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Dive into the research topics where Erik L. Carlton is active.

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Featured researches published by Erik L. Carlton.


Frontiers in Public Health | 2015

Accreditation intent, community health assessments, and local health department-hospital collaboration

Erik L. Carlton; Simone R. Singh

Background: Community health assessments (CHAs) are among the most core of activities conducted by local health departments (LHDs), and many LHDs have been conducting CHAs on a regular basis for years. More recently, completing a CHA has also become a prerequisite for LHDs seeking accreditation by the Public Health Accreditation Board (PHAB). Similarly, under the Affordable Care Act, tax-exempt hospitals are required to conduct periodic community health needs assessments. Opportunities thus exist for LHDs and tax-exempt hospitals to engage in collaborations related to CHAs. Yet, it remains unclear whether interest in PHAB accreditation provides incentive to LHDs to engage in collaborations with hospitals around community health assessment and improvement planning. Methods: Using data from the 2013 National Association of County and City Health Officials (NACCHO) Profile study, LHD-hospital collaborations related to CHAs were examined, including characteristics of LHDs involved in such collaborations and the relationships between LHDs’ level of engagement with accreditation activities and their involvement in collaborations with hospitals. Results: LHDs that collaborate with hospitals on CHAs are larger, have higher total and per capita expenditures, and are more likely to be locally governed and to have a local board of health. Three PHAB prerequisites—completion of a CHA, completion of a community health improvement plan, and completion of an agency-wide strategic plan within the previous 5 years—were all significantly correlated (p<0.01) with LHD-hospital collaborations, suggesting that accreditation efforts may be a positive influence on collaborations. Implications: Policymakers could provide incentive for voluntary accreditation to encourage greater collaboration between LHDs and hospitals around CHAs.


Frontiers in Public Health | 2015

Full-Range Public Health Leadership, Part 1: Quantitative Analysis

Erik L. Carlton; James W. Holsinger; Martha C. Riddell; Heather M. Bush

Background Workforce and leadership development are central to the future of public health. However, public health has been slow to translate and apply leadership models from other professions and to incorporate local perspectives in understanding public health leadership. Purpose This study utilized the full-range leadership model in order to examine public health leadership. Specifically, it sought to measure leadership styles among local health department directors and to understand the context of leadership in local health departments. Methods Leadership styles among local health department directors (n = 13) were examined using survey methodology. Quantitative analysis methods included descriptive statistics, boxplots, and Pearson bivariate correlations using SPSS v18.0. Findings Self-reported leadership styles were highly correlated to leadership outcomes at the organizational level. However, they were not related to county health rankings. Results suggest the preeminence of leader behaviors and providing individual consideration to staff as compared to idealized attributes of leaders, intellectual stimulation, or inspirational motivation. Implications Holistic leadership assessment instruments such as the multifactor leadership questionnaire can be useful in assessing public health leaders’ approaches and outcomes. Comprehensive, 360-degree reviews may be especially helpful. Further research is needed to examine the effectiveness of public health leadership development models, as well as the extent that public health leadership impacts public health outcomes.


Frontiers in Public Health | 2016

Local Health Departments’ Involvement in Hospitals’ Implementation Plans

Simone R. Singh; Erik L. Carlton

Background: More than half of all local health departments (LHDs) in the U.S. are involved in collaborations with nonprofit hospitals on a community health needs assessment (CHNA), yet little is known about the role that LHDs play in hospitals’ implementation plans. Purpose: This study aims to explore the current state of hospital–LHD collaborations around the implementation plan using data from a survey of LHDs across the country. Methods: The study sample included 457 LHDs that completed both the 2015 Forces of Change survey and the 2013 Profile survey conducted by the National Association of County and City Health Officials. Univariate and bivariate analyses were used to compare LHDs involved in hospitals’ implementation plans to LHDs not involved in such activities. All analyses were conducted in 2016. Results: Of the 457 sample LHDs, 62% were involved in at least one activity associated with hospitals’ implementation plans. These LHDs were larger, had greater budgets, and were more likely to be locally governed. In addition, almost all of these LHDs reported that they also collaborated with hospitals around the CHNA. Implications: There is evidence of substantial involvement of LHDs in hospitals’ implementation plans. Importantly, joint CHNAs appear to pave the path for hospital–LHD collaboration in this area. Since LHDs that collaborate with hospitals on their implementation plans tended to be better resourced, policymakers may want to find ways to ensure that smaller LHDs have the necessary human and fiscal resources to be engaged in joint community health needs assessment and improvement planning activities.


American Journal of Emergency Medicine | 2016

Paid sick leave is associated with fewer ED visits among US private sector working adults.

Soumitra S. Bhuyan; Yang Wang; Jay Bhatt; S. Edward Dismuke; Erik L. Carlton; Dan Gentry; Chad A. LaGrange; Cyril F. Chang

CONTEXT The United States (US) is the only developed country that does not guarantee short-term or longer-term paid sick leave. OBJECTIVE This study used a multiyear nationally representative database to examine the association between availability of paid sick leave and frequency of emergency department (ED) use among US private sector employees. STUDY SAMPLE We used the National Health Interview Survey data (2012-2014). The final study sample consists of 42,460 US adults between 18 and 64years of age and working in nongovernmental private sector. RESULTS Our results suggest that availability of paid sick leave is significantly associated with lower likelihood of ED use, for both moderate (1-3 times/year) and repeated users (4 or more times/year). After controlling for confounding factors, respondents with paid sick leave are 14% less likely to be moderate ED users (adjusted odds ratio, 0.86; 95% CI, 0.79-0.93) and 32% less likely to be repeated ED users (adjusted odds ratio, 0.68; 95% CI, 0.50-0.91). DISCUSSION Although expansion of health insurance coverage under the Affordable Care Act has not been shown to reduce utilization of high cost health care services such as the ED, our study suggests other factors such as the availability of paid sick leave may do so, by allowing patients to seek care through other more cost-effective mechanisms (eg, primary care providers). To reduce ED utilization, health policymakers should consider alternative reforms including paid sick leave.


Advances in health care management | 2014

Answering the call for integrating population health: insights from health system executives.

Erik L. Carlton

PURPOSE The Affordable Care Act is transforming health care practice nationwide through emphasis on population health and prevention. Health care organizations are increasingly required to address population health needs. However, they may be ill equipped to answer that call. DESIGN/METHODOLOGY/APPROACH This study identified ways that health care organizations might better integrate public and population health efforts to better respond to this new emphasis on population health. Employing semi-structured key informant interviews, barriers to and facilitators of integration were explored and implications for health care and public health leaders were developed. FINDINGS - Participants (n = 17)--including senior hospital executives, group practice administrators, and health department officials--dentified strategies for health care and public health leaders to more effectively integrate in order to achieve better performance and popula-ion health gains. These strategies and their implications are discussed. OORIGINALITY/VALUE:The results of this study provide important value to health care administrators leading efforts to integrate population and public health.


American Journal of Preventive Medicine | 2017

Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults

Oluwaseyi O. Isehunwa; Erik L. Carlton; Yang Wang; Yu Jiang; Satish Kedia; Cyril F. Chang; Daniel Obadare Fijabi; Soumitra S. Bhuyan

INTRODUCTION There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. METHODS The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. RESULTS Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. CONCLUSIONS Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees.


Frontiers in Public Health | 2015

Full-Range Public Health Leadership, Part 2: Qualitative Analysis and Synthesis.

Erik L. Carlton; James W. Holsinger; Martha C. Riddell; Heather M. Bush

Public health leadership is an important topic in the era of U.S. health reform, population health innovation, and health system transformation. This study utilized the full-range leadership model in order to examine the public health leadership. We sought to understand local public health leadership from the perspective of local health department leaders and those who work with and for them. Public health leadership was explored through interviews and focus groups with directors (n = 4) and staff (n = 33) from local health departments. Qualitative analytic methods included reflexive journals, code-recode procedures, and member checking, with analysis facilitated by Atlas.ti v.6.0. Qualitative results supported and expanded upon previously reported quantitative findings. Leading by example and providing individual consideration to followers were found to be more important than other leader factors, such as intellectual stimulation, inspirational motivation, or idealized attributes of leaders. Having a clear and competent vision of public health, being able to work collaboratively with other community agencies, and addressing the current challenges to public health with creativity and innovation were also important findings. Idealized leadership behaviors and individual consideration should be the focus of student and professional development. Models that incorporate contextual considerations, such as the situational leadership model, could be utilized to ensure that optimal individual consideration is given to followers.


Frontiers in Public Health | 2015

Answering the Call to Integrate: Simple Strategies from Public Health and Healthcare Executives in One Urban County

Erik L. Carlton; Paul C. Erwin

Background: As the Affordable Care Act transforms the practice of both public health and health care, it also provides opportunity for both to become more closely linked through improved integration and collaboration. Yet, while public health agencies are increasingly called to work with healthcare partners to address population health needs, both public health leaders and their healthcare counterparts may not be well equipped to answer that call. Although recent studies have begun exploring the collaborative strategies and capacity of public health system partners, there is still much to learn. The purpose of this study was to identify, through the perspective of senior public health and healthcare leaders, actionable strategies that might facilitate better integration or linkages between public health and healthcare organizations. Methods: Through semi-structured key informant interviews with senior healthcare and public health executives in one urban county, strategies were identified that public health and healthcare leaders might use to more effectively link population health programs and activities. Data were collected in 2013–2014; analysis was conducted in 2014. Results: Identified strategies include: focusing on targeted issues with shared interest; leveraging payers and business partners to expand support for integrated efforts; training and retraining the workforce for interdisciplinary, population health work; and developing and supporting a strong, neutral convening agency. Implications: As they employ these strategies to structure collaborative efforts, public health and healthcare leaders may improve linkages around population health programs and activities.


Frontiers in Public Health | 2015

Editorial: Leading People - Managing Organizations: Contemporary Public Health Leadership.

James W. Holsinger; Erik L. Carlton; Emmanuel D. Jadhav

Effectively leading people engaged in the practice of public health has never been more critical than in the early years of the twenty-first century. Likewise, effectively managing the organizations in which these individuals practice the various professional disciplines of public health has become increasing important and difficult. Taken together, leading the people and managing public health organizations requires well educated and appropriately trained public health leaders and managers. Although leadership is often viewed as one of the key attributes of management, not every great manager will be a great leader and vice versa. While some leaders may be born with the inherent skills to lead, most effective leaders develop the requisite skills through education, additional training, and practice. Our aim is to focus the attention of public health practitioners on the importance of effectively leading public health organizations. Public health managers should recognize that their most valuable resource is the people they lead. The articles comprising the eBook on Leading People – Managing Organizations is composed of articles expressing the opinion of their authors of the need for effective public health leaders; perspective articles establishing their authors’ understanding of how leadership may be applied in various situations; methods articles that demonstrate how public health leadership may be applied, and original research articles that establish the role of public health leadership research studies.


Obesity Research & Clinical Practice | 2015

Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions.

Soumitra S. Bhuyan; Aastha Chandak; Patti Smith; Erik L. Carlton; Kenric Duncan; Daniel Gentry

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Yang Wang

University of Nebraska Medical Center

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Aastha Chandak

University of Nebraska Medical Center

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