Medicine and Health Sciences Commons^™

Improving Breastfeeding Rates In A Rural And Medically Underserved Community, Kaylie D. Waters

Culminating Experience Projects

Background: The Centers for Disease Control and Prevention reports national breastfeeding rates that are inconsistent with the recommendation of exclusive breastfeeding for the first six months of life (CDC, 2020). The rate of infants receiving any breastmilk by six months of age in a rural Midwest County is only 16% in contrast to 55% nationally (CDC, 2020; XXXXX, 2021). This discrepancy was addressed by evaluating breastfeeding status in that Midwest community followed by strategies to improve breastfeeding rates.

Methods: A multi-intervention quality improvement project was implemented using the SEIPS framework. The project evaluated the effectiveness of documenting breastfeeding status in …

Comparing The Health Care Resource Utilization And Medication Adherence Of People With Epilepsy And People With Diabetes By Insurance Status, Nikole Hoffman, Gerald Shoultz, Sarah Nechuta

Culminating Experience Projects

Background: Epilepsy is one of the most common neurological diseases worldwide; diabetes is a chronic metabolic disease that affects how the body produces and uses insulin. Prescribed medications are vital for controlling these and other chronic diseases by minimizing severe health issues, which can be affected by insurance type and status. Consequences of non-adherence include uncontrolled blood glucose in people with diabetes and uncontrolled seizures in people with epilepsy. We aimed to compare the healthcare resource utilization and medication adherence of people with epilepsy and people with diabetes by insurance status. Methods: Data was from the 2021 National …

The Use Of Occupational Therapy Services In Outpatient Mental Health, Kelsey A. Wasik, Matt T. Valois, Kaylee M. Essenberg, Kelcie P. Beck

Masters Theses

The purpose of this study is aimed to explore the structure and utilization details of occupational therapy in outpatient behavioral health settings. Two occupational therapists participated in qualitative phenomenological interviews which were transcribed and analyzed using the thematic approach. A total of two themes emerged: billing and coverage, and education and advocacy. Participants identified there are necessary factors for reimbursement of services, in addition to the need for education and advocacy for occupational therapists to practice in outpatient behavioral health settings. Future research should be aimed at recruiting more participants, occupational therapists, and from other roles in these clinics such …

Evaluating The Caprini Risk Assessment In An Inpatient Rehabilitation Facility, Alissa Payne, Kelsey Boersma, Sarah Nechuta

Culminating Experience Projects

Deep vein thrombosis (DVT) is an often underdiagnosed disease that can be life threatening for individuals. Currently, the best practice approach to assess the risk of venous thromboembolism (VTE) in patients within a rehabilitation hospital is unknown. We examined how well the Caprini risk assessment (CRA) score predicts VTE events (deep vein thrombosis (DVT), pulmonary embolism (PE)) within an inpatient rehabilitation hospital. Between January 2015 and October 2020, VTE events, the CRA Score, and risk factors were collected from a chart review conducted at Mary Free Bed Rehabilitation Hospital (MFB) among 3,091 patients. Results from the unadjusted logistic regression model …

Interrupted Time Series Analysis To Evaluate The Performance Of Drug Overdose Morbidity Indicators Shows Discontinuities Across The Icd-9-Cm To Icd-10-Cm Transition, Hannah Yang, Emilia Pasalic, Peter Rock, James W. Davis, Sarah Nechuta, Ying Zhang

Peer Reviewed Articles

Introduction: On 1 October 2015, the USA transitioned from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, 10th Revision (ICD-10-CM). Considering the major changes to drug overdose coding, we examined how using different approaches to define all-drug overdose and opioid overdose morbidity indicators in ICD-9-CM impacts longitudinal analyses that span the transition, using emergency department (ED) and hospitalisation data from six states’ hospital discharge data systems.

Methods: We calculated monthly all-drug and opioid overdose ED visit rates and hospitalisation rates (per 100 000 population) by state, starting in January 2010. We applied …

Impact Of Benzodiazepines And Polysubstance Status On Repeat Non-Fatal Drug Overdoses, Sarah Mayberry, Sarah Nechuta, Shanthi Krishnaswami

Peer Reviewed Articles

Research has shown that benzodiazepines and mental health disorders can increase the likelihood of repeat overdose, but researcher have not explored this association in Tennessee (TN). We examined benzodiazepines, polysubstance overdose status with/without benzodiazepines, and mental health comorbidities with repeat overdose using statewide data in TN. This study analyzed TN hospital discharge data on nonfatal overdoses for patients ages 18–64 from 2012 to 2016 for 21,066 patients with an initial inpatient visit and 36,244 patients with an initial outpatient visit. The study assessed each patient at one year after initial overdose to determine likelihood of repeat overdose. We used a …

Improving Health Care Accessibility Among Geriatric Patients In Rural Communities, Capriana Calvachi

Honors Projects

The following literature review and analysis compiles information regarding ways to improve rural geriatric healthcare accessibility through the use of interprofessional care and outreach. I also wish to bring to light the various deficiencies often seen in this realm of care, and the reasons behind the inadequate rural physician retention rates. Using this background information, I compiled various collaborative approaches which seek to ease the strain faced by the healthcare system and its elderly patients.

Improving healthcare accessibility through the use of interprofessional care and outreach is an essential facet in geriatric medicine. By exploring the deficiencies of geriactric healthcare …

Descriptive Exploration Of Overdose Codes In Hospital And Emergency Department Discharge Data To Inform Development Of Drug Overdose Morbidity Surveillance Indicator Definitions In Icd-10-Cm, Leigh M. Tyndall Snow, Katelyn E. Hall, Cody Curtis, Allison L. Rosenthal, Emilia Pasalic, Sarah Nechuta, James W. Davis, Bretta Jane Jacquemin, Sherani R. Jagroep, Peter Rock, Elyse Contreras, Barbara A. Gabella, Katherine A. James

Peer Reviewed Articles

Background: In October 2015, discharge data coding in the USA shifted to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), necessitating new indicator definitions for drug overdose morbidity. Amid the drug overdose crisis, characterising discharge records that have ICD-10-CM drug overdose codes can inform the development of standardised drug overdose morbidity indicator definitions for epidemiological surveillance.

Methods: Eight states submitted aggregated data involving hospital and emergency department (ED) discharge records with ICD-10-CM codes starting with T36-T50, for visits occurring from October 2015 to December 2016. Frequencies were calculated for (1) the position within the diagnosis billing fields where …

Occupation-Based Learning Modules In Preparation For Parole: A Program Evaluation, Alisha Cheyne, Gabrielle Martino, Elizabeth Vander Wall, Natalie Wallace

Community Based

A qualitative research study was conducted that examined occupational therapy students’ fieldwork rotation at Muskegon Correctional Facility, where they implemented a 15-week pre-parole program. One focus group with three participants was conducted. Transcription, coding, and theming followed, providing five themes; restriction, OT perceptions, learning styles, future needs, and relationships. Results showed areas of needs within this population, ways occupational therapy can address this need, and general improvements that can be made to pre-release programs.

A Health Care Comparison Of Areas In Ghana And In The United States, Lindsey Matsumoto

Honors Projects

The health care system is an important factor for the well-being of the human population all around the world, and yet, health care can differ greatly depending on a variety of factors including location and culture. When referring to health care, it is appropriate to include skilled physicians, hospitals, care clinics, and medical equipment. This article conducts a literature review that compares the health care systems of two countries, the Republic of Ghana and the United States of America. This information is relevant for not only expanding one’s knowledge, but also for travel purposes, as both countries have highly populated …

A Collaborative Approach To Incentivizing Healthy Food Choices Among Uncontrolled Diabetic Patients At A Local Federally Qualified Health Center To Improve Health Outcomes, Briauna J. Taylor

Doctoral Projects

Background: The rate of uncontrolled diabetes among patients at a local Federally Qualified Health Center (FQHC) is higher than the nation standard, a phenomenon believed to be caused by the effects of social determinants of health (SDOH). SDOH, specifically food insecurity, play a significant role in health outcomes of diabetic patients. Increasing access to healthy foods, thereby reducing food insecurity, has the potential to improve glycemic control and reduce diet related chronic disease.

Objectives: The project aims to determine if partnership with a membership based incentivized grocery store has the potential to positively impact health outcomes among vulnerable patients with …

A Policy Analysis Of Adult Lead Exposure Screening In Michigan, Omoyemi A. Idowu

Doctoral Projects

A growing body of scientific literature suggests that even at low levels, lead is an important, but often overlooked risk factor for cardiovascular disease mortality in adults. Through an initial literature review and organizational assessment, the DNP student was able to identify a potential gap between current research and policy guidelines related to adult lead exposure screening in the state of Michigan. The purpose of this policy analysis project was to examine current literature and policy guidelines related to lead exposure screening in the adult population in order to identify and analyze a potential gap that may be amenable to …

Lack Of Food Access And Food Consumption Patterns Of Late Midlife Women In Southeast Michigan, Sarah S. Bassiouni, Ebony M. White, Carrie Karvonen-Gutierrez, Sioban D. Harlow

Michigan Journal of Public Health

Background: Food access is a key social determinant of health for older adults at high risk of chronic disease and physical disability.

Methods: This cross-sectional analysis examined correlates of food access and the relationship between food access and food consumption characteristics in a sample of 316 late midlife women from Southeast Michigan in 2015-2016.

Results: Lack of food access, defined as access to self-perceived adequate grocery shopping resources in one’s neighborhood, was reported by 20.9% of women. Women who reported lack of food access were less likely to report making meals at home (p=0.02) and had less frequent consumption of …

Evaluating The Needs Of Cancer Survivors Through Focus Groups And Surveillance Data, Maria George Mph, Taylor Seaton Ms, Debbie Webster Bsn, Rn, Lmsw, Diana Haggerty Ms

Michigan Journal of Public Health

Abstract:

Introduction

As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum.

Methods

Using data compiled from the 2015 Michigan Behavioral Risk Factor Survey (MiBRFS), the Cancer Registry, and focus groups, several areas of need amongst cancer survivors were identified.

Results

In focus groups cancer survivors identified the 27 needs that fell into three categories: improving health-related behavior, utilizing health care services, and receiving emotional support. The MiBRFS provided population estimates for 10 of the 27 …

The Burden Of Chronic Health Conditions Among Iraqi Refugees In Michigan, Melissa M. Reznar Phd, Mph, Florence J. Dallo Phd, Mph, Andrew J. Kurecka Mph, Julie J. Ruterbusch Mph, Kendra Schwartz Md, Msph, Madiha Tariq Mph

Michigan Journal of Public Health

The vast majority of refugees in Michigan is from Iraq, and yet the health status of this population is not well defined. The purpose of this study was to describe chronic disease prevalence of Iraqi refugees and examine associations between sociodemographic characteristics and chronic disease. This study reviewed medical charts of 613 Iraqi refugees to examine the association between demographic characteristics and chronic conditions. The dependent variables were body mass index, non-fasting blood glucose, and history of hypertension and diabetes. The independent variables were birth place, age, sex, and smoking history. Men were 3.99 times (95% CI=1.88, 8.48) as likely …

Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman

Michigan Journal of Public Health

Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.

Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …

An Evaluation Of The Michigan State Loan Repayment Program, Dennis Tsilimingras, Wanda Gibson-Scipio, Ramona Benkert, Leon Hudson, Xuefeng Liu, Liying Zhang, Thomas Reed, Tsveti Markova

Michigan Journal of Public Health

No abstract provided.

Preventive Primary Care Screening Patterns After Provider Ehr Adoption For Michigan Medicaid Adults, William D. Corser 9183470, Zhiying You, John Hazewinkel

Michigan Journal of Public Health

Introduction

It remains largely unknown how use of electronic health records (EHR) impacts ordering of preventive/screening services (PSS). These analyses examined the influence of confirmed Medicaid provider EHR adoption on primary care ordering rates of five major PSS. Sample was comprised of 10,149 continuously enrolled Michigan Medicaid adults linked to 6,587 providers.

Methods

The authors obtained complete office-based billing claims data from the Michigan Medicaid Data Warehouse for adults with 29 or more months of continuous state Medicaid coverage. PSS claims data were linked to patients’ Medicaid-assigned providers who either had, or had not, EHR-attested during the 60-month analytic window. …

Letter From The President, Roger Racine

Michigan Journal of Public Health

No abstract provided.

Letter From The Editor, Greg Cline

Michigan Journal of Public Health

No abstract provided.

Comparing The Care Of Pregnant Women In Ghana And The United States, Olivia Zander

Honors Projects

During pregnancy, factors such as maternal nutrition, location of delivery, the number of antenatal care visits, maternal age, and more can all impact the health of both the mother and the developing fetus. All of these factors are subject to change based on where the mother lives and the resources that her country has to offer her. The objective of this paper was to compare and contrast the nutritional and non-nutritional care of pregnant women in Ghana and the United States and its impact on maternal/child mortality in the two countries. The information collected for this project was taken from …

Teaching Health Education Through The Development Of Student Centered Video Assignment, Heather M. Wallace, Julia Vandermolen

Peer Reviewed Articles

The purpose of this study was to explore the ways in which a student centered video assignment enhanced student learning about developing and teaching a health education plan designed to address a complex public health problem. The objectives of the assignment included (1) to explore a complex public health problem, (2) practice developing a corresponding health education plan, and (3) develop and fully execute a multimedia video to deliver high impact health education and or promotion to a diverse audience. The assignment referred to as the student centered video assignment was developed and piloted at Grand Valley State University and …

The Role Of Spirituality And 12 Step Groups In Addressing Treatment Fear And Worry Among Head And Neck Cancer Patients, Heather M. Wallace

Funded Articles

Diagnosis of head and neck squamous cell carcinoma (HNSCC) presents a multifarious problem. Because of uncertainty regarding appropriate clinical treatment, as well as the high potential for disfigurement and functional loss resulting in diminished quality of life (QOL), satisfactory patient participation in quality decision-making is critical. Previous research has consistently revealed that older adults frequently defer decisionmaking to their physician and make decisions more quickly than younger adults. Research also suggests that lay health beliefs, past experiences and various strategies of emotional regulation, based on perceptions of the quantity and quality of remaining time till death, may influence the decisionmaking …

Examining The Effect Of A Hypothetical Safe Injection Facility On Hiv And Hcv Transmission Rates In Kent County, Michigan, Trevor Ditmar

McNair Scholars Manuscripts

Previous literature has established that increases in prescription opioid misuse has resulted in similar increases in injection drug use (IDU), collectively referred to as the “opioid epidemic” in the US. Due to this surge in IDU, incidence of Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) are on the rise in many regions. Research conducted in Canada and elsewhere has supported the use of Safe Injection Facilities (SIFs) and Needle Syringe Programs (NSPs) to mollify disease incidence, but only NSPs are operating in the US despite SIFs having been in use in Canada for several decades. As little research has …

Dominican Sisters Quality Of Life Assessment, Eva Vanartsen

Other Undergraduate Research

Background: The quality of life in older women has been found to decrease with poverty, poor health, decreased access to healthcare and low education, while marriage and children can both improve or decrease the quality of life. The information on the quality of life of older women living in faith based communities is lacking.

Objectives: The purpose of this study was to explore the quality of life and factors impacting quality of life in Sisters living in an assisted living facility.

Methods: The short form 36 Health Survey Questionnaire (SF-36) was used to measure quality of life of the Dominican …

Exploring Neighborhood Level Variation In Incidence And Secondary Transmission Of Seasonal Influenza, Melissa Freeland

Masters Theses

Influenza epidemics in the United States, are major causes of morbidity and mortality, and cause serious economic disruption on an annual basis. Evidence has begun to accumulate linking neighborhood-level socioeconomic disadvantage to higher rates of hospitalization and mortality related to influenza (Cordoba & Aiello, 2016; Jung, Lin, & Viswanath, 2013). Some studies suggest that this may be due to lower rates of vaccination, higher rates of comorbidities in socioeconomically disadvantaged communities (Cordoba & Aiello, 2016; Jung, Lin, & Viswanath, 2013; Ross & Mirowsky, 2001). However, few studies have evaluated the effects of neighborhood level socioeconomic disadvantage and structural features on …

Prevalence And Risk Factors Associated With Long-Term Opioid Use After Injury Among Previously Opioid-Free Workers, Zoe Durand, Sarah Nechuta, Shanthi Kreishnaswami, Eric L. Hurwitz, Melissa Mcpheeters

Peer Reviewed Articles

Importance Using opioids for acute pain can lead to long-term use and associated morbidity and mortality. Injury has been documented as a gateway to long-term opioid use in some populations, but data are limited for injured workers.

Objective To evaluate the prevalence and risk factors of long-term opioid use after injury among workers in Tennessee who were opioid free at the time of injury.

Design, Setting, and Participants This cohort study identified injured workers aged 15 to 99 years who reported only 1 injury to the Tennessee Bureau of Workers’ Compensation from March 2013 to December 2015 and had no …

The Benefits And Accessibility Of Integrative Exercise In Geriatric Populations, Elizabeth Nisper

Honors Projects

There are many physical and mental benefits of conventional exercise and they have been well-studied. However, integrative exercise practices aim to encompass more than physical fitness. There is also a spiritual/ethical component when taking into account aspects such as meditation and mindfulness. By examining a number of different health domains, we can study whether the benefits of yoga and tai chi extend beyond the benefits of exercise more broadly. While the short-term physical fitness benefits of other cardio and strength training may exceed those of integrative practices, yoga and tai chi appear to be equally as beneficial in the long …

Occupational Therapy In Prisons, Amber Carmean, Amanda Boman, Katie Kowalski, Joselyn Walsworth

Community Based

This study investigates the needs of incarcerated individuals upon reintegration into the community. In this article, we use thematic analysis to dissect two prison documentaries in order to best assess the needs of these individuals to inform occupational therapy intervention. Occupational therapy seeks to empower individuals while analyzing needs and how the individuals can be best supported. Our analysis shows that there are many needs that go unaddressed prior to community reintegration leading to a higher chance of recidivism recurring. Through better understanding the needs of individuals, occupational therapy can become better informed on how intervention can benefit this specific …

Advocacy-Related Occupations Among People With Disabilities: Assessing Program Outcomes Of An Advocacy Workshop, Audrey Tarbutton, Stefanie Austin, Rachel Bendewald, Hayley Monforte

Community Based

An emerging area of occupational therapy (OT) practice includes program development for persons with disabilities (PWD). These programs are designed to train PWD how to identify issues and advocate for inclusion and accessibility (Umeda et al., 2017). Among the available literature on community-based advocacy programs, results show positive social outcomes including increased self-advocacy knowledge and related behaviors (i.e. Kramer, 2015; Mishna et al., 2011). Regarding the present study, an advocacy training program titled “Community Organizing Advocacy Skills Training” (COAST) was developed using the Midwest Academy Training Manual for the Advocate. The purpose of this study was to pilot a tool …