Medicine and Health Sciences Commons^™

The Impact Of The Diabetes Management Incentive On Diabetes-Related Services: Evidence From Ontario, Canada., Thaksha Thavam, Rose Anne Devlin, Amardeep Thind, Gregory S Zaric, Sisira Sarma

Epidemiology and Biostatistics Publications

Financial incentives have been introduced in several countries to improve diabetes management. In Ontario, the most populous province in Canada, a Diabetes Management Incentive (DMI) was introduced to family physicians practicing in patient enrollment models in 2006. This paper examines the impact of the DMI on diabetes-related services provided to individuals with diabetes in Ontario. Longitudinal health administrative data were obtained for adults diagnosed with diabetes and their family physicians. The study population consisted of two groups: DMI group (patients enrolled with a family physician exposed to DMI for 3 years), and comparison group (patients affiliated with a family physician …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

The Life-Saving Drug That No One Knows About: Naloxone Education And The Health Belief Model, Sarah Tilford

Undergraduate Honors Theses

Naloxone hydrochloride, popularly known by the brand name Narcan, is an emergency treatment used to reverse an overdose on opioid drugs. The CDC reports upwards of 26,000 individuals saved by naloxone between 1996 and 2014 (Centers for Disease Control and Prevention, 2015). Despite this success rate, those outside of the medical field largely remain unaware of what naloxone is or how they can use it in an emergency, leading to needless loss of life. Many studies focusing on naloxone access and education have been unable to offer findings meant to increase the use and ownership of the drug by lay …

Common Experiences And Beliefs Among Highly-Active, Previously-Sedentary, Middle-Aged Adults, Jordan Hirae Spt, Erin Krekling Spt, Elizabeth Piper Spt, Danny Mcmillian Pt, Dsc, Ocs, Cscs

Physical Therapy Research Symposium

BACKGROUND: Physical Activity (PA) Guidelines recommend reducing sedentarism and describes correlations between adequate PA and improving health outcomes. The self-determination theory (SDT) was used to identify motivational factors crucial to a physically active lifestyle.

PURPOSE: Identify and analyze how motivational characteristics, fulfillment of psychological needs, and individual experiences/beliefs influence an individual’s motivation for PA.

METHODS: Participants (3 females, 2 males; age 36-55) were recruited using nominated sampling and public advertising. Current levels of moderate-to-high PA were determined by the International Physical Activity Questionnaire and previous-sedentarism was self-reported as a minimum of 18 months. The SDT was the …

Influence Of Incentive Design And Organizational Characteristics On Wellness Participation And Health Outcomes, Jessica Grossmeier, David J. Mangen, David R. Anderson, Stefan B. Gingerich, Rebecca J. Mitchell, Mary T. Imboden, Gordon D. Kaplan, Gregg M. Gascon, Seth A. Serxner, Tony Bodak

Faculty Publications - Department of Kinesiology

Objective: To explore how changing incentive designs influence wellness participation and health outcomes.

Methods: Aggregated retrospective data were evaluated using cluster analysis to group 174 companies into incentive design types. Numerous statistical models assessed between-group differences in wellness participation, earning incentives, and over-time differences in health outcomes.

Results: Four incentive design groups based on requirements for earning incentives were identified. The groups varied in support for and participation in wellness initiatives within each company. All four design types were associated with improved low density lipoprotein (LDL)(P < 0.01), three with improved blood pressure (P < 0.001), and two with improved fasting glucose (P < 0.03). No incentive plan types were associated with improved body mass index (BMI), but designs predominantly focused on health outcomes (eg, Outcomes-Focused) exhibited a significant increase over time in BMI risk.

Conclusion: Incentive design and organizational characteristics impact population-level participation and health outcomes.

Barriers To Psychosocial Support And Quality Of Life For Patients With Inflammatory Bowel Disease: A Survey Study, Rebecca Lawrence, Md, Cuckoo Choudhary, Md

Department of Medicine Faculty Papers

Background: Psychological comorbidities are common among people with inflammatory bowel disease (IBD) and are associated with worse disease outcomes. Evidence-based psychotherapy is an effective means to increase psychosocial support. This study aimed to identify the barriers to attending psychotherapy.

Methods: This electronic survey study included a demographic, quality of life, and barriers to psychotherapy questionnaire. Quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Barriers were assessed using the Perceived Barriers to Psychological Treatments scale (PBPT). Linear regression was used to identify participant characteristics associated with higher PBPT scores.

Results: One hundred eighty-seven …

Core Neuropsychological Measures For Obesity And Diabetes Trials: Initial Report, Kimberlee D'Ardenne, Cary R. Savage, Dana Small, Uku Vainik, Luke E. Stoeckel

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Obesity and diabetes are known to be related to cognitive abilities. The Core Neuropsychological Measures for Obesity and Diabetes Trials Project aimed to identify the key cognitive and perceptual domains in which performance can influence treatment outcomes, including predicting, mediating, and moderating treatment outcome and to generate neuropsychological batteries comprised of well-validated, easy-to-administer tests that best measure these key domains. The ultimate goal is to facilitate inclusion of neuropsychological measures in clinical studies and trials so that we can gather more information on potential mediators of obesity and diabetes treatment outcomes. We will present the rationale for the project and …

When Pandemic Hits: Exercise Frequency And Subjective Well-Being During Covid-19 Pandemic, Ralf Brand, Sinika Timme, Sanaz Nosrat

Publications and Research

The governmental lockdowns related to the COVID-19 pandemic have forced people to change their behavior in many ways including changes in exercise. We used the brief window of global lockdown in the months of March/April/May 2020 as an opportunity to investigate the effects of externally imposed restrictions on exercise-related routines and related changes in subjective well-being. Statistical analyses are based on data from 13,696 respondents in 18 countries using a cross-sectional online survey. A mixed effects modeling approach was used to analyze data. We tested whether exercise frequency before and during the pandemic would influence mood during the pandemic. Additionally, …

To Be Or Not To Be An Obstetrician / Gynaecologist, Iffat Ahmed, Abid Ashar

Department of Obstetrics & Gynaecology

Objectives: This qualitative study aimed to explore motivational sources of physicians, at the time of selection and while pursuing ObGyn career. Secondary aim was to explore challenges and strategies adapted by these physicians to overcome these challenges.
Methods: This is qualitative study with constrictive worldview. ObGyn residents and consultants of Aga Khan University, Karachi, were interviewed from July 2017 till Jan 2019, after ethical approval, using purposeful maximum variation sampling. Analysis were conducted by identifying keywords and phrases, these unedited verbatim with no assumptions provided basis for codes, which then clustered as trends. Emerging findings were discussed among authors and …

Covid-19 Impact On Radiology Students’ Distance Learning, Mary Lee, Fahameda Hassan, Zoya Vinokur

Publications and Research

Distance learning (DL) is a teaching tool that offers education to students remotely in various locations (Ruiz, 2006). The increase in distance learning education is evident in all types of educational programs including those in Radiologic Sciences. DL education programs are expected to comply with all standards just as traditional programs are (Aaron, 2015). With a traditional class setting, knowledge is taught at a given time and day, which is structured in terms of course development and attendance. It does not factor in the domestic and familial responsibilities of the students outside the classroom walls. What happens when a pandemic …

Physical Activity Motivational Factors Of Activity Trackers For Young Adults, Amy L. Dalton

Theses and Dissertations

BACKGROUND: Physical activity for the majority of individuals is below recommended levels despite strong evidence of its significant health benefits. Activity tracker devices present as a promising and affordable tool to help promote physical activity and active choices. Additionally, young adults present as an ideal age group to implement behavior change interventions. OBJECTIVE: To determine what features of activity tracker hardware and software are helpful in motivating active choices. METHODS: This cross-sectional study included 149 participants ranging in age from 18-29 years old who wore an ActiGraph GT3X+ accelerometer for one week. They then continued to wear the accelerometer in …

Covid-19 And Procrastination: The Struggle To Stay Motivated In A Pandemic, Singapore Management University

Social Space

COVID-19 has led to the cancellation of countless internships, travel plans, summer jobs, music concerts and festivals, graduations, conferences, you name it. Fixed deadlines have become fluid, and both short-term and long-term goals are presently at the mercy of something far beyond our control. In the face of a global pandemic, we may find ourselves wondering, “Why bother planning for anything anyway?" Yet this very mindset is the crux of the coronavirus procrastination problem, says CHARDONNAY NEEDLER.

Covid-19 And Boredom: A Photoessay, Kylie Cooper

Social Space

For the second time in my life, I was riding a train alone. I looked around to see what my fellow passengers were up to. A woman wearing a lime green beanie was leaned over, asleep with her mouth open. Nearby, a man was flipping through the pages of a newspaper, pausing every now and then to take a sip of his drink. Why were they on the southbound train on a foggy Saturday morning at 7:30 am?

Assessing The Effect Of Chronic Dopamine Receptor 2 Blockade As A Potential Model Of Secondary Negative Symptoms In Rats Using The Fr5/Chow Feeding Choice Task, Cyrene Nicholas

Honors Scholar Theses

Haloperidol, a dopamine (DA) D2 receptor antagonist, is an antipsychotic drug which is commonly used to treat schizophrenia and other psychiatric disorders. These disorders are often characterized by elevated striatal dopamine, which is speculated to have a role in producing positive symptoms such as hallucinations, delusions, and paranoia, as well as symptoms related to motivational salience and reward prediction. Individuals with schizophrenia also exhibit negative symptoms, such as amotivation, anergia, fatigue, and apathy among others. While some negative symptoms of schizophrenia are inherent to the pathophysiology, other negative symptoms are hypothesized to be partially induced by chronic exposure to antipsychotic …

Expectations Of Aging And Goals As Motivation For Type 2 Diabetes Self-Management In Individuals With Early Diagnosis, Lisa M. Blohm

Theses and Dissertations

Type 2 diabetes continues to plague the United States as a major cause of disability, mortality, and healthcare cost. Engagement in self-management before complications develop is the goal for individuals in early stages of the disease. Those newly diagnosed often do not engage in health behaviors to improve their prognosis. Reasons for their lack of engagement vary widely. The purpose of this study was to understand relationships between aging expectations, personal goal setting, perceived quality of life, and self-efficacy on motivation to engage in type 2 diabetes self-management. Social Cognitive Theory provided the framework. Using a cross-sectional design, 99 newly …

Understanding Motivation To Lead In Nurses, Janete Sheiner

Dissertations & Theses (Open Access)

Background: Nurse leaders are indispensable to the delivery of quality, patient-centered care. They are influential in the practice environment, contributing to front-line staff job satisfaction. They work to improve retention, turnover, organizational health, and patient outcomes. Yet, there is a dearth of research investigating the motivating factors that appeal to, encourage, discourage, and help retain nurse leaders in their roles. The forecast of a shortage of nurse leaders, along with the reluctance of nurses to assume leadership roles, is affecting healthcare organizations throughout the United States. An in-depth understanding of the underlying factors related to motivation that appeal to, encourage, …

Ohiohealth Benefits & Wellness Practicum, Rebecca Gallagher

Masters Theses/Capstone Projects

OhioHealth incorporates programs and training for their employees in order to keep them healthy and fit, the program is called OhioHealthy. This project seeks to understand corporate wellness and the programs or practices that can be used in order to promote this wellness.

Motivation To Access Laparoscopic Skills Training: Results Of A National Survey Of Obstetric And Gynaecology Residents, Jocelyn Stairs, Bradley W. Bergey, Finlay Maguire, Stephanie Scott

Publications and Research

Objective

Competency based medical education (CBME) requires novel approaches to surgical education. Significant investment has been made in laparoscopic simulation, which has been shown to foster skill development prior to patient encounters. However, research suggests variable voluntary use of these resources by residents, and little is known about the motivational factors that influence their utilization. The purpose of this study was to characterize factors that motivate residents to seek laparoscopic simulation experience outside of the formal curriculum.

Design

We developed a questionnaire grounded in Expectancy Value Theory, an established psychological theory of motivation, by adapting validated measures to fit the …

Adolescent Interventions To Manage Self-Regulation In Type 1 Diabetes (Aims-T1d): Randomized Control Trial Study Protocol., Alison L Miller, Sharon L Lo, Dana K. Albright Phd, Joyce M Lee, Christine M Hunter, Katherine W Bauer, Rosalind King, Katy M Clark, Kiren Chaudhry, Niko Kaciroti, Benjamin Katz, Emily M Fredericks

Health Services and Informatics Research

BACKGROUND: Self-regulation (SR), or the capacity to control one's thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity …

The Role Of University-Required Fitness Courses In Students' Health And Exercise Practices, Haley Turner, Kara Jones, Katelyn Cole, Yunsuk Koh, Heather Hudson

International Journal of Exercise Science: Conference Proceedings

Lifetime fitness (LF) classes include exercise, sport, and recreational activity courses. The main purposes of LF classes are to give health education that elicits mental, social, and physical preparation for a lifelong experience of fitness. However, previous research has not extensively investigated the role of LF classes on students’ motivations to exercise during and after completing the course. PURPOSE: To determine whether or not taking an LF class contributes to a student’s motivation to exercise, to determine a motivation for signing up for an LF course, to determine why they chose that specific class, and to determine the degree to …

Effects Of Virtual Reality During Rowing Ergometry On Metabolic And Performance Parameters, Tomas Chapman-Lopez, Nicholas J. Kelling, David J. Arecemant, William E. Amonette, Kirk L. English

International Journal of Exercise Science: Conference Proceedings

Physical activity and moderate or intense exercise improve musculoskeletal and metabolic health; however, approximately 80% of Americans do not meet the minimum exercise recommendations from the American College of Sports Medicine (ACSM) or the Centers for Disease Control (CDC). Exercise intensity may be the most important factor in eliciting positive physical outcomes with exercise. PURPOSE: To assess the effectiveness of a proprietary virtual reality (VR) interface to increase metabolic and physical performance during rowing ergometry. METHODS: A novel VR software program for rowing ergometry was developed. Subsequently, sixteen apparently healthy, recreationally active individuals (12M, 4F; 35.5 ± 13.9 …

Exploring Young Opioid Users’ Motivation To Seek Treatment For Substance Use Disorder, Patricia Gianotti-Avella

Walden Dissertations and Doctoral Studies

In the past 15 years, the nonmedical use of opioids in the United States has reached epidemic proportions, resulting in a 21% increase in overdose fatalities. This surge in opioid use and dependence represents a shift in the demographic from inner-city populations over the age of 40 to young adults between the ages of 20 and 34 who dwell in primarily white suburban neighborhoods. Research has identified physicians’ liberal prescribing practices as one cause of this epidemic and has documented the ineffectiveness of current interventions with young addicts. The purpose of this narrative study was to gain insight into what …

Job Satisfaction, Engagement, And Motivation For Nursing Leadership Among Millennial Registered Nurses, Oluwaseyi Stover

Walden Dissertations and Doctoral Studies

There is a shortage of nursing leaders because current nursing leaders who are in the baby boomer generation are retiring. Millennial RNs are needed to fill vacant nursing leadership positions, but millennial RNs are not satisfied in their jobs and lack motivation and engagement, which impedes their interest in nursing leadership positions. The purposes of this quantitative, descriptive, correlational study, guided by King’s theory of goal attainment, were to examine the relationship between job satisfaction, motivation, engagement, and the aspiration of millennial RNs for nursing leadership positions in the acute care hospital setting, and the combined effects of job satisfaction, …

Factors Of Physical Activity In Youth, Joshua Held

Capstone Showcase

JOSHUA HELD

Factors of Physical Activity (PA) Levels in Youth

PA levels in youth can help to predict PA levels in adults, improve cognitive function in youth, and is associated with improved health-quality of life, blood pressure, and even mental health in adults. Thus, it is imperative to understand the various factors associated with motivating and hindering PA levels in youth and how these factors can translate into the PA habits of their adult lifestyles. The factors analyzed in this study are socio-economic status, adult influence, social influence, sedentary lifestyle, and physical/mental health. These factors overlap and differ in their …

Barriers To Exercise: Patients With Diabetes In Washington County, Joshua Bruce Taylor

Family Medicine Clerkship Student Projects

According to the Vermont Department of Health physical inactivity is one of the three main behaviors that predisposes patients to cancer, heart disease/stroke, lung disease, and type 2 diabetes, which result in over 50 percent of deaths among Vermonters. Washington County has a higher rate of overweight adults than the statewide average, making exercise an important component to healthier living. Barriers to exercise, especially among patients with diabetes, impose serious health ramifications for the residents of Washington County, and avenues must be made available to circumvent these barriers.