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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 …

Partner Build Grow: Resources To Sustain Partnerships And Advance Prevention Initiatives, Evelyn Frankford, Rachel Sadlon, Olga Acosta Price, Linda Sheriff

Prevention and Community Health Faculty Publications

Alignment of programs, practices, and policies by practitioners at the state and local levels can create health-promoting environments for all children. Such alignment, guided by principles of prevention science and public health, can enhance school–community partnerships involved with the mental, emotional, and behavioral well-being and positive development of children and youth. The key to success of such prevention approaches is sustaining the work over time. Partner Build Grow, an online Action Guide, supports sustainability through cross-sector collaborations and systems change to create school– community environments that promote equity. Informed by local and national experts along with field experience and application …

Parents' Knowledge Of Child-Passenger Safety And Child-Passenger Restraint Usage, Amanda Cadore

Walden Dissertations and Doctoral Studies

Although occupant protection laws exist, limited research has been conducted on how current child passenger safety (CPS) issues and CPS marketing strategies relate to child passenger safety seat (CPSS) usage. The purpose of this cross-sectional study was to analyze the relationship between parents' perception and knowledge of CPS issues and CPSS usage rates. The diffusion of innovation and the social marketing theories provided the frameworks for this study. The overall research question for the study examined the correlation between parents' knowledge of CPS issues and CPSS usage. Data (participants' surveys, car seat check-up information, and observational statistics) were collected from …

Geographically Distributed Employees' Perceptions Of Employee Assistance Program Access, Davina Smith

Walden Dissertations and Doctoral Studies

Many investigators have documented high levels of stress in the U.S. workplace and the underutilization of employee assistance programs (EAP). Researchers in other studies have concluded that an employee's perception of a service influences participation and service use. However, the perceptions of geographically distributed employees, who represent a growing population, have not been sufficiently examined. The purpose of this study was to investigate geographically distributed employees' perceptions regarding access to EAP stress management services to address the problem of EAP underutilization. Organizational justice theory served as the theoretical framework. The study design was generic qualitative. A purposeful sample of 15 …

The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn

Walden Dissertations and Doctoral Studies

Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public …

Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris

Walden Dissertations and Doctoral Studies

There is a growing need for healthcare teams within the Veterans Administration (VA) healthcare system to effectively collaborate and communicate to improve patient outcomes. The need to improve patient care in the Patient Aligned Care Team (PACT) has been well established. The scholarly literature does not provide evidence whether using the primary care PACT model on communication and teamwork by an interdisciplinary medical team ameliorates these communication breakdowns. Bronstein's design for interdisciplinary collaboration provided the overarching framework for this study. The purpose of this qualitative case study was to investigate the use of the PACT model on communication and teamwork …

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …

Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller

Walden Dissertations and Doctoral Studies

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …

Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes

Walden Dissertations and Doctoral Studies

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …

Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern

Walden Dissertations and Doctoral Studies

No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …

Patient-Centered Medical Homes In Community Oncology Practices: Changes In Spending And Care Quality Associated With The Come Home Experience, Teresa M. Waters, Cameron M. Kaplan, Ilana Graetz, Mary M. Price, Laura A. Stevens, Barbara L. Mcaneny

Health Management and Policy Faculty Publications

PURPOSE:

We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality.

PATIENTS AND METHODS:

We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for …

Relationship Between Nursing Safety Culture And Patient Perception Of Safety In Inpatient Units Of An Academic Specialty Hospital, Miguel Angel Lozano Garcia

Dissertations and Theses (Open Access)

The objective of this research was to analyze the relationship between nursing safety work culture in inpatient nursing units of a specialty academic hospital and their patients’ perception of safety using quantitative and qualitative methods. The aim of the quantitative study was to quantitatively evaluate whether nursing safety culture, as measured on the Hospital Survey on Patient Safety Culture (HSOPS) safety questions of the institutional employee opinion survey, was associated with patients’ perception of safety during their inpatient care, as measured by responses on the inpatient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The aim of the …

An Evaluation Of Implementing Trauma-Informed Care Training In Healthcare Settings, Amanda Kis

Capstone Experience: Master of Public Health

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding …

Patient Barriers For Weight Management Among African American Women, Owen Bowie, Jennifer Kusch, George L. Morris Iii, Tracy Flood, Jessica Gill, Renee E. Walker, Ron A. Cisler, Jennifer T. Fink

Journal of Patient-Centered Research and Reviews

Purpose: The primary aim of this study was to assess the perceptions of local African American women who are overweight or obese using semi-structured focus groups to identify barriers to weight management and factors that support strategy success. The secondary aim of this study was to determine recommendations for patient-centered weight management interventions established specifically for African American women in the Milwaukee-area community.

Methods: Three semi-structured focus groups to explore barriers to weight management were performed among women patients. Participants (N = 41) were recruited via email, postal mail, and phone as available from an academic medical center in Milwaukee, …

Evaluating The Kentucky Association Of Extension 4-H Agents Annual Conference Using The Re-Aim Framework, Michael Elijah Wilson

Dissertations

The Reach, Effectiveness, Adoption, Implementation, and Maintenance (REAIM) evaluation framework, as first introduced by Glasgow, Vogt, and Boles (1999), offers a straightforward method for evaluating Extension related programs. In this study, the RE-AIM framework is used to evaluate the Kentucky Association of 4-H Extension Agents (KAE4-HA) annual conference by examining pre-existing organizational data and records that include the results from KAE4-HA post-conference surveys that had never been reviewed as part of a comprehensive program evaluation.

This dissertation is divided into five chapters. Chapter I provides an overview of the study. Chapter II reviews the history of Extension in Kentucky, program …

Evaluation Of Processes And Procedures For Care Of The Opioid Recipient Patient In The Primary Care Setting, Anne Sproat

Doctoral Projects

Introduction: Chronic non-cancer pain is far reaching, affecting over 100 million Americans (Zgierska et al., 2018). Opioids are commonly prescribed for chronic pain, with approximately 20% of patients presenting to primary care offices with symptoms of pain or pain-related diagnoses (Dowell, Haegerich, & Chou, 2016). As a result, opioid prescribing rates are increasing at a faster rate for primary care practice compared with other specialties (Dowell et al., 2016). Within the United States population, it is estimated that three percent to four percent of the adult population are prescribed long-term opioids for the treatment of chronic non-cancer pain (Dowell et …

Pubh 7090 – Public Health Practice Trends, Gulzar H. Shah

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

Today’s public health landscape is increasingly complex and constantly changing. This course focuses on emerging trends and challenges in public health practice that epitomize the increasing complexity and nature of challenges facing public health practitioners.

Pubh 7890 – Directed Independent Study, Jian Zhang

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

Provides the student with an opportunity to investigate an area of interest under the direction of a faculty mentor

Pubh 8136: Theoretical Perspectives Of The Social And Behavioral Sciences In Public Health, Stacy W. Smallwood

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

This course will explore social and behavioral science theories, models, and approaches that inform public health research and practice, as well as their philosophical foundations. With emphasis on an ecological perspective, students will apply relevant theories to understanding community health issues and to developing interventions. The course also examines social and behavioral determinants of health equity across the ecological spectrum. In this course, students will gain an enhanced understanding of the contributions of the social and behavioral sciences to public health.

Attitudes Toward Evidence-Based Practice, Occupational Stress And Work-Related Social Support Among Health Care Providers In China: A Sem Analysis, Shan Qiao Ph.D., Xiaoming Li Ph.D., Yuejiao Zhou, Zhiyong Shen, Bonita Stanton

Faculty Publications

Individuals’ attitudes toward evidence-based practices (EBP) are critical in adopting, implementing and maintaining the EBP in clinical settings. Multiple empirical studies have examined how work context may shape perceptions and attitudes towards EBP. The current study aims to further explore how both work and family contexts, as assessed by three psychosocial indicators (i.e., occupational stress, work-related social support from coworkers, and work-related social support from family), may affect attitudes toward EBP among health care providers in HIV clinics in China. We analyzed cross-sectional survey data from 357 health care providers recruited from 40 HIV clinics across 16 cities/counties in Guangxi …

Phld 9231 – Health Informatics & Decision Making, Gulzar H. Shah

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

This course focuses on the fundamental concepts of managing information as an asset in public health and healthcare delivery contexts. Emphasis will be placed on converting data into information and converting information into decision support models.

Bios 9135– Advanced Survival Analysis, Lili Yu

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

This course will be placed on the theory on survival data. Counting processes and martingale method will be introduced. Emphasis will be place on the applications of the theory on the methodologies for survival data, such as Kaplan-Meier estimate, log-rank test, Cox model, etc. The students will learn how to use R language to setup survival dataset and perform analysis.

Chbe 9235 Communication And Advocacy, Moya L. Alfonso

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

This course is designed to familiarize students with the history and current applications of health communication theory and strategies to public health practice and research. This course examines how to structure, develop and evaluate social marketing, media advocacy, risk communication and advocacy skills for change. In addition, systematic qualitative data collection processes such as interviewing skills, participant observation and focus groups will be developed. Emphasis is placed on critical thinking skills to help students analyze and utilize these skills in research and practice.

Chbe 9335 A – Global Health And Preparedness, Andrew Hansen

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

This course will focus on global public health and preparedness for domestic and global emergencies. Students will explore patterns of health and disease around the world, and compare them to public health issues in the United States. An ecological framework will be employed to illustrate the complex political, social, economic, and environmental determinants of global health inequity. Concepts from the social sciences, epidemiology, health systems, and policymaking will be incorporated. The course will emphasize issues related to humanitarian emergencies and natural disasters both globally and domestically, and the need to build public health infrastructure and preparedness to mitigate them.

Epid 8130 – Field Methods In Epidemiology, Kelly L. Sullivan

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

This course addresses practical aspects of management and implementation of research studies and will focus on the conduct of research consistent with the scientific method. Topics include planning study activities, questionnaire design and implementation, and operations research.

Epid 8230 – Observational Study Design And Analysis, Kelly L. Sullivan

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

This course will focus on the design and conduct of observational research designs including cohort, case-control and cross-sectional approaches. This course will provide instruction related to issues specific to observational research approaches. Students will develop and present detailed study plans for each research approach.

Epid 9132 – Epidemiology Of Infectious Diseases Transmitted Via Bodily Fluids (Aka "Infectious Disease 2" Listed In Folio), Isaac Chun-Hai Fung

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

This course covers advanced topics in epidemiology of infectious diseases transmitted via bodily fluids, primarily sexually transmitted infections and bloodborne infections. Important themes may include outbreak preparedness and response, surveillance, and interventions that prevent and control transmissions. Computational, mathematical and statistical tools relevant to the practice of infectious disease epidemiology will be introduced.

Phld 9130 – Public Health Research Methods, Yelena N. Tarasenko

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

The course focuses on the concepts and methods of health services and public health research. It is structured around the primary stages of research proposal development. It is designed for DrPH students in the College of Public Health and other graduate or professional students who have successfully completed the appropriate prerequisites. By the completion of this course, Students will acquire the necessary knowledge and skills to write a research proposal, plan for the dissertation, and develop and carry-out research projects.

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …