Medicine and Health Sciences Commons^™

Child Health And The Implementation Of Community And District-Management Empowerment For Scale-Up (Codes) In Uganda: A Randomised Controlled Trial, Peter Waiswa, Flavia Mpanga, Danstan Bagenda, Rornald Muhumuza Kananura, Thomas O'Connell, Dorcus Kiwanuka Henriksson, Theresa Diaz, Florence Ayebare, Anne Ruhweza Katahoire, Eric Ssegujja, Anthony Mbonye, Stefan Swartling Peterson

Journal Articles: Anesthesiology

INTRODUCTION: Uganda's district-level administrative units buttress the public healthcare system. In many districts, however, local capacity is incommensurate with that required to plan and implement quality health interventions. This study investigates how a district management strategy informed by local data and community dialogue influences health services.

METHODS: A 3-year randomised controlled trial (RCT) comprised of 16 Ugandan districts tested a management approach, Community and District-management Empowerment for Scale-up (CODES). Eight districts were randomly selected for each of the intervention and comparison areas. The approach relies on a customised set of data-driven diagnostic tools to identify and resolve health system bottlenecks. …

Medicaid Managed Care And The Health Care Utilization Of Foster Children, Makayla Palmer, James Marton, Aaron Yelowitz, Jeffery Talbert

Economics Faculty Publications

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large …

Integrating Nutrition Interventions Into An Existing Maternal, Neonatal, And Child Health Program Increased Maternal Dietary Diversity, Micronutrient Intake, And Exclusive Breastfeeding Practices In Bangladesh: Results Of A Cluster-Randomized Program Evaluation, Phuong Hong Nguyen, Sunny S. Kim, Tina Sanghvi, Zeba Mahmud, Lan Mai Tran, Sadia Shabnam, Bachera Aktar, Raisul Haque, Kaosar Afsana, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, community mobilization, distribution of free micronutrient supplements, and weight-gain monitoring through an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. We evaluated the effect of providing nutrition-focused MNCH compared with standard MNCH (antenatal care with standard nutrition counseling) on coverage of nutrition interventions, maternal dietary diversity, micronutrient supplement intake, and early breastfeeding practices. We used a cluster-randomized design with cross-sectional surveys at baseline (2015) …

Physician Satisfaction With Integrated Behavioral Health In Pediatric Primary Care., Jeffrey F. Hine, Allison Q. Grennan, Kathryn M. Menousek, Gail Robertson, Rachel J. Valleley, Joseph H. Evans

Manuscripts, Articles, Book Chapters and Other Papers

As the benefits of integrated behavioral health care services are becoming more widely recognized, this study investigated physician satisfaction with ongoing integrated psychology services in pediatric primary care clinics. Data were collected across 5 urban and 6 rural clinics and demonstrated the specific factors that physicians view as assets to having efficient access to a pediatric behavioral health practitioner. Results indicated significant satisfaction related to quality and continuity of care and improved access to services. Such models of care may increase access to care and reduce other service barriers encountered by individuals and their families with behavioral health concerns (ie, …

Maximizing Health Outcomes In A Medical Home For Children With Medical Complexity: The Beacon Program., Ingrid Larson, Amber Hoffman, Michael Artman

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Interhospital Transfer Of Children In Respiratory Failure: A Clinician Interview Qualitative Study., Folafoluwa O. Odetola, Renee R. Anspach, Yong Y. Han, Sarah J. Clark

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: To investigate the decision making underlying transfer of children with respiratory failure from level II to level I pediatric intensive care unit care.

METHODS: Interviews with 19 eligible level II pediatric intensive care unit physicians about a hypothetical scenario of a 2-year-old girl in respiratory failure: RESULTS: At baseline, indices critical to management were as follows: OI (53%), partial pressure of oxygen in arterial blood (Pao

CONCLUSION: Interhospital transfer of children in respiratory failure is triggered by poor response to escalation of locally available care modalities. This finding provides new insight into decision making underlying interhospital transfer of children …

Urgent Care And Emergency Department Visits In The Pediatric Medicaid Population., Amanda Montalbano, Jonathan Rodean, Juhi Kangas, Brian R. Lee, Matt Hall

Manuscripts, Articles, Book Chapters and Other Papers

Background: Urgent care (UC) is one of the fastest growing venues of health care delivery. We compared clinical and cost attributes of pediatric UC and emergency department (ED) visits that did not result in admission.

Methods: Our study examined 5 925 568 ED and UC visits of children under 19 years old in the 2010 through 2012 Marketscan Medicaid Multi-State Database. Basic demographics, diagnoses, severity, and payments were compared. Between ED and UC visits, χ(2) tests were used for proportions and Wilcoxon rank-sum tests were used for continuous variables.

Results: The UC and ED had the same most common diagnoses. …

The Creation Of A Model Pediatric Ward For African American Children In 1920s Kansas City., Jane F. Knapp, Robert Schremmer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Sarah L. Goff MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Improving Child Survival Through A District Management Strengthening And Community Empowerment Intervention: Early Implementation Experiences From Uganda., Anne R. Katahoire, Dorcus K. Henriksson, Eric Ssegujja, Peter Waiswa, Florence Ayebare, Danstan Bagenda, Anthony K. Mbonye, Stefan S. Peterson

Journal Articles: Epidemiology

BACKGROUND: The Community and District Empowerment for Scale-up (CODES) project pioneered the implementation of a comprehensive district management and community empowerment intervention in five districts in Uganda. In order to improve effective coverage and quality of child survival interventions CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. This paper presents early implementation experiences in five pilot districts and lessons learnt during the first 2 years of …

Aan News & Opinion. Identification Of Nursing Care Quality And Outcome Indicators For Children For Use By Parents Selecting Health Care Services For Their Children, Martha Craft-Rosenberg, M. Krajicek

Martha J. Craft-Rosenberg

No abstract provided.

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman

Joanne Nicholson

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of …

Parents With Severe Mental Illness And Their Children: The Need For Human Services Integration, Andrea Blanche, Joanne Nicholson, James Purcell

Joanne Nicholson

This article presents the findings and recommendations of a statewide interagency task force on parents with mental illness who have young children. Based on testimony from consumers, providers, and advocates, the task force concluded that this is a substantial and neglected public policy issue requiring an intergovernmental, services integration approach. Recommendations were made in the areas of services, policies and procedures, and service coordination.

The Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Nicole Dube, Jodi Adams, Bernice Gershenson

Joanne Nicholson

Family Networks is a comprehensive system transformation initiative to redesign and integrate traditional categorical services across Massachusetts into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Presented at the 21th Annual Research Conference. A System of Care for Children’s Mental Health: Expanding the Research Base. Tampa, Florida, February …

The Massachusetts Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Jodi Adams, Bernice Gershenson, Katherine Woolsey, Brenda Warren

Joanne Nicholson

Family Networks is a comprehensive systems transformation initiative to redesign and integrate traditional categorical services across the Commonwealth into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services (MA/DSS) and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Findings from the Family Networks Implementation Study will inform MA/DSS strategic planning, system refinements, and the Family Networks outcomes evaluation. …

"Safecare: Application Of An Evidence-Based Program To Prevent Child Maltreatment", Anna Edwards-Gaura, Daniel Whitaker, John Lutzker, Shannon Self-Brown, Ericka Lewis

Dan Whitaker

No abstract provided.

Practice-Based Care Coordination: The Outcomes Of Care Coordination Activities In An Inner-City Pediatric Clinic, Giorelly Jacqueline Prado

UCHC Graduate School Masters Theses 2003 - 2010

No abstract provided.

A Call To Action: The Institute Of Medicine Report On Emergency Medical Services For Children., J F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.