Category Archives: Health & Health Care Policy

Sep 6 2012
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Human Capital News Roundup: Nursing environments, value-based care, recognizing signs of violence, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

Zachary Goldberger, MD, an RWJF Clinical Scholar, spoke to the New York Times about a study he led that examined the ideal amount of time to continue cardiopulmonary resuscitation (CPR) on patients in cardiac arrest. “The study found that patients have a better chance of surviving in hospitals that persist with CPR for just nine minutes longer, on average, than hospitals where efforts are halted earlier,” the story reports.  First published in The Lancet, the study is one of the first to link the duration of CPR efforts with survival rates.  It is expected to prompt hospitals to reconsider their protocols.

RWJF Health & Society Scholar Jason Houle, PhD, continues to receive media coverage for his study that finds students from middle-income families leave school with an average of $6,000 more in student loan debt than their lower-income peers. The students were also more likely to have more student loan debt than their higher-income peers. Among the outlets to report on the findings: United Press International, Bloomberg Business Week, the Atlanta Journal-Constitution, and the Wisconsin State Journal.

A study supported by the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) finds that “when nurses take steps to intervene in the medication process, they are more likely to catch would-be errors before they reach the patient,” Fierce Healthcare reports. The findings also indicate that a supportive practice environment is associated with a higher quality of nursing care. Read more about the study.

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Sep 4 2012
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National Diaper Need Awareness Week

Joanne Goldblum is a Robert Wood Johnson Foundation Community Health Leader, and the founder and executive director of the National Diaper Bank Network. The following post originally appeared on the Huffington Post.

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This year, the National Diaper Bank Network is recognizing the week of September 10-17 as National Diaper Need Awareness Week, and local diaper banks across the country have asked their state and local officials to do the same. But more than merely declaring a week, we are acknowledging that the country is becoming more and more aware of the fact that diapers are a basic need for infants, toddlers, and those who suffer from incontinence, and that more people are willing to do something about it.

We have come very far in bringing attention to diaper need in the eight years since I began this journey in 2004. When I started The Diaper Bank in New Haven, CT there were very few diaper banks in America, so I looked to the example of the Diaper Bank of Southern Arizona, the nation’s first diaper bank. That program began in 1994 when a small consulting firm in Tucson, Arizona held a diaper drive during the holiday season to assist a local crisis nursery. Encouraged by the enthusiastic response, and seeing the great need in their community, the firm made the December Diaper Drive an annual tradition, and within five years they were collecting 300,000 diapers each December, benefiting families at 30 local social service agencies. In 2000, the diaper drive effort was spun off into an independent non-profit organization, the Diaper Bank of Southern Arizona, which continues to provide desperately needed diapers to the people of southern Arizona.

The Diaper Bank of Southern Arizona served as my inspiration in 2004 when I decided to start a diaper bank. Through my work with families in need New Haven, I learned that many of the hygiene products I took for granted, such as toilet paper, toothpaste, and diapers, were not available to people who had only food stamps to buy their groceries. The need for diapers, which are so critical for a baby’s health and comfort, was particularly acute. I started small, working out of my living room, but in a few years time, with the help of many others, what started as The New Haven Diaper Bank (now, The Diaper Bank) has grown into the nation’s largest diaper bank, distributing over 14 million diapers since its inception.

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Aug 31 2012
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Federal Nursing, Health Care Workforce Grants Announced

The U.S. Department of Health and Human Services (HHS) this week announced more than $100 million in new grants to expand and strengthen the nation’s health care workforce. The goal of the funding is to educate and strengthen training for health care workers, and provide fellowships and traineeships.

The grants include:

Nursing ($30.2 million): Partial loan forgiveness for students who serve as full-time nursing faculty for a designated period of time after graduating from a master’s or doctoral program; grants for schools of nursing to provide financial aid and mentoring to students from disadvantaged backgrounds underrepresented in nursing; and funding for nurse anesthetist traineeship programs for licensed registered nurses enrolled in master’s or doctoral nurse anesthesia programs.

Dental ($3.0 million): Grants to increase oral health care education capacity for programs that train future faculty in general, pediatric, or public health dentistry, or in dental hygiene.

Public Health ($48.0 million): Funds for 37 Public Health Training Centers to train current and future public health workers in basic health skills and key public health issues; and grants to expand public health training programs and support medical residency-type fellowships at state and local health departments.

Interdisciplinary and Geriatric Education ($6.6 million): Grants for projects to train and educate workers to provide geriatric care for the elderly; and support for the collaboration and integration of public health curricula in medical and clinical education.

Centers of Excellence ($18.8 million): A five-year program to support the recruitment and performance of underrepresented minority students entering health careers, and to support research and the development of curricula, training and resources related to minority health issues.

“These grants and the programs they support are vital to achieving a comprehensive and culturally competent health professions workforce capable of meeting future health care challenges,” HHS Secretary Kathleen Sebelius said in a statement announcing the funds.

Learn more about the new federal grants here and here.

Aug 30 2012
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Framing Public Health Issues

This Q&A originally appeared on the RWJF New Public Health Blog. Read more about Nisbet’s research.

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Environmental issues are consistently a topic of hot debate. A new study reveals that how we talk about these issues could have a big impact on whether people feel compelled to act on them. According to new research led by two awardees of the Robert Wood Johnson Foundation Investigator Awards in Health Policy Research, Matthew C. Nisbet, PhD, MS, and Edward W. Maibach, PhD, MPH, talking about the environmental consequences of climate change may not convince the unconvinced—while talking about the public health consequences might have a better chance.

As the American University and George Mason University professors write in a newly published study in the journal Climatic Change Letters, “Results show that across audience segments, the public health focus was the most likely to elicit emotional reactions consistent with support for climate change mitigation and adaptation.”  The study was co-authored with Teresa Myers and Anthony Leiserowitz.

We caught up with Matthew Nisbet to get his take on the latest findings, and how the public health field can do a better job of framing issues in a way that motivates action.

New Public Health: What is message framing?

Matthew Nisbet: When you frame something as a communicator or as a journalist or as an expert, what you do is you emphasize one dimension of a complex issue over another, calling attention to certain considerations and certain arguments more so than other arguments. In the process, what you do is you communicate why an issue may or may not be a problem, who or what is responsible for that problem and then what should be done. One of the common misunderstandings about framing is that there can be something such as unframed information. Every act of communication, whether intentional or not, involves some type of framing.

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Aug 30 2012
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Human Capital News Roundup: 'Superbugs,' doctor rating systems, drug safety, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

Forbes named RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, to its annual list of the “World’s 100 Most Powerful Women.” The list includes political leaders, corporate executives, NGO heads, top government officials and a first lady.

The Academic Progression in Nursing (APIN) program has announced grants to nine states, Nurse.com reports. California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina, Texas, and Washington state will receive two-year, $300,000 grants to advance state and regional strategies aimed at creating a more highly educated, diverse nursing workforce. Read more about the APIN grants.

City Biz List Baltimore reports on the selection of Jason E. Farley, PhD, MPH, CRNP, to be a 2012 RWJF Nurse Faculty Scholar. He is among the 12 talented junior nurse faculty members chosen for the highly competitive program. Read more about the new cohort of Nurse Faculty Scholars.

RWJF Physician Faculty Scholars alumnus Deverick J. Anderson, MD, MPH, spoke to the Associated Press about hospital infection control and “superbugs,” or antibiotic-resistant germs. The story was picked up by USA Today, U.S. News & World Report, and CBS News, among other outlets.

The University of California, Los Angeles (UCLA) School of Nursing honored the Future of Nursing: Campaign for Action with one of its “Nurse 21 Awards” at its second annual gala, Nurse.com reports.

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Aug 24 2012
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Science, Through a Policy-Maker's Lens

Allison Aiello, PhD, MS, is an associate professor of epidemiology at the University of Michigan School of Public Health, and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This post is part of a series on the program, running in conjunction with its tenth anniversary.  The RWJF Health & Society Scholars program is designed to build the nation’s capacity for research, leadership and policy change to address the multiple determinants of population health.

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You’ve seen it, used it, and probably even bought it. Its manufacturer claims it keeps your hands free of bacteria, and that it works better than regular old soap. For a couple decades now, Americans have been encouraged by soap manufacturers to buy anti-bacterial hand and bath soap, and many of us have taken them up on it, judging from its ubiquity on store shelves. It comes in pump bottles as well as traditional hand and bath bars, all relying on a similar active ingredient, a chemical called triclosan in liquid soaps and triclocarban in bar soaps. In fact, you can find triclosan in a range of hygiene products, including deodorants, toothpastes, mouthwashes, and more.

The marketing message behind all of them is the same: By killing bacteria—or more accurately, by stopping it from reproducing—the stuff makes us cleaner and safer.

Alas, I’ve spent years researching triclosan, and I can tell you that it’s not nearly so simple. Triclosan may have its uses, but as a soap additive, the bulk of the evidence is that it offers no particular advantage over using regular soap, while posing some worrisome threats to health and the environment. Given that, it’s a mystery to me why it’s allowed on the market years after the problems with it first came to light.

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Aug 23 2012
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Human Capital News Roundup: Healthy food "prescriptions," student debt, the tax system, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

Women who had attention-deficit hyperactivity disorder (ADHD) as girls are more likely to hurt themselves or attempt suicide, compared to those who did not have ADHD, according to a longitudinal study led by RWJF Investigator Award in Health Policy Research recipient Stephen P. Hinshaw, PhD. More than half of the girls, ages 6 to 12, who were tracked by the study were reported to have engaged in self-injurious behavior, and more than one-fifth had attempted suicide, United Press International reports. Among the other outlets to report on the findings: Health Day, MediLexicon, Health Canal, and Science Daily.

The New York Times interviewed RWJF Clinical Scholars alumna Comilla Sasson, MD, MS, and others who were working at the University of Colorado Hospital the night of the shootings at an Aurora movie theater. Sasson’s team treated 23 patients, and every patient who arrived at the hospital with a pulse survived. “We went into emergency medicine because we know it’s crazy—you never know what’s going to come through the door,” she said. “But the thing none of us have gotten over is, we made it through. We really, truly shined [that night].” Read a post Sasson wrote for the RWJF Human Capital Blog about the experience.

RWJF/U.S. Department of Veterans Affairs Physician Faculty Scholar Rebecca Sudore, MD, continues to receive media coverage for a study she led that finds almost half of adults with type 2 diabetes experience acute and chronic pain. “Palliative care has already begun to be woven into the care provided to patients with cancer, heart failure and kidney failure,” Sudore told Health Day. “Our results highlight the need to expand diabetes management to also include the palliative care model.”

RWJF Executive Nurse Fellows alumna Cynda Hylton Rushton, PhD, RN, FAAN, spoke to NBC News about a study conducted by researchers in England that finds “some terminally ill children experience unnecessary treatment and prolonged suffering because their parents believe they will experience a ‘miracle cure.’” These situations occur rarely, Rushton says, and “it takes time to evolve and fully understand every perspective and rationale. The process should take seriously the implications of overruling parents’ deeply held religious viewpoints, and include sufficient safeguards that are fair and balanced.”

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Aug 22 2012
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Oral Health: Putting Teeth Into the Health Care System

Last week, the Robert Wood Johnson Foundation (RWJF) and The Alliance for Health Reform sponsored a briefing to discuss oral health care in the United States, particularly for children and other vulnerable populations.

The discussion was co-moderated by David Krol, MD, MPH, FAAP, RWJF Human Capital Portfolio team director and senior program officer. “Oral health is an integral part of overall health,” he said. It faces the same challenges as overall health care, including “racial, ethnic, geographic disparities in disease and access to care, financing challenges, issues of determining and maintaining quality of care, and workforce controversies.” Krol said he would like to see “all conversations on health and health care… naturally include oral health.”

In 2009, preventable dental conditions accounted for more than 830,000 emergency department visits nationwide, Julie Stitzel, MA, of the Pew Center on the States’ Children’s Dental Campaign told the audience. Children were the patients for 50,000 of those visits. “There’s a real opportunity for states to save money because these visits, again, are totally preventable,” she said. “We know that getting treated in an emergency room is much more costly than the care delivered in a dental office, and states are bearing a significant share of these expenses through Medicaid and other public programs.”

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Aug 20 2012
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An Opportunity to Update the Way We Think About Training Health Professionals

Catherine Dower, JD, is the associate director for research at the Center for the Health Professions at the University of California, San Francisco. Dower recently wrote a policy brief for Health Affairs about the state of graduate medical education funding. Read the brief on the Robert Wood Johnson Foundation website.

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Human Capital Blog: What is graduate medical education (GME) and why is it important?

Catherine Dower: GME refers to the practical training doctors undergo after medical school, when they work for a few years as ‘residents’ – usually in hospitals – under more experienced physicians before they can practice on their own. As all doctors must go through GME before being licensed, it’s a big piece of their professional preparation.  Also, the number of doctors who go through GME correlates directly with the number of doctors who can be newly licensed each year, affecting supply. The number of residencies has always been larger than the total number of U.S. medical school graduates, with the gap being filled by internationally-trained medical graduates, who often stay in the U.S. to practice. Importantly, residents play a big role in a hospital’s labor force and GME is expensive.

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Aug 16 2012
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Human Capital News Roundup: Senior housing, trauma care nurses, conflict of interest disclosures, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

José A. Pagán, PhD, recipient of an RWJF Investigator Award in Health Policy Research and a member of the RWJF Health & Society Scholars National Advisory Committee, spoke to Senior Housing News about funding and programs from the Affordable Care Act that will benefit the senior living industry.

The Westfield Patch reprinted an article from the New Jersey Nursing Initiative (NJNI) newsletter about how the program benefited Maria Torchia LoGrippo, MSN, RN, a member of the program’s inaugural cohort in 2009. “I was truly honored and humbled when I received the scholarship,” she says. “[G]iven this amazing opportunity from the RWJF, I will be able to achieve my goal to become a nursing professor.”

The University of Texas at El Paso (UTEP) School of Nursing has received a grant from the Texas Higher Education Coordinating Board that will help train more emergency and trauma care nurses, KDBC-TV reports. The Emergency and Trauma Care Education Partnership Program will train students through August 2013. RWJF Executive Nurse Fellow Elias Provencio-Vasquez, PhD, RN, FAAN, FAANP, is dean of the UTEP School of Nursing.

A project funded in part by the RWJF Clinical Scholars program at Yale University is working to create a video game “aimed at preventing the spread of HIV among minority adolescents,” the Stamford Advocate reports. Teens can create an avatar to navigate through the game’s interactive world, facing a series of challenging situations and choices.

A team of researchers led by Investigator Award in Health Policy Research recipient Aaron Kesselheim, MD, JD, MPH, finds that only one in seven physicians and scientists (15 percent) sufficiently disclose conflicts of interest with pharmaceutical companies in published studies. “We were surprised at the relatively low number of adequate disclosures,” Kesselheim told The Scientist. “We were also surprised at the variability of the disclosures, and how some journals seemed to have very clear disclosures where some did not.” MediLexicon also reports on the findings. Read a post Kesselheim wrote for the RWJF Human Capital Blog about pharmaceutical industry marketing to medical students.