Medicine and Health Sciences Commons^™

National Longitudinal Survey Of Public Health Systems: Comparative Report Of 2012 Results, Glen Mays

Glen Mays

The third wave of the National Longitudinal Survey of Public Health Systems was fielded in 2012 in a nationally-representative cohort of local communities. The survey measures the availability of 20 recommended public health activities in the community, the range of organizations that participate in performing each activity, and the perceived effectiveness of each activity. Prior waves of the survey were fielded in 1998 and 2006. Local health officials report data for this survey and receive a customized report of results that compare data for their community with national norms and with "peer groups" of similar communities. This document provides an …

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Comparative Effectiveness Research And Patient-Centered Outcomes Research In Public Health Settings: Design, Analysis And Funding Considerations, Glen Mays

Glen Mays

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Data Acquisition Plan For The Public Health Multi-Network Practice And Outcome Variation (Mprove) Study, Glen Mays

Glen Mays

This brief details the steps to be followed in obtaining and compiling data on the core (and optional) measures of public health service delivery for the MPROVE study. MPROVE data will need to be obtained from several different sources. Data for some measures already exist in administrative records, surveillance systems, or other sources maintained by the local and state public health agencies that participate in your PBRN. For other measures, it may be necessary to obtain data from other agencies that collaborate with the public health agencies in your PBRN. In still other cases, it may be necessary to undertake …

Expanding Delivery System Research In Public Health Settings: Lessons From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg

Health and Clinical Sciences Faculty Publications

BACKGROUND: Delivery system research to identify how best to organize, finance, and implement health improvement strategies has focused heavily on clinical practice settings, with relatively little attention paid to public health settings-where research is made more difficult by wide heterogeneity in settings and limited sources of existing data and measures. This study examines the approaches used by public health practice-based research networks (PBRNs) to expand delivery system research and evidence-based practice in public health settings.

METHODS: Practice-based research networks employ quasi-experimental research designs, natural experiments, and mixed-method analytic techniques to evaluate how community partnerships, economic shocks, and policy changes impact …

A Profile Of Nonurgent Emergency Department Use In An Urban Pediatric Hospital, Katrina Kubicek, Deborah Liu, Christy Beaudin, Jocelyn Supan, George Weiss, Yang Lu, Michele Kipke

Yang Lu

Objectives: This study was designed to develop a descriptive profile of parents and caregivers who bring their children to the emergency department (ED) for nonurgent issues and to explore the reasons for presenting to an urban hospital pediatric ED for nonurgent conditions. Such work is necessary to develop effective interventions.

Methods: A total of 106 parents/caregivers whose child was triaged with a nonemergent/urgent condition completed a 15- to 20-minute computerized survey (English and Spanish) in an urban pediatric ED.

Results: Most respondents described themselves as Latino (76%) and foreign born (62%). About one half (49%) reported having an annual income …

Predictors Of Potentially Avoidable Emergency Department Visits: A Systematic Review, Lisa M. Lines, Arlene S. Ash

Lisa M. Lines

Potentially avoidable, or primary care sensitive, emergency department (PCS ED) visits include non-emergencies and problems that potentially could have been prevented with better primary care. Our goal was to summarize the literature on the predictors of PCS ED visits. A total of 16 articles met all inclusion criteria. Characteristics found to predict PCS ED use included being female, African American, and/or covered by Medicaid. Studies defined a PCS ED visit in various ways, complicating the question of how best to prevent such visits. We identified several gaps in the literature, including lack of recent, nationally representative data; little clarity on …

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen Mays

Glen Mays

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Ranking Usrds Provider-Specific Smrs From 1998-2001, Rongheng Lin, Thomas A. Louis, Susan M. Paddock, Greg Ridgeway

Rongheng Lin

Provider profiling (ranking, "league tables") is prevalent in health services research. Similarly, comparing educational institutions and identifying differentially expressed genes depend on ranking. Effective ranking procedures must be structured by a hierarchical (Bayesian) model and guided by a ranking-specific loss function, however even optimal methods can perform poorly and estimates must be accompanied by uncertainty assessments. We use the 1998-2001 Standardized Mortality Ratio (SMR) data from United States Renal Data System (USRDS) as a platform to identify issues and approaches. Our analyses extend Liu et al. (2004) by combining evidence over multiple years via an AR(1) model; by considering estimates …

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman

Joanne Nicholson

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of …

A Qualitative Study Of Programs For Parents With Serious Mental Illness And Their Children: Building Practice-Based Evidence, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. …

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …

Using Health Information Technology To Engage Communities In Health, Education, And Research, Lisa K. Marriott, David A. Nelson, Shauntice Allen, Karen Calhoun, Christina Eldredge, Kim S. Kimminau, Robert J. Lucero, Fernando Pineda-Reyes, Bernice B. Rumala, Arti P. Varanasi, June S. Wasser, Jackilen Shannon

School of Information Faculty Publications

The August 2011 Clinical and Translational Science Awards conference "Using IT to Improve Community Health: How Health Care Reform Supports Innovation" convened four "Think Tank" sessions. Thirty individuals, representing various perspectives on community engagement, attended the "Health information technology (HIT) as a resource to improve community health and education" session, which focused on using HIT to improve patient health, education, and research involvement. Participants discussed a range of topics using a semistructured format. This article describes themes and lessons that emerged from that session, with a particular focus on using HIT to engage communities to improve health and reduce health …