Tesis: "Public research and health policies"

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Gómez, Sofia y Sofia Gómez. "Arizona's Immigration Enforcement Policies: Implications for Accessibility of Care in Immigrant Families". Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/624470.

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BACKGROUND: Arizona has enacted some of the harshest state-level immigration policies restricting public benefits and services to immigrant families. The passage and enactment in 2010 of Arizona Senate Bill 1070 (SB1070), "Support Our Law Enforcement and Safe Neighborhoods Act", criminalized the act of hiring or harboring undocumented immigrants (Magaña 2013a). Particularly affected are children of mixed-status families where one or more children are U.S. citizens and entitled to public services. There is limited knowledge on the effects of immigration enforcement policies on immigrant access to health services in Tucson, Arizona (Hardy et al. 2012, Toomey et al. 2014). Of particular interest to scholars and policymakers is how the family unit navigates accessibility to care when one or several members have varied immigration statuses. OBJECTIVE: The purpose of this dissertation is to explore healthcare accessibility and the healthcare experiences of Latino mixed-status families in Arizona's political context. The overall goal of this research is to identify promoters and barriers to healthcare accessibility in Arizona's immigrant communities particularly mixed-status households. METHODS: To conduct this formative research a mixed methods approach was utilized consisting of three study aims: 1) semi-structured interviews (quantitative and qualitative) with members of immigrant families (n = 43) 2) the use of photovoice, a qualitative participatory research method, to understand healthcare experiences of immigrant youth under the Deferred Action for Childhood Arrival (referred to as DACAmented youth) (n = 7) and 3) dissemination of photovoice results through an exhibition and dialogue with the community and policymakers. RESULTS: The results by specific study aims demonstrate: 1) factors limiting access to healthcare relate to complexity of application requirements (57%); discrimination and fear (26%), and long wait times for application approvals and appointments (13%). Other reasons reported (26%) relate to cost of care, confusion over eligibility of care and misunderstanding regarding coverage. Promoters to care relate to affordability of care (43%); positive customer service (37%); colocation of services (20%) and assistance with applications (17%). Other findings relate to proximity of location, language availability, ease of appointments and employer based assistance with insurance, 2) DACAmented youth shared concerns related to the high costs of medical care, the complicated requirements to access care, limited healthcare options, discrimination and fear while also emphasizing their community's strength and resilience. Most importantly, DACAmented youth sought to be understood, asking that their humanity be acknowledged, and 3) public exhibits, presentations and meetings with policymakers provided additional lessons for both participants and researchers by illuminating the challenges that health practitioners face in delivery of care to mixed-status families (and particularly to undocumented individuals) in a politically restrictive environment and how this impacts perceptions of "deservingness" of care. CONCLUSIONS: The study results indicate that local response particularly safety net programs are vital and offer a platform to respond to the unique challenges that mixed-status families' face especially when family members are deported and/or detained. This study offers lessons and insights on how anti-immigrant and restrictive political environments impact health and how to engage immigrant populations in achieving health equity. Results not only have important implications and relevancy in Arizona but also over growing national fears of family separation and deportations under the Trump administration. Healthcare providers can benefit from the proposed recommendations in building bridges to care to address health equity in immigrant communities. RECOMMENDATIONS: In efforts to continue to address and expand access to care to mixed-status families recommendations include the expansion of safety net programs and training of healthcare professionals and frontline staff to address the unique needs of mixed-status families in the provision of care. Additionally there is a need for increased outreach to immigrant families to provide health literacy programming and know your health rights workshops to facilitate usage and assist in the navigation of healthcare programs to gain a better understanding of health systems. The inclusion of youth voices in participatory health research and health policy development is also at the core of this research. This recommendation would require health policymakers to work differently and to seek ways to engage and collaborate with youth on health matters. Ultimately continued advocacy for immigration reform and inclusivity in healthcare is at the heart of achieving health equity.

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Pena, Ricardo Sparapan 1977. "O apoio institucional como estratégia de gestão em coletivos na saude mental". [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312020.

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Orientador: Sergio Resende Carvalho
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Esta pesquisa busca analisar a intervenção ativada pelo Apoio Institucional para a construção de redes de produção de saúde junto às equipes que atuam nos serviços de saúde localizados no território do Distrito de Saúde Leste (DSL), órgão da Secretaria Municipal de Saúde/Campinas/SP. Podemos destacar que o trabalho dos profissionais da Saúde Mental aparece como elemento central na constituição destas redes. Frente a este quadro, o desafio encontrado pelo Apoio Institucional é desconstruir esta centralidade, problematizando a ação da Saúde Mental junto às demais áreas estratégicas, a atuação das equipes no acolhimento aos usuários, assim como a construção de projetos terapêuticos baseados na integralidade das ações em saúde. Para tanto, faz-se necessário construir coletivamente pactos de gestão que alinhem o trabalho em saúde neste território aos investimentos apontados pelas atuais políticas públicas em curso no campo da Saúde Mental, o que configura o cenário de práticas do Apoio. No curso desta intervenção, as ações operacionalizadas se dão pela presença constante do apoiador institucional nos serviços de saúde e também nos espaços coletivos de gestão do DSL, os quais se constroem cotidianamente. Para a análise da intervenção, os espaços eleitos para a construção dos diários de campo que forneceram os materiais empíricos desta pesquisa são as reuniões semanais entre trabalhadores e apoiadores da saúde mental e de outras áreas, sediadas no DSL e coordenadas pelos apoiadores institucionais ligados ao campo da Saúde Mental. A análise dos materiais produzidos nestes espaços de gestão busca compor uma cartografia do Apoio Institucional, sendo que o referencial teórico utilizado para este empreendimento cartográfico consiste na produção brasileira no campo da Saúde Coletiva, assim como no estudo da Análise Institucional e dos pensadores da diferença. A intervenção do Apoio Institucional é contínua e seus efeitos geram ações de cuidado que podem ser observadas e analisadas ao longo do tempo. Neste estudo, concentramos o trabalho de campo entre os anos de 2011 e 2012
Abstract: This research seeks to analyze the intervention enabled by Institutional Support for the construction of production networks with the health staff working in health services located within the Eastern Health District, an agency of the Municipal Health/Campinas/SP. We highlight, firstly, that the work of Mental Health's professionals appears as a central element in the formation of these networks. Facing this situation, the challenge faced by Institutional Support is to deconstruct this centrality, questioning the action of Mental Health along with other strategic areas, the teams' work hosting the users, as well the development of therapeutic projects based on completeness of shares health. Therefore, it is necessary to build collectively management pacts that align health work in this area indicated by the current investment policies in progress in the field of Mental Health, which sets the scene for the support practices. In the course of this intervention, actions occur operationalized by the constant presence of supportive institutional health services and also in collective spaces of the District, which are built daily. For the analysis of the intervention, the spaces chosen for the construction of field diaries that provided the empirical material of this study are weekly meetings between workers and supporters of mental health and other areas, based on District and coordinated by institutional supporters connected to the field of Mental Health. The analysis of the material produced on those managements spaces seeks to compose a map of Institutional Support. The theoretical basis for this venture is to produce cartographic Brazilian in the field of Health as well as the study of Institutional Analysis and Difference's thinkers. The intervention of Institutional Support is ongoing and its effects generate care actions that can be observed and analyzed over time. We concentrated our field study between the years 2011 and 2012
Doutorado
Política, Planejamento e Gestão em Saúde
Doutor em Saude Coletiva

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Greenham, Felicity J. "How the New Labour Government Third Way policies (1998-2010) and the delivery of the New Deal for Communities (NDC) regeneration programme impacted on participation in health care in an area-based initiative. A longitudinal study using action-learning research methodology in a New Deal for Communities Area Based Initiative". Thesis, University of Bradford, 2018. http://hdl.handle.net/10454/16922.

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The research examines New Labour’s Third Way policies and the impact New Deal for Communities (NDC) regeneration programme had on participation in health care. This longitudinal study (1998-2007) explores participatory joint working, welfare state, social capacity, health inequalities, citizen involvement and community capacity. It captures the experiences of local community and front-line workers whilst delivering the Health Focus Group (HFG) in the NDC programme. Using action learning reflection techniques, the study analyses a purposeful sample of 15 from the local community, front-line workers, and strategic respondents involved in the NDC health programme. The research demonstrated the NDC did increase participation, joint working and involvement of local actors 1998–2003. The importance of communication, leadership and relationships was recognised as an important catalyst for developing community governance models. The new action learning spaces initiated, designed and delivered 19 new models of joint local clinical, community and complementary health and well-being projects. In 2001, New Labour introduced public private finance initiatives with the Primary Care Trust (PCT) which conflicted with the local actors’ involvement in the participatory joint decision-making. The reconfiguration of health and social care services and the new public health models introduced complex governance and monitoring models, further distancing the local actors from the process. Strategic staff changes in key governance positions also adversely affected the communication and trust established with local actors. The research concluded operational, tactical, and strategic alignment is necessary to maximise joint participation in decision-making.

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Peters, Lilian Rose. "O Programa Pesquisa para o Sus: gestão compartilhada em saúde - PPSUS como ferramenta de descentralização do fomento à pesquisa em saúde". Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-14082014-131103/.

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INTRODUÇÃO: O Brasil adentrou o século 21, caracterizado como o século da Ciência e Tecnologia - C&T, buscando discutir, identificar e implantar mecanismos de construção de uma sociedade onde o conhecimento seja o propulsor de conquistas sociais, econômicas e culturais. Tinha pela frente a tarefa de confrontar desafios que se apresentavam no cenário do sistema nacional de C&T, como a fragmentação das atividades de C&T, a ausência de coordenação interinstitucional e a concentração das atividades de C&T em determinadas regiões do país. OBJETIVO: Este estudo se propôs analisar uma das principais estratégias do recém-criado Departamento de Ciência e Tecnologia do Ministério da Saúde para o enfrentamento a estes desafios, desenvolvido, entre os anos 2002 e 2008 por meio do Programa Pesquisa para o SUS: gestão compartilhada em saúde PPSUS. MÉTODO: Trata-se de um estudo exploratório e descritivo, desenvolvido por meio de recursos dos métodos quantitativo de pesquisa e com suporte de instrumentos multivariados de coleta de dados: pesquisa bibliográfica e pesquisa documental. No tocante aos dados, foram coletados dados sobre o conjunto de projetos de pesquisa em ciência e tecnologia em saúde, fomentados no país no período de 2002 a 2008 e financiados pelo Ministério da Saúde, em ação compartilhada com Fundações de Amparo à Pesquisa (FAPs) de Unidades Federativas do país e com Secretarias Estaduais de Saúde (SES). As fontes de coleta dos dados foram a base de dados gerenciais PesquisaSaúde do Ministério da Saúde e a base de dados do Curriculum Lattes do CNPq. A coleta de dados abrangeu o universo de 1.271 projetos de pesquisa, fomentados no país desde o início do programa de fomento à pesquisa em ciência e tecnologia em saúde (2002), até 2008, quando teve início a pesquisa. RESULTADOS: Nas três edições do PPSUS estudadas, houve a participação de todos os 27 estados da federação, 213 instituições de pesquisa e 1.151 pesquisadores. Do total de recursos 41 por cento foram alocados pelas FAPs e SES, mostrando uma crescente responsabilização destes como parceiros efetivos na consolidação do programa. CONCLUSÃO: Os resultados observados reforçaram a hipótese positiva de que o programa de gestão descentralizada produziu efetivamente uma reestruturação em termos de gestão de C&T, interferindo no aprimoramento das políticas de C&T nos estados, institucionalizando ações de gestão de forma a se constituírem numa rotina administrativa. Quanto à redução das desigualdades na distribuição de recursos de C&T entre as grandes regiões do país, os resultados demonstraram que, nos estados onde as FAPs e SES estavam mais estruturadas foram, justamente, aqueles que mais contribuíam para as ações de C&T. Este movimento repete o status quo, proporcionando a continuidade das disparidades regionais. Porém, teve o êxito de produzir uma adesão positiva para ações efetivas em C&T em Estados onde não havia um histórico nesta área, traduzindo-se num forte aliado para a redistribuição de forças no cenário de C&T.
INTRODUCTION: Brazil began the 21st century characterized as the century of Science and Technology - S&T, seeking to discuss, identify, and implement mechanisms for building a society where knowledge is the engine of social achievements, economic and cultural. Its objective was to confront challenges that were presented in the national scenario of S&T, as the fragmentation of S&T, the lack of interagency coordination and, concentration of S & T in certain regions of the country. OBJECTIVE: This study aimed to analyze one of the main strategies of the newly created Department of Science and Technology of the Ministry of Health to face these challenges, developed between 2002 and 2008 by the \"Research Program to the SUS: management shared health - PPSUS\". METHOD: This was an exploratory and descriptive, developed through features of quantitative methods of research and support tools for multivariate data collection: bibliographic research, desk research. As regards the data were collected on the number of research projects in science and technology in health, fostered in the country in the period 2002-2008 and funded by the Ministry of Health, in action shared with the Research Support Foundations (FAPs) of Federal Units of the country and the State Departments of Health (SES). The sources of data collection were the data base management \"PesquisaSaúde\" the Ministry of Health and, the database of the CNPq Lattes Curriculum. The data collection covered the universe of 1,271 research projects, promoted in the country since the beginning of the program to encourage research in science and technology in health (2002) until 2008, when the survey began. RESULTS: In the three editions of PPSUS studied, there was participation from all 27 states of the federation, 213 research institutions and researchers 1151. 41 per cent of the total funds were allocated by FAPs and SES, showing an increasing accountability of consolidation as effective partners in the program. CONCLUSION: The results reinforced the positive assumption that the program of decentralized produced effectively restructured in terms of management of C&T, interfering in improving policies for S & T in the states, institutionalizing management actions in order to constitute an administrative routine. As for the reduction of inequalities in the distribution of resources in S & T among the major regions of the country, the results showed that, in states where the FAPs were more structured and SES were precisely those who most contributed to the actions of S&T. This movement repeats the status quo, providing continuity of regional disparities. But the success had to produce a positive adherence to effective actions in S&T in states where there was a historic in this area, resulting in a strong ally for the redistribution of forces in the scenario of S&T.

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Bosworth, Ryan Cole. "Demand for public health policies /". view abstract or download file of text, 2006. http://proquest.umi.com/pqdweb?index=0&did=1192186841&SrchMode=1&sid=1&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1176749188&clientId=11238.

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Thesis (Ph. D.)--University of Oregon, 2006.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 127-130). Also available for download via the World Wide Web; free to University of Oregon users.

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Pozzoli, Sandra Maria Luciano [UNIFESP]. "Cartografia do Processo de Cuidado num Serviço de Atenção Domiciliar". Universidade Federal de São Paulo (UNIFESP), 2017. http://repositorio.unifesp.br/11600/41866.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Introdução: A prática do cuidado de pessoas doentes em seus domicílios remete a tempos imemoriais. Desde o século passado observa-se, devido principalmente ao envelhecimento da população, uma crescente institucionalização de tal prática em serviços de atenção domiciliar, que assumem modelos e processos de trabalho muito diferentes nos diferentes países. O objetivo principal desta pesquisa foi conhecer o processo de cuidado no Serviço de Atenção Domiciliar (SAD) de um município de médio porte no Estado de São Paulo como componente da Rede de Urgência e Emergência (RUE). Método: É um estudo de caso no qual assumi um ethos cartográfico em todo caminho da pesquisa, participando da rotina do SAD e registrando em um diário de campo as cenas do cotidiano. Realizei também entrevistas gravadas com cuidadoras e com uma enfermeira hospitalar e conduzi um grupo focal com enfermeiras da Atenção Básica (AB). Como estratégia de análise dos dados, a primeira aproximação do material empírico foi a definição de “Planos de Corte”, isto é, recortes intencionais realizados a partir de elementos ou componentes da política de atenção domiciliar. Na segunda aproximação analítica, foram evidenciados os “Planos de Visibilidade”, cenas do cotidiano que revelam as complexas relações entre o trabalho prescrito (aquilo que a política oficial define) e o trabalho real (como é realizado o cuidado pelas equipes em suas condições concretas de trabalho). Resultados e Discussão: Através dos planos de corte e planos de visibilidade foi possível identificar problemas relacionados à gestão, em particular aqueles que estabelecem limites para o trabalho das equipes; as limitações no uso do sistema de informação; os aspectos positivos, mas também as tensões presentes no trabalho multiprofissional; os conflitos presentes no cotidiano do trabalho; as deficiências na formação dos trabalhadores; o isolamento do SAD em relação aos demais equipamentos de saúde; as limitações da AB para apoiar efetivamente o SAD; a sobrecarga do cuidador e a incontornável necessidade de estratégias de apoio ao seu trabalho e elementos do universo dos pacientes, marcado pela perda de autonomia e, muitas vezes, pela falta de perspectiva de “construção de futuro”, evidenciando vulnerabilidade humana em diferentes perspectivas, e o sentido que cada família dá ao sofrimento vivido pelo familiar dependente de cuidado de longo prazo. Conclusões: O estudo evidenciou que a atenção domiciliar é um modelo de atenção inovador, se assumido pelo sistema de saúde com suficientes recursos humanos, materiais, equipamentos, transporte e sistema de informação ágil e flexível para inclusão de informações reais. Os cuidadores sugeriram que a assistência seja integrada entre os profissionais e com os outros pontos da Rede de Atenção à Saúde (RAS). Há dificuldades para a AB assumir esse modelo de atenção e o empírico indicou a necessidade de haver serviços de apoio social para contribuir com a qualidade de vida do cuidador.
Introduction: The practice of caring for sick people in their homes refers to immemorial times. Since the last century, due to the aging of the population, there has been a growing institutionalization of such practice in home care services, which had assumed very different models and work processes in different countries. The main objective of this research was to know the process of care in the Home Care Service (SAD) of a medium-sized municipality in the State of São Paulo as a component of the Emergency and Urgency Network (RUE). Method: It is a case in which I take on a cartographic ethos in every way of the research, participating in the routine of SAD and recording in a field diary the daily scenes. I also have recorded interviews with caregivers and a hospital nurse, and I have conducted a focus group with Primary Care nurses (AB). As a data analysis strategy, the first approximation of the empirical material was the definition of Cutting Plans, that is, intentional cuts made from elements or components of home care policy. In the second analytical approach, there are the Visibility Plans, that are scenes of the daily life that reveal the complex relationships between the prescribed work (that the official policy defines) and the actual work (that is how care is performed by the teams in their concrete conditions of work). Results and Discussion: Through the cutting plans and visibility plans, it was possible to identify problems related to management, in particular those that establish limits for the team work; limitations in the use of the information system; the positive aspects and also the tensions present in the multiprofessional work; the conflicts present in the daily work; deficiencies in the training of workers; the isolation of SAD in relation to other health equipment; the limitations of AB to effectively support SAD; the overload of the caregiver and the inescapable need of strategies to support their work and elements of the patient universe, marked by the loss of autonomy and often by the lack of perspective of future building, showing human vulnerability in different perspectives and the sense that each family gives to the suffering experienced by the dependent family member of long-term care. Conclusions: The study evidenced that home care is a model of innovative care, if assumed by the health system with sufficient human resources, materials, equipment, transportation and agile and flexible information system to include real information. Caregivers suggested that care must to be integrated among professionals and with other points of the Health Care Network (RAS). There are difficulties for AB to assume this model of care, and the experience indicated the need of social support services to contribute to the quality of life of the caregiver.
BV UNIFESP: Teses e dissertações

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Olmo, Neide Regina Simões. "Poluição atmosférica e exposição humana: a evolução científica epidemiológica e sua correlação com o ordenamento jurídico". Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-24052011-162041/.

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INTRODUÇÃO: Atualmente inexiste no Brasil, uma correlação entre a área da saúde e o direito, no que tange a adoção de políticas públicas tendentes a prevenir/evitar, remediar ou minimizar os efeitos adversos da poluição atmosférica na saúde humana. OBJETIVO: O presente trabalho tem como objetivo evidenciar a necessidade cada vez mais iminente da interação entre a epidemiologia e o direito, revelando estas áreas, não como ciências autônomas, mas como instrumentos integrados, a serem utilizados na busca de políticas públicas eficientes, em matéria de poluição atmosférica causada por veículos automotores. MÉTODOS: Elaboramos uma revisão sistemática dos estudos epidemiológicos referentes aos efeitos da poluição atmosférica na saúde humana utilizando como base de dados o PubMed, por meio de descritores bem definidos. Esta revisão foi submetida posteriormente a seleção de três pesquisadores independentes com experiência no tema. Foi realizada uma revisão da legislação ambiental nacional relativa à poluição atmosférica, em base de dados oficiais, incluindo normas CONAMA (Conselho Nacional de Meio Ambiente) e pesquisa dos documentos internacionais relativos aos padrões de emissão atmosférica. Realizamos entrevistas estruturadas com formuladores de políticas públicas na área ambiental, com o fim de análise das opiniões dos representantes desses segmentos distintos da sociedade, sobre o tema em questão. RESULTADO: Dos 2.530 estudos selecionados inicialmente apenas 32 nacionais e 112 internacionais foram considerados adequados aos critérios de inclusão estabelecidos. Dos estudos nacionais 27 evidenciaram efeitos adversos na saúde humana, mesmo em concentrações menores do que as permitidas legalmente e 18 discutiram de alguma maneira políticas públicas. Dos estudos internacionais 78 evidenciaram efeitos adversos na saúde humana, mesmo em concentrações menores do que as permitidas legalmente e 13 discutiram políticas públicas. Em relação aos entrevistados, todos foram uníssonos quanto à necessidade de atualização dos atuais padrões de emissão; quanto ao dever de cumprimento do cronograma de emissões e em relação à falta de entendimento adequado entre a área da saúde e a adoção de medidas de políticas públicas, mostrando conhecimento das pesquisas científicas realizadas e sua preocupação com os dados apresentados. CONCLUSÃO: Evidenciamos então: a necessidade de uma composição entre direito e epidemiologia para elaboração de diretrizes públicas; a necessidade de conscientização da população e alteração dos padrões de emissão e a participação efetiva dos órgãos públicos do segmento político e da saúde. A identificação, reconhecimento e aceitação da complexidade e dos dados das pesquisas são peças chave na interface entre os domínios da ciência, da sociedade e da política
INTRODUCTION: Currently, there is no correlation between the fields of healthcare and law in Brazil regarding the adoption of public policies aimed at preventing/avoiding, remedying or minimizing the adverse effects of atmospheric pollution on human health. OBJECTIVE: The present study had the objective of demonstrating the increasingly eminent need for interaction between epidemiology and law, thereby revealing that these fields are not autonomous sciences but integrated instruments for use in seeking efficient public policies relating to atmospheric pollution caused by automotive vehicles. METHODS: We built up a systematic review of epidemiological studies relating to the effects of atmospheric pollution on human health, using the PubMed database and well-defined descriptors. The search results then underwent selection by three independent researchers with experience of this topic. A review of the national environmental legislation relating to atmospheric pollution was made, using official databases, including the CONAMA (National Environment Council) standards, and international documents relating to atmospheric emission standards were investigated. We conducted structured interviews with public policymakers in the environmental field, with a view to analyzing the opinions of representatives of this distinct segment of society regarding the matter in question. RESULT: Out of 2,530 studies initially selected, only 32 Brazilian and 112 foreign studies were considered to fit within the inclusion criteria established. Among the Brazilian studies, 27 showed that there were adverse effects on human health even at concentrations lower than what is legally permitted, and 18 discussed public policies in some manner. Among the foreign studies, 78 showed that there were adverse effects on human health even at concentrations lower than what is legally permitted, and 13 discussed public policies. The interviewees unanimously stated that there was a need to update the current emission standards and comply with the emissions timetable, and that there was inadequate understanding between the field of healthcare and the adoption of public policy measures. They showed that they were aware of the scientific research that had been conducted and were concerned about the data presented. CONCLUSION: We thus demonstrated that: there is a need for law and epidemiology to combine in order to draw up public guidelines; a need for the populations awareness to be raised, and for emission standards to be changed and the effective participation from public bodies within the policymaking and healthcare sectors. Identification, recognition and acceptance of the complexity and the research data are the cornerstones of the interface between the domains of science, society and politics

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Franckle, Rebecca L. "Sugar-Sweetened Beverages and Their Role in Obesity Prevention Programs and Policies". Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27201729.

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It is well established that sugar-sweetened beverages (SSBs) are associated with obesity and chronic diseases. Although there is some emerging evidence that consumption of added sugars is declining in the United States, on average Americans’ consumption still exceeds recommended levels. Consequently, it is imperative that researchers continue to delve further into the question of exactly how SSBs influence obesity and associated chronic diseases, as well as consider creative and novel strategies for reducing their impact on consumers’ health. Several important gaps in the research are addressed by this dissertation. Chapter one considers the role of SSBs and overall diet quality with respect to the growing body of evidence that demonstrates an association between sleep duration and obesity. We used linear regression to examine the associations of sleep duration with dietary indicators in elementary school students taking part in a multi-sector, community-based obesity prevention intervention (the Massachusetts Childhood Obesity Research Demonstration Project). We found that students who reported sleeping <10 hours/day consumed soda more frequently and vegetables less frequently compared with students who reported optimal sleep. Chapter two assesses whether fast food customers are worse at estimating the caloric content of their meal when their purchase includes a high-calorie beverage (HCB). We used linear regression to examine the association between purchasing HCB and calorie estimation among adult and adolescent fast food customers, and found that among adults, drinking HCB contributes to underestimating calories. HCB may be influencing calorie estimation in a unique way compared to high-calorie food items. Chapter three considers the relevance of SSBs with respect to proposed changes to the Supplemental Nutrition Assistance Program (SNAP). Using sales data from a large supermarket chain in the Northeast, we used multivariate analysis of variance to determine whether there is an association between SNAP receipt and shopping patterns. We found that SNAP shoppers spent more than non-SNAP shoppers on sugar-sweetened beverages, red meat, and cold convenience foods, and spent less on fruits, vegetables and poultry. Each chapter lends additional support for a focus on SSB consumption in obesity prevention efforts and will inform the development of prevention strategies in the future.

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Foushee, Deborah. "Prematriculation Immunization Policies: A Survey of Kentucky Colleges and Universities". TopSCHOLAR®, 1996. http://digitalcommons.wku.edu/theses/869.

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Immunizations for vaccine preventable diseases are ordinarily completed by young adulthood, and the school system is typically the institution required to determine compliance with state immunization requirements prior to enrollment. In recent years, outbreaks of measles on college campuses across the United States have led to the implementation of immunization requirements. Kentucky fouryear postsecondary institutions are not required by state law to request proof of immunization. The purpose of this study was to assess prematriculation immunization policies of Kentucky four-year colleges and universities. Participants completed a survey which appraised the existence of a university prematriculation policy, the diseases covered by their policy, year of policy implementation, and university departments responsible for initiating the policy. In addition, participants were asked if immunizations are available on campus, which vaccinations are available, if an immunization policy had been considered and how recently, and feedback from students, parents and faculty/staff. The survey assessed the attitudes of the respondent regarding policy benefits/dislikes, need for state legislation, and institutional attitude toward governmental intervention of their policy making. Future research on this topic should address the following: the status of prematriculation immunization policies among Kentucky state postsecondary institutions from an epidemiological/public health perspective; explore in greater detail the reason(s) affecting the institutional decision to implement or abandon a prematriculation immunization requirement; investigate or survey the attitudes of students, parents, and faculty/staff toward vaccination programs; include attempts to interview in person a representative from institutions that did not respond to the mailed survey. Further investigation should be conducted; Kentucky four-year colleges and universities would benefit from additional research on vaccine preventable diseases among college students and information gathered from other states with regard to PMIR policies.

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Pérez, Durán Ixchel. "Accountability for public policies the case of health policy in Spain". Doctoral thesis, Universitat Pompeu Fabra, 2013. http://hdl.handle.net/10803/130818.

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This research is a contribution to the analysis, measurement and explanation of accountability for public policies. Firstly, I develop a proposal to analyze and measure accountability for public policies. This proposal is innovative since it provides an analytical framework that can be used to measure and compare levels of accountability in different kinds of policies (e.g., health, education, pensions, etc.) or in different contexts (from countries or regions to complex multi-layered authority structures). Secondly, I test the validity of my proposal with an empirical application centered in the health policy in Spain, whose decentralized design allows analyzing the differences in levels of accountability of health policies in each of the 17 autonomous communities. Finally, I analyze the causal conditions that can -or can not- lead to the accountability of this public policy.
Esta investigación es una contribución al análisis, la medición y la explicación de la rendición de cuentas de las políticas públicas. En primer lugar, desarrollo una propuesta para analizar y medir la rendición de cuentas de las políticas públicas. Esta propuesta es innovadora, ya que proporciona un marco analítico que puede ser utilizado para medir y comparar niveles de rendición de cuentas en diferentes áreas de políticas (por ejemplo, salud, educación, pensiones) y en diferentes contextos (por ejemplo, entre distintos países, regiones o gobiernos multinivel). En segundo lugar, pongo a prueba la validez de mi propuesta con una aplicación empírica centrada en la política de salud en España, cuyo diseño descentralizado permite analizar las diferencias en los niveles de rendición de cuentas de esta política en cada una de las diecisiete comunidades autónomas. Finalmente, analizo las variables que pueden favorecer o dificultar la rendición de cuentas de esta política pública.

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11

FARIA, ALESSANDRA MAIA TERRA DE. "PARTICIPATION AND REPRESENTATION: THE HEALTH PUBLIC POLICIES IN RIO DE JANEIRO". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2014. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=24958@1.

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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO
O estudo de caso selecionado sobre a participação na política municipal de saúde no Rio de Janeiro analisa o processo de institucionalização do Conselho Municipal (CMS) e dos Conselhos Distritais de Saúde (CODS), e sua regulamentação por iniciativas da Câmara Municipal (CM), tendo em vista os preceitos constitucionais de 1988 ao longo dos últimos 25 anos, com ênfase no período entre 2009 e 2013. Foi analisada a concomitante consolidação da Promotoria de Tutela Coletiva da Saúde da Capital do Rio de Janeiro, sua fundação, ampliação e funcionamento e enfatizadas as ações participativas recentes promovidas por setores do Ministério Público do Rio de Janeiro. A partir de análises comparativas, a pesquisa buscou situar a perspectiva própria da cidade. Considerada a dinâmica nacional, pontuou-se a lógica municipal, posta em fricção com a experiência distrital. A sistematização dos parâmetros legais das políticas públicas de saúde, o escrutínio das atas, impressão de observação participante nas Plenárias, audiências públicas, entrevistas e documentos de reuniões oitivas do Ministério Público contribuíram para a análise proposta. As reações da política carioca à perspectiva de municipalização anterior a 2008, a crise da saúde na cidade e as forças políticas resistentes foram problematizadas em perspectiva histórica. Destacaram-se enquanto pontos cruciais de dissenso político o novo modelo das OS ( Organizações Sociais) em processo de implantação pela prefeitura, e a proposta recente da Nova Empresa de Saúde da cidade – a RioSaúde.
The case study about the participation on the Rio de Janeiro Municipal health policies analyses both the process of institutionalization of the Conselho Municipal (CMS) and the Conselhos Distritais de Saúde (CODS) and their regulamentation by initiatives of the Câmara Municipal (CM), taking into consideration the constitutional principles of 1988 over the past 25 years, with emphasis on the period between 2009 and 2013. The concomitant consolidation of the Promotoria de Tutela Coletiva da Saúde da Capital do Rio de Janeiro is also analyzed, as well as its founding, growth and functioning, concentrating on the recent participative actions promoted by sectors of the Ministério Público of Rio de Janeiro. Based on comparative analyses, the research tried to point out the city s own perspective. Taking into consideration the national dynamic, the research contrasted the municipal logic with the district experience. The systematization of the legal framework of public health policies, meetings notes, participatory observation of meetings, public audiences, interviews and documents of the Hearing Sessions of Ministério Público were all used to construct the present analysis. Reactions of Rio de Janeiro s politics to the then possible municipalization prior to 2008, the health crisis in the city and the political forces that resisted were considered in a historical perspective. The crucial points of political dissent concentrated on the new model of OSes (Organizações Sociais) that were being implemented by the Prefeitura Municipal and the proposal of a new health office for the city called RioSaúde.

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12

Jeffs, Lynda Caron y n/a. "A culturally safe public health research framework". University of Otago. Christchurch School of Medicine & Health Sciences, 1999. http://adt.otago.ac.nz./public/adt-NZDU20070524.120343.

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The concept of cultural safety arose in Aotearoa me Te Waipounamu/New Zealand in the late 1980�s in response to the differential health experience and negative health outcomes of the first nation people of Aotearoa me Te Waipounamu/New Zealand, the New Zealand Maori. It was introduced and developed by Maori nurses initially, as they recognised the effect culture had on health and understood safety as a common nursing concept. The concept of cultural safety has developed into a disipline which is taught as part of all nursing and midwifery curricula in Aotearoa me Te Waipounamu/New Zealand. As cultural safety has developed the concept of culture has been extended to include people who differ from the nurse by reason of: age, migrant status, sexual preference, socioeconomic status, religious persuasion, gender, ethnicity, and in Aotearoa me Te Waipounamu/New Zealand, the Treaty of Waitangi status of the nurse and recipient/s of her/his care. Nationally and internationally, health experience and health outcomes are poorer for people of minority group status than for people who are part of the dominant group. Public-health research is therefore generally conducted on, or with, people with minority group status. Public-health researchers, by education, are members of the dominant culture and may be unaware that their own and their clients; responses may relate to one/other or both cultures being diminished do not always ensure the safety of their own culture or the culture being researched. This study�s objective was to develop a flexible, culturally safe public health research framework for researches to use when researching people who are culturally different from themselves. The study will argue that the use of such a framework will contribute significantly to improved health outcomes for people with minority status and will assist the movement towards emancipatory social change. The methods undertaken included: gaining permission from Irihapeti Ramsden, the architect of cultural safety to undertake the research, conducting a literature review, consideration of primary sources and their key concepts, consulting widely with people in the field of public health and cultural safety, self reflecting on the writers own personal and professional experience and finally designing the culturally safe public health research framework.

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Gaines, Alisha Beth Gropper Sareen Annora Stepnick. "Evaluation of Alabama public school wellness policies and state school mandate implementation". Auburn, Ala, 2008. http://repo.lib.auburn.edu/EtdRoot/2008/FALL/Nutrition_and_Food_Science/Thesis/Gaines_Alisha_46.pdf.

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Ngwa, Chenwi Mbuoko. "Investigating Funding Policies for New Clinics in Rural Northwest Region, Cameroon". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4540.

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Abstract Healthcare policies are complex health promotion strategies used by healthcare policy designers to create awareness, educate, and develop the capacity of sustainable health promotion practices in rural communities. The purpose of this phenomenological study was to investigate an occurrence being experience by rural residents in the NWR of Cameroon where residents lacked nearby healthcare clinics where they can seek medical treatment and to determine if there were any funding policy requirements for the construction of new rural community clinics at the NW Regional Delegation of Public Health. Using Wright's conceptual framework on policy analysis and evaluation and Coleman's rational action theory, data were collected through in-depth interviews from a sample of 10 participants composed of healthcare policy designers and rural community residents. The data were analyzed using Colaizzi's 7-step method for analyzing phenomenological data. Findings indicated that the lack of primary health care clinics in rural communities imposed five main challenges which limit access to rural healthcare: the non-availability of healthcare facilities in rural settings, inaccessibility to rural communities, the unaffordability of healthcare in rural communities and lack of healthcare insurance, unacceptability due to lack of health education and social stigma, as well as lack of accommodation for new clinics. Furthermore, the Minister of Public Health use existing healthcare funding policy requirements at the NW regional delegation to make final policy decisions. The results of this study may be used to create positive social change by establishing nonbiased health policy intervention strategies and will also help the Government of Cameroon to establish health promotion policy guidelines and policy adjustments that address the lack of clinics in rural NWR of Cameroon.

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15

Bekker, Marleen Petra Maria. "The politics of healthy policies redesigning health impact assessment to integrate health in public policy /". Delft : Rotterdam : Eburon ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10491.

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Carter, Mary Frances. "Beliefs, Costs, and Policies Influencing African American Men's Decisions on PSA Screening". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4605.

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Despite the growing concerns about routine prostate-specific antigen (PSA) screening in men, little is known about the societal and economic impact of screening among the African American population. The purpose of this qualitative case study was to explore beliefs among African American men about PSA screening, funding for screening, and the role of the United States Preventive Service Task Force in addressing the problem. Guided by rational choice theory, data collection consisted of completion of a health beliefs survey, face-to-face interviews, field notes taken during interview, and interview audio recording. The population for the study included African American men residing in a large metropolitan Midwestern city, who are between the ages of 45 and 65, and who have not been diagnosed with prostate cancer disease. Data were analyzed using NVivo10-© to identify themes and patterns. Results from the study show that the decision to participate in prostate screening for African American men is hindered due to concerns about access, cost, and affordability. These three factors should be further evaluated in a larger setting for a greater understanding of their roles in more effective screening programs and policies. Insights gained from this study may positively impact future policy by providing a deeper understanding of the beliefs held by African American men on the issue of prostate cancer screening that may eventually lead to developing and successfully implementing policies that can be cost effective.

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17

Parter, Carmen. "Decolonising public health policies: Rightfully giving effect to Aboriginal and Torres Strait Islander peoples’ knowledges and cultures of ways of being, knowing and doing in public health policies". Thesis, University of Sydney, 2021. https://hdl.handle.net/2123/24415.

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This thesis details how the current health system consistently fails to incorporate Indigenous ways of knowing, being and doing. Using the Intervention Level Framework and the 3Es (enact, embed, and enable), the thesis demonstrates the ongoing coloniality and systemic racism of Indigenous public health policymaking and health systems in Australia. The research cogently demonstrates the need for greater self-determination and control of Indigenous affairs by Indigenous people, the necessity of privileging Indigenous voices, and Indigenous control, direction, and co-design a public policy-making, and the requirement to disrupt, deconstruct and decolonise Western knowledges and cultures of ways of being knowing and doing in order to move beyond colonial imperialist traumatic approaches to Indigenous public health policy which continue to this day. The research provides identifiable and concrete leverage points in the system which can be used to transform those racialized rules and norms to achieve sustainable transformational systemic, organisational and individual change such as legislation, statutory bodies and government commitments underpinned by the need to overcome deep-seated resistance to changing status quo mindsets and beliefs in order to address Indigenous oppression and disadvantage and implement Indigenous culture once it has been incorporated into a public policy. The findings fundamentally call for a turning away from white possessive logics and willingness to deeply listen with an open heart and open mind in genuine partnership with Aboriginal and Torres Strait Islander people so as to decolonise and Indigenise health systems and policy-making, including non-Indigenous people and governments being held to account and relinquishing power and control over Indigenous affairs in favour of localised place-based community-led approaches based on relatedness, connectivity, respect, reciprocity, reverence and responsibility.

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18

Nkwam, Florence Ejogha. "British medical and health policies in West Africa, c1920-1960". Thesis, SOAS, University of London, 1988. http://eprints.soas.ac.uk/28628/.

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This thesis deals with the parts played by the Colonial Office and colonial governments in providing medical and health services in British West Africa. The themes addressed are: the provision of medical and health services; the organization of Colonial medical research; and the recruitment of medical officers. The inter-war period saw the development of a number of medical institutions established in government centres by the various colonial administrations. The provision of health care facilities in the rural areas was the responsibility of local authorities. During world war two, the Colonial Advisory Medical Committee produced for the first time a statement of policy on medicine and health for the Colonial Empire. This emphasised not only the provision of curative facilities but also the provision of preventive health care services. Apart from the provision of medical and health facilities, efforts were also made to stimulate interest in medical research. Medical research in British West Africa before WWII was carried out as part of the routine duties of Colonial Medical Departments. However, the Colonial Medical Research Committee, set up in 1945 by the Colonial Office, was to exert considerable influence on research policy in the region. The committee, which was dominated by the Medical Research Council favoured fundamental research. However, fundamental research was considered not relevant to the immediate needs of colonial peoples. Instead, there was established a medical research organization, with emphasis on applied research and the investigation of the most prevalent diseases in West Africa. Meanwhile, between the wars, the Colonial Office tackled the problem of recruiting medical officers by creating the post of Chief Medical Adviser and by the amalgamation of the colonial medical services (CMS). Upto the outbreak of the war, however, the Office was still unable to meet the personnel requirements for the CMS. This problem was further aggravated with the creation in 1940, of the National Health Service. The end of WWII also saw an increase in international cooperation. United Nations specialised agencies such as the World Health Organization began to take an active interest in the health problems of African peoples.

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19

Elhardt, Michael C. "Progressive Drug Policies and the Impacts of Supply-Side Control". Scholarship @ Claremont, 2015. http://scholarship.claremont.edu/cmc_theses/1103.

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For over a century the international community has widely accepted a policy of universal drug prohibition. However, an increasing number of countries have been willing to experiment with progressive drug policies as the shortcomings of strict prohibition become more clear. This thesis is a study of the structures of drug laws in four countries – the Netherlands, Portugal, the United States, and Mexico – and their economic, public health, and human rights outcomes. The policies range in restrictiveness from the decriminalization of all drugs in Portugal to complete criminalization in Mexico. This thesis focuses on cannabis and heroin, two drugs which differ markedly in their risk for addiction and acute harm. A wide range of sources in the drug policy literature was analyzed. Evidence suggests that progressive policies in Portugal and the Netherlands have not significantly increased drug use and have led to numerous favorable public health outcomes. States in America that have legalized marijuana face many legal and economic challenges, and they should be observed closely as their policies develop further. Strict supply-control enforcement in Mexico has, on the other hand, led to an extreme upsurge in violent crime. These results suggest that in the future policymakers should drastically reallocate resources from ineffective supply-side strategies and pursue proven policies centered on public health and the protection of human rights.

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20

Lubold, Amanda Marie. "Family Policies and Public Health Initiatives: A Comparative Analysis of Breastfeeding Outcomes". Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/333485.

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Breastfeeding rates vary considerably among high-income countries who are members of the Organization for Economic Co-operation and Development (OECD). In the 1960's, breastfeeding outcomes, both initiation of breastfeeding and breastfeeding duration, were at an all-time low. Over the past half century, breastfeeding outcomes have increased among all OECD countries, but at very different rates. This dissertation examines both the policy-level and public health-level initiatives that have affected the differential growth of breastfeeding rates among 18 high-income, OECD countries. Using a combination of multiple regression, fuzzy-set qualitative comparative analysis, and small-n methods, I find that countries in the broad Scandinavian welfare regime have combined policy support for women's reproductive and productive labor, along with a strong female representation in government to facilitate positive breastfeeding outcomes. I find that countries who have a strong commitment to the World Health Organization's Baby-Friendly Hospital Initiative have higher breastfeeding initiation rates than countries who do not have a high percentage of hospitals following the WHO protocol. This dissertation adds to the broader understanding of how welfare state policies and public health initiatives operate in tandem to support positive breastfeeding outcomes among high-income countries.

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O'Meara, Sandra C. "Potential Factors of Influence on Local Wellness Policies of Georgia Public School Systems". Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/iph_theses/33.

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Background: This study analyzes local wellness policies of 176 Georgia public school systems. The purpose of the study was to analyze potential relationships between demographic characteristics of Georgia school systems and compliance with the Child Nutrition and WIC Reauthorization Act of 2004, as well as the strength of wellness policy goals in the areas of nutrition, physical activity, and other school-based activities. Methods: Demographic data from the Georgia Department of Education were used as independent variables. Compliance ratings and the strength of wellness policy goals were derived from an evaluation tool developed by a research team at Georgia State University’s Institute of Public Health as part of a project contracted by the Georgia Department of Education. Analysis was conducted using Pearson’s correlation (two-tailed), crosstabulation, and linear regression. Results: Statistically significant positive associations were found between academic performance and strength of overall wellness policy goals (p < .05), as well as goals in the areas of nutrition education and other school-based activities (p < .01). Economic status of the student population was found to be positively associated with the strength of nutrition education goals (p < .05). No statistically significant associations were identified between demographic characteristics of school systems and physical activity goals. No associations were identified between involving community stakeholders in wellness policy development and having more comprehensive wellness policy goals. Conclusions: This study found statistically significant evidence of districts with stronger academic performance having more comprehensive overall wellness policy goals and stronger goals specifically in the areas of nutrition education and other school-based activities goals. Findings should assist the Georgia Department of Education in allocating its limited resources to help school systems improve wellness in public schools throughout Georgia. Recommendations are made to strengthen federal and state policy regarding school wellness, to conduct more research regarding the influence of community involvement on school wellness, and to provide guidance to local school systems having less resources and lower student academic performance in order to ensure health disparities are not further exacerbated.

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22

Quann-Youlden, Cathy y n/a. "Commonwealth Higher Education Policies: Their Impacts on Autonomy and Research in Australian Universities". University of Canberra. Business & Government, 2008. http://erl.canberra.edu.au./public/adt-AUC20081202.151704.

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In recent years, the Australian Government's (Commonwealth) relationship to universities has become one of greater involvement as political circles recognise the escalation in the significance of higher education as a key determinant in Australia's economic, social, cultural, and intellectual development. The increasing role of the Commonwealth in Australian universities is largely a consequence of this recognition, but it is also due in part to changes in the way governments approach the public sector and publicly funded institutions. Both the literature and extensive Commonwealth reports provide an array of details in relation to: what the Commonwealth wants from its universities; why it wants it; what it is doing to ensure that it gets what it wants; and the results of its actions-at least from the perspective of the Commonwealth. But what is missing is how universities themselves perceive the impact of the Commonwealth's increasing involvement in universities. Although academics and managers in Australian universities have much to say about how current and proposed Commonwealth policies affect their working environment they are not given much of a venue to opine. As such there is a lack of literature on how universities perceive the impact of this increasing involvement. This dissertation aims to fill the gap by providing a forum that addresses universities' perceptions of how Commonwealth policies affect their universities. Specifically, this dissertation sets out to discover if and how Commonwealth policies change universities and focuses on how policies influence autonomy and research in Australian universities through the responses of those who work in the offices of the deputy vice chancellors of research in twelve Australian universities. One of the most significant findings of the thesis is that the Commonwealth's increasing involvement in universities is viewed by respondents as a consequence of the Commonwealth's mistrust of Australian universities. Furthermore, the Commonwealth is seen as lacking expertise in areas relating to universities-their needs, history, purpose, mission, and how they best relate to and contribute to society-and their need for autonomy. This dissertation offers some insights into perspectives whereby policies built on the Commonwealth's mistrust and lack of expertise in university matters negatively influence autonomy and research productivity in Australian universities. The results indicate decreased productivity which leads to further mistrust that appears to decrease productivity even morea cycle that respondents fear might be a self-propelling downward spiral. Eight hypotheses and one overarching proposition emerge from the findings. In addition, nine areas are identified as adding to the overall understanding of the affect that Commonwealth policies have on university autonomy and research productivity in Australian universities.

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23

Chitondo, Pepukayi David Junior. "Data policies for big health data and personal health data". Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2479.

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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.
Health information policies are constantly becoming a key feature in directing information usage in healthcare. After the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 and the Affordable Care Act (ACA) passed in 2010, in the United States, there has been an increase in health systems innovations. Coupling this health systems hype is the current buzz concept in Information Technology, „Big data‟. The prospects of big data are full of potential, even more so in the healthcare field where the accuracy of data is life critical. How big health data can be used to achieve improved health is now the goal of the current health informatics practitioner. Even more exciting is the amount of health data being generated by patients via personal handheld devices and other forms of technology that exclude the healthcare practitioner. This patient-generated data is also known as Personal Health Records, PHR. To achieve meaningful use of PHRs and healthcare data in general through big data, a couple of hurdles have to be overcome. First and foremost is the issue of privacy and confidentiality of the patients whose data is in concern. Secondly is the perceived trustworthiness of PHRs by healthcare practitioners. Other issues to take into context are data rights and ownership, data suppression, IP protection, data anonymisation and reidentification, information flow and regulations as well as consent biases. This study sought to understand the role of data policies in the process of data utilisation in the healthcare sector with added interest on PHRs utilisation as part of big health data.

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24

Watts, Christina. "Tobacco industry interference in supply-side policies in Australia". Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/24682.

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Tobacco smoking rates in Australia are at a historic low, largely due to decades of tobacco control policy reforms aimed at reducing consumer demand for tobacco products. However, while some conditions have been placed on the sale of tobacco, such measures are not explicitly aimed at reducing the supply of tobacco products by restricting their sale. Tobacco therefore remains one of the most widely available consumer goods on the market in Australia, which contributes to a perception that tobacco is a normal part of everyday life. The widespread retail availability of tobacco in Australia undermines smokers quit attempts and increase impulse purchases, which ultimately increases tobacco consumption. Regulating the supply of tobacco in Australia is an essential next step to achieving future reductions in smoking prevalence. However at present, the lack of regulation on the “supply-side” of tobacco control presents opportunities for the tobacco industry to exploit loopholes, undermine tobacco control policies and exert its power and influence. Tobacco companies and tobacco retailers both play a unique and interrelated role in the sale of tobacco in Australia and it is critical that research exploring supply-side tobacco control policies investigates the motivations and activities of both tobacco companies and retailers, and how they work together. This is particularly paramount in light of the tobacco industry’s increasing attempts to reframe its corporate image alongside efforts to undermine and influence the public health policy landscape. This body of work will establish an understanding of attitudes, beliefs and experiences of retailers in regards to selling tobacco and uncover the ways in which tobacco companies manage relationships with retailers to covertly market their products to maximise profitability. It will also investigate the tobacco industry’s tactics to interfere with and influence policy through a corporate social responsibility agenda and explore the implications of this on tobacco retail reform in the future.

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25

Hameed, Shaffa. "Sexual health policies and youth : a case study of the Maldives". Thesis, London School of Economics and Political Science (University of London), 2012. http://etheses.lse.ac.uk/731/.

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This research examines sexual health (SH) policies and experiences of youth, using the Maldives as a case study. Youth SH is a controversial and under-researched issue in The Maldives, an Islamic state where premarital sexual activity is a punishable offence. This thesis addresses the question: To what extent, and why is there a mismatch between official Maldivian SH policies, services and data and the lived experiences of youth in Maldives? It is a mixed methods study involving four research methods and sets of data: i) qualitative in-depth interviews (n=61) with youth aged 18-24 years from three sites within the Maldives; ii) key informant interviews (n=17) with policy actors and service providers; iii) a web-based quantitative survey of Maldivian youth (n=480); and iv) secondary analysis of the Maldives DHS 2009. There are four main findings from this research, three of which are substantive, and one of which is methodological. Sociocultural and religious factors heavily influenced policymaking, service provision and youth experiences. Contrary to most theocratic states, the SH policymaking process in the Maldives is shaped by policy actors and institutions whose strengths have more sociocultural basis than religious expertise. Whilst published official data and original secondary analyses of the MDHS suggest that premarital sexual activity among youth is very limited; this thesis finds extensive reporting of sexual activity. This contrast was also reflected in youth’s knowledge of STIs- where official data displayed a higher level of awareness than found through in-depth interviews and the web-based survey- and their experience of unwanted pregnancies and abortions, which appear to be under-reported in official data. Analyses of the web-based survey using the same questions as the DHS show significantly higher levels of reporting of sexual activity, showing a strong modality effect on survey response. Results from the web-based survey demonstrated that if sociocultural factors were removed from questionnaire design (e.g. censorship of certain issues) and administration (e.g., privacy and anonymity- difficult to achieve in small island communities typical of the Maldives); it is possible to improve response rates and quality of the data. Finally, this thesis highlights two key characteristics of the relationship between SH policy, services, data and youth experiences in the Maldives. Firstly, youth SH experiences appear to be disconnected from SH policies, services and data. Secondly, there is a mutually reinforcing relationship between official SH data and policies, where restrictive policies dictate the type and extent of data that may be collected, which then reinforce justifications for the current restrictive policies and limited services. Policy implications of this research include identifying and addressing the links between SH policymaking and religious and sociocultural factors, and addressing the subsequent effect on SH policy and services for youth.

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Quann-Youlden, Cathy. "Commonwealth higher education policies : their impacts on autonomy and research in Australian universities /". Canberra, 2006. http://erl.canberra.edu.au/public/adt-AUC20081202.151704/index.html.

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Sparrow, Shelagh. "Research in uncertainty : issues relating to power and quality arising out of an action research study with nurses from an inner London health authority". Thesis, University of Nottingham, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263101.

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Chrisinger, Laura. "Policies and practices associated with medication administration in Ohio public elementary schools". Connect to this title online, 2004. http://hdl.handle.net/1811/180.

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Thesis (Honors)--Ohio State University, 2004.
Title from first page of PDF file. Document formatted into pages; contains 24 p.; also includes graphics (some col.). Available online via Ohio State University's Knowledge Bank. Includes bibliographical references (p. 20-21). Available online via Ohio State University's Knowledge Bank.

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Bonakdar, Tehrani Ali. "Federal Policies and Prescription Drugs". VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4144.

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This dissertation comprises three discrete empirical papers, with an introductory essay that evaluates the impact of different federal policies on prescription drug prices, utilization, and spending. Two main databases are used: (a) Medicaid State Drug Utilization Data and (b) the Medical Expenditure Panel Survey (MEPS) data. These two databases are designed to track Medicaid drug utilization and overall medical use and expenditures, respectively. The variables of interest in this dissertation are prescription drug price, prescription drug use and spending, and overall drug expenditures. The objective of the first paper (Chapter 2) is to examine whether oncology drug prices have significantly changed because the Medicaid rebate increased under the Patient Protection and Affordable Care Act (ACA). The analytic sample includes top-selling oncology drugs, both branded and generic, over an 8-year time period. The prices of top-selling oncology drugs in 2006 were followed through 2013 to find the extent to which drug prices have changed while controlling for state fixed-effect, package size, type of manufacturer, brand or generic, and drug strength. Thus, this study examines whether and to what extent oncology drug prices have changed after the increase in the Medicaid rebate under the ACA. The second paper’s objective (Chapter 3) is to study whether Medicare Part D has reduced racial disparities in diabetes drug use, coverage, and spending since its implementation in 2006. The analytic sample includes individuals aged 55 years and older who had diabetes from 2001 to 2010. Although the impact of Medicare Part D has been studied from different perspectives, its impact on racial disparities in drug use, coverage, and expenditures among diabetics has not been studied yet. The third paper (Chapter 4) focuses on the association between closing the Medicare doughnut hole and prescription drug utilization and spending for Medicare Part D beneficiaries with chronic diseases through 2013. The objective of the third paper is to determine whether the provisions of the ACA that close the coverage gap have affected prescription drug utilization and out-of-pocket (OOP) spending among Medicare seniors with Part D coverage.

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30

Linde, Anders. "Evaluative study of Tanzania’s public policies : Special focus on Education, Health and the Environment". Thesis, Linnéuniversitetet, Institutionen för samhällsstudier (SS), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-38379.

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31

Khalil, Basem A. "Modern insights into the policies affecting public health in the Islamic Caliphate (622CE – 1258CE)". Thesis, University of Gloucestershire, 2016. http://eprints.glos.ac.uk/6153/.

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Background/aim: In the Western world, the emergence of historical research on the effects of the social determinants of health has provided the discipline of public health with new insight into this aspect of population health complementing the more traditional focus on the history of medicine. The Islamic Caliphate was a dominant power in its time and little is known about its public health history. This thesis aims to provide a chronologically historical account of the policies taken in this period and analyse them in the light of modern theories of public health. Materials and Methods: This thesis employed a qualitative research technique. Known primary and secondary historical sources were examined and data translated and presented in a chronological order. Modern historical sources analysing the historical accounts of that era were also used. Policies affecting health were retrieved and analysed using modern day research into the same policies. Results: The analysis has resulted in a revisionist argument that policies affecting public health in a positive way did exist in a sophisticated manner in the Islamic Caliphate albeit in an inconsistent manner. The study complements the works of medical historians who identified a “Golden Age” in the later era of the Caliphate with advancements in medical science with a potential “Golden Age” in the early era related to the social determinants of health. Conclusion: This thesis provides for the first time a chronological study of policies affecting public health in an era of public health history that has not been studied before. In addition it provides for the first time a modern analysis of these policies.

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32

Zardini, Agnese. "Modeling the transmission of viral diseases: understanding hidden processes to inform public health policies". Doctoral thesis, Università degli studi di Trento, 2021. http://hdl.handle.net/11572/313656.

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The diffusion of viral diseases may critically depend on hidden processes, like human mobility, people’s behavior, or underlying environmental conditions. The thesis focuses on the investigation of those variables that remain partially unobserved but that could strongly influence the spread of infectious diseases. First, an innovative method is introduced to estimate the overall abundance of mosquitoes over time across all sites of interest in Europe and the Americas, on the basis of only freely available eco-climatic data. The model, calibrated against a large set of entomological data, is used to highlight which mosquito species could contribute to the disease transmission across different regions and identify the areas at higher risk of autochthonous transmission of dengue, chikungunya, and zika fever. A similar approach is also discussed to investigate the potential burden of Usutu virus (USUV) in the northeast of Italy. The conducted analysis estimates the potential USUV prevalence expected among Culex pipiens mosquitoes and human blood donors. The second part of the thesis focuses on the study of the global pandemic of COVID-19. Results obtained with an epidemiological model based on novel age-specific contact data, collected across different geographical contexts of Ethiopia is presented. The analysis aims at assessing how socio-demographic factors and observed mixing patterns can impact the burden of COVID-19 in the scenario of an unmitigated SARS-CoV-2 epidemic and under a school closure mandate. Finally, an epidemiological analysis of individual COVID-19 records collected during the first epidemic wave in the Lombardy region (Italy) is presented. Leveraging an unbiased sample of infections, the performed analysis quantifies all the main parameters related to the natural and healthcare burden caused by the natural history of SARS-CoV-2. Estimates provided are essential for modeling activities aimed at investigating the disease spread or projecting the impact of alternative public measures on the disease and healthcare burden.

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33

Zardini, Agnese. "Modeling the transmission of viral diseases: understanding hidden processes to inform public health policies". Doctoral thesis, Università degli studi di Trento, 2021. http://hdl.handle.net/11572/313656.

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The diffusion of viral diseases may critically depend on hidden processes, like human mobility, people’s behavior, or underlying environmental conditions. The thesis focuses on the investigation of those variables that remain partially unobserved but that could strongly influence the spread of infectious diseases. First, an innovative method is introduced to estimate the overall abundance of mosquitoes over time across all sites of interest in Europe and the Americas, on the basis of only freely available eco-climatic data. The model, calibrated against a large set of entomological data, is used to highlight which mosquito species could contribute to the disease transmission across different regions and identify the areas at higher risk of autochthonous transmission of dengue, chikungunya, and zika fever. A similar approach is also discussed to investigate the potential burden of Usutu virus (USUV) in the northeast of Italy. The conducted analysis estimates the potential USUV prevalence expected among Culex pipiens mosquitoes and human blood donors. The second part of the thesis focuses on the study of the global pandemic of COVID-19. Results obtained with an epidemiological model based on novel age-specific contact data, collected across different geographical contexts of Ethiopia is presented. The analysis aims at assessing how socio-demographic factors and observed mixing patterns can impact the burden of COVID-19 in the scenario of an unmitigated SARS-CoV-2 epidemic and under a school closure mandate. Finally, an epidemiological analysis of individual COVID-19 records collected during the first epidemic wave in the Lombardy region (Italy) is presented. Leveraging an unbiased sample of infections, the performed analysis quantifies all the main parameters related to the natural and healthcare burden caused by the natural history of SARS-CoV-2. Estimates provided are essential for modeling activities aimed at investigating the disease spread or projecting the impact of alternative public measures on the disease and healthcare burden.

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34

Nilson, C. Bradley (Charles Bradley) 1969. "Technological innovations and public research & development policies : a case study of the photovoltaic industry". Thesis, Massachusetts Institute of Technology, 1998. http://hdl.handle.net/1721.1/69398.

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35

Sherry, Tisamarie Bose. "Maternal Health and Child Development Programs in the United States and Rwanda: An Evaluation of Policies to Improve Quality and Efficiency". Thesis, Harvard University, 2012. http://dissertations.umi.com/gsas.harvard:10657.

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This dissertation evaluates national programs in the United States and Rwanda that aim to strengthen maternal care and promote healthy child development, which remain significantly policy challenges globally. Chapter one analyzes the impact of Rwanda’s national pay-for-performance (P4P) program on rewarded maternal and child health services, multitasking and health outcomes. In a difference-in-differences analysis using the Rwanda Demographic and Health Surveys, we find that P4P significantly increased the output of several rewarded maternal health services, but had no significant impact on other rewarded services or health outcomes. There was little evidence of multitasking. We also find mixed effects of P4P by baseline facility quality. Our results highlight the opportunities and challenges in implementing P4P in resource-limited settings. Chapters two and three examine Head Start, the largest federally funded child development program in the US. In chapter two, using experimental data from the Head Start Impact Study (HSIS) I compare the effects of Head Start on child development relative to two distinct groups: children who received home care, and children who attended other non-Head Start centers. Relative to home care, I find that Head Start achieves larger gains across a range of developmental outcomes; relative to other centers, Head Start’s impacts are smaller and restricted to improved behavior and access to health care. Compared to either group, gains from Head Start largely dissipate within one year of leaving the program. These findings suggest that Head Start enhances child development in the short-term, particularly in comparison to home care – but also raise questions about longer-term impacts. Chapter three examines efficiency and equity trade-offs of targeting strategies that seek to increase Head Start’s average impact by prioritizing enrollment of children with larger expected treatment effects. I identify child and family characteristics that predict variations in Head Start’s impacts in the HSIS data, construct targeting strategies based on these characteristics, and simulate their effects on cumulative program impacts and equity measures. I find that prioritizing enrollment of 4 year-olds otherwise likely to receive home care achieves the largest efficiency gains, but increases racial disparities in access to Head Start. Further prioritizing the enrollment of children from the most disadvantaged households, however, can eliminate these disparities while maintaining efficiency gains.

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36

Sparer, Emily Helen. "Improving Health and Safety in Construction: The Intersection of Programs and Policies, Work Organization, and Safety Climate". Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:16121136.

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Statement of Problem: Despite significant advancements in occupational health and safety in recent decades, injury rates in commercial construction remain high. New programs that address the complexity of the construction work environment are needed to keep workers healthy and safe. Methods: The first step of this dissertation was to explore associations between organizational programs and policies, as measured by a Contractor Safety Assessment Program (CSAP) score, and worker safety climate scores. Next, a safety communication and recognition program was developed and piloted. It was evaluated through a mixed methods approach in a randomized controlled trial. Primary outcome measures included safety climate, awareness, communication, and teambuilding. Additionally, the dynamic nature of the construction site was quantified through an analysis of the determinants of length of stay of construction workers on the worksite. Results: Correlations between CSAP scores and safety climate scores were weak at best, thus highlighting a gap in communication between management and workers. The B-SAFE program, a safety communication and recognition program was developed to meet this gap. It used data from safety inspection scores to provide feedback to workers on hazards and controls, and provided a reward when the site met a pre-determined safety inspection threshold (a measure that was fair, consistent, attainable and fair). In the final program design, the whole site was treated as the unit of analysis. B-SAFE led to many positive changes, including a statistically significant increase in safety climate scores of 2.29 points (p-value=0.012), when adjusting for time-varying parameters and worker characteristics. Workers at the B-SAFE sites noted increased levels of safety awareness, communication, and teamwork, when compared to control sites. The composition of workers on-site at any given month changed by approximately 50%, and the length of stay on-site was associated with race/ethnicity, union status, title, trade, and musculoskeletal pain (p-values<0.05). Conclusions: The construction work environment is dynamic, with over half of the population on-site changing each month. This makes applying and evaluating traditional worksite based interventions challenging. Interventions like B-SAFE that are developed to address the complexities can have a positive impact on site safety measures.
Environmental Health

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37

Hartzell, Michele Spurgeon. "Obesity challenges and benefits of implementing local wellness policies in Georgia public schools /". Click here to access dissertation, 2008. http://www.georgiasouthern.edu/etd/archive/spring2008/michele_s_hartzell/hartzell_michele_s_200801_EDD.pdf.

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Thesis (Ed.D.)--Georgia Southern University, 2008.
"A dissertation submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Doctor of Education." Under the direction of Charles A. Reavis. ETD. Electronic version approved: May 2008. Includes bibliographical references (p. 109-113) and appendices.

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38

Schneider, Michelle. "The setting of health research priorities in South Africa". Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/26613.

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The health and development of a nation are linked. Health research is a vital element helps bring about improved health and has the potential to serve as an impetus for equitable development. Generally, it is necessary to prioritise needs in order to optimise the use of scarce resources for development. The overall aim of this thesis is an analysis of the setting of health research priorities, with specific reference to South Africa. Other objectives include describing the technical approaches used for priority setting and developing a suitable framework for analysing and classifying health research. Two other objectives concern measurement for priority setting: Specifically, how burden of disease quantification fits into the process of priority setting and a thorough critique of the Disability Adjusted Life Expectancy (DALY). Another objective was to examine priority setting and Essential National Health Research (ENHR) in the South African context. A further important objective is the development of a framework for guiding the analysis of health research priorities. This framework is part of model for health research priority setting that incorporates ENHR strategy and burden of disease methodology. The methods used ranged from an extensive literature review to statistical analysis. The literature review included grey literature and draws on multiple disciplines such as economics, public health policy and economics.

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39

McCants, Zauditu Esther. "A study of whether African American students in the Atlanta university Center schools were knowledgeable of public health policies and programs concerning abused and neglected children". DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2009. http://digitalcommons.auctr.edu/dissertations/68.

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This study analyzed whether African American students in the Atlanta University Center schools were knowledgeable about public health policies and programs concerning abused and neglected children. Two hundred and one (201) participants were selected utilizing convenience sampling. The study surveyed males and females of which 91% were African American students. A survey questionnaire was utilized to collect data. The findings of the study indicated that a majority or 57.2% of the students were not knowledgeable about public health policies for abused and neglected children. However, a majority of the students indicated that they were knowledgeable about public health problems and programs for this population. A majority or 84.1% indicated that they were not abused and neglected as children, but a significant percentage or 15.9% indicated that they were abused and neglected. When the chi square test for significance was applied, the null hypothesis was accepted indicating that there was no statistically significant evidence at the .05 level of probability that the students were abused and neglected when they were children.

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40

Harrison, Mark. "Public health and medical research in India, c.1860-1914". Thesis, University of Oxford, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.315793.

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41

Burchett, Helen. "Perceptions of the usefulness of public health research in Ghana". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2010. http://researchonline.lshtm.ac.uk/682424/.

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This study aimed to explore researchers' and policy stakeholders' perceptions of the usefulness of public health research for policy, using the example of maternal health in Ghana. Sixty-nine government decisionmakers, maternal health policy stakeholders and researchers were interviewed. Concepts of research were broad. Research was dichotomised into `big', formal research and 'small', applied research such as operations research. 'Small research' was highly valued, due to its speedy completion and its focus on topics pertinent to service delivery; big research was not always considered necessary. Effectiveness research, one type of `big research', was not highly valued. Interviewees tended to feel that 'effective' policies and programmes could be designed once there was a thorough understanding of the situation. There was an implicit assumption that as long as these interventions were implemented well, they would be effective. Six dimensionso f local applicability/transferabilitwye re identified.T he most influential factors were the ease with which the intervention could be implemented, the study's congruence with interviewees' previous experiences and the perceived need for the intervention. Little attention was paid to study findings. Judgements of an intervention's potential effectiveness tended to be based on the ease of implementation or knowledge of similar projects. Adaptation was considered to be crucial, although often conceptualised not as a factor within local applicability/transferability assessments, but rather a distinct, essential step in the research use process. This study suggests that the factors of local applicability/transferability frequently cited in the literature do not reflect those considered to be most important by stakeholders in Ghana.

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42

Polaha, Jodi y C. Studts. "Tidings from TIDIRH: Dissemination and Implementation Research in Public Health". Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6675.

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43

Hayes, Ann M. 1964. "Health care workers infected with the human immunodeficiency virus : an ethical analysis of U.S. and Canadian government and professional policies". Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23893.

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On July 27th, 1990, the U.S. Centers for Disease Control reported that a Florida dentist had transmitted the human immunodeficiency virus (HIV) to five of his patients. These incidents raised many, previously unaddressed, questions regarding the ethical obligations of the HIV-infected health care worker (HCW), as well as the ethical responses to this difficult situation by patients and society.
This paper attempts to address these questions from an ethical viewpoint examining risk of harm and the individual duties of the HCW, the patient and society as well as through analysis of policies regarding HIV-infected HCWs. These policies were written by the federal U.S. and Canadian governments as well as state and provincial health departments and registrars of medical associations in the U.S. and Canada.
The policies were analyzed for five categories of requirements or recommendations with respect to: (1) notification of government and professional organizations or health care institutions and notification of patients of the HCW's HIV status, (2) mandatory HIV testing of HCWs, (3) work restriction for the HCW, (4) retrospective notification of the patient, and (5) monitoring compliance with the policy.
It was found that, in their practical interpretation, the policies left room for a wide spectrum of interpretation possibly due to poorly defined risk of individual invasive procedures. This indicates the need to accurately determine the risks of HIV transmission, from HCW to patient, during specific medical interventions.
It was concluded that certain policies, such as Health and Welfare Canada's Laboratory Centre for Disease Control (LCDC), policy and New York State Department of Health's policy allow enough flexibility to minimize risks of harm as well as to provide the possibility of a balance of the interests of all involved. (Abstract shortened by UMI.)

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44

Sofia, Gustina y n/a. "Information needs of health researchers at the National Institute of Health Research and Development, Ministry of Health, Indonesia". University of Canberra. Information, Language & Culture, 1992. http://erl.canberra.edu.au./public/adt-AUC20061109.083237.

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The present study attempted to investigate the information needs/information seeking behaviour of health researchers at the National Institute of Health Research and Development, Ministry of Health, Indonesia. Its objective was to identify the relationship between information needs/information seeking behaviour and the characteristics of those health professionals. Those characteristics include institution to which health professionals belonged, institution geographic location, level of appointment, level of education, and work experience. Research was carried out through survey by using a questionnaire. This survey obtained a response rate of 92 percent from a sample of 131 health professionals. Their information needs/information seeking behaviour were correlated with their characteristics to determine relationships, and the Statistical Package for the Social Sciences (SPSS) was used to analyse the data. Frequency distribution, chi-square analysis, and descriptive analysis were used to obtain the results. The study found that the health information available did not match the health professionals' needs and that there was strong demand by these personnel for automated information services. It also found that total hours reading per week was significantly related to level of appointment, level of education, and work experience at other institutions. The perceived usefulness of journals as information sources was significantly related to institution, geographic location, level of appointment, level of education and work experience at other institutions. Government publications and statistical data as a source of information were found to be related significantly to institution and geographic location. There was also a relationship between the perceived value of reference books and work experience at the current institution. The usefulness of library catalogues as a guide to information was found to be related significantly to institution and geographic location, as was the usefulness of abstracting and indexing services to level of education. Frequency of visiting libraries was significantly related to institution, geographic location and level of appointment. The membership of professional organizations and obtaining useful information from friends, colleagues or personal contact were found to be significantly related to level of education. The study concludes with recommendations and suggestions for further research.

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45

McGinley, Susan. "Insect Hormones and Anti-Hormones: Protecting Plants and Public Health". College of Agriculture and Life Sciences, University of Arizona (Tucson, AZ), 1995. http://hdl.handle.net/10150/622378.

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46

Milani, Natalie. "An Examination of Local Wellness Policies as Predictors of Student Obesity and Diabetes in School-Age Children". Thesis, Northcentral University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10092280.

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The problem addressed in this study was a decade after the Child Nutrition and WIC Reauthorization Act mandated implementation of school-based local wellness policies, the prevalence of childhood obesity and incidence of diet-related chronic diseases including Type 1 and Type 2 diabetes had not shown significant coinciding reductions. The purpose of this quantitative study utilizing a correlational research design examined hypothetical directional relationships between comprehensive federal mandate content and strong language that was specific and directive in local wellness policies, and the prevalence of obesity and incidence of diabetes in school-age children through the diffusion of innovation theoretical framework. Stratified, random sampling of obesity and diabetes data for school-age children grades K–12 represented outcome variables. Purposive sampling of local wellness policies was utilized to obtain the comprehensiveness and the language strength scores for the implementation, evaluation, and communication components of policies, which then represented predictor variables. The research method employed a secondary analysis of the outcome variables, collected by the Pennsylvania Department of Health for the academic year 2012–2013 utilizing hierarchical linear modeling. Higher content comprehensiveness scores reflected lower prevalence of obesity in K–6^th grade (t(40) = -3.03, β = -4704.86, p = .004) and 7^th–12^th grade, (t(39) = -2.65, β = -3893.79, p = .012); likewise, a lower incidence of Type 1 diabetes, (t(40) = -3.39, β = -250.58, p = .002), for K–12^th grade. The mean language strength score of 20% was consistent with previously reported outcomes; however, a predictive relationship between the prevalence of obesity and language strength scores was inconsistent with the hypothesized correlational relationship expressed in previous studies. Comparative score evaluations suggest that language strength scores did not necessarily hinder communication channels for the diffusion of an innovation, such as local wellness policies and the implementation of federally-mandated content that is comprehensive. Further discernment is necessary to avert the premature deaths associated with childhood obesity and, simultaneously, the correlated epidemics of obesity and diabetes.

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47

Raval-Nelson, Palak Brulle Robert J. "An evaluation of the role of conventional and alternative discourses on breast cancer research funding policies /". Philadelphia, Pa. : Drexel University, 2008. http://hdl.handle.net/1860/2817.

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48

Collins, Patricia A. "A study of the services, materials and policies provided for homeschooling families by New Jersey public libraries /". Full text available online, 2005. http://www.lib.rowan.edu/home/research/articles/rowan_theses.

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49

Hood, Nancy Elizabeth. "Smoke-free policies in subsidized housing". The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337089587.

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50

Komporozos-Athanasiou, Aris. "Policies of representation in hybrid space : the case of patient and public involvement". Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648199.

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