Health Services Research Commons^™

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Contextualizing Performance Of Coordinated Care Network Of Veteran Services In Virginia, Marina Saitgalina, Donta Council

School of Public Service Faculty Publications

Coordinated care network is an approach to human service delivery that is recognized to improve client outcomes at a reduced cost. However, general mixed findings on the effectiveness of coordinated care networks warrant research contextualization. This article seeks to discover factors influencing the performance of a coordinated care network delivering social services to veterans and their families. The study provides a contextual analysis of a coordinated care network launched in 2016 in southeastern Virginia for two samples of 1,512 and 375 veterans and their families. Results of the regression analyses indicate that initial progress has been made both in efficiency …

Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner

Health Services Research Dissertations

Females between the ages of 18 and 24 consistently experience higher rates of sexual violence compared to females in any other age group (Sinozich & Langton, 2014). Approximately one in five college women experience sexual violence victimization (SVV; Krebs, Lindquist, Berzofsky, Shook-Sa & Peterson, 2016) during the academic year. Among undergraduate female students, 23.1% are victims of sexual violence due to physical force, violence or incapacitation (Cantor et al., 2015). Sexual victimization has been associated with several short- and long-term psychological health consequences, accounting for enhanced symptoms of depression, anxiety, PTSD, and suicide risk (Basile, Smith, Breiding, Black & Mahendra, …

Unmet Needs And Service Utilization By Informal Caregivers, Ryan Marie Diduk-Smith

Health Services Research Dissertations

The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability …

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 …

Standardized Patient Encounters Periodic Versus Postencounter Evaluation Of Nontechnical Clinical Performance, T. Robert Turner, Mark W. Scerbo, Gayle A. Gliva-Mcconvey, Amelia M. Wallace

Psychology Faculty Publications

Introduction: Standardized patients are a beneficial component of modern healthcare education and training, but few studies have explored cognitive factors potentially impacting clinical skills assessment during standardized patient encounters. This study examined the impact of a periodic (vs. traditional postencounter) evaluation approach and the appearance of critical verbal and nonverbal behaviors throughout a standardized patient encounter on scoring accuracy in a video-based scenario.

Methods: Forty-nine standardized patients scored either periodically or at only 1 point in time (postencounter) a healthcare provider's verbal and nonverbal clinical performance during a videotaped standardized patient encounter. The healthcare provider portrayed in this study was …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Community & Environmental Health Faculty Publications

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Modeling Solutions For Prevention Of Medicare Insolvency For The Baby Boomer Generation (Born 1946 - 1964), Gregory Thomas Scott

Health Services Research Dissertations

Medicare, a United States social insurance program operated by the United States federal government, began operating in a deficit in the year 2010. More funding was expended than revenue received for medical care, creating significant shortfalls for the Medicare Trust Fund. This study examined possible initiatives to describe Medicare funding related to issues as financial shortfalls utilizing mathematical modeling and simulation. The Park Conceptual Model is a framework created to identify internal and external changes that influence bankruptcies related to municipalities, and this Model served as the theoretical basis for this study.

The following study addressed insolvency as negative cash …

Factors Associated With Quality Of Life Among Mothers Of Children With Autism Spectrum Disorder, Marian Marconyak

Health Services Research Dissertations

The increasing prevalence of Autism Spectrum Disorder (ASD) has levied associated effects upon the quality of life (QOL) of mothers of children with ASD. These mothers are subjected to various influences upon their lives as a result of their role as caregivers to children with ASD. The purpose of this study was to assess the International Classification of Functioning, Disability and Health (ICF) Body Functions and Structures, Activities, Participation, Environmental, and Personal Factors associated with QOL among mothers of children with ASD.

English literate, inhabitants of the United States, mothers over the age of 18, of children with ASD were …

Quality Of Life Of Families With Children Who Have Severe Developmental Disabilities: A Comparison Based On Child Residence, Joni Taylor Mcfelea, Sharon Raver

Communication Disorders & Special Education Faculty Publications

This study measured the quality of life of two groups of families with children who had severe developmental disabilities-families whose child lived at home and families whose child lived in a residential facility. Participants were 54 primary caregivers of children who had severe intellectual disabilities and who lacked the ability to both ambulate without assistance and communicate conversationally. Participants completed the "Family Quality of Life Scale" (Hoffman, Marquis, Poston, Summers, & Turnbull, 2006). Analyses revealed that both groups rated their family quality of life (FQOL) as exemplary. FQOL was higher in the family home group than in the residential facility …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Test Of A Multidisciplinary Health Behavior Model Of Medicare Elders' Antihypertensive Acquisitions, Ann Marie Kopitzke

Health Services Research Dissertations

This study examined the relative utility of the enhanced Health Belief Model as compared to the proposed Pharmaceutical Acquisition Model for Medicare Elders (PAMME) in describing antihypertensive acquisition with usage intentions for Medicare elders (65 years or older) in Southeastern Virginia. Data collection included record reviews to identify hypertensive Medicare elders. Consenting Medicare elders were randomly selected for invitation, with consenting Medicare elders contacted by telephone or in-person interviews. The survey instrument utilized open and closed ended questions. The target population for this study is Southeastern Virginia Medicare elders enrolled in a Part D plan and prescribed at least one …

The Cost-Effectiveness Of Improving Diabetes Care In U.S. Federally Qualified Community Health Centers, Elbert S. Huang, Qi Zhang, Sydney E. S. Brown, Melinda L. Drum, David O. Meltzer, Marshall H. Chin

Community & Environmental Health Faculty Publications

Objective. To estimate the incremental cost-effectiveness of improving diabetes care with the Health Disparities Collaborative (HDC), a national collaborative quality improvement (QI) program conducted in community health centers (HCs).

Data Sources/Study Settings. Data regarding the impact of the Diabetes HDC program came from a serial cross-sectional follow-up study (1998, 2000, 2002) of the program in 17 Midwestern HCs. Data inputs for the simulation model of diabetes came from the latest clinical trials and epidemiological studies.

Study Design. We conducted a societal cost-effectiveness analysis, incorporating data from QI program evaluation into a Monte Carlo simulation model of diabetes.

Data Collections/Extraction …

Devolpment Of A Scale To Assess Home Health Care Aides' Ability To Recognize Depression In Older Adults, Tina M. Nerney

Community & Environmental Health Theses & Dissertations

Depression afflicts 20% to 40% of people 65 and older. Depression in older adults is frequent and chronic. The challenge of a hospital stay and the knowledge of having a long term disability may increase the risk for a depressive episode. In today's health care environment older adults are being released from hospitals after a short length of stay and are frequently dependent on home health services for assistance with activities of daily living. Home health care aides are given the responsibility of providing these services to the older adult in the home environment and need to be aware of …