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1

Haughton, Betsy y Alexa George. "The Public Health Nutrition workforce and its future challenges: the US experience". Public Health Nutrition 11, n.º 8 (agosto de 2008): 782–91. http://dx.doi.org/10.1017/s1368980008001821.

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AbstractObjectivesTo describe the US public health nutrition workforce and its future social, biological and fiscal challenges.DesignLiterature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors.SettingThe United States.SubjectsNutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services.ResultsThe workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81·7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18·2 % speaking Spanish as a second language.ConclusionsThe future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce’s capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.
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Pittman, Patricia, Candice Chen, Clese Erikson, Edward Salsberg, Qian Luo, Anushree Vichare, Sonal Batra y Guenevere Burke. "Health Workforce for Health Equity". Medical Care 59, Suppl 5 (9 de septiembre de 2021): S405—S408. http://dx.doi.org/10.1097/mlr.0000000000001609.

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Whiley, Harriet, James C. Smith, Nicole Moore, Rebecca Burton, Nadia Conci, Helen Psarras y Kirstin E. Ross. "Climate Change and Health: Challenges to the Local Government Environmental Health Workforce in South Australia". International Journal of Environmental Research and Public Health 20, n.º 14 (18 de julio de 2023): 6384. http://dx.doi.org/10.3390/ijerph20146384.

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Climate change is the most urgent and significant public health risk facing the globe. In Australia, it has been identified that Environmental Health Officers/Practitioners (EHOs/EHPs, hereafter EHOs) are a currently underutilized source of knowledge and skills that can contribute to climate change adaptation planning at the local government level. The ability of local government EHOs to utilize their local knowledge and skills in human health risk assessment during a public health emergency was demonstrated through their role in the response to COVID-19. This study used a survey and follow up interviews to examine the roles and responsibilities of EHOs during the COVID-19 pandemic and used the results to examine the potential of the workforce to tackle climate change and health related issues. What worked well, what regulatory tools were helpful, how interagency collaboration worked and what barriers or hindering factors existed were also explored. A workforce review of EHOs in South Australia was also undertaken to identify current and future challenges facing EHOs and their capacity to assist in climate change preparedness. The findings demonstrated that the workforce was used in the response to COVID-19 for varying roles by councils, including in education and communication (both internally and externally) as well as monitoring and reporting compliance with directions. Notably, half the workforce believed they could have been better utilized, and the other half thought they were well utilized. The South Australian Local Government Functional Support Group (LGFSG) was praised by the workforce for a successful approach in coordinating multiagency responses and communicating directions in a timely fashion. These lessons learnt from the COVID-19 pandemic should be incorporated into climate change adaptation planning. To ensure consistent messaging and a consolidated information repository, a centralized group should be used to coordinate local government climate change adaptation plans in relation to environmental health and be included in all future emergency management response plans. The surveyed EHOs identified environmental health issues associated with climate change as the most significant future challenge; however, concerningly, participants believe that a lack of adequate resourcing, leading to workforce shortages, increasing workloads and a lack of support, is negatively impacting the workforce’s preparedness to deal with these emerging issues. It was suggested that the misperception of environmental health and a failure to recognize its value has resulted in a unique dilemma where EHOs and their councils find themselves caught between managing current workload demands and issues, and endeavouring to prepare, as a priority, for emerging environmental health issues associated with climate change and insufficient resources.
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4

Woltring, Carol S. y Lloyd F. Novick. "Public Health Workforce". Journal of Public Health Management and Practice 9, n.º 6 (noviembre de 2003): 438–39. http://dx.doi.org/10.1097/00124784-200311000-00001.

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Nancarrow, Susan A., Gretchen Young, Katy O'Callaghan, Mathew Jenkins, Kathleen Philip y Kegan Barlow. "Shape of allied health: an environmental scan of 27 allied health professions in Victoria". Australian Health Review 41, n.º 3 (2017): 327. http://dx.doi.org/10.1071/ah16026.

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Objective In 2015, the Victorian Department of Health and Human Services commissioned the Victorian Allied Health Workforce Research Program to provide data on allied health professions in the Victorian public, private and not-for-profit sectors. Herein we present a snapshot of the demographic profiles and distribution of these professions in Victoria and discuss the workforce implications. Methods The program commenced with an environmental scan of 27 allied health professions in Victoria. This substantial scoping exercise identified existing data, resources and contexts for each profession to guide future data collection and research. Each environmental scan reviewed existing data relating to the 27 professions, augmented by an online questionnaire sent to the professional bodies representing each discipline. Results Workforce data were patchy but, based on the evidence available, the allied health professions in Victoria vary greatly in size (ranging from just 17 child life therapists to 6288 psychologists), are predominantly female (83% of professions are more than 50% female) and half the professions report that 30% of their workforce is aged under 30 years. New training programs have increased workforce inflows to many professions, but there is little understanding of attrition rates. Professions reported a lack of senior positions in the public sector and a concomitant lack of senior specialised staff available to support more junior staff. Increasing numbers of allied health graduates are being employed directly in private practice because of a lack of growth in new positions in the public sector and changing funding models. Smaller professions reported that their members are more likely to be professionally isolated within an allied health team or larger organisations. Uneven rural–urban workforce distribution was evident across most professions. Conclusions Workforce planning for allied health is extremely complex because of the lack of data, fragmented funding and regulatory frameworks and diverse employment contexts. What is known about this topic? There is a lack of good-quality workforce data on the allied health professions generally. The allied health workforce is highly feminised and unevenly distributed geographically, but there is little analysis of these issues across professions. What does this paper add? The juxtaposition of the health workforce demographics and distribution of 27 allied health professions in Victoria illustrates some clear trends and identifies several common themes across professions. What are the implications for practitioners? There are opportunities for the allied health professions to collectively address several of the common issues to achieve economies of scale, given the large number of professions and small size of many.
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Gerding, Justin A., Bryan W. Brooks, Elizabeth Landeen, Sandra Whitehead, Kaitlyn R. Kelly, Amy Allen, David Banaszynski et al. "Identifying Needs for Advancing the Profession and Workforce in Environmental Health". American Journal of Public Health 110, n.º 3 (marzo de 2020): 288–94. http://dx.doi.org/10.2105/ajph.2019.305441.

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An ever-changing landscape for environmental health (EH) requires in-depth assessment and analysis of the current challenges and emerging issues faced by EH professionals. The Understanding the Needs, Challenges, Opportunities, Vision, and Emerging Roles in Environmental Health initiative addressed this need. After receiving responses from more than 1700 practitioners, during an in-person workshop, focus groups identified and described priority problems and supplied context on addressing the significant challenges facing EH professionals with state health agencies and local health departments. The focus groups developed specific problem statements detailing the EH profession and workforce’s prevailing challenges and needs according to 6 themes, including effective leadership, workforce development, equipment and technology, information systems and data, garnering support, and partnerships and collaboration. We describe the identified priority problems and needs and provide recommendations for ensuring a strong and robust EH profession and workforce ready to address tomorrow’s challenges.
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Gebbie, Kristine M., Amanda Raziano y Sterling Elliott. "Public Health Workforce Enumeration". American Journal of Public Health 99, n.º 5 (mayo de 2009): 786–87. http://dx.doi.org/10.2105/ajph.2008.137539.

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Boddy, Bethany. "Health visitor workforce numbers". Journal of Health Visiting 10, n.º 9 (2 de septiembre de 2022): 390–92. http://dx.doi.org/10.12968/johv.2022.10.9.390.

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There are now lower numbers of health visitors than when the Health Visitor Implementation Plan was first introduced in 2011, says Bethany Boddy. Where does that leave the profession and what needs to happen to implement change?
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Glynn, M. Kathleen, Michael L. Jenkins, Christina Ramsey y Patricia M. Simone. "Public Health Workforce 3.0". Journal of Public Health Management and Practice 25 (2019): S6—S9. http://dx.doi.org/10.1097/phh.0000000000000971.

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Tilson, Hugh y Kristine M. Gebbie. "The Public Health Workforce". Annual Review of Public Health 25, n.º 1 (abril de 2004): 341–56. http://dx.doi.org/10.1146/annurev.publhealth.25.102802.124357.

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Stewart, Katharine E., Paul K. Halverson, Arlene V. Rose y Sandra K. Walker. "Public Health Workforce Training". Journal of Public Health Management and Practice 16, n.º 5 (2010): 465–69. http://dx.doi.org/10.1097/phh.0b013e3181ce4f0b.

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Kennedy, Virginia C., William D. Spears, Hardy D. Loe y Frank I. Moore. "Public Health Workforce Information". Journal of Public Health Management and Practice 5, n.º 3 (mayo de 1999): 10–19. http://dx.doi.org/10.1097/00124784-199905000-00004.

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Ruderman, Marjory y Holly Grason. "Public Health Workforce Development". Journal of Public Health Management and Practice 8, n.º 2 (marzo de 2002): 84–86. http://dx.doi.org/10.1097/00124784-200203000-00011.

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Lichtveld, Maureen Y. y Joan P. Cioffi. "Public Health Workforce Development". Journal of Public Health Management and Practice 9, n.º 6 (noviembre de 2003): 443–50. http://dx.doi.org/10.1097/00124784-200311000-00003.

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Gebbie, Kristine, Jacqueline Merrill, Lorraine Sanders, Eric N. Gebbie y D. W. Chen. "Public Health Workforce Enumeration". Journal of Public Health Management and Practice 13, n.º 1 (enero de 2007): 72–79. http://dx.doi.org/10.1097/00124784-200701000-00012.

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Sexton, K. y S. A. Perlin. "The federal environmental health workforce in the United States." American Journal of Public Health 80, n.º 8 (agosto de 1990): 913–20. http://dx.doi.org/10.2105/ajph.80.8.913.

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Balanay, Jo Anne G. y Stephanie L. Richards. "Insights into Diversity in the Environmental Health Science Workforce". Environmental Health Insights 16 (enero de 2022): 117863022210775. http://dx.doi.org/10.1177/11786302221077513.

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Walker, Bailus y Melvin Span. "The Need for Diversity in the Environmental Health Workforce". Journal of Health Care for the Poor and Underserved 19, n.º 1 (2008): 16–25. http://dx.doi.org/10.1353/hpu.2008.0009.

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Mumford, Karen, Andrea C. Young y Saira Nawaz. "Federal Public Health Workforce Development". Journal of Public Health Management and Practice 22, n.º 3 (2016): 290–97. http://dx.doi.org/10.1097/phh.0000000000000205.

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Brown, Jessica N., Jonathan Fuchs y Alexa Ristow. "Prioritizing the Public Health Workforce". Journal of Public Health Management and Practice 25 (2019): S183—S184. http://dx.doi.org/10.1097/phh.0000000000000975.

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Lyle, David y David Perkins. "Health Workforce Australia: For all?" Australian Journal of Rural Health 18, n.º 5 (octubre de 2010): 179–80. http://dx.doi.org/10.1111/j.1440-1584.2010.01158.x.

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22

Dreisinger, Mariah, Terry L. Leet, Elizabeth A. Baker, Kathleen N. Gillespie, Beth Haas y Ross C. Brownson. "Improving the Public Health Workforce". Journal of Public Health Management and Practice 14, n.º 2 (marzo de 2008): 138–43. http://dx.doi.org/10.1097/01.phh.0000311891.73078.50.

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Akhter, Mohammed N. "Professionalizing the Public Health Workforce". Journal of Public Health Management and Practice 7, n.º 4 (julio de 2001): 46–49. http://dx.doi.org/10.1097/00124784-200107040-00007.

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Setliff, Rebecca, Janet E. Porter, Michael Malison, Steve Frederick y Thomas R. Balderson. "Strengthening the Public Health Workforce". Journal of Public Health Management and Practice 9, n.º 2 (marzo de 2003): 91–102. http://dx.doi.org/10.1097/00124784-200303000-00003.

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Cioffi, Joan P., Maureen Y. Lichtveld, Lee Thielen y Kathleen Miner. "Credentialing the Public Health Workforce". Journal of Public Health Management and Practice 9, n.º 6 (noviembre de 2003): 451–58. http://dx.doi.org/10.1097/00124784-200311000-00004.

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Beaglehole, Robert. "Challenging the public health workforce". Scandinavian Journal of Public Health 32, n.º 4 (agosto de 2004): 241–42. http://dx.doi.org/10.1080/14034940410028118.

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Walters, R. "Mapping the public health workforce 1 a tool for classifying the public health workforce". Public Health 116, n.º 6 (noviembre de 2002): 388. http://dx.doi.org/10.1016/s0033-3506(02)00567-x.

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Walters, R. "Mapping the public health workforce I: a tool for classifying the public health workforce". Public Health 116, n.º 4 (julio de 2002): 201–6. http://dx.doi.org/10.1016/s0033-3506(02)90067-3.

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Popovic, Tanja. "Workforce Science". Journal of Public Health Management and Practice 15, Supplement (noviembre de 2009): S3—S4. http://dx.doi.org/10.1097/phh.0b013e3181bdfe76.

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Cometto, Giorgio, James Buchan y Gilles Dussault. "Developing the health workforce for universal health coverage". Bulletin of the World Health Organization 98, n.º 2 (4 de diciembre de 2019): 109–16. http://dx.doi.org/10.2471/blt.19.234138.

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Freudenberg, Nicholas. "Preparing the Urban Public Health Workforce". American Journal of Public Health 111, n.º 7 (julio de 2021): 1177–79. http://dx.doi.org/10.2105/ajph.2021.306327.

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Ellery, Jane. "TRAINING THE PUBLIC HEALTH EDUCATION WORKFORCE". American Journal of Public Health 92, n.º 7 (julio de 2002): 1053–52. http://dx.doi.org/10.2105/ajph.92.7.1053.

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Payne, Karen. "Playing the Game: public health workforce". Perspectives in Public Health 131, n.º 6 (noviembre de 2011): 261. http://dx.doi.org/10.1177/1757913911425746.

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Singh, Pankaj, Amrita Gupta, Akhilesh Tripathi, Meera Dhuria y Pradeep Aggarwal. "Developing public health capacities of Frontline Public Health Workforce in Uttarakhand". Indian Journal of Community Health 34, n.º 3 (30 de septiembre de 2022): 448–50. http://dx.doi.org/10.47203/ijch.2022.v34i03.025.

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Recent COVID-19 pandemic has highlighted the importance of increase in the ability of public health workforce to detect and respond to the public health threats. For timely implementation of an adequate response and mitigation measure, the standardized and sustainable capacity building programme for frontline public health workforce is the need of hour. National Center for Disease Control (NCDC), Ministry of Health and Family Welfare, in partnership with U.S. Centers for Disease Control and Prevention (CDC), developed a three-month in-service Basic Epidemiology Training programme. This is a tailor-made programme for frontline public health workforce to strengthen epidemiological skills. This training was a practical interactive approach to field epidemiology for three months on the job training for frontline public health workforce that addressed the critical skills needed to conduct surveillance effectively at the local level while focusing on improving disease detection, reporting and feedback. The training also demonstrated the role of learning model in form of interaction between the mentor and the mentees. The importance of handhold support given by the mentors to the mentees in quality outbreak investigations and documentation.
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Mitchell, Chris. "NRF: The health of the rural health workforce". Australian Journal of Rural Health 15, n.º 3 (junio de 2007): 222–23. http://dx.doi.org/10.1111/j.1440-1584.2007.00892.x.

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Panzera, Annette June, Richard Murray, Ruth Stewart, Jane Mills, Neil Beaton y Sarah Larkins. "Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland". Australian Journal of Primary Health 22, n.º 1 (2016): 63. http://dx.doi.org/10.1071/py15149.

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Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services that meet the needs of the population and contribute to service and system improvement and innovation.
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Baker, Edward L. "Addressing Urgent Public Health Workforce Needs". Journal of Public Health Management and Practice 21 (2015): S5—S6. http://dx.doi.org/10.1097/phh.0000000000000316.

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Yeager, Valerie A., M. Kristina Wharton y Leslie M. Beitsch. "Maintaining a Competent Public Health Workforce". Journal of Public Health Management and Practice 26, n.º 1 (2020): 57–66. http://dx.doi.org/10.1097/phh.0000000000000750.

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Crawford, Carol A. Gotway, Wm Thomas Summerfelt, Kakoli Roy, Zhuo (Adam) Chen, David O. Meltzer y Stephen B. Thacker. "Perspectives on Public Health Workforce Research". Journal of Public Health Management and Practice 15, Supplement (noviembre de 2009): S5—S15. http://dx.doi.org/10.1097/phh.0b013e3181bdff7d.

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Rutkow, Lainie, Arielle Traub, Rachel Howard y Shannon Frattaroli. "Educating the Future Public Health Workforce". Journal of Public Health Management and Practice 19, n.º 1 (2013): 47–52. http://dx.doi.org/10.1097/phh.0b013e31824c6095.

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Turnock, Bernard J. "Public Health Workforce Trends Since 1980". Journal of Public Health Management and Practice 15, n.º 2 (marzo de 2009): 105–8. http://dx.doi.org/10.1097/01.phh.0000346005.21157.a6.

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Gebbie, Kristine M. y Jacqueline Merrill. "Enumeration of the Public Health Workforce". Journal of Public Health Management and Practice 7, n.º 4 (julio de 2001): 8–16. http://dx.doi.org/10.1097/00124784-200107040-00003.

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Turnock, Bernard J. "Roadmap for Public Health Workforce Preparedness". Journal of Public Health Management and Practice 9, n.º 6 (noviembre de 2003): 471–80. http://dx.doi.org/10.1097/00124784-200311000-00006.

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Fraser, Michael R. "The Local Public Health Agency Workforce". Journal of Public Health Management and Practice 9, n.º 6 (noviembre de 2003): 496–99. http://dx.doi.org/10.1097/00124784-200311000-00009.

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Gebbie, K. M. "The public health workforce: key to public health infrastructure." American Journal of Public Health 89, n.º 5 (mayo de 1999): 660–61. http://dx.doi.org/10.2105/ajph.89.5.660.

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Maisel, Natalya C., Sally Haskell, Patricia M. Hayes, Vidhya Balasubramanian, Anupama Torgal, Lakshmi Ananth, Fay Saechao, Samina Iqbal, Ciaran S. Phibbs y Susan M. Frayne. "Readying the Workforce". Medical Care 53 (abril de 2015): S39—S46. http://dx.doi.org/10.1097/mlr.0000000000000298.

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Kirkland, Chelsey, Janette S. Dill y Harshada Karnik. "Retention of Community Health Workers in the Public Health Workforce: Public Health Workforce Interests and Needs Survey, 2017 and 2021". American Journal of Public Health 114, n.º 1 (enero de 2024): 44–47. http://dx.doi.org/10.2105/ajph.2023.307462.

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Objectives. To investigate the organizational factors contributing to the intent of community health workers (CHWs) to quit their jobs in local and state health departments in the United States. Methods. We used the 2017 (n = 844) and 2021 (n = 1014) Public Health Workforce Interests and Needs Survey data sets to predict CHWs’ intent to leave with Stata 17 balanced repeated replication survey estimations. Results. CHWs dissatisfied with organizational support, pay, or job security had high probabilities of reporting an intent to leave (50%, P < .01; 39%, P < .01; and 42%, P < .01, respectively) relative to satisfied or neutral workers (24%, P < .01; 21%, P < .01; and 26%, P < .01, respectively). Conclusions. Improving organizational support, pay satisfaction, and job security satisfaction in public health agencies can significantly improve CHW retention, potentially lowering overall organizational costs, enhancing organizational morale, and promoting community health. Public Health Implications. Our findings shed light on actionable ways to improve CHW retention, including assessing training needs; prioritizing diversity, equity, and inclusion; and improving communication between management and workers. (Am J Public Health. 2024;114(1):44–47. https://doi.org/10.2105/AJPH.2023.307462 )
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Naccarella, Lucio, Jim Buchan y Peter Brooks. "Evidence-informed primary health care workforce policy: are we asking the right questions?" Australian Journal of Primary Health 16, n.º 1 (2010): 25. http://dx.doi.org/10.1071/py09060.

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Australia is facing a primary health care workforce shortage. To inform primary health care (PHC) workforce policy reforms, reflection is required on ways to strengthen the evidence base and its uptake into policy making. In 2008 the Australian Primary Health Care Research Institute funded the Australian Health Workforce Institute to host Professor James Buchan, Queen Margaret University, UK, an expert in health services policy research and health workforce planning. Professor Buchan’s visit enabled over forty Australian PHC workforce mid-career and senior researchers and policy stakeholders to be involved in roundtable policy dialogue on issues influencing PHC workforce policy making. Six key thematic questions emerged. (1) What makes PHC workforce planning different? (2) Why does the PHC workforce need to be viewed in a global context? (3) What is the capacity of PHC workforce research? (4) What policy levers exist for PHC workforce planning? (5) What principles can guide PHC workforce planning? (6) What incentives exist to optimise the use of evidence in policy making? The emerging themes need to be discussed within the context of current PHC workforce policy reforms, which are focussed on increasing workforce supply (via education/training programs), changing the skill mix and extending the roles of health workers to meet patient needs. With the Australian government seeking to reform and strengthen the PHC workforce, key questions remain about ways to strengthen the PHC workforce evidence base and its uptake into PHC workforce policy making.
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Sundberg, Michael A., Loretta Christensen, Allison Kelliher, Matthew L. Tobey, Michael Toedt y Mary J. Owen. "Why the Indian Health Care Improvement Act Has Failed to Effectively Fund Workforce Development for the Indian Health Service". Journal of Health Care for the Poor and Underserved 35, n.º 1 (febrero de 2024): 375–84. http://dx.doi.org/10.1353/hpu.2024.a919824.

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Abstract: The Indian Health Service (IHS) faces severe workforce shortages due to underfunding and underdevelopment of clinical training programs. Unlike other direct federal health care systems that have implemented clinical training paradigms as central parts of their success, the IHS has no formalized process for developing such programs internally or in partnership with academic institutions. While the Indian Health Care Improvement Act (IHCIA) authorizes mechanisms by which the IHS can support overall workforce development, a critical portion of the act (U.S. Code 1616p) intended for developing clinical training programs within the agency remains unfunded. Here, we review the funding challenges of the IHCIA, as well as its authorized and funded workforce development programs that have only partially addressed workforce shortages. We propose that through additional funding to 1616p, the IHS could implement clinical training programs needed to prepare a larger workforce more capable of meeting the needs of American Indian/Alaska Native communities.
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Monroe, Judith A. y Georgia A. Moore. "Data, Workforce, Action!" Journal of Public Health Management and Practice 21 (2015): S7—S8. http://dx.doi.org/10.1097/phh.0000000000000270.

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