Medicine and Health Sciences Commons^™

Dental Care Utilization Among U.S. Children Participating In Early Head Start Programs, Ahlam Ibraheem Joufi

Health Services Research Dissertations

Early childhood caries (ECC) remains one of the most common preventable diseases among children under the age of 6 years. Several national stakeholders recommend establishing a continuous collaboration of individuals involved with receiving oral health services (dental home) and routine dental care for the child by 12 months. Despite this recommendation, disparities exist among young, low-income children in preventive dental service utilization. The Early Head Start (EHS) program serves low-income children aged 0-3 years and their families and promotes oral health practices and service utilization within the program. This study aims to examine predictors of dental care utilization among children …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner

Health Services Research Dissertations

Females between the ages of 18 and 24 consistently experience higher rates of sexual violence compared to females in any other age group (Sinozich & Langton, 2014). Approximately one in five college women experience sexual violence victimization (SVV; Krebs, Lindquist, Berzofsky, Shook-Sa & Peterson, 2016) during the academic year. Among undergraduate female students, 23.1% are victims of sexual violence due to physical force, violence or incapacitation (Cantor et al., 2015). Sexual victimization has been associated with several short- and long-term psychological health consequences, accounting for enhanced symptoms of depression, anxiety, PTSD, and suicide risk (Basile, Smith, Breiding, Black & Mahendra, …

Unmet Needs And Service Utilization By Informal Caregivers, Ryan Marie Diduk-Smith

Health Services Research Dissertations

The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability …

School Policy, Food And Physical Activity Environment, And Childhood Obesity, Ruicui Liu

Health Services Research Dissertations

The purpose of this study is to examine the effect of school food and physical activity environments on energy balance-related behaviors and Body Mass Index (BMI) and to simulate the effect of school-based nutrition and physical activity policies on childhood obesity prevention. Four models based on the Social Ecological Framework of childhood obesity were developed. Parameters of these models were calibrated and validated with empirical data derived from the Early Childhood Longitudinal Study – Kindergarten Class of 1998-99 and the 2003-2004 National Health and Nutrition Examination Study. The correlation between observed and simulated BMI was 0.85 for 5th grade children …

Modeling Solutions For Prevention Of Medicare Insolvency For The Baby Boomer Generation (Born 1946 - 1964), Gregory Thomas Scott

Health Services Research Dissertations

Medicare, a United States social insurance program operated by the United States federal government, began operating in a deficit in the year 2010. More funding was expended than revenue received for medical care, creating significant shortfalls for the Medicare Trust Fund. This study examined possible initiatives to describe Medicare funding related to issues as financial shortfalls utilizing mathematical modeling and simulation. The Park Conceptual Model is a framework created to identify internal and external changes that influence bankruptcies related to municipalities, and this Model served as the theoretical basis for this study.

The following study addressed insolvency as negative cash …

Factors Associated With Quality Of Life Among Mothers Of Children With Autism Spectrum Disorder, Marian Marconyak

Health Services Research Dissertations

The increasing prevalence of Autism Spectrum Disorder (ASD) has levied associated effects upon the quality of life (QOL) of mothers of children with ASD. These mothers are subjected to various influences upon their lives as a result of their role as caregivers to children with ASD. The purpose of this study was to assess the International Classification of Functioning, Disability and Health (ICF) Body Functions and Structures, Activities, Participation, Environmental, and Personal Factors associated with QOL among mothers of children with ASD.

English literate, inhabitants of the United States, mothers over the age of 18, of children with ASD were …

Utilizing The Technology Acceptance Model To Predict System Use Of An Interactive Behavior Change Technology To Deliver Virtual Diabetes Health Education, Koren Sher'keyer Goodman

Health Services Research Dissertations

Diabetes is expected to affect more than 21% of the U.S. adult population by the year 2050 (Boyle, Thompson, Gregg, Barker, & Williamson, 2010). What is important to understand about diabetes is that there are safe, effective non-pharmaceutical lifestyle modifications and pharmaceutical treatment options that can prevent and delay the onset of complications. Telehealth efforts are practical solutions increasingly used in the health services delivery model to improve self-care management practices among patients with multiple chronic conditions (Davis, Hitch, Salaam, Herman, Zimmer-Galler, & Mayer-Davis, 2010; Eng, Gustafson, Henderson, Jimison, & Patrick, 1999; Fitzner & Moss, 2013; Gruman, 2011; Lin, 1999; …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Intimate Partner Physical Violence Against Women In Saudi Arabian Primary Healthcare Clinics, Halah M. Eldoseri

Health Services Research Dissertations

Intimate partner violence against women (IPPVAW) is a serious public health concern. The Ecological Model provides a model to study several factors associated with IPPVAW. In Saudi Arabia, studies addressing IPPVAW are limited and do not cover the various aspects of the problem. The purpose of this study was to investigate the various factors associated with IPPVAW at the personal, interpersonal, community and societal levels. Methods: 200 ever-married women attending six PHC in Jeddah, Saudi Arabia were recruited via convenient sampling method. Women were interviewed on factors related to IPPVAW using an adapted version of WHO survey for violence against …

The Relationship Of Financial Performance, Quality Indicators, And The Role Of Nurse Executives In Virginia Nursing Homes, Jeany V. Murphy

Health Services Research Dissertations

Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, …

A Gis Analysis Of The Environmental Variables Related To Rift Valley Fever Outbreaks, Jacqueline Florette Jackson

Health Services Research Dissertations

Rift Valley fever is a mosquito-borne disease that causes widespread febrile illness and mortality in domestic animals as well as humans (Gaff, 2007). Rift Valley fever virus was first isolated in 1931 (Daubney, 1931), and since then, outbreaks have occurred in sub-Saharan Africa, southern Africa, Egypt, Saudi Arabia, Yemen and Madagascar, proving it to be a virus able to invade ecologically diverse regions (Gaff, 2007). The potential introduction of Rift Valley fever into the United States suggests the potential for human infection and major economic disruption. It is important to understand the role environmental variables have played in historical outbreaks …

Test Of A Multidisciplinary Health Behavior Model Of Medicare Elders' Antihypertensive Acquisitions, Ann Marie Kopitzke

Health Services Research Dissertations

This study examined the relative utility of the enhanced Health Belief Model as compared to the proposed Pharmaceutical Acquisition Model for Medicare Elders (PAMME) in describing antihypertensive acquisition with usage intentions for Medicare elders (65 years or older) in Southeastern Virginia. Data collection included record reviews to identify hypertensive Medicare elders. Consenting Medicare elders were randomly selected for invitation, with consenting Medicare elders contacted by telephone or in-person interviews. The survey instrument utilized open and closed ended questions. The target population for this study is Southeastern Virginia Medicare elders enrolled in a Part D plan and prescribed at least one …

Psychometric Evaluation Of An Instrument For Assessing Policy Outcomes For Families With Children Who Have Severe Developmental Disabilities: The Beach Center Family Quality Of Life Scale, Joni Taylor Mcfelea

Health Services Research Dissertations

The purpose of the study was to evaluate the psychometric properties of the Beach Center Family Quality of Life Scale (BCFQLS) in a sample of families with children who have severe developmental disabilities. The study sought to determine whether or not the scale could be used to measure the quality of life of such families and to differentiate between the quality of life of two family groups—those whose child lives in the family home and those whose child lives outside the family home.

The study used an observational, cross-sectional design and both qualitative and quantitative methods. Self-identified primary caregivers of …

Changes In Formal-Informal Caregiving In Elderly Stroke Survivors, Holly Anne Beard

Health Services Research Dissertations

The purpose of this study is to determine the extent to which the Andersen and Aday Model of Health Services Use to predict cross-sectional and longitudinal differences in the caregiving source among stroke survivors (n=477) over a six-year period. This study involves a secondary analysis of a longitudinal panel study focusing upon three waves of interview data from the HAS/AHEAD study spanning 1998 through 2002. Multinomial logistic regression was utilized to examine caregiving source cross-sectionally at each wave. Clustered multinomial logistic regression was used to examine relationships between predictor variables in the model and caregiving source across waves while holding …

A Study Of The Factors That Impact Female Military Beneficiaries Obtaining Preventive Health Services, Cynthia Andrea Chargois

Health Services Research Dissertations

The purpose of this study was to determine what factors predict whether female military retirees or the female beneficiary of a military retiree, ages 40 to 64, will obtain preventive health services, specifically, Pap smears, mammograms, and clinical breast examinations. Based on the findings of the study, it is suggested that it may be important for the Department of Defense to broaden their scope of interest to include those areas that are most prominent in affecting female military retirees or the female beneficiary of a military retiree, particularly those 40 to 64, in obtaining preventive health services.

The study comprised …

A Study Of The Knowledge And Attitudes Of Physicians Toward Victims Of Spouse Abuse, Ramani N. Garimella

Health Services Research Dissertations

The purpose of this study is to measure the knowledge and attitudes of physicians toward victims of spouse abuse. All 150 practitioners in the specialities of emergency medicine, family medicine, obstetrics-gynecology and psychiatry, in a large area general hospital are included in the sampling frame; 76 responded (RR = 51%). Knowledge and attitudes were measured using the Physician Survey on Spouse Abuse. Rosenberg's Tripartite Model of Attitude formed the theoretical basis for this study. Participants were 72% male, 90% white, 88% currently married, with a mean age of 44 years (SD = 7.99). Mean years in practice was 14.61 (SD …

Measurement Of Hospital Performance: Environmental And Organizational Factors Associated With Cost, Debra Kay Dierksmeier Anderson

Health Services Research Dissertations

As U.S. health care expenditures top the $1 trillion mark, there is increased interest in measuring the performance of health care providers. For bottom line oriented payors such as government and business, the focus is on measuring cost. As hospitals account for over one-third of health care expenses, hospital cost per admission is a common measure of performance.

Many environmental and organizational factors come into play in determining hospital cost per admission. This research examines several of these factors, using Raymond Zammuto's model of organizational effectiveness assessment. Using Zammuto's framework, this research looks at the relationship of social, physical, and …

A Comparison Of Factors Associated With Referrals, Service Placements And Length Of Service For African-American And Caucasian Youth With Serious Emotional And Behavioral Disturbances Served Through The Comprehensive Services Act In Virginia, Vanessa B. Sheppard

Health Services Research Dissertations

Despite the efficacy of community-based treatment, many emotionally and behaviorally disturbed youth still receive restrictive service placements. This is quite problematic for minority youth since studies have reported they are more at risk of out-of-home placements. The purpose of this study was to examine differences in referrals, out-of-home placements, residential placements and length of service for African-American and Caucasian youth. This historical cohort study was a secondary analysis of data from the Comprehensive Services Act in Virginia. The sample consisted of 2,883 youth ages 10-19. Multiple logistic regression was employed for data with dichotomous outcomes in order to adjust for …

Coping Processes Used By Mothers Of Triplets, Susan Mullen Kaplan

Health Services Research Dissertations

The purpose of the study was to identify and describe the coping processes used by mothers of triplets. Using a descriptive design, interpersonal comparisons of 92 mothers of triplets attending a national meeting of families of higher order multiples were made. Variables, in addition to sociodemographic characteristics, included coping processes, levels of depression, perceived availability of social support, and current stress levels. Coping processes were measured using the Ways of Coping Questionnaire (Folkman & Lazarus, 1988), derived from their cognitive-phenomenological theory of stress and coping. Level of depression was measured using the Zung Self-rating Depression Scale (Zung, 1965). Perceived availability …

The Association Between Perceived Family Support And Psychological Well-Being In Infertile Couples, Linda Marquardt Mintle

Health Services Research Dissertations

A correlational research design utilizing a cross-sectional survey methodology was used to investigate the association between perceived family support and psychological well-being in infertile couples. Family stress theory and the construct of boundary ambiguity were conceptual frameworks applied to the developmental family life cycle. Respondents were 35 married infertile couples with primary infertility recruited from a private For-profit infertility clinic located in Virginia Beach, Virginia. Responses on the Moos and Moos (1984) Family Environment Scale and from the SCL-90-R developed by Derogatis (1977) measured perceived family support and psychological distress respectively. Major findings indicated that infertile couples rated their families …

An Assessment Of The Descriptors And Determinants Of Academic Success Of Selected Allied Health Students In Virginia, Theodora Christine Gordon

Health Services Research Dissertations

This study assessed the relationship of cognitive and noncognitive variables in relationship to academic success of students from selected allied health majors: respiratory therapist (RTT), radiologic technology (RT), surgical technology (ST) and medical records technician (MRT) from hospital based and community college programs in Virginia. Student academic success was defined as academic (classroom) grade point average, clinical grade point average, cumulative grade point average and passing status. The cognitive variables were preclinical (high school) grade point average, academic, clinical and cumulative grade point averages. The noncognitive variables were character type, temperament type/preference for learning style, and the Sedlacek Noncognitive Questionnaire …

Psychosocial Determinants Of Age-Appropriate Immunizations Of Infants In Norfolk, Virginia, Hoda Youssef Atta

Health Services Research Dissertations

This study represents an investigation of psychosocial factors affecting age-appropriate immunizations of infants in Norfolk, Virginia. A household survey was conducted in Norfolk, Virginia, from 4/93-8/93, to assess immunization coverage of children 12-30 months of age. This survey included a total of 389 children in the target age range. A subset of 201 mothers were randomly selected and reinterviewed to assess their knowledge and attitudes and the relationships of these factors to age-appropriate immunizations at 12 months of age. Sixty-two percent of children were not age-appropriately immunized at 12 months of age. Almost all mothers (99%) considered vaccines to be …

The Effect Of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Education Program On Knowledge, Attitudes And Sexual Behavior Of Selected College Students, Arlene Jaine Jackson Montgomery

Health Services Research Dissertations

The problem studied in this investigation was whether a behaviorally focused Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) Program affects the knowledge, sexual attitudes and sexual behavior of college students.

Three hundred and six first-and third-year college students were included in the study from one university located in Southeastern Virginia. The sample was predominately female, African-American and mainly between the ages of 16-22 years of age.

Freshmen students were presently enrolled in the institution's HIV/AIDS education program, which was a part of a required course. The class sessions consisted of a pretest prior to student's completing the reading assignment …

A Multiple Case Study Of Selected Individuals Who Facilitate The Successful Adoption Of Environmental Public Policy, John H. Austin

Health Services Research Dissertations

The purpose of this study was to determine the personal and professional characteristics of successful individuals who have had a positive influence on the development of public policy concerning the environment. Additionally, which characteristics are most likely to enhance success and determine which of these characteristics might contribute to efforts toward developing public environmental policy in the future were investigated. The purpose was accomplished through the design and implementation of a multiple case study utilizing a qualitative research methodology. The sample for this study included six public servants who were identified as actively involved in affecting the development of public …