3) identified a strategy for addressing the subtheme.
    Results: The most common gaps identified included prepare workforce for community engagement/partnership (34.3%, n = 69), followed by resource/fund training (24.9%, n = 50). The subtheme that had the most instances of an identified strategy to address it was assess training needs (84.1%, n = 169), followed by foster quality improvement (QI) culture/provide QI training (63.2%, n = 127). While both of these strategies were common among the majority of HDs, those subthemes were rarely identified as a gap. Secondary findings indicate that increase recruitment diversity/recruit from a more diverse applicant pool was rarely identified as a gap (6.0%, n = 12) and rarely had an identified strategy for addressing the subtheme (9.0%, n = 18).
    Conclusion: While HDs recognized many workforce gaps, HDs did not always propose a strategy for addressing them within the WDP. Conversely, some WDPs proposed strategies for subthemes that did not reflect recognized gaps. Such discrepancies between identified gaps and strategies in WDPs may suggest areas where HDs could use additional support and guidance.
    MeSH term(s) Humans ; Public Health ; Cross-Sectional Studies ; Workforce ; Workplace ; Social Planning
    Language English
    Publishing date 2023-08-30
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2027860-3
    ISSN 1550-5022 ; 1078-4659
    ISSN (online) 1550-5022
    ISSN 1078-4659
    DOI 10.1097/PHH.0000000000001805
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Ultrasound assessment of postplacental copper intrauterine device position 6 months after placement during cesarean delivery.

    Gurney, Elizabeth P / McAllister, Arden / Lang, Britt / Schreiber, Courtney A / Sonalkar, Sarita

    Contraception: X

    2020  Volume 2, Page(s) 100040

    Abstract: Objective: The objective was to describe the sonographic position of copper intrauterine devices (IUDs) 6 months after insertion during cesarean delivery.: Study design: This prospective, observational study followed participants who received a ... ...

    Abstract Objective: The objective was to describe the sonographic position of copper intrauterine devices (IUDs) 6 months after insertion during cesarean delivery.
    Study design: This prospective, observational study followed participants who received a copper IUD during cesarean delivery. We performed pelvic examination at 6 weeks and 6 months and sonography at 6 months to determine IUD position. Patients had additional examinations as needed to address complications.
    Results: Sixty-nine participants provided outcomes through 6 months: 41 (59%) had correctly positioned IUDs, 21 (30%) had malpositioned intrauterine IUDs, 5 experienced expulsion (3 partial, 2 complete), and 2 had elective removal; 52 (75%) had missing strings. Missing strings at 6 weeks predicted an incorrect IUD position in 22 of 52 participants (positive predictive value 42%), and visible or palpable strings predicted a correct IUD position in 7 of 12 participants (negative predictive value 58%).
    Conclusion: Although 59% of copper IUDs placed during cesarean were correctly positioned at 6 months, nearly one third were malpositioned.
    Implications: Ultrasound may be indicated for patients receiving a copper IUD during cesarean delivery as checking IUD strings alone does not assure correct placement. Providers offering postpartum IUDs should ensure that appropriate processes for the evaluation and management of devices with missing strings or abnormal position are available to all patients regardless of insurance status.
    Language English
    Publishing date 2020-10-09
    Publishing country United States
    Document type Journal Article
    ISSN 2590-1516
    ISSN (online) 2590-1516
    DOI 10.1016/j.conx.2020.100040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Pregnant and bleeding: A model to assess factors associated with the need for emergency care in early pregnancy.

    McAllister, Arden / Lang, Britt / Flynn, Anne / Meisel, Zachary F / Abernathy, Alice / Sammel, Mary D / Schreiber, Courtney A

    The American journal of emergency medicine

    2021  Volume 53, Page(s) 94–98

    Abstract: Objective: To assess the prevalence of Critical or Emergent patient classification among pregnant patients presenting to the Emergency Department (ED) and to identify characteristics that discriminate between patients requiring Emergency care from those ...

    Abstract Objective: To assess the prevalence of Critical or Emergent patient classification among pregnant patients presenting to the Emergency Department (ED) and to identify characteristics that discriminate between patients requiring Emergency care from those who can be safely triaged to the ambulatory setting.
    Study design: In this cross-sectional study conducted in 3 urban EDs, patients under 16 weeks gestation who presented with bleeding and/or cramping completed a 7-item questionnaire. We compared baseline clinical variables and survey responses among patients classified as Critical or Emergent per the American Board of Emergency Medicine's patient acuity definitions with those classified as Lower Acuity to identify independent risk factors for outcomes.
    Results: Of 484 participants, 21 (4.3%) were classified as Critical or Emergent and required interventions. While no demographic characteristics differentiated Critical patients from Lower Acuity patients, survey questions associated with a higher likelihood of emergency intervention included history of prior ectopic pregnancy (OR 8.7, 95% CI 3.2-23.5) heavy bleeding in the past two hours (OR 11.8, 95% CI 3.8-36.1), as well as having made a prior ED visit in the current pregnancy (OR 1.9, 95% CI 0.7-5.1). Joint consideration of these risk factors in a multivariable model performed well at discriminating between Critical and Lower Acuity patients with an area under the ROC curve of 0.82 (95% CI 0.71-0.93).
    Conclusion: Patients with a history of ectopic pregnancy, heavy bleeding in the past two hours, and/or prior presentation to the ED in the current pregnancy had the highest risk of needing emergency-level care. The vast majority of patients presenting to the ED with early pregnancy complaints were discharged without intervention.
    MeSH term(s) Cross-Sectional Studies ; Emergency Service, Hospital ; Emergency Treatment ; Female ; Humans ; Pregnancy ; Pregnancy, Ectopic ; Uterine Hemorrhage/epidemiology ; Uterine Hemorrhage/therapy
    Language English
    Publishing date 2021-12-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2021.12.052
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    Zs.A 2005: Show issues Location:
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  6. Article ; Online: Contraceptive use and preferences among females with sickle cell disease.

    Roe, Andrea H / Lang, Britt / McAllister, Arden / Gaitors, Morine Cebert / Smith-Whitley, Kim / Schreiber, Courtney A / Sayani, Farzana

    Contraception

    2021  Volume 105, Page(s) 42–45

    Abstract: Objectives: Females with sickle cell disease now have a life expectancy that extends well into and beyond their reproductive years. Pregnancy and childbirth are accompanied by high morbidity and mortality in this population, rendering contraception a ... ...

    Abstract Objectives: Females with sickle cell disease now have a life expectancy that extends well into and beyond their reproductive years. Pregnancy and childbirth are accompanied by high morbidity and mortality in this population, rendering contraception a critical part of their health care.
    Study design: We approached adult female patients of the Hospital of the University of Pennsylvania hematology clinic who were of reproductive age (ages 18-45) and carried a diagnosis of sickle cell disease. We evaluated contraceptive method uptake and method characteristic preferences, as well as other reproductive history, and compared contraceptive uptake rates to that from female respondent data from the National Survey of Family Growth (2017-2019).
    Results: Of 95 eligible patients, we completed surveys with 48 participants (response rate of 51%). Over half (n = 27, 56%) of participants were not currently using any form of contraception-double the rate of the general United States population (25%). The most common contraceptives currently used were the depot medroxyprogesterone (DMPA) injection (n = 6, 13%) and the progestin intrauterine device (IUD) (n = 6, 13%). DMPA uptake was significantly higher, and permanent contraceptive and oral contraceptive pill uptake significantly lower, among these participants with sickle cell disease compared to the general United States population. Participants' preferred contraceptive characteristics included effectiveness (n = 39, 81%), control over when to use the contraceptive (n = 39, 81%), and lack of side effects (n = 38, 79%).
    Conclusions: Contraceptive uptake was significantly lower and method mix different among females with sickle cell disease compared to the general United States population. Further research is needed on contraceptive safety, non-contraceptive benefits, and contraceptive decision-making for females with sickle cell disease.
    Implications: This study sheds light on the contraceptive choices and preferences of females with sickle cell disease, who are at disproportionate risk for pregnancy complications. In order to maximize the reproductive health of females with sickle cell disease, we must consider how their disease interacts with contraception and better understand how they approach contraceptive decision-making.
    MeSH term(s) Adolescent ; Adult ; Anemia, Sickle Cell ; Contraception ; Contraceptive Agents, Female ; Contraceptives, Oral ; Female ; Humans ; Intrauterine Devices ; Medroxyprogesterone ; Middle Aged ; Pregnancy ; United States ; Young Adult
    Chemical Substances Contraceptive Agents, Female ; Contraceptives, Oral ; Medroxyprogesterone (HSU1C9YRES)
    Language English
    Publishing date 2021-08-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80106-9
    ISSN 1879-0518 ; 0010-7824
    ISSN (online) 1879-0518
    ISSN 0010-7824
    DOI 10.1016/j.contraception.2021.08.009
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