ItemUnderstanding Spatial and Contextual Factors Influencing Intraregional Differences in Child Vaccination Coverage in Bangladesh(Sage Publications Inc, 2018-11-30) Vyas, Priyanka; Kim, Dohyeong; Adams, Alayne; 0000-0002-1428-1451 (Kim, D); Kim, DohyeongIn Bangladesh, policy discourse has mostly focused on regional inequities in health, including child immunization coverage. Knowledge of local geographical and contextual factors within regions, however, becomes pertinent in efforts to address these inequities. We used the Bangladesh Demographic and Health Survey 2011 to examine factors that influence intraregional differences in vaccination coverage using a multilevel analysis. We found that in spite of the provision of health facilities at each level of administrative governance, only distance to the Upazilla Health Complex was a consistent predictor for each dose of vaccine, highlighting the remote locations of the communities that remain underserved. Our analysis demonstrates the value of subregional analyses that identify the characteristics of communities that are vulnerable to incomplete immunization coverage. Unless specific policy actions are taken to increase coverage in these remote areas, geographic inequities are likely to persist within regions, and desired targets will not be achieved. ItemSpatio-Temporal Comparison of Pertussis Outbreaks in Olmsted County, Minnesota, 2004-2005 and 2012: A Population-Based Study(BMJ Publishing Group, 2019-05-19) Wi, C. -I; Wheeler, P. H.; Kaur, H.; Ryu, E.; Kim, Dohyeong; Juhn, Y.; 0000-0002-1428-1451 (Kim, D); Kim, DohyeongObjective: Two pertussis outbreaks occurred in Olmsted County, Minnesota, during 2004-2005 and 2012 (5-10 times higher than other years), with significantly higher incidence than for the State. We aimed to assess whether there were similar spatio-temporal patterns between the two outbreaks. Setting Olmsted County, Minnesota, USA Participants: We conducted a population-based retrospective cohort study of all Olmsted County residents during the 2004-2005 and 2012 outbreaks, including laboratory-positive pertussis cases. Primary outcome measure: For each outbreak, we estimated (1) age-specific incidence rate using laboratory-positive pertussis cases (numerator) and the Rochester Epidemiology Project Census (denominator), a medical record-linkage system for virtually all Olmsted County residents, and (2) pertussis case density using kernel density estimation to identify areas with high case density. To account for population size, we calculated relative difference of observed density and expected density based on age-specific incidence. Results: We identified 157 and 195 geocoded cases in 2004-2005 and 2012, respectively. Incidence was the highest among adolescents (ages 11 to <14 years) for both outbreaks (9.6 and 7.9 per 1000). The 2004-2005 pertussis outbreak had higher incidence in winter (52% of cases) versus summer in 2012 (53%). We identified a consistent area with higher incidence at the beginning (ie, first quartile) of two outbreaks, but it was inconsistent for later quartiles. The relative difference maps for the two outbreaks suggest a greater role of neighbourhood population size in 2012 compared with 2004-2005. Conclusions: Comparing spatio-temporal patterns between two pertussis outbreaks identified a consistent geographical area with higher incidence of pertussis at the beginning of outbreaks in this community. This finding can be tested in future outbreaks, and, if confirmed, can be used for identifying epidemiological risk factors clustered in such areas for geographically targeted intervention. © 2018 Author(s) (or their employer(s)). ItemBarriers and Incentives for Sustainable Urban Development: An Analysis of the Adoption of LEED-ND Projects(Academic Press, 2019-05-22) Cease, Brett; Kim, HyoungAh; Kim, Dohyeong; Ko, Y.; Cappel, C.; 0000-0002-1428-1451 (Kim, D); Cease, Brett; Kim, HyoungAh; Kim, DohyeongThe adoption rate for Leadership in Energy and Environmental Design – Neighborhood Development (LEED-ND) projects has varied considerably across the United States. Local governments and developers face variation in the incentives and barriers while implementing LEED-ND projects across four key dimensions – economic, policy, public awareness, and organizational. This paper investigated the drivers of variation using a mixed-methods approach including a two-stage Heckman model, a survey of Texas subdivision developers and interviews with local planning officials. Results indicate that initial public funding may lead to more LEED-ND projects being completed, but with a diminishing return as these projects become established within the region. Support for local programs including tax abatement, public-private partnerships, and other incentives were also demonstrated to help facilitate LEED-ND project adoption. Overall this paper underscored the important role, especially early on, the public sector and local governments play in initiating local LEED-ND projects to inform and motivate the land development industry. © 2019 Elsevier Ltd ItemSpatiotemporal Association between Temperature and Assaults: A Generalized Linear Mixed-Model Approach(Sage Publications Inc.) Jung, Yeondae; Kim, Dohyeong; Piquero, Alex R.; 0000-0002-1428-1451 (Kim, D); 0000-0003-4198-4985 (Piquero, AR); 2088022 (Piquero, AR); Jung, Yeondae; Kim, Dohyeong; Piquero, Alex R.We aim to analyze the association between temperature and assault at highly disaggregated spatial units with great temporal resolution to investigate their spatiotemporal dynamics. We applied generalized linear mixed models (GLMMs) to assault and weather data from 2015, aggregated weekly at 424 subdistricts in Seoul, South Korea, controlling for various socioeconomic and environmental variables. Analyses revealed a positive and significant linear association between temperature and assaults and a few small but significant interaction effects that relate to an increase in assaults. A more enhanced understanding of the spatiotemporal relationship between temperature and crime would provide useful implications for targeted crime prevention and resource allocations. ©2019 The Author(s). ItemUnderstanding Needs and Barriers to Using Geospatial Tools for Public Health Policymaking in ChinaKim, Dohyeong; Zhang, Yingyuan; Lee, Chang Kil; Kim, Dohyeong; Zhang, YingyuanDespite growing popularity of using geographical information systems and geospatial tools in public health fields, these tools are only rarely implemented in health policy management in China. This study examines the barriers that could prevent policy-makers from applying such tools to actual managerial processes related to public health problems that could be assisted by such approaches, e.g. evidence-based policy-making. A questionnaire-based survey of 127 health-related experts and other stakeholders in China revealed that there is a consensus on the needs and demands for the use of geospatial tools, which shows that there is a more unified opinion on the matter than so far reported. Respondents pointed to lack of communication and collaboration among stakeholders as the most significant barrier to the implementation of geospatial tools. Comparison of survey results to those emanating from a similar study in Bangladesh revealed different priorities concerning the use of geospatial tools between the two countries. In addition, the follow- up in-depth interviews highlighted the political culture specific to China as a critical barrier to adopting new tools in policy development. Other barriers included concerns over the limited awareness of the availability of advanced geospatial tools. Taken together, these findings can facilitate a better understanding among policy-makers and practitioners of the challenges and opportunities for widespread adoption and implementation of a geospatial approach to public health policy-making in China. ItemA Meta-Regression Analysis of the Effectiveness of Mosquito Nets for Malaria Control: The Value of Long-Lasting Insecticide Nets(MDPI) Yang, Gi-geun; Kim, Dohyeong; Anh Pham; Paul, Christopher John; 0000-0002-1428-1451 (Kim, D); Kim, DohyeongLong-lasting insecticidal nets (LLINs) have been widely used as an effective alternative to conventional insecticide-treated nets (ITNs) for over a decade. Due to the growing number of field trials and interventions reporting the effectiveness of LLINs in controlling malaria, there is a need to systematically review the literature on LLINs and ITNs to examine the relative effectiveness and characteristics of both insecticide nettings. A systematic review of over 2000 scholarly articles published since the year 2000 was conducted. The odds ratios (ORs) of insecticidal net effectiveness in reducing malaria were recorded. The final dataset included 26 articles for meta- regression analysis, with a sample size of 154 subgroup observations. While there is substantial heterogeneity in study characteristics and effect size, we found that the overall OR for reducing malaria by LLIN use was 0.44 (95% CI = 0.41-0.48, p < 0.01) indicating a risk reduction of 56%, while ITNs were slightly less effective with an OR of 0.59 (95% CI = 0.57-0.61, p < 0.01). A meta-regression model confirms that LLINs are significantly more effective than ITNs in the prevention of malaria, when controlling for other covariates. For both types of nets, protective efficacy was greater in high transmission areas when nets were used for an extended period. However, cross-sectional studies may overestimate the effect of the nets. The results surprisingly suggest that nets are less effective in protecting children under the age of five, which may be due to differences in child behavior or inadequate coverage. Compared to a previous meta-analysis, insecticide-treated nets appear to have improved their efficacy despite the risks of insecticide resistance. These findings have practical implications for policymakers seeking effective malaria control strategies. ItemRole of Spatial Tools in Public Health Policymaking of Bangladesh: Opportunities and ChallengesKim, Dohyeong; Sarker, Malabika; Vyas, PriyankaIn spite of the increasing efforts to gather spatial data in developing countries, the use of maps is mostly for visualization of health indicators rather than informed decision-making. Various spatial tools can aid policymakers to allocate resources effectively, predict patterns in communicable or infectious diseases, and provide insights into geographical factors which are associated with utilization or adequacy of health services. In Bangladesh, the launch of District Health Information System 2, along with recent efforts to gather spatial data of facilities location, provides an interesting opportunity to study the current landscape and the potential barriers in advancing the use of spatial tools for informed decision making. This study assessed the current level of map usage and spatial tools for health sector planning in Bangladesh, focusing on investigating why map usage and spatial tools remained at a basic level for the purpose of health policy. The study design involved in-depth interviews, followed by an expert survey (n = 39) obtained through snowball sampling. Our survey revealed that assessing areas with shortage of community health workers emerged as the top most for basic map usage or primarily for visualization purpose, while planning for emergency and obstetric care services, and disease mapping was the most frequent category for intermediate and advanced map usage, respectively. Furthermore, we found lack of inter-institutional collaboration, lack of continuous availability of trained personnel, and lack of awareness on the use of geographic information system (GIS) as a decision-making tool as three most critical barriers in the current landscape. Our findings highlight the barriers in increasing the adoption of spatial tools for health policymaking and planning in Bangladesh.