Open Access Publications

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Open access publications by faculty, postdocs, and graduate students in the Biden School of Public Policy & Administration.

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    Critical facility accessibility and road criticality assessment considering flood-induced partial failure
    (Sustainable and Resilient Infrastructure, 2022-11-25) Gangwal, Utkarsh; Siders, A. R.; Horney, Jennifer; Michael, Holly A.; Dong, Shangjia
    This paper examines communities’ accessibility to critical facilities such as hospitals, emergency medical services, and emergency shelters when facing flooding. We use travel speed reduction to account for flood-induced partial road failure. A modified betweenness centrality metric is also introduced to calculate the criticality of roads for connecting communities to critical facilities. The proposed model and metric are applied to the Delaware road network under 100-year floods. This model highlights the severe critical facility access loss risk due to flood isolation of facilities. The mapped post-flooding accessibility suggests a significant travel time increase to critical facilities and reveals disparities among communities, especially for vulnerable groups such as long-term care facility residents. We also identified critical roads that are vital for post-flooding access to critical facilities. The results of this research can help inform targeted infrastructure investment decisions and hazard mitigation strategies that contribute to equitable community resilience enhancement.
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    Are LARC Users Less Likely to Use Condoms? An Analysis of U.S. Women Initiating LARC in 2008–2018
    (Women's Health Issues, 2022-06-21) Eeckhaut, Mieke C. W.; Fitzpatrick, Katie
    Introduction: Public health professionals have raised concern that increased use of long-acting reversible contraceptives (LARC) could raise women's risk for sexually transmitted infections (STIs), because LARC's superior pregnancy protection may decrease women's motivation to use a barrier method for supplemental pregnancy prevention. This study uses population-based data to examine whether condom use is lower, particularly among young women who are at increased STI risk, after initiating LARC versus moderately effective methods. Methods: With the 2011–2019 data files of the National Survey of Family Growth, we examine the percent of sexually active months with condom use in the year after LARC or moderately effective method initiation for a nationally representative sample of 2,018 women aged 15–44 years. Multinomial logistic models regressed condom use on method type and age group, as well as their interaction, while adjusting for key confounders. Results: The unadjusted likelihood of any condom use is substantially lower among women who initiated LARC versus moderately effective methods (12% vs. 37%), and this difference is greater among younger versus older women. After accounting for differences in women's reproductive and sociodemographic profiles, however, a statistically significant difference in condom use by method initiated remains only for those aged 20–34 years. Conclusions: Crude estimates suggest that condom use is lower after initiating LARC versus moderately effective methods, especially among young women. After accounting for the confounding effects of LARC users’ distinct profiles—particularly in terms of parity and teenage childbearing—the difference is decreased overall and no longer significant for adolescent women. Overall results indicate a need for new STI prevention strategies and policies that emphasize the importance of dual prevention for LARC users at risk of STIs.
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    Ambiguity among Partners: Understanding Power and Perception Under Conditions of Mutuality
    (Perspectives on Public Management and Governance, 2022-10-05) Islett, Kimberley R.; Bryan, Tara K.; St Clair-Sims, Rebekah L.
    Power is a construct that is relevant anytime two actors come together. Typically power examinations have been focused on assessments among actors with asymmetrical power profiles. We argue existing characterizations of power are insufficient to understand perceptions of relationship quality when partners have a more balanced power profile. This is the case with an important class of partnerships—those between governments and philanthropic Foundations. We assessed power mutuality and its effects on relationship quality with a mixed methods approach, relying heavily on fuzzy-set qualitative comparative analysis techniques and interview data. Our findings point to new insights into those power relationships typically examined in the extant literature, those with asymmetry, as well as under condition of mutuality. With regard to asymmetrical power, we point to needed investigation into the role of intangible resources, such as knowledge and legitimacy, to achieve goals, rather than the predominant focus on financial and other tangible resources. With regard to conditions of mutuality, we illustrate that mutuality yields relational ambiguity in the relationship and results in partner tension. Furthermore, our study finds that under conditions of mutuality, resource contributions from the benefactor need to address instrumental organizational needs, not just needs that contribute to mission outcomes.
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    Prior Evictions Among People Experiencing Homelessness in Delaware
    (Delaware Journal of Public Health, 2022-08) Metraux, Stephen; Mwangi, Olivia; McGuire, James
    Eviction is frequently a precursor to homelessness. This is an exploratory study that looks at a group of homeless adults who stayed in Delaware homeless shelters in 2019 and the extent by which their homelessness is preceded by an eviction filing. Specifically, we match records of homeless shelter use with records from a court-based database of eviction filings, both in Delaware, to determine the frequency and correlates of prior eviction among adults staying in Delaware shelter and/or transitional housing facilities in 2019. Results show that 21 percent of the people in the study group had records of eviction filings in the 2-year period prior to initial homeless services use. Recent history of eviction filings was much more prevalent among study group members who were homeless with their children (i.e., with families), who were Black, and/or who were female. These findings are consistent with prior research and demonstrate the potential of interventions designed to mitigate eviction to also reduce homelessness, especially among families with children.
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    Utilizing an Equity, Place-Based Approach to Guide Our Collaborative Work on Health Equity in Delaware
    (Delaware Journal of Public Health, 2022-08) McDonough, Kalyn
    When it comes to a healthy community, the University of Delaware’s Partnership for Healthy Communities (PHC) understands that place matters. Through the culmination of lived experiences and empirical research, there is a well-established understanding that there are healthy communities and less healthy communities and that this is a result of varying conditions in these communities, conditions referred to as the social determinants of health (SDoH). These varying conditions have been produced and reproduced through political systems, economic and social policies, and social norms, and resulted in persistent health inequities. PHC utilizes this knowledge and evidence to inform the collaborations and investments with communities that have the most to gain in the state of Delaware. Through a description of its four strategic partnerships, we outline how an equity, place-based approach guides our collaborative work to achieve health equity in our state.
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