Medicine and Health Sciences Commons^™

Readmission Rates Of Mothers Experiencing Preeclampsia Or Complications After Delivery In Underserved Populations, Sadia Robinson

MUSC Theses and Dissertations

Hospital readmissions during pregnancy nationwide impacts maternal health outcomes elevating the risk of maternal deaths after discharge. The accessibility and affordability of necessary prenatal care is integral to the field of health across the lifespan. Socioeconomic barriers within rural locations place expecting mothers at an adverse risk of developing conditions including preeclampsia and other complications that may result in hospital readmission. Economic barriers including hospital closures, shortages of specialty healthcare providers, unstable internet access and, ease of care access on further contribute to this disparity among rural women.

A retrospective analysis was conducted using data from Health Care Cost and …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Establishing A Sustainable Occupational Therapy Student-Led Pro Bono Clinic At The University Of Saint Augustine In Austin, Texas, Daija Chumley

Student Capstone Papers

Under-resourced and underserved communities across the United States experience significant health disparities. These communities lack access to valuable services resulting in health inequities that impinge on their health, quality of life, and engagement in meaningful occupations. There is a need for occupational therapy to provide valuable services to the under-resourced and underserved community to address the historical inequity that impacts their overall quality of life. Universities have the potential to fulfill the gaps within these communities by establishing a pro bono clinic. The purpose of this capstone project is to establish a sustainable occupational therapy pro bono clinic at the …

Black Hearts Matter: A Comparative Study Of Sociodemographic, Clinical, And Psychosocial Characteristics In Black And White Persons With Heart Failure, Hannah M Anderson Hughes

Theses and Dissertations

Heart failure (HF) is a chronic, progressive, debilitating illness that disproportionately affects Black individuals, often leading to poor quality of life (QOL). Various sociodemographic, clinical, and psychological characteristics are related to QOL in patients with HF. Because most studies do not include representative Black samples or report findings from racial subgroup analyses, these relationships and any existing racial differences are not well understood. The purpose of this descriptive, comparative study was to explore the relationships among sociodemographic, clinical, and psychological characteristics and QOL in patients with HF and to determine if there were racial differences between Black and White individuals. …

Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo

Theses and Dissertations (ETD)

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. …

The Impact Of The Hospital Value-Based Purchasing Program On Healthy Days, Health Inequity, And Hospital Community Benefit Spending, Samhita Kadiyala

Scripps Senior Theses

The Hospital Value-Based Purchasing Program (HVBP) is a Centers for Medicare and Medicaid Services (CMS) program implemented in 2012 to reward acute-care hospitals with incentive payments for the quality of care provided to Medicare patients in inpatient settings. Under this policy, payment adjustments are made based on a variety of factors including clinical quality, patient experience, and cost reductions. This paper uses state-level variation in the implementation of HVBP to ascertain whether the policy led to improvements in Healthy Days (a CDC-designed composite measure of individuals’ self-reported number of physically and mentally “healthy” days per month), health disparities, and community …

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh

Walden Dissertations and Doctoral Studies

Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …

Exploring The Narratives Of Black Male Nurses In Southeast Georgia: Implications For The Implementation Of Culturally Responsive Pedagogy In Nursing Curriculum, Celine M. Pfund

Electronic Theses and Dissertations

ABSTRACT

This dissertation inquiry explores the narratives of two Black male nurses in southeast Georgia. The framework for my research includes a variety of different theoretical components including works from both major nursing and curriculum studies scholars. The nursing workforce remains homogenized despite major recruiting. The intention of my research was to explore the experiences of Black male nurses to identify challenges, barriers, and systems of oppression that they may have encountered working in a profession dominated by White females in order to facilitate development of culturally responsive pedagogy in nursing. Methodologically, I mainly drew upon James Spradley’s work on …

A Meta-Analysis Of The Aftermath Of South Africa’S Apartheid On Its Health Care System, Caitlin Jaeckel

Senior Honors Projects, 2010-2019

The objective of the study was to access the possible problems of the quality of health care that whites and non-whites receive in South Africa. The research question was specific to how the residual effects of apartheid are affecting South Africa’s health care today and if citizens still feel the presence of apartheid in health care. Prior to the start of the study the researcher hypothesized that access, quality, and funding of South Africa’s health care system has not been able to recover from the effect of apartheid and South Africans still observe the effects of apartheid on an individual …

Mental Health Clinical Managers And Their Multicultural Leadership Practices, Christie Marie Melonson

Theses & Dissertations

There is a general recognition that the United States has historically failed to provide adequate mental health services to ethnic minorities. The American Counseling Association has mandated multicultural competence of counseling professionals in today’s context of dramatic demographic change. Despite numerous studies on practitioners, organizations, models, and interventions geared toward minorities, disparities in access, usage, and outcomes in still exist. Simultaneously, counseling fields have emphasized leadership development as a key factor in improving services, yet training or research on leadership remains scarce. In response to these conditions, this basic interpretive qualitative study focused on exploring clinical managers’ perceptions of their …

An Analysis Of The Differences In Preemptive Kidney Transplantation Between Blacks And Whites, Kennard D. Brown

Theses and Dissertations (ETD)

Background. This cohort study investigates whether there are inequities in the allocation of cadaver kidneys for preemptive kidney transplants (PKT) between blacks and whites.

Methods. This analysis uses descriptive statistics and univariate and multivariate analyses to identify factors associated with the determination of whether a patient receives a PKT or a conventional, post dialysis kidney transplant. The sample includes patients identified by the Centers for Medicare and Medicaid Services (CMS) as having end stage renal disease (ESRD), >19 years of age, either black or white, and receiving either a PKT (0-<6 months dialysis) or conventional transplant between January 1, 2000 and December 31, 2003 (n = 10,067) from any of the 11 organ procurement regions in the United States.

Results. Whites were more likely to receive a PKT …