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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]

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]

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]

Healthy People 2010: Understanding and Improving Health and corresponding state health improvement plans provide roadmaps for planning, monitoring, and evaluating population health improvement in the United States. These documents offer relevant guidance for nursing education because they address health workforce education specifically, use a population perspective, and include evidence-based action priorities. However, information about how these documents are used in nursing education is limited. This article discusses the relevance of national and state health planning documents for nursing education. Nurse educators are encouraged to reflect on the alignment of current nursing education efforts with national and state health planning agendas. Suggestions for future use of national and state population health improvement planning documents in guiding strategic, curricular, and course planning are offered. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports the characteristics of recent public health nursing (PHN) practice change experienced by staff-level public health nurses. Recommendations for improving PHN practice offered by study participants are reported and discussed. Design: A cross-sectional written survey was used to collect data from 424 public health nurses in 76 local health departments (LHDs) in Wisconsin (68% response rate) in 2003. Characteristics of practice change were identified using a 15-item-scaled response set. Recommendations on improving practice were made through responses to an open-ended survey question. Content analysis was conducted to identify major themes among the responses. Results: PHN practice has become more population focused. Major themes emerging from the recommendations for practice improvement included increasing system and organizational resources, expanding visibility of public health, and strengthening collaboration. Conclusions: Implications for practice include the need for continuing education in concepts and skills required for population-focused PHN practice, advocacy for more public health resources, and collaboration with academic partners for education and research. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) play critical roles in public health surveillance systems in the United States. Increased understanding of public health surveillance systems can help PHNs appreciate their role in surveillance and improve the quality and usefulness of surveillance data. This paper describes the National Immunization Survey, the public health surveillance system currently in place for tracking immunizations, as well as immunization registries and HEDIS performance indicators, two emerging approaches to immunization surveillance. The contributions of public health nursing to these systems and implications for public health nursing practice are discussed. High quality public health surveillance information is essential for monitoring the progress of disease trends and program effectiveness. PHNs can help assure the quality of surveillance data. [ABSTRACT FROM AUTHOR]

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.

Objectives: Interest is increasing in collaborations between public health and primary care to address the health of a community. Although the understanding of how these collaborations work is growing, little is known about the barriers facing these partners at the local level. The objective of this study was to identify barriers to collaboration between primary care and public health at the local level in 4 states., Methods: The study team, which comprised 12 representatives of Practice-Based Research Networks (networks of practitioners interested in conducting research in practice-based settings), identified 40 key informants from the public health and primary care fields in Colorado, Minnesota, Washington State, and Wisconsin. The key informants participated in standardized, semistructured telephone interviews with 8 study team members in 2014 and 2015. Interviews were audio recorded and transcribed verbatim. We analyzed key themes and subthemes by drawing on grounded theory., Results: Primary care and public health participants identified similar barriers to collaboration. Barriers at the institutional level included the challenges of the primary care environment, in which providers feel overwhelmed and resources are tight; the need for systems change; a lack of partnership; and geographic challenges. Barriers to collaboration included mutual awareness, communication, data sharing, capacity, lack of resources, and prioritization of resources., Conclusions: Some barriers to collaboration (eg, changes to health care billing, demands on provider time) require systems change to overcome, whereas others (eg, a lack of shared priorities and mutual awareness) could be addressed through educational approaches, without adding resources or making a systemic change. Overcoming these common barriers may lead to more effective collaboration.

Objective: The objective of this study was to explore current and future use of shared service arrangements as a management strategy to increase capacity to provide public health essential services in Wisconsin., Design: An online cross-sectional survey of 99 local and tribal health departments in Wisconsin was conducted. Select variables from the 2010 Wisconsin Local Health Department Survey were merged. Other data sources included results from a Board of Health governance analysis and the Wisconsin Department of Health Services region data. Descriptive analysis was performed of current and future shared service arrangements and the characteristics of the types of arrangements and agreements in place., Results: Ninety-one of 99 Wisconsin local and tribal health departments responded, yielding a 92% response rate. Seventy-one percent of respondents currently share services with 1 or more other health departments. More frequent arrangements were present in programmatic areas than in departmental operations. Most frequently reported motivators include making better use of resources, providing better services, and responding to program requirements. Extensive qualitative comments indicate arrangements accomplished what the local health department hoped it would with perceived gains in efficiency and effectiveness., Conclusion: There is widespread use of shared services among health departments in Wisconsin. Extensive qualitative comments suggest participant satisfaction with what the arrangements have accomplished. Motivating factors in developing the arrangements and limited mention of expiration dates suggest continued study of how these arrangements may evolve. Further examination of shared services as a potential mechanism to advance service effectiveness and efficiency is needed.

Introduction: Multisector partnerships are promoted as a mechanism to improve population health. This study explored the types and salient features of multisector partnerships in US counties with improving population health metrics., Methods: We used the "Framework for Understanding Cross-Sector Collaborations" proposed by Bryson, Crosby, and Stone to guide data collection and interpretation. Comparative case studies were conducted in 4 counties selected on the basis of population, geographic region, an age-adjusted mortality decline better than the US average, and stable per capita income. Data were collected through website and report reviews and through in-depth interviews with key informants (N = 59) representing multiple sectors. County reports were developed and cross-case themes related to partnership types and salient features were derived., Results: Multisector collaboration was common in all 4 counties despite substantial variations in population, geographic size, demographic diversity, and other characteristics. Most partnerships were formed by professionals and organizations to improve delivery of health and social services to vulnerable populations or to generate policy, system, and environment changes. Multisector collaboration was valued in all cases. Outcomes attributed to partnerships included short- and long-term effects that contributed to improved population health., Conclusion: The Bryson, Crosby, and Stone model is a useful framework for conducting case study research on multisector partnerships. Outcomes attributed to the multisector partnerships have the potential to contribute to improvement in population health. Further study is needed to confirm whether multisector partnerships are necessary for improving population health within counties and to understand which partnership characteristics are critical for success.

Objective: Preceptors are an essential component in preparing student nurses to become practicing public health nurses. Preparation for the preceptor role is important for achieving a quality learning experience for students. This study was conducted to explore the relationship between completion of a Web-delivered preceptor education program and both knowledge of the preceptor role and self-efficacy to perform in the preceptor role., Design and Sample: This study used a pretest-posttest, quasi-experimental design. The participants were experienced public health nurses (n=31) working in one state in the United States., Measures: Pretest and posttest Web-delivered survey using the preceptor self-efficacy questionnaire and an instrument assessing knowledge gain., Intervention: A Web-delivered preceptor education program tailored for public health nurses., Results: The program was associated with improved self-efficacy scores at both the immediate and the 3-month posttest, and with increased knowledge of the preceptor role evident at the immediate posttest only. Self-efficacy scores were independent of knowledge scores. Preceptor age was not correlated with self-efficacy or knowledge scores. Nurses with higher levels of education demonstrated higher self-efficacy scores in all 3 measurements., Conclusions: Web-delivered continuing education targeted to public health nurse preceptors is an effective method to increase confidence and knowledge for the preceptor role., (© 2011 Wiley Periodicals, Inc.)

Collaboration between public health and faith communities is encouraged by national and state policies. The study in this article examined the prevalence, characteristics, and effectiveness of partnerships between faith-based organizations and local health departments in Wisconsin. Data were collected from local health departments using a 2-stage, cross-sectional survey. A subset analysis of partnerships that included faith-based organizations was conducted using descriptive, bivariate, and 2-level logit regression methods, with partnerships nested in health departments. Twenty-four percent of local health department partnerships included faith-based organizations (n = 224). Community assessment was the most commonly reported partnership focus. Partnerships that included faith-based organizations were more likely to include many partners and have few partners contributing financially. Partnerships that include faith-based organizations are no more likely to be effective than those that do not. Predictors of local health department/faith-based organizations effectiveness included having a budget and longer time in existence. Local health departments engage faith-based organizations in partnership strategies when addressing issues that require broad community attention. Partnership effectiveness is enhanced by existence of a budget and sufficient time for development.

Compliance with statutes and rules is a measure of local health department (LHD) performance. This study analyzed compliance rates in one state. High overall compliance rates were found, although gaps existed between measured and expected compliance. Factors associated with lower compliance included lower LHD certification level (characteristic of smaller agencies) and human services organizational structure in lower-level LHDs. Improvements in compliance rates will require increased attention to development and documentation of policies, procedures, and local ordinances. Compliance is necessary for LHD effectiveness but may not be a sufficient measure of overall LHD performance.

The success of mandating memoranda of understanding (MOU) in promoting collaboration between Medicaid managed care (MCMC) plans and local health departments (LHDs) was examined in this research project. The mandate resulted in MOUs that contributed to increases in collaborative activities, increased perceived quality of health care, and successful management of reimbursement to LHDs. Factors associated with success included a local initiative type of health plan, longer length of time that the MOUs were in place, and higher interorganizational collaborativeness. Concerns related to the MOU approval process and lack of contribution of the MOUs to quality of public health services were identified. MOUs promote collaborative relationships between MCMC plans and LHDs on health care issues important to both sectors.