Digital Commons Network^™

Evaluating Hospital Community Benefit And Community Health Improvement Requirements, Shelly Johnson

Dissertations

The Internal Revenue Service's (IRS) hospital community benefit standard aims to improve the community's health, it is a test the IRS uses to determine whether a hospital is organized and operated for the charitable purpose of promoting health. Participation in this program is required of all not-for-profit hospitals in the US, who spend billions of dollars annually in community benefit in place of taxes. Hospitals must annually submit IRS form 990 Schedule H and are required to report costs associated with their provision of community benefit spending. In addition, a hospital must conduct community health needs assessment (CHNA) and implementation …

An Examination Of Types Of Health Insurance And The Reported Prevalence Of Autism In The United States, Jennifer L. Thompson

Dissertations

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of …

Developing A Diagnostic Tool Of A Community’S Health, Ruth Kurtycz

Dissertations

Where we live can affect nearly every aspect of our lives, including how long those lives will be. Previous studies have demonstrated large health disparities between communities in the United States; since the health of a community can significantly impact its residents, evaluating and predicting community health is of interest to many people. Currently the Federal government collects and publishes data on community-level demographics, housing, crime rates, and disease. State-level and non-governmental agencies track and share community housing prices, school performance, neighborhood safety, and other characteristics. In short, there is a wealth of information but the work being done around …

Behavioral Economic Modeling Of The Effects Of Symptom, Severity, And Cost On Seeking Medical Care, Mark J. Rzeszutek

Dissertations

While the United States has some of the highest healthcare spending in the world, it has some of the worst health outcomes. For example, maternal mortality in the United States is almost five times as high as in other similarly wealthy countries. It also has the highest rates of avoidable deaths. One of the reasons for this may be the cost of accessing healthcare due to privatized insurance. For example, Americans may avoid important preventive medical visits and other health screeners due to cost. While lack of health insurance has been correlated with decreased health utilization, a precise understanding of …

The Assessment Of Co2 Exposures, Workload Demands, And Musculoskeletal Disorder Risk On Heart Rate For Select Craft Brewery Job Tasks, David L. Huizen

Dissertations

Americans have embraced craft beer, and the ensuing demand has resulted in an ever-increasing number of craft breweries opening over the past 20 years. Craft brewers are generally small employers and, as such, lack the resources necessary to address the safety and health of their employees adequately. Brewers face many safety and health hazards in their work environment. These hazards include exposures to carbon dioxide (CO₂), workload demand, and MSD risk. It is essential to evaluate these hazards in craft breweries as they handle carbon dioxide (CO₂) differently than large breweries by having the CO_{2 …}

Diabetes Prevention Program: Exploring Spirituality And Spiritual Interventions On Outcomes, Sharon E. Plutko Long

Dissertations

Purpose

The purpose of this study is to explore a relationship between a modified Diabetes Prevention Program (DPP) for adults with pre-diabetes (pre-DM) or type-2 DM with variables of spirituality and religiosity (S/R) to illuminate the potential religion-health connection based in changes in participant weight, body mass index (BMI) and physical activity. A secondary purpose is identifying spiritual interventions used by faith-based DPP coaches in a group setting.

Methods

A mixed-methods study was conducted with 34 DPP participants and 11 DPP coaches who completed the core section (weeks 1-26) of DPP courses held in Macomb Country, Michigan. Independent variables are …

Evaluation Instruction In Council On Education For Public Health Accredited Master Of Public Health Schools And Programs, Kristin Ann Hobson

Dissertations

Despite the increasing role of evaluation in public health practice and research (Association of Schools and Programs of Public Health [ASPH], 2006; Institute of Medicine [IOM], 1998; Public Health Functions Steering Committee, 2008; United States Government Accountability Office [GAO], 2012), as well as Henry and Mark’s (2003) assertion of a need for systematic evidence on evaluation training and education, the literature continues to lack studies on evaluation instruction in Council on Education for Public Health (CEPH)-accredited Master of Public Health (MPH) schools and programs. As such, this study explored evaluation instruction in CEPH-accredited MPH schools and programs in the following …

Outcomes Of Prediabetes And Diabetes Education Programs Tailored For Vulnerable Popuations, Diana Al Sayed Hassan

Dissertations

Diabetes is a debilitating disease and if not managed properly it can lead to multiple complications and even premature death. Diabetes continues to disproportionately affect vulnerable populations. The purpose of this three-paper method dissertation was to examine the implementation of a prediabetes and diabetes programs in a community setting to serve vulnerable populations in addition to understanding future diabetes-related educational needs.

The first paper is an evaluation of a shortened five-week diabetes prevention program for older adults with prediabetes or at a high risk for developing type 2 diabetes mellitus (T2DM). Chang in nutrition knowledge, eating and physical activity behaviors, …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …

A Metaevaluation Of Evaluations Of Health Care Programs That Employ The Chronic Care Model, Jan Fields

Dissertations

Background: The purpose of this dissertation is to explore the use of metaevaluation to evaluate the quality of healthcare studies conducted on programs that employ the Chronic Care Model (CCM) to provide chronic illness care. In this study, healthcare studies of CCM programs are regarded as program evaluations. Method: Using a non-experimental cross-sectional design, 28 healthcare studies of CCM programs were evaluated using the accuracy standards portion of the Program Evaluations Metaevaluation Checklist (Stufflebeam, 2011). The results of the metaevaluations were analyzed and compared to the HEAL grade of the same healthcare studies as determined by the Hierarchy of Evidence …

The Intersection Of Depression, Partner Violence And Poverty During The Perinatal Period, Catherine L. Kothari

Dissertations

Problem: Despite the wealth of research documenting the individual links between maternal depression, partner violence, and poverty, important gaps remain regarding their combined interactions, and their variation related to perinatal timing (pregnancy and postpartum). The current dissertation examined the interplay of these phenomena across perinatality.

Methods: This dissertation utilized secondary analysis of telephone survey data from a representative sample of women recruited during their postpartum hospital stay and interviewed four times over the subsequent 18 months. Linear regression was used for predictive modeling of fixed effects, and generalized estimating equation regression was used for multivariate analysis of temporal trends.

Findings: …

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Local Public Health System Partnerships: A Mixed Methods Multi-State Study, Priscilla A. Barnes

Dissertations

The purpose of this three-paper dissertation was to conduct a mixed methods multi-state examination of specific partnership-related activities among local public health systems (LPHSs) as well as to explore perceptions of LPHS practitioners regarding partnership practices.

In the first paper, secondary data analysis of questions from the National Public Health Performance Standards Program (NPHPSP, n = 110) was used to determine the frequency that partnership activities were conducted optimally (> 75% of the time) and whether any associations existed between three different partnership capacities. Activities were matched with relational, organizational, and programmatic capacities from the Collaborative Capacity Framework. Overall, 86% …

Perceptions Of Quality Of Life Of Latinos With Diabetes Living In The U.S.: Variations By Geographic Region Of Origin, Janice M. Long

Dissertations

The Latino population, the largest ethnic minority in the United States, is a diverse group originating from numerous geographic regions of Latin America. Latinos vary in the risk for type 2 diabetes, a condition that exacts a costly burden on those who suffer with it. With the Latino population diversity, diverse strategies are needed. One strategy is to improve outcomes of life quality by improving knowledge of those who deliver health services to Latinos with type 2 diabetes. Through measurement of quality of life (QOL), the more precious aspects of living, how one feels about living with diabetes, can be …

A Study Of Disaster Preparedness Of Rural Hospitals In The United States, Barbara Cliff

Dissertations

This dissertation examines disaster preparedness in the U.S. and explores the relationships between risk perception, funding from the Health Resources and Services Administration (HRSA), and preparedness. Secondary data analysis was conducted using the National Study of Rural Hospitals from Johns Hopkins University. The study, based on a random sample of rural hospitals, consisted of a mail questionnaire and a follow-up phone interview with the hospital's Chief Executive Officer (n = 134).

A model of disaster preparedness was utilized to examine seven elements of preparedness. Risk perception was examined by seven risk threats, and HRSA funding was examined as a …

Promoting Healthy Behavior Change In Skin Cancer Risk Reduction Using The Transtheoretical Stages Of Change Model, Sherry L. Pagoto

Dissertations

Skin cancer is the most commonly diagnosed cancer in the United States with 20% of people developing some form of skin cancer in their lifetime (American Cancer Society, 1999). In spite of the high incidence of skin cancer, it is highly preventable. Approximately 90% of the cases are caused by exposure to ultraviolet radiation from the sun (Skin Cancer Foundation, 1992). The effect of an intervention aimed at reducing skin cancer risk was compared to a survey only control group in 99 Chicago beach-goers. The intervention was based on the Transtheoretical Stages of Change Model (TTM) and included sun sensitivity …

Behavior And Attitudes Related To The Prevention Of Sexually Transmitted Disease And Unplanned Pregnancy, J. Lee Hoover

Dissertations

A sample of 214 persons was tested to determine the impact of gender role orientation, neuroticism, extraversion, authoritarianism, race, gender, and sexual orientation on attitudes and behavior relevant to the prevention of sexually transmitted disease and unintended pregnancy. Specifically measured was the impact of these factors on attitudes toward the condom as contraceptive, attitudes toward the condom as prophylactic, and reported condom use.

Gender role orientation was measured using the short form of the Bern Sex Role Inventory (BSRI) (Bern, 1978), neuroticism and extraversion were measured using the NEO-Five Factor Inventory (NEO-FFI) (Costa & McCrae, 1992), and authoritarianism was measured …

The Use Of Guided Imagery And Progressive Relaxation In Treating Hemodialysis Patients For Dietary Compliance, James B. Morrissey

Dissertations

Studies have confirmed that many hemodialysis patients experience numerous psychological difficulties as a result of their physical illness. One behavioral manifestation of these psychological states is noncompliance to imposed dietary restrictions. In spite of life threatening implications, many hemodialysis patients find it very difficult to maintain dietary compliance.

Recently, guided imagery and progressive relaxation have been used as methods to assist clients to overcome negative psychological states. In most cases, the treatments are adjunctive to on-going counseling or psychotherapy. The purpose of this investigation was to test the idea that guided imagery and progressive relaxation alone can be successfully used …

Maternal/Infant Care: A Systems Approach To Organizational Structures And Services Of Community Agencies, Nancy B. Carlson

Dissertations

No abstract provided.