John Snow, Inc. - Region

North America - Current Projects

Projects are listed by award date. Alternatively, list projects by title.

Colorado Medicaid Expansion Gap Analysis
In 2009 the Colorado state legislature passed the Colorado Health Care Affordability Act (HB-1292), which will expand coverage to more than 100,000 uninsured Coloradoans over the next five years. The ultimate success of the Act is highly dependent on the degree to which newly eligible individuals enroll in Medicaid and CHP+, and are linked with an appropriate source of care. The Department of Health Care Policy and Finance is developing an outreach strategic plan to engage and enroll the expansion population groups and has hired JSI to lead an outreach assessment and gap analysis. This assessment and analysis will inform the development of outreach and marketing campaigns for the newly eligible expansion populations and identify populations and/or geographic areas that are not reached with the current outreach efforts. JSI is working closely with the Department to identify existing and historic outreach efforts by conducting a high-level literature review and interviewing key informants.
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Massachusetts Tobacco Control Program Pricing and Promotions Study
The Massachusetts Tobacco Control Program has asked JSI to conduct a survey of cigarette prices and advertising in order to gauge the effect of recent Federal and State excise tax increases. In addition, the study will collect information on advertising at point of sale, including signs, promotions, and other tobacco-related marketing.

A first round of data collection established a baseline of cigarette prices prior to the Federal excise tax increase. When combined with data collected in this activity, after the excise tax increase, the survey will indicate to what extent the amount of the tax increase was passed on to consumers, as opposed to being absorbed by manufacturers or retailers. The survey will also provide cross-sectional data on variations in prices and advertising across the state, especially in areas with sizable low-income and minority populations.
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Engaging Smokers in Cessation Through Financial Assistance Programs
JSI Research & Training Institute, Inc. has been awarded a Small Innovative Grant from the American Legacy Foundation to engage low-income smokers in tobacco cessation via employment security and financial assistance programs. JSI is collaborating with employment readiness and financial assistance programs in New Hampshire and Rhode Island.

The project's goal is to connect low-income smokers with evidence-based cessation resources, specifically quitline counseling services and nicotine replacement therapy (NRT) through channels not traditionally utilized by tobacco control programs. Specific objectives are 1) to partner with community-based employment readiness and financial assistance programs to integrate proactive quitline referral into employment counseling and budget management counseling sessions, 2) to increase individual smokers' motivation to quit smoking now by focusing on the immediate personal financial impacts of tobacco use, 3) to connect low-income smokers to their state's quitline via proactive fax referral, and 4) to disseminate information on the potential and feasibility of this approach to tobacco control programs nationwide.
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Indian Health Service Urban Indian Health Program Uniform Data System
JSI has been contracted for five years by the Indian Health Services, Urban Indian Health, to develop and implement an automated process for collecting, validating, and disseminating Uniform Data System (UDS) information from all Urban Indian Health Programs (UIHPs) across the country. The IHS is required by law to conduct an annual program review using various program standards of IHS and to provide technical assistance. The snapshot provided by the UDS shows the full activity of each program, including services provided, staffing, productivity, characteristics of individuals served, payor mix, and finances. The OUIHP and its programs collect this information to support program improvement at the national and program levels.
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DPH HIV Policy Research
JSI Research & Training Institute, Inc. conducts a range of policy research and evaluation to assist the Massachusetts Department of Public Health (MDPH) HIV/AIDS Bureau (HAB) with prevention, treatment, and systems development activities. JSI provides technical expertise with respect to the local epidemic while placing it in the context of national epidemiologic trends, government policies, and research findings.
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NH Try-to-Stop Tobacco
JSI contracts with the New Hampshire Department of Health and Human Services, Office of Community and Public Health, to implement the Tobacco User Resource and Information Center. JSI established the Try-To-STOP TOBACCO Resource Center of New Hampshire as a companion project - separate yet integrally linked - to an ongoing JSI contract, the Try-To-STOP TOBACCO Resource Center of Massachusetts, funded by the Massachusetts Department of Public Health (MDPH) as part of its Massachusetts Tobacco Control Program (MTCP).
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Public Health Preparedness Technical Assistance 2
Through this contract, JSI provides technical assistance to NH's 15 All Health Hazards Planning Regions (AHHRs), assisting them with the facilitation of emergency planning processes and emergency plan development, including the development of regional medical surge plans, mass prophylaxis clinic plans, isolation and quarantine plans, multiagency coordination center plans, and risk communications plans. JSI makes recommendations to the NH Department of Public Health Services (DPHS) and NH Homeland Security and Emergency Management (HSEM) regarding the AHHR need for planning templates. Among the regional planning templates developed by JSI is a pandemic influenza annex template, and a medical surge annex template. JSI assists the planning regions with the development and implementation of HSEEP-compliant discussion-based exercises to evaluate and improve their public health emergency plans.

In order to assist with the response to Influenza A (H1N1), JSI supported the implementation of vaccine administration workshops and developed refrigerator toolkits which were distributed with refrigerators to all regions to assist with cold-chain maintenance. JSI implemented a rapid survey of health care provider personal protective equipment (PPE) needs to assess statewide supply status.
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Public Health Preparedness Training 2
JSI works with the NH Department of Health and Human Services and NH Homeland Security and Emergency Management (HSEM) to provide training to public health emergency planning partners in NH's 15 All Health Hazards Planning Regions (AHHRs). These regional planning groups are charged with developing Public Health Emergency Preparedness and Response Plans for medical surge, community containment, mass prophylaxis, and risk communications for public health emergencies.
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Technical Assistance for Preventing Teen Dating Violence
The MA Department of Public Health contracted with JSI to provide technical assistance to the Teen Dating Violence Prevention Team (TDVPT), a group of violence and injury professionals convened to disseminate resources and best practices around teen dating violence prevention in Boston. JSI's responsibilities include assisting with the analysis of surveillance data and tracking the incidence of TDV in the city, and providing guidance on developing environmental and policy scans of TDV prevention initiatives in Boston and beyond.
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Tobacco Addiction and Treatment Services (TATS)
The QuitWorks-NH project links the New Hampshire TPCP (Tobacco Prevention and Control Program), the NH Medicaid staff, state insurance providers and physicians into a public health and health plan collaborative providing proactive tobacco cessation telephone counseling for all NH tobacco users regardless of health insurance status.

QuitWorks is designed to expand adoption of underutilized evidence-based provider intervention and referrals to treatment, while also increasing utilization of Quitline services.
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NH Center for Excellence
The NH Center for Excellence is a statewide technical assistance resource center for evidence-based practice in substance abuse services. The Center will establish a base of evidence-based practices in prevention, develop a learning collaborative of networks and practitioners to engage in systems change to support evidence-based practice, and establish data dissemination systems to ensure that data is both an input to and output of evidence-based practice. An expert panel will endorse evidence-based practice selections, outcome measurement designs, and the process by which promising practices may develop a base of evidence of effectiveness in New Hampshire.
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H1N1 Influenza Vaccine Project
JSI Research & Training Institute, Inc. was engaged by the Massachusetts Department of Public Health to hire, train, and deploy a field staff to assist in the roll-out of novel human virus H1N1 (swine flu) influenza vaccine within the Commonwealth, as it becomes available. The Research Associates (RAs), under the guidance of JSI consultants, will answer health provider questions regarding registration as a providing site, allocation of vaccine and reporting of vaccine use. They are assisting providers and the DPH to resolve any difficulties arising in the process. Additionally, the staff will track deployment and depletion of vaccine stocks, and analyze data looking for gaps in availability. RAs will help to ensure the timely reporting of data to the Commonwealth's Vaccine Unit, and coordinate reporting with CDC.
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AIDS.gov Project
Since 2006, JSI has served as the management, communications, and training contractor for the U.S. Department of Health and Human Services, Office of HIV/AIDS Policy (OHAP)'s AIDS.gov Project. By increasing access to HIV information, AIDS.gov aims to decrease HIV infection rates, increase HIV testing, and expand early access to care among communities of color and others at greatest risk of HIV in the U.S. JSI has helped fulfill AIDS.gov's mission of providing access to Federal HIV & AIDS information in communities at greatest risk for HIV through both a variety of new media channels (social networking sites, podcasts, and blog) and national HIV new media campaigns (World AIDS Day and National HIV Testing Day). JSI's integrated communications approach has fostered a dynamic multi-channel online and offline conversation about the use of new media tools to respond to HIV (to read the AIDS.gov blog, go to blog.aids.gov).

Read the following story about the project: Reaching New Audiences through New Media
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Lawrence Oral Health Initiative
The Lawrence Oral Health Initiative contracted JSI to conduct focus groups with parents to learn more about children's oral health and behaviors. The Lawrence Oral Health Initiative (LOHI) is a project of the Northeast Center for Healthy Communities, a program of the Greater Lawrence Family Health Center. The LOHI is a group of individuals and organizations that have come together to improve the oral health of people living in Lawrence. The group presently includes representatives from the Lawrence Public Schools, the City of Lawrence, the Greater Lawrence Family Health Center, the YWCA, BU School of Dental Medicine, and local dental practices.

JSI conducted two focus groups, one in English and one in Spanish with an average of eight parents per group. Through the focus groups the LOHI wants to learn about parents' experiences with their children's teeth and gums and with visiting dentists. The LOHI will utilize the findings to promote oral health for children and to improve communication between dental and other health professionals and parents regarding oral health in Lawrence.
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Governor's Commission on Healthy Aging
JSI worked with the State of Vermont to help design and implement the Governor's new Commission on Healthy Aging, sponsored by the National Governor's Association. Goals of the initiative included establishing a new Commission on Healthy Aging, identifying and treating older adults with depression, and collaborating with the state to create a health education strategy that will target rural older adults and their unique needs. The Healthy Aging Plan developed under the project was included by legislature in the May 2006 Vermont Health Reform Bill.
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Management Reengineering Across Safety Net Clinics - California HealthCare Foundation
In an effort to evaluate process reengineering efforts taking place across the healthcare safety net, JSI Research & Training Institute, Inc. has been asked by the California HealthCare Foundation (CHCF) to develop a publicly available Issue Brief in the domain of management reengineering across safety net organizations. JSI will identify practices applied to safety net clinics in reorganizing their practices to achieve additional efficiencies. While not tied to the adoption of health information technology (health IT), health IT will be one aspect that is evaluated in this domain. In addition, the landscape analysis will evaluate, but not be limited to, the following components:

Lean
Six sigma
Patient visit redesign
Medical home models
Continuous quality improvement
Business process modeling

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Multistate Learning Collaborative
Lead States in Public Health Quality Improvement (MLC-3)
New Hampshire is one of 16 Lead States in Public Health Quality Improvement that participate in the Multistate Learning Collaborative (MLC-3). The MLC-3, funded by the Robert Wood Johnson Foundation and managed by the National Network of Public Health Institutes, aims to improve public health services and the health of communities by implementing quality improvement practices. The Community Health Institute/JSI (CHI/JSI), in partnership with the New Hampshire Division of Public Health Services (DPHS), provides training, technical assistance, and tools to three Quality Improvement Learning Teams (QuILTs) comprised of community-level organizations focusing on reducing childhood obesity and improving public health improvement capacity. Through the MLC-3, CHI/JSI also supports preparation for voluntary accreditation of local public health systems through the NH Public Health Regionalization Initiative. State-level voluntary accreditation preparedness activities include participation in the internal DPHS Public Health Improvement Team, and the development of a web-based outcomes reporting tool for DPHS-contracting agencies to deliver public health services.
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Landscape Analysis on eVisits Across the Safety Net
JSI Research & Training Institute, Inc. has been asked by the California HealthCare Foundation (CHCF) to evaluate activity in the e-Visit arena with the goal of providing internal guidance to CHCF on potential strategies to support or enhance safety net efforts around electronic visits in California. This will include identifying and defining the spectrum of electronic patient visits. The landscape analysis will cover the use of health information technology tools and supporting practices that are relevant to providing such services as:

Triage,
Patient education,
Medication management,
Consultations and referrals,
Chronic disease management, and
Follow ups.

The focus will be on safety net organizations, but will also explore innovative practices by those who are paying for these services, such as Medicare, Medicaid, indigent care programs, as well as any private payor agencies identified during this research.
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CDC HIV Capacity Building Assistance to Community-Based Organizations
JSI Research & Training Institute, Inc. has been contracted by the Centers for Disease Control and Prevention (CDC) to provide capacity building assistance (CBA) to community-based organizations to help improve the delivery and effectiveness of HIV prevention services for high-risk and/or racial/ethnic minority populations. JSI will provide assistance with (1) organizational infrastructure and program sustainability, (2) selection, adaptation, implementation, and evaluation of evidence-based interventions and public health strategies, and (3) monitoring and evaluation.

JSI's CBA services will be national in scope and may include on-site technical assistance, content-specific training and technical support, and institutes that bring together organizations with similar missions and needs.
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Vermont Asthma Evaluation
In 2009, the Vermont Department of Health (VDH) Asthma Program received a new five-year grant award from the Centers for Disease Control & Prevention (CDC) requiring the Program to conduct program evaluation activities, including the development of a comprehensive, five-year evaluation plan, as well as the development and implementation of evaluation plans for specific program initiatives. The VDH contracted JSI to conduct these evaluation activities, which are to align closely with the Program's State Asthma Prevention Plan. The evaluation will include a comprehensive literature review, both quantitative and qualitative data collection and analysis, meetings with stakeholders, and development of interim and final reports.
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2010 Sexuality Education Listening Tour
In 2007, JSI worked with the Massachusetts Department of Education to conduct a Sexuality Education Listening Tour. As part of that project, JSI held five discussion groups with health education teachers across Massachusetts to better understand what resources and support health educators need to deliver factual, comprehensive sexuality education in a manner scientifically proven to be effective.

In 2010, JSI has been contracted by the Massachusetts Department of Public Health's Office of HIV/AIDS to conduct a follow-up assessment. As part of this Listening Tour, JSI will conduct six discussion groups with parents and six discussion groups with teens throughout Massachusetts to better understand what parents want their kids to learn, as well as what teens are learning and want to learn as part of comprehensive sexuality education in school.
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Youth Substance Abuse Services Needs Assessment and Business Planning Project
JSI was contracted by CAB Health and Recovery Services (CAB) to conduct a needs assessment and strategic planning project aimed at assessing the demand for, and supply of, youth substance abuse services in CAB's service area. Based on anecdotal reports as well as its own experience, staff at CAB believe that there are major gaps in these preventive and treatment services in the North Shore area of Massachusetts. The goal of this assessment is to provide CAB with the information it needs to better understand the extent and nature of existing service gaps in order to develop sound business plans.
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Dover Drug Free Communities Evaluation
Through this project, JSI/CHI will provide evaluation services to the Dover, NH Coalition for Youth, a Drug Free Communities initiative. Evaluation efforts will support the coalition's efforts to reduce alcohol, tobacco, and other drug use and abuse among youth in the Dover, New Hampshire region.
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Promotores for Health
Access to accurate, trustworthy information on health is an important basis for healthy living. Despite the growth in health resources available on the Internet, obstacles to finding and using such information present significant barriers for those with limited English proficiency and/or literacy skills.

JSI has received support from the National Network of Libraries of Medicine (NNLM) New England Region to provide health outreach that helps bridge the information gap. Through this project, JSI will build long-term capacity within the Lawrence community, one of the most underserved cities in the Commonwealth, MA.

Promotores for Health Information: Developing a Model Latino Health Information Outreach Program is a community-based train-the-trainer program. JSI is training librarians, educators, and providers of community-based health services to access, understand, and apply health information relevant to the populations they serve. To overcome barriers of language, literacy, and culture, the project is enlisting health promotores (lay health workers) who are part of health and social service organizations in Lawrence as well as developing health communication leadership among youth who will serve as Promotores for their friends, family and community.
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Beverly Hospital Needs Assessment Community Dissemination
As a follow-up to a comprehensive community health needs assessment that JSI conducted in 2008 and 2009, JSI was contracted to disseminate findings from its needs assessment to city and town administrators and to other community stakeholders. The overall goal of this project was to develop and foster productive partnerships between Beverly Hospital, municipalities in the Hospital's catchment area, and other community organizations in order to address the most pressing community health needs identified in the study. JSI staff facilitated a series of community meetings/forums and developed reports summarizing the assessment's findings, specifically for a number of the area's largest cities and towns.
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Evaluation Design and Implementation for the Childhood Healthy Weight Initiative
Being overweight as a child is associated with negative health outcomes, including Type 2 diabetes (previously a disease afflicting primarily adults), high blood pressure, high cholesterol, asthma, joint problems, and gallbladder disease, as well as depression and anxiety. The childhood obesity epidemic in upstate New York and Monroe County mirrors that in the United States at large. The Greater Rochester Health Foundation (GRHF)'s Childhood Healthy Weight Initiative is a multifaceted, 10 year commitment with a single goal: to increase the prevalence of healthy-weight children from 70% to 85% by 2017.

JSI has been contracted to conduct an evaluation of the Initiative's successes in the past three years and to propose refinements to the GRHF's approach to improve these outcomes. JSI will provide analyses, and potentially primary data collection, to help GRHF improve evidence-based decisionmaking with respect to the Initiative.
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New Hampshire Survey of Dentists and Dental Hygienists
JSI has been contracted to conduct surveys of the Dentists and Dental Hygienists licensed in New Hampshire, and to develop reports and presentations based on the findings. The surveys are intended to describe the current provider pool in the state, and examine factors that influence current capacity and the future supply of dental providers. The project will also involve crosswalk analysis of the current state provider licensing lists in comparison to the lists from several years earlier, to identify trends in dental providers entering and leaving the state. The project is a collaboration between the Bi-State Primary Care Association, the NH Dental Society, and the NH Department of Health and Human Services.
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Assisting Family and Medical Counseling Services, Washington DC
JSI is assisting Family and Medical Counseling Services (FMCS), a Washington, DC-based HIV/AIDS service provider, to become a Federally Qualified Health Center. FMCS received ARRA stimulus funding to support planning for expansion of their primary medical and dental services to be able to serve residents of South East DC. JSI is helping FMCS conduct a needs assessment, redesign their operational systems and procedures, and train the organization's staff and Board to facilitate a smooth transition to becoming a comprehensive primary health care center.
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Peak Vista Access and Retention
Peak Vista Community Health Centers contracted JSI to identify potential causes of patient attrition (particularly within the Medicaid, State Children's Health Insurance Program and Medicaid payer groups), and to identify specific steps that could be taken to reduce attrition and facilitate a more desirable payer mix. Peak Vista is headquartered in Colorado Springs, Colorado and provides comprehensive primary care to over 54,000 individuals in El Paso and Teller Counties of Colorado.

Attrition data was analyzed to identify departments/panels experiencing the most attrition, and the points of contact at which attrition most commonly occurred. On-site visits, patient record reviews, and patient surveys were conducted to better understand potential contributors to attrition and help identify potential action steps for attrition reduction. These visits focused on enrollment processes and included customer satisfaction surveys related to the enrollment process. Additionally, attrited patients were interviewed by phone to explore reasons for attrition.

Based on the findings of the data analysis and on-site visits, potential factors that may contribute to attrition or inhibit retention among Peak Vista members were identified. Subsequent interviews with Peak Vista leadership explored the feasibility of changing practices to address barriers to member retention, while upholding Peak Vista's mission and commitment to foster hospitality throughout the organization.

Peak Vista's Action Team will use the findings of the report to further its goal of increasing patient retention.
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Hunger-Free and Healthy
JSI is the evaluator for the Hunger-Free and Healthy (HFH) Program supported by the Health Foundation of Central Massachusetts (HFCM). HFCM has funded the Worcester County Food Bank as the lead agency in a coalition of groups promoting food security and healthy eating in the City of Worcester. Activities include advocating for healthier foods in schools, promoting policies that support access to fresh and local foods (including farmer's markets), community gardens and increased access to fruits and vegetables at corner stores.
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NH Center for Excellence in Treatment & Recovery
The NH Center for Excellence is a resource center for best practices in alcohol and other drug services. Beginning in Spring 2010, the Center will expand its services beyond prevention to include support for evidence-based interventions in treatment and recovery based on a thorough assessment of current practice, capacity, and outcomes.

As contractor for the NH Center for Excellence, JSI Research & Training Institute, Inc. will build technical assistance frameworks for data systems, evidence based practice, and systems change for treatment and recovery providers and practitioners in New Hampshire. The work of Center in fostering systems improvement across the spectrum of prevention, intervention, treatment and recovery services is overseen by a panel of experts in addiction services from state, regional and national realms and is supported through technical assistance from SAMHSA's Center for Applied Prevention Technology (CAPT) and Center for Substance Abuse Treatment (CSAT).
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National Juvenile Information Sharing Project Evaluation
Public and private agencies working with youth and their families historically have experienced difficulties accessing pertinent "need to know" information. Addressing this problem, the Center for Network Development is implementing a National Juvenile Information Sharing (JIS) Initiative funded by the NIJ's Office of Juvenile Justice and Delinquency Prevention. The Initiative will pilot test juvenile justice-based national guidelines for information sharing incorporating an innovative electronic data model. The Center has contracted with JSI for evaluation and assessment services for this Initiative. The evaluation plan will use both qualitative and quantitative methods to provide formative, process, and outcome assessment.
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Healthcare Associated Infection Data Validation
JSI has been contracted by the NH DHHS, Division of Public Health Services (DPHS) to develop a healthcare-associated infections (HAI) data validation plan for DPHS to use to validate HAI data received from New Hampshire hospitals through the Centers for Disease Control and Prevention(CDC) National Healthcare Safety Network (NHSN). Upon completion, JSI will provide a written plan and validation materials such that DPHS can implement the actual work of validating data.
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Lab Interface Project
The lab interface project supports the automated collection of lab test transactions for the Title X Family Planning Data System. The Rhode Island grantee for the project found that the number of lab tests were being significantly underreported by the healthcare provider agency. The root cause was determined to be that clients were referred for lab tests at the point of intake, but that the client visit records in the data system were not being updated by the lab technicians when the lab tests were actually performed. The lab interface automates the reporting of the lab tests and eliminates the need for the lab technician to log into the data system and manually update the client visit record. Lab test counts reported in the data system increased by 50% following the implementation of the lab interface.
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Emergency Preparedness for H1N1
JSI is assisting the Massachusetts Department of Public Health Emergency Preparedness Bureau (EPB) as they work to address outbreaks of the novel H1N1 influenza virus. As part of the project, JSI is working to provide documented guidance and protocols for the state Strategic National Stockpile (SNS) as well as health care facility SNS shortages for H1N1. JSI is also helping put in place systems for tracking scheduled flu vaccination clinics and distribution of assets from the state SNS for H1N1. JSI is also assisting with activities to prepare the After Action Report. As part of this activity, JSI is working in partnership with Harvard University to conduct interviews with selected key stakeholders who were involved in the planning, coordinating and addressing the H1N1 pandemic. JSI is analyzing and preparing a report on data collected by the Massachusetts Department of Public Health Emergency Preparedness Bureau from hospitals in Massachusetts on their stock status and usage of N95s and surgical masks.
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Entre Nosotras 2010
The Entre Nosotras (Between Us) program seeks to reduce the impact of HIV, hepatitis, and substance abuse among Latinas living in Boston and their families. EN provides comprehensive risk reduction interventions as well as HIV counseling, testing, and referral. JSI serves as evaluator for this program, developing data collection tools, conducting analysis & reporting, and training program staff.
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Business Case Analyses of Telemedicine in Three Community Clinics
In 2007, three community health center organizations were awarded telemedicine grants by the California HealthCare Foundation (CHCF) to utilize telemedicine as a mechanism for increasing access to specialty care. CHCF contracted with JSI to analyze the business case of the telemedicine programs at each organization.

This project investigates questions of financial sustainability and patient volume break-even points. A separate business case will be developed for each of the three clinic organizations, based on a publicly-available financial model reflecting the specifics of each organization. The results of this project will be a greater understanding of the financial considerations health centers must make in implementing telemedicine programs.
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Rochester Bridging the Gap
Through this project, JSI/CHI provides evaluation services to the Rochester Bridging the Gaps community coalition, a Drug Free Communities initiative. Evaluation activities support the coalition's efforts to reduce alcohol, tobacco, and other drug use and abuse among youth in the Rochester, NH region.
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Urban Hispanic/Latino MSM HIV Prevention Project
The Colorado Department of Public Health and Environment (CDPHE) contracted with JSI to conduct a formative evaluation to guide HIV prevention services for urban Hispanic/Latino MSM in 2010. JSI held focus groups and interviews with Hispanic/Latino men who have sex with men and who live in the Denver Metro area. The qualitative data was then analyzed for common themes and a report was made to the CDPHE and the agencies funded to provide HIV prevention services within the Denver Metro Area.

HIV Prevention Needs Among Hispanic/Latino Men Who Have Sex with Men in the Denver Metro Area Report
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Measures Alignment of HRSA Core Measures and Quality Improvement Initiatives from Across Bureaus and Offices
The HRSA health service delivery programs vary in their size and patient population, but all strive to improve access to quality care for underserved populations. The HRSA Center for Quality is charged with developing quality performance measures and performance improvement to ensure HRSA programs provide high quality care. The Center for Quality has identified a set of 12 Core Clinical Measures that span the life cycle for alignment across all HRSA direct service programs.

JSI worked with the Center for Quality in 2007 to implement a feasibility study of diverse HRSA grantees' ability to collect these twelve measures. Continuing this work, HRSA has now contracted with JSI to assist in developing a broad strategy to address agency wide-implementation of measures alignment. JSI will interview the HRSA bureaus and programs to identify a strategy for alignment and will write a series of reports addressing different components of the alignment process.
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National Cancer Institute (NCI) Health Disparities Calculator (HD*Calc) Dissemination Project
Healthy People 2010 goals include the reduction of cancer disparities related to cancer mortality and morbidity, cancer screening, preventive interventions and risk factors. In addition to the goals of Healthy People 2010, it is of highest priority to the National Cancer Institute (NCI) to eliminate health disparities among various subpopulations of the nation. It has become clear that the method of analysis used to examine cancer related health disparities impacts the results. Specifically the statistical properties of individual measures used to determine the direction and magnitude of cancer related health disparities affects the results and evaluation of trends.

NCI hired JSI to complete the Health Disparities Calculator (HD*Calc) Dissemination Project. The purpose of this project is to manage the completion and dissemination of a software application, that can be used as an extension of SEER*Stat to calculate multiple measures of cancer related health disparities from Surveillance Epidemiology and End Results (SEER) data. The application can also be applied to other population-based public health data sources. The Health Disparities Calculator Dissemination Project aims to facilitate the use of a range of health disparities summary measures so that researchers can explore their utility in different situations; encourage examination of health disparities statistics in population-based health data; and promote the evaluation and monitoring of health disparities using data from SEER.
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AHRQ Health IT Project Monitoring and Reporting
Established in 2004, the Agency for Healthcare Research and Quality (AHRQ) Health IT Program is chartered to develop evidence that health IT can be used to improve the quality, safety, efficiency, and effectiveness of the United States healthcare system. AHRQ established the National Resource Center for Health IT (NRC) to help disseminate the results of AHRQ-sponsored projects, synthesizing results into an extensive knowledge base that can be utilized by healthcare, research, policy and technology professionals across the country.

As part of the NRC, JSI is tasked with the overall reporting and monitoring of the AHRQ Health IT grantees. The project aims to promote and enable information sharing and synergy across projects; disseminate information about the projects themselves (e.g., project focus, types of health IT applications used, challenges and innovations), findings, tools and other 'outputs' (e.g., publications, surveys) with the health IT community at large; and enable the annual evaluation of the effectiveness of the AHRQ Health IT portfolio's activities.
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BPHC Uniform Data System
The purpose of this project is to support the collection of the Bureau of Primary Health Care (BPHC) Uniform Data System (UDS) data and the Health Center Quarterly Report (HCQR) data. JSI has supported data collection for the BPHC UDS since 1999 and the HCQR since its inception through the provision of training and technical support to over 1,200 BPHC grantees. JSI provides training and technical assistance to grantees, works with BPHC and system developers to enhance data collection and reporting functions, and provides analytic support to the BPHC in interpretation of BPHC program data to support management of the Health Center Program.
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HIVQUAL-US Evaluation Project
HIVQUAL-US is a national three-year program focusing on quality improvement of HIV/AIDS care provided by Ryan White Part C and D-funded grantees. Working with the NY State Department of Health AIDS Institute, JSI's evaluation examines the three main activities of the HIVQUAL project: 1) capacity building for quality management, 2) performance measurement, and 3) improvement in quality of care for PLWHA. JSI is evaluating the change in quality over time, capacity building outcomes through site and regional activities, and population disparities in quality of care. Results of the data analyses are providing guidance and recommendations for improvements in data collection, management and interpretation, as well as information to strengthen current and planned project activities.
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Proteccion en Construccion: Lawrence Latino Safety Partnership
Fatal and disabling injuries disproportionately affect workers in the building trades, particularly immigrants and Latinos who have the highest injury and death rates among American workers.

JSI Center for Environmental Health Studies, working in collaboration with the Department of Work Environment at the University of Massachusetts Lowell School of Health and Environment, the Mayor's Health Task Force in Lawrence, MA, and Local 175 of the Laborers' International Union of North America, is engaged in a community-based participatory research program funded by the National Institutes of Occupational Safety and Health.

Interdisciplinary and participatory approaches will bring together workers, contractors, residents, health providers, community organizations, and government agencies to increase the safety and health practices at construction work sites. Links among workers, their families, contractors, and local agencies are expected to ensure adequate training and proper safety equipment through community awareness and expectation.
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Rhode Island HIV Quality Management Project
JSI has contracted with the Rhode Island Department of Health to implement an HIV Quality Management initiative with Ryan White Title II-funded providers. The overall goal of this project is to increase the capacity of Rhode Island HIV/AIDS services providers to implement quality management activities that will improve the quality of care provided for persons living with HIV/AIDS in Rhode Island.
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Suffolk County NY Health Center Network Assessment and Strategy Development
The County of Suffolk Department of Health Services engaged JSI to develop a cost effective model to provide primary care services to the medically-indigent and -underserved residents of Suffolk County, New York. The primary goal of the project is to determine the best strategic option for the ongoing operation of the Division's ten Health Centers, referred to as the Health Center Network. Strategy options will be based on the results of practice assessments (operational and financial) for each of the Health Centers, analysis of current users, and a demographic analysis of the Suffolk County population. JSI will further evaluate possible strategy options by developing pro forma financial results and testing for financial viability. JSI will work with the County to determine the best strategic option, develop an implementation plan, and assist the County with implementation in selected areas.
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Planning Phase of the Comprehensive Evaluation of the Delaware Health Information Network (DHIN)
Delaware Health Information Network (DHIN), an operational health information exchange, engaged JSI to develop an evaluation plan to understand the value of health information exchange for its stakeholders. JSI worked with Delaware stakeholders to identify potential measurements of DHIN benefits, understand challenges and limitations of specific measurement approaches, identify existing and new data sources that are required for the evaluation, and clarify resources of both DHIN and its stakeholders for participation in the evaluation.

JSI developed an evaluation project plan for the DHIN to be executed over a two year time period. This plan included evaluation metrics developed by JSI and selected by the DHIN Evaluation Steering Committee. For each metric, the plan outlines the definition and the hypotheses being tested, a brief description of the evaluation methodology, and potential methodological considerations.
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Strategic Prevention Framework to Reduce Underage Drinking and Alcohol Abuse
JSI's Community Health Institute (CHI) is providing assessment and evaluation training, technical assistance, data analysis, and data profiles for a state-defined region to plan for and implement evidence-based strategies to prevent and reduce alcohol use and abuse among 12 to 17 year olds.
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Technical Assistance to ECCS Grantees
John Snow, Inc. has been awarded a two-year task order to provide technical assistance (TA) to HRSA's Maternal and Child Health Bureau State Early Childhood Comprehensive Systems grantees. These grantees are funded to establish or bolster early childhood systems, including child care, health care, education, and after-school programs, in their states. JSI TA Coordinators will work with grantees from 47 states, Washington, DC, Puerto Rico, Guam, Palau and the Northern Mariana Islands.
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Minnesota MSM HIV Prevention
The HIV/AIDS epidemic continues to increase among gay, bisexual and other men who have sex with men. The Minnesota Department of Health (MDH) contracted with JSI to learn more about the current status of HIV prevention in the MSM community in Minnesota. JSI conducted key informant interviews, focus groups, and an online survey to assess the current view of HIV & AIDS among members of the gay and bisexual men's community, to learn about their perception of existing HIV prevention services and to get a sense of what an ideal HIV prevention service system might look like going forward.
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Enhancing Health Care Delivery to the Medically Underserved and Indigent in Nashville and Davidson County
The Metropolitan Government of Nashville and Davidson County (Metro) contracted with JSI to assess the delivery of health care to the medically-underserved and indigent population in the County, and to identify opportunities to enhance services while reducing the total annual cost to Metro. JSI gained a thorough understanding of the local environment and researched successful attributes of safety net models nationally. Based on this research, JSI recommended a more cost effective model for Nashville/Davidson County's safety net system.
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Caritas Christi Health Care Community Benefit Needs Assessment
Caritas Christi Health Care is New England's largest community-based hospital network. Massachusetts law requires that all non-profit hospitals and health plans submit an annual Community Benefits Report that details the extent to which these institutions provide charity care and support community health activities in their service areas. As part of this requirement, hospitals are expected to conduct periodic community health needs assessments that clarify the leading health concerns, service gaps, and barriers to access for their patients.

In 2009, JSI was engaged by Caritas Christi Health Care, Inc. to assist them with their community health needs assessment for each of their Massachusetts-based hospitals. More specifically, the JSI Project Team compiled and analyzed secondary data drawn from existing federal, state, and local sources as well as analyzed primary data that Caritas Christi collected on their own through a survey administered to patients in clinic waiting rooms.

The goal of JSI's activities was to assist Caritas Christi to determine, in both quantitative and qualitative terms, the leading health concerns for patients in the primary service areas for each of Caritas Christi's hospitals.
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Delaware Oral Health Infrastructure
Dental disease is one of the nation's leading health issues and has become what many experts call "the silent epidemic." Millions of people throughout the country suffer from the impacts of dental disease, which disproportionately affects low-income families, minorities and the elderly. In March of 2009, JSI was hired by Delaware Health Care Commission to assist the State in assessing the feasibility of three high-impact strategies to address oral health workforce shortages and expand access to services for the state's most vulnerable populations. As part of this project, JSI is conducting a comprehensive series of interviews and a review of best practices nationally in order to identify the most appropriate models. More importantly, JSI is pursuing a rigorous operational and financial analysis to determine the financial sustainability and estimate the impact of the models identified.
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Amsterdam, New York, Needs Assessment
JSI was contracted to work with a health care provider in the City of Amsterdam, located in rural Montgomery County, New York, to provide a health needs assessment and assist in Federally Qualified Health Center (FQHC) development. The project included initial planning, including board development, staffing, service planning, and data for the needs component of the grant application and writing assistance.
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Assessing the Montgomery Cares Program
In May of 2009, JSI was hired by the Montgomery County, MD DHHS and the Montgomery Cares Program to assess the management and governance structures of the Montgomery Cares Program. The program has had outstanding achievements since its inception and on the whole functions well. However, the County and its Community Advisory Board appreciate that there is room for improvement and that they must strive to ensure that all of the county's low income, uninsured, and otherwise vulnerable populations receive the care and services they need. In light of this, JSI conducted a comprehensive series of interviews with the Montgomery Care Program's partners and other key stakeholders in the community as well as a formal review of best practices among other similar, nationally recognized programs. Ultimately, JSI developed a series of recommendations regarding how the current governance and management structures could be improved.
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VT Tobacco Evaluation and Quality Assurance Monitoring
Certain segments of Vermont's population have some of the highest smoking rates in the state. The smoking rates for these groups are not decreasing, as they are for other smoking segments of the population.

The Vermont Department of Health, Tobacco Control Program contracted with JSI Research & Training Institute, Inc. to conduct quality assurance monitoring and evaluation of its pilot Smoking Cessation During Pregnancy incentive program, operating in two of the state's district offices. The objective of the incentive program is to support and encourage quitting smoking early and throughout the pregnancy by recruiting women who smoke among the clients seeking WIC nutritional services.

JSI conducted quality assurance monitoring and evaluation activities over the course of six months. These activities consisted of site visits, key informant interviews, a literature review and analysis of the Pregnancy Smoking Cessation Program (PSCP) data base. JSI study findings are presented in the final report.
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Lahey Clinic Community Needs Assessment and Engagement Project
Since it inception in 1923 the Lahey Clinic Medical Center (LCMC) has been an active community partner and has been committed to working with the communities it serves to identify and address unmet health and social needs. LCMC in Burlington, Massachusetts hired JSI to conduct a Community Health Needs Assessment and Community Engagement Project that 1) assessed the health and social service needs and priorities of the major cities and towns in LCMC's service area, 2) reviewed the effectiveness and impact of LCMC's current community health programs, and 3) assisted LCMC to develop a community health strategy to guide their community health investments over the next 3-5 years.
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Metro Community Provider Network, Patient-Centered Medical Home and Chronic Care Model
Metro Community Provider Network (MCPN) is a Section 330-funded Federally Qualified Health Center (FQHC) and has provided medical and health education services to the underserved since 1989. In 2004, with support from the Colorado Health Foundation and the Medical Center of Aurora (TMCA), MCPN developed Potomac Street Health Center (PSHC), a clinic for the purposes of serving an older adult population (primarily 55 and older) facing barriers to health care as well as individuals with disabilities and with chronic and complex health conditions.

John Snow, Inc. (JSI) was contracted in early 2009 to assist PSHC in the development of a Medical Home and Chronic Care Management Model. JSI Analyzed PSHC's services, operations, electronic health record and current users in terms of number, demographics, and health status; as well as conducted an external review of community resources, referral partners and potential collaborators to determine what steps PSHC needed to take to move from their current state to the agreed upon model. In addition, JSI created an evaluation plan and assisted in conducting the evaluation that allowed PSHC to determine how effectively it was implementing the new care model and if the model is producing the desired results.

The medical home model was then spread through the other nine MCPN sites.

In early 2010, JSI was once again contracted by MCPN to assist them in applying for patient-centered medical home (PCMH) recognition with the National Committee on Quality Assurance (NCQA).

Download PSHC Patient-Centered Medical Home and Chronic Care Model Report
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Maine Health Access Foundation Integration Initiative Evaluation
Lack of both access to timely behavioral health services and coordination of care across behavioral health and medical providers are pervasive barriers to quality health care, especially in rural states. The Maine Health Access Foundation has committed to increasing the integration of primary medical and behavioral health care through multiple year grants to a variety of health providers including Federally Qualified Health Centers, private primary care providers, and mental health centers throughout the state to initiate collaborations across providers and build more coordinated systems of care. MeHAF has contracted with John Snow, Inc., to evaluate the multiyear integration initiative from both a qualitative and quantitative perspective. JSI will support grantees with data collection to document progress towards integration and qualitatively assess the successes, challenges, and best practices of the programs integrating primary medical care and behavioral health.
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Boulder County Unintended Pregnancy Research Project
JSI was awarded a contract from Boulder County Public Health (BCPH) to research the local issues and factors associated with unintended pregnancy in Boulder County. The research activities included quantitative and qualitative data collection among a diverse group of young men and women, as well as their immediate social network, health care and social service providers, and key stakeholders. The key areas of interest to BCPH include: demographics, un/intentionality rates, disparities, perceptions of unintended pregnancy, repercussions of unintended pregnancy, obstacles to and resources for prevention. The subsequent plan was designed to reflect the values of the Boulder County residents it will serve.

The Boulder County Unintended Pregnancy Study
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ASO Children's Mental Health
In New Hampshire, the array of appropriate mental health services for children is often limited by the capacity of the state agency in charge of their care. In addition, no single agency provides a full continuum of services nor ensures that mental health needs are first addressed at the community level before referral to high intensity out-of-home placement.

JSI is implementing the ASO-Children's Mental Health project on behalf of the NH Department of Health and Human Services (DHHS) to create an integrated care and service delivery system for children with mental health needs who receive care from one or more governmental agencies.

The project will assess current systems and care outcomes for children currently in residential placement, form an advisory panel, consult national experts, and operationalize a process to be piloted in 2010 that will coordinate care and funding mechanisms to improve outcomes for children with mental health needs. This project is funded by the NH Endowment for Health.
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ABCD - Entre Nosotras (Between Us)
The Entre Nosotras (Between Us) program was a multi-agency, peer-led risk reduction intervention that sought to reduce the impact of HIV, Hepatitis and substance abuse among Latinas in Boston. JSI assisted Action for Boston Community Development with the development and implementation of the evaluation plans for three of their community programs. This work included developing a program logic model, data collection tools, conducting focus groups, data collection training, database development, and data analyses, as well as providing recommendations to the programs based on results.
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Assessment of School HIV Prevention Education in Rural Colorado
The Colorado Organization of Adolescent Pregnancy, Parenting and Prevention (COAPPP) received funding from the Colorado Department of Public Health and Environment to complete an assessment of HIV prevention education in rural schools and school districts. COAPPP subcontracted with JSI to design and implement an on-line survey and key stakeholder interviews targeting rural school districts. The information gathered will help COAPPP and state and local partner organizations identify gaps in HIV prevention education delivered throughout Colorado and possible root challenges, barriers, and resources to fill these gaps.
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Municipal Wellness Capacity Building
JSI helped the Massachusetts Department of Public Health (MDPH) and its partners develop a Community Wellness Planning and Implementation Program to combat overweight and obesity. Justice Resources Inc. subcontracted JSI to develop a process to award grants in approximately ten cities or towns across the state to support policy and environmental change.
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Evaluation of the MAI Fund
In FY 1999, the United States Congress created the Minority AIDS Initiative (MAI) to address the HIV prevention, care and support needs in African American communities. Later the MAI was expanded to include other communities of color disproportionately impacted by HIV.

The MAI has two funding streams: 1) Congressional Appropriation included in the annual Labor, Health, Human Services and Education Appropriations legislation and; 2) a $50 million allocation to the Department of Health and Human Services known as the Secretary's MAI Fund. JSI partnered with American Cybernetics Corporation, Inc, a Disabled Veteran Business Enterprise (DVBE) to: 1) conduct a review of all documents, products and resources created by the MAI Fund between fiscal years 2006 and 2008; 2) create an inventory of MAI Fund and MAI Congressional appropriation documents during the similar period, and 3) implement an assessment and evaluation of programs sponsored by the MAI Fund during the same period.
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Improving Women's Health: General Support to the US DHHS, Regional Offices on Women's Health
The Department of Health and Human Services (DHHS), Regional Office on Women's Health has contracted with JSI to provide general support to the ten Regional Offices on Women's Health within the DHHS in two areas. These areas are: 1) Managing regional health projects and activities in women's health in the ten DHHS regions and 2) providing logistical support and travel arrangements for select meetings with women's health partners.
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OAPP Annual Conference
The U.S. Department of Health and Human Services, Office of Population Affairs, Office of Adolescent Pregnancy Programs contracted with John Snow, Inc. to provide Conference Logistics Support services to Adolescent Family Life grantees under the Office of Adolescent Pregnancy Programs (OAPP/AFL). Adolescent Family Life demonstration and research projects are focused on the prevention of adolescent pregnancy and on interventions for pregnant and parenting adolescents, their babies, and their families.

JSI is responsible for an annual conference meeting the needs of OAPP and its AFL grantees. By providing Conference Logistics Support, JSI creates the project plan and schedule with OAPP, developing white papers for the conference, managing conference logistics, managing conference consultants, developing conference materials and post-conference materials, and providing feedback. By the end of the grant, JSI will have provided Conference Logistics Support to OAPP for five conferences, lasting until September 2013.
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HIV Integration in Reproductive Health Settings
Through a five year cooperative agreement with Centers for Disease Control, JSI provided training and technical assistance to reproductive health clinics and programs throughout New England to assist them in activities aimed at integrating HIV prevention and testing. The 2006 CDC HIV Testing Recommendations for Healthcare Settings has shifted the environment around HIV prevention, counseling, and testing. Training involved skills building around rapid testing, efficiency training, and counseling skills. On-site technical assistance offered strategic planning and systems development in how to more fully integrate HIV in every aspect of service delivery (e.g., clinic flow, staff supervision).

As part of this project, JSI staff created a Frequently Asked Questions brochure for clients receiving a new HIV-positive diagnosis in Rhode Island, Maine, Connecticut, Northeastern Massachusetts and Southeastern Massachusetts and a binder designed as a referral guide to accompany the patient booklet.

Many agencies JSI worked with under the grant have requested technical assistance on implementing Rapid HIV Testing into their services. Fear of giving a positive HIV result - especially with a Rapid HIV Test - is a self reported barrier both to increased testing and to implementing rapid testing for family planning clinics. Agencies and providers fear not knowing what to say or where to refer their HIV positive clients and worry about the process disrupting clinic flow. The Referral Guide and FAQs were designed to address these fears. The purpose of the resource is to facilitate the provision of high quality referrals to HIV-positive clients and to increase provider use of the HIV Rapid Test by providing referral resources specific to their community and answers to common questions at the tip of their fingers.

Read the following success story about the project: A Paradigm Shift in HIV Testing
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New England Training Center for Adolescent Pregnancy Prevention
The New England Training Center for Adolescent Pregnancy Prevention (NETCAPP), funded by the CDC, assists local, state and regional organizations in creating the infrastructure and capacity required to incorporate evidence-based methodology into their efforts to reduce unintended teen pregnancy, STIs and HIV infection.

Within a five year cooperative agreement with the CDC, JSI is working with key stakeholders to increase collaboration and coalition-building, with the explicit aim of establishing culturally-competent model access points instituting best practices. The anticipated success of these sites will facilitate replication in targeted rural, urban, and mixed communities.

The facilities' focus on serving ethnically and racially diverse communities from a culturally centered standpoint has the best chance of connecting with a client base unreachable by other means, and often suspicious of imposed solutions.

The partnership of local and national experts translating science-based findings into user-friendly, meaningful - even novel - programs and strategies serves to increase essential life-skills development and health risk awareness. Delivery methods include multiple formats and diverse media.
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Evaluation of the Essex County Juvenile Drug Court (2)
The Essex County Juvenile Drug Court (JDC), funded by SAMHSA/CSAT between October 2006 and September 2009, has been designed to provide integrated case management and substance abuse treatment services, in combination with a strong incentive/sanction program, to referred non-violent juvenile offenders from across the North Shore of Massachusetts through the Salem and Lynn juvenile courts. Evaluation is a core element of the JDC program. Process and outcome monitoring activities are conducted by JSI, in collaboration with program staff, in order to provide a clear picture of ongoing program activities, and to serve as a basis for discussion toward program improvement and clarification of goals and objectives. JSI also coordinates efforts related to collection and reporting of the GAIN (Global Appraisal of Individual Needs) required under the CSAT grant. Program staff members collect this survey data and also complete several other data collection tools developed by the evaluation team. JSI works closely with program staff to develop forms, conduct training, clean and submit the data, and conduct data quality assurance procedures, and performs analysis on all of this data in an ongoing manner.
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Region VIII HIV Integration Project
JSI/Denver was funded to implement Program Announcement 04073 for the integration of HIV and other prevention services in reproductive health and community settings. Through this cooperative agreement, JSI-Denver implemented the HIV Prevention Integration Checklist, developed in partnership with CDC and the HIV Integration Regional Project, to assist our sites to assess their readiness and preparation for HIV integration services.

JSI assisted the Indian Health Service, Tribal Health, Urban Indian health clinic, and Title X family planning sites in working through the seven key steps of HIV prevention integration. Through the use of the Checklist, we helped sites determine where they were and where they wanted to go in regards to integrating HIV services. The Checklist served two functions: 1) measuring improved proficiency in the HIV prevention services provided by reproductive health clinics and 2) educating clinic staff on what constitutes good HIV prevention services and successful HIV integration.

We encouraged sites to utilize the toolkit, "Roadmap to HIV Integration: HIV Prevention is Reproductive Health" which is a collaborative of the Division of RH, CDC and each of the regional HIV Integration Training, as the framework for the implementation plan to integrate HIV prevention and testing services, in particular the levels of integration and seven key steps of integration. These two sub-frameworks, along with the Checklist, incorporate evaluation into the program development and implementation phases.
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Revision of the Federal Rules for HPSA/MUA/P Designation
JSI has been awarded a contract with HRSA's Bureau of Health Professions to revise and consolidate the rules by which federal shortage area designations are evaluated (including HPSAs, MUAs, & MUPs). In the decades since they were created, these designations have become the foundation upon which nearly every component of the federal health care safety net system now rests to some degree. As such, changes to these rules are of intense interest to all stakeholders in the federal safety net system. This project follows two prior attempts to revise the rules over the past 10 years, both of which resulted in intense resistance from such stakeholders.

JSI staff will work with the Bureau of Health Professions and a panel of national experts in health care access, to craft revisions to the current rules. JSI will be responsible for conducting extensive analysis in support of the factors being considered for inclusion, and ultimately for evaluating the likely impact of the changes adopted on the existing safety net infrastructure nationwide.
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Uniform Data System for Urban Indian Health Program
The Indian Health Services' Urban Indian Health Program (UIHP) contracted with JSI to manage the data collection, validation and dissemination of the Uniform Data System (UDS) data and to assure that timely and accurate data is available to users of the information. The UDS is a sophisticated, highly technical and constantly-evolving reporting system. The activities performed under this contract assure that the UDS data is accessible in formats that are useful.
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Public Health Emergency Preparedness (PHEP) Data Collection and Reporting Training Project
JSI is contracted by the Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR) to provide training and technical assistance (TA) on the collection and application of Public Health Emergency Preparedness data collection for program evaluation and monitoring activities aimed at program planning, management and improvement. Specific tasks under this contract include:

1) Design and develop a technical assistance and training program for 62 state and territorial health departments to enable them to continuously improve their capabilities and capacities and to accurately report on their progress;
2) Develop and conduct technical assistance and training to CDC staff and contracted staff so they can provide assistance to grantees in support of program monitoring and improvement;
3) Design and conduct surveys to support an evaluation of the Centers for Public Health Preparedness training program, a training needs assessment for the CDC Responder Workforce, and an evaluation strategy for assessing the PERFORMS training program; and
4) Provide logistical support for the Public Health Response Certificate Program in 2009 and 2010.
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Evaluation of SPAN Prisoner Release Program
JSI is the evaluator for SPAN's prisoner release substance abuse prevention program. Data are collected at baseline by SPAN and at six months post-enrollment using SAMHSA's GRPR survey. JSI is responsible for conducting 6 month follow-up interviews and entering GPRA surveys from baseline and followup into the system.
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Capacity Building for Smoking Cessation
The JSI Research & Training Institute was hired by the Massachusetts Department of Public Health to provide technical assistance and build the capacity of eight community-based tobacco control programs across Massachusetts to manage and implement free nicotine replacement therapy (NRT) patch giveaway programs. JSI developed a template to guide community agencies and organizations in planning, promoting, and conducting the programs and provided on-going support throughout the process. A Toolkit developed by JSI included a ToDo List and activity timeline, tools for enlisting partners, promoting events, planning and holding a press conference/launch event, conducting giveaways in-person in the community, assisting people in calling for help from the Massachusetts Tobacco Quitline, and sample materials for each stage of the process.
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Evaluating Telemedicine to Improve Access and Efficiency at California CHCs
JSI Research & Training Institute, Inc. has been hired by the California HealthCare Foundation to evaluate three telemedicine demonstration projects being implemented at community health centers in California. Two are urban focused programs in the San Francisco and Los Angeles areas, while the third is a rural health program in the far northern counties of California. Each of the clinics and networks chose a telemedicine model, using telecommunications and information technologies to provide health care remotely, to meet the needs of their patient populations.

JSI will be evaluating perceptions of improvements from the patient, provider, and staff perspectives, as well as the impact of telemedicine on access to specialty services by low-income and uninsured patients.

JSI will produce three case studies that will highlight the challenges to implementation and sustainability, the potential for replication of programs, and key factors for success of these models.
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RHInterchange, Improved RH Supplies Management for Greater Contraceptive Security: Creation of a Community of Practice
The RHInterchange (RHI) is a project of the Reproductive Health Supplies Coalition (RHCS) comprised of multilateral and bilateral donors and foundations, as well as representatives from civil society, developing countries, and NGOs. The goal of this effort is to create a community for reproductive health supplies management that is standards- and evidence-based and that makes use of best practices in reproductive health commodity security, especially related to the collection, dissemination, and use of information for supply chain management. The RHI is a web-based tool that currently collects order and shipment information from the central procurement departments of UNFPA, USAID, and IPPF, providing details of each order for each country and program. Following further funding by the Gates Foundation, RHI is now focused on engaging country-based managers to see how this tool might better help in-country supply management. Encouragement of dialogue between and among concerned managers and donors, based upon actual and accurate data, is expected to improve commodity security and better donor harmonization with government-led priorities. The expansion of information to include procurements conducted in-country, as well as program-level forecasts, is the ultimate goal.
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Continuity of Operations Planning for Community Health Centers
JSI worked with the Bistate Primary Care Association to assist Community Health Centers to increase their organizational preparedness to both maintain operations in an emergency and to assist with response. In phase 1 of the project, JSI developed a training program to assist CHCs to develop Continuity of Operations Plans (COOPs). In phase 2 of the project, JSI trained CHC staff in how to implement a tabletop exercise to evaluate the strength of the COOP plan.
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Continuity of Operations Planning for Community Health Centers
The JSI/Community Health Institute in New Hampshire worked with the Bi-State Primary Care Association under contract with the New Hampshire Department of Health and Human Services, Division of Public Health Services (DPHS) to strengthen the ability of agencies receiving Community Health Center (CHC) funding from DPHS to continue to provide health care to low-income and uninsured families throughout New Hampshire under emergency conditions. JSI researched and developed a template Emergency Operations Plan for CHC use, a training for CHC staff, and a Homeland Security Exercise Evaluation Program-compliant tabletop exercise enabling CHCs to test the adequacy of their Emergency Operations Plans.
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New Bedford PCB Exposure Assessment
The JSI Center for Environmental Health Studies was contracted by the Bureau of Environmental Health at the Massachusetts Department of Public Health to conduct interviews with residents of New Bedford to determine PCB exposure levels associated with New Bedford High School, Keith Middle School, and adjacent neighborhoods. New Bedford High School was built on land formerly used as a burning dump thought to contain PCBs and other industrial waste. Keith Middle School was built across the street on land created from fill removed during construction of the high school. New Bedford High School was also constructed during peak years when building materials, such as caulking and adhesives, contained PCBs.

The interviews were conducted in response to health concerns raised by teachers, staff, former students, and neighborhood residents to identify 100 individuals with the highest potential exposure to PCBs. Those individuals were invited to participate in free PCB blood/serum testing.
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Public Health Preparedness Technical Assistance
JSI was contracted by the NH Department of Health and Human Services Division of Public Health Services (DPHS) to provide technical assistance to NH's 19 All Health Hazards Planning Regions (AHHRs). These regional planning groups are charged with developing Public Health Emergency Preparedness and Response Plans including contingencies for medical surges, community containment, mass prophylaxis, and risk communications for public health emergencies, such as pandemic influenzas ("swine" flu or avian flu). Also as a part of this project, JSI worked with DPHS and NH Homeland Security and Emergency Management to implement a one-day statewide emergency preparedness conference.
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Public Health Preparedness Training
The NH Department of Health and Human Services contracted with JSI to provide or assist NH DHHS in providing training to public health emergency planning partners in NH's 19 All Health Hazards Planning Regions (AHHRs) to increase public health emergency response capacity. These regional planning groups are charged with developing Public Health Emergency Preparedness and Response Plans for medical surge, community containment, mass prophylaxis, and risk communications for public health emergencies, such as pandemic influenzas ("swine" flu or avian flu).

JSI conducted a training needs assessment to inform the development of skills-based training programs that fit into the ongoing planning work of the 19 AHHRs. Priority training topics identified in the first year were: continuity of operations planning for facilities serving functional-needs populations, crisis and emergency risk communications procedures for local public health officials, defining local roles in isolation and quarantine implementation, rolling out Homeland Security Exercise Evaluation Program (HSEEP) Training Programs, and developing a train-the-trainer course enabling regional planners to orient municipal officials to public health emergency plans.
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Evaluation of the Youth Offender Re-Entry Program
The Youth Offender Re-Entry Program (YORP), funded under a SAMHSA/CSAT grant, uses a case management-focused treatment and re-entry model to support young people released from incarceration into North Shore communities in Massachusetts. Many of these clients have histories of substance abuse as well as co-occurring mental health disorders. The YORP program provides case management motivational counseling, re-entry planning, treatment and referrals toward developing and sustaining linkages between clients and service providers in the community. Through a team-based evaluation approach, JSI works collaboratively with program administrators and staff to define key evaluation questions, develop data collection measures that effectively capture program efforts, and to present relevant program data in a formative manner toward promoting ongoing, reflective program improvement.
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New Hampshire Health Professional Shortage Area (HPSA) Analysis
The NH Office of Rural Health and Primary Care has, for many years, contracted with the Community Health Institute/JSI (CHI/JSI) to conduct health care capacity shortage designations and to provide technical support covering all aspects of HPSA/MUA/P designations. This includes tracking and processing designation renewals, assessing and preparing new designations, working with providers and community members interested in programs accessed through various designations, interfacing with the federal Office of Shortage Designation (OSD) staff, and developing/maintaining a GIS (mapping) enabled database of all pertinent information related to designations and the designation process.

In 2009, the CHI worked with the NH DHHS, the Board of Medicine, and the Governor's office to develop and field the state's first comprehensive physician capacity survey.
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Connecticut Statewide Health Information Technology Plan
JSI Research & Training Institute, Inc., collaborated with the Connecticut Department of Public Health to develop a statewide strategic plan for implementing health information technology (HIT) and an electronic health information exchange (HIE), as well as a Regional Health Information Organization (RHIO) to manage and oversee the overall plan. In support of that effort, JSI conducted an extensive information gathering process with stakeholders from across Connecticut within four key focus areas.
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CDC HIV Prevention Capacity Building Assistance Program
With funding from the Centers for Disease Control & Prevention, JSI/Denver was responsible for a five-year program to implement a Capacity Building Assistance (CBA) Program for the CDC (directly funded) community-based organizations (CBOs), health departments (HDs) and (health department-funded) CBOs that addressed the HIV prevention needs of Latinos in the CDC-defined Mid-West Region of the United States (CO, IA, KS, MO, MT, NE, ND, SD, UT, WY). The goal of this program was to improve the capacity of CBOs and HDs to implement, improve, and evaluate HIV prevention interventions for high-risk Latino individuals of unknown serostatus, including pregnant women, and people living with HIV/AIDS and their partners.
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Vermont State Plan on Dementia
Under contract with the Vermont Department of Disabilities Aging and Independent Living JSI developed a State Plan on Dementia which outlined the strategic programming to improve existing services for persons with Alzheimer's disease and related disorders as well as project the future service needs of the population.

Download the Report
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Latina Rompiendo Barreras de Salud (Latina Breaking Health Barriers)
Latina Rompiendo Barreras de Salud (Latina Breaking Health Barriers) is a community-based participatory research project funded by the Massachusetts Department of Public Health to engage Latinas in Lawrence, Massachusetts in identifying barriers, challenges, and gaps in their reproductive and family planning knowledge and use of services. Through this project, JSI and it's partner, Health Quarters, researched traditional practices and products used by Latina for reproductive health that are brought to the United States from their country of origin, purchased in bodagas or botanicas, or made at home. Results will be used to validate practices that are useful and beneficial and to educate women of those that may not work and could even be harmful. The final report of three Focus Groups presents the study findings. A survey is also being conducted to gather information from a larger segment of the community and a final report will be available in August, 2010.
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Assessment of the Needs of People Living with HIV/AIDS in Massachusetts and the Boston EMA
JSI Research & Training Institute has been awarded contracts with the Boston Public Health Commission (BPHC) and the Massachusetts Department of Public Health (MDPH) to conduct a coordinated assessment of the needs of people living with HIV (PLWH) in Massachusetts and the Boston Ryan White Part A Eligible Metropolitan Area (Boston EMA), which includes southern New Hampshire. The goal of the project is to assess and describe the need for HIV care and support services, barriers to accessing services, and experiences living with HIV & AIDS, including quality of life, stigma, self-sufficiency, and other challenges. The project used mail, online, phone, and field-administered surveys to reach PLWH, including those in care and harder-to-reach populations. Data collected will help drive planning and policy decisions at MDPH and BPHC.
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BPHC HIV Services Consumer Satisfaction Survey
JSI was awarded a contract by the Boston Public Health Commission (BPHC) to develop and administer a satisfaction survey of people living with HIV/AIDS (PLWH) who are consumers of Ryan White Part A-funded services (including HIV case management, food, and peer support services). The survey, distributed to 2,200 PLWH living in the 10 counties of the Boston eligible metropolitan area (EMA), assessed satisfaction with the quality and accessibility of services, as well as the role of these services in PLWH's health care and quality of life.

JSI prepared a detailed report of the survey results, and presented the data to the Boston EMA HIV Health Services Planning Council in late May 2008.

Download the report
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Lyme Disease Assessment
Massachusetts consistently ranks in the top ten states in the US in reported Lyme disease cases, and its numbers are decidedly on the rise. JSI was contracted by the Massachusetts Department of Public Health, Bureau of Communicable Disease Control, to conduct a statewide needs assessment to explore the public's perceptions, knowledge, attitudes, and preventive behaviors with respect to Lyme disease, and to gain a better understanding of primary care providers' experiences, practice patterns, and knowledge of Lyme disease.

The goal of the project was to provide information to the Massachusetts DPH that would guide them in their efforts to reduce the overall incidence of Lyme disease and promote community awareness, while also encouraging prompt recognition, appropriate diagnosis and effective treatment of the disease by the medical community.

MA Lyme Disease Needs Assessment Final Report
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Underserved Audience Assessment for Waquoit Bay Reserve
JSI is working with the Waquoit Bay National Estuarine Research Reserve on Cape Cod to conduct a community cultural assessment that will obtain information about the demographics, beliefs, and interests of populations which don't speak English as a primary language living in the Reserve watershed area. The goal is to assist the Reserve to develop a well-targeted program that will better engage underserved populations in the Reserve's activities, both to enrich their lives, as well as enlist them as better stewards of the coast.
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Community Health Needs Assessment and Community Engagement Project
Northeast Health System (NHS) is a coordinated network of hospitals, long-term care organizations, behavioral health services, and clinicians serving Massachusetts' North Shore communities.

JSI was engaged by Beverly Hospital and NHS to conduct a needs assessment and community engagement initiative to guide Beverly Hospital's efforts to improve the area's health status, ensure that its services and community health programs are responsive to the communities they serve, and build working partnerships with the communities and other stakeholders in the area.

Beverly Hospital Community Health Needs Assessment Executive Summary
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Tri-Town CHC Needs Assessment and FQHC Development Project
Tri-Town Community Action Agency is a community-based, multi-purpose organization based in Johnston, Rhode Island, that is committed to providing quality, comprehensive health care, social, and advocacy services to individuals and families in need. Tri-Town operates a broad array of programs, including a comprehensive community health center, that are tailored to meet the needs of those at-risk in its service area.

JSI was engaged by Tri-Town to assist them to conduct a brief community health needs and health center operational assessment. However, the primary aim of the project was to assist the agency to develop and submit a Federally Qualified Health Center Application to the Bureau of Primary Health Care so that Tri-Town could become a 330-funded FQHC. JSI staff conducted the needs assessment, a comprehensive operational and program assessment, and then worked with Tri-Town staff to write and submit the application, which was funded in early 2009.
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Innovative Strategic Solutions, Inc: Build Her Up (BHU) Project
The Build Her Up Project was an HIV/AIDS and violence-prevention community level collaborative based in Boston, MA and funded as a demonstration project by the Office on Women's Health. The project provided weekly girl-centered, gender-specific HIV and violence prevention education group sessions with predominantly Black/African American girls ages 9-17 living in low income neighborhood of Boston to reduce involvement in violence, juvenile delinquency and HIV/AIDS/STI risk taking behaviors by building up girls' critical thinking and analytical skills, self-esteem, and positive peer relationships. JSI conducted the evaluation of the program including development of a logic model, data collection tools, database for data entry, process monitoring system and tools, data collection training for program staff, data analysis and reporting preparation, and conducted focus groups.
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New Hampshire Youth Vision Assessment
JSI was contracted by the Workforce Community Council, Inc. to conduct a needs assessment and gap analysis of youth between the ages of 16 and 25 served by the Manchester, NH, district office.

Working under the direction of the NH Youth Vision Team, a group of federally-funded youth agency stakeholders committed to serving youth in need of state care, JSI is gathering quantitative and qualitative data from key participants and stakeholders in services for out-of-home care youth.
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CHATT Conference
The Department of Health and Human Services, Food and Drug Administration has awarded JSI Research & Training Institute a five-year grant to provide conference planning services to the Colorado Health and Treatment Task Force (formerly the Colorado HIV/AIDS Treatment Task Force). Tasks include speaker management, negotiating conference expenses, registration management as well as evaluation services for the meeting.
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Training Adolescent Family Life Grantees
U.S. Department of Health and Human Services contracted with JSI Research & Training Institute, Inc., to provide technical assistance and training over 12 months to Adolescent Family Life grantees under the Office of Adolescent Pregnancy Programs (OAPP/AFL). Adolescent Family Life demonstration and research projects are focused on the prevention of adolescent pregnancy and on interventions for pregnant and parenting adolescents, their babies, and their families.

JSI is responsible for identifying relevant training needs and topics for AFL project providers and staff, recommending appropriate experts in the field for presentations, and providing logistical support for on-site workshops as well as net-conferences. By the end of the contract, JSI will have hosted six net-conferences and nine technical assistance workshops at locations throughout the United States, and developed two e-training modules.
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Vermont Prison Rape Elimination Act Project
The VT Dept. of Corrections contracted with JSI to develop program monitoring procedures for the Prison Rape Elimination Act (PREA) program; to develop measurements for the cultural assessment process related to the identification of sexual assault indicators and staff and inmate perceptions of safety in the system; to develop data collection and reporting mechanisms to improve existing surveillance activities on incidents; and to construct a database that supports this process.
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UDS Data System
Since 1999, the BPHC has contracted with John Snow, Inc. (JSI) to manage the data collection, validation and dissemination of the Uniform Data System (UDS) data and to assure timely and accurate data is available to users of the information. The UDS is a sophisticated, highly technical and constantly evolving reporting system. The activities performed under this contract assure that the UDS data is accurate and accessible in formats that are useful.
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Children's Health Fund Consultation
Children's Health Fund (CHF) contracted with JSI to evaluate its "medical home-plus" model and special asthma and mental health initiatives with an aim to developing curricula allowing replication of its programs by other organizations. The resulting manuals will incorporate an evaluation plan identifying appropriate process and outcome measures, and include approaches to surveying parents and teachers in order to assess links between asthma care/mental health care and academic performance.
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Male Reproductive Health Institute
Given the different attitudes and expectations that men and women have toward health care, it is apparent that involving men in their own care requires a different approach from that which has been successful with women in family planning clinics. Equally, many family planning clinics that have traditionally focused services on females require improvements in customer service to achieve gender parity.

In order to increase males' participation in reproductive health care activities, focused training is necessary to assist Region VIII Title X grantees in developing and refining approaches to draw men into Title X family planning services. JSI worked with the Regional Health Administrator (RHA) and the Region VIII Office of Family Planning (OFP) to plan and conduct a one day Male Reproductive Health Institute.
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Evaluation of Vermont's Alzheimer's Disease Demonstration Grant to States Programs
The incidence of Alzheimer's Disease or a related disorder (ADRD) is expected to increase significantly as the population ages. In Vermont more than 20% of the state's population will be over the age of 65 by 2020, making it the second "grayest" state in the nation and as such, disproportionately impacted by ADRD. JSI performed an evaluation of Vermont programs funded by the Administration on Aging's Alzheimer's Disease Demonstration Grant to States including the Caregiver Bridges Project, Dementia Respite Grant Program and professional education for the Vermont Department of Disabilities, Aging and Independent Living.

JSI's evaluation of these programs presents important considerations for other states which may be planning the development of similar interventions and programs. Download report
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NH Healthy Eating Active Living Initiative
JSI was contracted by a partnership of foundations and state agencies in New Hampshire to develop a statewide plan for promoting healthy eating and active living to improve health and quality of life for all NH residents. JSI facilitated a process led by a statewide Steering Committee composed of representatives from schools, health care industry, businesses, communities, and government.

Five workgroups were established to prioritize policy, educational and programmatic interventions to promote individual wellness, including: schools, health care industry, worksites, food and recreational industry, and community. A statewide conference was convened to present the recommended interventions by sector.

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Download HEAL Executive Summary
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Black Lung Clinic Program Evaluation
The Black Lung Clinic Program (BLCP), under the auspices of HRSA's Office of Rural Health Policy, was established to provide support for health clinics to evaluate and treat coal miners with respiratory impairments. Located in 11 states throughout the Mid-Atlantic and the East North Central portion of the Midwest, BLCP-funded clinics provide unique pulmonary and respiratory care as well as outreach and education through 16 community-based organizations.

The goals of the project are to 1) determine the number and location of current and retired miners living in the US, and 2) conduct a general program assessment, including an in-depth cost study. Through these efforts, the Office of Rural Health Policy hopes to gain important information that will help them improve outreach efforts, guide grantee technical assistance activities, and ultimately, improve the overall quality of services to the target population.
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Vermont 340B Drug Pricing Program
Heinz Family Philanthropies contracted JSI to write a concept paper for the State of VT, Dept of Corrections, that presents options for operationalizing a 340B Drug Pricing Program in VT facilities. Specifically, this paper was written using Federally Qualified Health Centers as the preferred provider of medical services and the most viable qualifying entity for this type of program (340B).
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Choctaw Tribal Healing to Wellness Court Evaluation
The Choctaw Nation Tribal Court subcontracted with JSI to provide technical assistance and evaluation services in the development of their Tribal Healing to Wellness Court. This specialized court provides intensive case management services for substance-abusing offenders. Evaluation activities included the development of a client tracking database and quantitative and qualitative data collection.
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VT Pandemic Flu Community Mitigation Planning
It is highly unlikely that the most effective tool for mitigating a flu pandemic (i.e., a well-matched pandemic strain vaccine) will be available when a pandemic begins. This means that we must be prepared to face the first wave of the next pandemic without vaccine and potentially without sufficient antiviral medications. Therefore, pandemic mitigation plans need to be developed based upon nonpharmaceutical interventions that rely on State agencies and local communities to implement until each wave of pandemic flu subsides, or sufficient pharmaceutical interventions become available.

JSI was contracted by the Vermont Department of Health to develop a planning document for state government and communities designing local and statewide Pandemic Flu Community Mitigation Plans. In order to accomplish this, JSI staff worked with a statewide committee composed of state representatives and eight subcommittees composed of state staff and community organizations. The resulting document consists of operational guidelines that target foundational components for future planning and implementation of pandemic flu readiness activities. In addition, the document sets forth criteria, providing a framework for planning processes and preparedness activities which address nonpharmaceutical interventions to mitigate pandemic flu.
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CCHN Primary Care Fund Review
An increase in Colorado's tax on cigarettes and tobacco products became effective January 1, 2005 and created a cash fund that was designated for health-related purposes, including a Primary Care Fund serving the medically indigent. These dollars are allocated to health care providers in proportion to the number of medically indigent patients served. JSI developed a protocol for certifying these numbers and conducted on-site certifications for ten applicant agencies.
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Needs Assessment of Grandparent Caregivers in Dona Ana County, New Mexico
More than 2.4 million grandparents in the US are raising 4.5 million children - numbers that have risen steadily since the 1970s. Geographically, the southern states of the US have the highest rates of grandparent co-residents and grandparents who are responsible for raising their grandchildren. In 2004, the New Mexico State Legislature awarded funds to the Housing Authority of the City of Las Cruces to provide housing options for grandparents and other caregivers raising children (GRCs). To help develop appropriate and effective services to meet the needs of grandparents raising grandchildren, the City of Las Cruces contracted with JSI in 2007 to conduct a comprehensive housing and social services needs assessment in Doña Ana County, NM.

Working with the Housing Authority of the City of Las Cruces, the City of Las Cruces Senior Programs, and the Grandparents Raising Grandchildren Housing Study Committee, JSI surveyed over 100 grandparents raising grandchildren in the county. The results of the survey and the needs assessment were presented to local government officials and community service providers in February 2008.

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Vermont Health Care Provider Education Initiative
The Vermont Department of Health Tobacco Control Program contracted with JSI to provide training and technical assistance around the state assisting medical practices to develop systems to determine the smoking status of every patient at every visit as a standard of care. This included an intervention and fax-referral for smokers for evidence-based assistance. JSI also coordinated the implementation of a pilot project to supply participating providers with nicotine replacement products to be dispensed to patients who were willing to make a quit attempt, but were unwilling to avail themselves of services.
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Nutrition and Physical Activity among Latino Students'--Focus Group Project
In the spring of 2007, JSI was funded by the Massachusetts Department of Education to conduct qualitative focus group research with Latino/-a youth in Massachusetts, ages 11-15. The main purpose of the project was to determine the role of public schools in improving eating habits and increasing their physical activity. The research assessed nutritional and physical activity habits and documented suggestions from focus group participants for schools for improving nutrition and physical activity.
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Westerly, RI Environmental Health Profile
Southeastern Rhode Island communities face unique environmental health concerns. While claiming an abundance of assets in the form of natural resources, several of these communities nevertheless face a combination of concerns that reflect a crossing of rural, suburban, and even urban issues. JSI was hired by citizen advocates to use proceeds from a settlement with a polluting textile mill in Bradford, RI to advance local environmental health in mill communities of Southern Rhode Island. Working to bring residents together with a broad range of community and regional organizations, JSI provided residents with the information and resources to help identify and address the most important environmental health concerns facing their families.
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Evaluating Healthy People, Places, and Practices in the Community
Evaluating Healthy People, Places, and Practices in the Community was an initiative that offered community-based organizations (CBOs) across the country the opportunity to conduct activities promoting improved nutrition, increased physical activity, healthy lifestyle choices, and that provided preventative health screenings.

As a key component of the project, JSI designed and implemented a basic program evaluation for funded projects which included a process, implementation, and outcome focus. After completing their projects, CBOs submitted their evaluations to JSI. Findings from the evaluations were compiled and synthesized in a report that documents the processes behind this type of initiative and includes recommendations based on lessons learned for future initiatives.
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Design of the NH Fit WIC Evaluation Plan
JSI's Community Health Institute (CHI) was contracted by the New Hampshire Department of Health and Human Services, Nutrition and Health Promotion Section to develop an evaluation plan for the NH Fit WIC Program.

NH Fit WIC is a program designed by the NH Women, Infants and Children Program (WIC) to address the emerging health issue of childhood overweight and obesity. Implementation of the Fit WIC Program will strengthen the nutrition education element of the WIC Program by implementing participant-centered nutrition counseling that is focused on behavior change for life.

Developing the evaluation plan was accomplished through a five-step process. Working in collaboration with the Fit WIC staff, CHI consultants: (a) developed a comprehensive review of the implementation strategies, (b) developed evaluation criteria, (c) designed evaluation tools and logic model, (d) pilot tested and redesigned the evaluation plan, and (e) compiled a final NH Fit WIC Evaluation Plan.
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Dutchess County Comprehensive Cancer Control Plan
In Dutchess County, New York (population approximately 295,000), cancer is the second leading cause of death, surpassed only by heart disease. The Dutchess County Department of Health (DCDOH) has shown extraordinary commitment to cancer control in the county through their development of a Dutchess County Cancer Advisory Council (CAC) and commitment to the development of a county-level cancer control plan. As part of this effort, DCDOH hired JSI Research & Training Institute to conduct a comprehensive assessment of cancer prevention, screening, treatment, and support services in the county.

As part of this assessment, JSI conducted several activities, including: an epidemiologic profile of the cancer burden; key informant interviews with key stakeholders; a resource inventory that systematically describes cancer control resources; and focus groups to learn from community health workers, consumers, and potential consumers of cancer services about their perceptions of the availability and quality of those services.

Overall, the findings of the comprehensive assessment could be categorized into three main themes: Information and education; access to care and concern for disparities; and quality of care. These themes and recommendations following from them were developed in greater detail in the full report given by JSI to the Department of Health. Together, these themes and recommendations form a basis and provide direction for the next stage of Comprehensive Cancer Control in Dutchess County.

JSI presented these findings at the FDR Presidential Library in Dutchess County in October 2007. Attendees had an opportunity to provide feedback on the needs assessment at the event and afterwards, prior to the completion of the final document.

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Tobacco and Literacy Education Project
JSI Research & Training Institute collaborated with adult education programs in New Hampshire to develop and field test a series of tobacco education lessons for adult learners in ABE and GED programs. The project's goal was to bring accurate and compelling information on tobacco use health effects and smoking cessation resources to a young adult population with both high rates of tobacco use and low levels of tobacco knowledge, through a channel not traditionally utilized by tobacco educators. For participating adult learners, evaluation findings showed significant gains in understanding of secondhand smoke exposure health effects, and in knowledge of local smoking cessation programs. The lessons are being disseminated to adult literacy instructors and tobacco educators nationwide via professional listservs and the Health & Literacy Special Collection, a website that provides instructional resources and easy-to-read health information to ABE teachers and health educators.

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JSI and World Education, Integrating Tobacco Awareness into Adult Education in New Hampshire Case Study, in Building Effective Collaborations: Organizations and Communities Working Together in Tobacco Control, The American Legacy Foundation, May 2009, p 26.
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REACH 2010 Breast and Cervical Cancer Project
REACH 2010 (Racial and Ethnic Approaches to Community Health) is a national, multi-level program that serves as the cornerstone of CDC's efforts to eliminate racial and ethnic disparities in health.

The Boston Public Health Commission's (BPHC) REACH 2010 initiative focuses on breast and cervical cancer. Under contract to the Boston Public Health Commission (BPHC), JSI is developing culturally competent health promotion materials for consumers and tools for peer educators to address health disparities and inequities in health care access that affect black women and their families in Boston.
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Massachusetts Healthcare-Associated Infections Prevention and Control
The importance of healthcare-associated infections as a cause of preventable illness and death has been recognized increasingly in recent years, and several states have initiated public reporting of individual hospital rates. The use of hospital-specific performance data to stimulate improved quality of care and enhance consumer choice is a controversial area. Several states have initiated mandatory public reporting of such infection rates in the past few years. To determine the Massachusetts approach, the Department of Public Health and the Betsy Lehman Center for Patient Safety and Medical Error Reduction selected JSI Research & Training Institute to coordinate a new statewide Infection Prevention and Control Program in late 2006.

The report from a multidisciplinary panel of experts and 6 working groups charged with examining the problem of prevention, monitoring and cost of healthcare-associated infections, Prevention and Control of Healthcare-Associated Infections in Massachusetts, was released in August 2007, and generated significant local and national press. Moving forward, JSI is designing and implementing the validation plan for HAI data being reported by hospitals since July 1, 2008. Other involvement includes data analysis of specialized surveys including annual MRSA point prevalence surveys, ongoing training and support to hospitals for reporting, plus participation in the statewide Technical Advisory Group.
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Vermont Rural Health and Primary Care Plan
Under contract with the Vermont Department of Health JSI facilitated a strategic planning process to develop a State Plan on Rural Health and Primary Care. The plan is a requirement of the Federal Office of Rural Health Policy as part of the funding requirements for all State Offices of Rural Health. In addition the plan provided guidance for primary care activities and the Rural Hospital Flexibility (FLEX) Program.

Download the Report
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Evaluation and Support to Achieve Healthy People 2010 Objectives for Children and Youth with Special Health Care Needs
This evaluation project is designed to provide the Division of Services for Children with Special Healthcare Needs (DSCSHN) with technical support and expertise to meet its mission of achieving quality community-based systems of services for children and youth with special healthcare needs and their families by the year 2010. JSI is conducting an evaluation and strategic planning to assess the DSCSHN's progress in achieving the Healthy People 2010 Goals and the President's New Freedom Initiative; completing mini-evaluation studies of four initiatives aimed at specific Healthy People 2010 performance measures (Health Insurance, Medical Home, Healthy and Ready to Work and Family/Professional relations); and evaluating and supporting the State Implementation Grantees and National Centers funded under the President's New Freedom Initiative.
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National HIV/AIDS Community Mobilization Campaign Assessment and Evaluation Project
JSI was contracted by the Office of HIV/AIDS Policy to conduct a formative evaluation and evaluation of the National HIV/AIDS Community Mobilization Campaign to determine the impact and efficacy of the scheduled events and activities, the efficiency of their processes and implementation, and whether improvements or enhancements were necessary during the two-year project.
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Uncompahgre Medical Center Strategic Plan
JSI assisted the Uncompahgre Medical Center (UMC) in developing a market analysis that was used as a basis for developing a strategic plan. The plan set the future direction for the clinic and allowed it to respond to the community's needs.
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Analysis, Information Management, and Communications Activity (AIM)
The Analysis, Information Management, and Communications Activity (AIM) provides the U.S. Agency for International Development (USAID) with evidence-based information and services to guide the design and management of the Agency's Bureau for Global Health (GH). AIM is committed to helping USAID achieve its strategic objectives in such critical global health concerns as HIV & AIDS and other infectious diseases, nutrition, family planning, and reproductive, maternal, and child health. Analyses of public health issues and research topics by AIM staff guide the technical direction, leadership, and services that GH provides to USAID Missions worldwide. AIM's knowledge management staff delivers technology solutions for tracking and reporting on USAID health programs worldwide. AIM's communications team expands awareness of GH's programs and achievements to key stakeholders through design, editing, and production of print and web-based publications; development and maintenance of GH's external and internal websites; planning and support for live meetings and events; and product evaluation.
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Ryan White HIV/AIDS Data Training and Technical Assistance Cooperative Agreement
From 2005 - 2009, JSI collaborated with HRSA's HIV/AIDS Bureau (HAB) on the National Data Training and Technical Assistance Center to help Ryan White HIV/AIDS Program grantees improve the collection, quality, reporting and utilization of their program data. JSI conducted a comprehensive needs and capacity assessment with 101 Ryan White Program grantees from across the country to assess their data management and reporting capacity, and identify their related TA needs. In an extension of this inquiry, JSI then conducted a qualitative RFI with 18 of these same grantees to assess current Pap test documentation and reporting practices.

Based on these findings, JSI developed several online tools including the project website, dataCHATT, a series of web conferences, and an online training program, Data Academy. dataCHATT (http://www.datachatt.jsi.com) served as a comprehensive website for Ryan White grantees to access resources and request on-site technical assistance. In 2008 and 2009, JSI coordinated four web-based TA conferences that were attended by nearly 400 grantees, covering topics including data security, getting data from contracted providers, and HIPAA and data sharing. All web conferences are archived on the TARGET Center website (www.careacttarget.org).
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Open Door Evaluation
JSI evaluated a unique model to build cultural competency for working with lesbian, gay, bisexual and transgender seniors throughout the elder services network in Massachusetts. The evaluation employed qualitative and quantitative methods to measure the effectiveness of the Open Door Program through both process and outcome measures. Various perspectives were incorporated into the evaluation including AAA/ASAP executive directors, Task Force members, the Open Door Program Director and Open Door advisory board members.
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Program Evaluation Monitoring System (PEMS)
JSI completed a five-year cooperative agreement with Centers for Disease Control and Prevention (CDC), providing national training and technical assistance to more than 220 community-based organizations and health departments as they use the Program Evaluation Monitoring System (PEMS) to enter data on HIV prevention services provided at the local level.

JSI supported grantees with program monitoring and evaluation strategies, data use, report analysis, and tailored TA plans. JSI was responsible for training new PEMS users at the local level, as well as PEMS administrators and implementation coordinators. In addition, JSI developed evaluation field guides for seven EBI (Effective Behavioral Intervention) and two Public Health Strategies for national deployment.
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Assessing HIV Care Quality and Measuring Clinical Outcomes in Title I CARE Act Funded Clinics
The Boston Public Health Commission has contracted with JSI Research & Training Institute to conduct a series of quality assurance chart reviews at Title I funded primary care sites. As part of the CARE Act Title I Quality Management program (required by the Ryan White CARE Act Reauthorized Legislation of 2000), JSI has developed a flexible and comprehensive quality assurance/continuous quality improvement plan (including protocol, instruments and software) for use in CARE Act Title I primary care funded sites
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Infertility Prevention Project - Region 8
JSI received supplemental funds from the CDC to coordinate infrastructure activities in Region 8 for a national infertility prevention program. The program was based on the premise that timely treatment for Chlamydia trachomatis can reduce the debilitating complications caused by this sexually transmitted disease, including pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. The program's goal is to provide routine screening and treatment services for Chlamydia trachomatis infection in family planning and sexually transmitted diseases clinics. JSI advised the program on data collection and maintenance, service protocols and the development of quality assurance systems. JSI also evaluated regional data, and coordinated trainings as well as regular advisory committee meetings.

The project continues under a new contract
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Try-To-Stop Tobacco Resource Center
JSI managed an integrated and comprehensive multi-state tobacco control effort for the Massachusetts, Rhode Island and New Hampshire Public Health Departments. The projects served the general public, tobacco control professionals, educators, and health care providers.
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Regional Quality Indicators Project (RQIP) - Region VIII
Since 2001, JSI Denver has coordinated the RQIP with the Region VIII Family Planning Program Grant Directors to implement a set of quality indicator tools and collect data using the tools at a number of pilot sites throughout Region VIII. The Region VIII Regional Quality Indicators Project (RQIP) was developed to assist Region VIII Title X family planning clinics with the collection of quality assurance data for the purpose of improving the services offered by the clinics. RQIP utilizes a defined set of common indicators to evaluate the quality of care provided in Region VIII Title X family planning clinics. For the needs of the RQIP process, the focus is on quality indicators related to reproductive health. The goal of the project is to enable the family planning clinics to monitor and ultimately improve the quality of care they provide, by implementing performance measurement and quality assurance systems. The purpose of the project is to enable the Title X programs to communicate the quality of the services provided by their clinics.
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Ryan White CARE Act Grantees, Service Providers and Coalitions
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act provides services and treatment for people living with HIV and AIDS throughout the United States. JSI provided assistance to Ryan White CARE Act grantees, HIV/AIDS service providers and community coalitions nationwide to assist them in providing effective services to improve the lives and well-being of individuals and families living with HIV/AIDS. JSI provided the assistance through the HIV/AIDS Bureau of the Health and Resources Services Administration (HRSA), as well as working directly with states, eligible metropolitan areas (EMA's), and community-based organizations. We provided technical expertise to identify needs, develop comprehensive plans, ensure effective consumer input, organize and finance services, and develop quality management programs. JSI was also responsible for the development of training programs, manuals and web-based resources projects.
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Perchloroethylene (PCE) Cape Exposure and Its Impact on Reproductive Outcomes
JSI collaborated on a study to measure the impact of PCE (also known as tetrachloroethene) exposure on reproductive and developmental outcomes under a subcontract to the Boston University School of Public Health. Studies on the risk of reproductive and developmental toxicity associated with PCE exposure have shown numerous adverse effects among animals and humans. During the period 1968 to 1983, tens of thousands of Cape Cod residents were exposed to PCE when it leached from the vinyl lining of asbestos cement drinking water pipes. This was a population-based retrospective cohort study including approximately 1,750 Cape Cod children and their families.
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Women of Color AIDS Council
The MA Department of Public Health contracted with JSI to provide technical assistance services and to serve as the fiscal conduit for the Women of Color AIDS Council (WCAC) in Boston, Massachusetts. WCAC is a peer-led, consumer-driven, community-based organization providing HIV education, drop-in services, advocacy, and peer support for women of color in Boston. The goal of the partnership between WCAC and JSI was to assist WCAC in building its organizational capacity in the areas of financial management, program development and sustainability. In partnership with JSI, WCAC has strengthened its infrastructure capacity, developed new program initiatives and been successful in its pursuit of additional resources.
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