Medicine and Health Sciences Commons^™

Transition In Occupations Of Refugees During Resettlement, Jacqueline-Elizabeth Cantrell, Kimberley K. Banuelos, Adam Chan, Jennifer H. Daine

Occupational Therapy | Graduate Capstone Projects

Purpose: In 2016, there were 22.5 million refugees worldwide (UNHCR, 2017). California resettled just over 5,000 of those 85,000 (Igielnik & Krogstad, 2017). Limited research has been conducted in the United States (U.S.) focusing on the refugee experience; furthermore, there is a significant gap in research regarding the impact of the refugee experience on the occupations of refugees as they transition to living in the U.S. Smith (2012) explored the adaptation of cultural weaving among Karen refugees to maintain their previous occupations and the impact of daily weaving on their lives within Western culture; however, the study focused only on work occupations. This study sought to capture the experience of refugees and the impact ...

Using Networks And Econometrics To Identify Pathways For Population Health Improvement, Glen P. Mays

Glen Mays

Improving Population Health Through System Alignment: Lessons For Local Boards Of Health, Glen P. Mays

Glen Mays

Acknowledgment Of 2018 Jpcrr Peer Reviewers

Journal of Patient-Centered Research and Reviews

The editors of Journal of Patient-Centered Research and Reviews gratefully acknowledge the contributions of submission reviewers from the previous year. Peer review is an essential component to publishing quality, trustworthy scientific literature.

Delineating And Operationalizing The Definition Of Patient-Oriented Research: A Modified E-Delphi Study, Navdeep Kaur, Pierre Pluye

Journal of Patient-Centered Research and Reviews

Purpose: The importance of patient-oriented research (POR) has been recognized by the scientific community and governmental agencies, and its development is exponential across most health-related disciplines. The current Canadian Institutes of Health Research (CIHR) definition of POR is overly broad and hinders the reliable selection of POR-related publications from bibliographic databases. The present study was aimed to adapt CIHR’s definition of POR into an operational definition that can be used by stakeholders for selecting POR publications.

Methods: Eighteen POR experts in Québec, Canada, were invited to participate in a modified e-Delphi study. Two rounds of Delphi surveys were undertaken ...

Physical Therapists’ Perceptions Of Barriers To The Use Of Evidence-Based Fall Prevention Intervention With Individuals Of 65 Years Of Age Or Older, Charles Agbonghae

Student Dissertations

Falls are a problem in the elderly population. Evidence-based fall prevention programs are available but physical therapists do not always utilize them. The literature identifies a number of barriers to clinician’s use of evidence-based interventions in general but there is limited knowledge of barriers to the use of evidence-based interventions in the clinical practice area of fall prevention. The purpose of this study was to identify barriers perceived by physical therapists to the use of evidence-based fall prevention interventions with individuals of 65 years of age or older. The study utilized an on-line survey of physical therapists licensed in ...

Who Speaks For Me?: Addressing Variability In Informed Consent Practices For Minimal Risk Research Involving Foster Youth, Mary V. Greiner, Sarah J. Beal, Antonio Allen, Vikash Patel, Jareen Meinzen-Derr, Armand Antommaria

Journal of Health Disparities Research and Practice

Background: Youth in protective custody (i.e., foster care) are at higher risk for poorer physical and mental health outcomes compared with those who are not. These differences may be due in part to the lack of research on the population to create evidence-based recommendations for health care delivery. A potential contributor to this lack of research is difficulties in obtaining informed consent for empirical studies in this population. The objective of this study was to describe the approaches to obtaining informed consent in minimal risk studies of foster youth and provide recommendations for future requirements.

Methods: We conducted a ...

Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley

Journal of Health Disparities Research and Practice

Identifying and eliminating disparities are priorities for State Medicaid programs, especially in the context of increased enrollment through Medicaid expansion. We assessed racial, ethnic, regional, and managed care organization (MCO) differences, as well as time trends before and after Medicaid expansion, in primary care and emergency department (ED) utilization in a large Medicaid program. We performed a cross-sectional evaluation of data from Pennsylvania Medicaid from 2011-2015. Three primary care outcomes included: 1) adult access to primary care; 2) adolescent access to primary care; and 3) pediatric access to dental care. Our fourth outcome reflected ED utilization. We observed significant racial ...

Financial Barriers And Utilization Of Medical Services In Prison: An Examination Of Co-Payments, Personal Assets, And Individual Characteristics, Brian R. Wyant Phd, Holly M. Harner

Journal for Evidence-based Practice in Correctional Health

Although research has found that requiring incarcerated individuals to pay fees for medical service decreases use, there are still important unanswered questions about this association: 1) Is the copayment fee a barrier to those seeking medical attention? 2) If so, what individual factors are associated with viewing the copayments as the reason to avoid seeing a medical professional? Using 2012 survey data collected from 45 incarcerated persons housed in a maximum security prison on the East Coast, it was discovered that over 70% of the men surveyed reported avoiding medical services at least once in the past three months due ...

General Population Normative Data For The Eortc Qlq-C30 Health-Related Quality Of Life Questionnaire Based On 15,386 Persons Across 13 European Countries, Canada And The Unites States, S. Nolte, G. Liegl, M. A. Petersen, N. K. Aaronson, A. Costantini, P. M. Fayers, M. Groenvold, B. Holzner, C. D. Johnson, G Kemmler, K. A. Tomaszewski, A. Waldmann, T. E. Young, Matthias S. F. Rose

Open Access Articles

OBJECTIVE: The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 health-related quality of life questionnaire is one of the most widely used cancer-specific health-related quality of life questionnaires worldwide. General population norm data can facilitate the interpretation of QLQ-C30 data obtained from cancer patients. This study aimed at systematically collecting norm data from the general population to develop European QLQ-C30 norm scores and to generate comparable norm data for individual countries in Europe and North America.

METHODS: We collected QLQ-C30 data from the general population across 11 European Union (EU) countries, Russia, Turkey, Canada and United States (n ...

Establishing The European Norm For The Health-Related Quality Of Life Domains Of The Computer-Adaptive Test Eortc Cat Core, G. Liegl, M. A. Petersen, M. Groenvold, N. K. Aaronson, A. Costantini, P. M. Fayers, B. Holzner, C. D. Johnson, G. Kemmler, K. A. Tomaszewski, A. Waldmann, T. E. Young, Matthias S. F. Rose, S. Nolte

Open Access Articles

OBJECTIVE: The computer-adaptive test (CAT) of the European Organisation for Research and Treatment of Cancer (EORTC), the EORTC CAT Core, assesses the same 15 domains as the EORTC QLQ-C30 health-related quality of life questionnaire but with increased precision, efficiency, measurement range and flexibility. CAT parameters for estimating scores have been established based on clinical data from cancer patients. This study aimed at establishing the European Norm for each CAT domain based on general population data.

METHODS: We collected representative general population data across 11 European Union (EU) countries, Russia, Turkey, Canada and the United States (n > /= 1000/country; stratified by ...

Factors Affecting Patient Satisfaction With Healthcare System Of Turkey, Serdar Aydin

Theses and Dissertations

The World Health Organization (WHO) defines health system as comprising of all the organizations, resources, and institutions dedicated to improving health. Health systems have a responsibility not just to improve the health of the population they serve but to provide financial protection against the costs of illness and to respond to people’s expectation with dignity. Besides, healthcare satisfaction and consumer satisfaction have become the latest trend in measuring quality to have a competitive advantage or best practice in the healthcare industry. Over the past 30 years, consumer satisfaction has gained widespread recognition as a measure of quality in many ...

Defining Homelessness In The Rural United States, Amelia Yousey, Rhucha Samudra

Online Journal of Rural Research & Policy

Rural homelessness in the United States is an understudied phenomenon. Among those studies which do address the issue, there exists no uniform or consistent definition for rural homelessness. In this review of the literature, we look at rural homelessness and consolidate the literature into four main groups based on the definitions currently in use. We recommend a comprehensive definition for rural homelessness that looks at this phenomenon on a spectrum of needs, populations, and periodicity. We further recommend that current homeless count methodology be improved by using a more detailed survey of homeless situations, not only in the rural United ...

Trends In Opioid Use In Pediatric Patients In Us Emergency Departments From 2006 To 2015, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Erik J. Linstead

Pharmacy Faculty Articles and Research

Importance The use of opioids to treat pain in pediatric patients has been viewed as necessary; however, this practice has raised concerns regarding opioid abuse and the effects of opioid use. To effectively adjust policy regarding opioids in the pediatric population, prescribing patterns must be better understood.

Objective To evaluate opioid prescribing patterns in US pediatric patients and factors associated with opioid prescribing.

Design, Setting, and Participants This cross-sectional study used publicly available data from the National Hospital Ambulatory Medical Care Survey from January 1, 2006, to December 31, 2015. Analysis included the use of bivariate and multivariate models to ...

One-Sentence, One-Word: An Innovative Data Collection Method To Enhance Exploration Of The Lived Experiences, Shannon L. Sibbald, Dylan Brennan, Aleksandra Zecevic

The Qualitative Report

Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and subsequently propose solutions to potential problems in the partnership. By applying an experience-based methods lens, we sought to augment traditional qualitative interviewing methodologies by using a novel method we named “one-sentence, one-word” (1S1W). To apply our 1S1W method, we used a phenomenological study that examined the relationship between the risk of falling and the desire of master athletes to engage in competitive sports. Participants reflected and recorded their subjective ...

Designing Shared Decision-Making Interventions For Dissemination And Sustainment: Can Implementation Science Help Translate Shared Decision Making Into Routine Practice, Andy S. Tan L, Kathleen M. Mazor, Daniel Mcdonald, Stella J. Lee, Demetria Mcneal, Daniel D. Matlock, Russell E. Glasgow

Open Access Articles

Shared decision making (SDM) is not widely practiced in routine care due to a variety of organizational, provider, patient, and contextual factors. This article explores how implementation science-which encourages attention to the multilevel contextual factors that influence the adoption, implementation, and sustainment of health care practices-can provide useful insights for increasing SDM use in routine practice. We engaged with stakeholders representing different organizations and geographic locations over three phases: 1) multidisciplinary workgroup meeting comprising researchers and clinicians (n = 11); 2) survey among a purposive sample of 47 patient advocates, clinicians, health care system leaders, funders, policymakers, and researchers; and 3 ...

Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. Mcmanus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg

Open Access Articles

BACKGROUND: To examine age-specific differences in the frequency and impact of cardiac and non-cardiac conditions among patients aged 65years and older hospitalized with acute myocardial infarction (AMI).

METHODS: Study population consisted of 3863 adults hospitalized with AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The presence of 11 chronic conditions (five cardiac and six non-cardiac) was based on the review of hospital medical records.

RESULTS: Participants' median age was 79years, 49% were men, and had an average of three chronic conditions (average of cardiac conditions: 2.6 and average of non-cardiac conditions ...

Improving Efficiency In Neuroimaging Research Through Application Of Lean Principles, Alexandra Roy, Julia Colpitts, Kara Becker, Judson A. Brewer, Remko Van Lutterveld

Open Access Articles

INTRODUCTION: "Lean" is a set of management principles which focus on increasing value and efficiency by reducing or avoiding waste (e.g., overproduction, defects, inventory, transportation, waiting, motion, over processing). It has been applied to manufacturing, education, and health care, leading to optimized process flow, increased efficiency and increased team empowerment. However, to date, it has not been applied to neuroimaging research.

METHODS: Lean principles, such as Value stream mapping (e.g. a tool with which steps in the workflow can be identified on which to focus improvement efforts), 5S (e.g. an organizational method to boost workplace efficiency and ...

Update: Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, 2012-2015, Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Between 2014 and 2015, the number of pneumococcal vaccine services delivered to fee-for-service (FFS) Medicare beneficiaries increased by 380% as a result of uptake of PCV13 vaccine.
• Continued disparities in delivery of pneumococcal vaccine services to FFS Medicare beneficiaries in rural and urban communities are noted, with a 63% higher vaccination rate observed in urban areas.
• The majority of pneumococcal vaccine services delivered to FFS Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (24.2%) of these services.
• Pharmacy providers in rural communities play an increasing role in pneumococcal ...

A Population-Based Investigation Of Health-Care Needs And Preferences In American Adults With Multiple Sclerosis, Chungyi Chiu, Malachy Bishop, Bradley Mcdaniels, Byung-Jin Kim, Lebogang Tiro

Early Childhood, Special Education, and Rehabilitation Counseling Faculty Publications

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and ...

Correctional Nurse Competency And Quality Care Outcomes, Deborah Shelton, Bill Barta, Louise A. Reagan

Journal for Evidence-based Practice in Correctional Health

Purpose: In this paper, we report on the clinical care outcomes resulting from implementing a nurse competency education intervention to a nursing staff in a statewide correctional system. Background: State correctional healthcare systems face ongoing and serious challenges attracting and retaining an adequate number of qualified health professionals owing to the perceived undesirability of working in correctional facilities; high occupational stressors; and the effects of high turnover on the workloads of remaining nursing staff.

Methods: Nursing outcomes were evaluated on four most frequently used nursing protocols. The education intervention consisted of self-directed computer-based modules, hands-on clinical review of skills, and ...

Core Curricular Priorities For Professional Development Of Nurses In Correctional Systems: A Delphi Study, Deborah Shelton, Annette T. Maruca, Louise A. Reagan

Journal for Evidence-based Practice in Correctional Health

Objective: To identify the core curricular elements to assure competency and professional development of registered nurses working with justice-involved populations.

Background: Numerous assessments of education priorities have been articulated for nurses working with patients who interface with justice systems. But no consensus of what comprises the core elements of a curriculum for nurses employed by justice systems has been published. Guidance from correctional nurse education experts is needed.

Design: A web-based Delphi survey methodology was used. Three de-identified surveys were sent to academic and clinical correctional nurse educators two weeks apart by email following an invitation and voluntary agreement to ...

From Prison To The Community: Opportunities For Pharmacists To Support Inmate Medication Adherence, Elliott Bosco, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

The United States correctional system is a vital treatment source for chronic illnesses. Whether treating a chronic mental or physical illness, correctional healthcare requires effective resource utilization. Limited research exists on pharmacists' ability to directly address inmate medication adherence. Thus, this study explores inmate perception of medication adherence and management as part of their treatment plan. Semi-structured interviews were conducted with inmates throughout Connecticut. Diseases of interest were divided into a physical illness group (hypertension, diabetes mellitus, HIV/AIDS) and a mental illness group (depression, bipolar disorder, schizophrenia, substance abuse). A content analysis was conducted on four questions: 1) Do ...

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those ...

Dual Use Of A Patient Portal And Clinical Video Telehealth By Veterans With Mental Health Diagnoses: Retrospective, Cross-Sectional Analysis, Erica A. Abel, Stephanie L. Shimada, Karen Wang, Christine Ramsey, Melissa Skanderson, Joseph Erdos, Linda Godleski, Thomas K. Houston, Cynthia A. Brandt

Open Access Articles

BACKGROUND: Access to mental health care is challenging. The Veterans Health Administration (VHA) has been addressing these challenges through technological innovations including the implementation of Clinical Video Telehealth, two-way interactive and synchronous videoconferencing between a provider and a patient, and an electronic patient portal and personal health record, My HealtheVet.

OBJECTIVE: This study aimed to describe early adoption and use of My HealtheVet and Clinical Video Telehealth among VHA users with mental health diagnoses.

METHODS: We conducted a retrospective, cross-sectional analysis of early My HealtheVet adoption and Clinical Video Telehealth engagement among veterans with one or more mental health diagnoses ...

Tell Me More: Promoting Compassionate Patient Care Through Conversations With Medical Students, Danielle Qing, Anjali Narayan, Kristin Reese, Sarah Hartman, Taranjeet Ahuja, Alice Fornari

Patient Experience Journal

Tell Me More^® (TMM) is a medical student driven project that represents a movement amongst the rising generation of physicians to practice humanistic, patient-centered medicine through a collaborative approach. Students interviewed patients to create individualized posters designed to build rapport and trust between patients and clinicians, remind patients of their special strengths by highlighting their unique interests and qualities, and encourage more personal and compassionate patient-clinician interactions in order to enhance the patient experience. Students asked each patient three questions: 1. “How would your friends describe you?” 2. “What are your strengths?” 3. “What has been most meaningful to you ...

Effectiveness Of The Communication Model, C.O.N.N.E.C.T., On Patient Experience And Employee Engagement: A Prospective Study, Agnes Barden, Nicole Giammarinaro

Patient Experience Journal

Northwell Health is a large integrated healthcare organization comprised of 66,000+ employees, 23 hospitals and over 650 medical practice locations located geographically across New York State. In an effort to align and structure interactions between patients, families and healthcare professionals, Northwell Health created a communication model, C.O.N.N.E.C.T. This unique, humanistic model is an acronym that stands for: Contact, Opening Greeting, Name/Title, Needs, Explanation, Closing and Thank. This prospective 3-part study explores the impact of the C.O.N.N.E.C.T. model on professional education, engagement and patient experience. A holistic ...

Perceptions Of Patient-Centered Care Among Veterans With Gastroesophageal Reflux Disease On Proton Pump Inhibitor Therapy, Salva N. Balbale, Andrew Gawron, Sherri L. Lavela Phd, Mph, Mba

Patient Experience Journal

The aim of this study was to explore perceptions of patient-centered care (PCC) among Veterans with gastroesophageal reflux disease (GERD) on proton pump inhibitor (PPI) therapy using patient-reported outcome (PRO) measures. We used three validated surveys to measure PCC concepts in a national sample of Veterans with GERD on PPI therapy. The Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness (COMRADE) measures patient experiences with risk communication and decision-making. The Patient Activation Measure (PAM) evaluates confidence and knowledge needed for self-management. The Patient Assessment of Care for Chronic Conditions (PACIC) assesses views of chronic care received. We ...

A Photo-Elicitation Study Of Homeless And Marginally Housed Veterans’ Experiences With Patient-Centered Care, Samuel F. Sestito, Keri L. Rodriguez, Kristina L. Hruska, James W. Conley, Michael A. Mitchell, Adam J. Gordon

Patient Experience Journal

As part of a qualitatively-driven mixed-methods study, this analysis aimed to describe Veterans Affairs (VA) Homeless Patient Aligned Care Team patients’ experiences with patient-centered care. Veterans participated in audio-recorded, semi-structured photo-elicitation interviews about their health and VA health care. Transcripts were analyzed by two coders using template analysis. In 31/36 interviews, 19/20 participants discussed patient-centered care. Veterans noted Picker’s Patient-Centered Care Principles; 1) access to care, 2) respect for patient-centered values, preference and expressed needs, 3) information, communication, and education, and 4) coordination and care integration were most commonly discussed, followed by 5) physical comfort, 6 ...

Rules Of Engagement: Strategies Used To Enlist And Retain Underserved Mothers In A Mental Health Intervention, Maureen J. Baker Phd, Rn, Cnl, Beth Perry Black Phd, Rn, Faan, Linda S. Beeber Phd, Pmhcns-Bc, Faan

Patient Experience Journal

Patient engagement has been identified as both a goal and strategy to lower health care costs and improve health care outcomes. However, a lack of consensus and clarity exists as to how the process of patient engagement is implemented in clinical practice. Research addressing the underlying and crucial components of effective patient engagement is limited, leaving a significant gap as to how providers engage patients as active collaborators in their health and health care.

This study provides specific, detailed insight and description into the processes through which advanced practice mental health nurses engaged low-income depressed mothers in a mental health ...