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Dental Care Utilization Among U.S. Children Participating In Early Head Start Programs, Ahlam Ibraheem Joufi

Health Services Research Dissertations

Early childhood caries (ECC) remains one of the most common preventable diseases among children under the age of 6 years. Several national stakeholders recommend establishing a continuous collaboration of individuals involved with receiving oral health services (dental home) and routine dental care for the child by 12 months. Despite this recommendation, disparities exist among young, low-income children in preventive dental service utilization. The Early Head Start (EHS) program serves low-income children aged 0-3 years and their families and promotes oral health practices and service utilization within the program. This study aims to examine predictors of dental care utilization among children …

Tobacco Smoking Among Saudi College Students: Validation Of An Arabic Health Belief Model Instrument, Saad Abdullah S. Alotaibi

Health Services Research Dissertations

This dissertation intended to learn more about Saudi college students' behavior in relation to the use of tobacco smoking. Multiple interrelated projects have been carried out in order to achieve this ambitious goal. The goal of the first study was to evaluate the scope of the existing smoking issue as indicated by research, by systematically estimating the prevalence of tobacco use among higher education students in Saudi Arabia. The second study aimed to systematically analyze and integrate the existing information on the determinants of smoking among Saudi college students. The last project aimed to develop a psychometric instrument to evaluate …

Predictors Of Dental Students’ Behavioral Intention Use Of Teledentistry: An Application Of The Unified Theory Of Acceptance And Use Of Technology (Utaut) Model, Jafar Hassan Alabdullah

Health Services Research Dissertations

Shortages of dental professionals and access barriers to dental care are challenges to improving oral health and decreasing the burden of dental diseases. There are more than 57 million individuals in the U.S. who live in dental health professional shortage areas (DHPSA). The U.S. DHPSA areas need 9,951 dental practitioners to overcome the obstacles to oral care access. Due to dental care needs for these populations, it is imperative to find a new method to reach these underserved populations. Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Unfortunately, there is …

Examine Predictors Of Bmi Classification And Perception Of Overweght Status Of Caregivers Of Preschool Children, Beth H. Chopp

Health Services Research Dissertations

Since the 1970’s the rate of childhood obesity in the United States has tripled and now one in five school-aged children is obese (Ogden et al., 2016). The childhood obesity epidemic will have medical, social, economic implications for future generations. Risk factors for childhood obesity include genetics, food intake, and physical activity, maternal health during pregnancy, parental weight, maternal employment and sociodemographic influences. This study examined the relationship between caregiver misperception of their preschoolers’ overweight/obese weight status and possible predictors that may assist in future interventions. The study evaluated NHANES data of 1245 caregivers with a child under age five …

Asthma-Related Health Outcomes In New Jersey After A Natural Disaster Event, My Ngoc Thuy Nguyen

Health Services Research Dissertations

The occurrence of a natural disaster event such as a hurricane may further hinder the asthma management of asthmatic individuals. Unmanaged asthma has led to increased work absenteeism, preventable emergency department visits, costly hospitalizations and possibly death in severe cases. To improve asthma management in asthmatic adults in New Jersey (NJ) following a natural disaster event, this study examined whether predisposing, enabling and need factors are predictors for asthma exacerbation and asthma-related health care utilization in New Jersey. A retrospective secondary analysis of New Jersey Behavioral Risk Factor Surveillance System (NJBRFSS) data and New Jersey Asthma Call Back Survey (NJACBS) …

A Model To Predict Pre-Hospital Endotracheal Intubation Success, Leigh Ann Diggs

Health Services Research Dissertations

Background: Pre-hospital endotracheal intubation (ETI) is one of the most critical skills performed by paramedics and is considered the “gold standard” of airway management. Pre-hospital ETI success rates are variable, ranging from 33% to 100% across EMS systems in the U.S. Previous investigative efforts have identified factors associated with pre-hospital ETI success, but the generalizability of findings is limited. Few researchers have controlled for the concurrent effects of multiple factors when examining pre-hospital ETI success. Methods: In this retrospective exploratory study, we used national data from the National Emergency Medical Services Information System (NEMSIS) and data from a four state …

Diabetes Status, Predisposing, Enabling, And Oral Health Illness Level Variables As Predictors Of Preventive And Emergency Dental Service Use, Sabha Alshatrat

Health Services Research Dissertations

The purpose of this study was to clarify the relationship between diabetes and dental service use. This study addressed the question of whether individuals with diabetes are more or less likely to utilize dental services, measured in terms of preventive and emergency services during the past year. A cross-sectional study was conducted to assess the contributions of diabetes status to dental service use, relative to the contributions of Andersen and Newman Framework of Health Services Utilization dimensions (predisposing, enabling, and illness variables) in predicting dental service utilization during the past year using a nationally representative sample from a 2001-2002 National …

Factors That Influence Nonadherence Outpatient Medical Follow-Up By African Americans With Hiv/Aids At An Outpatient Infectious Disease Clinic, Cynthia Burrell Banks

Health Services Research Dissertations

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) does not discriminate among different races, ethnicities or genders; however, African Americans carry a larger burden related to the HIV epidemic than others (CDC, 2010c; Cunningham, Sanchez, Heller & Sohler, 2007; Mugavero, et al., 2009). Persons living with HIV/AIDS (PLWHA) who do not adhere to their medical regimen, including failure to maintain contact with their health care provider for health care monitoring, tend to have poorer health outcomes from the disease as compared to HIV/AIDS patients who adhere to their medical regimen (Cunningham et al., 2006; Lima et al., 2009). African Americans represent …

Using Modeling And Simulation To Improve Oral Health Services Delivery In Hampton Roads, Virginia, Mohammad J. Alzahrani

Health Services Research Dissertations

The purpose of this study is to examine the system performance in delivering oral health services in a public health district based on the Conceptual Framework to Measure Performance of the Public Health System (PHS). Using modeling and simulation, a predictive model based on the conceptual framework dimensions: mission, structural capacity, processes, and outcomes was developed to predict the performance of public health district in delivering oral health services.

This is a retrospective longitudinal study. The main objective of this study is to use a modeling and simulation approach to predict the performance of public health district dental clinic in …

Application Of The Interactional Model Of Cultural Diversity To Identify Diversity Climate Factors Associated With Organizational Effectiveness In Accredited U.S. Physical Therapist Education Programs, Elizabeth Francis Giles

Health Services Research Dissertations

Accredited U.S. physical therapist education programs are responsible for the preparation of its graduates to provide culturally sensitive care to meet the physical therapy needs of an increasingly diverse population. While the importance of workforce diversity has been articulated, the effect of diversity climate on organizational effectiveness within accredited U.S. physical therapist education programs has not been described. The purpose of this study was to evaluate the effectiveness of the Interactional Model of Cultural Diversity (IMCD, Cox, 1993) as a theoretical framework to identify diversity climate factors associated with organizational effectiveness in accredited U.S. physical therapist education programs. A descriptive, …

Psychometric Evaluation Of An Instrument For Assessing Policy Outcomes For Families With Children Who Have Severe Developmental Disabilities: The Beach Center Family Quality Of Life Scale, Joni Taylor Mcfelea

Health Services Research Dissertations

The purpose of the study was to evaluate the psychometric properties of the Beach Center Family Quality of Life Scale (BCFQLS) in a sample of families with children who have severe developmental disabilities. The study sought to determine whether or not the scale could be used to measure the quality of life of such families and to differentiate between the quality of life of two family groups—those whose child lives in the family home and those whose child lives outside the family home.

The study used an observational, cross-sectional design and both qualitative and quantitative methods. Self-identified primary caregivers of …

Application Of The Traditional Epidemiological Model To Predict Occupational Injury Rates In Manufacturing Industries, Gary A. Morris

Health Services Research Dissertations

This study was designed to test the usefulness of the Traditional Epidemiological Model of disease causation in modeling occupational injury rates and the presence of occupational illness in the manufacturing industry. More specifically, this research involved use of the agent, host, and environment constructs of the Traditional Epidemiological Model to examine the effects of five environmental-related workplace health and safety practices on occupational injury and illness. Data from the National Occupational Exposure Survey (NOES), conducted by the National Institute for Occupational Safety and Health (NIOSH) in 1981–1983, were used to ascertain the presence of specific workplace characteristics and to calculate …

Predictors Of Oral Health Behaviors: Examining The Effect Of Patient Perceived Humanistic Attitude In The Context Of The Health Belief Model, Linda Leigh Hawkins Carroll

Health Services Research Dissertations

The purpose of this study was to test the explanatory power of The Health Belief Model with the added environmental condition of perceived humanistic attitude of a dental hygienist in its ability to predict individual's performance of oral disease prevention behaviors. A cross section survey of an intact group of 1,943 full time employees of Old Dominion University was conducted. The response rate was 52% (n = 1001). An exclusionary rule eliminated respondents who did not have a dental hygienist provide preventive services during dental visits. Seven hundred and fifty four were included in the study analyses. The study participants …

A Longitudinal Study Examining The Stability Of Occupational Stressors Identified By Nursing Home Administrators, Gay Lynne Andrucci-Armstrong

Health Services Research Dissertations

As a result of the ever changing and expanding role of the nursing home administrator in conjunction with the stricter legislation governing nursing facilities over the past decade and the graying of America, a study specific to this population was warranted. The purpose of this study is to determine the relative change in the self-reported occupational stressors of nursing home administrators over a five year period (December 1994 to June 1999) secondary to the increased regulatory climate of the nursing home industry.

This study was carried out in three phases and included all practicing nursing home administrators in Virginia. Phase …

A Health System Analysis Approach To Health Outcomes In Medicare Clients With Chronic Illnesses, Christine A. Elnitsky

Health Services Research Dissertations

Since 1863, outcomes measurement efforts have provided information to health care consumers, administrators, and policymakers in assessing concerns about access, quality and costs. With a growing population of older adults with chronic illnesses, cost-cutting strategies in health delivery systems, and federal endorsement of managed care systems, researchers have begun to evaluate the impact of different delivery system organizations on health. The current study combines two areas of health services research to provide the first published hierarchical analysis of the influence of delivery system factors, and a profile of population and community characteristics and utilization factors, on perceived health outcomes of …

Factors Which Affect Post-Hospital Resource Use And Patient Health Outcomes Among Taiwanese Older Adults, Chouh-Jiaun Lin

Health Services Research Dissertations

The purpose of this study was to explore relationships among population characteristics, patient post-hospital resource use and patient health outcomes in terms of the Andersen health behavioral model. An additional purpose of this study was to examine a discharge planning screening instrument used in a large urban hospital in Taiwan to determine if it predicts resource use and patient outcomes. A longitudinal research design was adopted for this study. Data were collected from the general medicine departments of an 800-bed university teaching hospital. Out of 109 patients who were interviewed, 78 participants qualified (participation rate = 71.6%).

The majority of …

A Comparison Of The Utilization Of Health Services In The Presence Or Absence Of Prescriptive Drug Insurance In A Managed Care Environment, Martha Groblewski

Health Services Research Dissertations

This study tested if the availability of third party payment for prescriptive drugs as part of employer sponsored health insurance was associated with a change in the utilization of four types of health services in an independent practice association (IPA). The study employed the individual determinants component of the Andersen-Newman theoretical framework for health services utilization. Groups of employees in companies that offered health insurance identical in all ways except for the presence or absence of the prescriptive rider were included in the study which resulted in a population of 122 companies (89 with prescriptive rider insurance and 33 without …