Health Services Research Commons^™

An Updated Look At Mental Health Services In American Public And Private Prisons, Lieren E. Tyira

Student Theses

People residing in American prisons have the legal right to mental health care while incarcerated (Justia, 2021). This is important, as the prevalence of mental disorders is high in this population (Prins, 2014), and incarceration is a psychologically damaging experience, which hinders a person’s success at rehabilitation. Numerous of issues related to the mental health services (MHSs) in both public and private prison facilities have been reported in recent years, which warrants systematic exploration. The little existing research comparing the presence of MHSs in these facilities has produced mixed results, it uses out-of-date datasets, and none has explored MHSs in …

A Multi-Method Exploration Of Health Disparities And Covid-19 Incidence And Mortality In The United States, S M Asger Ali

Theses and Dissertations

The 21^st century experienced several health crises, especially in the form of infectious disease outbreaks such as the SARS outbreak in 2003, the H1N1 in 2009, and Ebola outbreaks in 2013. However, none has produced a worldwide socio-economic and health impact compared to the recent pandemic, known as COVID-19. As of October 4, 2022, more than 614 million cases with 6 million deaths have been reported worldwide. The United States is currently in the leading position with more than 98 million cases and 1 million deaths. The pandemic, however, did not impact the entire region similarly, and the infections …

Suicide Among South Asians In The United States: A Growing Public Health Problem, Aruna Jha, Manik Ahuja, Rajvi J. Wani

ETSU Faculty Works

This research study quantifies and describes suicide among South Asian Americans (SAAs), an emerging population that are underrepresented group in suicide research. The purpose of this study was to examine key characteristics of suicide deaths among SAAs. Data were employed from DuPage County, IL, a county with a large SAA population. Following federal recommendations for disaggregating Asian American data at a granular level, four SAA researchers used name recognition to identify all SAA cases classified as suicide in the DuPage County coroner’s database from 2001 to 2017 (N = 38). Coroner’s reports were analyzed for contextual details and correlating …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

Full Issue, Winthrop Mcnair Research Bulletin

The Winthrop McNair Research Bulletin

Winthrop McNair Research Bulletin Volume 5, Full Issue

Adult Day Services In Maine: Benefits, Challenges, And Opportunities, Elizabeth Gattine Jd, Eileen Griffin Jd, Kimberly I. Snow Mhsa, Ba

Disability & Aging

In Maine and nationally, adult day services tend to be underfunded and underutilized compared to other types of long term services and supports (LTSS). In part, investment in adult day services is hampered by a lack of standardized data collection and limited research on issues of accessibility, cost-effectiveness, and the impact of adult day services on the broader health system. Lack of uniformity in state regulatory frameworks for licensing, program design, service delivery, and other administrative requirements further complicates cross-state comparisons. Considering these limitations, a key goal of this report is to provide a more detailed and comprehensive understanding of …

Heterogeneity In The Prevalence Of Premature Hypertension Among Asian American Populations Compared With White Individuals: A National Health Interview Survey Study, Sina Kianoush, Mahmoud Al Rifai, Anwar T. Merchant, Xiaoming Jia, Zainab Samad, Aneil Bhalla, Ayesha Khan, Dongshan Zhu, Salim S. Virani

Section of Cardiology

Background: Differences in prevalence of risk factors such as hypertension may explain heterogeneity in cardiovascular risk across Asian American populations.
Methods: We used National Health Interview Survey (NHIS) data from 2006 to 2018 among White, Chinese, Asian Indian, Filipino, and 'other Asians' (Japanese, Korean, and Vietnamese). Unadjusted and adjusted odds ratios (aOR) with 95% confidence intervals were reported using logistic regression models for the association between race and self-reported premature hypertension (age old). Models were adjusted for sex, education, body mass index, smoking status, diabetes, and coronary heart disease.
Results: We studied 99,864 participants with history of hypertension (mean age, …

“High Spending, Poor Productivity Gains!” Assessing Public Health System (In)Efficiency And Hospital Performance In The State Of Kuwait: Would More Private Delivery Improve Healthcare?, Aljawhara Alsabah

NYMC Student Theses and Dissertations

The healthcare sector in the State of Kuwait has been nurtured for many decades by the government, where the majority of health services in the country are controlled by the Ministry of Health (MoH). Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This dissertation aims to analyze public health system efficiency and hospital performance in the State of …

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 …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

Visual Factors Associated With Physical Activity In Schoolchildren, Síofra Harrington, John Kearney Prof, Veronica O'Dwyer Dr

Articles

Clinical relevance Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland.

Background This study explored the association between visual function in children and their engagement with physical activities outside school.

Methods Participants were 1,626 schoolchildren (728 aged 6–7 years, 898 old 12–13 years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (/week engaged in sports), or regular activity ( …

The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp

Electronic Thesis and Dissertation Repository

The goal of this study was to share the stories of older adults with age-related vision loss (ARVL) and how they have coped to maintain meaningful occupational engagement. Grounded in a constructivist paradigm, data collection and analysis were guided by the narrative inquiry methodology. The participants consisted of six older adults aged 60 or older, diagnosed with one of the following ARVL conditions: macular degeneration, diabetic retinopathy, and/or glaucoma. Participants were recruited from vision loss non-profit organizations such as the Canadian National Institute for the Blind (CNIB) and the Alliance for Equity of Blind Canadians (AEBC). One older adult was …

Three Essays About Preventing Mental And Behavioral Disorders, Snehal Lopes

All Dissertations

Prevention efforts in the public health field operate at various levels, including primary prevention among those without a disease of interest, secondary prevention among persons at high risk or showing early signs of the disease, and tertiary prevention among persons with the disease. The three essays presented in this dissertation are centered around the theme of prevention, and taken together, have implications for prevention at the primary, secondary, and tertiary levels. Specifically, the essays focus on the prevention of depressive disorders and the prevention of behavioral and mental health correlates for depression in the context of various populations (general adult, …

Congregational Leaders And Covid-19: Human Flourishing And Future Directions For Research, Isaac Voss

Essays

No abstract provided.

Gis Automated Delineation And Analysis Of Cancer Service Areas In The United States, Changzhen Wang

LSU Doctoral Dissertations

Delineating a meaningful and reliable geographic unit pertaining to cancer care is essential in examining geographic variations in cancer care for better analysis, management, and planning. Public health researchers have devoted great efforts to defining various service areas, which; however, lack scientific rigor or are unrepresentative of the highly specialized cancer care markets, and their methods have become obsolete in the era of big data and high geo-computation. This study develops the “Spatially Constrained Leiden (ScLeiden)” method, a network community detection algorithm in Geographic Information Systems (GIS), and applies it to delineate a series of coherent cancer service …

Mental Health, Chronic Disease, And Substance Use: Findings From Rural Texas, Subi Gandhi, Ryan Glaman, Elizabeth Wachira, Muna Bashir, Sushma Sharma, Chelsea Mowles, Jasmine Luttrell

Journal of Social, Behavioral, and Health Sciences

There are vital links among mental health conditions, chronic diseases, and substance use disorders. Simultaneous examination of the relationship among these three conditions is essential for providing well-integrated care to rural residents who have limited resources and for representing medically underserved areas. We aimed to assess the burden of behavioral health conditions and chronic diseases from a rural Texas community to garner context-specific insights and inform effective health promotion strategies in similar communities. We conducted a cross-sectional study among 181 residents from various zip codes in a rural Texas county. A self-administered, 18-item health-needs questionnaire was used to collect data …

Determinants Of Nurse Turnover In Rural Primary Health Centres At Micro, Meso And Macro Levels Within The Health System Of Tamil Nadu, India: A Study Protocol, Ponnambily Chandy Ms, Bart Criel Dr, Lakshmi L Dr

Manipal Journal of Nursing and Health Sciences

Introduction: Nurses play a critical role in delivering patient care services at the grassroots level. But, frequent nurse turnover in rural primary health centres (PHCs) becomes a barrier in achieving health goals in Tamil Nadu (TN), which is the highest populated state in South India. Objective: The study aims to identify the determinants of nurse turnover in rural PHCs and to inform the policy-making at micro, meso, and macro levels within the health system of Tamil Nadu, India. Methods: We will adopt an integrative qualitative design consisting of five phases. In phase 1, we will do a rapid literature review …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

MD Honors Theses

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Ageism, Eldercare, And Healthcare: An Examination Of Growing Old In Costa Rica, Akshaya Vijayasankar

Honors Theses

The world’s aging population and the Covid-19 pandemic have revealed the high level of ageism against older adults around the globe, which has resulted in an overall decreased quality of life for elders. Societies are now faced with the challenge of creating a suitable and equitable model of care to support their aging population. Despite the recent publication of the World Health Organization's Global Report on Ageism, there is still a large gap in the literature regarding ageism. This paper addresses the issues of institutional ageism in the eldercare and healthcare sector. I argue that Costa Rica serves as a …

Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins

Research Days

Watch recording of live presentation.

Background: Adverse childhood experiences (ACEs) have been shown to be associated with poor health outcomes, and children living in poverty are more likely to experience ACEs. Our objective was to estimate the association between spending on benefit programs and cumulative exposure to ACEs among children.

Methods: This cross-sectional study examined state and federal spending, at the state-level, on 5 categories of public benefit programs: cash, housing, and in-kind assistance; housing infrastructure; childcare assistance; refundable Earned Income Tax Credit; and Medical Assistance Programs (e.g., Medicaid). The primary exposure was median annual spending per person living below …

A Systematic Review Of The Barriers Of Opioid Addiction Treatment For Young Adult Males (Ages 18-26) Living In Low Income Areas In The United States Of America, Atish Gandhi, Asim Shafique, Jillian Baker

Rowan-Virtua Research Day

NOTE: This is a broad literature review, not a systematic review.

This systematic review aims to analyze the reasons behind reduced access to opioid addiction treatment for individuals of low socioeconomic standing. Understanding these barriers may allow communities to build a more comprehensive plan to lower addiction rates. In addition, this review will be examining further developments of theopioid crisis due to the recent COVID-19 pandemic. The literature search used publications from the following databases: PubMed, Google Scholar, and NCBI. The keywords searched were “opioid addiction”, “substance abuse”, “low-income area”, “barriers to treatment”, “young male addiction”, “opioid treatment”, “Narcan”. There …

The Effect Of Covid-19 On Depression In Hispanic Vs. Non-Hispanic Populations In South Jersey, Rana Cheikhali, Daniel Casal

Rowan-Virtua Research Day

The COVID-19 pandemic has been challenging for Americans and the world as a whole. It has especially taken a toll on mental health. Studies show that the incidence of depression in the United States was three times greater during the pandemic compared to pre-pandemic times. One specific community in the United States that has been greatly affected by the pandemic is the Hispanic American community. Many Americans across the country have received federal surveys that aim to determine the social and economic impacts of COVID-19. Results revealed that the Hispanic population had the greatest rise in mental illness, with 40% …

Identifying Motivators For Getting Vaccinated Against Sars-Cov-2 In Those Who Have Been Vaccinated. A Single Center Cross-Sectional Study, Nicole Lacap, Suzanna Hosein

Rowan-Virtua Research Day

The purpose of this study is to explore the primary motivations of patients getting vaccinated against SARS-Cov-2 as well as to determine any correlations between demographic information and specific motivators. We hypothesized that generally internal motivators (being in the best interest of oneself) will predominate as the reason for vaccination. The sample consisted of 227 patients vaccinated against SARS-CoV-2 at the Rowan Medicine Vaccine Clinic during the month of June 2021. Patients were given an online questionnaire collecting demographic information as well as primary reason for getting vaccinated. Preliminary analysis shows that 63% of participants were motivated by reasons that …

A Geographically Targeted Approach For A Preceptor Tax Incentive Using Primary Care Health Professional Shortage Areas (Hpsas), Julia Mattingly, Sarah Belcher, Samuel C. Kessler

Commonwealth Policy Papers

Years before the COVID-19 pandemic brought on a health care shortage in Kentucky, its rural areas were already struggling to obtain and attract primary care medical practitioners. Even though the number of medical school graduates in the U.S. has steadily increased throughout the years, there is a general disinterest in rural or small-town practice, and legislators throughout the country have pondered ways to address this issue plaguing communities. Versions of Preceptor Tax Incentive legislation in Kentucky have been proposed in the General Assembly to address care shortages in the state, however, all have been unsuccessful at truly targeting rural areas …

Community Characteristics And Financial And Operational Performance Of Rural Health Clinics In The United States: A Chartbook, John Gale Ms, Zachariah Croll Mph, Jamar Croom Ms, Louisa Munk Mph, Yvonne Jonk Phd

Rural Health Clinics

This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues using data from CMS’s Provider of Services file, Medicare Cost Reports, and the Robert Wood Johnson Foundation’s’ County Health Ranking and will be useful to policymakers and others interested in the performance of RHCs nationally. It can also be useful to RHC administrators to benchmark staffing patterns, productivity, and efficiency. Finally, it provides a discussion of the challenges related to collection and reporting of RHC quality data.

For more information, please contact John Gale, john.gale@maine.edu