Breaking Barriers: Advancing the Mission of The Equity in Heart Transplant Project.

The Equity in Heart Transplant Project, Inc (TEHTP), a 501(c)(3) public charity founded in 2022, addresses financial and social barriers impeding access to heart transplantation for patients with end-stage heart failure in the United States. Rooted in the World Health Organization's declaration on health as a fundamental right, TEHTP champions equitable care. Financial impediments disproportionately affect minority populations, perpetuating disparities in heart transplant outcomes. Since its inception in 2022, TEHTP has successfully supported 31 patients. Looking ahead, TEHTP aims to influence health policies surrounding insurance coverage through advocacy efforts and expand assistance to posttransplant care. Past accomplishments and future goals exemplify the organization's commitment to eradicating systemic barriers and ensuring that poverty does not become a death sentence for transplant patients.

Empowerment at Work?: Examining Employment-Based Economic Empowerment Initiatives for Survivors of Commercial Sexual Exploitation.

Many organizations serving survivors of commercial sexual exploitation (CSE) have begun economic empowerment programs, providing financial literacy education, vocational training, and/or employment opportunities for survivors. Yet, very little research has examined these programs, especially those that employ survivors. This project draws on a qualitative, multi-method study of 15 organizations that serve and employ CSE survivors to examine how economic empowerment is constructed through organizational discourse and practices, what tensions emerge in these processes, and how organizational actors frame and respond to them. The findings outline the components of "economic empowerment" and explicate the key tensions of authority-autonomy and compassion-accountability.

Oral health, a public health issue in 2023: Reflections and actions of the ASPBD / La santé orale, un enjeu de santé publique en 2023 ­ Réflexions et actions de l'ASPBD

The first Dental Public Health Day, in 2001, was not only the starting point for the creation of the Association des Acteurs de la Santé Publique Bucco-Dentaire (ASPBD), but also for the recognition of this specialty in France, even though it had already been recognized by the American Dental Association as early as 1950. Every year, the ASPBD organizes a national oral health day. The ASPBD brings together the vast majority of French odontologists and academic researchers in the field, as well as other French-speaking academics. Throughout the year, we work to bring together the dental and non-dental worlds, mainly the institutional and non-profit sectors with users, freelancers, and employees, the World Health Organization, and the French Public Health Society. This is in keeping with the partnership approach taken by the association for the past twenty-two years. Our aim is to bring together all the actors concerned to work toward integrating oral health into all health policies and health promotion and prevention schemes. We believe it is vital to provide oral health training for medical and paramedical staff, as well as for those working in education and outreach. Likewise, we are working to ensure that prevention is organized on a territorial level, involving local people as closely as possible and focusing on their needs. This is why we are actively involved in the fight against social and territorial inequalities in health, oral health being a strong indicator of these inequalities.

La première Journée de santé publique dentaire, en 2001, a été non seulement le point de départ de la création de l'association des Acteurs de la santé publique bucco-dentaire (ASPBD), mais aussi celui de l'identification en France de cette spécialité, alors qu'elle était déjà reconnue comme telle par l'Association dentaire américaine dès 1950. L'ASPBD organise, depuis annuellement une journée nationale de santé publique bucco-dentaire. L'ASPBD rassemble la grande majorité des odontologistes, enseignants-chercheurs hospitalo-universitaires français, mais aussi les autres hospitalo-universitaires francophones. Nous œuvrons tout au long de l'année à faire travailler ensemble le dentaire et le non-dentaire, principalement le monde institutionnel et associatif avec les usagers, les libéraux et les salariés, l'Organisation mondiale de la santé et la Société française de santé publique. À l'image du binôme qui préside chacune de nos journées depuis vingt-deux ans. Notre association a pour vocation de rassembler tous les acteurs concernés pour œuvrer à l'intégration de la santé orale dans toutes les politiques de santé et dispositifs de promotion de la santé et de prévention. Nous pensons qu'il est indispensable de former à la santé orale tant les personnels médicaux et paramédicaux que ceux de l'éducation et de l'animation. De même, nous agissons pour que la prévention s'organise à l'échelon territorial, au plus près des populations en fonction de leurs besoins. C'est le sens de notre participation active à la lutte contre les inégalités sociales et territoriales de santé, la santé orale étant un marqueur fort d'inégalités sociales de santé.

An action research partnership in an urban Texas county to explore barriers and opportunities for collaborative community health needs assessments.

Background: The Affordable Care Act mandated triennial community health needs assessments (CHNAs) for greater nonprofit hospital accountability in responding to community health needs. Over 10 years later, hospital spending on community benefits remains largely unchanged. While greater collaboration in CHNA implementation can increase hospital investment in community-based initiatives, nonprofit hospitals in conservative states are subject to policy, political, and economic factors that inhibit public health partnerships and magnify existing disparities in health care access. This participatory action research study explores the decision-making environment of collaborative CHNA implementation within a group of nonprofit hospitals in a north Texas urban county. Methods: In 2017 faculty from an urban anchor institution initiated an academic-community partnership with a coalition of nonprofit hospitals, public health departments, and academic institutions. An interdisciplinary research team engaged in multi-method document review and qualitative data collection to describe historical barriers for local CHNA processes and develop practical strategies for joint CHNA initiatives. Local CHNA documents were first reviewed through team-based content analysis and results applied to develop a qualitative study protocol. Key informants were recruited from county-based nonprofit hospitals, community-based nonprofit organizations, and public health systems. Seventeen senior- and mid-level professionals participated in semi-structured research interviews to describe their perspectives relating to CHNA-related planning and implementation decisions. Through iterative data collection and analysis, the research team explored CHNA-related knowledge, experiences, and processes. A constructivist lens was subsequently applied to examine historical barriers and future opportunities for local collaboration. Results: Findings reveal CHNA implementation is a multi-stage cyclical process in organizational environments with accountability to a wide range of public and private stakeholders. This promotes varied levels of inclusivity and conservatism in data collection and community benefit implementation. Decisions to collaborate are hindered by competing priorities, including compliance with existing guidelines, administrative simplicity, alignment with health care service delivery, and efficient resource use. Efforts to promote greater CHNA collaboration may be facilitated through intentional alignment with organizational priorities and clearly communicated benefits of participation for leaders in both public and private nonprofit health systems. Discussion: We consider implications for policymakers and health systems in restrictive political environments and advance a conceptual framework for greater CHNA collaboration.

Public welfare crowdfunding decision-making of environmental nonprofit organizations based on social responsibility.

Sustainable crowdfunding has emerged as a significant factor in the quest for alternative funding streams in recent times. The process has entailed the removal of financial obstacles and intermediaries, facilitating proximity between entrepreneurs' initiatives and fund providers, thereby initiating modifications in conventional investment and profitability criteria. The correlation between corporate social responsibility (CSR) and sustainable business returns is a significant metric that may enhance funding costs. CSR initiatives and crowdfunding possess the potential for mutually beneficial outcomes in terms of fundraising. However, fundraisers encounter obstacles and competition in their efforts to attain their donation objectives. As an illustration, CSR endeavors may provide a chance to raise capital via crowdfunding. Conversely, crowdfunding has the potential to serve as a means of micro-funding various social initiatives that align with a corporation's corporate social responsibility objectives. The present research investigates the correlation between efficacious donation fundraising campaigns in the context of crowdfunding endeavors that hold the possibility of transforming into corporate social responsibility initiatives. The present study investigates the correlation between the initial amount of funds raised on the first day of a fundraising campaign and the target amount of funds sought by the fundraiser, as well as the type of activities involved. The present study utilizes data derived from crowdfunding endeavors in Southeast Asian nations to scrutinize the funds amassed through donations by juxtaposing trends, cultures, and characteristics of fundraisers employing donation-based crowdfunding. The present investigation employs data collected between the period spanning from the beginning of September 2021 to the end of September 2021 in the economies of Southeast Asia, including Singapore, Indonesia, Malaysia, Thailand, and the Philippines. The present investigation utilizes the partial least squares structural equation modeling (PLS-SEM) approach for the estimation of the variables. The findings of the hypothesis indicate that there exists a positive correlation between crowdfunding, environmental nonprofit organizations, organizational profitability, and CSR.

Building resilient partnerships: How businesses and nonprofits create the capacity for responsiveness.

Increasingly, businesses are eager to partner with nonprofit organizations to benefit their communities. In spite of good intentions, differences between nonprofit and business organizations can limit the ability of potential partnerships to respond to a changing economic and public health landscape. Using a retrospective, multiple-case study, we sought to investigate the managerial behaviors that enabled businesses and nonprofits to be themselves together in sustainable partnerships. We recruited four nonprofit-business partnerships in the Boston area to serve as cases for our study. Each was designed to address social determinants of health. We thematically analyzed qualitative data from 113 semi-structured interviews, 9 focus groups and 29.5 h of direct observations to identify organizational capacities that build resilient partnerships. Although it is common to emphasize the similarities between partners, we found that it was the acknowledgement of difference that set partnerships up for success. This acknowledgement introduced substantial uncertainty that made managers uncomfortable. Organizations that built the internal capacity to be responsive to, but not control, one another were able to derive value from their unique assets.

Information-led Policing: Non-Profit Organization's Terrorist Financing.

In order to prevent and fight terrorism, a new research area has developed called terrorist financing. An important aspect is the financing of terrorism by Non-Profit Organization (NPO), through transfer funds, terrorist alliances, abuse of NPOs, terrorist recruitment, and false NPOs and agents. Therefore, the NPO counter-terrorist financing strategy was established, considering four major aspects: warning information indicators, internal management mechanisms, international cooperation and information sharing, and counter-terrorist Financing legislation. This paper provides a new way to supervise the terrorist financing of NPOs. First, actual cases should be collected, and viable warning indicators for regulatory agencies and NPOs should be established. Second, internal management mechanisms should be strengthened to actively prevent terrorist activities within NPOs. Third, given the global activity of NPOs and terrorist organizations, information-led international cooperation must be emphasized. Fourth, from the angle of independent counter-terrorist Financing legislation, the gap should be filled in NPO counter-terrorist Financing legislation.

Influence of Not-for-Profit Hospital Ownership Type on Community Benefit and Charity Care.

Non-profit hospitals are expected to provide charity care and other community benefits to adjust their tax exemption status. Using the Medicare Hospital Cost Report, American Hospital Association Annual Survey, and the American Community Survey datasets, we examined if church-affiliated hospitals spent more on charity care and community benefit. For this analysis, we defined five main categories of community benefits were measured: total community benefit; charity care; Medicaid shortfall; unreimbursed other means-tested services; and the total of unreimbursed education and unfunded research. Multiple regression was used to examine the effect of church ownership, controlling for other factors, on the level of community benefit in 2644 general acute care non-profit hospitals. Descriptive analyses and multiple regression were used to show the relationship between the provision of community benefits and church affiliation including Catholic (CH), other church-affiliated hospitals (OCAH), and non-church affiliated hospitals (NCAH). The non-profit hospital on average spent 6.5% of its total expenses on community benefits. NCAH spent 6.09%, CH spent 7.5%, and OCAH spent 9.4%. Non-profits spent 2.8% of their total expenses on charity care, with the highest charity care spending for OCAH (5.2%), followed by CH (3.9%), and NCAH (2.4%). Regression results showed that CH and OCAH, on average, spent 1.08% and 2.16% more on community benefits than NCAHs. In addition, CH and OCAH spent more on other categories of community benefits except for education and research. Church-affiliated hospitals spend more on community benefits and charity care than non-church affiliated nonprofit hospitals.

The new world of philanthropy: How changing financial behavior, public policies, and COVID-19 affect nonprofit fundraising and marketing.

Evolving financial behavior, an unpredictable public policy atmosphere, and an unparalleled global pandemic have collaborated to disrupt nonprofit fundraising. The COVID-19 pandemic alone exacerbated consumer demands for nonprofit services while curtailing nonprofit organizations' ability to fundraise. Without fundraising, nonprofit organizations cannot achieve their mission or support their causes, leading to a precarious situation for societal well-being. Meanwhile, consumers are changing their financial behaviors, with younger generations often going cashless. At the same time, governments continue to change policies that affect nonprofit organizations. In keeping with the transformative consumer research movement, the present study provides a conceptual framework for the state of nonprofit fundraising amid the challenges associated with changes in financial behavior and public policy, coupled with the effects of the global pandemic. Marketing strategies for fundraising success are presented to aid nonprofits going forward and serve societal interests.

A Case Study of Community-Academic Partnership in Improving the Quality of Life for Asthmatic Urban Minority Children in Low-Income Households.

Community-academic partnerships (CAPs) are being increasingly used to study and address health disparity issues. CAPs help to create new bodies of knowledge and innovative solutions to community problems, which benefits the community and academia. Supported by a grant, a partnership was formed between an academic research team and a community health organization to analyze and interpret data collected from the caregivers of asthmatic African American children living in urban low-income households. Using a case study approach, we discuss how we built a healthy CAP and the lessons learned from the process. Our analysis was guided by the six main factors that facilitate success in developing collaborative relationships, including (1) environment; (2) membership; (3) process and structure; (4) communication; (5) purpose; and (6) resources. Based on these six factors, we describe our collaboration process, challenges, and areas for improvement. We aimed to provide a "points-to-consider" roadmap for academic and community partners to establish and maintain a mutually beneficial and satisfactory relationship. Collaborating with community members and organizations provides unique opportunities for researchers and students to apply their skills and knowledge from textbooks and the classroom, engage with community members, and improve real-life community needs. Building a constructive CAP involves efforts, energy, and resources from both parties. The six major themes derived from our project offer suggestions for building a healthy, collaborative, and productive relationship that best serves communities in the future.

The role of communication, building relationships, and adaptability in non-profit organisational capacity for health promotion.

While the non-profit sector has an integral role in health promotion, it is unclear whether these organisations have the capacity for health promotion activities. This study aims to explore and describe capacity changes of a non-profit organisation during a 3-year community-based nutrition intervention. The non-profit organisation, with 3800 members throughout the state of Queensland, Australia, implemented a 3-year food literacy community-based intervention. A team of qualified nutritionists delivered the program in partnership with community-based volunteers. A separate aim of the intervention was to build capacity of the non-profit organisation for health promotion. A qualitative study was undertaken, using a social constructivist approach to explore organisational capacity changes longitudinally. All relevant participants including non-profit executive managers and nutritionists were included in the study (100% response rate). Data collection included semi-structured interviews (n = 17) at multiple intervention time points and document analysis of program newsletters (n = 21). Interview transcripts and documents were analysed separately using thematic and content analysis. Codes and categories between the two data sources were then compared and contrasted to build themes. Organisational capacity was predominantly influenced by four themes; 'communicating', 'changing relationships', 'limited organisational learning' and 'adaptability and resistance to change'. Developing non-profit organisational health promotion capacity appears to require focusing on fostering communication processes and building positive relationships over time. Capacity changes of the non-profit organisation were not linear, fluctuating across various levels over time. Assessing non-profit organisational capacity to implement community interventions by describing adaptive capacity, may help researchers focus on the processes that influence capacity development.

Using social network analysis as a tool in action research.

The following paper presents case examples of one research team's use of social network analysis (SNA) with three different collaboratives in South Florida: (a) a Collective Impact initiative seeking to end youth homelessness, (b) a university collaborative of campus organizations working towards Black students' concerns, and (c) a movement network of local social justice organizations. The research team used SNA to assess the level of connectivity of three different community coalitions. While research questions were slightly different for each collaborative, each project asked about the frequency of communication between organizations to determine connectivity. Results vary between case examples. Both the Youth Homeless Collaboration and the Black Student Association used Gephi to analyze results, while The Community Partnership used R to measure network centrality. The paper concludes with a general discussion of challenges related to using SNA as an action research tool, as well as the role of power in organizational networks.

Reflections on activism, the academy and the Non-Profit Industrial Complex in Colombia: What a revolutionary ethos might look like.

This essay brings together different voices to reflect on several participatory research projects carried out in Colombia, based on human rights, 'empowerment', harm reduction, (im)mobility and forced migration, gendered and political violence, armed conflict, and the right to health of people in the social margins. We look back on nine years of activism to explore the foundations of what our friendships and relationships have come to know as a revolutionary ethos. We critically re-visit and reflect on the concept of 'the activist' in the realms of the human rights apparatus in Colombia, the academy and the Non-Profit Industrial Complex (NPIC). We look back on what was forged and what was lost to propose the critical concept of 'radical honesty and self-care' as the basis for a revolution that supports processes of healing and social justice. Finally, we imagine what 'healing' can look like, as committed activists despite our differences and positionalities. We engage with and problematise the different forms of activism that emerge in social struggles and we address self-criticisms, constant reflection, radical honesty and uncomfortableness as powerful tools in joining forces to continue social justice work and caring.

State Regulation and Hospital Community Benefit Spending in Medicaid Expansion States.

CONTEXT: Previous studies show that nonprofit hospital spending on charity care declined in Medicaid expansion states. We test whether state community benefit regulations mitigated the decline in charity care spending. METHODS: We use a fixed effects model to evaluate the association between state regulations and nonprofit hospital community benefit spending and its subcategories as a share of total expenses in Medicaid expansion states. We obtained community benefit spending data from the Internal Revenue Service Form 990 Schedule H filings of 1,738 hospitals in 44 states and the District of Columbia from 2010 to 2017. We determine the stringency of state regulations by comparing the provisions of state and federal requirements based on regulation information compiled by the Hilltop Institute. FINDINGS: State minimum community benefit requirements are associated with increased community benefit and charity care spending by nonprofit hospitals in Medicaid expansion states. CONCLUSIONS: States that imposed minimum community benefit requirements on nonprofit hospitals did not experience a decline in charity care spending after Medicaid expansion. The results suggest state minimum community benefit rules may expand the provision of community benefit and charitable care spending.

Comparing the value of community benefit and Tax-Exemption in non-profit hospitals.

OBJECTIVE: We examined the characteristics of non-profit hospitals providing more community benefits and charity care than value of their tax exemptions and how this relationship changed between 2011 and 2018. DATA SOURCES: Primary dataset was schedule H Form IRS 990 data. This data was merged with the American Hospital Association, Medicare Hospital Cost Report, and the America Community Survey. STUDY DESIGN: We measured six categories of tax benefits and 17 types of community benefits. Subtracting the average value of community benefits provided by for-profit hospitals, we computed incremental community benefit and charity care provided by each non-profit hospital. EXTRACTION METHODS: A nationally representative sample was created of 11 776 non-profit hospital-year observations from 1472 unique hospitals over the 2011 to 2018 period was created. Descriptive analyses and random effect logistic regression were used to show associations between hospital characteristics and difference between incremental net community benefits and the value of tax-exemption. PRINCIPAL FINDINGS: After adjusting for community benefits provided by for-profits hospitals, on average, non-profit hospitals spent 5.9% (CI: 5.8%-6.0%) of their total expenses on community benefits; 1.3% (CI: 1.2%-1.3%) on charity care; and received 4.3% (CI: 4.2%-4.4%) of total expenses in tax exemptions. A total of 38.5% of non-profit hospitals did not provide more community benefit and 86% did not provide more charity care than the value of their tax exemption. Hospitals with fewer beds, providing residency education and located in high poverty communities were more likely to provide more incremental community benefits and charity care than the value of their tax exemption, while system affiliation had a negative association. CONCLUSION: The amount of community benefits and charity care provided by non-profits varied substantially across non-profit hospitals. Establishing minimum requirements for non-profit hospitals or publicly ranking hospitals based on their community benefit or charity care contributions, could encourage greater community benefits and charity care.

Nonprofit Financial Response to Immigration.

Nonprofit organizations are important actors in local communities, providing services to vulnerable populations and acting as stewards for charitable contributions from other members of the population. An important question is whether nonprofits spend or receive additional revenues in response to changes in the populations they serve. Because immigrant populations both receive and contribute to nonprofit resources, changes in immigrant numbers should be reflected in changing financial behavior of local nonprofits. Using data from the National Center for Charitable Statistics and the American Community Survey, we study whether nonprofit financial transactions change in response to changes in the local immigration population, the nature of the change, and the degree to which these changes vary by nonprofit type. Findings suggest that nonprofit financial behavior changes with growth and decline in immigrant populations underscoring the importance of nonprofits as service providers and contribute to an understanding of how organizations respond to external forces.

Non-profit breastfeeding organisations' peer support provision in areas of socio-economic deprivation in the UK: A meta-ethnography.

In many high-income countries such as the United Kingdom, inequalities in breastfeeding initiation and continuation rates exist, whereby socio-economically advantaged mothers are most likely to breastfeed. Breastfeeding peer support interventions are recommended to address this inequality, with non-profit breastfeeding organisations providing such support in areas of deprivation. As these organisations' roots and membership are often formed of relatively highly resourced women who have different backgrounds and experiences to those living in areas of deprivation, it is important to understand their practices in this context. In order to explore how UK non-profit organisations practice breastfeeding peer support in areas of socio-economic deprivation, a systematic review and meta-ethnography of published and grey literature was undertaken. Sixteen texts were included, and three core themes constructed: (1) 'changing communities' reveals practices designed to generate community level change, and (2) 'enabling one to one support', explains how proactive working practices enabled individual mothers' access to supportive environments. (3) 'forging partnerships with health professionals', describes how embedding peer support within local health services facilitated peer supporters' access to mothers. While few breastfeeding peer support practices were directly linked to the context of socio-economic deprivation, those described sought to influence community and individual level change. They illuminate the importance of interprofessional working. Further work to consolidate the peer-professional interface to ensure needs-led care is required.

Comparison of Trends in Nonprofit Hospitals' Charity Care Eligibility Policies Between Medicaid Expansion States and Medicaid Nonexpansion States.

Nonprofit hospitals provide charity care to financially disadvantaged patients according to their self-designed eligibility policies. The Affordable Care Act may have prompted nonprofit hospitals to adopt more generous eligibility policies, but no prior research has examined the longitudinal trend. The expansion of Medicaid coverage in many states has been found to reduce charity care provision, but it is unclear whether the change in charity care eligibility policies differed between Medicaid expansion and nonexpansion states. Using mandatory tax filings, we found that both hospitals in Medicaid expansion states and hospital in nonexpansion states adopted more generous eligibility policies in 2018 than in 2010, but the change was greater in the former for discounted charity care; while the former provided less charity care regardless of their policy changes, the latter provided more when their policies became more generous. This study has implications for policy discussions on the justification of nonprofit hospitals' tax-exempt status.

Charity Care and Community Benefit in Non-Profit Hospitals: Definition and Requirements.

Policymakers are using different ways to measure the community benefit provided by non-profit hospitals because different policy makers have different policy objectives. We compare 3 commonly used measures of community benefit; examine the correlation across the 3 measures; examine how the distribution of community benefits varies across non-profit hospitals; and compare the factors associated with the level of community benefit for each definition. The main dataset for this study is the Schedule H of IRS Form 990 data for 2017. We merged this data with the 2017 American Hospital Association (AHA), the 2017 CMS Hospital Cost Report, and the 2018 American Community Survey data. The final sample consists of 1904 non-profit hospitals. We define 3 measures of community benefit: (1) Total community benefits: combining all 17 possible measures in the 990 data; (2) Total community benefits less unreimbursed Medicaid care because it reflects a policy choice made by the state; and (3) only charity care. We also subdivided the community benefits into individual and service-based benefit. Gini Coefficients and descriptive analysis show the distribution of 3 types of community benefit measures. On average, hospitals spent 8.1% of their expenses on all community benefits; 4.3% on community benefits less unreimbursed Medicaid; and 1.7% on charity care. The provision of charity care showed more variation (Gini coefficient) than the other 2 measures. Different hospital and geographic characteristics were associated with each definition, suggesting that different types of hospitals place emphasis on different community benefits. When policy makers choose among different definitions of community benefit, they should consider what incentives they want to instill.

Hospital Board of Directors' Composition and Financial Performance: Empirical Evidence from Taiwan.

The board of directors of a nonprofit proprietary hospital is responsible for supervising and managing major operational matters and reviewing operational results. This study investigates how hospital financial performance is influenced by director and supervisor characteristics among the board members of nonprofit proprietary hospitals in Taiwan. Data were obtained from the Division of Medical Services of the Ministry of Health and Welfare. A generalized linear model was used to evaluate 32 non-profit proprietary hospitals for the years 2006 to 2017, totaling 363 observations. The empirical results revealed a significant positive correlation between the proportion of directors with management qualifications and hospital financial performance. Moreover, the results represented that a higher proportion of board members with a medical background did not correspond to higher hospital financial performance. Although doctors accounted for the highest proportion of board members, indicating their key role in hospital management, the need for board members with management expertise cannot be ignored. Therefore, a balance between directors with management experience and medical knowledge on the board of directors is beneficial for hospital financial performance.