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Christopher Trenholm Barbara Devaney Kenneth Fortson Melissa Clark Lisa Quay Bridgespan Justin Wheeler 《Journal of policy analysis and management》2008,27(2):255-276
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexually transmitted diseases (STDs). Based on an experimental design, the impact analysis uses survey data collected in 2005 and early 2006 from more than 2,000 teens who had been randomly assigned to either a program group that was eligible to participate in one of the four programs or a control group that was not. The findings show no significant impact on teen sexual activity, no differences in rates of unprotected sex, and some impacts on knowledge of STDs and perceived effectiveness of condoms and birth control pills 相似文献
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Clark MA 《Journal of health politics, policy and law》2010,35(5):743-769
After Hurricane Katrina, there was good reason to believe that a gaping window of opportunity had opened for Louisiana to revamp its safety-net health care system. But two years of discussions among stakeholders within Louisiana and extensive negotiations with federal officials resulted in no such change. This article argues that any explanation for this outcome needs to incorporate both structure and process. In terms of structure, the rules of the Medicaid disproportionate-share hospital (DSH) program give states substantial independent authority to decide which hospitals to fund. Federal authorities could not force Louisiana, which had historically turned its DSH money over to the state hospital system, to redirect it toward an insurance expansion. In the process of negotiation after Katrina, those who defended the institutions wedded to the prestorm status quo conducted a better strategy than their challengers. They narrowed the purview of the Louisiana Health Care Redesign Collaborative, set up to propose changes in the safety net to the federal government, such that the question of whether to rebuild Charity Hospital in New Orleans was off the table. Meanwhile, on a separate track, the state and the Department of Veterans Affairs successfully pursued a plan to jointly build replacement hospitals. 相似文献
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Havighurst CC 《Journal of health politics, policy and law》2004,29(4-5):947-67; discussion 1005-19
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This paper presents similar findings about the lack of support and understanding for people bereaved through suicide from four different countries and reports on each country's unique response to this challenge. This paper reports on presentations made at the conference workshop of the International Association for Suicide Prevention meeting in Chennai in 2001, and on participants' suggestions of how best to help the bereaved. 相似文献