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A meningococcal serogroup B (MenB) outbreak at a large public university prompted an emergency response to immunize undergraduates. Objective: To report on a successful meningococcal serogroup B (MenB) vaccine clinic response at a large public university. Methods: We assembled the team leaders to write this case report. Results: Activation of the emergency plan and points of dispensing required cooperation of many units on campus under the leadership of university health officials with support from Centers for Disease Control and Prevention, state division of public health and the city-county health department. Significant efforts to provide consistent messages to students and parents regarding the outbreak and the availability of the MenB vaccines were made. Volunteers were recruited to staff the clinics alongside university healthcare providers. Over 22,000 doses of vaccine were administered. Conclusion: We report our experience and lessons learned which may be helpful to universities in preventing and responding to disease outbreaks.

Background The opioid epidemic and rising rates of injection drug use are increasing the risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among pregnant people. According to national clinical guidelines, pregnant people should be universally tested for HIV and HBV, and risk-based tested for HCV. The aim of this study was to determine the proportion and characteristics of prenatal HIV, HBV, and HCV testing and diagnosis among pregnant people with Wisconsin Medicaid coverage between 2011 and 2015. Methods Wisconsin birth certificates and Medicaid enrollment data were used to identify the sample. Standard billing and diagnosis codes were used to assess study variables. Data for each pregnancy were analyzed to describe the proportion of pregnancies that had evidence of testing, diagnoses, and yearly trends. Results Of the 78,917 pregnancies, prenatal testing estimates were 67% for HIV, 73% for HBV, and 6% for HCV. The estimated rate of infections during the study period was 1.82 for HIV, 2.09 for HBV, and 3.52 for HCV per 1000 pregnancies. Compared to the other race/ethnicity groups, pregnant people who were Black were most likely to be tested for HIV (78%) and HBV (80%), and pregnant people who were White were most likely to be tested for HCV (7%). Conclusions Clinical testing guidelines have not been effectively translated to practice. Additionally, compared to HIV and HBV, HCV infections during pregnancy are becoming more prevalent, yet current national HCV screening guidelines are the least comprehensive., Author(s): Theresa Watts [sup.1] , Lauren Stockman [sup.2] , Justin Martin [sup.2] , Sheila M. Guilfoyle [sup.2] , James M. Vergeront [sup.2] , Susan Zahner [sup.1] Author Affiliations: (1) grid.14003.36, [...]

To describe experiences of student nurses and faculty who participated in COVID‐19 vaccine delivery through a multischool collaboration. Cross‐sectional survey. Student nurses and faculty members from five university schools and colleges of nursing who participated in one or more COVID‐19 vaccination or education events in 2021. Surveys were designed for students and faculty to document process and outcome experiences associated with project participation. Surveys were administered through an online survey platform. Overall, 648 students and 68 faculty members participated in the project. The evaluation survey was completed by 115 students (18%) and 58 faculty members (85%). Students valued increasing their clinical skills and reported the experience influenced their perspectives on nursing, fueling their passion and informing future career choices. Students reported that it was personally important to contribute to the vaccination effort. Few students reported challenges in participating in the project. Faculty reported positive experiences including gaining knowledge about public health and their communities, fueling their passion for nursing education, feeling a deeper connection with students, and experiencing personal satisfaction from contributing to the pandemic response. This project resulted in meaningful student learning opportunities, enhanced capacity for the public health emergency response, and strengthened partnerships among nursing programs and between academia and public health community partners. [ABSTRACT FROM AUTHOR]

• The U.S. needs advanced practice nurses focused on the health of whole populations. • DNP specialty preparation in public health is essential to the nursing profession. • Investments are needed for graduate nursing education in this specialty practice. The COVID-19 pandemic has highlighted the need for nurse leaders who "embrace the interconnection" between medicine and public health. The inequitable impact of COVID-19 on people of color demonstrates the importance of applying expertise from nursing practice and public health systems to work with communities and other professions on complex health issues. Yet, despite a clear need for improved population health, educational programs designed to produce Advanced Public Health Nurses, with skills to address complex system changes, have become increasingly scarce. We put forward the perspective that the nation needs more advanced practice nurses prepared for leadership roles focused on the health of whole populations, marginalized communities, and the systems and policies that promote their health. We argue that opportunities should be expanded for nurses to attain education for these roles through increased investments in the Doctor of Nursing Practice model to prepare nurses for advanced public health specialty practice. [ABSTRACT FROM AUTHOR]

Objective: To conduct a literature review about the breadth of risks for acquiring hepatitis C virus (HCV) among women who are living in the United States. Design: A mixed research synthesis of qualitative, quantitative, and mixed‐methods studies guided by the Socioecological Model and Theory of Gender and Power. Sample and Analytic Strategy: The sample consisted of 29 studies: 10 qualitative, 18 quantitative, and one mixed‐methods studies. Data were analyzed using a segregated approach and integrated into a narrative synthesis of themes by components of the Socioecological Model. Results: Individual risks themes were drug use as a coping strategy, transition to injection drug use, and lack of awareness about HCV. Interpersonal risks themes were social norms of drug use and drug use and sexual activities. Community risks themes were community re‐entry, housing instability, and community HCV resources. Societal risks themes are policies affecting drug markets and social construct of "worthlessness." Conclusions: Findings highlight the need for comprehensive gender‐specific HCV prevention strategies built around harm reduction. In partnership with women with lived experience, public health nurses can apply findings to build harm reduction collaborations aimed at implementing HCV risk‐reduction or risk‐elimination strategies. [ABSTRACT FROM AUTHOR]

Objective: To describe types of strategic actions nurses take to promote environmental justice (EJ) through research, education, advocacy, and practice (REAP) reported in peer‐reviewed literature. Design and Sample: A scoping review of literature was conducted that described EJ nursing strategies and included nurses listed as authors, subjects, partners, or organizational members. The sample consisted of 35 articles, representing 24 primary research studies and 11 nonresearch articles. Data were separately analyzed by research and nonresearch articles for a clearer understanding of evidence‐based strategies within domains of REAP. Results: Articles in the sample highlighted the importance of authentic community partnership and represented diversity of nursing strategies that addressed a range of environmental exposures and subsequent health and racial inequities. Climate justice, a concept that emerged from the EJ movement and intersects with planetary health, is a recent focus in professional nursing. Conclusions: This scoping review establishes an understanding of the extent of nursing knowledge and research in EJ and lays the groundwork for further research on effective EJ nursing strategies. Community‐Based Participatory Research/Participatory Action Research methods are fundamental for EJ research, and further theoretical development is needed to guide evaluation of EJ nursing strategies for education, advocacy, and practice. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence, characteristics, and gender differences among people aged 15–44 years who are living with current HCV infections in the United States. Design and sample: We conducted a cross‐sectional, secondary data analysis using data from people who participated in National Health and Nutrition Examination Survey (NHANES) cycles in 2009–2018. Measurements: Sociodemographic, social behavior, and clinical factors that had been identified as related to having HCV, barriers to receiving HCV screening, care, or treatment, and health conditions that increase the risks of developing HCV‐related complications were studied. A weighted‐data analysis approach was used to generate descriptive statistics. Results: The estimated, weighted prevalence of current HCV infections was 0.3% (95% CI, 0.2–0.4), representing approximately 363,161 people (95% CI, 301,402–424, 920). Females were more likely than males to have an unknown risk factor and reported worse overall health. Males were more likely to have comorbidities such as obesity or diabetes that put them at risk for developing life‐threatening complications. Conclusions: Increased public health attention with gender‐specific actions are needed to address the health needs of the thousands of people aged 15–44 years who are living with current HCV infections across the United States. [ABSTRACT FROM AUTHOR]

Background A strong public health infrastructure is necessary to assure that every community is capable of carrying out core public health functions (assessment of population health, assurance of accessible and equitable health resources, and development of policies to address population health) to create healthy conditions. Yet, due to budget cuts and inconsistent approaches to base funding, communities are losing critical prevention and health promotion services and staff that deliver them. Purpose This article describes key components of and current threats to our public health infrastructure and suggests actions necessary to strengthen public health systems and improve population health. Discussion National nursing and public health organizations have a duty to advocate for policies supporting strong prevention systems, which are crucial for well-functioning health care systems and are fundamental goals of the nursing profession. Conclusion We propose strengthening alliances between nursing organizations and public health systems to assure that promises of a reformed health system are achieved. [ABSTRACT FROM AUTHOR]

Objective: Describe cross-jurisdiction service sharing (CJS) by local and tribal health departments (LHD) in Wisconsin in 2014 compared to 2012. Design: An online survey of 91 LHD directors in Wisconsin was conducted. Results were compared to the results of a 2012 survey. Characteristics of CJS arrangements and differences in results by population size, geographic region, and governance type were described. Standardized proportion differences (h) were estimated using the arcsin transformation. Confidence intervals were estimated using unconditional exact confidence intervals for the difference of proportions.8 A forest plot of the estimates and confidence intervals was generated to visualize change in CJS for each population category. Results: Seventy-eight percent of respondents in 2014 reported currently sharing services compared to 71% of respondents in 2012. Positive effect sizes indicate increased sharing in year 2014 relative to 2012. CJS was more frequent for LHD serving smaller jurisdictions, consistent with both 2012 survey results and national findings. All governance types continue to engage in sharing public health services. Implications: Cross jurisdictional service sharing is widespread and increasing in Wisconsin, implying that it is a useful strategy for providing public health services under some circumstances. Educating public health practitioners and students about CJS strategies in public health is recommended. [ABSTRACT FROM AUTHOR]

Current standards and competencies guiding public health nursing (PHN) practice promote population-focused practice, but few studies have examined the extent to which change toward this type of practice has occurred. A cross-sectional, mail-back survey was conducted among public health nurses in Mississippi to examine recent changes in their practice, contextual factors related to population-focused practice, and recommendations for improving practice and educational preparation for practice. The survey response rate was 54% (n=150 [of 277]). Participants were predominantly female (95%), White (85%), 46 years or older (62%) and held an associate degree in nursing (69%). Most experienced nurses (n=106, 70%) reported perceived practice changes compared to five years prior, but did not consistently report changes toward greater population-focused practice. Participants reported funding decreases and negative effects on practice stemming from the nursing shortage. Recommendations for improving practice conditions included increasing resources, improving workplace environment and management practices, changing the focus of services, and promoting awareness of public health and PHN. Recommendations for improving education included providing more clinical experiences in public health settings and increasing financial supports and distance learning options. Additional research is needed to determine the nature and characteristics of population-focused PHN as practiced in Mississippi and elsewhere.

Many new initiatives for population health improvement feature partnerships of leaders and organizations across multiple sectors of society. The purpose of this article is to review 1) the rationale for such partnerships as an important, if not essential, tool for population health improvement; 2) key organizational and contextual factors that appear to be associated with effective multisector partnerships; and 3) the limited evidence regarding the effect of such partnerships on population health outcomes. We conclude that systems thinking - accounting for the collective effect of many actors and actions - is essential to organizing and sustaining efforts to improve population health, and to evaluating them. More research is needed to understand how and why multisector partnerships are formed and sustained and the conditions under which multisector partnerships are necessary or more effective than other strategies for population health improvement. Research on and evaluation of multisector partnerships also need to incorporate more standard measures of partnership contexts, characteristics, and strategies and adopt longitudinal and prospective designs to accelerate social learning in this area. Finally, studies of multisector partnerships must be alert to the value of such initiatives to individuals and communities apart from any direct and measurable impact on population health.

Background: Local health departments contribute to population health improvement through the core functions of assessment, policy development, and assurance. Their capacity to perform these functions may be affected by funding and staffing., Objective: To describe local health department funding and staffing levels and determine the relationship between these measures and county-level health outcomes., Methods: Ten years of total funding, funding by revenue source, and staffing data from local health departments in all 72 Wisconsin counties were collected from the Department of Health and Family Services and analyzed. Summary measures for county health outcomes were obtained from the 2006 Wisconsin County Health Rankings, and a correlation matrix was created to determine associations between outcomes and measures of health department capacity., Results: On average, Wisconsin local health departments spend $20.60 per capita, ranging from $7.50 to $68.30 among counties. While total per capita funding in the state (adjusted for inflation) increased $0.82 per year, a closer look reveals 3 distinct periods: increases of $0.20 per year during 1995-1997 and $1.33 per year during 1997-2001; but a decrease of $0.27 during 2001-2004. Local health departments in counties with worse health outcomes had only slightly higher average funding and staffing levels during 2002-2004., Conclusion: Levels of health department funding in Wisconsin, already low by US standards, declined slightly in the past 3 years. Although counties with the worst health outcomes had slightly higher levels of public health funding, considerable disparities exist. State policymakers might consider investing more resources in counties with the greatest need, to support evidence-based public health programs and reduce existing geographic health disparities in Wisconsin.