For the past three years, Division 38 (Health Psychology) of the American Psychological Association has conducted monthly policy dinner meetings featuring various national health policy experts as guest speakers. The express purpose behind these meetings has been to develop an appreciation within the division for the complexities of formulating public policy. A desirable, though secondary, goal has been to educate guest\ speakers to the potential contributions that psychology could make in various program areas. The resulting dialogues have been stimulating and have opened a number of administrative doors to input from psychologists. The authors urge other APA divisions, committees, and especially state and local associations to initiate their own series of similar meetings. The importance of the profession's developing a first-hand appreciation of the intricacies and truly interdisciplinary nature of the political process governing health care in our nation is especially stressed.The authors would like to express their appreciation for the encouragement and continuing support of Joseph Matarazzo, Stephen Weiss, Neal Miller, and Jerome Singer in their roles as presidents of APA Division 38 (Health Psychology). We would also Jike to express our sincerest appreciation for the volunteer help provided by Hazel Thomas, Patty Camp, and Lisa Jonas, staff of the Association for the Advancement of Psychology.

BackgroundApplying global estimates of the prevalence of mental disorders suggests that about 2.4 million Ghanaians have some form of psychiatric distress. Despite the facts that relatively little community-based treatment is available (only 18 psychiatrists are known to actively practice in Ghana), and that mental disorders are more concentrated among the incarcerated, there is no known research on mental disorders in Ghana prisons, and no forensic mental health services available to those who suffer from them. This study sought to determine the rate of mental distress among prisoners in Ghana.MethodsThis cross-sectional research used the Kessler Psychological Distress Scale to estimate the rates and severity of non-specific psychological distress among a stratified probability sample of 89 male and 11 female prisoners in one of the oldest correctional facilities in the country. Fisher’s exact test was used to determine the rates of psychological distress within the study population.ResultsAccording to the Kessler Scale, more than half of all respondents had moderate to severe mental distress in the four weeks preceding their interviews. Nearly 70% of inmates with only a primary education had moderate to severe mental distress. Though this was higher than the rates among inmates with more education, it exceeded the rates for those with no education.ConclusionsThe high rate of moderate to severe mental distress among the inmates in this exploratory study should serve as baseline for further studies into mental disorders among the incarcerated persons in Ghana. Future research should use larger samples, include more prison facilities, and incorporate tools that can identify specific mental disorders.

Background Tobacco use remains a major public health problem in the U.S. disproportionately affecting underserved communities. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) initiative is an intervention to address the problem using a community-based participatory research (CBPR) approach. Objective This study compares quit rates in a peer-led community-based intervention with those achieved in a clinical setting. Methods The intervention consisted of three Phases. Phase I (n= 404) was a clinic-based trial comparing two types of counseling. Phase II (n= 398) and Phase III (n=163) interventions were conducted in community venues by trained Peer Motivators. Results Quit rates at 12-week follow-up increased from 9.4% in Phase I (clinic-based) to an average of 23.7% in Phases II and III combined (community-based). The main predictor of smoking cessation was delivery of services in community settings (OR=2.6, 95% CI=, 1.7–4.2) while controlling for possible confounders. Conclusion A community-based approach can significantly guide and improve effectiveness and acceptability of smoking cessation services designed for low-income urban populations. In addition, CBPR can result in better recruitment and retention of the participants.

This research determined the levels and odds ratios for low birth weight (LBW) infants delivered under the National Health Insurance Scheme (NHIS) compared to LBW infants delivered under the previous "Cash and Carry" system in Northern Ghana. Birth records of infants delivered before and after implementation of the NHIS in Northern Ghana were examined. Records of each day's births during the identified periods were abstracted. Days with fewer or no births were accommodated by oversampling from days before or after. Chi squared tests of independence were used to examine the bivariate association between categorical independent variables and LBW. Multiple logistic regression models were used to examine the relationships among selected variables for mothers and infants and the odds ratios for LBW. Infants delivered under NHIS had lower rates of LBW (16.8 %) compared to infants born under Cash and Carry (23.3 %). Mothers who delivered under NHIS were significantly less likely to have infants at LBW (unadjusted OR 0.65; 95 % CI 0.49, 0.86). The rate of LBW among infants delivered under NHIS is significantly lower than among infants delivered under Cash and Carry. The rate of LBW under Cash and Carry in 2000 fell by 27 % in relation to the NHIS in 2010. These findings confirm that the NHIS, which gives pregnant women in Northern Ghana four antenatal visits and access to skilled health professionals for delivery at no cost to the mother, significantly improved birth weight outcomes.

The U.S. has the highest rate of incarceration in the world, releasing 12 million ex-offenders each year. These ex-offenders are disproportionately male, Black, poor, under-educated, and unhealthy, and return to our nation's poorest neighborhoods. Through a survey questionnaire and focus groups, this study examined the health status, health needs, access to and utilization of health care services among a sample of ex-offenders living in transitional housing in Baltimore City. More than half reported at least two major, chronic health problems. Only 40% had any form of health coverage; even more predictive of the ability to obtain health services was being able to name a specific provider (doctor, clinic or health organization). Recommendations for halting the downward spiral of poverty and sickness for this population and their communities include providing assistance with accessing, understanding, and navigating our complex and consumer-unfriendly health care system.