Abstract
Utilizing An Urban Healthcare Setting to Prevent Teen Dating Violence: Evaluation Of Outcomes From A Pilot Study
Katrina Debnam, PhD1, Sarah Lindstrom Johnson, PhD2, Sarah Colome3, Jacqueline Bran4 and Krishna Upadhya5
(1)Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, (2)Arizona State University, Tempe, AZ, (3)Break the Cycle, Los Angeles, CA, (4)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (5)Johns Hopkins Children's Center, Baltimore, MD
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
BACKGROUND - Ten year prevalence estimates suggest that teen dating violence (TDV) remains a persistent public health problem. Despite its prevalence and harms, many healthcare providers do not screen for TDV. This gap in screening represents a missed opportunity for intervention and support. In previous research, adolescents endorse the need for healthcare providers to screen all adolescents for TDV exposure, and indicate a belief that screening by a healthcare provider is necessary. However, to date, no evidenced based intervention has been developed with healthcare providers as the catalyst for preventing TDV.
METHODS – A national nonprofit organization working to end dating violence provided a two-hour training on dating violence to 16 health care providers at an urban adolescent health clinic. Components of the training included epidemiology, suggested screening questions, and strategies for responding to positive screens. Health care providers’ self-efficacy, outcome expectancies, knowledge, and behavioral capabilities were examined pre and post training in addition to a 6-month follow-up in February 2016.
RESULTS – ANOVA tests show significant differences in provider knowledge and self-efficacy post training, and at 6-month follow-up. Specifically, significant increases were observed in providers’ ability to define dating abuse, identify warning signs of dating abuse, talk with patients about dating violence, and their perceived ability to reduce patients’ involvement in dating violence.
CONCLUSIONS – This pilot training intervention successfully improved adolescent healthcare provider self-efficacy, outcome expectancies, knowledge, and behavioral capability regarding TDV. Additional research is needed to determine whether the training leads to improved TDV screening and intervention.
Conduct evaluation related to programs, research, and other areas of practice Provision of health care to the public Public health or related nursing
Abstract
Caregivers’ agreement with their child’s report of suicidality: Discoveries in a sample of sexually abused children and their parents
Catherine Dunlop, MPH, Jeffrey Wherry, PhD, ABPP and Colton Kurth, MS
Dallas Children's Advocacy Center, Dallas, TX
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: Studies have provided evidence of an association between abuse during childhood and suicidality during adolescence or adulthood. This association implies that sexually abused children must be closely evaluated for suicidality, and parents should monitor children for concerning behaviors. This study examines agreement between abused children and their parents regarding suicidality, and explores potential reasons behind discrepancies in reporting.
Methods: Agreement between abused children age 8-12 and their parents regarding suicidality reporting was determined using items from the Trauma Symptom Checklist for Children and the Trauma Symptom Checklist for Young Children. Discrepancies in agreement were explored based on severity of abuse, parental support, events since disclosure, lifetime traumatic events, and demographic data.
Results: Agreement between caregiver and child about the child being suicidal was 9.2%. Agreement that the child was not suicidal was 71.5%. While 21% of children said they had thought about killing themselves only 44% of their parents were aware of their child’s suicidality. Parental support reported by the child was significantly associated with 15% lower odds of having discordant reporting on suicidality, suggesting higher parental support is associated with more accurate reporting on suicidality.
Conclusions: The poor agreement between parents and their children regarding reporting suicidality indicates that measures need to be taken to ensure that parents are aware of signs that could indicate suicidality. Child-perceived parent support is associated with a higher likelihood of agreement in reporting on suicidality and suggests that parents who are more supportive may also be more aware of their child’s suicidality.
Assessment of individual and community needs for health education Public health or related research Social and behavioral sciences
Abstract
Firearm Suicide in the United States: Abundance of Guns or Shortage of Mental Health Services?
Gi Lee, MSW1 and Mark S. Kaplan, DrPH2
(1)University of California, Los Angeles, Los Angeles, CA, (2)UCLA, Los Angeles, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: In 2014, firearm suicide accounted for nearly two-thirds of the 33,599 gun deaths in the United States. Compared to other race/ethic groups, white men had the highest firearm suicide rate (12.9/100,000). Recently, there have been debates about expanding the mental health system in order to reduce the levels of gun violence, including suicides. There is little, if any, evidence that increased expenditures on public mental health services will reduce gun deaths, including suicides. In fact, extensive evidence indicates that gun availability is a more salient risk factor for firearm suicide. Thus, the primary aim of this study was to assess the effects of gun availability on firearm suicides before and after controlling for per capita state mental health services expenditures in all 50 states.
Methods: Using state level data on age-adjusted rates of firearm suicide for white men (2012-2014) obtained from the CDC’s WISQARS, a proxy measure for gun ownership (fraction of all suicide involving guns), and per capita mental health services expenditures (2012) obtained from the National Association of State Mental Health Program Directors Research Institute, a correlational analysis was performed with and without adjustments for state-level mental health services expenditures.
Results: Bivariate correlation between gun ownership and age-adjusted firearm suicide for white males was 0.89 (p < 0.000). The partial correlation coefficient remained unchanged after holding state mental health services expenditures constant.
Conclusions: To reduce the rate of firearm suicide, policy initiatives should focus on reducing overall gun ownership levels, rather than expanding the mental health services.
Public health or related public policy Public health or related research Social and behavioral sciences
Abstract
Assessing stakeholder awareness and use of North Carolina's violent death data and resources
Jessica Tufte, MPH1, Lillie Armstrong, MPH2, Eyerusalem Tessema, MPH2, Genevieve Olson, MPH2, Scott Proescholdbell, MPH3 and Nidhi Sachdeva, MPH, CHES4
(1)UNC Chapel Hill, Carrboro, NC, (2)UNC Chapel Hill, Chapel Hill, NC, (3)NC Division of Public Health, Injury and Violence Prevention Branch, Raleigh, NC, (4)NC Division of Public Health, Raleigh, NC
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: Nearly 2,000 people die each year from violence in North Carolina. The North Carolina Violent Death Reporting System (NC-VDRS) is a comprehensive, statewide, population-based surveillance system developed by the CDC that tracks violent deaths across NC. Since its 2004 establishment, NC-VDRS has collected detailed data on over 20,000 violent deaths. NC-VDRS is meant to provide data to communities and researchers to inform interventions and evaluation efforts that help prevent future violent deaths. The purpose of this study was to assess stakeholder awareness and utilization of NC-VDRS data/resources.
Methods: Based on a CDC evaluation framework, a quantitative survey was developed to include information from 12 semi-structured key informant interviews. This survey was distributed to NC-VDRS e-Newsletter subscribers (n=531). Respondents (n=151) included local health department staff, law enforcement officials, researchers, and other community partners. Researchers performed a descriptive analysis to assess current stakeholder awareness and utilization of NC-VDRS resources.
Results: The top reason for not accessing NC-VDRS resources was lack of awareness: 50%-70% of all respondents were simply unaware of a given resource. Over 90% of users aware of data resources reported ease of data access and use, and these uses (needs assessments, advocacy, grant-writing, etc.) depended on the type of resource.
Conclusion: Despite several years of existence, stakeholder awareness of NC-VDRS and its resources are low, making it important to bridge the gap between research and practice. Tailored recommendations were created to increase awareness of NC-VDRS resources, which may increase the number of data-informed violence prevention programs and interventions.
Epidemiology
Abstract
Long Term Effectiveness of Differential Response in Preventing Child Maltreatment Re-Report
Amy Hunter, MPH, PhD1, Dustin Long, PhD2 and Ian R. H. Rockett, PhD, MPH2
(1)Connecticut Children's Medical Center, Hartford, CT, (2)West Virginia University, Morgantown, WV
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: Differential Response policy allows families reported for child maltreatment to receive supportive services in place of an investigation. Studies show similar results in the prevalence of maltreatment re-report for differential response and investigation at 2 years. However, the long term effectiveness of this policy is unknown. This study compares the risk of child maltreatment re-report in those receiving differential response and those receiving an investigation following first report of maltreatment.
Method: This analysis used data on 844,121 children < 18 years of age from the National Child Abuse and Neglect Data System (NCANDS) Child File for 2004-2014. Included states (Louisiana, Minnesota, Missouri, Wyoming) utilized a state-level differential response policy throughout the study period. Cox proportional hazards analysis was used to calculate adjusted and unadjusted hazard ratios (HRs). A Directed Acyclic Graph (DAG) was developed as the theoretical statistical model. Sensitivity analysis compared risk of re-report at 2 years for both response types.
Results: After 11 years, risk of re-report was 11% greater in differential response cases than those receiving an investigation (HRa: 1.11, p<.0001). Sensitivity analysis showed that at 2 years, differential response reduced risk of re-report by 2% (HRa: 0.978, p<0.0001). Results remained unchanged after controlling for child age at first report of maltreatment.
Conclusion: Consistent with existing literature, our results demonstrated a short term benefit of differential response against child maltreatment re-report. However, the 11 year analysis suggests that the effectiveness of this policy is not sustainable.
Epidemiology Planning of health education strategies, interventions, and programs
Abstract
Differences in Near Miss Reporting Practices Between Temporary and Payroll Construction Workers: Evidence from the Falls Reported Among Minority Employees (FRAME) in Residential Construction Pilot Study
Jordan Stillman, BA, MS1, Katerina Santiago, MPH2, Xuan Yang1, Samuel R. Huntley, BS2, BreAnne Young, MSPH2, Charles Chen, MPH, BS2, Estefania Ruano, MPH3, Agnes Poveda, MPA, MCJ1, Kevin J. Moore, MD, MPH4, Juanita Chalmers, MPH5, Phillip Cavicchia, PhD5 and Alberto Caban-Martinez, DO, PhD, MPH1
(1)University of Miami, Miller School of Medicine, Miami, FL, (2)University of Miami Miller School of Medicine, Miami, FL, (3)Univeristy of Miami, Miller School of Medicine, Miami, FL, (4)Brigham and Women’s Hospital, Boston, MA, (5)Florida Department of Health, Tallahassee
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background/Objective(s):
Contingent workers, i.e., temporary employees, day laborers, contracted employees, and freelancers, comprise a growing population in the construction industry. Despite efforts to improve work-related safety and health on constructions sites, there is limited information on characterizing precursor events to injuries, such as near misses. In the present pilot study, we describe near misses and unsafe working conditions in a convenience sample of temporary and payroll construction workers.
Methods:
In June 2016 we surveyed a total of 250 commercial full-time and temporary construction workers employed at three South Florida construction sites (98% response rate). The workers volunteered their time during breakfast and lunch breaks to complete a 68-item survey instrument about near misses. Workers were consented and compensated $10 for survey participation.
Results:
The proportion of construction workers in payroll jobs who personally experienced a near miss was greater than the number of workers in temporary jobs (53.6% vs. 46.0%, p=0.151). Fewer survey respondents in temporary roles had ever reported hazardous working conditions, injury, or other complaints to a job site supervisor compared to payroll workers (64.9% vs 71.5%, p=0.309). However, there was a significant difference between the two groups in their inclination to report a near miss if someone were injured (81.5% vs. 64.9%, p=0.033).
Conclusion(s):
We documented differences in near miss reporting preferences between temporary and full-time construction workers. Further comparative studies are needed to understand the root cause of this difference and the role incentive structures play in reporting near misses.
Epidemiology Occupational health and safety
Abstract
Development and Evaluation of a Near Miss Reporting Survey Instrument using data from the Falls Reported Among Minority Employees (FRAME) Pilot Study
Katerina Santiago, MPH1, Xuan Yang2, Jordan Stillman, BA, MS2, Samuel R. Huntley, BS1, BreAnne Young, MSPH1, Estefania Ruano, MPH3, Charles Chen, MPH, BS1, Agnes Poveda, MPA, MCJ2, Kevin J. Moore, MD, MPH4, Juanita Chalmers, MPH5, Phillip Cavicchia, PhD5 and Alberto Caban-Martinez, DO, PhD, MPH2
(1)University of Miami Miller School of Medicine, Miami, FL, (2)University of Miami, Miller School of Medicine, Miami, FL, (3)Univeristy of Miami, Miller School of Medicine, Miami, FL, (4)Brigham and Women’s Hospital, Boston, MA, (5)Florida Department of Health, Tallahassee
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background/Objective(s):
The construction industry is responsible for about one-fifth of all U.S. worker fatalities. Near misses are events that do not result in injury; however, they can lead to harm or worker death, particularly among temporary workers who are often not provided with adequate worksite-based training. This study aims to define the term near miss, to identify commonplace hazards, and to assess workplace safety knowledge and reporting practices among temporary and payroll construction workers.
Methods:
We utilized a two phased, sequential exploratory mixed-methods study design. In Phase 1, we conducted six focus groups with temporary construction workers (n=46) at a temporary staffing agency to qualitatively explore worker experiences with falls, injuries, and near misses. Data collected from our focus groups was used to develop a near miss survey instrument. In phase 2, we administered the near miss survey to a convenience sample of 250 construction workers employed at large construction sites.
Results:
Among all survey respondents, 32.5% selected “almost being hurt or injured” as the most representative definition of near miss. When compared to temporary workers, significantly more workers on payroll perceive “slipping on a ladder wrung” (33.8% vs. 20.3%, p=0.037) and “improperly operating heavy-duty machinery” (19.9% vs. 8.11%, p=0.024) as a near miss hazard. Additionally, 61.2% of the total sample reported that additional OSHA training on near miss identification would be helpful.
Conclusion(s):
Identification and reporting practices of near misses in the construction industry should be explored further to understand worker attitude and motivation for reporting worksite near misses.
Assessment of individual and community needs for health education Diversity and culture Environmental health sciences Implementation of health education strategies, interventions and programs Occupational health and safety Planning of health education strategies, interventions, and programs
Abstract
A Mixed-Method approach to inquiry: Understanding the experiences of survivors of sex trafficking in the healthcare setting and their reasons for seeking services
Arduizur Richie-Zavaleta, DrPH, MASP, MAIPS
University of New England, Portland, ME
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background/Purpose: In the United States of America (US), thousands of individuals are victims of Human Trafficking (HT). HT victims experience extreme abuses daily and do not possess the freedom to leave their circumstances. Some of these abuses include: forced commercial sex exploitation, forced labor and debt bondage. At times, HT victims encounter healthcare providers. Due to the lack of awareness, training, and efficacy, healthcare providers miss the identification of HT victims at their settings.
The aims of this study are: 1) to understand what type of settings survivors mostly go to receive healthcare services during their victimization period; 2) to learn about the main reasons for going to receive medical care; and 3) to gain insights about the interactions between the healthcare providers and the HT victims while receiving services.
Methods: This study utilizes an exploratory concurrent mixed-method research approach. Collection of data will take place in the Spring-Summer 2016 in two metropolitan areas: San Diego, CA and Philadelphia, PA. Twenty survivors of sex trafficking are expected to participate. Participants answer a 48-item questionnaire followed by a semi-structured interview. Recruitment has been established through non-for-profit organizations that service victims and survivors of HT. All participants identification will be confidential coded with fictitious names and randomized assigned numbers. Descriptive analysis of quantitative data will be followed by qualitative analysis using open and focused coding using. SPSS and Atlas.ti software will be used accordingly. Results: Preliminary findings are expected for Fall 2016.
Other professions or practice related to public health Public health or related research
Abstract
Effectiveness of the Environmental Health and Occupational Safety Leadership Program for Young Workers: A Tale of One Program in Two Cities
Sue Ann Sarpy, M.S., Ph.D.1, Jennifer Langhinrichsen-Rohling, Ph.D.2, Peyton Williams, B.S.3 and Jabaria Jenkins, MDiv, SPHR4
(1)Sarpy and Associates, LLC, Charlottesville, VA, (2)University of South Alabama, Mobile, AL, (3)University of South Alabama, Mobile,, AL, (4)Mobile Area Education Foundation, Mobile, AL
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Recently, the National Academies of Science provided funding to create the Environmental Health and Occupational Safety (EHOS) Leadership program. EHOS is designed to enhance knowledge in risk analysis, occupational safety regulations, occupational emergency response, and leadership and communication skills of high school students through field experiences, hands-on exercises, problem-based learning activities and guest speakers. EHOS is developed to create a cadre of potential middle-skill workers with increased capacity to influence safety in future workplace settings. High school participants (n = 25) were recruited from two Career Academies in Mobile County, Alabama: (1) Bryant High School, located in a rural area (Bayou LaBatre); and (2) Williamson High School, an inner city school with a high minority population. EHOS requires students to attend a health and safety certification class, 9 afterschool sessions, and culminates with a weeklong Summer Challenge camp. A comprehensive evaluation system gathered qualitative and quantitative data across all major program stakeholders. The program’s effectiveness with at-risk students from the two distinct communities was assessed. Despite a small sample, results indicated that participation in the EHOS program significantly enhanced student’s competency-related knowledge, skills, and abilities (p < .05). Moreover, comparisons between student cohorts indicated that training outcomes varied by location. For example, Williamson (urban) students reported “awareness of hazards” whereas Bryant (rural) students reported “importance of safety” as the most important aspect of training. Implications of the results will be discussed with respect to making quality improvements to EHOS as well as strengthening related programs across cultures and geographic regions.
Conduct evaluation related to programs, research, and other areas of practice Occupational health and safety
Abstract
Protecting those who protect us: U.S. Department of Homeland Security Workforce Protection and Medical Support
Ivan A. Zapata, DrPH, MS, CHES, U.S. Department of Homeland Security, Washington, DC
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
background: As the largest law enforcement agency in the world with over 300,000 employees, the U.S. Department of Homeland Security (DHS) has a very delicate and intricate mission to protect and secure the homeland. To achieve this grand task, DHS must first ensure well-being protection to those protecting our nation. The DHS Office of Health Affairs (OHA) employs a multidimensional and multidisciplinary approach to workforce health and medical support to our diverse operational missions.
methods: OHA mainly provides this support to the workforce via its Workforce Protection and Medical Support (WHMS) division. The WHMS is comprised of five branches: Occupational Health and Medical Countermeasures Program, Medical Quality Management, Medical First Responder Coordination, Medical Liaison Officers, and Global Heath Security.
results: Over the last three years, WHMS has provided invaluable support to the DHS operational components to ensure they can carry out their respective missions. For example, Customs and Border Protection (CBP) was able to mitigate a public health catastrophe due to overcrowding in border patrol stations during the 2014 Unaccompanied Alien Children Influx in south Texas; DHS personnel implemented special medical screening procedures at U.S. ports of entry during the 2014-15 Ebola outbreak; and more recently, WHMS provided situational awareness information on how Zika Virus could affect DHS operations.
conclusions: Providing occupational health messages, guidance documents, EMS protocols and medical/public health standard operating procedures to the DHS workforce promotes well-being and ensures a department-wide higher level of readiness.
Occupational health and safety Other professions or practice related to public health Program planning Protection of the public in relation to communicable diseases including prevention or control Public health or related organizational policy, standards, or other guidelines