Medicine and Health Sciences Commons^™

Impact Of Algorithmic Bias On Hospital Risk Stratification Scores Among Insurance Recipients, Peter Zdunek, Sarah Reed, Saima Anis, J. Alex Wrem

Phase 1

Introduction: Artificial intelligence-based modelling has created an opportunity to improve upon existing hospital readmission risk score systems by redefining priority and uncovering new criteria, but inherent systematic errors known as algorithmic bias can impact applicability. This study evaluated whether there is racial bias for unplanned readmission risk scores in a novel model prepared for the CMS AI challenge.

Methods: The study population provided by the CMS challenge included Medicare recipients from 2012 (unique beneficiaries n=1,667,362, total claims n=34,233,260). Risk scores for unplanned hospital readmissions were projected on the basis of clinical and demographic criteria, including age, sex, comorbidities, and prior …

Sport, Gender And Development : Intersections, Innovations And Future Trajectories, Lyndsay M C Hayhurst, Holly Thorpe, Megan Chawansky Dr.

Faculty Books

The ebook edition of this title is Open Access, thanks to Knowledge Unlatched funding, and freely available to read online. In a context where striving for gender equity in relation to achieving the UN Sustainable Development Goals seems more pressing than ever before, Sport, Gender and Development: Intersections, Innovations and Future Trajectories bring together an exploration of sport feminisms to offer new approaches to research on Sport for Development and Peace (SDP) in global and local contexts. Including postcolonial and decolonial feminist lenses by drawing upon fieldwork with organizations and individuals in Afghanistan, Uganda, Nicaragua, and India, Sport, Gender and …

Psychological Sense Of Community Among Older Adults In Puerto Rico Two Years After Hurricane María, Thomas D. Buckley

Theses and Dissertations

Hurricane María devastated Puerto Rico in 2017 and resulted in adverse long-term outcomes. Psychological sense of community (PSOC) may serve as a protective factor against the effects of Hurricane María for older adults in Puerto Rico. Using a three-paper format, this dissertation draws on a resilience framework and theories of PSOC and the Ecological Theory of Aging to examine the role of PSOC among older adults in Puerto Rico two years after Hurricane María.

Paper one is a scoping review of the concept of PSOC in research with community dwelling older adults. I begin by presenting findings on study characteristics …

“Eyes In The Home”: Addressing Social Complexity In Veterans Affairs Home-Based Primary Care, Elizabeth Catherine Hulen, Avery Laliberte, Sarah S. Ono, Somnath Saha, Samuel T. Edwards

Sociology Faculty Publications and Presentations

BACKGROUND: Home-Based Primary Care (HBPC) has demonstrated success in decreasing risk of hospitalization and improving patient satisfaction through patient targeting and integrating long-term services and supports. Less is known about how HBPC teams approach social factors.

OBJECTIVE: Describe HBPC providers’ knowledge of social complexity among HBPC patients and how this knowledge impacts care delivery.

DESIGN, SETTING, AND PARTICIPANTS: Between 2018 and 2019, we conducted in-person semi-structured interviews with 14HBPCproviders representing nursing,medicine, physical therapy, pharmacy, and psychology, at an urban Veterans Affairs (VA) medical center. We also conducted field observations of 6 HBPC team meetings and 2 home visits.

APPROACH: We …

Previously Incarcerated Individuals' Perception Of Job Acquisition Post Transitional Program Participation, Arbutas Antinet Washington

Walden Dissertations and Doctoral Studies

AbstractTransitional programs prepare previously incarcerated individuals (PIIs) to re-enter society and acquire employment. However, many such programs have failed to offset the effects of prisonization, a process that affects the social skills needed for the job interview process and employment acquisition. The purpose of this generic qualitative research study was to explore the experiences and perceptions of PIIs after participation in a transitional program and a job interview. The theoretical foundation for the study included the theories of prisonization and self-efficacy. The research question concerned experiences and perceptions of 23 to 39-year-old PIIs regarding the job interview process after serving …

Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang

Walden Dissertations and Doctoral Studies

AbstractOverweightinadolescenceincreasestheriskofobesityandmanyadversehealthoutcomeslaterinlife.The purpose of this quantitative cross-sectionalstudy was to investigatetheassociationbetweencell phoneuseandweightstatusinadolescents,ages14 17yearsold,livingintheUnitedStates.Thesocio-ecologicalmodel(SEM)wasusedtoexplainthelinkbetweencellphoneuseandoverweightamongadolescents.Threeresearchquestionswere used to explore(a)therelationshipbetweencellphoneuseandadolescentweightstatusaftercontrollingforage,gender,andrace;(b)the effectofcellphoneuseonoverweightandnormalweightstatusesamongadolescentsaged 14 17yearsaftercontrollingforage,gender,andphysicalactivity;and(c)themodifyingeffectofraceontherelationshipbetweencellphoneuseandadolescentoverweightaftercontrollingforageandgender.Secondary data from the2017YouthRiskBehavioralSurveillanceSystemwere analyzed usingbinarylogisticregressiontoanswer theresearchquestions.Highcellphoneusesignificantlyandpositivelypredictedoverweightinadolescentsaftercontrollingforage,gender,andrace(p<0.001).Afteraccountingforage,gender,andphysicalactivity,highcellphoneusewasasignificantpredictorofoverweight(p<0.001).Similarly,racehadasignificantmodifyingeffectonthepositiveassociationbetweenhighcelluseandoverweightamongadolescents(p<0.001).Thekeypositivesocialchange implication of this studyis the potentialtointegratehealthycellphoneusewithexistingobesitypublichealthinterventionsthatcanreduceoverweightandpositivelyimpactindividuals,families,andcommunities.

Don't Miss These Patients! The Experience Of Working Full Time While Also Being A Caregiver, Debbie Conner, Alyncia Bowen

All Faculty and Staff Scholarship

The project sought to understand the experiences of working professionals who are also the caregiver for others with a health care issue. A caregiver in this research study is an individual who provides personal, financial, social, physical, and or psychological support from individuals other than themselves. It has believed that a significant number of professionals serve as a caregiver for individuals such as, but not limited to, a parent, partner, significant other, spouse or child.

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

English Summary:
The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of …

Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran

Walden Dissertations and Doctoral Studies

The prevalence of potentially inappropriate medications (PIMs) among nursing home residents continues to be high. Researchers have demonstrated that the use of a medication screening tool identifying PIMs can improve medication safety among older adults. Screening tools, such as the Beers criteria and the Screening Tool for Older Persons’ Prescriptions (STOPP), are evidence-based guidelines that use several validated criteria to identify PIMs in older adults’ medication regimens. While the use of these tools is standard in the acute care setting, limited studies have been conducted regarding their use in the nursing home setting. The purpose of this project was to …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Covid-19 Infection In Hypertensive Patients In Correlation With Race, Elizabeth Durkin

Honors Undergraduate Theses

Disparities in healthcare exist in the U.S., particularly between different racial categories. This study investigated the frequency of COVID-19 cases and hypertension cases among five different racial groups (White, Black, Asian, Native American, and Native Hawaiian). The study also examined the correlation between COVID-19 and hypertension. It was hypothesized that, because of genetic predisposition to certain diseases and existing socioeconomic barriers, Black populations would have the highest rates of both COVID-19 and hypertension. It was also proposed that a positive correlation exists between COVID-19 and hypertension frequency. To test this, the Kaiser Family Foundation's data for COVID-19 cases and race …

Reflections On The Bgj Anti-Racism Seminar, Michelle Billies

Publications and Research

In this Letter to the Editor, Billies (2021) responds to critical and supportive opinion pieces in the British Gestalt Journal (BGJ) following their plenary presentation at BGJ’s 2018 annual seminar (see Asherson Bartram, 2019; O’Malley, 2019). As author of the companion article "How/ Can Gestalt Therapy Promote Liberation from Anti-Black Racism?” (Billies, 2021), Billies, who identifies as white, discusses the intent at the seminar to support white people to increase accountability and reduce harm in dialogue with people of color, while supporting the work and needs of people of color on their terms from a Gestalt perspective. Describing a fishbowl …

Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger

Walden Dissertations and Doctoral Studies

People who have not overcome childhood trauma and who have developed mental illnesses have difficulties dealing with life challenges. The purpose of this quantitative study used a correlational design to test any relationship between childhood trauma experience levels and resilience against life challenges in adulthood. The theoretical framework used for this study was Barnes’ social support theory. Data were collected from 104 participants over a 7-week period. Participants voluntarily answered the ACE questionnaire, 2-way support scale, and resilience scale. Key results indicate that people with mental illness who receive social support are positive impacted by that support. Receiving adequate levels …

Working With Sexually Violent Persons: Grit, The Supervisory Working Alliance, And Burnout, Stalina Harris

Walden Dissertations and Doctoral Studies

Clinicians who work with sexually violent persons (SVPs) are faced with various problems related to the nature of their job duties, job settings, and the specificity of the population they serve. Although researchers have investigated the phenomenon of burnout extensively over the last decade, research focusing on burnout among counselors who work with SVPs is insufficient. The purpose of this quantitative comparative survey study was to investigate differences in burnout among clinicians working with SVPs by examining their grit, the supervisory working alliance, and job settings. The Grit Short Scale (Grit-S), the Supervisory Working Alliance Inventory—Trainee version (SWAI-T), and the …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

[In Arabic] The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls.

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The …

The Ideology Of Baby-Mama Phenomenon: Assessing Knowledge And Perceptions Among Young People From Educational Institutions, Opeyemi S. Adeojo, Daniel Egerson, Gabriel Mewiya, Rowland Edet

Department of Sociology: Faculty Publications

This study investigated the knowledge and perception of the ideology of baby-mama concept among the youths. Particularly, this paper assessed the knowledge of the concept of baby mama among youths and also their opinion on the acceptability of this style of family structure. The study employed a qualitative approach through an in-depth interview research method. Forty respondents between the ages of 16 and 40 years were selected across three educational institutions in Oyo state, south-west Nigeria. The participants of the study voluntarily agreed to participate in the research and everything said during the course of the interview was transcribed and …

Cross-National Attitudes About Paid Parental Leave Offerings For Fathers, Qi Li, Chris Knoester, Richard J. Petts

Department of Sociology: Faculty Publications

Using cross-national data from the 2012 International Social Survey Programme (N = 33,273), this study considers institutional, self-interest, and ideational factors in analyzing public opinions about the provision, length, and source of paid parental leave offerings for fathers. We find substantial support for generous leave offerings. Multilevel regression results reveal that being a woman, supporting dual-earning expectations, and realizing more family strains lead to support for more generous leave offerings. Endorsing separate spheres and intensive mothering attitudes reduces support for more generous leave offerings; although, gendered attitudes interact with one another in predicting leave preferences, too. Finally, country-level indicators …

Attitudes About Paid Parental Leave: Cross-National Comparisons And The Significance Of Gendered Expectations, Family Strains, And Extant Leave Offerings, Chris Knoester, Qi Li, Richard J. Petts

Department of Sociology: Faculty Publications

Using data on paid parental leave preferences from 35,488 adults situated within 26 different OECD countries, and multilevel modeling, this study examines public opinions about the provision of paid parental leave, some government funding of leave offerings, and preferred lengths of leave offerings. We consider how attitudes may be similar or different across social contexts and then focus upon the extent to which gender, gendered parenting role attitudes, family strains, and country-level institutionalized leave offerings are associated with leave preferences. The findings indicate that the vast majority of respondents are in favor of rather widespread and generous paid parental leave …

Dialogic Identity Construction: The Influence Of Latinx Women's Identities In Their Health Information Management Practice, Maria A. Caban Alizondo

Antioch University Dissertations & Theses

The purpose of this qualitative research was to study the experiences of Latinx women who lead in health information management in the United States. Latinx health information management professionals are faced with everchanging workplace dynamics and biases in which they are repeatedly reminded of their individual and ethnic differences that require them to construct and co-construct new facets to their identities in social contexts. By grounding this work in narrative inquiry and viewing identities critically, space is given for delving deeper into the specifics of how gender, ethnicity, culture, and class influenced Latinx women’s leadership practice. Interviews offered the opportunity …

Parents Of Non-Binary Children: Stories Of Understanding And Support, Brooks Bull

Antioch University Dissertations & Theses

Parents of non-binary children undergo profound changes as they learn to first understand and then support their child. In order to provide family therapists with a foundation from which to work with these families, a thorough review of the literature is provided as well as a narrative research study. Chapter one provides an introduction to the topic of non-binary gender and transgender identities, defines the terms non-binary, transgender, and transsexual, and clarifies the conceptual frameworks at use in the dissertation: social constructionism and transfeminism. Chapter two is a review of peer-reviewed literature on therapy with children and adolescents who identify …

Supporting Resilience In Reserve Component Spouses During Deployment: The Impact Of Family Life Cycle Phase And Deployment History On Social Support Needs, Jennifer L. Ceminsky

All Graduate Theses, Dissertations, and Other Capstone Projects

This exploratory study used a researcher developed survey to examine the relative value of instrumental, emotional, and informational support for Reserve Component spouses during deployment. Although all types of support were valued by nearly all study participants, significant differences were found between ratings of helpfulness for each type of support. Emotional support was the support type most valued by 73.1% of spouses in this study. Instrumental support was most valued by21.1%, and only 2.8% of spouses valued informational support most. Regression analyses were used to identify factors that were predictive of value placed on each type of social support. The …

Other People’S Families: How Social Ties Shape Entrance Into The Medical Profession, Lillian Sims

Theses and Dissertations--Educational Policy Studies and Evaluation

Not enough members of low-income, rural, and minoritized populations are successfully prepared for and recruited into medical school, exacerbating issues of unequal access to healthcare and limiting access to the profession. While a multitude of factors contribute to this problem, early social exposure to others in a field can act as a key contributor to career interest and a key advantage for entering the profession. Meanwhile, students without early social exposure to healthcare may take unconventional paths to medical school or may struggle to fit into the unique culture of medicine when they do enter training, especially if they belong …

Mental Health Treatment Services Exposure In Lgbtq+ College Students Of Color, Arianna Kholanjani

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Online Or In-Person? Examining College Decisions To Reopen During The Covid-19 Pandemic In Fall 2020, Jacob Felson, Amy Adamczyk

Publications and Research

When coronavirus disease 2019 (COVID-19) became a major impediment to face-to-face college instruction in spring 2020, most teaching went online. Over the summer, colleges had to make difficult decisions about whether to return to in-person instruction. Although opening campuses could pose a major health risk, keeping instruction online could dissuade students from enrolling. Taking an ecological approach, the authors use mixed modeling techniques and data from 87 percent of two- and four-year public and four-year private U.S. colleges to assess the factors that shaped decisions about fall 2020 instructional modality. Most notably, the authors find that reopening decisions about whether …

Harassment And Mental Health In Surgical Training: A Pilot Survey Of Surgical Trainees In Pakistan, Russell S. Martins, Syeda Amrah Hashmi, Hina Inam, Mahin Janjua, Mahim Malik

Medical College Documents

Objective: To assess harassment among surgical trainees and its effects on mental health, and to explore its association with gender.
Methods: The nationwide cross-sectional pilot study was conducted by the Association of Women Surgeons of Pakistan from July to September 2019, and included surgical trainees of either gender working in both public and private hospitals. Data was collected using an anonymous online survey form to assess harassment and self-perceived burnout and depression. Data was analysed using SPSS 22.
Results: Of the 147 respondents, 49(33.3%) were males; 98(66.6%) were females; and 118(80.3%) were residents. Workplace harassment was reported by 80(54.4%) trainees. …

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …

Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan

Walden Dissertations and Doctoral Studies

The increasing focus on end-of-life (EOL) care is influencing the role of advance directive (AD) documents. Difficult conversations among family caregivers and their loved ones are becoming more and more critical. Considering the value of communicating EOL wishes, family caregivers’ perceptions about ADs for their loved ones with Parkinson’s disease (PD) must be examined. Using the theory of planned behavior (TPB) as a foundation, the purpose of this generic qualitative study was to understand family caregivers of PD patients and their perceptions and experiences relating to AD documents. This study involved using purposeful sampling and semi-structured interviews with 11 family …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Ethnic Comparisons In Perceptions Of Health, Happiness, Hope, And Related Social Determinants Of Health In A Majority-Minority Midwestern Town, Virginia Chaidez, Yumou Qiu, Angela L. Palmer-Wackerly, Julie A. Tippens, Gilbert R. Parra, Patrick Habecker, Kimberly Gocchi Carrasco, Jordan Soliz, Lisa M. Pytlikzillig, Kirk Dombrowski

The Journal of Sociology & Social Welfare

In a rural Midwestern community sample (n=273), large proportions of Somalis and Whites ranked overall health as "Very good" (57% and 50%, respectively), while Hispanics (42%) considered it "Good". Across all groups, most are either "Happy" or "Very happy" with their jobs—64%, 91%, 83%—or their families—85%, 93%, 91.6%— with reference to Hispanics, Somalis, and Whites, respectively. When asked “In the past 30 days, how often did you feel hopeless?”, 83% of Somalis and two-thirds (67%) of Whites responded, "None of the time", while half (50%) of Hispanics indicated the same. Overall, Hispanics appeared to be less …