Adopting YouTube to Promote Health: Analysis of State Health Departments.

INTRODUCTION: We describe videos posted to the YouTube video-sharing Web site by US state health departments (SHDs) and associated institutional factors. METHODS: YouTube channels from SHDs were identified, their data retrieved, and their videos saved to a playlist on January 10, 2016. Ten randomly sampled videos from each channel were manually coded for topics. The 2012 Association of State and Territorial Health Officials profile survey was used to obtain information on staff, expenditure, and top 5 priorities for each SHD. Descriptive statistics and univariable regression were conducted. RESULTS: Forty-three SHDs had YouTube channels. Together, all SHDs posted 3957 videos, accumulated 12,151,720 views, and gained 6302 subscribers. In total, 415 videos were manually coded. Information about the agency (17.6%), communicable diseases (12.5%), and mother/infant health (8.9%) comprised the largest share of topics. No statistically significant association was observed between the log-transformed number of videos posted on an SHD's YouTube channel and any of the explanatory variables of SHD staffing and expenditure in 2011. The number of full-time employees (r = 0.34, p = 0.03), number of epidemiologists and biostatisticians (r = 0.41, p = 0.01), and 2011 total year expenditure (r = 0.38, p = 0.02) were positively correlated with the log-transformed number of views per YouTube video posted by SHDs. No meaningful patterns of statistical association were observed between the percentage of expenditure on a specific program area and the topics of videos. CONCLUSION: Most SHDs are using YouTube, which provides a unique opportunity for SHDs to disseminate health messages.

Prescripción de antibióticos en pediatría de atención primaria: una responsabilidad compartida / Antibiotics prescribing in paediatric primary care: A shared responsibility

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The New York City Mental Health Needs Assessment Study (MHNAS): Objectives, design, and methods.

OBJECTIVES: This paper describes the objectives, design, and methods of the Mental Health Needs Assessment Study (MHNAS). The objective of the MHNAS was to assess the needs of individuals transitioning to the community following psychiatric hospitalization and again 3-5 months later to inform community service planning. Needs were defined broadly to include domains like housing, employment, treatment, and social support. METHODS: The MHNAS used a 2-stage clustered sampling approach where the primary sampling units were hospitals and secondary sampling units were patients. The study included an in-person patient interview, an assessment of need from a key hospital worker, and a follow-up telephone interview 3-5 months after discharge. RESULTS: One thousand one hundred twenty-nine patients from 8 randomly selected hospitals participated. The overall response rate was 54.3% with a cooperation rate of 71.8%. The sample was similar to the overall population of psychiatric patients with respect to several key demographics. CONCLUSION: The MHNAS demonstrates the feasibility of conducting a needs assessment with a random sample of psychiatric inpatients in a large urban setting. Results from this study may improve community service planning to better meet individuals' needs, with the ultimate goal of reducing rehospitalization and promoting recovery.

The Role of Publicly Funded Family Planning Sites In Health Insurance Enrollment.

CONTEXT: Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. METHODS: In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance. Weighted univariate and bivariate analyses were conducted to examine enrollment activities and perceived barriers to facilitating enrollment by site characteristics. RESULTS: Most family planning program sites provided eligibility screening (68%), enrollment education (77%), on-site enrollment assistance (55%) and referrals for off-site enrollment support (91%). The proportion of sites offering each type of assistance was highest among community clinics (83-96%), primary care and multispecialty sites (65-95%), Title X-funded sites (72-98%), sites with contracts to provide primary care services (64-93%) and sites using only electronic health records (66-94%). Commonly identified barriers to providing assistance were lack of staff time (reported by 52% of sites), lack of funding (47%), lack of physical space (34%) and lack of staff knowledge (33%); only 20% of sites received funding to support enrollment activities. CONCLUSIONS: Although there were significant variations among them, publicly funded family planning providers in California are actively engaged in health insurance enrollment. Supporting their vital role in enrollment could help in the achievement of universal health insurance coverage.

Harm Reduction Agencies as a Potential Site for Buprenorphine Treatment.

BACKGROUND: Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients. METHODS: Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. Multivariable logistic regression was used to determine factors associated with harm reduction agency preference. RESULTS: Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), whereas fewer preferred general medical clinics (13%), drug treatment programs (12%), or were not interested in BMT (25%). In multivariable analysis, experiencing ≥1 barrier to BMT was strongly associated with preferring harm reduction agencies (adjusted odds ratio [aOR] = 3.39, 95% confidence interval [CI]: 1.00-11.43). CONCLUSIONS: The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT. Offering BMT at harm reduction agencies could improve access to treatment, but studies are needed to determine safety and efficacy of this approach.

[Investigation of the status of ophthalmology in China].

OBJECTIVE: To identify the quantity, constitution, distribution, human resources, medical service, equipment utilization conditions of our ophthalmic organizations. METHODS: Adopt the ophthalmology status survey forms developed by the Department of Health Administration of Ministry of Health and Office of National Committee for Prevention of Blindness to investigate the registered medical treatment organizations in the whole mainland of China in 1996. The collected data were analyzed using SAS software. RESULTS: There were 4,151 ophthalmological organizations, 43,204 beds for ophthalmic patients, 22,577 eye doctors, and 16,448 ophthalmic nurses in China in 1996. 41.55% of eye doctors worked in the general hospitals above the county level. CONCLUSION: The distribution of ophthalmic organizations and human resource is uneven. It may be the main cause to restrict the activities for prevention of blindness in China.

Should disability items in the census be used for planning services for elders?

PURPOSE: The main goal of this study was to determine how well the disability questions of both the 1990 and 2000 Census correlated with a standard measure of disability. If the census questions were to correlate moderately well with a standard measure of disability, then Area Agencies on Aging (AAA) and other organizations would be able to use census information in estimating service needs for their catchment (service) area. DESIGN AND METHODS: Questionnaires containing both the census disability questions and a standard measure of disability were mailed to 4,508 older adults; 1,514 completed surveys were returned. In order to assess reliability, 472 of the respondents who completed the mail survey were reinterviewed by phone. All three disability measures were collapsed into the following three categories: no needs, instrumental activities of daily living (IADL) needs only, and activities of daily living (ADL) needs. RESULTS: All three disability measures exhibited moderate to good test-retest reliability. Using a standard measure of disability as the criterion, validity for the 1990 Census measure was quite low (Kappas of approximately 0.35). Validity for the 2000 Census measure was moderate to good (Kappas of approximately 0.60). IMPLICATIONS: These results suggest that the 2000 Census disability questions may be sufficiently valid for planning purposes. However, additional research with more representative samples of older adults is needed.

The community as preclinical classroom: experience with a first-year clerkship.

The required first-year clerkship in family and community medicine at the University of Massachusetts Medical School is a major curricular innovation which has implications for physician education. Students have lived in communities and worked in health service settings with field sponsors, under full-time faculty guidance, in all regions of Massachusetts. This has been one answer to the school's mandate to address the physician maldistribution problem. The goals and objectives and the teaching methods used to implement the program are described. These lessons were drawn from the program experience: community medicine clerkships belong in the first year of the curriculum; full-time medical school faculty working with the field sponsor promotes an optimal learning environment; long-term evaluation remains an important consideration. The first eight years of experience with the clerkship have demonstrated its value, and it should be considered for inclusion in the curriculum of other medical schools.