This study's purpose is to examine the association between bullying and health-risk behavior outcomes among adolescents in Florida schools. Data were drawn from the 2015 Florida Youth Risk Behavior Survey (YRBS), a school-based survey of high school students from grades 9 to 12 that is conducted biennially. The YRBS estimates six types of health-risk behaviors that contribute to the disability of young youth and the leading causes of morbidity and mortality. The six health risk behaviors are unintentional injuries, tobacco use, sexual health behaviors, dietary, physical activity, and alcohol use. Overall, 6.4 % of students were involved in both kinds of bullying (in-person and electronic bullying); 7.6% in in-person bullying; 4.4% in electronic bullying; and 81.6% of students were uninvolved in bullying. This study adds to previous findings and emphasizes that bullying does not come about in seclusion, but is a pattern of risk behaviors or stipulations, such as school and sexual violence, suicide, substance use, and unhealthy weight control practices.
BACKGROUND:The SARS-CoV-2 virus responsible for severe respiratory infection associated with coronavirus disease 2019 (COVID-19) was first confirmed in Florida on March 1, 2020. Responding to the pandemic, multi-agency collaborative partnerships put in place actions integrating point-of-care antibody testing at established large-scale COVID-19 testing sites where the baseline seropositivity of COVID-19 in health care workers and first responders in Florida at the start of the pandemic was established. PURPOSE:Determine the seropositivity of healthcare workers and first responders at five drive thru testing sites using a rapid SARS-CoV-2 antibody test in Florida from May 6 through June 3, 2020. METHODS:The first drive-thru SARS-CoV-2 antibody test site was opened at Miami Hard Rock Stadium, May 6, 2020. Testing expanded to three additional sites on May 9, 2020: Jacksonville, Orlando, and Palm Beach. The fifth and final site, Miami Beach, began testing on May 21, 2020. Healthcare workers and first responder's self-seeking SARS-CoV-2 testing were designated for antibody testing and completed a laboratory collection form onsite for the point-of-care test. All testing was performed on whole blood specimens (obtained by venipuncture) using the Cellex Inc. qSARS-CoV-2 IgG/IgM Rapid Test. Seropositivity was assessed by univariate analysis and by logistic regression including the covariates age, sex, race/ethnicity, and testing location. RESULTS AND DISCUSSION:As of June 3, 2020, of 5,779 healthcare workers and first responders tested, 4.1% were seropositive (range 2.6-8.2%). SARS-COV-2 antibody tests had higher odds of being positive for persons testing at the Miami Hard Rock Stadium (aOR 2.24 [95% C.I. 1.48-3.39]), persons of Haitian/Creole ethnicity (aOR 3.28 [95% C.I. 1.23-8.72]), Hispanic/Latino(a) ethnicity (aOR 2.17 [95% C.I. 1.50-3.13], and Black non-Hispanic persons (aOR 1.63 [95% C.I. 1.08-2.46]). SARS-COV-2 antibody prevalence among first responders and healthcare workers in five sites in Florida varied by race and ethnicity and by testing location.
SUBTITLE: WHEN PILOTS ARE CALLED FOR ACTIVE DUTY, CORPORATE FLIGHT DEPARTMENTS ARE CHALLENGED.
Recommended Citation Apatu, Emma; Owen, Deborah M.; Stallings-Smith, Sericea; Spaulding, Aaron; and Hamadi, Hanadi (2020) "A Visit to the World Health Organization: Student Perceptions of Interprofessional Learning after a ShortTerm Public Health Study Abroad Course in Switzerland," Florida Public Health Review: Vol. 17 , Article 10. Available at: https://digitalcommons.unf.edu/fphr/vol17/iss1/10
Quality improvement (QI) is a tool in the public health inventory. It has value in that it provides a modality for accelerating science-based intervention into routine public health practice. In doing so, it holds promise to make transparent how care and service systems demonstrate efficiencies in the structure, operations, and outputs that should translate into improvements in population health outcomes. One HIV health services grant in Northeast Florida touches the lives of over 4,200 persons. How to render services so that it maximally benefits all clients is ongoing work. Service recipients engage nine HIV care funded providers, who differentiate on client census, service mix, staffing, expertise, and resources. Past 12-months QI activities indicated that seven of nine providers had implementation scores in the range of 62.32 to 88.90, (one standard deviation of the geometric mean of 74.51). Submitting implemented improvement activities for external evaluation allows for assessment of implementation fidelity and critique of methodology covering review of documents, including an improvement plan, an annual report, and a normative reference document, (NRD); completion of a scoring rubric, which modeled themes in the NRD, and rendering a qualitative, professional judgment of the extent to which agency annual reports operationalized the NRD underpinnings. Such transparency holds the promise to build public trust by demonstrating accountability to diverse stakeholders. Viewed this way, QI in public health is a necessity, not an option Watts GF Sr, Wright L. Building the HIV public health service structure by quality improvement. Florida Public Health Review. 2019;16:137-146. ____________________________________________________________________________________________ INTRODUCTION Public health researchers have been the vanguard of population health improvement. Fielding and Briss (2006) outlined the central tenet of improvements in the public’s health this way. Evidence-based public health [is] the process of integrating science-based interventions with community preferences to improve the health of populations. [The time has come for] accelerating the integration of scientific discoveries into routine public health practice and policy... [because] improvements in the health of populations result from the introduction of evidence-informed policies or programs.... Improved workplace safety [and] childhood vaccination are examples. In the 21 century, HIV remains a pandemic that holds specific sectors of the public hostage. For example, recent work by Gant and colleagues (2014), examining HIV diagnoses in Black men 15 years and older in 17 U.S. areas, points to the interplay of structural factors — poverty, socioeconomic status, and neighborhood distress — on disproportionate rates of HIV infection in this group. Hall et al., 2013 discussed critical findings of HIV public health research for HIV public health improvements. In high-income countries, ...Australia, the United States, Canada, Spain, and France, about a quarter to a third of people with HIV [receive a late diagnosis. Subtracting] late presentation [from the universe of all HIV diagnoses, then 2⁄3 to 3⁄4 of] HIV-infected people... engage in care soon after initial diagnosis. [They] have a lower risk for premature mortality, are more likely to achieve viral suppression and lower viral load burden. ...Early initiation of care is... essential... for... HIV prevention through health care, ...screening, and counseling for risk behaviors. How does this occur? Quality improvement (QI) is the key that unlocks the door to durable viral suppression, “...defined as all plasma viral load values less than 200 copies/mL over... two-years....” QI creates transparency regarding processes and policies that advance improvements in the health of HIV populations. Early diagnosis of HIV, entry to care, and viral suppression is not instantaneous. Multiple services and systems interconnect to navigate clients to suppressed viral loads. Therefore, research that adds new knowledge that reduces the information gulf between entry to care and sustained viral suppression is central to accelerating efficiencies in public health practice and improvements in the public’s health. Awareness of these goals provided the impetus for The Accreditation Coalition to define quality improvement 1 Watts: Building the HIV Public Health Service Structure by Quality Impro Published by UNF Digital Commons, 2019 Florida Public Health Review, 2019; 16, 137-146. Page 138 (QI) in public health. Riley and colleagues (2010), summarized the QI definition this way. Quality improvement in public health is the use of a... defined improvement process, such as PlanDo-Check-Act, which... [focuses] on activities that are responsive to community needs and [improves] population health. It refers to... [an] ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes, which achieve equity and improve the health of the community. Defined this way, QI is a distinct management process and set of tools and techniques that [upon coordination] ensure that departments consistently meet their communities’ health needs and strive to improve the health status of... populations [served]. But achieving continuous improvement can be elusive. It is easy to articulate but challenging to achieve. This dichotomy exists because QI, at its core, “...incorporates the notion of freeing up resources and redeploying them back into the organization.... [Such realignment challenges people in organizations] to fundamentally change how... [they] think and [examine] what they value.... [This dual emphasis] ...can transform how the entire organization behaves and approaches its work.” The elapse of time has increased the number of QI practitioners. QI has become a buzzword in American health care and health services lexicon. Thanks to the National Academies of Sciences, Engineering, and Medicine report, “Crossing the Quality Chasm: The IOM Health Care Quality Initiative.” Knowledgeable professionals speak the improvement language well and are convincing. Despite the improvement, rhetoric, “...Americans die sooner and experience more illness than residents in many other countries. ...Even relatively well-off Americans... experience inferior health in comparison with their counterparts in other wealthy countries. [One explanatory factor is] deficiencies in the health system....” Fifteen-year ago, Shojania and Grimshaw (2005) pointed to pervasive quality problems, unsupported QI activities, and the existence of hindrances that thwart implementation of evidence-based services. The picture painted here is not surprising because years ago, “W. Edward Deming pointed out... that persistent problem in organizations stem... from the system: the structure of the work; systemic practices, policies, and methods; and conventional thinking.” More recently, as in five-year ago, Taylor and colleagues (2014) decried the pervasive absence of evaluation on how the plan-do-study-act QI improvement methodology works. In 2016, the Agency for Healthcare Research and Quality published a Webpage titled, About EvidenceNOW: Background and Stories from the Field. One of “the goals of EvidenceNOW... [was] to improve patient care in an environment of discovery and change.” The passage of time has neither diminished the need for continuous improvement in health services nor evaluation of how positive change occurs. The current climate of health and social policies make understanding improvements in the public’s health an imperative. Improvement in HIV health services in the Jacksonville Transitional Grant Area (JTGA), is a priority. It is a Health Resources and Services Administration policy directive, which originated from Title XXVI of the Public Health Service (PHS) Act §§ 2604(h)(5), 2618(b)(3)(E), 2664(g)(5), and 2671(f)(2). How does the JTGA think of quality improvement? It is “...a sequence of connected and logically ordered activities...” that “...require the alteration of processes within complex social systems that change over time in predictable and unpredictable ways.” Portrayed here is reciprocal determinism arising from the interaction of methods, activities, and environment that yields critical performance metrics. It seems simple enough, but is it? Data and facts are at the core of making improvements, but Arah and colleagues, (2003, p. 377), addressed the complexity this way. Data and facts are not like pebbles on a beach, waiting... [for someone to] pick up.... They... [are] perceived and measured through an underlying theoretical and conceptual framework, which defines relevant facts, and distinguishes them from background noise. In the local community of Ryan White Part-A providers, nine recipients supply services to over 4,200 clients. In April 2018, the Administrative Agency gave a local HIV health services policy document to funded service providers. In return, all but one provider had a written QI implementation plan approved for execution during the past 12-months. Of the plans approved by the Administrative Agency for implementation, each proposal had a goal and one aim, (objective), aided by activities, roles, resources, person/s responsibility, outputs, outcomes, and a timeline. The release of the document was favorable to the community because since then 78%, (7 of 9) of service providers have changed quality improvement staff. This level of unprecedented turnover has not occurred in over ten years. If ever there was a time when the need exists for strengthening institutional QI knowledge and recreating a service culture that shows accountability for discovery and change, that time is now. Quarterly QI meetings host a forum for data and information sharing, troubleshooting enigmas, 2 Florida Public Health Review, Vol. 16 [2019], A
Sexually transmitted infections (STIs) are a leading health risk to the college-aged population with young adults age 15- 24 accounting for half the new STI diagnoses in the United States (Centers for Disease Control and Prevention, 2018). Despite these alarming numbers, approximately 50-70% of college students have not been tested for STIs (Barth, Cook, Downs, Switzer, & Fischhoff, 2002; Bontempi, Mugno, Bulmer, Danvers, & Vancour, 2009; Boudewyns & Paquin, 2011). The current manuscript draws on the Theory of Planed Behavior and the Health Belief Model to explore how attitudes, norms, perceived behavioral control, and barriers contribute to STI testing intentions. In a novel extension of Boudewyns and Paquin (2011) and Wombacher, Dai, Matig, and Harrington (2018), two unique groups of students are examined: those presenting for STI testing at a university health center, and individuals who did not present for testing. Results suggest attitude is the strongest predictor of intention to get tested, and individuals with previous experience as well as those presenting have greater intentions to engage in future STI testing. This comparison between young adults engaging in a positive health behavior (i.e., testing) and those who have not illuminates differences between these populations and provides valuable insight for future STI testing campaign message development.
