Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Shiver A[original query] |
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Benefits and challenges of consolidating public health functions into a National Public Health Institute: A policy analysis
Carnevale CR , Woldetsadik MA , Shiver A , Gutierrez M , Chhea C , Ilori E , Jani I , MaCauley J , Mukonka V , Nsanzimana S , Ospina ML , Raji T , Spotts Whitney EA , Bratton S . Health Policy Plan 2023 38 (3) 342-350 National Public Health Institutes (NPHIs) around the world vary in composition. Consolidated organizational models can bring together critical functions such as disease surveillance, emergency preparedness and response, public health research, workforce development, and laboratory diagnosis within a single focal point. This can lead to enhanced coordination and management of resources and enable more efficient and effective public health operations. We explored stakeholders' perceptions about the benefits and challenges of consolidating public health functions in an NPHI in seven countries where the U.S. Centers for Disease Control and Prevention (CDC) has supported NPHI establishment and strengthening. From August 2019 through January 2020, we interviewed a total of 96 stakeholders, including NPHI staff (N=43), non-NPHI government staff (N=29), and non-governmental and international organization staff (N=24) in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda, and Zambia. We conducted a policy analysis using Tea Collins's health policy analysis framework to assess various possible options for coordinating public health functions and their likely effectiveness. The findings can be used by policymakers as they consider public health infrastructure. We found that consolidating functions in an NPHI, to the extent politically and organizationally feasible, promotes efficiency, flexibility, and coordination, as well as supports data-driven health recommendations to government decision-makers. Countries pursuing NPHI establishment can weigh the potential challenges and benefits of consolidating functions when determining which public health functions will comprise the NPHI, including clarity of role, access to resources, influence over decisions, and political viability. |
Preventing childhood adversity through economic support and social norm strategies
Ottley PG , Barranco LS , Freire KE , Meehan AA , Shiver AJ , Lumpkin CD , Gervin DW , Holmes GM . Am J Prev Med 2022 62 S16-s23 Through the Essentials for Childhood program, the Centers for Disease Control and Prevention funds 7 state health departments (states) to address the urgent public health problem of adverse childhood experiences and child abuse and neglect, in particular. Through interviews and document reviews, the paper highlights the early implementation of 2 primary prevention strategies from the Centers for Disease Control and Prevention's child abuse and neglect technical package with the greatest potential for broad public health impact to prevent adverse childhood experiences-strengthening economic supports and changing social norms. States are focused on advancing family-friendly work policies such as paid family and medical leave, livable wage policies, flexible and consistent work schedules, as well as programs and policies that strengthen household financial security such as increasing access to Earned Income Tax Credit. In addition, states are launching campaigns that focus on reframing the way people think about child abuse and neglect and who is responsible for preventing it. State-level activities such as establishing a diverse coalition of partners, program champions, and state action planning have helped to leverage and align resources needed to implement, evaluate, and sustain programs. States are working to increase awareness and commitment to multisector efforts that reduce adverse childhood experiences and promote safe, stable, nurturing relationships and environments for children. Early learning from this funding opportunity indicates that using a public health approach, states are well positioned to implement comprehensive, primary prevention strategies and approaches to ensure population-level impact for preventing child abuse and neglect and other adverse childhood experience. |
Risk for HIV following a diagnosis of syphilis, gonorrhoea or chlamydia: 328,456 women in Florida, 2000-2011
Peterman TA , Newman DR , Maddox L , Schmitt K , Shiver S . Int J STD AIDS 2014 26 (2) 113-9 BACKGROUND: Several effective interventions are available for preventing HIV in women. Targeting interventions requires understanding their risk of acquiring HIV. METHODS: We used surveillance data to estimate risks of HIV acquisition for 13-59-year-old women following a diagnosis of syphilis, gonorrhoea or chlamydia in Florida during 2000-2009. We excluded women reported with HIV before their STI, and measured HIV reported subsequent to STI (through 2011). Rates were compared to women with no reported STI. RESULTS: A total of 328,456 women had: syphilis (3325), gonorrhoea (67,784) or chlamydia (257,347). During 2,221,944 person-years of follow-up, 2118 of them were diagnosed with HIV. For women with no STI reported, during 64,763,832 person-years, 19,531 were reported with HIV. The crude rate of subsequent HIV diagnosis (per 100,000 person-years) was higher for women diagnosed with syphilis (597.9), gonorrhoea (171.3) or chlamydia (66.3) than women with no STI (30.2). Annual rates of HIV decreased over-all by 61.8% between 2001 and 2011. CONCLUSION: Women with syphilis or gonorrhoea were at highest risk for HIV and therefore might benefit from intensive counselling. However, they represented only a small fraction of the women who acquired HIV. Most cases of HIV infection among women occurred among the large group of women who were not at highest risk. |
Cumulative risk of chlamydial infection among young women in Florida, 2000-2011
Peterman TA , Newman DR , Torrone E , Schmitt K , Shiver S . J Adolesc Health 2014 55 (2) 241-6 PURPOSE: Chlamydia trachomatis is a very common infection among young women in the United States; information on cumulative risk of infection is limited. We sought to estimate the cumulative risk of chlamydial infection for young women. METHODS: We measured cumulative risk of reported chlamydial infection for 14- to 34-year-old women in Florida between 2000 and 2011 using surveillance records and census estimates. We calculated reported infections per woman, analyzed first infections to get cumulative risk, and calculated risk of repeat infection over the 12-year period. RESULTS: There were 457,595 infections reported among 15- to 34-year-old women. Reports increased annually from 25,390 to 51,536. Nineteen-year-olds were at highest risk with 5.1 infections reported per 100 women in 2011. There were 341,671 different women infected. Among women aged 14-17 years in 2000, over 20% had at least one infection reported within 12 years, and among blacks, this risk was over 36%, and that underestimates risk because 18% of cases were missing race/ethnicity information. Repeat infections were common. Among 53,109 with chlamydia at the age of 15-20 years during 2000-2003, 36.7% had additional infections reported by 2011. CONCLUSIONS: More than one out of five women in Florida was reported as having chlamydia during her young-adult years; risk was highest for black women. True infection risks were likely much higher because many infections were not diagnosed or reported. Young women who had chlamydia were very likely to get reinfected. Rates of infection remain high despite years of screening. More information is needed on how to prevent chlamydial infection. |
High risk for HIV following syphilis diagnosis among men in Florida, 2000-2011
Peterman TA , Newman DR , Maddox L , Schmitt K , Shiver S . Public Health Rep 2014 129 (2) 164-9 OBJECTIVE: Multiple interventions have been shown to reduce the risk of HIV acquisition, including preexposure prophylaxis with antiretroviral medications, but high costs require targeting interventions to people at the highest risk. We identified the risk of HIV following a syphilis diagnosis for men in Florida. METHODS: We analyzed surveillance records of 13- to 59-year-old men in Florida who were reported as having syphilis from January 1, 2000, to December 31, 2009. We excluded men who had HIV infection reported before their syphilis diagnosis (and within 60 days after), then searched the database to see if the remaining men were reported as having HIV infection by December 31, 2011. RESULTS: Of the 9,512 men with syphilis we followed, 1,323 were subsequently diagnosed as having HIV infection 60-3,753 days after their syphilis diagnosis. The risk of a subsequent diagnosis of HIV infection was 3.6% in the first year after syphilis was diagnosed and reached 17.5% 10 years after a syphilis diagnosis. The risk of HIV was higher for non-Hispanic white men (3.4% per year) than for non-Hispanic black men (1.8% per year). The likelihood of developing HIV was slightly lower for men diagnosed with syphilis in 2000 and 2001 compared with subsequent years. Of men diagnosed with syphilis in 2003, 21.5% were reported as having a new HIV diagnosis by December 31, 2011. CONCLUSION: Men who acquire syphilis are at very high risk of HIV infection. |
Toward integration of STD, HIV, TB, and viral hepatitis surveillance
Weinstock H , Douglas JM , Fenton KA . Public Health Rep 2009 124 5-6 Public health surveillance is “the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice.”1 While the fundamental activities of surveillance include data collection, analysis, and dissemination, the value of surveillance is measured through its impact on public health practice. The integration of surveillance data on sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), tuberculosis (TB), and viral hepatitis is important insofar as an understanding of the intersection of these diseases geographically, in different populations, and by risk behaviors impacts the ability of public health programs to operate more efficiently and effectively. As Jennings et al.2 recommend in this special supplement of Public Health Reports, surveillance systems should be patient-based rather than case-based because program services themselves are most effective when they are patient-based. As many of the articles in this supplement illustrate, it is at the local and state levels where duplication and inefficiencies are felt most. These inefficiencies are felt by the patients who do not get the care they need in a timely fashion or who get fragmented care, by the programs that are being asked to accomplish more with diminished resources, and by the public, who are often provided fragmented rather than comprehensive summaries of problems of importance to their communities. | This special supplement highlights approaches to the integrated use of data by STD epidemiologists in the Outcome Assessment through Systems of Integrated Surveillance (OASIS) workgroup. OASIS was originally funded in 1998 by the Centers for Disease Control and Prevention's (CDC's) National Center for HIV, STD, and TB Prevention (the name was changed to the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention [NCHHSTP] in 2007) to promote the integrated interpretation and use of surveillance data across disease programs. The work of OASIS, only partially reflected in this supplement, demonstrates that state and local health departments, which have the most to gain from program integration, truly are the laboratories for creatively engineering more integrated surveillance and information systems. A system such as the Patient Reporting Investigation Surveillance Manager (PRISM), developed by the Florida Bureau of STD Prevention and Control and supported by OASIS, is one such example, as Shiver et al. describe in this issue.3 Groups like OASIS, consisting of local and state STD epidemiologists, can provide the energy and ideas to develop these efforts locally, but CDC must facilitate this work through leadership, coordination, funding, and dissemination of best practices. |
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