PKh88LLrefs.MYD A~|7)Patel, A. S. Powell, T. A. Woolard, C. D.2008aAssessment of applied epidemiology competencies among the Virginia Department of Health workforce119-27Public Health Rep 123 Suppl 1 2008/05/24Epidemiology/ organization & administration/standards Humans Professional Competence/ standards Public Health Practice/ standards VirginiaOBJECTIVES: Epidemiologists play critical roles in public health. However, until recently, no formal standards existed for epidemiology practice. In 2005, the Centers for Disease Control and Prevention and Council of State and Territorial Epidemiologists drafted Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs) that provide a foundation for expectations and training programs for three tiers of practice. We characterized the Virginia Department of Health (VDH) epidemiology workforce and assessed its baseline applied epidemiology competency by using these competencies. METHODS: Epidemiologists representing multiple divisions developed an Internet survey based on the AECs. Staff who met the definition of an epidemiologist were requested to complete the survey. Within eight skill domains, specific competencies were listed. For each competency, frequency and confidence in performing and need for training were measured by using Likert scales. Differences among tier levels were assessed using analysis of variance. RESULTS: Eighty-eight people from 10 program areas responded and were included in the analysis. Median epidemiology experience was four years, with 52% having completed formal training. Respondents self-identified as Tier 1/entry-level (38%), Tier 2/mid-level (47%), or Tier 3/senior-level (15%) epidemiologists. Compared with lower tiers, Tier 3 epidemiologists more frequently performed financial or operational planning and management (p=0.023) and communication activities (p=0.018) and had higher confidence in assessment and analysis (p<0.001). Overall, training needs were highest for assessment/ analysis and basic public health sciences skills. CONCLUSIONS: VDH has a robust epidemiology workforce with varying levels of experience. Frequency and confidence in performing competencies varied by tier of practice. VDH plans to use these results and the AECs to target staff training activities.Patel, Ami S Powell, Timothy A Woolard, C Diane United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:119-27.0033-3549 (Print)18497022iEpidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA. app8@cdc.goveng ~|79Birkhead, G. S. Davies, J. Miner, K. Lemmings, J. Koo, D.2008IDeveloping competencies for applied epidemiology: from process to product67-118Public Health Rep 123 Suppl 1 2008/05/24Competency-Based Education/organization & administration Education, Public Health Professional/standards Epidemiology/education/ organization & administration/standards Humans Professional Competence/ standards Public Health Practice/ standards United States+OBJECTIVES: We developed competencies for applied epidemiologic practice by using a process that is based on existing competency frameworks, that engages professionals in academic and applied epidemiology at all governmental levels (local, state, and federal), and that provides ample opportunity for input from practicing epidemiologists throughout the U.S. METHODS: The model set of core public health competencies, consisting of eight core domains of public health practice, developed in 2001 by the Council on Linkages Between Academia and Public Health Practice, were adopted as the foundation of the Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs). A panel of experts was convened and met over a period of 20 months to develop a draft set of AECs. Drafts were presented at the annual meetings of the Council of State and Territorial Epidemiologists (CSTE) and the American Public Health Association. Input and comments were also solicited from practicing epidemiologists and 14 national organizations representing epidemiology and public health. RESULTS: In all, we developed 149 competency statements across the eight domains of public health practice and four tiers of applied epidemiologic practice. In addition, sub- and sub-subcompetency statements were developed to increase the document's specificity. During the process, >800 comments from all governmental and academic levels and tiers of epidemiology practice were considered for the final statements. CONCLUSIONS: The AECs are available for use in improving the training for and skill levels of practicing applied epidemiologists and should also be useful for educators, employers, and supervisors. Both CDC and CSTE plan to evaluate their implementation and usefulness in providing information for future competency development.Birkhead, Guthrie S Davies, Jac Miner, Kathleen Lemmings, Jennifer Koo, Denise U60/CCU07277/CC/United States CDC Research Support, U.S. Gov't, P.H.S. United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:67-118.0033-3549 (Print)18497021vCenter for Community Health, New York State Department of Health, Albany, NY 12237-0658, USA. gsb02@health.state.ny.useng~|7HReid, W. M. Landis, D. C. Kintz, J. Ruzycki, S. Brown, L. M. Martini, L.2008FIRST things first: a practice-academic collaboration to develop and deliver a competency-based series of applied epidemiology trainings53-8Public Health Rep 123 Suppl 1 2008/05/243Competency-Based Education/ organization & administration Education, Distance Education, Public Health Professional/organization & administration Epidemiology/ education Florida Humans Internet Professional Competence Program Evaluation Public Health Practice Staff Development/organization & administrationThe Florida Center for Public Health Preparedness in the University of South Florida College of Public Health and the Florida Department of Health (FDOH) collaborated to design, develop, and deliver two competency-based epidemiology training programs aimed at increasing the epidemiologic preparedness and response capability of the FDOH workforce. They were also designed to meet the requirements of the National Incident Management System and recommendations or needs identified in national studies. The basis for the trainings is an epidemiology competency set developed by the Northwest Center for Public Health Practice at the University of Washington School of Public Health and Community Medicine. The target audiences for the two trainings are non-epidemiologists or practicing epidemiologists who have relatively little formal education in epidemiology. Both courses have online as well as onsite modules. Alternate tabletop exercises have been completed and delivered for anthrax and plague. Both trainings require participant demonstration of skills. The trainings have been well received, appear to be effective, and are used to credential members of Florida's epidemiology strike teams.3Reid, W Michael Landis, Danielle C Kintz, Jylmarie Ruzycki, Sandra Brown, Lisa M Martini, Leila U90/CCU424263-02/CC/United States CDC Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:53-8.0033-3549 (Print)18497019Florida Center for Public Health Preparedness, College of Public Health, University of South Florida, Tampa, FL 33612, USA. mreid@health.usf.edueng~|7RBaseman, J. G. Marsden-Haug, N. Holt, V. L. Stergachis, A. Goldoft, M. Gale, J. L.2008rEpidemiology competency development and application to training for local and regional public health practitioners44-52Public Health Rep 123 Suppl 1 2008/05/24Competency-Based Education/ organization & administration Education, Distance Educational Measurement Epidemiology/ education Humans Internet Northwestern United States Professional Competence/ standards Public Health Practice/ standardsIn 2002, the Northwest Center for Public Health Practice (NWCPHP) at the University of Washington initiated the Epidemiology Competencies Project, with the goal of developing competency-based epidemiology training for non-epidemiologist public health practitioners in the northwestern United States. An advisory committee consisting of epidemiology faculty and experienced public health practitioners developed the epidemiology competencies. NWCPHP used the competencies to guide the development of in-person trainings, a series of online epidemiology modules, and a Web-based repository of epidemiology teaching materials. The epidemiology competencies provided a framework for collaborative work between NWCPHP and local and regional public health partners to develop trainings that best met the needs of a particular public health organization. Evaluation surveys indicated a high level of satisfaction with the online epidemiology modules developed from the epidemiology competencies. However, measuring the effectiveness of competency-based epidemiology training for expanding epidemiology knowledge and skills of the public health workforce remains a challenge.7Baseman, Janet G Marsden-Haug, Nicola Holt, Victoria L Stergachis, Andy Goldoft, Marcia Gale, James L U90/CCU024247/CC/United States CDC Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:44-52.0033-3549 (Print)18497018Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA 98195, USA. jbaseman@u.washington.edueng~|7PTraicoff, D. A. Walke, H. T. Jones, D. S. Gogstad, E. K. Imtiaz, R. White, M. E.2008:Replicating success: developing a standard FETP curriculum28-34Public Health Rep 123 Suppl 1 2008/05/24MCenters for Disease Control and Prevention (U.S.) Competency-Based Education/ organization & administration Curriculum/standards Education, Public Health Professional/ organization & administration/standards Educational Measurement Epidemiology/ education Humans Professional Competence/standards Public Health Practice United StatesField epidemiology training programs have been successful models to address a country's needs for a skilled public health workforce, partly due to their responsiveness to the countries' unique needs. The Centers for Disease Control and Prevention has partnered with ministries of health to strengthen their workforce through customized competency-based training programs. While desirable, emphasis on program flexibility can result in redundancy and inconsistency. To address this challenge, the ADDIE model (analysis, design, development, implementation, and evaluation) of instructional design was used by a cross-functional team to guide completion of a standard curriculum based on 15 competencies. The standard curriculum has supported the development and expansion of programs while still allowing for adaptation. This article describes the process that was used to develop the curriculum, which, together with needs assessment and evaluation, is crucial for successful training programs.Traicoff, Denise A Walke, Henry T Jones, Donna S Gogstad, Eric K Imtiaz, Rubina White, Mark E United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:28-34.0033-3549 (Print)18497016Division of Global Public Health Capacity Development, Coordinating Office for Global Health, Centers for Disease Control and Prevention, Decatur, GA 30333, USA. DTraicoff@cdc.goveng`~|72McNutt, L. A. Furner, S. E. Moser, M. Weist, E. M.2008Applied epidemiology competencies for governmental public health agencies: mapping current curriculum and the development of new curriculum13-8Public Health Rep 123 Suppl 1 2008/05/24Competency-Based Education/organization & administration Curriculum Education, Public Health Professional/ organization & administration/standards Epidemiology/ education/ organization & administration/standards Humans Professional Competence Public Health Practice United StatesMcNutt, Louise-Anne Furner, Sylvia E Moser, Michael Weist, Elizabeth McGean United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:13-8.0033-3549 (Print)18497013]School of Public Health, University of Albany, State University of New York, Albany, NY, USA.eng||72008mGuiding principles for development of ACIP recommendations for vaccination during pregnancy and breastfeeding580MMWR Morb Mortal Wkly Rep5721 2008/05/30Breast Feeding Centers for Disease Control and Prevention (U.S.) Female Humans Obstetrics/ standards Practice Guidelines as Topic Pregnancy United States Vaccination/ standardsMay 30The Advisory Committee on Immunization Practices (ACIP) provides advice and guidance regarding effective control of vaccine-preventable diseases, including guidance for special populations that might warrant modification of routine recommendations. One such special population is pregnant and breastfeeding women. Formulation of recommendations for vaccination of pregnant and breastfeeding women is challenging because the available scientific evidence needed to guide decisions is limited. To promote use of a consistent process and uniform terminology, the ACIP Workgroup on Vaccines during Pregnancy and Breastfeeding was established in 2007 to develop guiding principles for drafting of ACIP recommendations for vaccination of pregnant and breastfeeding women. Workgroup members included ACIP members, members of professional medical organizations, experts in the field, and CDC consultants.Advisory Committee on Immunization Practices Centers for Disease Control and Prevention (CDC) United States MMWR. Morbidity and mortality weekly report MMWR Morb Mortal Wkly Rep. 2008 May 30;57(21):580.1545-861X (Electronic)18509303mm5721a3 [pii]eng~|7Crutcher, J. M.2008IApplied epidemiology competencies: perspectives of a state health officer11-2Public Health Rep 123 Suppl 1 2008/05/24Competency-Based Education/organization & administration Epidemiology/ education/ organization & administration/standards Humans Professional Competence Public Health Practice Staff Development/organization & administration State GovernmentyCrutcher, James M United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:11-2.0033-3549 (Print)18497012VOklahoma State Department of Health, Oklahoma City, OK 73117, USA. mikec@health.ok.goveng~|7 Thoroughman, D.2008:Applied epidemiology competencies: experience in the field8-10Public Health Rep 123 Suppl 1 2008/05/24Epidemiology/education/ organization & administration Government Agencies/organization & administration Humans Professional Competence Public Health Practice Staff Development/organization & administration State Government United StatesyThoroughman, Doug United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:8-10.0033-3549 (Print)18497011CDR U.S. Public Health Service, Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, KY 40621, USA. douglas.thoroughman@ky.goveng~|7 Moehrle, C.2008HWho conducts epidemiology activities in local public health departments?6-7Public Health Rep 123 Suppl 1 2008/05/24kCenters for Disease Control and Prevention (U.S.)/organization & administration Communicable Disease Control/organization & administration Epidemiology/ organization & administration Government Agencies/organization & administration Humans Local Government Public Health Practice Sentinel Surveillance Staff Development/organization & administration United StatesuMoehrle, Carol United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:6-7.0033-3549 (Print)18497010ZNorth Central District Health Department, Lewiston, ID 83501, USA. cmoehrle@phd2.idaho.goveng~|7 Thacker, S. B. Brownson, R. C.2008.Practicing epidemiology: how competent are we?4-5Public Health Rep 123 Suppl 1 2008/05/24Epidemiology/ organization & administration Evidence-Based Medicine Humans Professional Competence Program Evaluation Public Health Practice Staff Development/organization & administrationThacker, Stephen B Brownson, Ross C United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:4-5.0033-3549 (Print)18497009|Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. sbt1@cdc.goveng!~|7 'Koo, D. Birkhead, G. S. Reingold, A. L.2008ACompetency-based epidemiologic training in public health practice1-3Public Health Rep 123 Suppl 1 2008/05/24Epidemiology/ organization & administration Humans Professional Competence Public Health Practice Staff Development/organization & administrationKoo, Denise Birkhead, Guthrie S Reingold, Arthur L Editorial Introductory United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008;123 Suppl 1:1-3.0033-3549 (Print)18497008eng~|7 Tilson, H. H.2008@Public health accreditation: progress on national accountabilityxv-xxiiAnnu Rev Public Health29 2008/05/17Accreditation Health Policy Humans Institute of Medicine (U.S.) Public Health Administration/ standards Public Health Practice/ standards United StatesnTilson, Hugh H Editorial United States Annual review of public health Annu Rev Public Health. 2008;29:xv-xxii.0163-7525 (Print)18484113eng ||72008Use of enhanced surveillance for hepatitis C virus infection to detect a cluster among young injection-drug users--new York, November 2004-April 2007517-21MMWR Morb Mortal Wkly Rep5719 2008/05/16Adolescent Adult Cluster Analysis Disease Outbreaks/prevention & control Female Hepatitis C/ epidemiology/ prevention & control/transmission Humans Male New York/epidemiology Population Surveillance/ methods Risk Factors Substance Abuse, IntravenousMay 16Infection with hepatitis C virus (HCV) is a leading cause of chronic liver disease in the United States. Chronic hepatitis B and C virus infections were added to the nationally notifiable diseases list in 2003. Approximately 3.2 million persons in the United States have chronic HCV infection. The most common risk factor for HCV infection is illicit drug use (specifically injection-drug use [IDU]), although approximately one third to one half of cases have no identified risk factor. Because approximately 80% of acute HCV infections are asymptomatic and no serologic markers for recent infection exist, distinguishing recent from distant infection based on serology alone is challenging and establishment of national HCV infection incidence is difficult. CDC provides funding to enhance surveillance for HCV infection and other forms of viral hepatitis in New York State (NYS) and seven other areas. One project of enhanced surveillance is to identify those HCV infections most likely to have been acquired recently. Since January 2006, NYSDOH has prioritized follow-up of positive laboratory markers for HCV infection among persons aged <30 years because they are more likely to be newly infected than older persons. In February 2007, NYSDOH detected a cluster of HCV infections among persons in this age group by using the prioritized algorithm. This report describes the subsequent investigation by NYSDOH and the Erie County Department of Health (ECDOH), which identified a group of patients with histories of IDU who were linked through a single high school that all the patients had attended at some time. The findings demonstrate how targeted enhanced surveillance can effectively detect clusters and outbreaks and guide appropriate interventions.Centers for Disease Control and Prevention (CDC) United States MMWR. Morbidity and mortality weekly report MMWR Morb Mortal Wkly Rep. 2008 May 16;57(19):517-21.1545-861X (Electronic)18480744mm5719a3 [pii]eng5||7#Hovell, M. F. Adams, M. A. Semb, G.2008?Teaching research methods to graduate students in public health248-54Public Health Rep1232 2008/05/07Education, Graduate Education, Public Health Professional Educational Measurement Female Humans Linear Models Male Models, Educational Multivariate Analysis Problem-Based Learning Program Evaluation Research/ educationMar-AprHovell, Melbourne F Adams, Marc A Semb, George Clinical Trial Research Support, Non-U.S. Gov't United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008 Mar-Apr;123(2):248-54.0033-3549 (Print)18457081Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA. mhovell@projects.sdsu.edueng ;||7Williams, J. C.2008State of emergency preparedness of Kentucky's rural public health workforce: assessing its ability to identify community health problems178-88Public Health Rep1232 2008/05/07OCivil Defense Data Collection Disaster Planning/organization & administration Health Knowledge, Attitudes, Practice Health Status Humans Inservice Training Kentucky Multivariate Analysis Needs Assessment Population Surveillance Professional Competence Public Health/manpower Rural Health Services/manpower/organization & administrationMar-AprOBJECTIVE: The author examined the emergency preparedness readiness of all workgroups within Kentucky's rural public health departments as it related to the 10 Essential Public Health Services. This article describes the results related to the three emergency preparedness competencies for the first Essential Public Health Service: the ability to monitor health status to identify community health problems. METHODS: Onsite surveys were conducted in one urban and 93 rural Kentucky public health agencies during 2005 and 2006. Categorical data were analyzed using univariate and multivariate analysis techniques. The author compared responses to the level of confidence (LOC) and need for training (NFT) among the seven workgroup classifications. RESULTS: One thousand nine hundred ninety-four public health workers completed the surveys. Of these, 1,813 workers represented 55% of the state's rural local public health workforce. Kentucky's rural public health workforce can be described as predominantly Caucasian, female, and not planning to retire within the next five years. There were significant differences among workgroups for LOC and NFT for each competency examined. Across all workgroups, there was a mean LOC (58%) in the ability to describe the actions to take and procedures to follow in an emergency. There was a correspondingly higher mean perceived NFT (73%) for this competency. CONCLUSION: This study raises the question of whether we are adequately prepared to monitor our communities' health status. Further research that minimizes the limitations of self-reports and, instead, requires the worker to demonstrate the competency may provide a more accurate assessment of emergency preparedness.Williams, John C Multicenter Study United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008 Mar-Apr;123(2):178-88.0033-3549 (Print)18457070University of Kentucky College of Public Health, Depeartment of Health Services Management, Lexington, KY 40536, USA. johnc.williams@ky.goveng u||7Smith, P. J. Singleton, J. A.2008Vaccination coverage estimates for selected counties: achievement of Healthy People 2010 goals and association with indices of access to care, economic conditions, and demographic composition155-72Public Health Rep1232 2008/05/07Child, Preschool Health Services Accessibility Healthy People Programs Humans Infant Models, Statistical Outcome Assessment (Health Care) Poverty Small-Area Analysis Socioeconomic Factors United States Vaccination/ utilizationMar-AprOBJECTIVES: We provided vaccination coverage estimates for 181 counties; evaluated the extent to which Healthy People 2010 (HP 2010) vaccination coverage objectives were achieved; and examined how variations in those estimates depend on access to care and economic conditions. METHODS: We analyzed data for 24,031 children aged 19 to 35 months sampled from the 2004 and 2005 National Immunization Survey. RESULTS: Children living in the 181 counties represented 49% of all the 19- to 35-month-old children living in the U.S. None of the 181 counties had coverage for the polio, measles-mumps-rubella, Haemophilus influenzae type B, and hepatitis B vaccines that was significantly lower than the HP 2010 objective of 90% coverage. However, as many as 30.4% of the counties did not achieve the HP 2010 objective for diphtheria, tetanus toxoids, and acellular pertussis or diphtheria and tetanus toxoids and pertussis (DtaP/DTP), and as many as 6.6% did not achieve the goal for varicella (VAR). If children who received three doses of DTaP/DTP had received a final fourth dose, and if all children had received one dose of VAR, all of the 181 counties would have achieved the HP 2010 vaccination coverage target of 80% for the entire 4:3:1:3:3:1 vaccination series. Factors found to be associated with low county-level vaccination coverage rates were correlates of poverty, and factors found to be associated with high county-level vaccination coverage rates were correlates of access to pediatric services. CONCLUSIONS: HP 2010 vaccination coverage goals for all 181 counties can be achieved by improving vaccination coverage for only two vaccines. Those goals may be achieved most efficiently by targeting interventions in counties where indices of poverty are high or where access to pediatric services is low.Smith, Philip J Singleton, James A United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008 Mar-Apr;123(2):155-72.0033-3549 (Print)18457068Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA 30333, USA. PSmith3@cdc.goveng B||7.Cantreill, J. Hung, D. Fahs, M. C. Shelley, D.2008Purchasing patterns and smoking behaviors after a large tobacco tax increase: a study of Chinese Americans living in New York City135-46Public Health Rep1232 2008/05/07Adolescent Adult China/ethnology Commerce Cross-Sectional Studies Health Behavior Humans Male Middle Aged New York City Smoking/economics/ ethnology/ prevention & control TaxesMar-AprOBJECTIVES: Tobacco taxes are one of the most effective policy interventions to reduce tobacco use. Tax avoidance, however, lessens the public health benefits of higher-priced cigarettes. Few studies examine responses to cigarette tax policies, particularly among high-risk minority populations. This study examined the prevalence and correlates of tax avoidance and changes in smoking behaviors among Chinese American smokers in New York City after a large tax increase. METHODS: We conducted a cross-sectional study with data for 614 male smokers from in-person and telephone interviews using a comprehensive household-based survey of 2,537 adults aged 18-74 years. Interviews were conducted in multiple Chinese dialects. RESULTS: A total of 54.7% of respondents reported engaging in at least one low- or no-tax strategy after the New York City and New York State tax increases. The more common strategies for tax avoidance were purchasing cigarettes from a private supplier/importer and purchasing duty free/overseas. Higher consumption, younger age, and number of years in the U.S. were consistently associated with engaging in tax avoidance. Younger and heavier continuing smokers were less likely to make a change in smoking behavior in response to the tax increase. Despite high levels of tax avoidance and varying prices, nearly half of continuing smokers made a positive change in smoking behavior after the tax increase. CONCLUSIONS: Expanded legislation and enforcement must be directed toward minimizing the availability of legal and illegal low- or no-tax cigarette outlets. Public education and cessation assistance customized for the Chinese American community is key to maximizing the effectiveness of tobacco tax policies in this population.Cantreill, Jennifer Hung, Dorothy Fahs, Marianne C Shelley, Donna R01-CA93788-01/CA/United States NCI Research Support, N.I.H., Extramural United States Public health reports (Washington, D.C. : 1974) Public Health Rep. 2008 Mar-Apr;123(2):135-46.0033-3549 (Print)18457066Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. mjc68@columbia.edueng ||7Rogers, V. Parker, D. Price, J.2008kTranslating the cost benefits of the formal and systematic integration of public health in community design320-2J Public Health Manag Pract143 2008/04/15rCity Planning/ economics/organization & administration Cost-Benefit Analysis Decision Making Florida Public HealthMay-JunThe National Association of County and City Health Officials (NACCHO) is the national organization representing local health departments. NACCHO supports efforts that protect and improve the health of all people and all communities by promoting national policy, developing resources and programs, seeking health equity, and supporting effective local public health practice and systems.Rogers, Valerie Parker, Daniel Price, Julianne News United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):320-2.1550-5022 (Electronic)18408559G10.1097/01.PHH.0000316493.88006.83 [doi] 00124784-200805000-00018 [pii]eng||7 Morrow, J.2008>The role of local public health agencies in pesticide exposure311-2J Public Health Manag Pract143 2008/04/15Agriculture Local Government North Carolina Occupational Exposure/ analysis Pesticides/isolation & purification Population Surveillance Professional Role Public Health Practice Transients and MigrantsMay-JunMorrow, John Comment United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):311-2.1550-5022 (Electronic)18408556<Public Health, Pitt County, Greenville, North Carolina, USA.G10.1097/01.PHH.0000316490.03254.49 [doi] 00124784-200805000-00015 [pii]eng ||7$Tutor, R. P. Zarate, M. A. Loury, S.2008kPesticide exposure surveillance and prevention skills of staff in eastern North Carolina health departments299-310J Public Health Manag Pract143 2008/04/158Agriculture Congenital Abnormalities/prevention & control Female Health Knowledge, Attitudes, Practice Humans Male North Carolina Occupational Exposure/ analysis Organizational Case Studies Pesticides/ isolation & purification Population Surveillance Professional Competence Public Health Practice QuestionnairesMay-JunBACKGROUND: In 2006, the NC Division of Public Health reported on the prenatal occupational pesticide exposures of three female migrant farmworkers whose newborns had birth defects. Unknown response capabilities from local health departments to pesticide exposures led to this pilot study to determine the skills of staff in eastern NC health departments regarding pesticide exposure surveillance and prevention. METHODS: Randomly selected staff (n = 193) from seven health departments participated in the study. Using a self-administered questionnaire, data were gathered on staff's pesticide education, knowledge of resources to assist with pesticide issues, frequency of pesticide surveillance/education activities linked to routine services, and pesticide exposure prevention behaviors that were screened/educated for. FINDINGS: Twelve participants were environmental health staff. All staff completed an average of less than 0.17 pesticide education courses, have minimal knowledge of resources, and conduct limited pesticide exposure surveillance/education. Pesticide exposure surveillance and prevention activities were reported by less than 30 percent of all staff. CONCLUSIONS: Inadequately trained staff lack access to, or knowledge of, resources to effectively engage in pesticide exposure surveillance and prevention activities. Recommendations: To enhance information on surveillance and epidemiology of pesticide chronic exposures at the NC Division of Public Health and to conduct further data analyses of this study.Tutor, Robin P Zarate, Max A Loury, Sharon United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):299-310.1550-5022 (Electronic)18408555vNorth Carolina Agromedicine Institute, East Carolina University, Greenville, North Carolina 27834, USA. tutorr@ecu.eduG10.1097/01.PHH.0000316489.03254.9f [doi] 00124784-200805000-00014 [pii]eng5||7KFarhang, L. Bhatia, R. Scully, C. C. Corburn, J. Gaydos, M. Malekafzali, S.2008~Creating tools for healthy development: case study of San Francisco's Eastern Neighborhoods Community Health Impact Assessment255-65J Public Health Manag Pract143 2008/04/15Environmental Health Organizational Case Studies Program Development Public Health Residence Characteristics Risk Assessment/ methods San Francisco Urban Health Urban RenewalMay-Jun}The San Francisco Department of Public Health recently completed a 2-year collaborative process, the Eastern Neighborhoods Community Health Impact Assessment (ENCHIA), to evaluate the potential positive and negative health impacts of land use development. ENCHIA resulted in a number of outcomes, including (1) a vision of a healthy San Francisco; (2) community health objectives to reflect the vision; (3) indicators and data to assess and measure the objectives and vision; (4) a menu of urban development strategies to advance the objectives; and (5) the Healthy Development Measurement Tool, an evidence-based tool to support accountable, comprehensive, evidence-based, and health-oriented planning. This case study describes the 18-month ENCHIA process, key outcomes, and lessons learned. The case study also provides an overview of the Healthy Development Measurement Tool and examples of its first applications to urban planning. Given the growing understanding of built environmental influences on health, ENCHIA illustrates the ability of a local public health agency to effectively engage in land use policy as a health promotion strategy.Farhang, Lili Bhatia, Rajiv Scully, Cyndy Comerford Corburn, Jason Gaydos, Megan Malekafzali, Shireen United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):255-65.1550-5022 (Electronic)18408550~Program on Health, Equity and Sustainability, San Francisco Department of Public Health, San Francisco, California 94102, USA.G10.1097/01.PHH.0000316484.72759.7b [doi] 00124784-200805000-00009 [pii]eng||7Bassett, E. M. Glandon, R. P.2008$Influencing design, promoting health244-54J Public Health Manag Pract143 2008/04/15Adult City Planning Demography Diet Health Behavior Health Promotion/ organization & administration Humans Information Systems Michigan/epidemiology Motor Activity Organizational Objectives Population Surveillance Public HealthMay-JunThis article provides details of the goals and accomplishments of the Land Use and Health Resource Team composed of public health officials, planners, researchers, extension agents, advocacy organizations, and the development community. The team seeks to understand local land use and health relationships, increase community engagement, and facilitate positive change in policies and the built environment. The team's action plan is (1) research local land use and health relationships; (2) undertake public education and community mobilization; (3) identify interventions, seek funding, and pilot tools to integrate health and planning; and (4) monitor outcomes. In 2005, the team produced a report presenting a picture of local conditions related to health and the built environment. Findings were unveiled at a stakeholder conference, and local best practices and future actions were discussed. A geographic information system-based health impacts tool for use by planners in site plan review was developed. Funding was obtained to facilitate neighborhood organizations to complete self-assessments and develop interventions related to community environments, physical activity, and healthy eating. The team achieved initial goals of creating partnerships and spurring awareness. Future activities include wider field testing of the health impacts tool, participation in a health-oriented master planning process, and monitoring change in health risk behaviors related to changes in the built environment.Bassett, Ellen M Glandon, Robert Paul United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):244-54.1550-5022 (Electronic)18408549SUrban Studies and Planning, Portland State University, Portland, Oregon 97207, USA.G10.1097/01.PHH.0000316483.65135.a1 [doi] 00124784-200805000-00008 [pii]eng2||7 Dalbey, M.2008lImplementing smart growth strategies in rural America: development patterns that support public health goals238-43J Public Health Manag Pract143 2008/04/15Diffusion of Innovation Humans Obesity/epidemiology Organizational Objectives Public Health Rural Population Social Planning United States/epidemiology WalkingMay-JunRecent studies on obesity rates show alarming increases across the entire population. Some of these studies indicate higher rates of obesity in rural populations than urban and suburban populations. Obesity in children in rural places also outpaces their suburban and urban counterparts. Although a number of factors account for these differences, public health professionals and researchers have begun to recognize that conventional development patterns and land use policies in rural areas are playing an important role in the trend. Smart growth alternatives to current rural development patterns also support broad public health goals. Rural communities across America face a number of challenges, yet many are using smart growth development strategies to turn the challenges into opportunities. These strategies are structured in a way that builds on broadly held values in rural communities, ones that build upon the traditional development pattern and support multiple community goals. Public health professionals, managers, and academics will benefit from this discussion because it will explain the strategies that rural decision makers, planners, and citizens are adopting to create places that support multiple community goals including a built environment that sustains and promotes active living.Dalbey, Matthew United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):238-43.1550-5022 (Electronic)18408548Development, Community, and Environment Division, US Environmental Protection Agency, Washington, District of Columbia, USA. dalbey.matthew@epa.govG10.1097/01.PHH.0000316482.65135.e8 [doi] 00124784-200805000-00007 [pii]eng||7Shores, K. A. West, S. T.2008]The relationship between built park environments and physical activity in four park locationse9-16J Public Health Manag Pract143 2008/04/15Centers for Disease Control and Prevention (U.S.) Health Behavior Health Promotion Humans Motor Activity Recreation Risk Factors United StatesMay-JunDespite widespread knowledge that physical activity is a valuable mechanism for preventing many lifestyle diseases, data from the 2001 Behavioral Risk Factor Surveillance System indicate that less than half of the US population met activity recommendations established by the Centers for Disease Control and Prevention. To increase physical activity levels, community officials around the United States have identified public parks as a convenient, low-cost resource to enable active living. However, the amenities of the built park environment that best facilitate active park visits are unknown. The current article describes the relationship of micro-level environmental components and park visitors' physical activity. Using the System for Observing Play and Recreation in Communities, park visitation patterns are documented and described according to user demographics. Broadly, visitors who were observed in park environments, which contained playgrounds, sport courts, and paths, were significantly more active than visitors in settings without these features. Furthermore, six types of built features were able to explain 58% of the variance in observed activity intensity among park visitors. Findings suggest that built features that support physical activity across the life span (paths and courts in particular) may be considered by community leaders seeking relatively low-cost mechanisms to promote physical activity among residents.Shores, Kindal A West, Stephanie T United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):e9-16.1550-5022 (Electronic)18408541~Department of Recreation and Leisure Studies, East Carolina University, Greenville, North Carolina 27858, USA. shoresk@ecu.eduG10.1097/01.PHH.0000316495.01153.b0 [doi] 00124784-200805000-00020 [pii]engX||7(Seagle, H. M. Moore, J. B. DuBose, K. D.2008ZAn assessment of the walkability of two school neighborhoods in Greenville, North Carolinae1-8J Public Health Manag Pract143 2008/04/15zAdolescent Bicycling Child Child, Preschool Humans Motor Activity North Carolina Residence Characteristics Schools WalkingMay-JunyWalking to school provides the opportunity for increasing physical activity and for improving weight status in youth. Social ecological theory recognizes the link between supportive built environments and increased walking. To promote walking to school as a way to increase physical activity in youth, it is important to begin by assessing the presence and quality of sidewalks in school neighborhoods and then to advocate for improvements. The purpose of this study is to demonstrate the assessment of the walkability of two school neighborhood areas, using an evaluation process, which is designed for use by lay community members, that produces maps to disseminate the assessment findings to decision makers. A validated and reliable audit instrument was used to assess the walkability of 114 road segments in the immediately adjacent student enrollment areas surrounding two elementary schools. Ten variables characterizing the transportation and pedestrian environment were measured and used to calculate a walkability score for each road segment. Color-coded maps of the walkability scores for each road segment were created to display the patterns of walkability. Sidewalks were absent in 67 percent and 75 percent of the road segments surrounding the two schools, respectively. The maps reveal that the very few suitable roads for walking are isolated by networks of streets with no sidewalks.Seagle, Heather M Moore, Justin B DuBose, Katrina D United States Journal of public health management and practice : JPHMP J Public Health Manag Pract. 2008 May-Jun;14(3):e1-8.1550-5022 (Electronic)18408539VDepartment of Planning, Policy, and Design, University of California, Irvine, CA, USA.G10.1097/01.PHH.0000316494.93529.e0 [doi] 00124784-200805000-00019 [pii]eng:~|7Prentice, R. L. Anderson, G. L.2008.The women's health initiative: lessons learned131-50Annu Rev Public Health29 2008/03/20Aged Breast Neoplasms/ prevention & control Calcium, Dietary/administration & dosage Colorectal Neoplasms/ prevention & control Coronary Disease/ prevention & control Diet, Fat-Restricted Estrogen Replacement Therapy/adverse effects Female Hip Fractures/ prevention & control Humans Middle Aged Postmenopause Primary Prevention/methods Randomized Controlled Trials as Topic United States Vitamin D/administration & dosage Women's Health.The Women's Health Initiative (WHI) was initiated in 1992 as a major disease-prevention research program among postmenopausal women. The program includes a randomized controlled intervention trial involving 68,132 women and four distinct interventions: conjugated equine estrogens, alone or in combination with medroxyprogesterone acetate, for coronary heart disease prevention with breast cancer as an anticipated adverse effect; a low-fat eating pattern for breast and colorectal cancer prevention; and calcium and vitamin D supplementation for hip fracture prevention. Results from this multifaceted trial have made a substantial impact in clinical practice. A companion cohort study among 93,676 women serves as a source for new risk factor information and provides a comparative observational assessment of the clinical trial interventions. A specimen repository and quality-controlled outcome data for a range of diseases are among the resources that support the ongoing research program. WHI clinical trial contributions and challenges are reviewed and discussed.Prentice, Ross L Anderson, Garnet L CA 119171/CA/United States NCI CA 53996/CA/United States NCI Research Support, N.I.H., Extramural Review United States Annual review of public health Annu Rev Public Health. 2008;29:131-50.0163-7525 (Print)18348708yDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. rprentic@whi.org110.1146/annurev.publhealth.29.020907.090947 [doi]engs~|7Kessler, R. C. Wang, P. S.2008XThe descriptive epidemiology of commonly occurring mental disorders in the United States115-29Annu Rev Public Health29 2008/03/20Adolescent Adult Age Distribution Age of Onset Comorbidity Early Diagnosis Humans Mental Disorders/diagnosis/ epidemiology Middle Aged Prevalence Risk Assessment Severity of Illness Index United States/epidemiologyQData are reviewed on the descriptive epidemiology of commonly occurring DSM-IV mental disorders in the United States. These disorders are highly prevalent: Roughly half the population meets criteria for one or more such disorders in their lifetimes, and roughly one fourth of the population meets criteria in any given year. Most people with a history of mental disorder had first onsets in childhood or adolescence. Later onsets typically involve comorbid disorders. Some anxiety disorders (phobias, separation anxiety disorder) and impulse-control disorders have the earliest age of onset distributions. Other anxiety disorders (panic disorder, generalized anxiety disorder, post-traumatic stress disorder), mood disorders, and substance disorders typically have later ages of onset. Given that most seriously impairing and persistent adult mental disorders are associated with child-adolescent onsets and high comorbidity, increased efforts are needed to study the public health implications of early detection and treatment of initially mild and currently largely untreated child-adolescent disorders.Kessler, Ronald C Wang, Philip S R01 DA 016558/DA/United States NIDA R01 MH 069864/MH/United States NIMH R01 MH 070884/MH/United States NIMH R03 TW 006481/TW/United States FIC R13 MH 066849/MH/United States NIMH U01 MH 60220/MH/United States NIMH Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Review United States Annual review of public health Annu Rev Public Health. 2008;29:115-29.0163-7525 (Print)18348707lDepartment of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA. kessler@hcp.med.harvard.edu110.1146/annurev.publhealth.29.020907.090847 [doi]eng~|74Patz, J. Campbell-Lendrum, D. Gibbs, H. Woodruff, R.2008xHealth impact assessment of global climate change: expanding on comparative risk assessment approaches for policy making27-39Annu Rev Public Health29 2008/01/05?Air Pollution/adverse effects/prevention & control Conservation of Energy Resources Developed Countries Developing Countries Ecosystem Fossil Fuels/adverse effects/standards/utilization Greenhouse Effect Health Status Disparities Humans International Cooperation Public Health Public Policy Risk Assessment World HealthClimate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem. New choices for energy must be made carefully considering such effects as additional pressure on the world's forests through large-scale expansion of soybean and oil palm plantations, leading to forest clearing, biodiversity loss and disease emergence, expulsion of subsistence farmers, and potential increases in food prices and emissions of carbon dioxide to the atmosphere. Investigators must consider the full range of policy options, supported by more comprehensive, flexible, and transparent assessment methods.Patz, Jonathan Campbell-Lendrum, Diarmid Gibbs, Holly Woodruff, Rosalie Review United States Annual review of public health Annu Rev Public Health. 2008;29:27-39.0163-7525 (Print)18173382Center for Sustainability and the Global Environment (SAGE), Nelson Institute for Environmental Studies & Department of Population Health Sciences, University of Wisconsin, Madison, WI 53706, USA. patz@wisc.edu110.1146/annurev.publhealth.29.020907.090750 [doi]engU~|7 Walsh, M. P.2008nAncillary benefits for climate change mitigation and air pollution control in the world's motor vehicle fleets1-9Annu Rev Public Health29 2008/01/05Air Pollution/adverse effects/legislation & jurisprudence/ prevention & control Gasoline/standards Greenhouse Effect Humans International Cooperation Motor Vehicles/ standards/statistics & numerical data Vehicle Emissions/legislation & jurisprudence/ prevention & control World HealthPThe global motor vehicle population has grown very rapidly in the past half century and is expected to continue to grow rapidly for the next several decades, especially in developing countries. As a result, vehicles are a major source of urban air pollution in many cities and are the fastest-growing source of greenhouse emissions. Strategies exist to reduce both problems, but many countries emphasize one over the other rather than pursuing strategies that reduce both concerns. Using diesel as an example, this article illustrates that it is now possible not only to reduce carbon dioxide with the increased use of diesel vehicles but also to improve urban air pollution. Doing so requires both stringent emissions regulations and clean fuels. Several principles contained in the Bellagio Memorandum are highlighted as guides for policy makers.iWalsh, Michael P Review United States Annual review of public health Annu Rev Public Health. 2008;29:1-9.0163-7525 (Print)18173380XInternational Council on Clean Transportation, Arlington, VA 22207, USA. mpwalsh@igc.org110.1146/annurev.publhealth.29.091307.083257 [doi]eng~|7Kovats, R. S. Hajat, S.20080Heat stress and public health: a critical review41-55Annu Rev Public Health29 2007/11/23Age Factors Air Conditioning Greenhouse Effect Heat/ adverse effects Heat Stress Disorders/epidemiology/etiology/prevention & control Housing/standards Humans Information Dissemination Public Health Residential Facilities/standards Vulnerable PopulationsHeat is an environmental and occupational hazard. The prevention of deaths in the community caused by extreme high temperatures (heat waves) is now an issue of public health concern. The risk of heat-related mortality increases with natural aging, but persons with particular social and/or physical vulnerability are also at risk. Important differences in vulnerability exist between populations, depending on climate, culture, infrastructure (housing), and other factors. Public health measures include health promotion and heat wave warning systems, but the effectiveness of acute measures in response to heat waves has not yet been formally evaluated. Climate change will increase the frequency and the intensity of heat waves, and a range of measures, including improvements to housing, management of chronic diseases, and institutional care of the elderly and the vulnerable, will need to be developed to reduce health impacts.Kovats, R Sari Hajat, Shakoor Research Support, Non-U.S. Gov't Review United States Annual review of public health Annu Rev Public Health. 2008;29:41-55.0163-7525 (Print)18031221Public and Environmental Health Research Unit (PEHRU), London School of Hygiene and Tropical Medicine, London, UK. Sari.Kovats@lshtm.ac.uk110.1146/annurev.publhealth.29.020907.090843 [doi]eng||7 TReynolds, F. Petrovic, M. Will, S. Dutton, A. Paver, K. Kirkpatrick, A. Kempster, J.2008gManagement of measles in a traveller community: public health issues of trust, choice and communication390-3 Public Health1224 2007/10/26WAdolescent Emigrants and Immigrants Great Britain Health Education/organization & administration Humans Immunization Programs/organization & administration Male Measles/ epidemiology/ prevention & control Measles-Mumps-Rubella Vaccine/administration & dosage/ therapeutic use Public Health/ methods State Medicine/organization & administrationAprReynolds, Fiona Petrovic, Marko Will, Sheila Dutton, Andrea Paver, Keith Kirkpatrick, Aidan Kempster, Jeanette Case Reports England Public health Public Health. 2008 Apr;122(4):390-3. Epub 2007 Oct 23.0033-3506 (Print)17959206AUniversity of Manchester, Manchester, UK. FionaReynolds@gmail.com<S0033-3506(07)00270-3 [pii] 10.1016/j.puhe.2007.07.020 [doi]engL||7!6Kohr, J. M. Strack, R. W. Newton-Ward, M. Cooke, C. H.2008gThe use of programme planning and social marketing models by a state public health agency: a case study300-6 Public Health1223 2007/10/12Benchmarking Data Collection Health Planning Health Promotion Humans Interviews as Topic North Carolina Public Health Public Health Practice Qualitative Research Social MarketingMar{OBJECTIVES: To investigate the use of planning models and social marketing planning principles within a state's central public health agency as a means for informing improved planning practices. METHODS: Qualitative semi-structured interviews were conducted with 30 key programme planners in selected division branches, and a quantitative survey was distributed to 63 individuals responsible for programme planning in 12 programme-related branches. RESULTS: Employees who have an appreciation of and support for structured programme planning and social marketing may be considered the 'low hanging fruit' or 'early adopters'. On the other hand, employees that do not support or understand either of the two concepts have other barriers to using social marketing when planning programmes. A framework describing the observed factors involved in programme planning on an individual, interpersonal and organizational level is presented. CONCLUSIONS: Understanding the individual and structural barriers and facilitators of structured programme planning and social marketing is critical to increase the planning capacity within public health agencies.}Kohr, J M Strack, R W Newton-Ward, M Cooke, C H England Public health Public Health. 2008 Mar;122(3):300-6. Epub 2007 Oct 24.0033-3506 (Print)17928018HUniversity of North Carolina-Greensboro, Greensboro, NC 27402-6170, USA.<S0033-3506(07)00201-6 [pii] 10.1016/j.puhe.2007.06.009 [doi]engj~|7" Wakefield, J.2008Ecologic studies revisited75-90Annu Rev Public Health29 2007/10/05Bias (Epidemiology) Cluster Analysis Confounding Factors (Epidemiology) Data Interpretation, Statistical Ecology/ methods/standards Epidemiologic Methods Geographic Information Systems Humans Infant North Carolina/epidemiology Sudden Infant Death/epidemiologyfEcologic studies use data aggregated over groups rather than data on individuals. Such studies are popular because they use existing databases and can offer large exposure variation if the data arise from broad geographical areas. Unfortunately, the aggregation of data that define ecologic studies results in an information loss that can lead to ecologic bias. Specifically, ecologic bias arises from the inability of ecologic data to characterize within-area variability in exposures and confounders. We describe in detail particular forms of ecologic bias so that their potential impact on any particular study may be assessed. The only way to overcome such bias, while avoiding uncheckable assumptions concerning the missing information, is to supplement the ecologic with individual-level information, and we outline a number of proposals that may achieve this aim.Wakefield, Jonathan R01 CA 095994/CA/United States NCI Research Support, N.I.H., Extramural Review United States Annual review of public health Annu Rev Public Health. 2008;29:75-90.0163-7525 (Print)17914933tDepartment of Statistics and Biostatistics, University of Washington, Seattle, WA 98195, USA. jonno@u.washington.edu110.1146/annurev.publhealth.29.020907.090821 [doi]eng~|7#Cava, M.2008=Is public health ready for a professional practice framework?57-63J Health Serv Res Policy 13 Suppl 1 2008/04/23Focus Groups Humans Interviews as Topic Ontario Professional Competence/standards Professional Practice/ standards Public HealthJan*OBJECTIVE: To develop a framework for professional practice for a large urban public health unit in Canada. METHODS: The project involved a literature search, key informant interviews, an environmental scan and focus groups. RESULTS: Analysis and synthesis led to recommendations for the development of discipline-specific Professional Practice Leaders (PPL) and an Interprofessional Practice Leaders Network. The latter meets to discuss cross-cutting practice issues and is chaired by the chief executive officer of the health unit, the Medical Officer of Health. The one-year evaluation has demonstrated that this initiative has worked well in practice. It is a flexible framework which provides new leadership opportunities and gives staff valuable input into decision-making on practice issues. It is also a more efficient use of staff resources, including a comprehensive approach to solving problems and in breaking down silos between programs. Communication and collaboration between disciplines has increased. CONCLUSION: The initiative was evaluated successfully after the pilot year. In going forward areas to review include the time allotment for the PPL, communication between the PPL, the respective Program Director and the entire department, and expanding professional development opportunities for the PPL.wCava, Maureen England Journal of health services research & policy J Health Serv Res Policy. 2008 Jan;13 Suppl 1:57-63.1355-8196 (Print)18325171kToronto Public Health--Planning and Policy, 277 Victoria Street, Toronto, Ontario, Canada. mcava@toronto.ca10.1258/jhsrp.2007.007069 [doi]eng *||7$$O'Cathain, A. Murphy, E. Nicholl, J.2008@The quality of mixed methods studies in health services research92-8J Health Serv Res Policy132 2008/04/18UGreat Britain Health Services Research/ methods/ standards Humans Interviews as TopicAprfOBJECTIVES: To assess the quality of mixed methods studies in health services research (HSR). METHODS: We identified 118 mixed methods studies funded by the Department of Health in England between 1994 and 2004, and obtained proposals and/or final reports for 75. We applied a set of quality questions to both the proposal and report of each study, addressing the success of the study, the mixed methods design, the individual qualitative and quantitative components, the integration between methods and the inferences drawn from completed studies. RESULTS: Most studies were completed successfully. Researchers mainly ignored the mixed methods design and described only the separate components of a study. There was a lack of justification for, and transparency of, the mixed methods design in both proposals and reports, and this had implications for making judgements about the quality of individual components in the context of the design used. There was also a lack of transparency of the individual methods in terms of clear exposition of data collection and analysis, and this was more a problem for the qualitative than the quantitative component: 42% (19/45) versus 18% (8/45) of proposals (p = 0.011). Judgements about integration could rarely be made due to the absence of an attempt at integration of data and findings from different components within a study. CONCLUSIONS: The HSR community could improve mixed methods studies by giving more consideration to describing and justifying the design, being transparent about the qualitative component, and attempting to integrate data and findings from the individual components.O'Cathain, Alicia Murphy, Elizabeth Nicholl, Jon United Kingdom Medical Research Council Research Support, Non-U.S. Gov't England Journal of health services research & policy J Health Serv Res Policy. 2008 Apr;13(2):92-8.1355-8196 (Print)18416914Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK. a.ocathain@sheffield.ac.uk10.1258/jhsrp.2007.007074 [doi]engPKf8I/**refs.FRM 0B< !// !HPRIMARYyearIndex 6ByP/) idreference_type text_stylesauthoryear title pages secondary_title volume numbernumber_of_volumessecondary_authorplace_published publishersubsidiary_authoredition keywords type_of_workdate2)  abstractlabelurltertiary_titletertiary_author notes isbn custom_1 custom_2 custom_3 custom_4alternate_titleaccession_number call_number short_title custom_5 custom_6sectionoriginal_publicationH) reprint_editionreviewed_itemauthor_addressimagecaption custom_7 electronic_resource_number link_to_pdf translated_author translated_titlename_of_databasedatabase_providerresearch_notes language access_datelast_modified_date !! 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