Community Health Commons^™

Systems Approach To Evaluating Mih-Cp (Mobile Integrated Healthcare – Community Paramedicine): A Case Study Of East Baton Rouge Parish (Ebrp) Emergency Medical Services (Ems) Community Paramedicine Program Initiative, Oluwakemi Aiyedun

LSU Doctoral Dissertations

This study applied a holistic method of healthcare program assessment, known as systems approach, to evaluate the efficacy of the East Baton Rouge Parish (EBRP) EMS Community-integrated Health Program (CIHP). The author developed assessment metrics following the Quadruple Aim Framework: IHI (Institute for Healthcare Improvement) Triple Aim + Provider Experience.

Results showed that the CP program in this study delivers high ratings on patient experience and provided a 51% return on investment (ROI) through reduced emergency service utilization, ED visits and inpatient hospital admissions. However, findings did not demonstrate meaningful improvement in patients’ health-related quality of life (HRQoL) and self-efficacy (SE ...

Reflection: Reducing Long-Term Mortality In Suicidal Adolescents, Nina R. Bihani

Clinical Research in Practice: The Journal of Team Hippocrates

A transformative method to reducing mortality in suicidal adolescents involves a novel approach of educating and empowering their loved ones.

Estimated Cardiorespiratory Fitness Is Associated With Reported Depression In College Students, Sharon Jalene, Jennifer Pharr, Guogen Shan, Brach Poston

Integrated Health Sciences Faculty Publications

Depression is a serious but treatable health issue that affects college students at an alarming rate. Improved cardiorespiratory fitness (CRF) decreases depression risk and severity but this relationship has not been fully evaluated in the college student population. Non-exercise estimated CRF (eCRF) could be used to identify students at risk for or suffering from depression. This study investigated the associations of depression and eCRF in college students. Participants (N = 437) completed a survey which included demographic and student-status questions, eCRF variables, and a validated depression instrument. Descriptive, chi-square, t-test, regression, and odds ratio analyses were employed. Depression was associated with ...

An Overview Of The Health Profile Of Syrian Refugees Arriving In Kentucky From 2012-2017, Camila Calderon, Annie Rominger

Journal of Refugee & Global Health

Background:

The civil unrest in Syria has led to millions of displaced Syrians. The United States has relocated over 15,000 Syrian refugees, mostly arriving since 2015. Little is known about the health of Syrian refugees entering the United States.

Methods:

Syrian refugees in Kentucky who had a medical screening and documented RHA from October 2012 to September 2017 were included in the study. The information is collected and stored in the Arriving Refugee Informatics Surveillance and Epidemiology (ARIVE) database. This study is a retrospective review of the ARIVE database to describe the general health of the Syrian refugees arriving ...

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operational Excellence

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to ...

Life Satisfaction And Healthcare Utilization Among Immigrants To The United States, Merritt Christian Rachel Harrelson

LSU Master's Theses

Previous research suggests a relationship between life satisfaction and healthcare utilization or HCU (Habibov & Afandi, 2016; Kim, Park, Sun, Smith, & Peterson, 2014). However, no study was found that examined this relationship among elderly American immigrants. The purpose of this study was to determine whether life satisfaction is linked to HCU for this population. The researcher of the current study applied binary logistic regression to data taken from the Health and Retirement Survey to determine whether changes in life satisfaction could be linked to variance in HCU across seven domains, including hospitalization, overnight nursing home stays, doctors visits, dentist visits, use of prescription ...

Happy Brain, Healthy Body: Cultivating Vitality To Drive Sustainable Weight Loss, Alexandra Bono

Master of Applied Positive Psychology (MAPP) Capstone Projects

In the United States, nearly 40 percent of adults are overweight, a prevalence that has increased over the past decade. Although Americans spend nearly $33 billion annually on various weight loss solutions, research indicates that most individuals who diet do not lose weight, and even if they do, nearly all of them gain it back within a year. Achieving and maintaining weight loss requires long-term engagement in positive health behaviors such as a balanced diet and regular physical activity, which is often easier said than done. Frequently omitted from the prevailing paradigm of weight loss is the role of our ...

Implementing Autism Screening For Latino Children In Primary Care: Perspectives From Parents And Providers, Mary Troxel, Keri Linas, Diane Jacobstein, Matthew Biel, Sandra H. Soto, Isabella Lorenzo-Hubert, Soraya Dos-Santos, Rocio Mendez, Bruno J. Anthony

Journal of Health Disparities Research and Practice

While Autism Spectrum Disorder (ASD) and other developmental disabilities are being diagnosed at increasing rates, there is strong evidence of disparities in rates of identification and utilization of services by Latino children as compared to non-Latino children. Attempts to reduce these disparities include culturally-informed early screening for ASD risk. In preparation for initiation of a screening program in a primary care setting serving primarily Latino children, focus groups and interviews were conducted with Latino parents (N=31), medical staff (N=15), health care providers (N=4) to better understand the barriers and facilitators to engagement around developmental concerns that contribute ...

Disrupting The Intergenerational Transmission Of Trauma Among Alaska Native People: A Conceptual Model For The Family Wellness Warriors Initiative, Lily Ray, Bobbi Outten, Polly Andrews, Katherine Gottlieb

Journal of Health Disparities Research and Practice

Background: Increasing evidence demonstrates the life-long physical, emotional, and social effects of traumatic experiences. In recognition that many health disparities are driven by high rates of traumatic experiences, Alaska Native and American Indian people have created wellness programs that build health by first healing historical and lifetime trauma. Yet, many of these promising community-based interventions are not described in the health sciences literature. Southcentral Foundation’s Family Wellness Warriors Initiative (FWWI) was created by Alaska Native people, addresses traumatic experiences as the root cause of family violence, and builds on cultural strengths. The goal of this study was to build ...

Increasing Advanced Care Planning In An Ambulatory Care Setting, Jennifer Aronson, Elizabeth Eisenhardt, Adult Internal Medicine Clinic, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operational Excellence

Maine is experiencing an increasing percentage of its population being over 65 years old. Advanced Care Planning (ACP) is an important part of this aging population medical care so those ends of life preferences are known well in advance. An adult internal medicine clinic in a large academic tertiary medical center decided to create a performance improvement project that addressed ACP with embedded workflows.

The goal of this project was to have a minimum of 40% of patients 65 or older have an Advanced Care Directive or Serious Illness Conversation documented in EPIC.

Baseline metrics demonstrated that ACP discussion rates ...

Elbow Injury Prevention In Youth Dominican Baseball Players: A Training Intervention Pilot Study, Chelsey Erbaugh Franz, Dawn Hall-Bibb, Myra Stockdale, Aliya Thompson, Bailey Biggs

Internet Journal of Allied Health Sciences and Practice

Background: Research suggests deficits in shoulder and elbow strength and flexibility may explain the role of elbow injuries in overhead athletes, specifically ulnar collateral ligament (UCL) injury in baseball players. Significant damage to this ligament typically requires operative care for continued activity in the sport. Several studies have demonstrated the success of rehabilitation programs post-surgery; however, few studies have examined the role of UCL injury prevention programs. A recognized upper extremity (UE) injury prevention method is the Thrower’s Ten Program. This program may create elbow stability when pitching and throwing, theoretically reducing the risk of UCL injury. Purpose: The ...

Perceptions Of Health Practices And Interactions With The Us Healthcare System Among Bhutanese Refugees: A Qualitative Approach, Amy E. Szajna

Journal of Refugee & Global Health

Purpose

The aim of this pilot study was to explore health practices of Bhutanese refugees and their interactions with the US healthcare system and providers.

Methodology

Researchers conducted 12 in-depth interviews and 7 patient-provider observation units as part of this descriptive qualitative study.

Results

Participants identified individual definitions of health and behaviors they value to maintain health. They identified significant trust and faith in their healthcare provider and valued provider-directed suggestions. Participants cited concerns with patient-provider communication resulting from limited English proficiency and frequent changes in primary care providers.

Discussion

This study is useful to inform further research and potential ...

Impactful Care: Addressing Social Determinants Of Health Across Health Systems, Nicole Lisa Friedman

Dissertations and Theses

There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.

The goal of this applied research project ...

“You Do It Without Their Knowledge”: Is Nonconsensual Comdom Removal The New Public Health Emergency?, Marwa Awad Mohamed

Electronic Theses, Projects, and Dissertations

Background: Sexual consent is often defined as the voluntary agreement to participate in a sexual act, though the differing definitions across and within countries make legal consensus difficult. In recent years, due to popularization through social media, nonconsensual condom removal, termed stealthing, is becoming common, especially among young adults. Yet, little to no empirical evidence exists on this sexual behavior.

Methods: In this exploratory sequential mixed methods approach, we aimed to address the current perception of stealthing among young adults. College students were recruited from general education courses at a medium-sized four- year public university. Focus groups were conducted to ...

Supporting Marin County Youth Suffering From Anxiety And Depression, Victoria L. Grajeda

Counseling Psychology | Master's Theses

This toolkit was created to help shed light on the impact a stressful high school environment can have on today’s youth, and provide teachers, students, and parents with up-to-date information on what resources are available within the county of Marin. When working with adolescents, it is important to consider environmental threats to their mental health (i.e., lack of sleep) in order to make proper referrals and treatment plans. A study done by Kelley, Lockley, Kelley, & Evans (2017) implemented a 10:00 a.m. start time at an urban school in England. By delaying school start times, Kelley et al., found that absences related to illness were reduced by 50 percent compared to national rates. In general, school systems in the United States are not currently structured to ensure students can function at their maximum potential, and their academics, health, and relationships are deteriorating as a result. More importantly, suicide is becoming more prevalent in high schools within the United States, which means prevention programs need to be reevaluated or implemented to help Marin youth cope with academic and social stress. This guide will provide the community with psychoeducation on depression and anxiety; potential risk factors, how to help, and what treatment options are available.

Expressive Mindfulness: A Trauma-Sensitive Expressive Arts Therapy Group Method, Meghan Daly

Expressive Therapies Capstone Theses

Mindfulness and expressive arts therapy are both supportive of directing attention in a manner that promotes integration and function of a person. In this paper, a trauma-sensitive method was created for use in a day treatment setting for adults with severe and persistent mental illness (SPMI). This method utilized expressive movement, visual art making with three different materials, and creative writing to encourage mindful, non-judgmental acceptance of the present moment; a sense of relaxation; and an overall increase in quality of life. During development of the method arts-based research informed the choice of materials, music, and structure of the group ...

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters (n ...

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not ...

Perilous Times Call For Emergency Preparedness, Sonia K. Wrate, Ronda Christman

Adventist Human-Subject Researchers Association

As disasters become more frequent it is important that people are ready to respond. University students along with community volunteers learn with and from each other during a disaster simulation. Learn how participant’s perceptions of spirituality and civic engagement has changed following a disaster simulation.

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To what extent has the range expansion ...