Context:The Public Health Accreditation Board requires accredited local health departments (LHDs) to complete community health improvement plans (CHIPs). Evidence suggests that participatory planning frameworks, cross-sector collaboration, social determinants of health (SDOHs), and steering organizations are integral to effective public health planning. However, little is known about the degree to which LHDs incorporate these aspects during the CHIP process. Objectives: To describe the use of planning methods, SDOHs, cross-sector partnerships, and steering organizations during the CHIP development process among nationally accredited LHDs and to identify whether LHD jurisdictional size or region is associated with differences in use.
Design:The most recent CHIPs from 93% of all nationally accredited LHDs (n = 195) were qualitatively reviewed and numerically coded for each of the planning components to calculate frequency and degree of use. Differences in use of each component by LHDsʼ jurisdictional size and region were tested using the chi-square test. Main Outcome Measure: Use of CHIP planning frameworks, SDOH inclusion, cross-sector partnerships, and steering organizations. Results: One-half of LHDs (53%) reported use of Mobilizing for Action through Planning and Partnerships, but nearly onefourth of LHDs did not use any planning framework. LHDs with a large jurisdictional size (>500 000) were significantly more likely to include SDOHs to a high degree than LHDs with mid-(100 000-499 999) to small-(<99 999) jurisdictional size (P < .01). Similarly, large LHDs were more likely to include cross-sector partners except for the category community members, which were rarely (10%) included. Mid-sized LHDs were more likely to lead the CHIP steering committee (61%) than small (29%) and large (9%) LHDs (P < .01). Differences in use of the 4 components by region were less significant. Conclusions: Jurisdictional size, rather than region, was more strongly associated with LHD approaches to CHIP development. More studies are needed to determine how differences influence CHIP implementation and impact.
KEY WORDS: accreditation, community health, health planning, public health, social determinants of healthA community health improvement plan (CHIP) addresses the health priorities of a community. 1 It provides an action plan, creates
This study prospectively investigates associations among youth religiosity, religious denomination, and contraception use. Associations between youth religiosity and religious denomination, and type of contraceptive used and consistent contraceptive use among sexually active youth (N = 757) were analyzed using multinomial and binomial logistic regression. Identifying with a religious denomination was a predictor of dual contraceptive use relative to using no method of contraception (AOR = 2.17). There was no association between youth religiosity and type of contraceptive use or contraceptive consistency. Religious leaders and public health practitioners should collaborate to develop strategies to engage in conversations with sexually active youth about contraceptive use.
CASE REPORTWe report the first case of a child with known cardiac disease who presented in full cardiac arrest secondary to digoxin poisoning and was successfully resuscitated. A 12-week-old female presented 1-week status post surgical repair of a congenital heart anomaly in asystolic cardiac arrest. The patient was successfully resuscitated with standard Advanced Pediatric Life Support. A toxic digoxin level returned, Digoxin-specific antibody fragments (Digibind 1 1 1 1 1 1 , Fab) were administered, and all signs and symptoms of toxicity resolved. The patient was discharged 6 days after presentation with full neurological recovery.
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