Public Health Student Works

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Reports, posters, proceedings, presentations, articles and working papers by Fairbanks School of Public Health students.

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    Working with Overdose Lifeline to Influence State Policy: Syringe Decriminalization, Senate Bill 11, and A Day of Advocacy
    (2019-04-26) Pike, Caitlin; Richardson, Heather; Sterling, Catherine
    Our Capstone group worked with Overdose Lifeline, an Indianapolis non-profit group that advocates for increased harm reduction solutions to prevent overdose deaths and disease transmission. On January 3, 2019, Sen. Mike Bohacek and Sen. James Merritt introduced Senate Bill 11, which acted to amend current Syringe Exchange Program (SEP) legislation. Specifically, SB 11 proposed to “establish and maintain a syringe exchange program registry” that would track SEP participants statewide. The bill required a “qualified entity” to create a database that contains SEP participant names, dates of birth, last four of SSNs, and other identifying information to be determined, but did not name that entity and left many other questions unanswered.
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    Training Indiana's Family Medicine Residents to Address the Problem of Prescription Drug Abuse
    (2013-08-05) Fielding, Stephen M.; Duwve, Joan; Wilson, Gregory; Steele, Gregory
    Prescription drug abuse has been a growing problem in Indiana and around the nation for almost two decades. In recent years, prescription drug overdoses have pushed drug poisonings ahead of motor vehicle crashes as the leading cause of injury death. However, deaths due to overdoses of prescription drugs are only the tip of the iceberg when it comes to the much larger problem of abuse. This study has characterized prescription drug abuse in Indiana and taken an in-depth look at how it is and can be addressed both through organizational policies and state legislation. Opioid painkillers such as hydrocodone, oxycodone, and methadone are the most commonly abused prescription drugs, and most of these prescriptions are written by primary care physicians. Because more than 70% of Indiana’s family medicine residents will remain in the state to practice medicine following the conclusion of their residencies, it is worthwhile to take a look at how these residents are being educated during their training. St. Vincent’s Family Medicine Residency program in Indianapolis is one of several residency programs in Indiana training their residents on best practices of prescribing controlled substances. A review of residents’ prescribing patterns before and after training on the subject went into effect showed significant reductions in the number of opioid painkillers being prescribed, and showed the same reductions for alprazolam, a benzodiazepine anxiolytic.
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    Recruitment, Retention, and Evaluation Associated with American Recovery and Reinvestment Act of 2009
    (2014-08-28) Maxey, Hannah L.; Norwood, Connor W.; Walters, Stacie Jo; Sheff, Zachary
    Healthcare workforce shortages are central to healthcare reform discussions and are critical areas of interest for Indiana State Department of Health (ISDH). The National Health Service Corps (NHSC) is a financial incentive program that provides scholarship or loan repayment to primary healthcare providers in return for periods of obligation serving federally designated underserved communities. The American Recovery and Reinvestment Act of 2009 (ARRA) increased funding to the NHSC program with the intent of strengthening and expanding the NHSC program capacity. In addition to building workforce capacity, funding was made available to State Primary Care Offices (PCOs) for the coordination and implementation of activities to support NHSC participants, enhance recruitment and retention post-obligation, and evaluation of the impact of ARRA funding for the NHSC program. Indiana Area Health Education Centers (AHEC) Network entered into a contract with ISDH for the purpose of supporting current ARRA-funded NHSC scholars, clinicians, and obligation sites to improve retention and provider satisfaction. In addition, a team of researchers at the Center for Health Policy (CHP) in the Richard M. Fairbanks School of Public Health, Indiana University Purdue University Indianapolis (IUPUI) were subcontracted to perform an evaluation of activities outlined in the AHEC contract and evaluate the impact of ARRA funding on NHSC clinician retention, primary healthcare access, and primary care capacity. The NHSC project team, comprised of key personnel from AHEC and CHP, developed and administered surveys, conducted key informant interviews facilitated focus groups to gather data representing perspectives and experiences from ARRA-funded NHSC clinicians and obligation sites administrators to identify key issues and generate recommendations for the Indiana NHSC Program. The NHSC project team was comprised of key personnel from AHEC and CHP. The team developed and administered surveys, conducted key informant interviews, and facilitated focus groups. The activities were carried out to gather data on perspectives and experiences of ARRA-funded NHSC clinicians and site administrators in order to generate recommendations for the Indiana NHSC Program.
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    Indiana Housing & Community Development Authority: Policy Evaluation of Aging in Place
    (2014-08-28) Norwood, Connor W.; Omenka, Isaac O.
    Aging in place refers to making the living environment safe and adaptable for everyone to remain independent and thrive in their homes and community even as circumstances change. The primary target populations for aging in place strategies are seniors and persons with disabilities. The effort involves construction of buildings and communities that are accessible, and livable. Creation of these housing opportunities means Hoosiers can choose how and where they live: rent or own, urban or rural, close to school or close to work. The Indiana Housing and Community Development Authority (IHCDA) has been working on developing a working definition of “Aging in Place” (AiP) in order to enhance the aging in place strategic initiative to support seniors and persons with disabilities in Indiana. As a result an evaluation of the current initiative was completed to determine the needs of the target population and to enhance the strategic priority. The goal of the program evaluation is to determine if the working definition of AiP fully encompasses the needs of the community and target population. The evaluation design involves learning and improvement of the IHCDA AiP priority and intends to improve the process. The evaluation team conducted one focus group to collect more in-depth information on perceptions, insights, attitudes, experiences, and beliefs regarding AiP. Five major themes from the focus group were identified including family, accessibility, independence, community integration, and finances. The evaluation was also able to identify a unique perspective of the definition of “home” shared by the aging in place community. To establish a home a physical and psychological component must be met. Furthermore, independent senior living communities were identified as being in high demand. Based on the findings of the evaluation, three recommendations were developed to enhance the AiP priority at IHCDA. It is recommended that IHCDA amend the working definition to explicitly characterize the meaning of home based on the findings of this evaluation. IHCDA should also increase allocation of funds to independent senior living communities and should perform ongoing evaluations to ensure that current needs of the AiP community are being identified and met. Ongoing evaluation with the data collection tool developed in this evaluation will ensure that the AiP strategic priority at IHCDA is on the right path moving forward.
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    Conscientious objection in the healing professions: a readers' guide to the ethical and social issues
    (One Health: Information in an Interdependent World. Medical Library Association Annual Meeting and Exhibition; 2013 May 6-8; Boston, MA. http://www.mlanet.org/am/am2013/, 2013-05-07) Odell, Jere D.; Comer, Amber (Malcolm); Rua, Avril N.; Abhyankar, Rahul
    What is a health care provider to do when they find that their moral integrity is at odds with professional expectations? Should a nurse with religious objections to assisted reproduction be asked to stop working in obstetrics and gynecology? Can a pharmacist with moral objections to emergency contraception refer a patient to a colleague without being complicit in a perceived moral wrong doing? Should religious organizations be required to provide or pay for objectionable health services? When is a patient's health and well-being more important than a professional's moral integrity? Here we: 1) describe a collaboration between a medical librarian and the Indiana University (IU) Conscience Project 2) outline the subject of conscientious objection in the healing professions, and 3) introduce a new readers' guide on the topic.