Association Between Insurer Connectivity In Appalachian Population Health Networks And Preventable Hospitalizations: Evidence From Kentucky, 2023 University of Kentucky, College of Public Health
Association Between Insurer Connectivity In Appalachian Population Health Networks And Preventable Hospitalizations: Evidence From Kentucky, Rachel Hogg-Graham, Kelsey R. Gatton, Rick Ingram, Glen P. Mays
Journal of Appalachian Health
Introduction: Addressing complex health and social needs requires cross-sector collaboration to deliver medical, social, and population health services at the community level. Capacity in community health and social services networks may be constrained in regions like Appalachia due to the combined effects of rurality and persistently poor health and social outcomes. One way that cross-sector networks serving low-resource communities can expand their capacity is by engaging partners, like health insurers, who can leverage resources from outside the local area.
Purpose: This study examines insurer connectivity in cross-sector networks across Kentucky’s geographic regions and the association between connectivity and the probability …
The Appalachian Gap In Preventable Hospitalizations: Are We Seeing Any Progress?, 2023 University of Kentucky, College of Public Health
The Appalachian Gap In Preventable Hospitalizations: Are We Seeing Any Progress?, Rachel Hogg-Graham, Juan Lang, Teresa M. Waters
Journal of Appalachian Health
Introduction: Previous studies have documented geographic variation in preventable hospitalizations between rural and urban areas, but much less is known about preventable hospitalization patterns between heterogeneous rural areas. Unique challenges related to access of care and poverty may put the rural Appalachian Region at risk for higher rates of preventable hospitalizations.
Purpose: This study examines whether within-rural differences in Kentucky’s preventable hospitalization rates exist and how these differences may be changing over time.
Methods: Longitudinal and geographic trends in county-level preventable hospitalization rates were examined using Kentucky hospital discharge data from 2016 to 2019. Regression models were run to determine …
Patient Engagement In Patient Portals In Appalachia V. Surrounding U.S. Census Regions: An Analysis Of Hints (Health Information National Trends Survey) Data, 2017–2020, 2023 Eastern Kentucky University
Patient Engagement In Patient Portals In Appalachia V. Surrounding U.S. Census Regions: An Analysis Of Hints (Health Information National Trends Survey) Data, 2017–2020, Heather Lea Tudor, Rick Ingram, Sarah Wackerbarth
Journal of Appalachian Health
Introduction: Those living in the Appalachian Region face a greater number of significant health disparities than residents of other areas of the U.S. Patient portals can decrease disparities, increase health literacy, and improve health outcomes.
Purpose: This study explores if those living in the Appalachian Region are offered access to and use their patient portals differently than those in the surrounding U.S. Census regions. Additionally, the study aims to determine if there was a difference in reported reasons for the non-use of patient portals.
Methods: A secondary analysis was completed using data from the National Cancer Institute's Health Information National …
Association Between Acculturation, Dental Floss Use, Dental Visits And Unmet Dental Needs Among Asians In The United States: Findings From National Health And Nutrition Examination Survey (Nhanes) 2011–2018, 2023 Moores Cancer Center
Association Between Acculturation, Dental Floss Use, Dental Visits And Unmet Dental Needs Among Asians In The United States: Findings From National Health And Nutrition Examination Survey (Nhanes) 2011–2018, Ting Luo, Kaylin Beiter, Tung Sung Tseng
School of Graduate Studies Faculty Publications
Objectives: The objectives of this study were to examine the associations between acculturation and dental floss, regular dental visits and unmet dental care needs among Asian Americans, as well as the moderating effects of these associations. Methods: This study analysed national representative samples from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. A total of 2763 Asian Americans aged 20 and older were included in this analysis. The primary predictor, acculturation score, was determined by three questions: (i) language spoken at home (higher score for English), (ii) country of birth (higher score for United States) and (iii) length of …
Exploring The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, 2023 The University of Western Ontario
Exploring The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, Umma Salma
Electronic Thesis and Dissertation Repository
Background: Transition from the pediatric to adult health care system is an important phase of healthcare for youth with cerebral palsy (CP). Sexuality and gender are two very important components of health that are mostly ignored in the healthcare transition process. It is possible that health care providers only see a client’s disability, and therefore, key aspects of sexuality and gender diversity may be ignored, or deemed irrelevant as a result of their disability status. Therefore, the purpose of our study is to explore how gender and sexuality may influence the experience of health care transition for youth with cerebral …
The Changing Landscape Of Orthopaedic Surgery In Ontario: Where We Are, Where We Have Been, And Where We Are Going., 2023 Western University
The Changing Landscape Of Orthopaedic Surgery In Ontario: Where We Are, Where We Have Been, And Where We Are Going., Silvio Ndoja
Electronic Thesis and Dissertation Repository
Orthopedic surgery is a field which has often been talked about with regards to surgeon underemployment. This is particularly important given the paradoxical increasing demand for orthopedic care. There has not been well studied literature understanding the state of orthopedic surgery training in Ontario, Canada. Using a combination of various databases and surveying surgeons trained in Ontario we sought to provide some insight.
We demonstrated multiple important findings. More recent graduates are feeling less ready to enter practice and almost all graduates do at least 1 fellowship, with equal amount of 1 versus 2 fellowships. We showed an effect of …
Examining Individualized Participatory Approaches To Care For Individuals With Intellectual And Developmental Disabilities, 2023 The University of Western Ontario
Examining Individualized Participatory Approaches To Care For Individuals With Intellectual And Developmental Disabilities, Megann Yen Dong
Electronic Thesis and Dissertation Repository
Person-centred plans have been identified as an upstream approach to addressing the inequities experienced by individuals with intellectual and developmental disabilities. However, little evidence on implemented approaches exists. This integrated thesis consists of two studies exploring individualized participatory approaches to care within community-care services, guided by an integrated knowledge translation approach. The first study is a scoping review aimed to identify individualized participatory approaches to care in the literature. The second study is a qualitative descriptive study utilizing semi-structured interviews with community-care staff (n=11) to understand an operationalized person-centred planning approach. The scoping review provides insight into the variability of …
Chronic Lower Back Pain Among Women In India: Evidence-Based Approach To Risk Factors And Interventions, 2023 The University of San Francisco
Chronic Lower Back Pain Among Women In India: Evidence-Based Approach To Risk Factors And Interventions, Aelita Matosova
Master's Projects and Capstones
Chronic lower back pain (CLBP) is a prevalent issue worldwide, affecting about 1.71 billion people, with a significant proportion being women. CLBP is a major health concern in India, particularly among women, which were 80% reported experiencing this condition. Several factors, such as personal beliefs, sociocultural norms, restricted healthcare access, repetitive movements, and psychological aspects, contribute to this high prevalence leading to severe health and economic implications, including reduced work productivity and income. Although there have been several reports on prevalence and risk factors of CLBP, to our knowledge, there has not been enough work focusing on evidence-based interventions to …
Implementing Text-Messaging To Support And Enhance Delivery Of Health Behavior Change Interventions In Low- To Middle-Income Countries: Case Study Of The Lifestyle Africa Intervention., 2023 Children's Mercy Hospital
Implementing Text-Messaging To Support And Enhance Delivery Of Health Behavior Change Interventions In Low- To Middle-Income Countries: Case Study Of The Lifestyle Africa Intervention., Frank T. Materia, Joshua M. Smyth, Thandi Puoane, Lungiswa Tsolekile, Kathy Goggin, Stephen R. Kodish, Andrew T. Fox, Ken Resnicow, Scott Werntz, Delwyn Catley
Manuscripts, Articles, Book Chapters and Other Papers
The prevalence of non-communicable diseases, such as diabetes and cardiovascular disease, is rising in low- and middle-income countries (LMICs). Health behavior change (HBC) interventions such as the widely used Diabetes Prevention Program (DPP) are effective at reducing chronic disease risk, but have not been adapted for LMICs. Leveraging mobile health (mHealth) technology such as text messaging (SMS) to enhance reach and participant engagement with these interventions has great promise, yet we lack evidence-informed approaches to guide the integration of SMS specifically to support HBC interventions in LMIC contexts. To address this gap, we integrated guidance from the mHealth literature with …
Exploring The Post-Surgical Needs Of Guatemalan Children And Their Families From Low Socioeconomic Status (Ses) Communities Using An Occupational Therapy Perspective, 2023 University of St. Augustine for Health Sciences
Exploring The Post-Surgical Needs Of Guatemalan Children And Their Families From Low Socioeconomic Status (Ses) Communities Using An Occupational Therapy Perspective, Diana Del Carmen Tojin Romero, Karen Aranha, Angela Labrie Blackwell
Summer 2023 Virtual OTD Capstone Symposium
Background: Despite a decline in infant mortality rates in the Global South (GS), there has been a rise in congenital and developmental disabilities. International short-term medical (ISTM) missions in Guatemala seek to address the surgical needs of children from low SES communities, but the understanding of the impacts of such assistance and the post-surgical needs of these communities remains limited. Embracing the Human Rights-Based Approach (HRBA) to healthcare as a foundation for this study recognizes health as a fundamental human right. The main tenets of this approach will guide this investigation to understand the post-surgical needs of children and their …
Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, 2023 Medical University of South Carolina
Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini
MUSC Theses and Dissertations
Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …
Psychometric Properties Of The Impact Index In Patients With Chronic Conditions, 2023 Massachusetts General Hospital
Psychometric Properties Of The Impact Index In Patients With Chronic Conditions, Kd Valentine, Suzanne Brodney, Carol Cosenza, J. Lee Hargraves, Karen Sepucha, Susan Edgman-Levitan, Michael Barry
Patient Experience Journal
The purpose of this paper was to extend the generalizability of the patient-reported Impact Index by assessing convergent validity in patients with common chronic conditions. We conducted a cross-sectional survey of 1,000 English-speaking patients aged 21 and older who visited their provider in the past 6 months and were included in one or more of a hospital’s chronic condition registries. Patients completed a survey that included the Impact Index (4-item measure of how impacted a patient is by their health condition: range 0-12, higher score indicating greater negative impact on quality of life), overall health, and self-report of diagnosis of …
‘Making It Meaningful’: Co-Designing An Intervention To Improve Medication Safety For People From Culturally And Linguistically Diverse Backgrounds Accessing Cancer Services., 2023 Australian Institute of Health Innovation, Macquarie University
‘Making It Meaningful’: Co-Designing An Intervention To Improve Medication Safety For People From Culturally And Linguistically Diverse Backgrounds Accessing Cancer Services., Ashfaq Chauhan, Bronwyn Newman, Elsa Roberto, Ramesh Lahiru Walpola, Holly Seale, Melvin Chin, Reema Harrison
Patient Experience Journal
This study reports on the process of using an adapted Experienced-Based Co-Design (EBCD) conducted with culturally and linguistically diverse (CALD) consumers and cancer service staff to co-design the novel ‘Making it Meaningful’(MiM) instrument at a cancer service in Australia. Multi-source experiential and contextual information was gathered in phase 1 of the co-design and this evidence, coupled with knowledge gathered via a feedback event was used to inform three co-design workshops in phase 2. A series of meetings were conducted prior to and in between the workshops. Theory was progressively integrated into the workshop content. Two Mandarin speaking CALD consumers and …
Patient-Centered Care Frameworks, Models And Approaches: An Environmental Scan, 2023 University of Toronto
Patient-Centered Care Frameworks, Models And Approaches: An Environmental Scan, Aghna Wasim, Maria Sajan, Umair Majid
Patient Experience Journal
Although the definition of patient-centered care (PCC) remains unclear, researchers and healthcare professionals describe the concept as treating the patient as a unique human being with consideration for their physical and psychosocial needs and emphasize the importance of shared-decision making between patients and healthcare professionals. However, discussion around the connection and overlap between PCC and patient and family engagement (PE) has been limited. Some authors describe PE as an operationalization of PCC, while others consider PE a type of PCC. An enhanced understanding of PCC might allow for improvements in implementing PE across healthcare systems. Insight into the operationalization of …
The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, 2023 The University of Southern Mississippi
The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam
Dissertations
Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …
A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, 2023 University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center
A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, Yvonne Jonk Phd, Gary Wingrove Facpe, Cp-C, Nikiah Nudell Ms, Mphil, Nrp, Facpe, Kevin Mcginnis Mps
Emergency Medical Services (EMS)
This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Key Highlights: An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions. A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a …
Clinical And Environmental Factors Affecting The Survival Outcomes Among Stage 1a Tn0m0 First Primary Non-Small Cell Lung Carcinoma Patients In The United States., 2023 University of Louisville
Clinical And Environmental Factors Affecting The Survival Outcomes Among Stage 1a Tn0m0 First Primary Non-Small Cell Lung Carcinoma Patients In The United States., Naiya Patel
Electronic Theses and Dissertations
Background: Lung cancer is the second leading cause of death in the United States (U.S.). The most prevalent histological type of lung cancer is Non-Small Cell Lung Cancer (NSCLC), which has an overall five years survival of 5% if left untreated. Therefore, early treatment of NSCLC is vital to improve overall survival (OS) outcomes. Several factors affect survival outcomes, which can be categorized as modifiable or non-modifiable. The difference in timely receipt of guideline-concordant treatment affects the survival outcomes of patients with stage 1A NSCLC. This dissertation explored factors that affect treatment and survival outcomes among stage 1A NSCLC patients …
Communication Of Patients’ And Family Members’ Ethical Concerns To Their Healthcare Providers, 2023 Thomas Jefferson University
Communication Of Patients’ And Family Members’ Ethical Concerns To Their Healthcare Providers, Mariam Noorulhuda, Christine Grady, Paul Wakim, Talia Bernhard, Hae Lin Cho, Marion Danis
Student Papers, Posters & Projects
BACKGROUND: Little is known about communication between patients, families, and healthcare providers regarding ethical concerns that patients and families experience in the course of illness and medical care. To address this gap in the literature, we surveyed patients and family members to learn about their ethical concerns and the extent to which they discussed them with their healthcare providers.
METHODS: We surveyed adult, English-speaking patients and family members receiving inpatient care in five hospitals in the Washington DC-Baltimore metropolitan area from July 2017 to March 2020. Descriptive statistics were used to determine the frequency, comfortableness, and helpfulness of discussions regarding …
Revitalizing The Healthcare Market: An Analysis Of Hospital Pricing Transparency Compliance, 2023 Ursinus College
Revitalizing The Healthcare Market: An Analysis Of Hospital Pricing Transparency Compliance, Ellie Bruggeman
Business and Economics Summer Fellows
The healthcare industry is one of the most praised industries in the US due to its lifesaving capabilities and immersive care. Consumers regularly report that are satisfied with the care they receive from their physicians. Conversely, they also report frustrations and confusions associated with the costs of such care. In extreme cases, this frustration can turn to financial ruin as medical debt is the leading cause of bankruptcy in the US. The healthcare industry does not operate in congruence with other markets, largely due to the presence of insurance and other third-party payers. The undisclosed interactions between third party payers …
Primary Care Physician Engagement In Health System Transformation: A Case Study, 2023 Western University
Primary Care Physician Engagement In Health System Transformation: A Case Study, Atharv Joshi
Electronic Thesis and Dissertation Repository
Primary care physician engagement is essential in enhancing organizational performance, system efficacy, and provider collaboration; yet limited literature exists within health systems research. This thesis explored physician engagement throughout the development of an organization known as the London Middlesex Primary Care Alliance (LMPCA). This thesis used a qualitative case study approach guided by a constructivist paradigm. The findings revealed six themes which contributed to the development of the LMPCA and provided insight into how physicians were engaged within health systems work. Unique to this study were two facilitators for engagement: the role of a transformation lead and the use of …