Managerial and professional beliefs influencing public health privatization: results of a national survey of local health department directors

This article describes managerial and professional beliefs underlying decisions to privatize public health services. We drew a stratified, nationally representative sample of local health departments and interviewed 347 department directors by telephone. We used logistic regression to establish the independent effects of various beliefs on the decision to privatize. Over half of directors did not believe that there was valid evidence that privatization results in more efficient performance, and those who believed there was such evidence were not more likely to privatize. However, directors held professional and managerial beliefs that influenced their decision to privatize. Directors most likely to privatize were those who believed that local health departments should exclusively focus on the core public health functions, those who asserted that public health should become involved in an increasingly diverse array of social problems, and those who believed that employees should be used on a temporary and contractual, rather than permanent, basis wherever possible.     

Problem characteristics, decision processes and evaluation activity: a preliminary study of mental health center directors

This article reports on the results of a preliminary study on the characteristics of problems and problem solving in mental health centers. The major findings were that directors were generally quite satisfied both with the available level of information intended to help them make decisions, and with their ability to make good, even optimal, decisions. Much of this confidence resulted from the use of assumptions about the problems which reduced the need for empirical information. The problem solving process was highly dynamic and interactive, with changes over time in the characteristics of problems, constraints and alternative solutions. The directors played an active role in attempting to foster and influence the direction of many of these instabilities. Some implications for evaluation and research are discussed.     

Student health insurance programs at collegiate institutions: a national survey

Increasing health care costs are forcing collegiate institutions to find more economical ways to meet the health care needs of students. Student health insurance programs are a major component in meeting these needs. This national survey reports the extent to which student health insurance programs are offered or administered by 2-year and 4-year colleges, universities, and professional and graduate schools in both the public and private sectors. The study finds that most programs are optional, open to all registered students regardless of age or credit load, with dependent coverage options usually available. Reported enrollment levels suggest that less than 20% of the students participate at a majority of the institutions surveyed. Concern about group health insurance at the collegiate level reflects national concern over the large number of Americans who currently lack health coverage.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

Barriers and facilitators to evaluation of health policies and programs: Policymaker and researcher perspectives

Our research sought to identify the barriers and facilitators experienced by policymakers and evaluation researchers in the critical early stages of establishing an evaluation of a policy or program. We sought to determine the immediate barriers experienced at the point of initiating or commissioning evaluations and how these relate to broader system factors previously identified in the literature.We undertook 17 semi-structured interviews with a purposive sample of senior policymakers (n = 9) and senior evaluation researchers (n = 8) in Australia.Six themes were consistently raised by participants: political influence, funding, timeframes, a ‘culture of evaluation’, caution over anticipated results, and skills of policy agency staff. Participants also reflected on the dynamics of policy-researcher relationships including different motivations, physical and conceptual separation of the policy and researcher worlds, intellectual property concerns, and trust.We found that political and system factors act as macro level barriers to good evaluation practice that are manifested as time and funding constraints and contribute to organisational cultures that can come to fear evaluation. These factors then fed into meso and micro level factors. The dynamics of policy-researcher relationship provide a further challenge to evaluating government policies and programs.     

Predictors of smoking and smokeless tobacco use in college students: a preliminary study using web-based survey methodology

Cigarette smoking and smokeless tobacco (SLT) use are associated with numerous health hazards and economic costs, and rates of tobacco use have recently increased among young adults. In this study, the authors compared predictors of smoking and SLT use among college students (N = 21,410) from 13 Texas universities using a Web-based survey. Results revealed that sex, belonging to a fraternity or sorority, participation in intercollegiate sports, peer influences, and ethnicity predicted smoking and SLT use. Although common factors predicted both lifetime and current smoking and SLT use, patterns of prediction differed across dependent variables. The authors discuss implications for developing tobacco prevention programs targeting specific risk factors salient to the young adult population.     

Work rehabilitation programs: a 1997 survey

By adapting to the changing health care environment, legislative reforms, and consumer needs, work rehabilitation programs have experienced a metamorphosis. This study surveyed occupational therapists currently employed in work programs to ascertain a current demographic profile of work rehabilitation programs. Respondents indicated the delivery of services in the areas of prevention, assessment and rehabilitation. The majority of work rehabilitation programs in this study provide services in the form of ergonomics, education and training, and job analyses at the worksite. The area of work injury prevention services is forecasted for increased growth among work rehabilitation programs.     

A cost-benefit analysis of a smoking cessation program

Smoking cessation programs are usually evaluated in terms of the percentage of participants who have stopped smoking at least 6 months after the program's completion. This paper shows how a relatively low rate of behavior change may actually result in a high ratio of benefits to costs. Cost-benefit analysis is done for a specific program but the procedures and cost estimates are generalizable to other smoking cessation programs. Benefits to the firm included reduced costs of insurance and the savings due to employee absenteeism and disability. Costs included the program costs as well as the opportunity costs of the participants. Data from the literature and from the specific program are combined to form conclusions about the effectiveness of the program.     

College students define binge drinking and estimate its prevalence: results of a national survey

Data from the 1999 College Alcohol Study were used to examine how students define the term binge drinking, to determine how much binge drinking the students think exists on their campuses, and to analyze how students' estimates compare with aggregated self-reports of student drinking. The findings indicate that the median of the students' definitions of binge drinking is 6 drinks in a row for men and 5 for women, 1 drink higher than the definition used by researchers. Students' definitions of binge drinking vary with their own drinking levels, suggesting that dissenting views of the research definition may represent voices of the heaviest drinkers. At the median, students estimated that 35% of all students were binge drinkers. Half (47%) of the students underestimated the binge drinking rate at their school, 29% overestimated it, and 13% were accurate. Although programs designed to reduce the frequency or prevalence of binge drinking by emphasizing healthier norms would be most useful in addressing binge drinkers who overestimate drinking norms, this group includes only 13% of college students.     

Rational addiction and smoking cessation: An empirical study

The theory of rational addictive behavior has important implications concerning the impact of a smoker’s socioeconomic status on his or her incentive to quit. The research reported on here extends the previously developed theory of addictive behavior to show its implications for both successful and unsuccessful quitting. Further, it develops hypotheses as to how successful and unsuccessful smoking cessation should relate to an individual’s socioeconomic status if the theory is correct. The hypotheses are then tested empirically, using multinomial logit analysis for a sample of more than 24,000 Californians. The results support the theory of rational addictive behavior.     

Texas college students' opinions of no-smoking policies, secondhand smoke, and smoking in public places

Abstract. The authors examined college student opinions of no-smoking policies, secondhand smoke, and smoking in public places. A convenience sample of 1,188 (66.4% female; 26.9% White, 64.1% Black, and 9.0% Hispanic) students attending 5 Texas colleges volunteered to complete a 60-item anonymous survey on tobacco attitudes and behaviors. Results of our study showed that women, Black students, and nonsmoking students reported the most favorable attitudes toward no smoking. Male students, white students, and students who smoked in the past 30 days (current smokers) reported the least favorable attitudes. The lowest level of agreement by all subgroups was provided for prohibiting smoking everywhere on campus (inside and outside of buildings). Implications for tobacco control on college campuses are discussed.     

Perceived strengths and weaknesses in employment policies and services among people with multiple sclerosis: results of a national survey

More than 1,300 individuals with multiple sclerosis (MS) responded to an employment concerns survey. The results from this survey served as the topics of discussion for seven focus groups including people with MS and service providers in four states. Recommendations to improve the employment outcomes of people with MS that emerged from these discussions clustered in three areas: employment policies and practices, Social Security benefits, and healthcare. Strategies for preserving strengths in employment supports for people with MS clustered in two areas, access to respectful service providers and personal control.     

Prevalence and correlates of alcohol-induced blackouts among college students: results of an e-mail survey

The authors conducted an e-mail survey of 772 college students to learn more about their experiences with blackouts. Approximately half (51%) of those who had ever consumed alcohol reported they had experienced a blackout at some point in their lives, and 40% had experienced 1 in the year before the survey. Among those who drank in the 2 weeks before the survey, nearly 1 in 10 (9.4%) had experienced a blackout during that period. Many later learned that, during the blackout, they had vandalized property, driven an automobile, had sexual intercourse, or engaged in other risky behaviors. Experiencing 3 or more blackouts was associated with a variety of other experiences, including heavier drinking, lower grades, an earlier age of drinking onset, and having others express concerns about their drinking. The female students who reported blackouts during the 2 weeks before the survey drank far less than male students did during this time period, supporting the use of gender-specific definitions of risky drinking.     

The impact of citizen evaluation review on community mental health center programs

A field study of techniques for involving local citizens in the evaluation of Community Mental Health Center (CMHC) services shows that lay citizens can make recommendations that service agencies will use to improve services. Seventeen citizen groups received evaluation information from participating CMHCs and developed 310 recommendations. Seventy-one percent of these suggestions were used by the CMHCs. Staff and governing board attitudes, fiscal pressures, and other organizational characteristics affected the success of the citizen groups.