Medicine and Health Sciences Commons^™

Non-Urgent Use Of Emergency Departments By Rural And Urban Adults, Erika Ziller Phd, Carly Milkowski, Zachariah Croll, Yvonne Jonk Phd

Access / Insurance

This study, conducted by researchers at the Maine Rural Health Research Center, provides updated information and addresses gaps in knowledge about rural non-urgent ED use. Understanding the rates of non-urgent ED use among rural adults and the factors associated with this use can inform policy and practice efforts to reduce unnecessary and inappropriate use of EDs in rural communities.

Hospital emergency departments (EDs) serve a vital role in the US health care system, providing lifesaving, around-the-clock care to patients in acute health situations. However, use of the ED for non-urgent care is costly and reflects a suboptimal care setting, with …

Health Care Use Experiences Of Ethnoculturally Diverse Immigrant Older Adults: A Meta-Ethnography, Lorna De Witt, Kathryn A. Pfaff, Roger Reka, Noeman Ahmad Mirza

Nursing Publications

Purpose

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health care services?

Design/methodology/approach

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, …

Identifying Rural Health Clinics Within The Transformed Medicaid Statistical Information System (T-Msis) Analytic Files, Katherine Ahrens Mph, Phd, Zachariah Croll, Yvonne Jonk Phd, John Gale Ms, Heidi O'Connor Ms

Rural Health Clinics

Researchers at the Maine Rural Health Research Center describe a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Background: There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part this is because methods to identify RHC encounters within Medicaid claims data are outdated.

Methods: We used a 100% sample of the 2018 Medicaid Demographic and Eligibility and Other Services Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files for 20 states …

Health Equity And Policy Considerations For Pediatric And Adult Congenital Heart Disease Care Among Minoritized Populations In The United States., Keila N. Lopez, Kiona Y. Allen, Carissa M. Baker-Smith, Katia Bravo-Jaimes, Joseph Burns, Bianca Cherestal, Jason F. Deen, Brittany K. Hills, Jennifer H. Huang, Ramiro W. Lizano Santamaria, Carlos A. Lodeiro, Valentina Melo, Jasmine S. Moreno, Flora Nuñez Gallegos, Harris Onugha, Tony A. Pastor, Michelle C. Wallace, Deidra A. Ansah

Manuscripts, Articles, Book Chapters and Other Papers

Achieving health equity in populations with congenital heart disease (CHD) requires recognizing existing disparities throughout the lifespan that negatively and disproportionately impact specific groups of individuals. These disparities occur at individual, institutional, or system levels and often result in increased morbidity and mortality for marginalized or racially minoritized populations (population subgroups (e.g., ethnic, racial, social, religious) with differential power compared to those deemed to hold the majority power in the population). Creating actionable strategies and solutions to address these health disparities in patients with CHD requires critically examining multilevel factors and health policies that continue to drive health inequities, including …

Corrigendum: Comparing Tobacco And Alcohol Policies From A Health Systems Perspective: The Cases Of The Philippines And Singapore, Gianna Gayle H. Amul, Jean-Francois Etter

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Patient And Provider Perceptions Of Rapid Telehealth Implementation During The Covid-19 Pandemic, Ryan G. Seibert, Amanda K. Stephenson, Aubrey Podell, Yuxiu Lei, Sheri Keitz

The Lahey Journal

Introduction: Despite unprecedented telehealth adoption during the COVID-19 pandemic, its post-pandemic preservation remains uncertain. Understanding key stakeholders’ perspectives on telehealth during the pandemic can inform evidence-based policies and promote effective, sustainable virtual-based care.

Methods: Patients and providers who completed telehealth visits during the early pandemic in primary care, subspecialty, and surgical outpatient clinics at a large community-based academic medical center in New England were surveyed via telephone interviews or electronic surveys. Thematic analyses of qualitative comments further characterized experiences.

Results: Of 1,729 eligible patients called, 969 were contacted and 778 participated (response rate 80.3% among contacted patients). Among 753 eligible …

Public Health Ai Assignment, Amber Lyon-Colbert

AI Assignment Library

This assignment utilizes course foundational knowledge: Explain the social, political and economic determinants of health and how they contribute to population health and health inequities. This assignment addresses and strengthens our CEPH Competency #5 D2-11 Select methods to evaluate public health programs.

Reshaping Healthcare: A Bibliometric Analysis Of Lessons Learned In Post-Covid-19 Health Policy, Azliyana Azizan, Khairul Hafezad Abdullah, Sri Ratna Rahayu, Nadia Safirah Rusli, Nornajehah Tarmidzi

Kesmas

The COVID-19 pandemic has profoundly impacted health policy globally, leading to heightened concern and urgency. However, previous studies have been hampered by limited resources and insufficient discussions on the long-term implications for health policies following multiple COVID-19 waves. Thus, this study examined the evolution of international studies on post-COVID-19 health policy. A comprehensive analysis used well-known literature databases Scopus and Web of Science to explore parameters including publication growth, participating countries, areas of interest, and keyword analysis of topics such as"COVID-19" and "Health Policy." The United States emerged as an active participant, focusing on "Computer science." Key themes included "COVID-19 …

Improving Access To Colorectal Cancer Screening In Latino Communities In California: Eliminating Transition To Practice Hours For Nurse Practitioner Full Practice Authority, June Spilburg

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence based practice Doctor of Nursing Practice (DNP) project was to investigate barriers to colorectal cancer screening in young Latinos living in California. The goals of this project included examining current trends in colorectal cancer in young Latinos, factors which affect access to care, and the current and future state of the California primary health care provider workforce. The aim of this project was to make recommendations regarding strategies to improve access to colorectal cancer screening among Latinos in California.

Background: Early onset colorectal cancer (EO-CRC) is increasing in Latino communities, with colorectal screening rates …

Equivalent Running Leg Lengths Require Prosthetic Legs To Be Longer Than Biological Legs During Standing, Janet H. Zhang-Lea, Joshua R. Tacca, Owen N. Beck, Paolo Taboga, Alena M. Grabowski

Human Physiology Faculty Scholarship

We aimed to determine a method for prescribing a standing prosthetic leg length (ProsL) that results in an equivalent running biological leg length (BioL) for athletes with unilateral (UTTA) and bilateral transtibial amputations (BTTA). We measured standing leg length of ten non-amputee (NA) athletes, ten athletes with UTTA, and five athletes with BTTA. All athletes performed treadmill running trials from 3 m/s to their maximum speed. We calculated standing and running BioL and ProsL lengths and assessed the running-to-standing leg length ratio (Lratio) at three instances during ground contact: touchdown, mid-stance, and take-off. Athletes with UTTA had 2.4 cm longer …

The Pink Tax: A Comparative Case Study Between Tennessee And Washington State, Megha Chitturi

Baker Scholar Projects

The imposition of an additional luxury tax on menstrual health products, otherwise referred to as the “Pink Tax” or the “Tampon Tax”, is present in some states while absent in others. The decision to repeal such a tax is one that has proven to be critical, as it removes the connotation that such products are of “luxury” and make them more accessible to menstruators throughout the state. As of 2023, twenty-three states have eliminated the tax. The state of Washington falls under that parameter while Tennessee does not. The purpose of this undergraduate honors thesis is to explore the potential …

The Development Of Health System Resiliency: How Kenya's Experience With Malaria Impacted Its Reaction To The Covid-19 Pandemic, Zoe A. Ward

Baker Scholar Projects

Public health scholars have recently focused on health system resiliency to explain how previous experiences dealing with public health crises impact the healthcare sector, public behavior, and policy response to novel crises. However, it is unclear how resiliency develops. This study contributes by testing whether a health system’s experience with a health emergency and significant interventions impacts the response to a novel crisis. This research asks, “How has Kenya’s experience with malaria impacted its response to COVID-19?” Using the United States Agency for International Development (USAID) Malaria Indicator Survey (MIS), I develop a malaria adherence score to measure county-level compliance …

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

The Global Fatty Liver Disease-Sustainable Development Goal Country Score For 195 Countries And Territories, Jeffrey V. Lazarus, Hannah Han, Henry E. Mark, Saleh A. Schattenberg, Jörn M. J., Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background & Aims:

Fatty liver disease is highly prevalent, resulting in overarching wellbeing and economic costs. Addressing it requires comprehensive and coordinated multisectoral action. We developed a fatty liver disease-Sustainable Development Goal (SDG) country score to provide insights into country-level preparedness to address fatty liver disease through a whole-of-society lens.

Approach & Results:

We developed two fatty liver disease-SDG score sets. The first included six indicators (child wasting, child overweight, non-communicable disease [NCD] mortality, universal health coverage service coverage index, health worker density, and education attainment), covering 195 countries between 1990-2017. The second included the aforementioned indicators plus an urban …

Inclusión Cultural En Fonasa: Parto Aymara Como Un Estudio De Caso, Madison Singleton

Independent Study Project (ISP) Collection

Los primeros años de la década de 2000s sirven como un período legal transformador en Chile, debido al auge de los grupos de representación indígena y la introducción de la ley 20.584 que asegura un modelo de interculturalidad en los servicios de salud. El objetivo de esta investigación es comprender los factores que impactaron en la priorización de la inclusión cultural en el sistema público de salud (FONASA), utilizando el parto aymara en Arica como un estudio de caso. Esta investigación toma forma en un diseño de investigación cualitativa y exploratoria utilizando 5 entrevistas y 5 observaciones, así como las …

Differences In Birth Weight Between Immigrants' And Natives' Children In Europe And Australia: A Lifecycle Comparative Observational Cohort Study, Sandra Florian, Mathieu Ichou, Lidia Panico, Stéphanie Pinel-Jacquemin, Tanja G. M. Vrijkotte, Margreet W. Harskamp-Van Ginkel, Rae-Chi Huang, Jennie Carson, Loreto Santa Marina Rodriguez, Mikel Subiza-Pérez, Martine Vrijheid, Sílvia Fernández-Barrés, Tiffany C. Yang, John Wright, Eva Corpeleijn, Marloes Cardol, Elena Isaevska, Chiara Moccia, Marjolein N. Kooijman, Ellis Voerman, Vincent Jaddoe, Marieke Welten, Elena Spada, Marisa Rebagliato, Andrea Beneito, Luca Ronfani, Marie-Aline Charles

Research outputs 2022 to 2026

Objective:

Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives?

Setting:

Western Europe and Australia.

Participants:

We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance - France (N=12 494), the Raine Study - Australia (N=2283), Born in Bradford - UK (N=4132), Amsterdam Born Children and their Development …

Potential Chemical Risks From Tattoos And Their Relevance To Military Health Policy In The United States, James D. Blando, Blas A. Guigni

Community & Environmental Health Faculty Publications

We summarize and consolidate disparate sources of information about the practice of tattooing and its potential implications for military population health and policy. Each branch of the United States military has policies about tattoos for service members, but these have varied over time and do not cover health protection. The number of veterans receiving disability payments and the cost of those payments has been rising over time; the broad category of skin conditions accounts for 11% of disability claims. Any additional factor, such as tattoos that may increase the occurrence of adverse skin reactions, can substantially impact veteran benefit expenses …

Socioecological Factors Linked With Pharmaceutical Incentive-Driven Prescribing In Pakistan, Muhammad Naveed Noor, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Wafa Aftab, Sadia Shakoor, Rumina Hasan, Mishal Khan

Department of Pathology and Laboratory Medicine

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different …

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …

Covid-19 Lessons To Protect Populations Against Future Pandemics By Implementing Pppm Principles In Healthcare, Cuihong Tian, Lois Balmer, Xuerui Tan

Research outputs 2022 to 2026

The coronavirus disease 2019 (COVID-19) pandemic has continued for more than 3 years, placing a huge burden on society worldwide. Although the World Health Organization (WHO) has declared an end to COVID-19 as a Public Health Emergency of International Concern (PHEIC), it is still considered a global threat. Previously, there has been a long debate as to whether the COVID-19 emergency will eventually end or transform into a more common infectious disease from a PHEIC, and how should countries respond to similar pandemics in the future more time-efficiently and cost-effectively. We reviewed the past, middle and current situation of COVID-19 …

Bouncing Back From Covid-19: A Western Australian Community Perspective, Kiira K. Sarasjärvi, Paola Chivers, Ranila Bhoyroo, Jim Codde

Research outputs 2022 to 2026

Introduction: This study explored the behavioral profiles of residing Western Australians during a COVID-19 lockdown period and transitions in behavior post-lockdown. Methods: A total of 313 participants (76% female, age: M = 50.1, SD = 15.7 years) completed behavioral and mental health questionnaire items ~2 months after a 3-month COVID-19 lockdown in October 2020, using a retrospective recall to assess their experience during the lockdown period. Latent transition analysis (LTA) was used to identify behavioral profiles and transitions. Indicators were identified by assessing during–post-lockdown group differences (Kruskal–Wallis, chi-square tests) and profiles described using qualitative open-ended questions. Results: Significant indicators included …

Applying Data Science And Machine Learning To Understand Health Care Transition For Adolescents And Emerging Adults With Special Health Care Needs, Lisamarie Turk

Nursing ETDs

A problem of classification places adolescents and emerging adults with special health care needs among the most at risk for poor or life-threatening health outcomes. This preliminary proof-of-concept study was conducted to determine if phenotypes of health care transition (HCT) for this vulnerable population could be established. Such phenotypes could support development of future studies that require data classifications as input. Mining of electronic health record data and cluster analysis were implemented to identify phenotypes. Subsequently, a machine learning concept model was developed for predicting acute care and medical condition severity. Three clusters were identified and described (Cluster 1, n …

Predictors Of Covid-19 Vaccination Rate In Usa: A Machine Learning Approach, Syed M. I. Osman, Ahmed Sabit

WCBT Faculty Publications

In this study, we examine state-level features and policies that are most important in achieving a threshold level vaccination rate to curve the effects of the COVID-19 pandemic. We employ CHAID, a decision tree algorithm, on three different model specifications to answer this question based on a dataset that includes all the states in the United States. Workplace travel emerges as the most important predictor; however, the governors’ political affiliation (PA) replaces it in a more conservative feature set that includes economic features and the growth rate of COVID-19 cases. We also employ several alternative algorithms as a robustness check. …

Impact Of A Multifaceted Intervention On Physicians' Knowledge, Attitudes And Practices In Relation To Pharmaceutical Incentivisation: Protocol For A Randomised Control Trial, Muhammad Naveed Noor, Mishal Khan, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Sabeen Sharif Khan, Iqbal Azam, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Introduction: In settings where the private sector constitutes a larger part of the health system, profit-gathering can take primacy over patients' well-being. In their interactions with pharmaceutical companies, private general practitioners (GPs) can experience the conflict of interest (COI), a situation whereby the impartiality of GPs' professional decision making may be influenced by secondary interests such as financial gains from prescribing specific pharmaceutical brands.
Methods and analysis: This study is a randomised controlled trial to assess the impact of a multifaceted intervention on GPs' medical practice. The study sample consists of 419 registered GPs who own/work in private clinics and …

Navigating The “Perfect Storm”: Leading With A Commitment To Human Experience, Jason A. Wolf Phd

Patient Experience Journal

As was known even prior to the pressures placed on us by the pandemic, what lied just beneath the surface of our work in healthcare was clear. A healthcare workforce feeling overworked and overwhelmed. Communities seeing and feeling the impact of inequities and disparities in care. Patients and care partners working diligently to elevate what matters to them. A tearing at the social fabric that has led to incivility and even mortal violence. And healthcare systems laboring to maintain financial viability in the face of global economic uncertainties. We knew the opportunities then, and we cannot escape them now. This …

Policy Forum: Examining The Relationship Between Vacant Health Director Positions & Public Health, Ben Barber

Virginia Journal of Public Health

No abstract provided.

Learning From Lived Experience: Substance Use Policies, Emergency Shelters, And Harm Reduction In London, On, Jesse Cram, Dena Salehipour

Undergraduate Student Research Internships Conference

Since 2018, the number of overdoses reported by London housing and emergency shelter agencies to the city of London has increased by 790%.These agencies currently have inconsistent overdose response policies that lack research-based support, and want to establish comprehensive best practices that support those involved at all levels.

Through a community based course, we initially collected and analyzed survey data from managers and staff from various London housing and emergency shelter agencies with the aim of understanding the limitations of the current approaches to the opioid crisis. Wanting to expand on this, our current project focuses on those who are …

The Hearst Health Prize: The First Five Years, Alexa M. Waters, Alexis Skoufalos, Emily Frelick, Gregory Dorn, David B. Nash

Department of Family & Community Medicine Faculty Papers

The Hearst Health Prize is the first national annual award for excellence in population health. The prize was established "to discover, support, and showcase the work of an individual, group, organization, or institution that has successfully implemented a population health program or intervention that has made a measurable difference" in health outcomes. Now, 5 years since the award's inception, this article reflects on how submissions for the prize collectively mirror - and may even predict - changes within the field of population health. It examines how the most successful programs demonstrated genuine, measurable improvements in health outcomes and/or health behaviors. …

Narrative Synthesis Systematic Review Of Pakistani Women's Health Outcomes From Primary Care Interventions, Sara Rizvi Jafree, Qaisar Khalid Mahmood, Sohail Mujahid, Muhammad Asim, Jane Barlow

Community Health Sciences

Objective: Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women's mental and physical health and (2) identify the factors that promote effectiveness for women's health outcomes.
Methods: Five academic databases were searched, including PubMed, BMC …

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …