Medicine and Health Sciences Commons^™

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika C. Ziller Phd, Zachariah T. Croll Ba, Andrew F. Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of …

The Reliability And Validity Of The Task Analysis Recording Procedure (Tarp), Russell Brown Psyd

All Student Scholarship

Task analysis data collection typically focuses on the acquisition of skills by recording the percentage of steps in the response chain completed independently and correctly. While useful as a measure of skill acquisition, percentage correct does not promote a step based analysis of factors that may promote or interfere with skill acquisition, including necessary prompts and the occurrence of challenging behavior. This study evaluated the reliability and validity of the Task Analysis Recording Procedure (TARP) in recording physical stereotypy, a behavior often emitted by participants with autism or other developmental disabilities, by comparing TARP obtained physical stereotypy data to that …

A Pilot Investigation Of A Multi-Tier System Of Mathematics Instruction For Prekindergarten Students, William Benjamin Roy Psyd

All Student Scholarship

A Multi-Tier System of Support (MTSS) for academic skills is widely recognized as the best practice framework for supporting all students. Additionally, the recent shift from constructivist pedagogy toward more intentional teaching of mathematics at the preschool level has encouraged more explicit mathematics instruction with younger children. In spite of these advances, there are no published best practice guidelines for implementing MTSS for mathematics at the prekindergarten level. The current study sought to investigate one possible way to implement effective instructional practices for preschool mathematics within a multi-tier system, including the use of validated screening and progress monitoring instruments. A …

Health Information Exchange: A Strategy For Improving Access For Rural Veterans In The Maine Flex Rural Veterans Health Access, Karen B. Pearson Mlis, Ma, Amanda Burgess Mppm, John A. Gale Ms, Andrew F. Coburn Phd, Anush Yousefian Hansen Ms, Ma

Access / Insurance

This paper reports on the design and implementation of a first-in-the nation project to expand rural veterans’ access to healthcare by establishing a bi-directional connection between Maine’s statewide health information exchange (HIE) and Veterans Administration facilities and centers. The paper reviews key factors that have contributed to implementation challenges and successes and lessons relevant to efforts to create interoperable health IT systems across multiple, complex organizational settings.

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Adverse Childhood Experiences In Rural And Urban Contexts, Jean A. Talbot Phd, Donald Szlosek Mph, Erika C. Ziller Phd

Mental Health / Substance Use Disorders

Recent research shows that rural children are more likely than urban children to experience certain kinds of adversity. Researchers at the Maine Rural Health Research Center looked at how adverse childhood experiences (ACEs) have affected rural and urban adults. Using data from the Behavioral Risk Factor Surveillance System Assessment, this study found that, while the prevalence of ACEs was comparable in rural and urban adults, over half of rural adults surveyed reported having ACE exposure.Among those with any ACE history, about one quarter experienced four or more ACEs. Policy implications and strategies are highlighted in this brief.

Key Findings:

• Past …

A Comparison Of A Discrete Trial Teaching Procedure And An Incidental Teaching Procedure To Help Children With Developmental Disorders Acquire Sight Word Reading Skills, Adam Golonka Psyd

All Student Scholarship

Knowing how to read words that are relevant and important has the potential to help individuals with developmental disorders gain independence within both school and community settings. The current study compares the effectiveness of two teaching procedures targeting reading skills in children with developmental disorders. Discrete trial teaching (DTT) is a commonly used method of teaching multiple pre-academic and academic skills to individuals with developmental disorders. It involves a systematic presentation of stimuli, a teaching procedure, and delivery of reinforcement, and is often delivered in a mass trial format. Incidental or naturalistic teaching, on the other hand, takes place in …