Medicine and Health Sciences Commons^™

Linking Determinants And Outcomes: Examining The Relationship Between Key Determinants Of The Implementation Process And Implementation Outcomes, Marin Schmitt

Theses and Dissertations

Background: Implementation science advances public health by studying the process of implementing evidence-based practices in real-world settings. While our knowledge surrounding determinants (factors affecting the implementation process) and outcomes (measures of implementation success) has grown exponentially, it remains difficult to determine which determinants have the greatest impact on the implementation process, as well as their relationship with implementation outcomes. Research is needed to identify 1) key determinants that affect the implementation process, or those found to play the biggest role in the implementation process most frequently and 2) their relationship with implementation outcomes.Methods: The relationship between key determinants and implementation …

Perception Of Lean Adoption Among Emergency Department Personnel In Public Hospitals In Selangor, Malaysia, Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan Puteh, Kiran Ganesh Balakrishnan

Makara Journal of Health Research

Background: This research aims to assess the perceptions of the staff working in emergency departments in Selangor, Malaysia, regarding the adoption of lean management and identify the factors that affect their perceptions.

Methods: A cross-sectional study using the Lean in Healthcare Questionnaire was conducted with 251 respondents, which consisted of doctors, nurses and medical assistants employed in three selected hospitals.

Results: One-way analysis of variance (ANOVA) showed a significant difference in every domain score in accordance with the occupation category. For the domain process, a significant negative correlation was found between age and domain score (r = …

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, …

Frailty And Pain In An Acute Private Hospital: An Observational Point Prevalence Study, Rosemary Saunders, Kate Crookes, Karla Seaman, Seng Giap Marcus Ang, Caroline Bulsara, Max K. Bulsara, Beverley Ewens, Olivia Gallagher, Renée Graham, Karen Gullick, Sue Haydon, Jeff Hughes, Kim-Huong Nguyen, Bev O’Connell, Debra Scaini, Christopher Etherton-Beer

Research outputs 2022 to 2026

Frailty and pain in hospitalised patients are associated with adverse clinical outcomes. However, there is limited data on the associations between frailty and pain in this group of patients. Understanding the prevalence, distribution and interaction of frailty and pain in hospitals will help to determine the magnitude of this association and assist health care professionals to target interventions and develop resources to improve patient outcomes. This study reports the point prevalence concurrence of frailty and pain in adult patients in an acute hospital. A point prevalence, observational study of frailty and pain was conducted. All adult inpatients (excluding high dependency …

All-Cause And Opioid-Related Mortality Compared Between Traumatic Spinal Cord Injury And The Us General Population, Jaden Whitehead, Beatrice Ugiliweneza

The Cardinal Edge

Individuals with spinal cord injury (SCI) are susceptible to the misuse of opioids due to the introduction of these substances for pain management. There are very few studies examining the relationship between unintentional deaths caused by opioid usage following spinal cord injury. The objective of this study was to evaluate the trend of opioid-related mortality of individuals with spinal cord injury (SCI) over the years and compare these findings to the mortality rates due to opioid misuse in the general population. In this study, we used data provided by the National Spinal Cord Injury Model Systems (NSCIMS) for SCI 1999-2016 …

Delivering Health Services During Early Days Of Covid-19 Pandemic: Perspectives Of Frontline Healthcare Workers In Kenya’S Urban Informal Settlements, Vibian Angweny, Sabina Odero, Stephen Mulupi, Derrick Ssewanyana, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development

The COVID-19 pandemic has caused widespread disruptions to health, economic and social lives globally. This qualitative study explores frontline healthcare workers’ (HCWs) experiences delivering routine care in Kenya’s informal settlements during the early phases of the pandemic, amidst stringent COVID-19 mitigation measures. Thirteen telephone interviews were conducted with facility and community-based HCWs serving three informal settlements in Nairobi and Mombasa. Data were analyzed using the framework approach. Results indicate there were widespread fears and anxieties surrounding COVID-19 and its management. Secondly, access to facility-based care at the onset of the pandemic was reported to decline, with service availability hampered by …

Tackling Dementia Together Via The Australian Dementia Network (Adnet): A Summary Of Initiatives, Progress And Plans, Sharon L. Naismith, Johannes C. Michaelian, Cherry Santos, Inga Mehrani, Joanne Robertson, Kasey Wallis, Xiaoping Lin, Stephanie A. Ward, Ralph Martins, Colin L. Masters, Michael Breakspear, Susannah Ahern, Jurgen Fripp, Peter R. Schofield, Perminder S. Sachdev, Christopher C. Rowe

Research outputs 2022 to 2026

In 2018, the Australian Dementia Network (ADNeT) was established to bring together Australia's leading dementia researchers, people with living experience and clinicians to transform research and clinical care in the field. To address dementia diagnosis, treatment, and care, ADNeT has established three core initiatives: the Clinical Quality Registry (CQR), Memory Clinics, and Screening for Trials. Collectively, the initiatives have developed an integrated clinical and research community, driving practice excellence in this field, leading to novel innovations in diagnostics, clinical care, professional development, quality and harmonization of healthcare, clinical trials, and translation of research into practice. Australia now has a national …

Nursing In A Different World: Remote Area Nursing As A Specialist–Generalist Practice Area, Kylie Mccullough, Sara Bayes, Lisa Whitehead, Anne Williams, Vicki Cope

Research outputs 2022 to 2026

Objective

Remote area nurses provide primary health care services to isolated communities across Australia. They manage acute health issues, chronic illness, health promotion and emergency responses. This article discusses why their generalist scope of practice should be formally recognised as a specialist nursing practice area.

Design

Constructivist grounded theory, using telephone interviews (n = 24) with registered nurses and nurse practitioners.

Setting

Primary health care clinics, in communities of 150–1500 residents across Australia.

Participants

A total of 24 nurses participated in this study.

Results

Nurses' perceived their clinical knowledge and skill as insufficient for the advanced, generalist, scope of …

The Need For Sexual Health Clinics, Their Future Role, And Contribution To Public Health, Meena S. Ramchandani, Christopher Bourne, Lindley A. Barbee, Elske Hoornenborg, Preeti Pathela, Stephanie N. Taylor, Henry De Vries

School of Medicine Faculty Publications

Specialised sexual health clinics (SHCs) play an important role in addressing the staggering rates of STIs seen in many high-income nations. Despite increasing healthcare coverage in the US and nationalised health care in some countries, there is a continued need for SHCs to meet the needs of patients and the community, especially for high-priority populations: those at high risk of STI acquisition and/or groups historically marginalised and underserved in the traditional healthcare system. We need to mobilise resources to support a stronger clinical infrastructure in specialised SHCs. This review describes the importance of SHCs, their future role, and some of …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

Predicting Duration Of Outpatient Physical Therapy Episodes For Individuals With Spinal Cord Injury Based On Locomotor Training Strategy, Mauricio Garnier-Villarreal, Daniel Pinto, Chaithanya K. Mummidisetty, Arun Jayaraman, Candy Tefertiller, Susan Charlifue, Heather B. Tayler, Shuo-Hsiu Chang, Nicholas Mccombs, Catherine L. Furbish, Edelle C. Field-Fote, Allen W. Heinemann

Physical Therapy Faculty Research and Publications

Objective

To characterize individuals with spinal cord injuries (SCI) who use outpatient physical therapy or community wellness services for locomotor training and predict the duration of services, controlling for demographic, injury, quality of life, and service and financial characteristics. We explore how the duration of services is related to locomotor strategy.

Design

Observational study of participants at 4 SCI Model Systems centers with survival. Weibull regression model to predict the duration of services.

Setting

Rehabilitation and community wellness facilities at 4 SCI Model Systems centers.

Participants

Eligibility criteria were SCI or dysfunction resulting in motor impairment and the use of …

Evaluating The Military Medical Evacuation Dispatching And Delivery Problem Via Simulation And Self-Exciting Hawkes Process, Virbon B. Frial

Theses and Dissertations

The location, allocation, and utilization of military medical evacuation (MEDEVAC) resources significantly impact the quality and timeliness of medical care to injured troops. In 2009, Secretary of Defense Robert Gates introduced the Golden Hour mandate that entails the evacuation of critically-injured troops to military treatment facilities (MTFs) within an hour to prevent further complications. To develop high-quality policies that improve MEDEVAC system performance, several papers in the current literature assume that MTFs have both the capacity and capability of treating any patient, regardless of the type of injury. However, these assumptions are unrealistic when conducting high-intensity operations. While acknowledging MTF …

Frequency And Types Of Healthcare Encounters In The Week Preceding A Sepsis Hospitalization: A Systematic Review, Alexander H. Flannery, Chad M. Venn, Amanda Gusovsky, Stephanie Henderson, Adam S. Kiser, Hallie C. Prescott, Chanu Rhee, Chris Delcher, Peter E. Morris

Pharmacy Practice and Science Faculty Publications

OBJECTIVES: Early recognition and treatment are critical to improving sepsis outcomes. We sought to identify the frequency and types of encounters that patients have with the healthcare system in the week prior to a sepsis hospitalization.

DATA SOURCES: PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and the Cochrane Library.

STUDY SELECTION: Observational cohort studies of patients hospitalized with sepsis or septic shock that were assessed for an outpatient or emergency department encounter with the healthcare system in the week prior to hospital admission.

DATA EXTRACTION: The primary outcome was the proportion of patients with a healthcare encounter …

A Retrospective Cohort Study Of Factors Associated With Severity Of Falls In Hospital Patients, Manonita Ghosh, Beverly O’Connell, Ebenezer Afrifa-Yamoah, Sue Kitchen, Linda Coventry

Research outputs 2022 to 2026

Severity of falls in hospital patients are threat to patient safety which can result in a financial burden on the patient’s family and health care services. Both patient specific and environmental and organisational factors are associated with severity of falls in hospital. It is important to continuously analyse the factors associated with severity of fall which can inform the implementation of any fall preventive strategies. This study aims to identify factors associated with the severity of falls in hospitalised adult patients in Western Australia. This study involved a retrospective cohort analysis of inpatient falls records extracted from the hospital’s Clinical …

Factors Affecting Retention In The Philippine National Rural Physician Deployment Program From 2012 To 2019: A Mixed Methods Study, Erika Louise L. Flores, Edric Matthew R. Manahan, Miguel Paulo B. Lacanilao, Isabella Ma. Beatriz T. Ladaw, Mico Martin B. Mallillin, Nikolai Thadeus Q. Mappatao, Juan Alfonso Leonardia, Veincent Christian F. Pepito

Ateneo School of Medicine and Public Health Publications

Background

To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment.

Methods

A descriptive, mixed-methods, explanatory design was …

Looking Back And Moving Forward: A Scoping Review Of Research On Preschool Autism Interventions In The Field Of Speech-Language Pathology, Amanda Binns, Rachael Smyth, Allison Andres, Joyce Lam, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Background & Aims: Speech-language pathology services are frequently accessed by families of children who have suspected or diagnosed autism. This is expected given that social communication differences are a core feature of autism. This review looked broadly at the state of research in the field of speech-language pathology and preschool autism interventions in order to identify the types of studies that could be used to inform the practices of speech-language pathologists (SLPs), and to identify gaps in the field so they can be addressed in future research. Specifically, we examined the extent of research conducted on interventions delivered (at least …

Rural Hiv Prevalence And Service Availability In The United States: A Chartbook, Katherine Ahrens Phd, Amanda Burgess Mppm, Louisa Munk, Erika Ziller Phd

Population Health

This chartbook examines 2016 HIV prevalence and the availability of HIV prevention, testing, and treatment services across the rural-urban continuum and by US Census region. Publicly available county-level HIV prevalence data from the CDC and state-produced HIV surveillance reports were used to estimate HIV prevalence across the rural-urban continuum. HIV prevalence data include all diagnoses of HIV infection, with or without a stage 3 (AIDS) diagnosis. Geocoded data on organizations that provide prevention, testing, and treatment services related to HIV were obtained from the National Prevention Information Network.

HIV prevalence is higher in urban counties than rural counties (399 per …

Factors Influencing Health Service Utilization Among The Elderly In Insein Township, Yangon Region, Sandar Min Min Hlaing, Naw Clara, Aye Nanda Han

Makara Journal of Health Research

Background: With the increasing needs of the aging population and the increasing prevalence of non-communicable diseases, assessment of the equity and accessibility of health care among the elderly has become important.

Methods: A cross-sectional descriptive study was conducted from December 2018 to December 2019 among 225 elderly to describe the factors influencing health service utilization. Multistage sampling was applied, and structured questionnaire was used to interview the elderly. Chi-squared test and multiple logistic regression were performed in data analysis.

Results: The average age of the respondents was 71.7 ± 8.17 years old, and 68.4% of the respondents …

The Application Of Drones In Healthcare And Health-Related Services In North America: A Scoping Review, Bradley Hiebert, Elysée Nouvet, Vyshnave Jeyabalan, Lorie Donelle

Health Studies Publications

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Using drone aircraft to deliver healthcare and other health-related services is a relatively new application of this technology in North America. For health service providers, drones represent a feasible means to increase their efficiency and ability to provide services to individuals, especially those in difficult to reach locations. This paper presents the results of a scoping review of the research literature to determine how drones are used for healthcare and health-related services in North America, and how such applications account for human operating and machine design factors. Data were collected from …

The Health Wagon Partners With The Virginia Department Of Health To Provide Covid-19 Testing In Rural Southwest Virginia, Tauna Gulley, Teresa Tyson, Ethan Collins, Rachel Helton, Paula Hill-Collins, Nicole France, Sarah Hubbard

Journal of Appalachian Health

The Health Wagon has been providing care for the rural population of southwest Virginia for the past 40 years. The mission of the Health Wagon is to provide quality health care to the medically underserved people in the mountains of Appalachia. It has expanded to two stationary clinics, three mobile units, and a mobile dental unit, logging over 19,000 patients encounters in the past year.

Health And Dental Care Expenditures In The United States From 1996 To 2016, Man Hung, Martin S. Lipsky, Ryan Moffat, Evelyn Lauren, Eric S. Hon, Jungweon Park, Gagandeep Gill, Julie Xu, Lourdes Peralta, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: As total health and dental care expenditures in the United States continue to rise, healthcare disparities for low to middle-income Americans creates an imperative to analyze existing expenditures. This study examined health and dental care expenditures in the United States from 1996 to 2016 and explored trends in spending across various population subgroups.

Methods: Using data collected by the Medical Expenditure Panel Survey, this study examined health and dental care expenditures in the United States from 1996 to 2016. Trends in spending were displayed graphically and spending across subgroups examined. All expenditures were adjusted for inflation or …

Traditional Funeral And Burial Rituals And Ebola Outbreaks In West Africa: A Narrative Review Of Causes And Strategy Interventions, Chulwoo Park

Faculty Publications

Introduction: In West Africa, traditional funerals and burials have proven main contributors to the spread of infectious diseases, such as Ebola, plague, the Marburg virus, and others. Although the World Health Organization has provided guidelines for the safe burial process after learning of the culture of the afterlife in Ebola-affected areas, little effort has been made to integrate theoretical interventions and models for changing West Africans’ funeral behavior. This research was conducted to study 1) the background of traditional burial rituals, 2) interventions to contain Ebola outbreaks in West Africa, and 3) a strategic approach to future disease outbreak in …

Preferred Treatment Methods For Patients With Inflammatory Bowel Disease, James L. Deitschel

Theses and Dissertations

Shared decision making is the concept of physicians involving patients in the treatment planning process. The University of Maryland Medical Center is interested in applying shared decision making to the treatment of patients with Inflammatory Bowel Disease (IBD). The two treatment methods analyzed in this study were medical management and surgery. To explore patient preferences between these two alternatives, a discrete choice experiment (DCE) was employed. The responses for the DCE were binary, so logistic regression models were explored. The conditional logistic regression model was determined to be the most appropriate for this analysis. After step-wise regression was performed, a …

Depression And Awareness Of Mental Health Resources Among Minority And Non-Minority College Students, Henry David Browne

Walden Dissertations and Doctoral Studies

Minority college students experience higher levels of psychological stress and depression, and lower utilization of mental health resources (MHR) compared to the general student population. The purpose of this quantitative study was to examine the association between self-reported depressive symptoms and awareness of mental health services among college undergraduate minority and non-minority students, controlling for sex, interest in MHR information, and history of mental illness. The self-determination theory guided the study. The study utilized a cross-sectional research design using secondary survey data from the National College Health Assessment (NCHA). The NCHA dataset included 354,262 respondents from 52 self-selected U.S. colleges …

Unconditional Cash Transfers For Assistance In Humanitarian Disasters: Effects On The Use Of Health Services And Health Outcomes In Low- And Middle-Income Countries, Frank Pega, Sze Yan Liu, Stefan Walter, S K. Lhachimi

Sze Yan Liu

BACKGROUND:

Unconditional cash transfers (UCTs) are a common social protection intervention that increases income, a key social determinant of health, in disaster contexts in low- and middle-income countries (LMICs).

OBJECTIVES:

To assess the effects of UCTs in improving health services use, health outcomes, social determinants of health, health care expenditure, and local markets and infrastructure in LMICs. We also compared the relative effectiveness of UCTs delivered in-hand with in-kind transfers, conditional cash transfers, and UCTs paid through other mechanisms.

SEARCH METHODS:

We searched 17 academic databases, including the Cochrane Public Health Group Specialised Register, the Cochrane Database of Systematic Reviews …

Health-Seeking Behavioral Patterns Among Refugee Groups – A Case-Study In South-Central Kentucky, Chika Ejike, Grace Lartey, Randy Capps, David Ciochetty

Journal of Refugee & Global Health

Each year, thousands of people get displaced from their homes due to genocide, famine, civil wars and other crises in their countries. The United States has traditionally been receptive to resettling refugees. These refugees view resettlement as an opportunity to obtain proper health care. Due to the diverse cultural identities of refugee populations, it is essential to research complex culturally dependent healthcare utilization patterns. A purposeful sample of four refugees from the Burmese, Congolese and Iraqi refugee communities in south-central Kentucky- completed interviews. They shared experiences and insights from their cultural points of view. Results showed demographic factors directly impacted …

Oral Rapid Hiv Testing In The Dental Setting: Experiences From Three Dental Hygiene Clinics, Anthony J. Santella, Petal Leuwaisee, Susan H. Davide, Hanna Horowitz, Bhuma Krishnamachari

Publications and Research

Background: Oral rapid HIV testing (ORHT) is implemented in the dental setting to make individuals aware of their possibly undiagnosed HIV infection. The testing process and characteristics of clients willing to receive ORHT has yet, however, to be systematically collected. Case description: Three dental hygiene clinics located in academic institutions implemented ORHT from March 2016 to April 2017. Results: 231 persons received ORHT; all had non-reactive results. Most had seen a primary care provider in the past year (n = 130), had had a previous ORHT (n = 111), and described themselves as extremely likely or likely to accept a …

Twelve Principles To Support Caregiver Engagement In Health Care Systems And Health Research, Kerry Kuluski, Kristina M. Kokorelias, Allie Peckham, Jodeme Goldhar, John Petrie, Carole Anne Alloway

Patient Experience Journal

Family and friend caregivers (i.e., unpaid carers) play a critical role in meeting the needs of people across various ages and illness circumstances. Caregiver experiences and expertise, which are currently overlooked, should be considered in practice (such as designing and evaluating services) and when designing and conducting research. In order to improve the quality of health care we need to understand how best to meaningfully engage caregivers in research, policy and program development to fill this important gap. Our study aimed to determine principles to support caregiver engagement in practice and research. A pan Canadian meeting brought together 48 stakeholders …

College Of Health Professions News, Georgia Southern University

Waters College of Health Professions News (2018-2023)

• Exercise is Medicine on Campus names Georgia Southern Gold Level Campus

Adult Vaccination Rates In The Mentally Ill Population: An Outpatient Improvement Project, Leslie W. Miles, Nathalia Williams, Karlen Beth Luthy, Lacey Eden

Faculty Publications

Background: Adults who suffer with severe and persistent mental illness (SPMI) rarely access medical care to receive preventive vaccines. Aims: To increase the rate of vaccines among the SPMI population in an outpatient community mental health center (CMHC). Methods: A review of the literature identified a gap between the general population and SPMI clients in receiving preventive vaccinations. An initial mixed-method convenience survey of SPMI clients (n = 392) provided information on current vaccination status, demographics, beliefs, and interest in receiving vaccines. A vaccination program was developed to address identified barriers and increase vaccination rates. Postintervention data were collected …