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Access To Veterinary Care: Barriers, Current Practices, And Public Policy, Access To Veterinary Care Coalition

Faculty Publications and Other Works -- Small Animal Clinical Sciences

Pets have become an integral part of our families with over 80% of pet owners reporting that they consider their pets to be a member of their family. An estimated 29 million dogs and cats live in families that participate in the Supplemental Nutrition Assistance Program. There are also middle-class families that live paycheck to paycheck, with limited funds for veterinary care. These families deserve the companionship of pets to enjoy the mental, physical, and emotional benefits that come from this human-animal bond.

Through a grant from Maddie’s Fund®, the Access to Veterinary Care Coalition (AVCC) commissioned a national …

Overcoming Barriers For The Implementation Of Evidence-Based Practice Through Journal Clubs, Regina Thomas

Doctor of Nursing Practice Projects

Many barriers exist at a 134-bed rural hospital in southern Illinois that hinder generation, evaluation, and implementation of evidence-based research into practice. This DNP project was completed through a phase approach utilizing a modified version of Kotter’s Model of Change, the RNcEBP Survey to self-rate individual confidence in the EBP process, and the Iowa Model of Evidence-Based Practice to facilitate implementation of journal clubs. The RNcEBP survey revealed that nurses were familiar with the concept of EBP, have positive attitudes, and are confident that EBP changes can improve patient outcomes, but lack experience in evaluating literature to support implementing evidence-based …

Screening, Brief Intervention, And Referral To Treatment (Sbirt) For Substance Use Disorders In Title X Facilities: Assessing Barriers, Change Of Provider Behavior, And Patient Outcomes, Christian Iversen, Ms, Holly Ireland, Lcsw-C, Dickie Lynn Gronseth, Mph

Phase 1

Introduction: Substance use disorders, specifically opioids, are an increasing problem in the US. Screening, brief intervention, and referral to treatment (SBIRT) is a method to identify and treat patients at risk, or currently using illicit substances. Integrating SBIRT into Title X facilities, which provide reproductive healthcare to lower income populations, may allow identification and treatment of individuals that do not seek healthcare elsewhere. Objective: We aim to assess the efficacy of a longitudinal training program in Title X facilities. The program provides a structured approach to implementing new protocols, including an educational session on SBIRT and motivational interviewing (MI).

Methods: …

Addressing Barriers To Medication Adherence: An Evidence-Based Screening Instrument Validation Study, Donna Jean Washburn

Doctoral Dissertations and Projects

Adherence to a prescribed medication regimen is often critical to successful disease management. Cancer diagnoses often further complicate control of the comorbid diseases. Older cancer patients with multiple comorbidities receiving chemotherapy treatment are at increased risk for adverse health outcomes from uncontrolled disease when nonadherent to their medication regimen. The intent of this pilot study was to test the validity of an evidence-based screening instrument designed to identify patients at risk for medication nonadherence and uncontrolled illness. The W-BMA (Washburn-Barrier to Medication Adherence) screening criteria were applied to retrospective data of cancer patients with multiple co-morbidities. SPSS was used to …

Sustaining Daily Management With Gemba Walks: A Scheduling Model, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

SUSTAINING DAILY MANAGEMENT WITH GEMBA WALKS: A SCHEDULING MODEL

At an academic tertiary care medical center, there are 110 Operational Excellence teams across 4 campuses. Every weekday, 10 GEMBA walks occur with the 11^th on Wednesdays. The expanding program has made daily leadership visits to all KPIs challenging. As a result, consideration of reduced gemba walks to departments who have met specific maturity/performance criteria.

The scope of the eight-week pilot consisted of 13 pre-identified teams that have weekly workflows. The teams must have met a baseline level of performance. Performance was scored for 9 variables measuring engagement, PDSA, use …

The Nationwide Health Information Network: The Case Of The Expansion Of Health Information Exchanges In The United States, Morgan Ruley, Victoria Walker, Jana Studeny, Alberto Coustasse

Management Faculty Research

The Nationwide Health Information Network (NHIN) implemented secure exchange of health records through utilization of the Internet. NHIN has greatly assisted in achieving the goals of the HITECH Act by promoting the adoption of Meaningful Use. Epic introduced a Health Information Exchange (HIE) platform, Care Everywhere (CE), which has facilitated HIE availability. The purpose of this research was to determine the impact of NHIN and Epic Care’s CE on healthcare to determine whether their use in the ED has increased. The methodology for this study utilized a literature review. Twenty-nine sources were referenced for this study. With the NHIN implementation, …

The Barriers To Breastfeeding Among Women: A Single-Center Experience, Hala M. Shaheen, Nagwa N. Hegazy, Sara S.A Sakr

Menoufia Medical Journal

Objective To estimate the prevalence of exclusive breastfeeding (EBF) and to identify barriers to breastfeeding among the studied mothers in Berket El-Sabaa District, Menoufia Governorate, Egypt. Background Human breast milk is the ideal and unique food for infants. However, most infants today still do not receive the full benefits of breastfeeding. Low breastfeeding rates during the first 6 months imply that mothers are constantly faced with multiple barriers to continue breastfeeding. Patients and methods The study was a cross-sectional study. It was conducted on 370 mothers of infants aged 2–6 months. All participants were interviewed using a predesigned questionnaire included …

Increasing Use Of A Tobacco Cessation Quitline In A Rural Prenatal Population, Rachel T. Schleenbaker

Master's Projects

This paper addresses prenatal smoking rates within in a rural northern Michigan district health department (HD) through a Master of Science in Nursing (MSN) quality improvement project. The paper provides a detailed microsystem assessment of the Maternal Infant Health Program (MIHP) at the district HD describing the clinical problem and identifying a practice gap in care of prenatal smokers. The literature review describes the three most effective prenatal smoking cessation interventions: counseling, incentives, and feedback. The literature review also addresses the effectiveness of and barriers to smoking quitlines. The clinical protocol followed the Model for Improvement framework with the completion …

Knowledge, Attitude, And Barriers Of Nursing Research Among Bsc Nursing Students, In Selected Nursing College Of Malappuram District, Hanibernia S Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Nursing research is the systematic pursuit of knowledge involving the understanding and formulation of a problem, the collection of information through observation or any other method. This study aimed to assess the knowledge on nursing research and attitude towards it and also identify the barriers to conduct nursing research. Objectives: The objectives of the study were to assess the knowledge and attitude on nursing research among BSc nursing students, to find out the barrier of nursing research among BSc nursing students, and to find out the association between the knowledge and attitude score with selected demographic variables. Methods: A …

Gender Inequalities And Childbearing: A Qualitative Study Of Two Maternity Units In Nepal, Lesley Milne, Jillian C M Ireland Ms, Edwin Van Teijlingen, Vanora Hundley, Padam P. Simkhada

Journal of Asian Midwives (JAM)

The role and status of women in South Asian countries like Nepal are widely recognised to be lower than that of men. This gender inequality can be found throughout all levels of society. Our study is about the influence of gender on pregnancy and childbirth, which are very much in the female domain in South Asia, both at home and in health facilities.
A mixed-method, qualitative research study was undertaken in two birthing facilities in Kathmandu Valley to examine barriers to women accessing these services from the perspective of hospital staff. Thematic analysis identified seven subthemes related to gender, namely: …

Reducing Inter-Unit Patient Report Delays And Transfer Times, Natalya Marinov

Master's Projects and Capstones

Inter-unit coordination is essential in preventing a bottleneck in patient flow and its resultant stresses to staff, hindering quality patient care, and wasting time. The Medical-Surgical Unit (MSU) and Post Anesthesia Care Unit (PACU) struggle to establish efficient patient report times and transfers. Preliminary data demonstrated report delays attributed to an arduous workload and overburdened MSU nursing staff. The project’s objective focuses on reducing nurse-related report time delays by 10%, increasing understanding and teamwork, promoting proactive thinking to manage workflow efficiently, improving patient flow, and improving the inter-unit relationship between MSU and PACU. Increasing awareness and reducing transfer times are …

The Perception Of The Athletic Training Profession In The High School Setting, Brandin Williams-Johnson, Jennifer Walker, Erika Smith-Goodwin

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

In volume 4, Issue 1 of the JSMAHS you will find Professional Research Abstracts, as well as Bachelor Student Research Abstracts and Case Reports.

Thank you for viewing this 4^th Annual OATA Special Edition

Factors Influencing Physical Activity Among Immigrants From South India: A Qualitative Descriptive Study, Jaya Abraham

Dissertations & Theses (Open Access)

Background: In the United States (U.S), the percentage of diabetes and coronary artery diseases is higher among Asian Indian immigrants compared to other ethnic groups. Although research has been useful in describing patterns of physical activity among South Asian groups, very little is known about the factors influencing physical activity among Asian South Indian (ASI) immigrants. There is very limited research performed on the individual, social, cultural and environmental factors influencing physical activity among ASI immigrants.

Purpose: The study purpose was to explore the factors influencing physical activity with the following primary and secondary aims: The primary aim …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

School Nurses’ Experience Of Barriers To Care In Children With Type 1 Diabetes, Eden Joseph Donahue

Doctoral Projects

Purpose: The purpose of the study was to gather data on the lived-experience of providing and coordinating type 1 diabetes care in the school setting from school nurses who practice in California. Methodology: A descriptive phenomenological qualitative study design was used to collect data through structured interviews with 13 school nurses. Descriptive coding was used to analyze the interview data. Findings: School nurses face multiple barriers to care when providing type 1 diabetes care in the school setting. The three major themes school nurses encountered were difficulty with care coordination, communication, and parents.

Increasing Cervical Cancer Screening In Hiv Positive Women By Introduction Of A Provider Prompted Algorithm Tool: A Quality Improvement Project, Aubri B. Hickman

Doctoral Projects

Continuous quality improvement projects and appropriate documentation are an essential component to continue to receive Ryan White grant funding. Compliance with mandated aspects of quality improvement is an extremely important concept-specifically for a clinic setting that cares for the largest HIV positive population in the state of Mississippi. The Health Resources and Services Administration (HRSA) provides directives mandating that quality improvement projects should be applicable to areas of need and provide for outcomes that ensure quality care for HIV positive individuals (2016).

Initially, this clinic’s rate of compliance with the HRSA Cervical Cancer Screening Performance Measure was subpar to the …

Barriers To Addressing Hiv-Associated Neurocognitive Disorder (Hand): Community-Based Service Provider Perspectives, Renato M. Liboro, Francisco Ibanez-Carrasco, Sean B. Rourke, Andrew Easton, Claudia Medina, Daniel Pugh, Allan Rae, Lori E. Ross, Paul A. Shuper

Psychology Faculty Research

HIV-Associated Neurocognitive Disorder (HAND) is an emergent public health issue in developed countries. Consequently, people living with HIV who experience HAND will increasingly require support from community-based HIV service providers. The objective of our qualitative study was to identify barriers service providers face in addressing HAND among people living with HIV. Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed. Using thematic analysis, three types of barriers were identified: (a) personal/professional, (b) service access, and (c) systemic. This paper draws attention to HAND-related obstacles that service providers encounter in their work and presents options to overcome them.

Breast Cancer Knowledge, Perceptions And Practices In A Rural Community In Coastal Kenya, Shahin Sayed, Anthony Ngugi, Megan R. Mahoney, Jaameeta Kurji, Zohray M. Talib, Sarah B. Macfarlane, Theresa A. Wynn, Mansoor Saleh, Amyn B Lakhani, Esther Nderitu, Felix Agoi, Zul Premji, Jo Anne Zujewski, Zahir Moloo

Pathology, East Africa

Background: Data on breast healthcare knowledge, perceptions and practice among women in rural Kenya is limited. Furthermore, the role of the male head of household in influencing a woman’s breast health seeking behavior is also not known. The aim of this study was to assess the knowledge, perceptions and practice of breast cancer among women, male heads of households, opinion leaders and healthcare providers within a rural community in Kenya. Our secondary objective was to explore the role of male heads of households in influencing a woman’s breast health seeking behavior.

Methods: This was a mixed method cross-sectional study, conducted …

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Fabiana Kotovicz, MD

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin. Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. …

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Journal of Patient-Centered Research and Reviews

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin.

Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. …

Simulation-Based Nurse Mentoring To Promote Preeclampsia Care: What Is The Impact In Bihar, India?, Julia Haven Raney

Yale Medicine Thesis Digital Library

Background:

Inadequately treated, severe preeclampsia and eclampsia (PE/E) may rapidly lead to severe complications in both mothers and neonates and are estimated to cause 60,000 maternal deaths globally each year. Simulation-based training where health providers review basic emergency obstetric and newborn care through highly realistic cases have demonstrated promising results in low- and middle-income countries (LMIC). Two international simulation training programs, Helping Mothers Survive and PRONTO International, have demonstrated improved overall use of evidence-based practices (EBPs) in active management of third stage of labor and hemorrhage management, though individual skills varied. However, the impact of simulation training on use of …

Lessons Learned In The Implementation Of Healthesteps: An Evidence-Based Healthy Lifestyle Program, P. Karen Simmavong, Loretta M. Hillier, Robert Petrella

Lifestyle Research Team

HealtheSteps is a pragmatic, evidence-based lifestyle prescription program aimed at reducing the rates of chronic disease, in particular, type 2 diabetes. A pro- cess evaluation was completed to assess the feasibility of the implementation of HealtheSteps in primary care and community-based settings across Canada. Key informant interviews (program providers and participants) were conducted to identify facilitators and barriers to implementation and opportunities for future program adaptation and improvement. Forty-three interviews were conducted across five regions in Canada (15 sites ranging from remote, rural, suburban, and urban). Transcripts were analyzed using a qualitative naturalistic inquiry approach with several facilitating factors identified: …

Identifying Barriers To Long-Acting Reversible Contraceptive Usage Among Adolescents, Emily Kathleen Davis, Viktoryia Petrusevich

All Electronic Theses and Dissertations

Although LARC methods including IUDs and implants are highly effective in preventing pregnancies and both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend it for adolescents as a first-line choice given their efficacy, safety, and ease of use, its utilization by sexually active adolescents remains low. The purpose of this critical literature review was to identify what barriers to LARC impact utilization and continuation rates among adolescents and young women.

Barriers To Preventive Care For The Immigrant Population In Minnesota, Andrew Kenneth Gernand, Dustin Wayne Kingsley, Daleso Yadetta

All Electronic Theses and Dissertations

Immigrants in Minnesota face several barriers regarding access and use of preventive healthcare services. Current literature indicates a high area of need exists within the immigrant population for the prevention of chronic illness. Language, health literacy, cultural norms, and citizenship all play a role in limiting the use of preventive care. As the number of elderly immigrants increases and the overall immigrant population steadily rises in the United States, it is in the best interest of patients and providers to prevent or reduce the burden of long term diseases like diabetes, cancer, and hypertension. Knowing that barriers are present within …

Transition In Occupations Of Refugees During Resettlement, Jennifer H. Daine, Adam A. Chan, Jacqueline-Elizabeth Cantrell, Kimberley Keagan Banuelos

Student Research Posters

Purpose: In 2016, there were 22.5 million refugees worldwide (UNHCR, 2017). California resettled just over 5,000 of those 85,000 (Igielnik & Krogstad, 2017). Limited research has been conducted in the United States (U.S.) focusing on the refugee experience; furthermore, there is a significant gap in research regarding the impact of the refugee experience on the occupations of refugees as they transition to living in the U.S. Smith (2012) explored the adaptation of cultural weaving among Karen refugees to maintain their previous occupations and the impact of daily weaving on their lives within Western culture; however, the study focused only on …

An Evidence-Based Practice Assessment And Quality Improvement Initiative In Idaho's Critical Access Hospitals, Deena R. Rauch

Doctor of Nursing Practice Projects

Background: Health care providers and systems have been challenged to discard tradition-based care and outdated practices in lieu of evidence-based practice (EBP). Yet, little is known about the state of EBP, barriers and facilitators to EBP, and organizational readiness for EBP in Idaho’s Critical Access Hospitals (CAH). To affect positive change, it was necessary to understand whether providers in Idaho’s CAHs were using evidence as a foundation for practice—and, if not, what challenges existed in implementing EBP. Mitigating barriers and providing EBP education by way of webinar-based online technology has been proven to be practical and feasible. Providing EBP education, …

Perceived Benefits And Barriers Of A Community-Based Diabetes Prevention And Management Program, Samantha Shawley-Brzoska, Ranjita Misra

Faculty & Staff Scholarship

This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants’ perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% …

Investigating Falls In Adults With Intellectual Disability Living In Community Settings And Their Experiences Of Post-Fall Care Services: Protocol For A Prospective Observational Cohort Study, Portia Ho, Caroline Bulsara, Shane Patman, Max Bulsara, Jenny Downs, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain uncertain. Furthermore, people with ID rely heavily on familial and professional care support to address health problems, such as after having a fall. No studies have explored the post-fall care that people with ID receive.

Method: This research will be carried out in two phases using a convergent mixed methods …

Counselors' Perceptions On Adolescent Access And Use Of School-Based Mental Health Services, Samuel C Godwin Okeorji

Walden Dissertations and Doctoral Studies

The role of school-based mental health counselors (SBMHCs) is essential in addressing the mental health needs of U.S. adolescents. The purpose of this phenomenological study was to examine SBMHCs' perceptions about factors that affect the use of SBMH services by adolescents from a school district in Connecticut. SBMHCs were chosen for this study because they provide direct mental health services to adolescents. Mechanic's general theory of help-seeking provided the framework to interpret research findings using the 10 interrelated constructs. Fifteen SBMHCs participated in face-to-face semistructured interviews. Colaizzi's 6-steps-guide was used to organize, code, and identify common themes. The following themes …

Barriers To Oral Care Among African American Adolescents In Prince George's County, Maryland, Nkiruka Soribe Mcginnis

Walden Dissertations and Doctoral Studies

When adolescents forgo oral health treatment, factors that hinder them from obtaining these services put them at risk of detrimental consequences in their oral and overall health. The purpose of this qualitative phenomenological study was to identify the various barriers that adolescents encounter causing them to defer oral treatment. Through this study, public health officials, school health care providers, the state, and parents could be made aware of these factors and work together to implement programs and supplemental aid to help adolescents become more knowledgeable of the importance of oral care and encourage them to desire and seek treatment. The …