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An Analytic Framework for Effective Public Health Program Design Using Correctional Facilities

Journal(s): Informs Journal on Computing
Published: March 12, 2021
Author(s): Özgür M. Araz, Mayteé Cruz-Aponte, Fernando A. Wilson, Brock W. Hanisch, Ruth S. Margalit

General Description
Public correctional facilities play an important role in operational execution of several public health programs, including screening and treatment of sexually transmitted diseases. However, because of lack of capacity and resources, public health programs using correctional facilities are questioned by policy-makers in terms of their costs and benefits. We developed a computational epidemiology model to support public health policy making, and used data from Douglas County, Nebraska, to investigate and evaluate the effects of potential universal screening within the jail system. This study contributes to the computational epidemiology literature by presenting an analytical framework to guide effective simulation experimentation for policy decision making. The presented methodology can be applied to other complex policy and public health problems.

Academic Abstract
We present a decision analytic framework that uses a mathematical model of Chlamydia trachomatis transmission dynamics in two interacting populations using ordinary differential equations. A public health survey informs model parametrization, and analytical findings guide the computational design of the decision-making process. The potential impact of jail-based screen-treat (S-T) programs on community health outcomes is presented. Numerical experiments are conducted for a case study population to quantify the effect and evaluate the cost-effectiveness of considered interventions. Numerical experiments show the effectiveness of increased jail S-T rates on community cases when resources for a community S-T program stays constant. Although this effect decreases when higher S-T rates are in place, jail-based S-T programs are cost-effective relative to community-based programs.

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