Digital Commons Network^™

High Medicaid Nursing Homes: Organizational And Market Factors Associated With Financial Performance, Robert Weech-Maldonado, Justin Lord, Rohit Pradhan, Ganisher Davlyatov, Neeraj Dayama, Shivani Gupta, Larry Hearld

Faculty Publications

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. The purpose of this study is to examine the organizational and market factors that may be associated with better financial performance among high Medicaid nursing homes. Data sources included Long-Term Care Focus (LTCFocus), Centers for Medicare and Medicaid Services’ (CMS) Medicare Cost Reports, CMS Nursing Home Compare, and the Area Health Resource File (AHRF) for 2009-2015. There were approximately 1108 facilities …

Exploring The Cultural Perceptions Of Physical Activity Among Transnational Nigerian Immigrants, Kelechi D. Ibe-Lamberts, Daudet Ilunga Tshiswaka, Abi Fapohunda

Journal of Health Disparities Research and Practice

Background: Transnational Nigerian Immigrants, as other Transnational African Immigrants, are a subset of African immigrants with the unique ability to sustain multi-national ties. These ties could potentially affect health behavior choices and participation in physical activity. Physical Activity has the potential to improve health and prevent chronic diseases; however, there is a lack of literature regarding physical activity and its determinants within the Transnational African Immigrant population in general. This study investigated the cultural factors that shape Transnational Nigerian Immigrants’ perceptions and attitudes towards physical activity.

Methods: Semi-structured, individual interviews supported by photo-elicitation were conducted on 24 Transnational …

Ua66/13/2 Ogden College Of Science & Engineering Public Health Centers, Wku Archives

WKU Archives Collection Inventories

Records related to Public Health Centers.

Implementing Aromatherapy For Falls Reduction In The Inpatient Hospice Population, Kimberly Kay Pistek

Walden Dissertations and Doctoral Studies

Falls among the elderly is a health concern affecting multiple patients annually. Hospice patients and those with multiple comorbidities are at the greatest risk of falling and sustaining injuries from falls. Aromatherapy has been used for reducing multiple symptoms as well as for decreasing falls. The practice-focused question explored whether an education program on using aromatherapy for fall prevention would increase knowledge of this intervention for an interdisciplinary group of hospice staff. The design was developed using Knowles's theory of andragogy and Bloom's taxonomy. Thirteen staff members from the same facility participated in the education program. The program was targeted …

Social Networks, Identity, Health, And Quality Of Life Among Older Gay And Lesbian Individuals In Rural Environments, Marc Aaron Guest

Theses and Dissertations--Gerontology

The goal of this dissertation was to explore aging lesbian and gay individuals living in rural communities, in terms of their social networks and the relationships between these networks, identity, health, and quality of life. Guiding the study were three overarching questions. Using a multi-method design, the research was grounded within a socio-ecological context and focused on how structural systems create pathways for health and are affected by social position (intersectionality). Participants (n=25) were recruited from Kentucky (n=20), West Virginia (n=3), and Tennessee (n=2). Thirteen participants self-identified as gay and twelve as lesbian. Findings highlight the complexity of the aging …

Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is the most common form of dementia and affects an individual’s overall cognitive function, including orientation, memory, and executive function. Most AD patients in the United States reside in residential care facilities or private homes under the care of individuals with little education on the challenges of the AD patient. Among the challenges faced by caregivers are behavioral and psychological symptoms related to dementia (BPSD). Education has been shown to improve caregivers’ treatment of BPSD in AD patients and to improve caregiver retention. The purpose of this project was to develop an evidence-based education module guided by …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Vulnerable Older Populations Without Special Health Care In Egypt: A Need For Assessment & Reform / كبار السن الذين يفتقرون إلى الرعاية الصحية المتخصصة في مصر: متطلبات التقييم والإصلاح, Mahmoud Nassar, Sally Islam, Shaimaa Sabbah, Sondos Said Mubarak

Papers, Posters, and Presentations

The older population in Egypt needs a special healthcare system to fulfill its needs and expectations. Nowadays, the older people live longer than before due to the improvement of healthcare services. That leads to an increase in the number of older people and creates a pressure on resources especially with the limited resources in Egypt. Urbanization and the change in the Egyptian demographics is exacerbating the problem. Egypt now is becoming a nation of dignified older citizens that need additional care and special attention. A number of policies and reforms have already been discussed but never thoroughly analyzed. Some policies …

Experiences And Attitudes Of Older Homeless Women Toward Healthcare Access, Mary Ann Mueller

Walden Dissertations and Doctoral Studies

Homelessness among older women is a growing problem in many metropolitan areas of the United States. Researchers have indicated that health issues and problems accessing basic care are connected. Older homeless women face increased health issues, multiple challenges related to accessing basic care, and low incomes which put them at higher risk of becoming homeless, staying homeless, and delaying medical treatment. The homeless who lack fulfillment of social support and timely medical care are considered repetitive users of the emergency department and hospital stays. The purpose of this phenomenological study was to explore the experiences and beliefs of older homeless …

Culture And The Development Of Traditional Medicine In Africa, Rowland Edet, Oyedolapo Isaac Bello, Julianah Babajide

Department of Sociology: Faculty Publications

Traditional medicine has been the dominant healthcare system in Africa before westernization, civilization and colonialism. For people living in the rural areas, traditional medicine is easily available, accessible and affordable. The purpose of this paper is to examine how the cultural way of the life of Africans has contributed to the emergence and development of traditional therapeutic systems in the continent. By explaining the way Africans perceive illness and disease, this paper argues that various forms of healing were predicated on the sociocultural environment of the people. The paper therefore opts for concerted efforts in the development of traditional medicine …

Instrumental Role Modeling And The Sensitive Topic Of Obesity: A Grounded Theory, Tulie Blot Gay

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role is more prominent now than ever before in primary healthcare, positioning them as providers who defend initiatives and ongoing health agendas. Obesity is among those agendas. The concept of instrumental role modeling was explained as a combination of understanding and physical presence that gives meaning and quality to inspire change. It implied that health professionals are not merely insightful clinicians but suggested their expertise is complimented by demonstrations of wellness in knowledge and practice. This topic of weight was perceived as sensitive but must be addressed. In this grounded theory study, the perspectives of NPs …

Does Widowhood Affect Cognitive Function Among Chinese Older Adults?, Zhenmei Zhang, Lydia W. Li, Hongwei Xu, Jinyu Liu

Publications and Research

There is growing evidence from Western countries that widowhood may affect cognitive health in later life. However, little is known about whether widowhood isassociated with cognitive health in Eastern Asian countries such as China and what factors may explain the association between widowhood and cognitive health. Weadd to this line of research by investigating the effect of widowhood on 2-year change in cognitive function among Chinese adults ages 55 and older from 2011 to2013, using data from the China Health and Retirement Longitudinal Study. Cognitive function was measured by episodic memory and mental intactness (i.e.,attention and time orientation). Our results …

Attachment Security And Psychological Health In Adult Child Caregivers And Their Parents With Alzheimer’S Disease And Related Dementias, Wei Aiko Chang

Public Health Theses

Objective: Attachment theory is a helpful framework for examining one of the most fundamental needs in parent-child dyads across the lifespan and how attachment security might protect both dyad members’ psychological health, especially in times of crisis. In this study of adult child caregivers and their parents with early stage Alzheimer’s disease and related dementias (ADRD), we examined the associations between both dyad members’ attachment security, the adult child’s depressive symptoms, and quality of life of the parent with ADRD.

Method: Thirty-four individuals (parents) with ADRD and their 34 adult-child caregivers each completed the 12-item Experiences in Close Relationship Scale …

Older Adult Spouses’ Emotional Responses To Reminiscing About Their First Encounter: Associations With Mental Health, Marital Satisfaction, And Cardiovascular Reactivity, Hanzhen Lan

Public Health Theses

Objectives: While there has been growing interest in how close relationships affect older adults’ health, not much research has examined how emotional experiences in older married couples’ positive interactions relate to individual and relational well-being and physical health. The present study hypothesizes that positive emotional responses to older couples reminiscing about first encounter are associated with each spouse’s higher marital satisfaction, fewer depressive symptoms, and healthier cardiovascular reactivity (blood pressure and heart rate variability).

Method: One hundred and one couples completed a background questionnaire at home and then participated in a laboratory session in which they discussed how they first …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

The Journal of Sociology & Social Welfare

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Peter Syphers, C.J. Schumaker, Ronald P. Hudak

Journal of Sustainable Social Impact

Alzheimer’s disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest aging populations in the United States and the smallest, most underrecognized, and most culturally diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study …

The Effect Of Home Visit And Telephone Tracking Program On Knowledge, Caregiver Burden And Quality Of Life Among Dementia Caregivers Ratchaburi Province Thailand, Worarat Magteppong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Elders with dementia have serious behavioral problems and require extensive care from caregivers. This poses a significant problem for patients’ families. Multicomponent interventions have been reported to be more effective than interventions targeting one point of caregiver functioning. This study aims to examine the effect of a home visit and telephone tracking program on knowledge, caregiver burden, and quality of life among dementia caregivers. Methods: This study was a quasi-experimental with two group comparisons during November 2018 – July 2019. The participants of this study comprised 62 dementia caregivers (31 participants in intervention and 31 participants in control group) …

Cardiovascular Risk Factors Associated With Venous Thromboembolism, John Gregson, Stephen Kaptoge, Thomas Bolton, Lisa Pennells, Peter Willeit, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

Objective To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

Design, Setting, and Participants This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February …

One-Sentence, One-Word: An Innovative Data Collection Method To Enhance Exploration Of The Lived Experiences, Shannon L. Sibbald, Dylan Brennan, Aleksandra Zecevic

The Qualitative Report

Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and subsequently propose solutions to potential problems in the partnership. By applying an experience-based methods lens, we sought to augment traditional qualitative interviewing methodologies by using a novel method we named “one-sentence, one-word” (1S1W). To apply our 1S1W method, we used a phenomenological study that examined the relationship between the risk of falling and the desire of master athletes to engage in competitive sports. Participants reflected and recorded their subjective …

Association Between Psychosocial And Organizational Factors And Objectively Measured Sedentary Behavior In Desk-Dependent Office Workers, Andrew Lafrenz, Taryn Lust, Minot Cleveland, Alar Mirka, Andrew Downs, Bryan Goodin, Jacquie Van Hoomissen

CUP Faculty Research

Cross-sectional analysis of data from the Recharge@Work study was used to assess individual, interpersonal and organizational correlates of objectively- measured sedentary time, in desk-dependent office workers at 2 U.S. hospitals. Analysis included 65 participants (62 females and ~49.2 years old). Sedentary time was assessed by accelerometry across five consecutive days and expressed as prolonged sedentary bouts (60 min ≤ 150 cpm). Correlates measured a baseline included: age, BMI, active break enjoyment, active break outcome expectancy, active break self-efficacy, active break social support, direct supervisor support of active breaks and senior manager support of active breaks. As expected, we found that …

Pharmacy Staff Perspectives On Alcohol And Medication Interaction Prevention Among Older Rural Adults, Faika Zanjani, Hannah Allen, Rachel Vickers Smith, Demetra Antimisiaris, Nancy E. Schoenberg, Catherine A. Martin, Richard Clayton

Behavioral Science Faculty Publications

Older adults are at high risk for alcohol and medication interactions (AMI). Pharmacies have the potential to act as ideal locations for AMI education, as pharmacy staff play an important role in the community. This study examined the perspectives of pharmacy staff on AMI prevention programming messaging, potential barriers to and facilitators of older adult participation in such programming, and dissemination methods for AMI prevention information. Flyers, telephone calls, and site visits were used to recruit 31 pharmacy staff members who participated in semistructured interviews. A content analysis of interview transcriptions was conducted to identify major themes, categories, and subcategories. …

“My Determination Is To Live”: Narratives Of African-American Women Who Have Lived With Hiv For 10 Or More Years, Sabrina Cherry, Kathleen Demarrais, Cheryl Keita, Marsha Davis, Joel Lee

The Qualitative Report

Exploring the experiences of African-American women who have lived with HIV for many years can inform public health practice on how to better serve high-risk populations along the care continuum. To understand the experiences of African-American women who are HIV positive, the researchers used a narrative approach to guide repeat interviews. Under a theoretical framework of Womanism, we interviewed six African-American women ages 48-66 (M=57) who have lived with HIV for 10 years or longer and conducted analyses of narrative to identify key themes. The primary themes were: recollecting early hardships, HIV infection, and diagnosis; embracing social support; surviving and …

Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS: Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS: In total, 7% (107) of respondents reported they experienced …

The Impact Of Peer Support On The Risk Of Future Hospital Readmissions Among Older Adults With A Medical Illness And Co-Occurring Depression, Kyaien O. Conner, Tamara Cadet, Monique J. Brown, Joshua T. Barnett

Faculty Publications

Older adults account for 60% of all preventable hospital readmissions. Although not all readmissions are preventable, evidence indicates that up to 75% of hospital readmissions can be prevented with enhanced patient education, pre-discharge assessment, and effective care upon discharge. Social support, specifically peer support, after discharge from hospital may be a crucial factor in minimizing the risk of preventable hospital readmission. The pilot study reported here evaluated the relationship between peer support and hospital readmissions in a sample of depressed older adults (N = 41) who were recently discharged from hospital due to a medical condition and who simultaneously had …

Grandparent Caregivers’ Perceptions And Lived Experiences: Their Health And Wellbeing, Access To Health And State Of Health Services In Zimbabwe, Magen M. Mutepfa Dr

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

The study explored the perceptions and lived experiences of self-rated health, access to health, and state of health services for grandparent caregivers in Zimbabwe. In–depth interviews using semi-structured interview guides were carried out to elicit perceptions of lived experiences from grandparent caregivers (N=31; Mean age= 65.7; SD= 10.7). The data was thematically analysed and the software Nvivo 10 was used to help categorize emergent themes. The study found that grandparent caregivers experienced multiple chronic and complex self-rated health conditions (e.g., High blood pressure (HBP), arthritis, diabetes, hypertension, back pain, and heart problems), which influenced their health and Quality of Life …

Pubh 4231- Health Aspects Of Aging, James Thomas

College of Public Health: Faculty Syllabi (2014-2021)

This course examines the aging process from a health education perspective. Students will become acquainted with the process of and problems associated with aging in order to effectively manage this important public health issue. Knowledge and understanding of biological, psychological, and sociological aspects of aging as related to health and wellness will also be addressed. (2018-2019, Georgia Southern University Undergraduate and Graduate Course Catalog) Access to course materials are available for up to one year after graduation.

Women’S Pregnancy Life History And Alzheimer’S Risk: Can Immunoregulation Explain The Link?, Molly Fox, Carlo Berzuini, Leslie A. Knapp, Laura M. Glynn

Psychology Faculty Articles and Research

Background:

Pregnancy is associated with improvement in immunoregulation that persists into the geriatric phase. Impaired immunoregulation is implicated in Alzheimer’s disease (AD) pathogenesis. Hence, we investigate the relationship between pregnancy and AD. Methods:

Cross-sectional cohort of British women (N = 95). Cox proportional hazards modeling assessed the putative effects of cumulative months pregnant on AD risk and the mutually adjusted effects of counts of first and third trimesters on AD risk. Results:

Cumulative number of months pregnant, was associated with lower AD risk (β = −1.90, exp(β) = 0.15, P = .02). Cumulative number of first trimesters …

Influence Of Built Environment And Social Capital On Mental Health Of Residents Of Assisted Living Communities In Louisville, Ky., Sarah E. Walsh, A. Scott Lajoie

Faculty and Staff Scholarship

Objectives: Prior research has shown social capital and built environment quality are associated with overall health status and the incidence of mental illness. This study explores the relationship between social capital, built environment, and quality of life specifically for assisted living residents, currently a gap in the literature. Method: A total of 76 assisted living residents were interviewed for the study using researcher-administered questionnaires. In addition, site audits were conducted to quantitatively evaluate the built environment surrounding 12 assisted living communities in the Louisville Metro region. Results: There was a moderate, positive correlation between social capital and mental health, r …

Dynamical Properties Of Postural Control In Obese Community-Dwelling Older Adults, Christopher W. Frames, Rahul Soangra, Thurmon Lockhart, John Lach, Dong Sam Ha, Karen A. Roberto, Abraham Lieberman

Physical Therapy Faculty Articles and Research

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least …

Nativity Differences In Stress Among Asian And Pacific Islander American Women, Brittany N. Morey, Gilbert C. Gee, Salma Shariff-Marco, Gem M. Le, Alison J. Canchola, Juan Yang, Laura Allen, Sandra Lee, Roxanna Bautista, Trish Quema La Chica, Winston Tseng, Pancho Chang, Scarlett Lin Gomez

Journal of Health Disparities Research and Practice

According to the Stress Process Theory, people who are marginalized in society encounter more stress than those in more advantaged positions. Immigrants are one such marginalized group in the United States (US) who may experience greater psychological stress than their US-born counterparts due to (1) severing of social ties; (2) social disadvantage and marginalization; and (3) adaptation to a new environment. This study examines the disparity in stress by nativity, and how social factors contribute to this disparity for Asian and Pacific Islander (API) women. Data come from the Asian Community Health Initiative, which included a sample of 291 foreign-born …