Public Health Commons^™

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Will Lehmann, MD

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …

Identifying And Targeting Age-Related Colorectal Cancer Screening Rate Disparities In Family Medicine Residency Clinics, Jonathan J. Blaza, Jasmine R. Wiley, Matthew Gill, Alonzo Jalan, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns

Will Lehmann, MD

Background: Health care systems continuously seek to improve patient care through population-level analysis of clinical quality metrics and patient characteristics to identify disparities in care. Nationally, disparities in colorectal cancer (CRC) screening rates have been identified with lower screening rates reported for patients who are uninsured and/or lower socioeconomic status, African American/black, Asian, and non-English-speaking Hispanic patients. No age-related CRC screening rate disparities with associated interventions have been reported.

Purpose: Determine and address CRC screening disparities in care provided to eligible patients > 50 years old in two primary care residency clinics.

Methods: Retrospective analysis using REAL-G (race, ethnicity, age, preferred …

Intellectual Property And Public Health – A White Paper, Ryan G. Vacca, Jim Chen, Jay Dratler Jr., Tom Folsom, Timothy Hall, Yaniv Heled, Frank Pasquale, Elizabeth Reilly, Jeff Samuels, Kathy Strandburg, Kara Swanson, Andrew Torrance, Katharine Van Tassel

Katharine Van Tassel

On October 26, 2012, the University of Akron School of Law’s Center for Intellectual Property and Technology hosted its Sixth Annual IP Scholars Forum. In attendance were thirteen legal scholars with expertise and an interest in IP and public health who met to discuss problems and potential solutions at the intersection of these fields. This report summarizes this discussion by describing the problems raised, areas of agreement and disagreement between the participants, suggestions and solutions made by participants and the subsequent evaluations of these suggestions and solutions.

Led by the moderator, participants at the Forum focused generally on three broad …

Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns

Jeffrey Stearns, MD

Background: Hospital readmission rates are a focus of the Centers for Medicare and Medicaid Services. This was identified as a system opportunity to improve health care quality and patient education in order to reduce preventable readmissions. In 2009, 27% of obstetric readmissions were due to hypertensive disease, and preventable readmissions regarding hypertension are flagged as an area for quality improvement in our health care system. There is limited evidence on specific management of postpartum hypertension.

Purpose: Identify risk factors in our community and reduce postpartum readmissions for hypertension within our hospital.

Methods: We performed a retrospective chart review from November …

Identifying And Targeting Age-Related Colorectal Cancer Screening Rate Disparities In Family Medicine Residency Clinics, Jonathan J. Blaza, Jasmine R. Wiley, Matthew Gill, Alonzo Jalan, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns

Jeffrey Stearns, MD

Background: Health care systems continuously seek to improve patient care through population-level analysis of clinical quality metrics and patient characteristics to identify disparities in care. Nationally, disparities in colorectal cancer (CRC) screening rates have been identified with lower screening rates reported for patients who are uninsured and/or lower socioeconomic status, African American/black, Asian, and non-English-speaking Hispanic patients. No age-related CRC screening rate disparities with associated interventions have been reported.

Purpose: Determine and address CRC screening disparities in care provided to eligible patients > 50 years old in two primary care residency clinics.

Methods: Retrospective analysis using REAL-G (race, ethnicity, age, preferred …

Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell

Jacob Bidwell, MD

The author and issue editor describes the changing faces of health care as well as movements undertaken by U.S. health systems over the last two decades to improve the treatment and documented outcomes of minority or impoverished patients and to understand the impact of cultural differences on patient care. While much progress has been made, achieving health equity will require the continued efforts of many working toward this goal.

Prescription Drug Abuse Communication: A Qualitative Analysis Of Prescriber And Pharmacist Perceptions And Behaviors, Nicholas E. Hagemeier, Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Angela Hagaman, Robert P. Pack

Nicholas E. Hagemeier

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods: Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central …

Predictors Of Neonatal Abstinence Syndrome In Buprenorphine Exposed Newborn: Can Cord Blood Buprenorphine Metabolite Levels Help?, Darshan Shah, Stacy Brown, Nick Hagemeier, Shimin Zheng, Amy Kyle, Jason Pryor, Nilesh Dankhara, Piyuesh Singh

Nicholas E. Hagemeier

Background

Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns.

Methods

Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and …

Interprofessional Research, Training And Outreach: The Etsu Prescription Drug Abuse/Misuse Working Group, Robert P. Pack, Angela Hagaman, Sara Warfield, Jeffry A. Gray, Fred Tudiver, Arsham Alamian, Nicholas E. Hagemeier

Nicholas E. Hagemeier

No abstract provided.

Integration Of Rural Community Pharmacies Into A Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis, Nicholas E. Hagemeier, Sarah Blevins, Kyle Hagen, Emily Sorah, Richa Shah, Kelly Ferris

Nicholas E. Hagemeier

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation.

Methods: The sample consisted of community pharmacies within city limits …

Prevalence And Correlates Of Indoor Tanning And Sunless Tanning Product Use Among Female Teens In The United States, Megan Quinn, Arsham Alamian, Joel J. Hillhouse, Colleen Scott, Rob Turrisi, Katie Baker

Arsham Alamian

Background

Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens.

Methods

Teenage females (N = 778) aged 12–18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP …

Infant Sleep Problems And Childhood Overweight: Effects Of Three Definitions Of Sleep Problems, Arsham Alamian, Liang Wang, Amber M. Hall, Melanie Pitts, Joseph Ikekwere

Arsham Alamian

Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n=895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking …

Individual And Social Determinants Of Multiple Chronic Disease Behavioral Risk Factors Among Youth, Arsham Alamian, Gilles Paradis

Arsham Alamian

BACKGROUND: Behavioral risk factors are known to co-occur among youth, and to increase risks of chronic diseases morbidity and mortality later in life. However, little is known about determinants of multiple chronic disease behavioral risk factors, particularly among youth. Previous studies have been cross-sectional and carried out without a sound theoretical framework. METHODS: Using longitudinal data (n = 1135) from Cycle 4 (2000-2001), Cycle 5 (2002-2003) and Cycle 6 (2004-2005) of the National Longitudinal Survey of Children and Youth, a nationally representative sample of Canadian children who are followed biennially, the present study examines the influence of a set of …

Interprofessional Research, Training And Outreach: The Etsu Prescription Drug Abuse/Misuse Working Group, Robert P. Pack, Angela Hagaman, Sara Warfield, Jeffry A. Gray, Fred Tudiver, Arsham Alamian, Nicholas E. Hagemeier

Arsham Alamian

No abstract provided.

Ethnic Differences In Risk Factors For Obesity Among Adults In California, The United States, Liang Wang, Jodi L. Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, Youfa Want

Arsham Alamian

Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites …

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Fabiana Kotovicz, MD

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin. Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. …

2017 Florida Data Science For Social Good (Fl-Dssg) Annual Report, F. Dan Richard, Karthikeyan Umapathy

Karthikeyan Umapathy

The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans.

Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members.

Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

The Value In Verifying Medical Folklore, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Citing a related article published within this issue of the Journal of Patient-Centered Research and Reviews, the author opines on why traditional ideas regarding human health can persist over decades, and even centuries, despite a lack of scientifically accumulated evidence. It is important to keep in mind that some commonly accepted truths are supported by little to no factual data, and that occasionally patients may benefit from clarification on what is (or, often, is not) actually known about longstanding “rules of thumb” (eg, certain home remedies, disease-prevention measures or behavioral concerns). On the flip side, traditions that are shown to …

New South Wales Child Development Study (Nsw-Cds): An Australian Multiagency, Multigenerational, Longitudinal Record Linkage Study, Vaughn J. Carr, Felicity Harris, Alessandra Raudino, Luming Luo, Maina Kariuki, Enwu Liu, Stacy Tzoumakis, Maxwell Smith, Allyson Holbrook, Miles Bore, Sally Brinkman, Rhoshel Lenroot, Katherine Dix, Kimberlie Dean, Kristin R. Laurens, Melissa J. Green

Dr Katherine Dix

The initial aim of this multiagency, multigenerational record linkage study is to identify childhood profiles of developmental vulnerability and resilience, and to identify the determinants of these profiles. The eventual aim is to identify risk and protective factors for later childhood-onset and adolescent-onset mental health problems, and other adverse social outcomes, using subsequent waves of record linkage. The research will assist in informing the development of public policy and intervention guidelines to help prevent or mitigate adverse long-term health and social outcomes.

Positive Impact On Patient Satisfaction And Caregiver Identification Using Team Facecards: A Quality Improvement Study, Nicole M. Martin, Khalil Odeh, Lamya Boujelbane, Marvi V. Rijhwani, Susan Olet, Aijaz Noor, Colleen Nichols, Richard Battiola

Colleen Nichols

Background: Patients satisfaction is an increasingly important metric in measuring the quality of care that hospitals and physicians provide. It can be difficult for patients to remember their providers and their roles, all of which may potentially impact a patient’s overall satisfaction. Purpose: To see if giving facecards with pictures and names of caregivers and description of roles improved patient satisfaction and identification of care team members. Methods: Team facecards were designed and distributed to the patients during the interventional period of the study. Patients’ identification of team members, the role of each physician and overall satisfaction was measured using …

Authentic Leadership In Illness Blogs: What We Can Learn From Jaw Surgery Bloggers, Marilyn Mitchell

Marilyn Mitchell

This paper argues that authentic leadership theory provides a useful model for explaining the communication of orthognathic or jaw surgery bloggers. Previous studies concluded that illness blogs can empower patients, but no research considered any leadership theory as a model for blogging. For this study, 24 publicly available blogs were analyzed to find expressions that demonstrated each of the four components of authentic leadership, which are self-awareness, relational transparency, communication based upon an internalized moral perspective, and balanced processing of information. The research also analyzed blog comments to find expressions that demonstrated followers’ development of the positive psychological capacities of …

Benefits Of The 340b Drug Discount Program, Jarrett Gerlach, Sarah Mcsweeney, Angela Swearingen, Nitesh Patil, Alberto Coustasse

Jarrett D. Gerlach

Introduction: The 340B Drug Discount Program required drug manufacturers provide discounted outpatient drugs to healthcare organizations which serve vulnerable patient populations to allow these institutions to offer more services to more people. As the 340B program expanded, controversy has centered on which entities have benefited from the program. Many healthcare organizations sold 340B drugs to well-insured patients at full price, and thus have been financially rewarded. Amendments to the program have permitted 340B providers to utilize contract pharmacies to dispense 340B medication, which has furthered the debate over which stakeholders are benefiting from the program. Purpose of the Study: The …

Benefits Of The 340b Drug Discount Program, Jarrett Gerlach, Sarah Mcsweeney, Angela Swearingen, Nitesh Patil, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: The 340B Drug Discount Program required drug manufacturers provide discounted outpatient drugs to healthcare organizations which serve vulnerable patient populations to allow these institutions to offer more services to more people. As the 340B program expanded, controversy has centered on which entities have benefited from the program. Many healthcare organizations sold 340B drugs to well-insured patients at full price, and thus have been financially rewarded. Amendments to the program have permitted 340B providers to utilize contract pharmacies to dispense 340B medication, which has furthered the debate over which stakeholders are benefiting from the program. Purpose of the Study: The …

Segmenting Human Trajectory Data By Movement States While Addressing Signal Loss And Signal Noise, Sungsoon Hwang, Cynthia Vandemark, Navdeep Dhatt, Sai Yalla, Ryan Crews

Sungsoon Hwang

Jantzer, Anderson, Kuehl (2017) Jhl Breastfeeding Support And Work-Life Balance.Pdf, Amanda M. Jantzer, Anderson Jenn, Rebecca A. Kuehl

Rebecca A. Kuehl

No abstract provided.

2018 Cal Poly Basic Needs Report, Aydin Nazmi

Aydin Nazmi

No abstract provided.

Research Methods, Rsm311q (Birthingway College Of Midwifery), Daina Dickman

Daina Dickman, MA, MLIS, AHIP

Characterization Of Plasmodium Falciparum And Plasmodium Vivax Recent Exposure In An Area Of Significantly Decreased Transmission Intensity In Central Vietnam, Johanna Helena Kattenberg, Annette Erhart, Minh Hieu Truong, Eduard Rovira-Vallbona, Khac Anh Dung Vu, Thi Hong Ngoc Nguyen, Van Hong Nguyen, Van Van Nguyen, Melanie Bannister-Tyrrell, Michael Theisen, Adam Bennet, Andrew A. Lover, Thanh Duong Tran, Xuan Xa Nguyen, Anna Rosanas-Urgell

Andrew Lover