Health Services Research Commons^™

Mprove Measure Compilation Template, Glen Mays

Glen Mays

This template provides the data element layout and structure for compiling measures of local public health service delivery collected through the Multi-Network Practice and Outcome Variation Examination Study (MPROVE).

Improved Survival After Heart Failure: A Community-Based Perspective, Kristy T. Webster, Samuel W. Joffe, David D. Mcmanus, Michael S. Kiernan, Darleen M. Lessard, Jorge L. Yarzebski, Chad E. Darling, Joel M. Gore, Robert J. Goldberg

Senior Scholars Program

Background: Heart failure is a highly prevalent, morbid, and costly disease with a poor long-term prognosis. Evidence-based therapies utilized over the past 2 decades hold the promise of improved outcomes, yet few contemporary studies have examined survival trends in patients with acute heart failure.

Objectives: The primary objective of this population-based study was to describe trends in short and long-term survival in patients hospitalized with acute decompensated heart failure (ADHF). A secondary objective was to examine patient characteristics associated with decreased long-term survival.

Methods and Results: We reviewed the medical records of 9,748 patients hospitalized with ADHF at all ...

Association Of Acculturation And Country Of Origin With Self-Reported Hypertension And Diabetes In A Heterogeneous Hispanic Population, Fatima Rodriguez, Leroi S. Hicks, Lenny Lopez

Open Access Articles

BACKGROUND: Hispanics are the fasting growing population in the U.S. and disproportionately suffer from chronic diseases such as hypertension and diabetes. Little is known about the complex interplay between acculturation and chronic disease prevalence in the growing and increasingly diverse Hispanic population. We explored the association between diabetes and hypertension prevalence among distinct U.S. Hispanic subgroups by country of origin and by degree of acculturation.

METHODS: We examined the adult participants in the 2001, 2003, 2005, and 2007 California Health Interview Survey (CHIS). Using weighted logistic regression stratified by nativity, we measured the association between country of origin ...

Health Effects Of The Federal Bureau Of Prisons Tobacco Ban, Stephen A. Martin, Bartolome R. Celli, Joseph R. Difranza, Stephen J. Krinzman, Jennifer G. Clarke, Herbert Beam, Sandra Howard, Melissa Foster, Robert J. Goldberg

Open Access Articles

BACKGROUND: Tobacco smoking remains the leading cause of preventable death in America, claiming 450,000 lives annually. Chronic Obstructive Pulmonary Disease, caused by smoking in the vast majority of cases, became the third leading cause of death in the U.S. in 2008. The burden of asthma, often exacerbated by tobacco exposure, has widespread clinical and public health impact. Despite this considerable harm, we know relatively little about the natural history of lung disease and respiratory impairment in adults, especially after smoking cessation.

METHODS/DESIGN: Our paper describes the design and rationale for using the 2004 Federal Bureau of Prisons ...

Self-Reported Adherence With The Use Of A Device In A Clinical Trial As Validated By Electronic Monitors: The Vibes Study, Brianne A. Jeffrey, Marian T. Hannan, Emily K. Quinn, Sheryl Zimmerman, Bruce A. Barton, Clinton T. Rubin, Douglas P. Kiel

Open Access Articles

BACKGROUND: Adherences to treatments that require a behavioral action often rely on self-reported recall, yet it is vital to determine whether real time self reporting of adherence using a simple logbook accurately captures adherence. The purpose of this study was to determine whether real time self-reported adherence is an accurate measurement of device usage during a clinical trial by comparing it to electronic recording.

METHODS: Using data collected from older adult men and women (N=135, mean age 82.3 yrs; range 66 to 98 yrs) participating in a clinical trial evaluating a vibrating platform for the treatment of osteoporosis ...

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Glen Mays

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

Variations In Postoperative Complications Across Race, Ethnicity And Sex Among Older Adults, J Margo Brooks Carthon, Olga Jarrín, Douglas Sloane, Ann Kutney-Lee

Olga Jarrín

OBJECTIVES: To explore differences in the incidence of postoperative complications among three racial/ethnic groups (white, black and Hispanic) before and after taking into account potentially confounding patient and hospital characteristics.

DESIGN: A cross-sectional study using 2006-2007 administrative patient discharge data from hospitals in four states (CA, PA, NJ, FL), linked to American Hospital Association Annual Survey data, and data from the U.S. Census. Risk-adjusted logistic regression models were used in the analyses.

SETTING: Six hundred U.S. adult nonfederal acute care hospitals

PARTICIPANTS: Five hundred eighty seven thousand three hundred fourteen individuals, ages 65 and over, undergoing general ...

Overview And Guidance Documents For Public Health Pbrns, Glen P. Mays

Glen Mays

This brief provides an inventory of guidance documents and tools for use in developing, implementing, and evaluating practice-based research networks (PBRNs) in public health settings.

A Gap Analysis Of Mental Health And Addictions Support Services In Richmond, British Columbia — A Community-Based Research Study, Shelly Chopra

The Meducator

Across Canada, mental health and addictions (MHA) has become an area of concern for health providers: it is estimated that one in five adults is affected by a mental illness or addiction. In line with the provincial Ministries of Health Services and Child and Family Development ten-year plan to address MHA in BC, a community-based MHA service gap analysis was undertaken in the present study in Richmond, BC. The primary objectives of this research project were to identify and validate gaps in MHA support services in Richmond based on the informed perspectives of MHA community service providers. In addition to ...

Canada's Aging Population: Should Students Be Worried?, Emily Milko, Sherna Tamboly

The Meducator

No abstract provided.

The Value Of Public Health Financial Data, Glen P. Mays

Glen Mays

Effective policy and administrative decision-making in public health requires reliable information on the amount of resources invested in governmental public health programs and how these resouces are allocated and used across the U.S. public health system. This session examines current and potential uses of public health financial data in the U.S., and considers expanded roles for research in informing policy and administrative decisions.

The Ottawa Statement On The Ethical Design And Conduct Of Cluster Randomized Trials, Charles Weijer, Jeremy M. Grimshaw, Martin P. Eccles, Andrew D. Mcrae, Angela White, Jamie C. Brehaut, Monica Taljaard, Ottawa Ethics Of Cluster Randomized Trials Consensus Group, Catarina I. Kiefe

Quantitative Health Sciences Publications and Presentations

Summary points:

• In cluster randomized trials (CRTs), the units of allocation, intervention, and outcome measurement may differ within a single trial. As a result of the unique design of CRTs, the interpretation of existing research ethics guidelines is complicated.
• The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials aims to provide researchers and research ethics committees (RECs) with detailed guidance on the ethical design, conduct, and review of CRTs.
• A five-year mixed methods research project explored the ethical challenges of CRTs. Empirical studies documented the reporting of ethical issues in published CRTs, interviewed experienced trialists, and ...

Discrimination In Medical Settings And Attitudes Toward Complementary And Alternative Medicine: The Role Of Distrust In Conventional Providers, Tetyana Shippee, Carrie Henning-Smith, Nathan Shippee, Jessie Kemmick Pintor, Kathleen T. Call, Donna Mcalpine, Pamela Jo Johnson

Journal of Health Disparities Research and Practice

This study examines the relationship between racial/ethnic discrimination in medical settings, distrust in conventional medicine, and attitudes toward complementary and alternative medicine (CAM) among a racially/ethnically diverse sample. We also investigate how this relationship differs by nativity. Data are from a 2008 statewide stratified sample of publicly insured adults in Minnesota (N=2,194). Discrimination was measured as self-reported unfair treatment in medical settings due to race, ethnicity, and/or nationality. Outcomes are trust in conventional providers/medicine and attitudes toward CAM modalities. Discrimination in medical settings was positively associated with 1) distrust in conventional providers and 2 ...

Issues Regarding Complex Community-Based Cardiovascular Health Interventions, Ricardo N. Angeles

Open Access Dissertations and Theses

The thesis presents three papers discussing some of the methodological issues regarding studies investigating complex community-based cardiovascular health interventions. All three studies involved the Cardiovascular Health Awareness Program (CHAP), a standardised blood pressure and risk factor assessment and educational sessions held in pharmacies or other locally accessible areas in small to mid-sized communities in Ontario, Canada.

The first paper reviews the literature and proposes a guide on how to develop a theoretical framework for complex community-based interventions using CHAP as an example. The paper describes a stepwise process of developing a theoretical framework including challenges encountered and strategies employed to ...

Healthcare Seeking For Diarrhoea, Malaria And Pneumonia Among Children In Four Poor Rural Districts In Sierra Leone In The Context Of Free Health Care: Results Of A Cross-Sectional Survey, Theresa Diaz, Asha S. George, Sowmya R. Rao, Peter S. Bangura, John B. Baimba, Shannon A. Mcmahon, Augustin Kabano

Quantitative Health Sciences Publications and Presentations

BACKGROUND: To plan for a community case management (CCM) program after the implementation of the Free Health Care Initiative (FHCI), we assessed health care seeking for children with diarrhoea, malaria and pneumonia in 4 poor rural districts in Sierra Leone.

METHODS: In July 2010 we undertook a cross-sectional household cluster survey and qualitative research. Caregivers of children under five years of age were interviewed about healthcare seeking. We evaluated the association of various factors with not seeking health care by obtaining adjusted odds ratios and 95% confidence limits using a multivariable logistic regression model. Focus groups and in-depth interviews of ...

Cluster-Randomized Trial Of A Web-Assisted Tobacco Quality Improvement Intervention Of Subsequent Patient Tobacco Product Use: A National Dental Pbrn Study, Thomas K. Houston, Kathryn L. Delaughter, Midge N. Ray, Gregg H. Gilbert, Jeroan J. Allison, Catarina I. Kiefe, Julie E. Volkman

Quantitative Health Sciences Publications and Presentations

ABSTRACT:

BACKGROUND: Brief clinician delivered advice helps in tobacco cessation efforts. This study assessed the impact of our intervention on instances of advice given to dental patients during visits on tobacco use quit rates 6 months after the intervention.

METHODS: The intervention was cluster randomized trial at the dental practice level. Intervention dental practices were provided a longitudinal technology-assisted intervention, oralcancerprevention.org that included a series of interactive educational cases and motivational email cues to remind dental provides to complete guideline-concordant brief behavioral counseling at the point of care. In all dental practices, exit cards were given to the first ...

Dsm V: Hope Or Hype?, Amresh Srivastava

Amresh Srivastava

DSM V: HOPE OR HYPE?

Amresh Shrivastava,

MD,MPM,MRCPsych,FRCPC

Associate professor of Psychiatry

Western University

London, Ontario

Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients.

The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th ...

Is Obesity Socially Contagious?, Ciani Jean Sparks

Statistics

The main objective of this paper is to analyze three different articles that discuss whether obesity could be socially contagious. According to the World Health Organization in 2013, obesity is the fifth leading risk for deaths around the world. This disease has dramatically increased in the last decade, which has led scientists to believe there are other factors contributing to the epidemic besides genetics. The first article I analyzed, written by Nicholas Christakis and James Fowler, provided a logistic regression model to estimate the odds of a person becoming obese. The model included the explanatory variables: age, sex, education, smoking ...

The Characteristics Of Women Seeking Funding From The Dc Abortion Fund, Karin Elizabeth Bleeg

GW Research Days 2013

Objectives: To determine whether the population DCAF serves, based on current research, are those most in need of its financial services. Describe the population that DCAF is supports by age, race and ethnicity, poverty, educational attainment, union status, contraceptive method used, referral source, and number of prior pregnancies.

Methods: An adapted version of The Guttmacher Institute's National Patient Survey will be used to collect data from women who contact DCAF for financial assistance for their abortion (n=150). The data will be collected for one month and then analyzed in SPSS.

Results: Between January and March 2013 approximately 400 ...

Vital Statistics: The State Of The Public Health Pbrn Program, Glen Mays

Glen Mays

The Robert Wood Johnson Foundation's Public Health PBRN Program has continued to expand during the 2013 program year with new networks, new research projects, and expanded translation and dissemination initiatives. The program plays an increasingly powerful role in helping to transform the U.S. public health enterprise into a rapid-learning system for health improvement.