A stakeholder analysis of the Texas Youth Commission issue for the Texas 80th Legislative Session

The following is a policy analysis based on the Advocacy Coalition Framework by Paul Sabatier. The study question was who were the stakeholders in the legislative process for the issue of the Texas Youth Commission (TYC) overhaul during the Texas 80th Legislative Session. This analysis included the stakeholders identifying characteristics including beliefs and interests, goals and resources, and finally, the winning legislative solutions as embodied in three bills that were passed. The study linked the stakeholders with three bills and expanded on the literature for the stakeholder group of Policy Brokers. The conclusions were that all stakeholders including Youth Advocates, the Policy People and Policy Brokers were effective in advancing legislative solutions to address the need for an agency overhaul of TYC and that the three new policies will be evaluated in the future as either short term change or long-term reforms based on their implementation. ^

A global perspective on intimate partner violence during pregnancy: An analysis of twelve developing countries

Violence against women has been recognized as a significant worldwide human rights issue and public health problem. Women of reproductive age may be particularly at risk, and pregnancy may trigger or escalate violence. Using data available from Demographic and Health Surveys on 271,103 women of reproductive age (15-49) from Bolivia, Cameroon, Colombia, Dominican Republic, Egypt, Haiti, India, Kenya, Nicaragua, Peru, South Africa, and Zambia, this study examined the nature of domestic violence during pregnancy in developing countries, including prevalence, demographic and risk factors, maternal and child health outcomes, perpetrators of violence, help-seeking behavior, and social support. In the majority of countries analyzed, violence during pregnancy consistently occurred at approximately one-third the rate at which domestic violence occurred overall. Younger women and women with more children were particularly at risk. Abuse during pregnancy was significantly associated with history of a terminated pregnancy and under-5 child mortality in most countries, and with neonatal and post-neonatal mortality in most Latin American countries. Women who were abused during pregnancy were most often abused by their current or former husband or boyfriend and most never attempted to seek help. In most countries that examined social support, women abused during pregnancy had significantly less contact with family and friends. Implications for practice and research are discussed. ^

The role of social support in HIV prevention among young Latino men who have sex with men

The purpose of this formative study was to determine and prioritize the HIV-prevention needs of Latino young men who have sex with men (YMSM) in Chihuahua (Mexico), Texas, and California, based on YMSM and service provider perceptions of the factors affecting the assimilation and implementation of HIV-preventive behaviors. These factors included: perceived social support, identification of the modes of HIV transmission, perceived risk of HIV, perceived norms and attitudes of peers.^ The study, drawn from a secondary data set, was a convenience sample of providers (n=8) and clients (n=15). Participants completed face-to face interviews and a survey instrument. Interviews were analyzed to identify common themes and congruence among client groups, and among clients and providers. Providers’ understanding of theoretical constructs of interventions was also assessed. Survey data were analyzed to determine variable frequencies and their congruence to the qualitative analysis. ^ The results revealed several differences and many commonalities in the assimilation of protective messages. Client and provider perceptions were congruent across all domains. Providers demonstrated intuitive command of theoretical concepts but inconsistently verbalized their application. Both clients and providers recognized Latinos possessed high HIV-knowledge levels, despite inconsistent protective behaviors. Clients and providers consistently identified important reasons leading to inconsistent protective behaviors, such as: lack of access to targeted information and condoms, self-esteem, sexual identification, situational factors, decreased perceived HIV-risk, and concerns about homophobia, stigma, and rejection. Other factors included: poverty, failure to reach disenfranchised populations, and lack of role models/positive parental figures. The principal conclusion of the study was that there is a need for further study to understand the interrelationship between larger socioeconomic issues and consistent protective behaviors.^

THE IMPLEMENTATION OF FEDERAL FAMILY PLANNING POLICY: AN ANALYSIS OF FACTORS AFFECTING STATE EXPENDITURES, FISCAL YEARS 1976-1981 (WOMEN, BUDGET, POPULATION)

The purpose of this study was to analyze the implementation of national family planning policy in the United States, which was embedded in four separate statutes during the period of study, Fiscal Years 1976-81. The design of the study utilized a modification of the Sabatier and Mazmanian framework for policy analysis, which defined implementation as the carrying out of statutory policy. The study was divided into two phases. The first part of the study compared the implementation of family planning policy by each of the pertinent statutes. The second part of the study identified factors that were associated with implementation of federal family planning policy within the context of block grants.^ Implemention was measured here by federal dollars spent for family planning, adjusted for the size of the respective state target populations. Expenditure data were collected from the Alan Guttmacher Institute and from each of the federal agencies having administrative authority for the four pertinent statutes, respectively. Data from the former were used for most of the analysis because they were more complete and more reliable.^ The first phase of the study tested the hypothesis that the coherence of a statute is directly related to effective implementation. Equity in the distribution of funds to the states was used to operationalize effective implementation. To a large extent, the results of the analysis supported the hypothesis. In addition to their theoretical significance, these findings were also significant for policymakers insofar they demonstrated the effectiveness of categorical legislation in implementing desired health policy.^ Given the current and historically intermittent emphasis on more state and less federal decision-making in health and human serives, the second phase of the study focused on state level factors that were associated with expenditures of social service block grant funds for family planning. Using the Sabatier-Mazmanian implementation model as a framework, many factors were tested. Those factors showing the strongest conceptual and statistical relationship to the dependent variable were used to construct a statistical model. Using multivariable regression analysis, this model was applied cross-sectionally to each of the years of the study. The most striking finding here was that the dominant determinants of the state spending varied for each year of the study (Fiscal Years 1976-1981). The significance of these results was that they provided empirical support of current implementation theory, showing that the dominant determinants of implementation vary greatly over time. ^

A comparative analysis of Texas and Louisiana Oil-field NORM Waste Policy

NORM (Naturally Occurring Radioactive Material) Waste Policies for the nation's oil and gas producing states have been in existence since the 1980's, when Louisiana was the first state to develop a NORM regulatory program in 1989. Since that time, expectations for NORM Waste Policies have evolved, as Health, Safety, Environment, and Social responsibility (HSE & SR) grows increasingly important to the public. Therefore, the oil and gas industry's safety and environmental performance record will face challenges in the future, about its best practices for managing the co-production of NORM wastes. ^ Within the United States, NORM is not federally regulated. The U.S. EPA claims it regulates NORM under CERCLA (superfund) and the Clean Water Act. Though, there are no universally applicable regulations for radium-based NORM waste. Therefore, individual states have taken responsibility for developing NORM regulatory programs, because of the potential radiological risk it can pose to man (bone and lung cancer) and his environment. This has led to inconsistencies in NORM Waste Policies as well as a NORM management gap in both state and federal regulatory structures. ^ Fourteen different NORM regulations and guidelines were compared between Louisiana and Texas, the nation's top two petroleum producing states. Louisiana is the country's top crude oil producer when production from its Federal offshore waters are included, and fourth in crude oil production, behind Texas, Alaska, and California when Federal offshore areas are excluded. Louisiana produces more petroleum products than any state but Texas. For these reasons, a comparative analysis between Louisiana and Texas was undertaken to identify differences in their NORM regulations and guidelines for managing, handling and disposing NORM wastes. Moreover, this analysis was undertaken because Texas is the most explored and drilled worldwide and yet appears to lag behind its neighboring state in terms of its NORM Waste Policy and developing an industry standard for handling, managing and disposing NORM. As a result of this analysis, fourteen recommendations were identified.^

The use of social media to communicate child health information to low-income parents: A formative study

The Internet, and specifically web 2.0 social media applications, offers an innovative method for communicating child health information to low-income parents. The main objective of this study was to use qualitative data to determine the value of using social media to reach low-income parents with child health information. A qualitative formative evaluation employing focus groups was used to determine the value of using social media for dissemination of child health information. Inclusion criteria included: (1) a parent with a child that attends a school in a designated Central Texas school district; and (2) English-speaking. The students who attend these schools are generally economically disadvantaged and are predominately Hispanic. The classic analysis strategy was used for data analysis. Focus group participants (n=19) were female (95%); White (53%), Hispanic (42%) or African American (5%); and received government assistance (63%). Most had access to the Internet (74%) and were likely to have low health literacy (53%). The most preferred source of child health information was the family pediatrician or general practitioner. Many participants were familiar with social media applications and had profiles on popular social networking sites, but used them infrequently. Objections to social media sites as sources of child health information included lack of credibility and parent time. Social media has excellent potential for reaching low-income parents when used as part of a multi-channel communication campaign. Further research should focus on the most effective type and format of messages that can promote behavior change in this population, such as story-telling. ^

A comparative state policy analysis of the adoption of birth defects surveillance legislation

Birth defects are the leading cause of infant mortality in the United States and are a major cause of lifetime disability. However, efforts to understand their causes have been hampered by a lack of population-specific data. During 1990–2004, 22 state legislatures responded to this need by proposing birth defects surveillance legislation (BDSL). The contrast between these states and those that did not pass BDSL provides an opportunity to better understand conditions associated with US public health policy diffusion. ^ This study identifies key state-specific determinants that predict: (1) the introduction of birth defects surveillance legislation (BDSL) onto states' formal legislative agenda, and (2) the successful adoption of these laws. Secondary aims were to interpret these findings in a theoretically sound framework and to incorporate evidence from three analytical approaches. ^ The study begins with a comparative case study of Texas and Oregon (states with divergent BDSL outcomes), including a review of historical documentation and content analysis of key informant interviews. After selecting and operationalizing explanatory variables suggested by the case study, Qualitative Comparative Analysis (QCA) was applied to publically available data to describe important patterns of variation among 37 states. Results from logistic regression were compared to determine whether the two methods produced consistent findings. ^ Themes emerging from the comparative case study included differing budgetary conditions and the significance of relationships within policy issue networks. However, the QCA and statistical analysis pointed to the importance of political parties and contrasting societal contexts. Notably, state policies that allow greater access to citizen-driven ballot initiatives were consistently associated with lower likelihood of introducing BDSL. ^ Methodologically, these results indicate that a case study approach, while important for eliciting valuable context-specific detail, may fail to detect the influence of overarching, systemic variables, such as party competition. However, QCA and statistical analyses were limited by a lack of existing data to operationalize policy issue networks, and thus may have downplayed the impact of personal interactions. ^ This study contributes to the field of health policy studies in three ways. First, it emphasizes the importance of collegial and consistent relationships among policy issue network members. Second, it calls attention to political party systems in predicting policy outcomes. Finally, a novel approach to interpreting state data in a theoretically significant manner (QCA) has been demonstrated.^

Supplemental Nutrition Assistance Program: A policy analysis of restricting foods with minimal nutritional value

In 2011, expenditures for the Supplemental Nutrition Assistance Program (SNAP) reached an all-time high of $72 billion. The goal of SNAP is " to alleviate hunger and malnutrition…by increasing food purchasing power for all eligible households who apply for participation." It has been well established that proper nutrition is essential to good health, making SNAP an important program to public health consumers. Thus, this analysis examined whether SNAP is meeting its stated goal and whether the goal would be reduced if the purchase of foods of minimal nutritional value (FMNV) were restricted. ^ A review of existing literature found that SNAP has been shown to alleviate hunger, but the studies on the nutritional impact of the program were not sufficient to assert whether change is needed. When considering whether limiting FMNV would reduce or improve the effectiveness of SNAP at alleviating hunger and malnutrition, there is very little information on which to base a policy change, particular one that singles out a low income group to restrict purchases. ^ Several states have attempted to restrict the purchase of FMNV but, to date, no such change has been implemented or tested. Conducting pilot studies on the restriction of FMNV, along with better data collection on SNAP purchases, would guide policy changes to the program. Although there are many potential public health benefits to restricting FMNV purchase using SNAP dollars, research is needed to quantify the cost impact of these benefits.^

Policy analysis of shifting to the state-run Texas women's health program

During the 82nd Texas legislature, state leaders passed a provision stating that healthcare providers, who perform, promote, or affiliate with providers who perform or promote elective abortion services may not be eligible to participate in the Texas Medicaid Women's Health Program (WHP). The federal government reacted to this new provision by vowing to eliminate its 90% share of program support on the grounds that the provision violated a patient's freedom to choose a provider; a right protected by the Social Security Act. Texas leaders stated that the Women's Health Program would continue without federal support, financed exclusively with state funds.^ The following policy analysis compares the projected impact of the current Medicaid Women's Health Program to the proposed state-run program using the criteria-alternative matrix framework. The criteria used to evaluate the program alternatives include population affected, unintended pregnancy and abortion impact, impact on cervical cancer rate, and state-level government expenditures. Each criterion was defined by selected measures. The population affected was measured by the number of women served in the programs. Government expenditures were measured in terms of payments for program costs, Medicaid delivery costs, and cervical cancer diagnostic costs. Unintended pregnancy impact was measured by the number of projected unplanned pregnancies and abortions under each alternative. The impact on cervical cancer was projected in terms of the number of new cervical cancer cases under each alternative. Differences in the projections with respect to each criterion were compared to assess the impact of shifting to the state-only policy.^ After examining program alternatives, it is highly recommended that Texas retain the Medicaid WHP. If the state does decide to move forward with the state-run WHP, it is recommended that the program run at its previous capacity. Furthermore, for the purpose of addressing the relatively high cervical cancer incidence rate in Texas, incorporating HPV vaccination coverage for women ages 18-26 as part of the Women's Health Program is recommended.^

Method for the evaluation of social projects

This instrument was part of the research project "Research on Evaluation of Health and Education Plans and Programs in the Province of Buenos Aires", developed by the of Chair Preventive Psychology of the Psychology course of studies at the School of Humanities and Educational Sciences, National Univer- sity of La Plata (Argentina). The basis for proposing an assessment instrument is the need for a method enabling analysis, systematization of knowledge and the assignment of values distributed into scales and organized in general charts, on social programs. Its main concern is the analysis of health and education programs and projects, restricted to certain specific areas or regions, in search for theoretic trustworthi-ness, methodological accuracy as well as pragmatic operability. This is the result of four years of researching said programs at system, service and community levels.

Crises of social significances: adolescents and their projects for future work

This is a report on data raised through research, which has already finished, about Identification references in adolescents . Objetives : To analyze and reflect upon the collected data, adolescents' representations about the work field and their projects for future work. To conceptualize about the crises of social significances which produce and order sense and, therefore, organize our perceptions of work through social discourses and practices which have an impact on the subjectivity of adolescents and young adults. Methodology: Brief presentation of the concepts which frame the qualitative research in this area. Reading and analysis of fragments from adolescents' accounts, obtained in focal groups at different state secondary schools. Conclusions: The adolescents researched portray a self-image full of uncertainty and skepticism as regards their future possibilities. The impact produced by the fall of work as an ideal of doing and being is made evident in their accounts. Only some of them link their future project with an invested and valuable activity, even if this is not associated with economic safety and wellbeing. Others present themselves as incapable to modify the state of things, which offers a field connected with consumerist values and with the idea that "you are worth what you have (in material things)".

Method for the evaluation of social projects

This instrument was part of the research project "Research on Evaluation of Health and Education Plans and Programs in the Province of Buenos Aires", developed by the of Chair Preventive Psychology of the Psychology course of studies at the School of Humanities and Educational Sciences, National Univer- sity of La Plata (Argentina). The basis for proposing an assessment instrument is the need for a method enabling analysis, systematization of knowledge and the assignment of values distributed into scales and organized in general charts, on social programs. Its main concern is the analysis of health and education programs and projects, restricted to certain specific areas or regions, in search for theoretic trustworthi-ness, methodological accuracy as well as pragmatic operability. This is the result of four years of researching said programs at system, service and community levels.

Crises of social significances: adolescents and their projects for future work

This is a report on data raised through research, which has already finished, about Identification references in adolescents . Objetives : To analyze and reflect upon the collected data, adolescents' representations about the work field and their projects for future work. To conceptualize about the crises of social significances which produce and order sense and, therefore, organize our perceptions of work through social discourses and practices which have an impact on the subjectivity of adolescents and young adults. Methodology: Brief presentation of the concepts which frame the qualitative research in this area. Reading and analysis of fragments from adolescents' accounts, obtained in focal groups at different state secondary schools. Conclusions: The adolescents researched portray a self-image full of uncertainty and skepticism as regards their future possibilities. The impact produced by the fall of work as an ideal of doing and being is made evident in their accounts. Only some of them link their future project with an invested and valuable activity, even if this is not associated with economic safety and wellbeing. Others present themselves as incapable to modify the state of things, which offers a field connected with consumerist values and with the idea that "you are worth what you have (in material things)".

Method for the evaluation of social projects

This instrument was part of the research project "Research on Evaluation of Health and Education Plans and Programs in the Province of Buenos Aires", developed by the of Chair Preventive Psychology of the Psychology course of studies at the School of Humanities and Educational Sciences, National Univer- sity of La Plata (Argentina). The basis for proposing an assessment instrument is the need for a method enabling analysis, systematization of knowledge and the assignment of values distributed into scales and organized in general charts, on social programs. Its main concern is the analysis of health and education programs and projects, restricted to certain specific areas or regions, in search for theoretic trustworthi-ness, methodological accuracy as well as pragmatic operability. This is the result of four years of researching said programs at system, service and community levels.

Crises of social significances: adolescents and their projects for future work

This is a report on data raised through research, which has already finished, about Identification references in adolescents . Objetives : To analyze and reflect upon the collected data, adolescents' representations about the work field and their projects for future work. To conceptualize about the crises of social significances which produce and order sense and, therefore, organize our perceptions of work through social discourses and practices which have an impact on the subjectivity of adolescents and young adults. Methodology: Brief presentation of the concepts which frame the qualitative research in this area. Reading and analysis of fragments from adolescents' accounts, obtained in focal groups at different state secondary schools. Conclusions: The adolescents researched portray a self-image full of uncertainty and skepticism as regards their future possibilities. The impact produced by the fall of work as an ideal of doing and being is made evident in their accounts. Only some of them link their future project with an invested and valuable activity, even if this is not associated with economic safety and wellbeing. Others present themselves as incapable to modify the state of things, which offers a field connected with consumerist values and with the idea that "you are worth what you have (in material things)".