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PubMedDate not supplied

Design and operation of state and local infectious disease surveillance systems.

Since 2001, increased attention has been focused on improving acute infectious disease surveillance systems. This article describes options for their design and operation. Systems designed primarily to detect individual cases of reportable diseases may differ from those designed to detect outbreaks or support design or evaluation of control programs. Timeliness, sensitivity, and predictive value of surveillance systems cannot all be maximized at the same time. Core activities of surveillance systems include collection, analysis, and dissemination of information about health events under surveillance. Doing these well requires attention to the mechanics of surveillance, such as making the health department accessible at all times to receive reports and provide consultation, and maintaining current directories of persons for dissemination of surveillance data, alerts, and recommendations. Rapid access to electronic representations of health events (eg, laboratory reports, patient records, or health care claims) provides great opportunities for more timely and complete surveillance. Some important information (eg, exposures, contacts) will still need to be collected directly from affected persons. One productive strategy is to collect core demographic and onset data on all cases and detailed clinical, exposure, and outcome data on a subset.

Communicable Disease Control↗
PubMedDate not supplied

A review of strategies for enhancing the completeness of notifiable disease reporting.

Notifiable disease surveillance systems provide essential data for infectious disease prevention and control programs at the local, state, and national levels. Given that reporting completeness is known to vary considerably, this review identifies methods that can reliably enhance completeness of reporting. These surveillance-related activities include initiating active surveillance when appropriate; implementing automated, electronic laboratory-based reporting; strengthening ties with clinicians and other key partners in notifiable disease reporting; and increasing the use of laboratory diagnostic tests in identifying new cases. Despite ample data in support of these strategies, notifiable disease surveillance continues to receive insufficient attention and resources. Recent attention to public health preparedness provides an opportunity to strengthen notifiable disease surveillance and enhance completeness of reporting.

Disease Notification↗
PubMedDate not supplied

Community health assessment: driving the need for current, easily accessible population health data.

Community health assessment (CHA) is a core public health function. Community health assessment is a term that describes both a process and its tangible products, such as a community health profile or other types of reports on the status of the community's health and existing influences on its health, including the extent and nature of health-related resources. Assessment has enabled a better understanding of the community's health, and this has impacted public health decisions. The authors use the framework for community health improvement proposed in 1997 by the Institutes of Medicine to show how CHA is part of the community health improvement process. Community health assessment drives the need for current, easily accessible population health data. The importance of Web-based data query systems, the focus of the other articles in this special issue, can be best understood within the broader context of CHA. Selected case examples of how Web-based data query systems have impacted the CHA process in three states are highlighted.

Access to Information↗
PubMedDate not supplied

Characteristics, desired functionalities, and datasets of state Web-based Data Query Systems.

Based on a review of state public health department Web sites, this article describes Web-based Data Query Systems (WDQSs) currently used in 27 US states. In addition, functionalities of selected well-established state WDQSs are defined as major functionalities (11), subfunctionalities (21), and specific functionalities (141), on the basis of a consensus process with participants from states and national organizations in the United States and Canada. Also, on the basis of the consensus process, specific functionalities are categorized as core, enhanced, and expert. Key terms relevant to WDQSs are defined. The information contained in this article should prove useful to public health agencies developing, revising, or evaluating the WDQS.

Consumer Behavior↗
PubMedDate not supplied

Innovations in user-defined analysis: dynamic grouping and customized user datasets in VistaPHw.

Flexible, ready access to community health assessment data is a feature of innovative Web-based data query systems. An example is VistaPHw, which provides access to Washington state data and statistics used in community health assessment. Because of its flexible analysis options, VistaPHw customizes local, population-based results to be relevant to public health decision-making. The advantages of two innovations, dynamic grouping and the Custom Data Module, are described. Dynamic grouping permits the creation of user-defined aggregations of geographic areas, age groups, race categories, and years. Standard VistaPHw measures such as rates, confidence intervals, and other statistics may then be calculated for the new groups. Dynamic grouping has provided data for major, successful grant proposals, building partnerships with local governments and organizations, and informing program planning for community organizations. The Custom Data Module allows users to prepare virtually any dataset so it may be analyzed in VistaPHw. Uses for this module may include datasets too sensitive to be placed on a Web server or datasets that are not standardized across the state. Limitations and other system needs are also discussed.

Community Health Planning↗
PubMedDate not supplied

Implementation of an Internet-based geographic information system: the Florida experience.

Increasingly, Web-based data dissemination systems are being used to provide public health information. This article describes Florida's experience in augmenting a Web-based data query system, Florida CHARTS, with a geographic information system component. As with any systems development, users' needs guide the product. With a focus on community health assessment and improvement planning, several methods of data display have been established. A variety of issues are explored including the impact of small numbers of events on data display and data confidentiality, the selection of geographic units of analysis, and techniques for geographically coding data.

Florida↗
PubMedDate not supplied

Utah's IBIS-PH: an innovative user interface solution for Web-based data query systems.

The ability to make good Web-based data query system (WDQS) project management decisions requires an understanding of the trade-offs inherent among various technology options. This article presents the current options available for the user interface and data display and compares the advantages and disadvantages of each for use in a WDQS. Relevant options are also discussed for back-end technologies such as Web and application servers and data storage mechanisms. We explain our decisions in developing the Indicator-based Information System for Public Health (IBIS-PH) query system to increase the probability of success and minimize risk. Finally, we compare the resulting IBIS-PH application characteristics with our original design requirements: broad public access; rich, interactive, and easy-to-use interface; portability; accessibility; maintainability of software and interface; supportability; low cost; and security.

Data Display↗
PubMedDate not supplied

Perspectives on the Massachusetts Community Health Information Profile (MassCHIP): developing an online data query system to target a variety of user needs and capabilities.

The Massachusetts Community Health Information Profile (MassCHIP) has many distinctive features. These features evolved to maximize the usefulness of this query system for a broad group of users with varied needs, differing levels of knowledge about public health, and diverse experience using public health data. Three major features of MassCHIP help target our large user population. These features are as follows: (1) multiple avenues of entry to initiate queries ranging from an alphabetical list of simple topics to detailed International Classification of Disease codes; (2) the inclusion of data sets from other state agencies in addition to those of the Massachusetts Department of Public Health to reflect a broad view of public health; and (3) the capacity to retrieve data for multiple levels of geography, from the neighborhood through the state, including planning districts and hospitals. In this article, we discuss the history and design of MassCHIP, and focus on the features of MassCHIP that target a great variety of user needs and capabilities, and which are distinctive among Web-based data query systems.

Information Systems↗
PubMedDate not supplied

States' approaches to implementing a Web-based data query system.

BACKGROUND: Individual states have made different decisions regarding Web-based data query systems (WDQSs). The goal of this study was to help state, county, or city health departments deploy or update a WDQS by showing how different decisions are guided by unique situations within states at particular times. METHODS: Interviews were held with key informants from 10 states that had a WDQS to determine factors relating to how these states implemented their WDQSs. RESULTS: Three states designed and developed their own systems, three states implemented systems directly using a Web-query software package, two states adopted systems developed by other states, one state designed and developed its own system after adopting a system, and one state used a Web-query software package to implement a system after attempting to adopt a system. None of the states used a commercial off-the-shelf system to implement a WDQS. All the WDQSs were located in the health statistics office or in an umbrella division of the public health agency that included the health statistics office. The skill set of available personnel had a significant impact on a state's implementation decision. CONCLUSIONS: All key informants reported satisfaction with their decisions regarding implementing a WDQS. This provides support for states currently considering any of these options.

Information Systems↗
PubMedDate not supplied

Small numbers, disclosure risk, security, and reliability issues in Web-based data query systems.

This article describes the process for developing consensus guidelines and tools for releasing public health data via the Web and highlights approaches leading agencies have taken to balance disclosure risk with public dissemination of reliable health statistics. An agency's choice of statistical methods for improving the reliability of released data for Web-based query systems is based upon a number of factors, including query system design (dynamic analysis vs preaggregated data and tables), population size, cell size, data use, and how data will be supplied to users. The article also describes those efforts that are necessary to reduce the risk of disclosure of an individual's protected health information.

Adolescent↗
PubMedDate not supplied

Reflections on organizational issues in developing, implementing, and maintaining state Web-based data query systems.

Emerging technologies, such as Web-based data query systems (WDQSs), provide opportunities for state and local agencies to systematically organize and disseminate data to broad audiences and streamline the data distribution process. Despite the progress in WDQSs' implementation, led by agencies considered the "early adopters," there are still agencies left behind. This article explores the organizational issues and barriers to development of WDQSs in public health agencies and highlights factors facilitating the implementation of WDQSs.

Internet↗
PubMedDate not supplied

Measuring the impact of a Web-based data query system: the logic model as a tool in the evaluation process.

A review of program evaluation perspectives, including the concept of a logic model and its applicability to the evaluation of Web-based data query systems (WDQSs), is presented. A logic model is used to flesh out evaluation components of a WDQS, including inputs, constraints, program activities, program outputs, and outcomes. For each component, a list of potential items is presented for inclusion in the model, along with examples of initial, intermediate, and ultimate outcomes for a WDQS. Program evaluation is a process that is important to conduct both early in WDQS development to promote clarity of its vision and objectives and throughout the course of the WDQS implementation and maintenance to ensure that its objectives are being met. Should the WDQS not be producing desirable results, the logic model provides a road map for understanding which activities are not meeting the WDQS's objectives so that the course of WDQS development, implementation, and maintenance may be altered to improve the probability of reaching desirable outcomes.

Internet↗
PubMedDate not supplied

Community coalition project directors: what makes them effective leaders?

OBJECTIVE: Effective leaders, both voluntary and paid, facilitate successful coalitions. The attributes that characterize effective project directors, however, are unclear. Our aim was to identify characteristics of effective project directors leading community coalitions. METHODS: The study examined 13 project directors who led eight community-based coalitions established to combat substance abuse. We inductively identified common characteristics and leadership effectiveness of the project directors by abstracting data from detailed ethnographic studies of these coalitions. We assessed the validity of leadership effectiveness by comparing data abstracted from ethnographic studies with two independent ratings. We then employed a cross-case comparison strategy for analyzing patterns among the common characteristics identified and leadership effectiveness. Six characteristics emerged among the project directors studied: status with community (insider vs outsider); shared leadership; bridge building skills; substance abuse expertise; vision; and management style. RESULTS AND CONCLUSIONS: Shared leadership, bridge building skills, and insider status were consistently related to leadership effectiveness. Less support was found for substance abuse expertise or vision. When hiring project directors, coalition leaders may consider assessing whether candidates are "insiders" within the community and demonstrate shared leadership and bridge building skills.

Administrative Personnel↗
PubMed2004

Estimating the population burden of injuries: a comparison of household surveys and emergency department surveillance.

BACKGROUND: Injuries represent an important public health problem but their incidence is difficult to estimate. METHODS: We conducted a population-based household survey in Greece covering 4079 interviewed individuals. The interviewees reported, for themselves and for cohabitating adults (age 15 years and older; n = 7157), injuries that occurred during the preceding year. Major injuries were defined as those requiring contact with a health institution. We compared these survey data with data obtained through a national Emergency Department Injury Surveillance System (EDISS). RESULTS: For the month closest to the survey interview, the incidence reported for the responders was 5.9 per 100 person-year, whereas the incidence for cohabitating adults was 3.7 per 100 person-years. These incidence rates declined for months more remote to the interview. Comparison of survey and EDISS data suggested that survey reporting was less accurate for nontraffic-related injuries. Taking into account possible recall and telescoping biases, the best survey estimate of the national annual number of major injuries is 525,000 (5.9 per 100 person-year), whereas the EDISS data yielded an estimate of 1,150,000 major injuries (12.9 per 100 person-years) CONCLUSIONS: Comparison of survey and EDISS data systems provides quantitative assessment of accuracy of the survey data in relation to time of injury before report date, to severity of injury, and to whether the injury is to the interviewee or to a cohabitant. The 2 systems could be used in a complementary way, although EDISS generates information that is medically more accurate and is a more cost-effective data collection system.

Adolescent↗
PubMed2003

Humanitarian information systems and emergencies in the Greater Horn of Africa: logical components and logical linkages.

Natural and man-made emergencies are regular occurrences in the Greater Horn of Africa region. The underlying impoverishment of whole populations is increasing, making it more difficult to distinguish between humanitarian crises triggered by shocks and those resulting from chronic poverty. Shocks and hazards can no longer be seen as one-off events that trigger a one-time response. In countries that are both poor and exposed to frequent episodes of debilitating drought or chronic conflict, information needs tend to be different from the straightforward early warning/commodity accounting models of information systems that have proven reliable in past emergencies. This paper describes the interdependent components of a humanitarian information system appropriate for this kind of complex environment, noting the analytical links between the components and operational links to programme and policy. By examining a series of case studies from the Greater Horn region, the paper demonstrates that systems lacking one or more of these components will fail to provide adequate information--and thus incur humanitarian costs. While information always comes with a cost, the price of poor information--or none--is higher. And in situations of chronic vulnerability, in which development interventions are likely to be interspersed with both safety nets and emergency interventions on a recurrent basis, investment in improved information is a good investment from both a humanitarian and a financial viewpoint.

Africa, Eastern↗