Abstract
Developing the conceptual model of public health knowledge domains using literature data mining
Yoon-Ho Seol, PhD1, Genny Carrillo, MD, MPH, MSPH, ScD2, Anita Bhat, MD, PhD1 and Miguel A. Zuniga, MD, DrPH3
(1)Augusta University, Augusta, GA, (2)Texas A&M Health Science Center, School of Public Health, McAllen, TX, (3)Sam Houston State University, Huntsville, TX
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Given the growing body of literature and interdisciplinary nature of the field of public health, there is a wealth of evidence supporting the importance of understanding the knowledge domains of public health and their interactions in practices. In order to assess the diverse and complex domains of public health from the cross-disciplinary perspective, this study identified underlying knowledge domains indicated by the public health literature and examined their associations to characterize common patterns of their structures. Data were collected from MEDLINE citations related to public health, retrieved from PubMed from 2000 to 2010. We considered five core areas of public health in search strategies: Health Policy and Management, Epidemiology, Environmental Health Sciences, Social and Behavioral Sciences, and Biostatistics. From each citation, MeSH (Medical Subject Headings) index terms were extracted to assess pertinent knowledge domains. We used a co-occurrence analysis as well as association rule mining on the index terms to identify frequent patterns of co-occurrence among the terms, suggesting a range of multidisciplinary activities that constitute the main knowledge domains of public health. The analysis was largely driven by two main objectives: one was to examine the frequency and extent of occurrence of particular terms and the other was to explore their relationships in the context of interconnected knowledge domains. The frequent terms and patterns were organized using the MeSH concept hierarchy to facilitate comparison and interpretation. The findings of this study provided informative knowledge domains that could describe the field of public health, and may help guide its future directions to better respond to the needs and interests of public health workforce.
Communication and informatics Public health or related research
Abstract
Designing an SMS-based HIV/STI preventive maintenance intervention (PMI) for adolescent women
Teaniese Davis, PhD, MPH1, Ralph J. DiClemente, PhD2, Michael Prietula, PhD3 and Simone Sawyer4
(1)Morehouse College, Atlanta, GA, (2)Rollins School of Public Health, Emory Univeristy, Atlanta, GA, (3)Emory University, (4)Spelman College, Atlanta, GA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
African American adolescent females are disproportionately affected by co-occurring epidemics of STIs and HIV. Given the elevated risk of STI/HIV for this population, there is an urgent need to identify innovative strategies to enhance adoption and maintenance of STI/HIV preventive behaviors. Texting is seen as a potential technology for creating preventive maintenance interventions (PMIs) that extend the efficacy of the original intervention. However, little guidance in the public health literature is available toward this type of application. This research describe a formative study to design and test PMI texts for Afiya, an intervention based on a CDC-defined EBI known as HORIZONS, and designed for African American adolescent females. An advisory board (AB) from the target population consisted of six African American women aged 18 and 24 years, participating in formative activities for 12 weeks, involving components of the PMI design. The AB participated in the one-day Afiya workshop, followed by 4 weeks of texting PMI messages, engaged in a mid-course focus group, followed by 4 more weeks of texting PMI messages, ending with a final focus group. At the ABs request, the final phase included an optional, additional week of text PMI messages and access to the health educator. Analyses of text, texting content, focus group notes, and two-way text communications comments were conducted. Prior contact and context were essential, as the health educator was identified as a key persona in the process and the messages were based on the original EBI workshop context. Suggestions on how to expand the PMI to current, specific social contexts indicated an expanded use of narrative tailoring may be warranted.
Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Social and behavioral sciences
Abstract
Using Big Data for Chronic Disease Management
Kristin Paulson, JD, MPH
Center for Improving Value in Health Care, Denver, CO
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
All Payer Claims Databases can provide unique insight into chronic disease and chronic disease management. Much of the focus on chronic disease in big data has been on variation in incidence and prevalence across geographies and populations.
In collaboration with the Colorado SIM, the Center for Improving Value in Health Care (CIVHC) created claims-based measures of chronic disease management on a population scale. The Diabetes measure was based on NQF 0059 and 0061, and includes: prevalence by age, percent with an annual A1c, percent with a diabetic vision exam, percent with an annual lipid panel, percent receiving 1 of 3, 2 of 3, or 3 of 3 recommended services, percent of diabetics with hypertension, and medication adherence of hypertensive diabetics. This comprehensive measure allows CIVHC to get a clear picture of the management of chronic disease at a population level without having to consolidate extensive clinical data.
Though this measure falls short of demonstrating true control of diabetes (blood sugar readings, A1c results, etc.), it allows researchers to target specific populations not adhering to recommended control guidelines. Further geographic analysis will allow for detailed targeting of chronic disease management education and intervention efforts. CIVHC hopes this data will help tailor specific interventions so small efforts can have significant potential impact. Prevalence A1c Lipid Panel Vision Test Diabetes with HTN HTN Med Adherence
Medicare 20.52% 68.14% 49.08% 39.16% 61.77% 36.76%
Medicaid 9.58% 64.77% 56.77% 28.47% 57.66% 37.64%
Commercial 5.69% 76.23% 66.61% 36.71% 33.53% 26.68%
Total 11.31% 69.28% 54.56% 36.47% 54.61% 35.56% 1 of 3 tests 2 of 3 tests 3 of 3 tests
Medicare 80.70% 54.85% 20.83%
Medicaid 80.18% 54.57% 15.27%
Commercial 88.82% 68.70% 22.04%
Total 82.42% 57.90% 19.99%
Administer health education strategies, interventions and programs Assessment of individual and community needs for health education Chronic disease management and prevention Planning of health education strategies, interventions, and programs Program planning
Abstract
Feasibility of a multimedia-based obesity management program for low-income preschool parents
Wenxi Liu
University of Texas at San Antonio, San Antonio, TX
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Purpose: this pilot study tested the feasibility of Healthy Pad, a multimedia-based parent education on obesity management delivered using Android tablets. Methods: Participants were 15 Head Start parents whose children were either overweight or obese. After completing an orientation session, each parent was given a Healthy Pad tablet and asked to complete the Healthy Pad program following a five-week schedule. Healthy Pad had four components: 1) five parental education modules created with Articulate® Storyline; 2) weekly behavioral monitoring of child behaviors based on AAP recommendations (e.g. TV <2 h/d) using an application; 3) age-appropriate child activities (eBooks with health themes, education games and videos on nutrition, PA) that provided the opportunities to learn health habits and to replace passive sedentary behavior; and 4) adult use applications. The delivery design is guided by E-Learning and adult learning theories that engage adult learners and minimize the intimidation and frustration of multimedia use. Articulate® Storyline is an innovative e-Learning authoring tool that has intuitive user interface, allows embedding of various forms of multimedia content, provides revolutionary interactivity (avatars, voice narrations, animation) between users and content, has built-in assessment (quizzing with feedback) capability, and tracks and reports the user access and progress of the content. Access information to tablet content was collected to assess fidelity. Implication: It is feasible and promising to adopt the multimedia-based education intervention for raising the healthy awareness among low-income preschool families.
Chronic disease management and prevention Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences
Abstract
Influential journals in health research: A bibliometric study
Jose M Merigo1 and Alicia Núñez, Universidad de Chile2
(1)University of Chile, Santiago, Chile, (2)Universidad de Chile, Santiago, Chile
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
1) In the literature, there are many journals publishing health research. Web of Science currently indexes more than 300 journals classified in four categories.
2) This study develops a bibliometric overview of all the journals that are currently indexed in Web of Science database in any of the four categories connected to health research. The aim is to identify the leading journals over the last twenty-five years (1990-2014) according to a wide range of bibliometric indicators.
3) The work classifies the journals available in Web of Science on health research in nine subfields: Public Health, Environmental and Occupational Health, Health Management and Economics, Health Promotion and Health Behavior, Epidemiology, Health Policy and Services, Medicine, Health Informatics, Engineering and Technology, and Primary Care.
4) The results indicate a wide dispersion between categories being the American Journal of Epidemiology, Environmental Health Perspectives, American Journal of Public Health, and Social Science & Medicine, the journals that have received the highest number of citations over the last twenty-five years. According to other indicators, some other journals obtain better results which show the wide diversity of outlets available in the scientific community. The results are grouped according to the subfields so the focus is to identify the leading journals in each specific sub discipline of health.
5) This study analyzes health journals currently indexed in WoS database between 1990 and 2014 providing a general picture of the current position of the leading journals in this field. WoS has four categories that involve health research. However, this study has divided these four categories in nine more specific ones in order to provide a deeper analysis of the top journals in health research.
Assessment of individual and community needs for health education Communication and informatics Conduct evaluation related to programs, research, and other areas of practice Other professions or practice related to public health
Abstract
Both Mirror and Complement: A Comparison of Social Media Data and Survey Data about Flu Vaccination
David Broniatowski, Ph.D.1, Mark Dredze, PhD2, Karen Hilyard, PhD3, Maeghan Dessecker, M.A.4, Sandra Crouse Quinn5, Amelia Jamison, M.A.6 and Michael Paul, PhD7
(1)George Washington University, Washington, DC, (2)Johns Hopkins University, Baltimore, MD, (3)FHI 360, Atlanta, GA, (4)University of Georgia, Athens, GA, (5)University of Maryland, School of Public Health, College Park, MD, (6)University of Maryland, College Park, MD, (7)University of Colorado, Boulder, Boulder, CO
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
While social media can provide real time insight into knowledge, attitudes and behaviors, twin challenges for health communication researchers are gathering accurate, detailed demographic information about users and grappling with a large quantity of qualitative information. Surveys aptly handle these challenges, but may be too slow in an emerging public health crisis such as an infectious disease outbreak. Further, surveys often underrepresent young, urban participants and minorities, groups which can readily be captured via social media platforms. Using the 2014-15 influenza season as a test case, we employ rapid, computational Big Data techniques that use advanced natural language algorithms and geolocation to parse demographics and psychographics of social media. We compare our social media findings to published CDC survey data about vaccination, reporting where the data complement and/or overlap each other, where they diverge, and importantly, for which demographic groups. Our results suggest opportunities for researchers to track emerging epidemics more quickly and cheaply via social media, as well as suggesting other instances where social media may be insufficient and survey data is necessary to provide depth of detail in easily quantifiable and analyzable formats.
Communication and informatics Public health or related research Social and behavioral sciences
Abstract
EPAL: Pain Management in Cancer Patients Using a Smartphone Application - Preliminary Results from a 2-Arm Randomized Control Trial
Nils Fischer, MPH1, Stephen Agboola, MD, MPH2, Mihir Kamdar, MD3, Emily Caplan4, Joseph Kvedar, MD4 and Kamal Jethwani, MD MPH4
(1)Partners Connected Health, Boston, MA, (2)Partners Connected Health, Harvard Medical Schoola, Massachusetts General Hospital, Boston, (3)Massachusetts General Hospital, Boston, MA, (4)Partners Healthcare, Boston, MA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Pain management is still suboptimal for a great number of cancer patients. ePAL is multidimensional mobile application based on clinical guidelines to help cancer patients better manage their pain by encouraging improved self-management of pain and more regular pain assessments. Our objective was to evaluate the effect of ePAL in controlling cancer pain and improving quality of life in patients with cancer pain being treated at an academic palliative care clinic. The ongoing 2-arm randomized control trial included 65 patients randomized into control and intervention groups. Pain severity and quality of life metrics were assessed at the enrollment, midpoint (week 4), and closing (week 8) of the study. Pain severity was assessed using the Brief Pain Inventory (BPI) and Quality of Life was assessed with the Functional Assessment of Cancer Therapy (FACT-G). At the time of analysis, 41 subjects have completed the study. In the control group, overall pain severity increased from 3.51 (SD, 1.57) at enrollment to 3.81 (SD, 2.26) and to 3.79 (SD, 1.8) at closeout. In the intervention average pain severity scores decreased from 3.32 (SD, 2.08), to 3.20 (SD, 1.71), and to 3.13 (SD, 2.23). Quality of life increased from baseline in the intervention group [67.24 (SD, 15.67), 69.51 (SD, 14.61), and 69.97 (SD, 14.57)] but declined in the control group [68.37 (SD, 14.62), 66.55 (SD, 14.20), and 65.25 (SD, 15.55)].
While the study is still ongoing, preliminary results show that ePAL may reduce overall pain severity and could improve overall quality of life.
Clinical medicine applied in public health Conduct evaluation related to programs, research, and other areas of practice Provision of health care to the public
Abstract
Design of a randomized controlled trial of a multi-modal mHealth intervention to improve physical activity behavior in patients with high cardio-metabolic risk factors
Ramya Palacholla, MD, MPH1 and Stephen Agboola, MD, MPH2
(1)Partners Healthcare Pivot Labs, Harvard Medical School,, Boston, MA, (2)Partners Connected Health, Harvard Medical Schoola, Massachusetts General Hospital, Boston
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
background
Physical activity is an important modifier of cardio-metabolic risk factors and mobile applications are increasingly being used to engage patients to self-manage these risk factors. We aim to evaluate the effects of a mobile application, FeatForward, on physical activity levels and other cardio-metabolic risk factors in patients with chronic conditions.
intervention
FeatForward is a hyper-personalized smartphone app with the ability to respond to individual behavior patterns simulating an intelligent health coach, to achieve better health outcomes. The app includes machine learning components for tailoring message frequency based on users' activity levels, social networking and educational features to keep the participants engaged. Additionally, the app has a care provider portal integrated with the medical records that allows physicians to monitor the patients' progress and communicate when appropriate.
methods
300 patients with chronic conditions (hypertension, diabetes) will be randomized into two groups: an intervention group that receives a Smartphone with the FeatForward app and a Smartwatch to track physical activity and other biometric parameters; and a control group that receives a Smartphone with the S-Health app and a Smartwatch. The difference in physical activity levels between the control and intervention group will be measured as the primary outcome at baseline, 3 and 6 months. Secondarily, we will assess changes in CMR factors, quality of life, usability, satisfaction, participant engagement and physician engagement.
conclusions
Given the high prevalence of physical inactivity in the society, findings from this study, may help participants engage in healthier lifestyles and lead to improved health outcomes.
Administer health education strategies, interventions and programs Chronic disease management and prevention Clinical medicine applied in public health Public health or related education
Abstract
An Information Flow Diagram of The National Poison Data System
Kathryn Watson, M.D.
Texas A&M University, Lakeway, TX
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
This poster presents a comprehensive data flow diagram describing the National Poison Data System (NPDS), a nationwide, real-time surveillance system created to standardize documentation and reporting of human poison exposures that occur during every call received by all 57 poison control centers throughout the United States. The purpose of this poster is to identify sources and types of poison control data, display the data paths to stakeholders, to map possible public health responses that may occur as a result of the data collection and analysis, and to make recommendations based on an informatics evaluation of the data flow. The system was evaluated on several dimensions: (1) type of call received by the call center; (2) efficiency of uploading data into the national database; and (3) tracing the surveillance techniques used by the NPDS system to detection of case anomalies, and visualizing public health responses to those anomalies at the national, state, and local levels. Potential issues with the current NPDS system were identified, including the lack of software available to share the data collected with hospitals, emergency departments, and medical examiners offices, and an absence of a standardized quality assurance program for all 57 call centers. Areas for improvement included: (1) increasing funding to maintain staffing in current call center locations; (2) development of interoperable system software that allows for nationwide data sharing among the call center, NPDS and local hospitals, emergency departments, and medication examiners offices; and (3) a standardized quality improvement program that all call centers could utilize in order to implement a set of related activities designed to achieve measurable improvement in processes and outcomes of care associated with call center duties and employee actions. Ultimately, the NPDS serves a vital role in notifying the proper agencies of possible anomalies that may require a public health response.
Communication and informatics Systems thinking models (conceptual and theoretical models), applications related to public health