Assessment of the monitoring and evaluation system of a population-based program: Theory-driven evaluation approach.

The purpose of this study was to assess the performance of a monitoring and evaluation system (M&E) for a population-based program and to identify factors influencing its performance. The state health department provided a grant, guide, and training for health districts to implement the program and report quarterly and annually to the M&E. Some health districts did not meet this requirement. We also found that the M&E did not adequately capture the actual work of the districts in communities as related to the work plan. We identified several factors that negatively affected the performances of the M&E. For example, the state and health districts did not have a shared vision on how to develop and implement the program, and what to report to the M&E. We proposed strategies that could improve the timeliness and content of reports to the M&E, as well as its utilization in the future.

Socioeconomic, environmental and lifestyle factors associated with gestational diabetes mellitus: A matched case-control study in Beijing, China.

Gestational diabetes mellitus (GDM) is a common health problem during pregnancy and its prevalence is increasing globally, especially in China. The aim of this study was to investigate socioeconomic, environmental and lifestyle factors associated with GDM in Chinese women. A matched pair case-control study was conducted with 276 GDM women and 276 non-GDM women in two hospitals in Beijing, China. Matched factors include age and pre-pregnancy body mass index (BMI). GDM subjects were defined based on the International Association of Diabetes Study Group criteria for GDM. A conditional logistic regression model with backward stepwise selection was performed to predict the odds ratio (OR) for associated factors of GDM. The analyses of data show that passive smoking at home (OR = 1.52, p = 0.027), passive smoking in the workplace (OR = 1.71, p = 0.01), and family history of diabetes in first degree relatives (OR = 3.07, p = 0.004), were significant factors associated with GDM in Chinese women. These findings may be utilized as suggestions to decrease the incidence of GDM in Chinese women by improving the national tobacco control policy and introducing public health interventions to focus on the social environment of pregnant women in China.

Using the exhibited generalization approach to evaluate a carbon monoxide alarm ordinance.

Current interests in enhancing the focus of external validity or transferability call for developing practical evaluation approaches and illustrating their applications in this area for meeting the need. This study takes the challenge by introducing an innovative evaluation approach, named the exhibited generalization approach, and applying it in evaluating the carbon monoxide (CO) alarm ordinance passed by Mecklenburg County, North Carolina. The stakeholders specifically asked evaluators to determine the answers to the following two questions: (1) Does the alarm ordinance work? (2) What generalizable information can the Mecklenburg experience provide to other jurisdictions trying to decide if the alarm ordinance's planning, implementation, adoption, and outcomes are transferable to their communities? This study illustrates how to apply the exhibited generalization approach to provide the stakeholders with answers to these questions. Our results indicate that the alarm ordinance was effective in increasing CO alarm ownerships and reducing CO poisoning cases. The evaluation provides potential users and other interested parties with the necessary information on contextual factors and the causal mechanism underlying the CO alarm ordinance, so that these parties and users could decide whether the Mecklenburg alarm ordinance would be transferable to their own communities. Discussions include implications of this study for contributing in further advancing evaluation theory in addressing transferability or external validity issues.

A liaison-based academic health department in Georgia: a partnership for improving community health.

Public health practice in Georgia and the North Central Health District 5.2 in particular is facing several challenges. In recent years, public health program funding in the state department and district has been cut or eliminated. Many public health workers are scheduled to retire in the next few years. Low pay also makes it difficult to attract and retain qualified applicants to local health departments. This has become increasingly challenging in an environment where experienced public health professionals are becoming limited. Furthermore, accredited public health programs such as Mercer University are expected to provide practical learning experiences for students. Mutual benefits have prompted the North Central Health District and the Public Health Program of Mercer University to enter into a formal partnership through an affiliation agreement to form the academic health department. This article discusses the logic model underlying the academic health department and lessons learned from its initial implementation.

Tobacco use and low-income African Americans: policy implications.

BACKGROUND: Tobacco use has declined in the United States over the past decade, but smoking among low-income populations remains high in comparison. Although many studies have linked poverty and tobacco use, few studies have examined the prevalence and predictors of tobacco use among low-income African Americans in the South. METHODS: A total sample of 388 residents of a Housing Authority complex in the South were surveyed. This cross-sectional study examined the prevalence and predictors for current tobacco use among sampled participants. RESULTS: Results show that low-income populations in the South have high rates of smoking. Of the sample, about 43% were current tobacco users. Findings indicate that tobacco users were more likely to be older, have been exposed to secondhand smoke, have positive attitudes toward tobacco commercials, and have been arrested in the past. Results found several predictors of tobacco use in the study population including age, secondhand smoke, attitude toward tobacco media, and criminal activity. CONCLUSIONS: Housing Authority apartment complexes may be an important target for tobacco use prevention and treatment interventions. Other policy implications are recommended.

Association between tobacco use and lifestyle in a sample of lower income urban African-Americans in the American south.

There has been little research evaluating links between low-income populations' lifestyles and their tobacco use status. We surveyed 398 low-income individuals living in Housing Authority complexes in Columbus, Georgia. Current, former, and never tobacco users were compared for their health-related behaviors and lifestyles. Study findings suggest that current tobacco users were less healthy than comparisons, but had less unfavorable obesity measurements. In lifestyle choices, tobacco users were more likely than comparisons to be interested in sports (football, basketball, etc.), shopping, and participate in church activities.