Strengthening Linkages Between Health Care and Public Health: A Novel Framework for Public Health Action in Health Care Settings to Improve Cardiovascular Disease Risk.

The Chronic Disease Prevention and Control Program (CDPCP) at the Nebraska Department of Health and Human Services developed a novel public health framework and tools to translate public health knowledge, grant work, and terminology to a health care audience in order to inform clinical practice changes in the management of hyperlipidemia and hypertension. The CDPCP piloted the tools with 2 accountable care organizations that included 19 clinics and then funded 9 independent clinics. The project sought to empower clinics to design and implement interventions for reducing high blood pressure and high blood cholesterol focused on populations disproportionately at risk for those conditions utilizing electronic health records. A team comprising the CDPCP and evaluation specialists created a framework called CAAPIE (Capture, Assess, Action Plan, Implement, Evaluate) to provide a clinic-friendly approach to the public health-focused work. For the capture phase, baseline data were collected from clinics. To guide the assess, action plan, and evaluate phases, the team created a Scan & Plan Tool for clinics to assess practices and policies and then use results to develop an action plan. The assessment was repeated upon completion of the project to evaluate change. Interviews were conducted to assess the utility of these tools and capture information related to the implementation of the project. Clinicians reported the framework and tools provided a useful approach, aiding clinics in understanding public health terminology and intended outcomes of the project. Work resulted in the creation of new or enhanced clinical policies and procedures that led to modest improvements in the management of high blood pressure and high cholesterol. The CAAPIE framework is a novel approach for state health departments to utilize in translating public health grant work to health care professionals, promoting a working relationship between the spheres to achieve positive impacts on individual and population-based health care.

Determinants of Physical Activity for Latino and White Middle School-Aged Children.

BACKGROUND: Physical activity (PA) has long been acknowledged to contribute health benefits among children. However, research has consistently shown that PA declines as children grow older. Thus, this study examined the factors which are associated to children's PA in order to identify potential barriers to PA. METHODS: Using data from the KidQuest Program, we conducted bivariate and multivariate analyses on survey data collected from fifth to seventh grade students in a small Midwestern city. RESULTS: We found that food knowledge, eating breakfast, and talking with family about eating healthy foods, are positively related to PA. On the other hand, screen time is negatively related to PA. In addition, our results evinced differences between ethnicities and found that Latino children's screen time affects their PA levels more than their white counterpart. CONCLUSIONS: There are different factors which can be tapped to increase PA among middle school-aged children. Given the differences between the Latino and white samples especially in screen time, schools should consider individualized intervention, rather than a "one size fits all" program, to increase PA participation.

Facilitators and barriers to students' learning in an obesity prevention graduate program.

Childhood obesity is a major public health concern with underpinnings at the individual, family, community and societal levels. The Transdisciplinary Childhood Obesity Prevention Graduate Certificate Program (TOP) is an innovative graduate-level certificate program developed to train professionals to understand and address obesity from multiple perspectives using an interprofessional education (IPE) approach. Currently, there is limited knowledge on what promotes or hinders learning in IPE approaches dealing with obesity prevention. The goal of this report is to address this gap by describing facilitators and barriers to learning in a graduate-level training program. Using a qualitative research design, semi-structured interviews were collected from 23 professional students, as part of a larger program evaluation project for TOP. Thematic analysis revealed the challenges and strengths of the program that relate specifically to: its interprofessional approach, its structure, and its activities. Interprofessional exchanges were reported to expand students' learning, but adequate interprofessional representation must be maintained, and the complexity of interprofessional collaborations must also be well-coordinated. Standardising the program structure and courses for consistency across professions, and clear communication are critical to program success. Findings add to the existing literature on what promotes effective learning in a professional obesity prevention program using an IPE approach.

What do direct care workers say would improve their jobs? Differences across settings.

PURPOSE: The study's goals were to understand what changes in management practices would most improve the jobs of frontline workers from the perspective of workers themselves and to analyze differences across settings. DESIGN AND METHODS: The baseline survey of direct care workers (N=3,468) conducted as part of the National Study of the Better Jobs Better Care demonstration asked the following: "What is the single most important thing your employer could do to improve your job as a direct care worker?" We coded the open-ended responses and grouped them into categories. We then compared the percentages of workers recommending changes in these categories across settings and interpreted them in the context of previous conceptual frameworks. RESULTS: Across settings, workers called for more pay and better work relationships including communication; supervision; and being appreciated, listened to, and treated with respect. The fraction of workers calling for these changes and additional specific changes differed substantially across nursing facilities, assisted living facilities, and home care agencies. IMPLICATIONS: To increase retention of frontline workers, policy makers should design public policies and management practices to increase pay and to improve work relationships. However, specific strategies should differ across settings.