Category Archives: Health promotion and disease prevention
Timothy Landers, PhD, CNP, and Jason Farley, PhD, MPH, CRNP, are Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars. In his work, Landers focuses on the epidemiology and prevention of antibiotic-resistant infections, including the use of hand hygiene as a means of prevention. Farley evaluates treatment outcomes in multi-drug resistant infections including tuberculosis (TB) and Methicillin-Resistant Staphylococcus aureus (MRSA) in patients with HIV, with a focus on sub-Saharan Africa.
The recent outbreak of Ebola virus in West Africa is a stark reminder that we live in a globally connected world and that outbreaks can occur without warning. As infection prevention specialists, we are acutely aware of the risks health care workers face in caring for the public, both now and in times of relatively less chaos.
The good news is that despite media reports, nurses, physicians, infection prevention specialists and other health care workers are in an ideal position to lead the global response to this disease.
Our experience with measures to address hospital-acquired infections—isolation precautions, hand hygiene, contact tracing and public health measures—are also the same methods necessary to contain the spread of Ebola.
Building on experience addressing these infections, along with recognition of the differences in Ebola virus transmission, the Centers for Disease Control & Prevention (CDC) regularly updates the guidelines and is currently recommending enhanced versions of isolation precautions, including enhanced standard precautions, contact precautions, and droplet precautions.
Elizabeth Gross Cohn, PhD, RN, is director of the Center for Health Innovation at Adelphi University, an adjunct professor at the Columbia University School of Nursing, and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar.
It only took 24 hours for the hospital unit where I work to complete the Ice Bucket Challenge. My colleagues and I were quick to dump ice water on our heads and publicly post a video of it to YouTube. Compare that to the speed at which we adapt other initiatives—even those that benefit our own health.
Why the difference? What is prompting people to action and, more importantly, what can RWJF learn from this campaign as it works to advance a Culture of Health?
In case you’ve been unplugged over the past several weeks, the Ice Bucket Challenge started in golf and baseball but has spread virally. As of today, it has raised $100 million for Amyotrophic Lateral Sclerosis (ALS). Participation begins when you are challenged on social media to—within 24 hours—publicly accept, acknowledge the challenger by name, pour ice water over your head in as dramatic a method as you can imagine or afford, challenge two or three others to participate, and post the results to YouTube. This campaign has been embraced by the general public, celebrities, grandmothers, babies, and teams of teachers, firefighters, nurses, teachers and others.
We public health professionals can learn some important lessons about delivering information and impelling action from this extraordinary cultural phenomenon. Here are five factors that seem most potent to me. Do you see others?
A. Janet Tomiyama, PhD, an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2009-2011), is assistant professor of psychology and director of the Dieting, Stress, and Health (DiSH) Lab at the University of California, Los Angeles. She was recently named the 2013 recipient of the Early Career Investigator Award from the Society of Behavioral Medicine. Her favorite comfort food: potato chips.
What’s your favorite comfort food? Ice cream, pizza, chocolate—everyone’s got a preference, whether they’re from Los Angeles, London, Sao Paolo, or Tokyo. Stress eating is as universal as eating itself; indeed, even Cervantes in his 1605 classic Don Quixote addressed the practice with the line, “All sorrows are less with bread.” Humans seem to reach for food as a way to soothe negative emotions, and that food is often high-fat, high-sugar, and high-calorie. That’s why comfort eating is often blamed as one reason stress is bad for health—because stress causes us to find comfort in a dozen cookies.
If you’re like me, you’ll be surprised but delighted to know it’s not just humans that engage in comfort eating! Eating high-fat, sugary foods in response to stress is a behavior that we see in non-human species like rodents and primates. Under chronic stress conditions, for example, rats will shift their food intake away from standard food pellets to the rodent version of “comfort food” (researchers often use Crisco mixed with sugar).
Even more amazing: it works. These comfort-eating rats showed dampened biological stress reactivity in a stress system called the Hypothalamic-Pituitary-Adrenal (HPA) axis. Sustained over-activity of the HPA axis is associated with poor health, and these studies suggest that comfort eating is playing an important role in managing an organism’s stress levels.
Discovery Channel will air an encore of its medical documentary, “An Emerging Epidemic: Food Allergies in America,” on Saturday, September 21 at 8 a.m. ET. The program, which aims to raise awareness of food allergies as a serious and growing public health issue, features stories of families living with the potentially life-threatening condition.
The documentary features Robert Wood Johnson Foundation (RWJF) Physician Faculty Scholars alumna Ruchi S. Gupta, MD, MPH, who is an allergy researcher and mother of a child with egg, peanut, and tree nut allergies. Gupta wrote a post for the RWJF Human Capital Blog about the intersection of her professional and personal missions to keep children safe and raise awareness about food allergies.
The documentary is also available for viewing at www.discoverychannelpatienteducation.com and available for download on iTunes.
Ruchi S. Gupta, MD, MPH, is an alumna of the Robert Wood Johnson Foundation Physician Faculty Scholars program. She is an associate professor of pediatrics and director of the maternal and child healthcare program at the Northwestern University Feinberg School of Medicine, and an attending physician at the Ann & Robert H. Lurie Children's Hospital of Chicago. Learn more at www.ruchigupta.com.
This past spring, 12 students with asthma at James Hedges Elementary in Chicago’s Back of the Yards neighborhood took hundreds of pictures, filmed video Public Serve Announcements (PSAs), created a website, and rolled out a community intervention to improve asthma conditions. These activities were part of the Student Media-Based Asthma Research Team, or SMART program. We developed this program from a previous pilot program in Chicago’s Uptown neighborhood that empowered students to learn about their asthma and challenged them to create change in their own communities.
As the most common chronic condition in children and the most common cause of school absenteeism, asthma is responsible for 13 million days of school missed each year. Asthma disproportionately affects racial and ethnic minorities, as African Americans and Hispanics/Latino children have significantly higher asthma-related morbidity and mortality rates compared to White children. While evidence-based guidelines for asthma care have been available for 20 years, ethnic minorities have a lower likelihood of receiving or following proper asthma treatment. Across and within racial/ethnic groups, asthma care has been shown to be more effective when it is tailored to the individual community instead of one-size-fits-all intervention.
Mitesh Patel, MD, MBA, is a Robert Wood Johnson Foundation Clinical Scholar and senior fellow at the Leonard Davis Institute for Health Economics at the University of Pennsylvania. He is a practicing physician at the Philadelphia Veteran Affairs Medical Center; and author of Clinical Wards Secrets, a guide for medical students transitioning from the classroom to the hospital wards. This post is part of the "Health Care in 2013" series.
While most people spend a few hours a year visiting the doctor, they spend another 5,000 waking hours without any direct contact from the U.S. health care system. There has been an increasing amount of attention on how to design systems that encourage healthy behaviors among the population during their everyday activities. Insights from behavioral economics provide opportunities to design systems that monitor, incentivize and provide feedback to encourage these changes.
One proposal to change behavior is to increase price transparency in the U.S, with initiatives at the state and federal levels. Lessons from other industries and concepts from behavioral economics demonstrate that this must be designed carefully to increase the likelihood that price transparency changes behavior.
One example is the use of calorie-labeling in fast food restaurants. While its intended outcome is to reduce consumer consumption, there are several reasons why it has thus far not been very successful. Consumers may not understand the caloric information or the problem may be self-control and not related to information at all.
Using concepts from behavioral economics such as framing the information or making it more salient could improve its impact on reducing calorie consumption.
As the New Year approaches, millions of Americans will make resolutions to improve their diet, increase their exercise, or to quit smoking. Let’s do our part to design systems that help our population meet their goals and increase healthy behavior.
Jason Corburn, PhD, MCP, is associate professor at the School Public Health & Department of City & Regional Planning, University of California, Berkeley. He is a recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and an RWJF Health & Society Scholar. This post is part of the "Health Care in 2013" series.
The U.S. health care system must stop treating people only to send them back into the living, working and playing conditions that are making them sick in the first place. Glaring health inequities continue to persist in our metropolitan areas – differences in life expectancy, disease and disability by racial and ethnic groups and neighborhood location. Our zip codes are often a greater predictor of our likelihood of disease, disability and early death than our genetic code. We need to shift our health care system from a focus largely on cures to preventing illness and death by improving our living, working and playing environments.
2013 must be the year we all view community development and city planning as ‘preventative medicine.’
The Robert Wood Johnson Foundation (RWJF) recently announced the establishment of the Young Leader Awards: Recognizing Leadership for a Healthier America. The awards will honor young leaders, 40 years of age and under, who offer great promise for leading the way to improved health and health care for all. Up to 10 awards of $40,000 will be granted to outstanding young leaders.
The Young Leader Awards will recognize emerging leaders who have demonstrated the characteristics needed to improve health and health care through leadership and innovation. These characteristics—a combination of personal attributes, commitment to health and health care, and successful experience—demonstrate an ability to lead and innovate and they signal the potential to become a greater leader in the coming years.
The Young Leader Awards are part of RWJF’s 40th anniversary celebration. Awardees will be announced in October.
To learn more about the qualifications or to nominate a Young Leader, visit http://RWJFyoungleaderawards.org.
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:
“Preventing diseases before they start is one of the most common sense ways to keep people healthy,” writes Risa Lavizzo-Mourey, MD, MBA, RWJF president and CEO, in a blog post for The Atlantic, “but this nation continues to focus too narrowly on treating medical conditions after they occur.” Lavizzo-Mourey’s essay is part of the “America the Fixable” series, hosted by Atlantic.com in partnership with Common Good. See the full series here.
A study led by RWJF/U.S. Department of Veteran’s Affairs (VA) Clinical Scholar Charles Scales, MD, finds that the number of Americans suffering from kidney stones has nearly doubled since 1994, due in large part to the increase in obesity and diabetes, WTVD (Raleigh-Durham, N.C.) reports. “While we expected the prevalence of kidney stones to increase, the size of the increase was surprising,” Scales said. HealthDay also reported on the findings.
Kavita Patel, MD, MSHS, an alumna of the Clinical Scholars program, was a guest on NPR for a story that asked “Does Race Affect Your Hospital Stay?” The story keyed off findings from Sick in America, a poll commissioned by RWJF, NPR and the Harvard School of Public Health to better understand Americans’ experiences and attitudes related to the cost and quality of their medical care. Nearly half of respondents said that a lack of cultural understanding plays a big role in the problems with U.S. health care quality, the story reports.
Dominick L. Frosch, PhD, an alumnus of the RWJF Health & Society Scholars program, continues to receive media coverage for a study he led that finds some patients are afraid or feel they are unable to speak up and participate in shared decision making with their physicians. American Medical News and Forbes are among the outlets to report on the findings.
By Raina Merchant, MD, MSHP, Robert Wood Johnson Foundation Clinical Scholars program alumna and assistant professor, University of Pennsylvania Department of Emergency Medicine
If the person next to you went into cardiac arrest, would you know what to do? Would you know where to find an automated external defibrillator (AED) to shock and restart their heart? Millions of public places across the United States have AEDs that can save lives – airports, casinos, churches, gyms and schools, among them – but most people don’t know where they’re located. Every second counts when someone’s heart stops beating, and time spent searching for an AED is time wasted in increasing the chances of survival.
Surprisingly, no one knows where all of the country’s AEDs are located. Requirements for AED reporting and registration vary widely by state, and no comprehensive map of their locations has ever been compiled. As a result, 911 dispatchers aren’t always able to direct callers to an AED in an emergency, and callers have no good way of quickly locating one on their own.
This week, I launched the MyHeartMap Challenge with a multidisciplinary team from the University of Pennsylvania. This pilot study will use social media and social networking tools to gather this critical public health data and create searchable maps of Philadelphia’s AEDs that can be used by health professionals and the general public.
The first step of our challenge is a Philadelphia-based community-wide contest. We’re asking Philadelphians to find and photograph AEDs over the next six weeks, and submit the photo and location to us via a mobile app or our website. You can also participate if you don’t live in Philadelphia by finding a creative way to use your social network or harness crowdsourcing.