Health Services Research 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 …

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 …

Family Planning Information, Education And Communication With Contaceptive Use, Endah Winarni, Muhammad Dawam

Kesmas

Komunikasi Informasi dan Edukasi (KIE) berperan penting dalam meningkatkan pencapaian prevalensi kesertaan Keluarga Berencana (KB). Namun, prevalensi KB di Indonesia selama satu dekade terakhir (2002-2012) tidak meningkat secara signifikan, walaupun pelbagai kegiatan KIE KB telah dilaksanakan. Penelitian ini bertujuan untuk mengetahui faktor sosio ekonomi demografi yang berkaitan dengan KIE KB, pelbagai unsur KIE yang berkaitan dengan pemakaian KB, dan unsur KIE yang berpengaruh terhadap pemakaian KB. Analisis menggunakan sumber data Survei Demografi dan Kesehatan Indonesia 2012 dengan unit analisis perempuan berstatus kawin usia 15-49 tahun. Jumlah sampel yang dianalisis 33.465 perempuan berstatus kawin. Analisis menggunakan odds ratio atau rasio kecenderungan …

Effectivity Of Foot Care Education Program In Improving Knowledge, Self-Efficacy And Foot Care Behavior Among Diabetes Mellitus Patients In Banjarbaru, Indonesia, Mahdalena Mahdalena, Endang Sri Purwanti Ningsih

Kesmas

Masalah kaki diabetik di Indonesia masih merupakan masalah besar dan masih memerlukan perhatian yang optimal. Edukasi perawatan kaki adalah salah satu upaya yang harus dilakukan dalam mencegah masalah kaki untuk pasien diabetes melitus. Penelitian ini bertujuan untuk menganalisis efektivitas program pendidikan perawatan kaki dalam meningkatkan pengetahuan, efikasi diri, dan perilaku perawatan kaki pasien diabetes di wilayah Banjarbaru. Jenis penelitian yang digunakan adalah quasi experimental dengan prepost test, dilakukan di puskesmas wilayah Banjarbaru tahun 2013. Kelompok intervensi diberikan program pendidikan perawatan kaki. Sampel berjumlah 48 pasien (32 orang kelompok intervensi dan 16 orang kelompok kontrol) menggunakan teknik purposive sampling. Variabel yang …

Motivation Variables To Use Contraceptive Among Male In Yogyakarta, Susiana Sariyati, Febrina Suci Hati, Fatimah Fatimah

Kesmas

Program Keluarga Berencana (KB) merupakan salah satu program pembangunan nasional yang sangat penting dalam rangka mewujudkan keluarga Indonesia yang sejahtera. Peran program KB sangat besar pengaruhnya terhadap kesehatan reproduksi seseorang, baik untuk kesehatan reproduksi perempuan maupun kesehatan reproduksi laki-laki. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan motivasi laki-laki pasangan usia subur dalam menggunakan kontrasepsi di Desa Bumijo, Kecamatan Jetis, Kota Yogyakarta. Jenis penelitian ini bersifat kuantitatif dengan analisis regresi logistik. Hasil penelitian menunjukkan hubungan pengetahuan dengan motivasi yaitu nilai p = 0,368. Hubungan sosial budaya dengan motivasi yaitu nilai p = 0,147. Hubungan pendidikan dengan motivasi yaitu nilai …

The Risk Of Pneumonia Among Toddlers In Lambatee, Aceh, Rapitos Sidiq, Ritawati Ritawati, Roma Sitio, Siti Hajar

Kesmas

Pneumonia merupakan salah satu masalah kesehatan global yang sangat penting pada anak bawah lima tahun (balita), khususnya pada negara-negara berkembang. Saat ini, pneumonia merupakan salah satu kasus penyebab kematian pada anak terbesar, terutama pada periode baru lahir. Di Provinsi Aceh, penyakit pneumonia merupakan penyakit urutan ke-8 dari 25 penyakit terbesar yang ditemukan di puskesmas dengan jumlah 1.112 kasus. Sedangkan besarnya kasus pneumonia pada penderita rawat jalan di Aceh mencapai 434 kasus (29,03%). Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian pneumonia pada balita. Penelitian bersifat analitik dengan desain potong lintang. Sampel penelitian adalah ibu dan balita yang berjumlah …

Basis For Development Of Business Strategic Plan Primary Health Care With Local Public Service Entity Status In Gianyar District, Putu Ayu Indrayathi, Luh Putu Sinthya Ulandari

Kesmas

Puskesmas yang berbentuk Badan Layanan Umum Daerah (BLUD) perlu membuat rencana strategi bisnis yang tepat. Penyusunan rencana strategi bisnis perlu memerhatikan pesaing yang beroperasi di sekitar wilayah kerja. Penelitian ini bertujuan untuk mempelajari aspek lingkungan internal dan eksternal di Puskesmas Ubud 1 dan Tegallalang 1 serta mengembangkan model pengembangan rencana strategi bisnis di kedua puskesmas yang berstatus BLUD tersebut. Penelitian ini merupakan penelitian deskriptif eksploratif yang dilakukan pada tahun 2014. Data dikumpulkan melalui penyebaran kuesioner dan studi dokumentasi. Sampel penelitian ditentukan secara purposif dan diambil secara non proporsional, terdiri dari kepala dan staf Puskesmas Ubud 1 dan Tegallalalng 1. Data …

Coronary Heart Disease Risk Factors Among Women Aged Older Than 45 Years Old In Makassar, Masriadi Masriadi, Hasta Handayani Idrus, Arman Arman

Kesmas

Penyakit kardiovaskuler menyebabkan 8.6 juta kematian pada perempuan setiap tahun, yang merupakan penyebab kematian terbanyak, yaitu sepertiga dari seluruh kematian perempuan di seluruh dunia. Setengah dari seluruh kematian perempuan berusia di atas 50 tahun disebabkan oleh penyakit jantung dan stroke. Penelitian ini bertujuan untuk menganalisis faktor yang berhubungan dengan penyakit jantung koroner pada perempuan usia > 45 tahun di Rumah Sakit TNI AU Dody Sarjoto Makassar. Besar sampel sebanyak 76 sampel yang terdiri dari 64 kasus penyakit jantung koroner dan 12 kasus non penyakit jantung koroner. Penentuan sampel menggunakan metode purposive sampling. Data primer diperoleh melalui wawancara terhadap responden dengan menggunakan …

Lack Of Exclusive Breastfeeding Among Working Mothers In Indonesia, Yulia Sari

Kesmas

Keberlangsungan proses menyusui pada saat ibu kembali bekerja merupakan isu serius yang harus segera ditindaklanjuti agar program pemberian Air Susu Ibu (ASI) eksklusif selama enam bulan pertama kehidupan dapat tercapai. Selain memberikan banyak manfaat bagi bayi, ASI juga bermanfaat bagi ibu dan pengusaha. Penelitian ini bertujuan untuk mengetahui hubungan ibu bekerja terhadap pemberian ASI eksklusif. Desain penelitian yang digunakan adalah potong lintang dengan data sekunder Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 dengan sampel berjumlah 1.193 ibu berusia 15 – 49 tahun yang memiliki bayi berusia 0-5 bulan. Berdasarkan analisis multivariat, ibu bekerja dapat menurunkan peluang pemberian ASI eksklusif …

Social Determinant Of Health Of Adults Smoking Behavior: Differences Between Urban And Rural Areas In Indonesia, Fitri Kurnia Rahim, Thunwadee Suksaroj, Isareethika Jayasvasti

Kesmas

Indonesia memiliki prevalensi perilaku merokok tertinggi di antara negara-negara di Asia Tenggara. Penelitian ini bertujuan untuk mengetahui prediktor terhadap perilaku merokok antara wilayah pedesaan dan perkotaan. Data diambil dari Global Adult Tobacco Survey. Penelitian menggunakan studi analitik potong lintang dan analisis regresi logistik ganda. Sampel berjumlah 8.305 orang dewasa Indonesia berusia ≥ 15 tahun. Penelitian menunjukkan bahwa perokok di wilayah pedesaan lebih tinggi dibandingkan di wilayah perkotaan, masing-masing 36,8% dan 31,9%. Prediktor signifikan terhadap perilaku merokok di wilayah pedesaan dan perkotaan adalah usia, pekerjaan, jenis kelamin, tingkat pendidikan, status ekonomi serta aturan merokok di dalam rumah. Di wilayah perkotaan, usia …

Motor Development And Skill Acquisition In Elementary Aged Students, Joanna M. Guerrant Ms.

Posters-at-the-Capitol

Mastering physical movement occurs through motor learning and experience. Motor development is needed for successful acquisition of sport and other physical skills. A lack of motor skills has been associated with decreased physical activity later in life, which has been linked to a variety of hypokinetic diseases. This study examined motor learning and skill acquisition in elementary age children. Twenty 2^nd-5^th grade students were recruited through the local school system. Subjects did not have any injuries that would preclude them from performing three basic skills (modified squat, tree, and arm and leg raises). IRB approval, parental consent, …

Envisioning Mechanisms For Success: Evaluation Of Ebcd At Cheo, Kristina Rohde, Mireille Brosseau, Diane Gagnon, Jennifer Schellinck, Christine Kouri

Patient Experience Journal

To advance patient engagement (PE) and more comprehensively involve patients, families, and staff in quality improvement (QI) at the Children’s Hospital of Eastern Ontario (CHEO), the Experience Based Co-Design (EBCD) approach was piloted. Set against the backdrop of envisioning factors that would facilitate success, an evaluation was designed to assess five domains: strengthening of mutual understanding, collaboration, and partnerships between patients/families and staff; a greater involvement of patients, families, and staff in QI; satisfaction with the process; the ability of EBCD to generate clear and useful data to ascertain the patient/family and staff experience; and the ability of EBCD to …

Patient Advisors: How To Implement A Process For Involvement At All Levels Of Governance In A Healthcare Organization, Marie-Pascale Pomey, Edith Morin, Catherine Neault, Veronique Biron, Lise Houle, Louise Lavigueur, Guy Bouvette, Nicole St-Pierre, Martin Beaumont

Patient Experience Journal

Patient involvement at the operational (clinical care and services), tactical (management), and strategic (board of directors and executive management) levels of establishments is increasingly sought after. To address this specific challenge, a Canadian healthcare organization, the Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, has developed an integrated strategy based on three principles: (1) shared leadership between a patient and a manager to build the strategy; (2) a clear process for recruiting, training, and coaching patient advisors (PA) so that they can participate in decision-making at the various levels of governance of the establishment; and (3) …

Using Patient Value Statements To Develop A Culture Of Patient-Centred Care: A Case Study Of An Ontario, Canada Hospital, Erica Bridge, Madelyn P. Law, Miya Narushima

Patient Experience Journal

Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario …

Creating A Common Trajectory: Shared Decision Making And Distributed Cognition In Medical Consultations, Katherine D. Lippa, Valerie L. Shalin

Patient Experience Journal

The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patients and assess how distributed clinical cognition functions during interactions between medical professionals and patients with Multiple Sclerosis (MS). A combination of cognitive task analysis and discourse analysis reveals the distribution of clinical reasoning between 24 patients and 3 medical professionals engaged in MS management. Findings suggest that cognition was distributed between patients and physicians in all major tasks except …

Improving The Patient Experience Through A Commit To Sit Service Excellence Initiative, Cari D. Lidgett

Patient Experience Journal

Effective communication between nurses and patients positively impacts patient care, outcomes, and the patient experience.While in the hospital, patients receive information from multiple caregivers and are often overwhelmed and confused. Nurses make up the majority of interactions with patients and are in an ideal position to improve the patient experience from the front lines. The purpose of implementing the Commit to Sit service excellence initiative was to positively impact the patient’s perception of nurse communication by nurses sitting with their patients during each shift. Outcomes were measured by the overall nurse communication composite on the Press Ganey survey, as well …

Beyond Patient-Centered Care: Enhancing The Patient Experience In Mental Health Services Through Patient-Perspective Care, Timothy A. Carey Prof

Patient Experience Journal

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To …

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …

Why Human Resources Policies And Practices Are Critical To Improving The Patient Experience, Shari Berman

Patient Experience Journal

While providing patient-centered care seems to be a goal for many organizations, delivering on this goal requires practices which are embedded in the organization, which incent patient-centered behavior. The author argues Human Resources (HR) policies, procedures and programs are key to supporting an organizations’ vision and culture. This means an HR executive partnering with the CEO who sets the vision and HR builds programs to support the vision. As the organization understands what is important to patients and how to best serve them, HR can build patient care improvement into every aspect of the organization. The author describes how competency …

‘First, Do No Harm’: Shifting The Paradigm Towards A Culture Of Health, Karen Luxford

Patient Experience Journal

Over the past 17 years since the release of the Institute of Medicine report ‘To Err is Human’,¹ health services and agencies around the world have increasingly focused on improving the safety and quality of health care. Historically, the commitment by health care professionals to ‘first do no harm’ has produced a focus on the absence of interventions that may cause adverse outcomes. This clinical approach links to the Hippocratic Oath which includes the promise "to abstain from doing harm". The Oath reminds clinicians to first consider the possible harm that any intervention might do. This approach to interactions …

The Experience Era Is Upon Us, Jason A. Wolf Phd

Patient Experience Journal

In this moment in healthcare, the challenges for those in the system are dynamically shifting and the perspectives, desires and needs of the healthcare consumer are putting positive and lasting pressures on how healthcare works that will shift healthcare from where it has been to where it must go. At the heart of this transition are the ideas framing an experience era, where collaborative, consumer-focused and purposeful actions can and will lead to a healthcare system returning to its fundamental calling, that of human beings caring for human beings. In doing so we can change the nature of healthcare and …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika C. Ziller Phd, Zachariah T. Croll Ba, Andrew F. Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of …

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 …

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 …

Pharmacy Use By Dual-Eligible Non-Elderly Veterans With Private Healthcare Insurance, Brian C. Lund, Mary E. Charlton, Alan N. West

Dartmouth Scholarship

The Veterans Health Administration (VHA) is the largest nationally integrated healthcare system in the United States, operating 168 medical centers and more than 1000 community based outpatient clinics. However, many veterans seek care outside the VHA system, particularly when they are also covered by state or federal programs such as Medicare or Medicaid, or have access to private health insurance, often through employment. Concerted efforts have been made to facilitate communication and coordinate care between VHA and private sector healthcare, but concurrent use of these systems adds to an already fragmented U.S health care system.

Animal Carcinogenicity Studies: Implications For The Reach System, Andrew Knight, Jarrod Bailey, Jonathan Balcombe

Jarrod Bailey, PhD

The 2001 European Commission proposal for the Registration, Evaluation and Authorisation of Chemicals (REACH) aims to improve public and environmental health by assessing the toxicity of, and restricting exposure to, potentially toxic chemicals. The greatest benefits are expected to accrue from decreased cancer incidences. Hence the accurate identification of chemical carcinogens must be a top priority for the REACH system. Due to a paucity of human clinical data, the identification of potential human carcinogens has conventionally relied on animal tests. However, our survey of the US Environmental Protection Agency’s (EPA’s) toxic chemicals database revealed that, for a majority of the …

Animal Carcinogenicity Studies: 1. Poor Human Predictivity, Andrew Knight, Jarrod Bailey, Jonathan Balcombe

Jarrod Bailey, PhD

The regulation of human exposure to potentially carcinogenic chemicals constitutes society’s most important use of animal carcinogenicity data. Environmental contaminants of greatest concern within the USA are listed in the Environmental Protection Agency’s (EPA’s) Integrated Risk Information System (IRIS) chemicals database. However, of the 160 IRIS chemicals lacking even limited human exposure data but possessing animal data that had received a human carcinogenicity assessment by 1 January 2004, we found that in most cases (58.1%; 93/160), the EPA considered animal carcinogenicity data inadequate to support a classification of probable human carcinogen or non-carcinogen. For the 128 chemicals with human or …

‘Because I Don’T Know’: Uncertainty And Ambiguity In Closed-Ended Reports Of Perceived Discrimination In Us Health Care, Chih-Yuan Lee, Amy Irby-Shasanmi

Department of Public Health Scholarship and Creative Works

Objective

Surveys often ask respondents to assess discrimination in health care. Yet, patients’ responses to one type of widely used measure of discrimination (single-item, personally mediated) tend to reveal prevalence rates lower than observational studies would suggest. This study examines the meaning behind respondents’ closed-ended self-reports on this specific type of measure, paying special attention to the frameworks and references used within the medical setting.

Design

Twenty-nine respondents participated in this study. They were asked the widely used question: ‘Within the past 12 months when seeking health care do you feel your experiences were worse than, the same as, or …