Digital Commons Network^™

Ambulatory Intensive Care For Medically Complex Patients At A Health Care Clinic For Individuals Experiencing Homelessness The Summit Randomized Clinical Trial, Brian Chan, Christina Nicolaidis, Meg Devoe, Priya Srikanth, P. Todd Korthuis, Samuel T. Edwards, Devan Kansagara, Rachel Solotaroff, Somnath Saha

School of Social Work Faculty Publications and Presentations

Importance Intensive primary care interventions have been promoted to reduce hospitalization rates and improve health outcomes for medically complex patients, but evidence of their efficacy is limited.

Objective To assess the efficacy of a multidisciplinary ambulatory intensive care unit (A-ICU) intervention on health care utilization and patient-reported outcomes.

Design, Setting, and Participants The Streamlined Unified Meaningfully Managed Interdisciplinary Team (SUMMIT) randomized clinical trial used a wait-list control design and was conducted at a health care clinic for patients experiencing homelessness in Portland, Oregon. The first patient was enrolled in August 2016, and the last patient was enrolled in November 2019. …

Centering Communities Of Color In The Modernization Of A Public Health Survey System: Lessons From Oregon, Daniel F. López-Cevallos, Kusuma Madamala, Mira Mohsini, Andres Lopez, Roberta Hunte, Ryan Petteway, Tim Holbert

School of Social Work Faculty Publications and Presentations

Context: Public health survey systems are tools for informing public health programming and policy at the national, state, and local levels. Among the challenges states face with these kinds of surveys include concerns about the representativeness of communities of color and lack of community engagement in survey design, analysis, and interpretation of results or dissemination, which raises questions about their integrity and relevance.

Approach: Using a data equity framework (rooted in antiracism and intersectionality), the purpose of this project was to describe a formative participatory assessment approach to address challenges in Oregon Behavioral Risk Factor Surveillance System (BRFSS) and Student …

Understanding Veteran Perceptions About Mental Health And Its Treatment, Quinn Turner Stoddard

Dissertations and Theses

Mental health illnesses are a growing issue for a large part of the country, and veterans in particular are vulnerable to the numerous negative effects they pose. Despite the high number of people that may benefit from treatment, a variety of issues with trust, stigma, and attitudes may act as barriers to care utilization. In response, this study investigated the perceptions that veterans within the Pacific Northwest hold in regards to mental health treatment as well as their intentions to seek it out should they require it. Using the integrated model of behavioral prediction (IMBP), data was gathered about veterans’ …

Z60.5/(En)Coded, Ryan Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

No abstract provided.

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

Paperwork, Paradox, And Prn: Psychotropic Medication Deficiencies In Assisted Living, Sarah Dys, Paula Carder

Institute on Aging Publications

Individual state approaches to assisted living/residential care (AL/RC) licensing and oversight in the United States result in different practice standards and requirements, including psychotropic medication use. We examined 170 psychotropic medication deficiency citations issued to 152 Oregon AL/RC settings from 2015 to 2019. Applied thematic analysis resulted in the following themes: (1) documentation issues are primarily responsible for noncompliance, (2) unclear parameters place direct care workers in a role paradox, and (3) there is a persistent disconnect about when to seek qualified expertise before requesting psychotropic medications. AL/RC-specific mechanisms for medication prescription and administration are necessary to improve the structure …

A Hierarchical Decision Model To Evaluate Healthcare Organization's Readiness To Implement Clinical Decision Support Systems, Mohammed Oussama Laraichi

Dissertations and Theses

Clinical Decision Support Systems (CDSS) are essential tools for healthcare organizations as well as for healthcare providers to improve clinical care. However, successful implementation of CDSS can be challenging. Therefore, before implementing CDSS, it is crucial to assess the readiness of healthcare organizations to implement these tools.

Through a literature review, the first step of this research explores the concept of clinical decision support and CDSS, discussing their features, characteristics, and organizational hurdles to implementation. It also provides perspectives on CDSS adoption in the context of Information Systems and Health Technology. The review helped identify research gaps, objectives, and questions. …

Experiences Of People With Serious Mental Illness Seeking Services At Community Mental Health Centers During The Covid-19 Pandemic, Emily Leickly

Dissertations and Theses

Community mental health centers (CMHCs) have been underfunded and overburdened since Reagan-era disinvestment and the United States' move toward neoliberalism. Rates of mental illness have been rising consistently, particularly in Oregon, as CMHCs face continuing financial pressures and staff retention issues. This was before the COVID-19 pandemic. Today, we are still trying to understand the ongoing pandemic's impact on people with serious mental illnesses (SMI). Most of the studies in this area thus far are quantitative, and first-hand accounts of the pandemic from people with SMI are largely absent. Additionally, research in this area fails to draw on critical alternative …

The Experiences Of American Indian Participants And Site Coordinators In A Gestational Diabetes Risk Reduction Trial, Sarah Stotz, Kelly L. Gonzales, Kelly R. Moore, Heather Garrow, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Gestational diabetes mellitus is the most common complication of pregnancy and contributes to increased risk for type 2 diabetes in both the mother and offspring. We developed and evaluated a gestational diabetes risk reduction and preconception counseling program, Stopping GDM (SGDM), for American Indian females. The purpose of this study is to examine the experiences of American Indian mother-daughter dyad participants and the site coordinators who facilitated the SGDM randomized controlled trial to inform program revisions. We engaged mother-daughter dyads (n = 22 dyads) and site coordinators (n = 6) in focus group interviews. Four themes emerged: (1) …

Understanding The Experiences Of Latino Medical Students In A Learning Medical Environment, Leslie García

Dissertations and Theses

Very little is known about the experiences and perceptions of underrepresented minority (URiM) medical students in the U.S. allopathic medical schools. The limited literature posits URiMs experience more adverse experiences in the learning environment and have different learning outcomes in comparison to their White peer counterparts. Latino medical students represent 7.1% of all entering medical students across all U.S. medical schools. While they represent the largest ethnic minority in the United States within parity lack representation among the physician workforce [sic]. There is a dearth of knowledge of what factors contribute to the success of Latino medical students progressing in …