Medicine and Health Sciences Commons^™

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Exploring Knowledge, Beliefs And Practices Of Radon Gas Exposure Among Public Health Workers, Paschal Nwako

Seton Hall University Dissertations and Theses (ETDs)

Radon gas exposure is the highest cause of lung cancer among people that never smoked in the United States. People exposed to elevated levels of radon had a higher risk of developing lung cancer. Achieving the long term goal of the Indoor Radon Abatement Act (IRAA) of 1988 require a combined efforts of government agencies. Public health workers are change agents and their role in protecting and improving the health of their communities are well documented. This study created and utilized a multi question survey, the Public Health Workers Radon Assessment Instrument (PHWRAI) to explore knowledge, beliefs, personal and professional …

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …

Adoption Of Medication Management Technologies By U.S. Acute Care Hospitals After The Hitech Act, Aastha Chandak

Theses & Dissertations

Medication errors and adverse drug events (ADEs) are a significant public health concern in the United States as they pose a threat to patient safety. The medication management process is a complicated process in U.S. acute care hospitals, consisting of a series of steps such as ordering, transcribing, dispensing and administration and each step is prone to medication errors.The use of technology is considered to be an important intervention in improving the medication management process and thereby reducing medication errors and ADEs and further improve patient safety. The Health Information Technology for Economic and Clinical Health (HITECH) Act, implemented in …

The Impact Of Electronic Health Records On Healthcare Service Delivery, Patient Safety, And Quality, Kate Elizabeth Trout

Theses & Dissertations

The HITECH Act has provided over $30 billion of support through the Meaningful Use program to implement Electronic Health Records (EHRs) with aims to improve healthcare service delivery, efficiency, quality, and patient safety. New healthcare models, such as pay-for-performance and value-based purchasing, were envisioned to aligning quality with reimbursement mediated with the use of EHRs. It is unclear of how EHRs and Meaningful Use have impacted health service delivery, patient safety, and quality of care. Thus, making it difficult to determine if the specific set of objectives for Meaningful Use have had a positive impact on outcomes, which ultimately is …

Medication Nonadherence, Health Care Utilization, And Safemed Care Transitions Model Impact In Super-Utilizers, Satya Surbhi

Theses and Dissertations (ETD)

BACKGROUND: Super-utilizers are individuals with disproportionately high inpatient and emergency department (ED) use, and mostly have multiple chronic conditions and use multiple concurrent medications. They place a substantial burden on the U.S. healthcare system and have become the focus of policy initiatives aimed at reducing their disproportionate inpatient and ED use. Medication management is critical for these patients since nonadherence to essential chronic medications is associated with poor health outcomes, and higher health care utilization and costs. OBJECTIVES: This dissertation employed a three empirical research papers approach to study the following aims: (1) the prevalence and patterns of medication nonadherence …

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

School Policy, Food And Physical Activity Environment, And Childhood Obesity, Ruicui Liu

Health Services Research Dissertations

The purpose of this study is to examine the effect of school food and physical activity environments on energy balance-related behaviors and Body Mass Index (BMI) and to simulate the effect of school-based nutrition and physical activity policies on childhood obesity prevention. Four models based on the Social Ecological Framework of childhood obesity were developed. Parameters of these models were calibrated and validated with empirical data derived from the Early Childhood Longitudinal Study – Kindergarten Class of 1998-99 and the 2003-2004 National Health and Nutrition Examination Study. The correlation between observed and simulated BMI was 0.85 for 5th grade children …

A Test Of The Behavioral Model Of Health Services Use On Non-Emergent Emergency Department Use, Moira Crosby Mcmanus

Health Services Research Dissertations

Even though emergency departments (EDs) were created to treat trauma and emergent cases, there has been an increase in emergency department (ED) utilization for non-emergent reasons over the past half of a century. As non-emergent utilization grows as a result of the ED becoming a prevalent substitute for primary care, overcrowding of the ED and increased wait times will continue. Additionally, unnecessary cost to both the ED and the patient will be incurred. Previous research has examined and determined various reasons and risk factors driving non-emergent ED use, among them the influence of living location and the number of non-emergent …

The Effects Of Job Characteristics On Home Care Workers’ Well-Being And Job Performance: Understanding The Psychosocial Effects Of Relational Care, Emily C. Franzosa

Dissertations, Theses, and Capstone Projects

Home care workers are the lowest-paid and most precarious segment of the health care industry. Although these workers provide critical, non-medical support that allows elderly and disabled individuals to remain in their homes, the workforce is highly unstable, due to low wages, a lack of supportive benefits like health coverage, paid leave and retirement support, poor working conditions and a physically and emotionally demanding workload. But a lack of consensus around the nature and value of home care has made “quality”, in terms of both jobs and care provision, difficult to define, measure or improve. While home care is a …

An Examination Of African Americans' Utilization Of Health Care, Brittany Powell

Dissertations

The study examined the relationship between perceptions of discrimination, social support, quality of health care received, and utilization of health care services among African Americans. Data was analyzed from 99 African American respondents that completed either an online or paper questionnaire. The responses demonstrated significant relationships existed between discrimination and quality of health care as well as social support and utilization of health care. Results concluded that the more discrimination one perceives, the lower quality of health care they are to expect, and therefore they are less likely to utilize services. However, the data also reflected that even in the …

Understanding Views Of Evidence In Public Health Practice And Decision Making In Ontario, Sara Masood

Electronic Thesis and Dissertation Repository

Background: Perceptions of evidence by public health managers, practitioners and policy makers is one of the key determinants of evidence uptake. Therefore, understanding views of evidence in both practice and policy decision making is important to bridge the evidence-practice and policy gap in public health. Objectives & Methods: Two studies are presented in this thesis. The first is a systematic review synthesizing studies exploring the use of research evidence in public health decision making between 2010-2016. The second study is a qualitative descriptive study examining understandings about evidence in Ontario public health units by comparing perspectives from managers and frontline …

Disability And Return To Work Following Musculoskeletal Injury, Qiyun Shi

Electronic Thesis and Dissertation Repository

Musculoskeletal disorders (MSDs) are injuries, damage or disorders affecting the musculoskeletal system including muscles, ligaments, nerves, tendons, bones or cartilage etc. MSDs are highly prevalent and associated with sickness absence, reduced work efficiency, job changes and earlier retirement.. They also affect daily activity and social functioning. Although many MSDs are accompanied by minor symptoms and settled spontaneously, approximately 10% of the workforce with MSDs have difficulty resuming their original work or exit the workforce permanently. Return to work after MSDs is complex, and is influenced by many factors including physical, psychological, economic and social factors.

Although there are extensive studies …

Young Adult E-Cigarette Exposure: Implications For Policy And Prevention, Monica Page Daniel Dobbs

Graduate Theses and Dissertations

Objective. The purpose of this study is to examine factors associated with e-cigarette use among college students to better understand their behavior. Using Ajzen’s Reasoned Action Approach, this study sought to better understanding the influence of attitudes, Social norms, and perceived behavioral controls (PBCs) on college students’ intention to try e-cigarettes (even one puff) in the next 30 days.

Methodology. This study employed three phases for a mixed methods design that took place between December 2015 and April 2016. Phase 1 used Middlestadt’s salient belief elicitation procedure to capture responses through an open ended survey (n=58). Phase 2, a pilot …

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

The Information-Motivation-Behavioral Skills Model: An Examination Of Obesity Prevention Behavioral Change In Children Who Participated In The Afterschool Program Virginia Beach Let’S Move, Marilyn Miroshlava Bartholmae

Health Services Research Dissertations

The purpose of this study was to examine the utility of the Information-Motivation-Behavioral Skills Model (IMB) as a foundation to design childhood obesity prevention afterschool programs. This study employed a secondary analysis of pre (n=172), post (n=170), and 1-year follow-up (n=32) evaluations of the obesity prevention afterschool program Virginia Beach Let’s Move for children ages 5-11 years. Independent variables included demographic characteristics for the participating children and their parents. Dependent variables used in this study were the IMB constructs information and motivation. Motivation was measured by the attitudes of the children and information was measured by the children’s knowledge.

The …

Visualizing And Interacting With Social Determinants Of Health, Moutasem Zakkar

Electronic Thesis and Dissertation Repository

Purpose: The purpose of this study is to examine the use of information visualization to represent specific social determinants of health, and to examine the benefits of such representation for health policymaking. Methods: The study developed a prototype for a visualization tool (www.healthvisualization.ca), which represents the conceptual framework for the social determinants of health (CSDH) and new ways to represent related health equity indicators. This tool was used by study participants. The experience of these participants and the usability of the tool were evaluated using qualitative semi-structured interviews. Results: Visualizing the CSDH framework helps to present the social …

Prep Advocacy Project: Increasing The Adoption Of Pre-­Exposure Prophylaxis (Prep) In San Luis Obispo County, Leona Rajaee

Journalism

The following study investigates the need for Pre­exposure Prophylaxis (PrEP) in San Luis Obispo (SLO) County in order to develop an effective health outreach and advocacy program that could increase the adoption of PrEP treatment and in turn decrease new HIV transmissions in the community studied. The sponsor of this study is the Access Support Network (ASN), a non­profit organization that provides supportive services for individuals living with HIV/AIDS. ASN launched this study after observing the effectiveness of PrEP in metropolitan cities. At the same time, ASN also noticed a rise in new HIV transmissions, particularly among injecting drug users …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

Parents Of Children With Arthritis-Related Diseases: An Examination Of Knowledge Of And Participation In Select Support Programs And Services Offered By The Arthritis Foundation, Margo B. Deihl

Senior Honors Projects, 2010-2019

The purpose of this pilot study was to identify the knowledge of and participation in select Arthritis Foundation support programs and services among parents of children with arthritis-related diseases. Parents attending the 2014 Juvenile Arthritis National Conference in Keystone, Colorado completed an online survey that asked about their knowledge of and participation in these programs. The data collected for the study was quantitative and qualitative. Respondents were given the opportunity to add comments to some survey items, and these items were analyzed by grouping them according to common themes. Results indicated that the parents were more knowledgeable about the Juvenile …

Modifiable Barriers To Optimal Outcomes In Gout Management, Brian W. Coburn

Theses & Dissertations

Improving patient outcomes in chronic disease is of critical importance to the future of health care. Gout, affecting 4% of the US population, is a highly treatable chronic disease from which patients experience unnecessarily suboptimal outcomes. In this dissertation, I demonstrate how interrelated patient and provider factors affect patient outcomes in gout. First, I describe how only 14% of gout patients know their serum urate (SU) goal for urate lowering therapy (ULT) despite otherwise being knowledgeable about gout and its treatment. I then demonstrate the importance of multiple patient and provider factors in achieving SU goal. Specifically, I demonstrate that …

Essays On Immigration-Related Disparities In Health Behavior And Health Care Utilization, Yang Wang

Theses & Dissertations

The number of immigrants in the United States has recently been increasing significantly. Immigrants may experience some worse health outcomes than natives, due to substantial legal and socioeconomic barriers. Many immigration-related disparities in health behavior and health care utilization still remain unexplored. This dissertation comprises of 3 independent studies examining such disparities across immigration status, including (1) E-cigarette use and acculturation effects; (2) Cancer-related office-based medical provider visits among cancer patients; and (3) Potentially preventable emergency department visits.

Two nationally representative data sources included National Health Interview Survey and Medical Expenditure Panel Survey. We categorized the respondents into three immigration …

Super-Utilization: The New Perfect Storm Of Health Reform, Jill Diane Nault

Theses and Dissertations (ETD)

This three-essay dissertation was focused on geographic variation of super-utilization, or the disproportionately high healthcare utilization and costs attributed to a small sub-set of the inpatient population. For purposes of this research, super-utilization was operationalized as high repeat utilization (HRU) and referred to inpatient utilization and inpatient readmission expenditures attributed to beneficiaries with four or more 30-day readmissions per year. The overall purpose of the research was to identify geographic areas at increased risk for HRU. These areas corresponded to where beneficiaries live and were aligned with the geographically-bound healthcare delivery systems. Each essay employed an observational study design using …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Institutional Silence: Re-Victimization Of Sexual Assault Victims At Bgsu, Kendall Lake

Honors Projects

This study investigates the causes and effects of the lack of Sexual Assault Nurse Examiners (SANEs) at the Bowling Green State University (BGSU). The study draws on previous research about sexual assault reporting, deterrents to reporting, national prevalence studies, how psychological re-victimization occurs, and the importance of sexual assault nurse examiners. The data included is previous literature, interviews, and ethnographic research about the town Bowling Green, OH. The primary data for this research comes from interviews with the SANEs at the Wood County Hospital. Seven nurses were interviewed, and findings concluded that residential students at BGSU are not receiving medical …

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 …

A Comparative Analysis Of Attitudes Towards Women Physicians In Nineteenth Century Articles And Novels, Hannah White

Honors Theses

No abstract provided.

Improving Patient Adherence: A Look At Causal Knowledge, Treatment Credibility, And Treatment Expectancy, Kyra L. Mackenzie

Undergraduate Honors Theses

Lack of patient adherence to Cardiac Rehabilitation programs is a commonly reported problem (Bryne, Walsh, & Murphy, 2005) and is associated with increased morbidity and re-hospitalization rates (Platt, Green, Jayasinghe, & Morrissey, 2014). Factors that can increase the perceived credibility and expectancy of a treatment program predict better adherence (Nock, Ferriter, & Holmberg, 2007). A better understanding of a treatment rationale may improve treatment credibility and expectancy. For this study, causal knowledge is examined as a way to increase understanding because it has been shown to increase acquisition and retention of novel medical information (Goldszmidt, Minda, Devantier, Skye, & Woods, …

Essays On Household Health Expenditures, National Health Insurance And Universal Access To Health Care In Ghana, Evelyn Kwakye

Doctoral Dissertations

Access to quality health services is essential for maintaining a healthy population and economic development hence the growing global consensus that universal health coverage is necessary. Ghana attempts to expand access by making basic health services free at the point of delivery through its National Health Insurance Scheme (NHIS). Prior studies indicate NHIS increases demand for health services, but questions remain about its impact on out of pocket payments, quality of services, and the financial viability of the program. Hence, this dissertation analyzes the financial risk in health care seeking, the effect of NHIS on out of pocket payments and …