Jaime Gofin, MD, MPH

Jaime Gofin, MD, MPH

Jaime Gofin, MD, MPH

Faculty Highlight –  Jaime Gofin, MD, MPH, joined the UNMC College of Public Health (COPH) faculty in 2010.  He obtained his MD in 1972 and his MPH in 1974.  Prior to moving to Omaha, Dr. Gofin served as faculty at The George Washington University (GW) and Hebrew University.  He has served as a consultant to the Pan American Health Organization and World Health Organization since 1994.

Since 1981, Dr. Gofin has introduced more than 3,500 students and practitioners to Community Oriented Primary Care (COPC) through his courses and workshops in countries all over the world.  At the COPH, Dr. Gofin drew on his COPC expertise to develop the COPC concentration in the Master of Public Health Program, one of only two in the country.  He played a role in the development of the COPC concentration at GW and served as program director from 2008-2009.  He actively participated in the development of the dual-degree program, Master of Physician Assistant Studies/Master of Public Health in COPC, with the UNMC School of Allied Health Services.  Dr. Gofin continues to oversee the COPC concentration and is responsible for two of the four core concentration courses, Community Oriented Primary Care: Principles and Practice, and Opportunities and Challenges in the Application of COPC.

Dr. Gofin offered some sincere words about his teaching philosophy.   He sees teaching as much more than a transfer of information; he sees it instead as a bilateral conversation to stimulate reasoning and critical thinking that will translate into action.  He promotes “learning by doing” and wants students to thrive in their learning and not merely “pass through university”.

Dr. Gofin’s research focuses on the evaluation of community health and COPC programs and the quality of teaching and teachers’ training programs.  He has published more than 80 articles and two textbooks.  Dr. Gofin has served on more than 30 university, public health, medical, national, and international committees during his career, and was the founder and chairman of the Alumni Association of the School of Public Health and Community Medicine at the Hebrew University in Jerusalem.  For ten years, he was a proud elected member of the Board of Directors Community Administration for Ramot, a neighborhood of 45,000 residents in Jerusalem.  He won the 2007 Gordon-Wyon Award from the International Section of the American Public Health Association for his “outstanding leadership in community oriented primary care.”

Jaime Gofin, MD, MPH, is a professor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health.

Fang Qiu

Fang Qiu

Fang Qiu

Student Highlight – Fang Qiu is a PhD student in the Department of Biostatistics at the University of Nebraska Medical Center (UNMC) College of Public Health. She entered the PhD program on a part-time basis, and has now finished the first year of her doctoral program.  She is originally from ZaoZhuang, a small city in China.

After obtaining a master’s degree in statistics, Fang started to work for UNMC as a full-time statistical coordinator. She works collaboratively with investigators across the UNMC campus on experiment design, data management, data analysis, interpretation, and manuscript writing of health-related research studies.  As a statistical coordinator, Fang encountered several studies for which the data could not be analyzed using standard statistical methods, and she sought the assistance of faculty in the COPH Department of Biostatistics. These consultations with faculty led Fang to decide to pursue a PhD in biostatistics so that she could learn how to develop innovative statistical methods that would enable her to solve complex problems in medicine and public health. Fang’s research interests include clinical trials, survival data analysis, high-throughput data analysis, and meta-analysis.

After earning her PhD, Fang hopes to continue contributing to the prevention and cure of disease as a professional researcher and educator. Fang has found COPH faculty and staff to be very helpful and thoughtful. She also appreciates the encouraging learning environment at the COPH.

Justin Frederick, MPH (Health Administration, 2011)

Justin Frederick, MPH

Justin Frederick, MPH

Alumni Highlight –

Hometown: I grew up in Gretna, Nebraska, where my family has been established for nearly four generations.

Current career position: I am currently the supervisor of Communicable Disease Epidemiology with the Douglas County Health Department in Omaha, Nebraska. I’ve been with the department since 2003, and since then I’ve had the opportunity to investigate and prevent the ongoing transmission of many emerging diseases, including measles, mumps, H1N1 influenza, tuberculosis, West Nile, listeria, Legionellia, Histoplasmosis, Cyclospora, and many others. I enjoy the ongoing challenges that my job presents with the emergence of new and old infectious diseases. My job allows me to work directly with the community, which has its challenges, but knowing that my staff and I are making a positive difference is both rewarding and personally fulfilling.

My most memorable public health investigation occurred in 2010, when four individuals in Omaha who had not been vaccinated against measles traveled to a state where there were known measles cases, and then returned to Omaha, possibly carrying the infection with them.. Thousands of citizens in Omaha were potentially exposed within a few days by the index case; however, due to public health’s rapid detection and initiation of public health control measures, no additional cases were identified. This investigation proved to be resource intense, but an experience I’ll never forget.

I have also had the opportunity to work with both state and federal agencies on many occasions in the investigation and prevention of infectious disease.  Most recently, my staff and I were heavily involved in the ongoing, nationwide outbreak of Cyclospora. In fact, my department’s cluster investigation provided the statistical evidence identifying a contaminated ingredient in the salad mix, which directed the FDA and CDC’s trace back investigation. This was a proud moment for my department and all the staff involved.

What you value most about your time in our program:  I value building relationships with professionals from a variety of disciplines, developing lifelong friendships, and acquiring a deeper knowledge of public health. The program also helped develop various skill sets needed for my job today, including public health theory, education and prevention, analytic, epidemiology, and effective communication.

Advice for current students: Get involved with different organizations and groups that promote public health. Explore possible career opportunities, and look for opportunities to develop some on-the-job experience.

 

Ashish Joshi, PhD, MD, MPH

Ashish Joshi, PhD, MD, MPH

Ashish Joshi, PhD, MD, MPH

Spotlight on Research at COPH – Dr. Joshi’s research interests include global health; multifaceted technology-mediated interventions to support chronic care; and computer-mediated health education, geovisualization, and health outcomes.

Dr. Joshi blends his clinical medicine training with biomedical research, public health research, and computer science and engineering research. He uses technology-mediated, multifaceted interventions to support care of patients with chronic diseases. For example, Dr. Joshi designs and evaluates interventions that support disease prevention, monitoring, and management through technologies that are multifaceted, cost-effective, and accessible. He creates models that can be adopted in practice-based settings through effective collaborations among different stakeholders for improving health outcomes. His expertise is especially geared toward interactive health information platforms such as touch screen computers placed in kiosks for the purpose of recording demographic information, knowledge, attitudes, and practice information; self-reported clinical assessments; and risk assessment information and health education for lifestyle modification.

Since joining UNMC in 2010, Dr. Joshi has been involved in several public health interventions using evidence-based, culturally relevant, and cost-effective innovative informatics approaches to improve population health outcomes in various global settings. Dr. Joshi is the principal investigator on a two-year R21 research grant titled “Evaluation of a Touch Screen Computer-Based Breastfeeding Educational Support” funded by the Agency for Healthcare Research Quality. The study aims to improve breastfeeding knowledge and practices among Hispanic women living in rural settings through use of a touch screen, interactive, bilingual, standalone, and Internet-enabled breastfeeding educational program. He has  evaluated a computer-mediated interactive multiple sclerosis education program for the US Department of Veterans Affairs in Baltimore, Maryland. He was also funded by the Government of Orissa, India, to design, develop, and evaluate an interactive dengue fever health information portal. For his presentation on this project, he received the best oral presentation award at the Centre for Research in Medical Entomology’s “Brain Storming Conference on Dengue Scenario in India: Disease Burden, Surveillance and Control,” July 25-26, 2013, in Madurai, India.  Dr. Joshi, in collaboration with Dr. Stephen Obaro and with a grant from the Bill and Melinda Gates Foundation, also implemented a community-based surveillance system to monitor acute bacterial infections in Nigeria. This public health surveillance system is both a standalone and an Internet-enabled application that will generate data to improve public health decision making. Dr. Joshi also received a research grant from the Indian Council of Medical Research to evaluate the impact of a computer-mediated, bilingual, touch screen, kiosk-based program to support individuals at risk of metabolic syndrome in diverse Indian settings. This was the first-ever study to be conducted in India to evaluate the feasibility, usefulness, and effectiveness of a technology-enabled intervention to improve population health outcomes.

Dr. Joshi has also been funded through several industry partners, including Orion Diagnostics (Finland), Case Care Innovations (Florida), and Planet Water (Omaha). These projects vary from point-of-care testing to design, development, and implementation of an Internet-enabled medical monitoring system to evaluate the effect of Planet Water’s “AquaTowers” on water, sanitation, and hygiene-related outcomes among school children in rural India.

Since 2010, Dr. Joshi has published 25 research papers in peer reviewed journals, and given nearly 15 presentations at national and international conferences. He has received many awards, including the 2013 Mahatma Gandhi Pravasi Samman Award at the House of Lords, London; the 2012 and 2013 UNEMED Research Innovation Award; and the 2012 UNMC Distinguished Scientist New Investigator Award.

Ashish Joshi, PhD, MD, MPH, is the director of the Center for Program Informatics and an assistant professor in the UNMC COPH Department of Health Services Research and Administration and the Center for Global Health and Development.

 

The ‘New and Improved’ General Educational Development (GED) Test Series

scantron test Public Health Community Advisory – A recent report on the upcoming changes to the General Educational Development (GED) series of examinations stated “[In January 2014] the series will be replaced by a new, more rigorous version intended to meet modern expectations for college- and career-readiness.”[1] So, why will this change be important, who will it be important for, and what is the connection to the public’s health?

Simply put, it matters to all of us but in different ways. For those seeking a GED, the change may affect their access to preparation and testing. For those individuals and for communities as a whole, the change may affect both individual and community literacy and health literacy.

An increased testing fee could deter individuals from completing the GED. Those lacking a high school diploma often have limited employment options, and the increased testing fees could pose a barrier. However, the change that is likely to have the largest impact on individuals’ ability to obtain a GED is the adoption of computerized testing. This change is likely to have a negative effect in the short term but a positive effect in the long term. In the short term, computerized testing will prevent some smaller community literacy groups from offering GED exam preparation because they lack computers and/or the skills for computer training. In addition, the learning curve will be steep for those adult learners who have limited understanding of how to use technology and limited access to it. Organizations helping students prepare to take the computerized GED exams will need to have technology in their educational settings so students become comfortable using the technology before they begin the GED test series. In the long term, however, those who prepare for and take the computerized GED exams will have added that experience with technology to their skill set, which will be an asset when entering the workplace and/or continuing their education.

The change to computerized GED preparation and testing could have similar short-term (negative) and long-term (positive) effects on the health of communities. In the short term, financial or technical inability to access GED services may mean fewer adult literacy opportunities and therefore lower adult literacy. Lower adult literacy means lower health literacy, particularly for the elderly, racial and ethnic minorities, immigrants, and those with limited education. However, in the long term, those who obtain a GED and gain experience with technology will also increase their health literacy and the health literacy of their community. Individuals are affected by their own health literacy and the health literacy of those around them: family, friends, neighbors, co-workers. This “ripple effect” has been studied and proven with mapping research[2]. An individual living in a community with relatively high health literacy may benefit from the knowledge and abilities of his/her friends and neighbors. An individual living in a community with low health literacy may receive counter-productive information from friends and neighbors. So, as stated earlier, we all benefit from an educated community. Education plays a critical role for a healthy community. Promoting educational development is a pathway towards greater opportunities and stability for adult learners. Where we see low adult literacy we may be more likely to see poor health literacy and poorer health outcomes overall.

[1] Brynn Anderson, The Omaha World Herald, http://www.omaha.com/article/20131110/NEWS/131119921

[2] Bird, C.E. RAND Corporation.

This article was written by Denise H. Britigan, PhD, assistant professor in the COPH Department of Health Promotion, Social and Behavioral Health, and Kirsten Case, executive director of the Midlands Literacy Center in Omaha, Nebraska.  www.giveliteracy.org

Equity of Mental Health Services Coverage

source: bls.gov

source: bls.gov

Public Health in the National News – As part of the fallout from the recent school shootings and outbreaks of gun violence, the Obama administration promised to improve mental health services. One of the 23 executive actions taken to reach this goal was to issue the final rule to fully implement the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. Overall, the MHPAEA does not require insurers to provide mental health and substance abuse benefits unless they are being offered through the state insurance marketplaces as defined by the 10 essential health benefits implemented under the ACA. However, if benefits are offered, the final rule signals significant changes to large group health insurance plans by requiring that benefits for mental health and substance abuse services be treated equally to other types of health services, including treatment limitations, financial requirements, and annual or lifetime dollar limits. In addition, the ruling ensures access to intermediate levels of care for residential treatment and outpatient mental health services and clarifies plan participant disclosure rights (i.e., explanation of comparable deductible and visit limits for both mental and general health care). It also requires insurers to charge similar co-payments for mental health treatments and services as they would for physical health problems.  In addition, the final rule also clarifies that the Affordable Care Act trumps parity law by not allowing annual or lifetime limits on essential health benefits, which for mental health and substance use disorder services include behavioral health treatment (e.g., counseling and psychotherapy), inpatient services, and treatment for substance use disorders. The combination of these recent policy changes means improved access to behavioral health services for millions of Americans.

For further information:

General Resources for Mental Health

http://www.mentalhealth.gov

The Insurance Marketplace and Mental Health and Substance Use Services

https://www.healthcare.gov/do-marketplace-insurance-plans-cover-mental-health-and-substance-abuse-services/

Fact Sheet on the Mental Health Parity and Addiction Equity Act

http://cms.hhs.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet.html

Full Text of the Final Rule for the Mental Health Parity and Addiction Equity Act

https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-27086.pdf

This article was written by Kelly Shaw-Sutherland, MPA, a health data analyst in the UNMC COPH Department of Health Services Research and Administration, and Jim Stimpson, PhD, director of the UNMC COPH Center for Health Policy and an associate professor in the UNMC COPH Department of Health Services Research and Administration.