Health and Medical Administration Commons^™

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Organizational Wellness Programs As Internal Social Marketing: A Literature Review Of Feasible Approaches, Faith Bontrager Rn, Bsn, Kimball P. Marshall Ph.D.

Atlantic Marketing Association Proceedings

No abstract provided.

Physical Therapist Views And Experiences With Patient Use Of Marijuana, Arturo De La O Basurto Jr.

Cal Poly Humboldt theses and projects

Conditions seen within physical therapy settings overlap with reasons that patients seek marijuana. For this reason, information about these professionals’ outlooks on patients’ marijuana use in prime. Purpose: Gain current views and experiences of physical therapists (PTs)/physical therapist assistants (PTAs) on their patients’ use of marijuana in the physical therapy field. Methods: PTs/PTAs were invited to complete an anonymous survey asking relative PT/PTA views, experiences, and understanding of patients’ marijuana use. Results: PTs/PTAs who have had experience (did not have experience) with patients who use marijuana received information about marijuana from news media - 61% (60%), patients …

Dr. Tele-Corporation: Bridging The Access-To-Care Gap, Nader Amer

Dickinson Law Review (2017-Present)

The United States is currently confronting an access-to-healthcare crisis, which rural regions are experiencing at a disproportionate rate. Many commentators have touted telemedicine as a solution for the access-to-care issue. Telemedicine uses video and telecommunication technology to allow physicians to treat patients from distant locations and thus facilitates a more equal distribution of physicians throughout the United States.

Although the telemedicine industry is quickly growing, the corporate practice of medicine doctrine impedes the industry’s expansion and consequently obstructs a viable solution to the access-to-care crisis. Generally, the corporate practice of medicine doctrine prohibits corporations and limited liability companies from employing …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem

Walden Dissertations and Doctoral Studies

Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the …

Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson

Walden Dissertations and Doctoral Studies

Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …

Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku

Walden Dissertations and Doctoral Studies

Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …

Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide

Walden Dissertations and Doctoral Studies

This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing …

Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua

Walden Dissertations and Doctoral Studies

Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong

Walden Dissertations and Doctoral Studies

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …

Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy

Walden Dissertations and Doctoral Studies

This qualitative multiple-case study sought to provide an in-depth understanding of how children living in broken families-due to the wrongful conviction of parent(s)-developed psychosocial issues. The theoretical frameworks applied to this study were the social learning theory, the social control theory, the role-modeling theory, and the general theory of crime. A purposeful sample of 13 adults who were children at the time of their parents’ wrongful incarceration were drawn for phone and in-person interviews. The data were transcribed and analyzed to code, sort, and organize; to analyze connections in the information, and to compare and contrast cases. The multiple-case study …

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …

The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez

Walden Dissertations and Doctoral Studies

The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …

Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris

Walden Dissertations and Doctoral Studies

There is a growing need for healthcare teams within the Veterans Administration (VA) healthcare system to effectively collaborate and communicate to improve patient outcomes. The need to improve patient care in the Patient Aligned Care Team (PACT) has been well established. The scholarly literature does not provide evidence whether using the primary care PACT model on communication and teamwork by an interdisciplinary medical team ameliorates these communication breakdowns. Bronstein's design for interdisciplinary collaboration provided the overarching framework for this study. The purpose of this qualitative case study was to investigate the use of the PACT model on communication and teamwork …

Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is one of the most difficult and stressful chronic diseases for parents of afflicted children to manage. Managing SCD can be traumatic for parents particularly if they have no specific coping strategies for managing the disease or ensuring the child visits the doctor as scheduled. The use of certain coping strategies may affect the parents' and patients' perceptions of the illness and influence their decisions regarding treatment, which can have a lasting impact on their lives. Effective parental strategies such as positive thinking can aid in disease management, but there is limited research on the coping …

Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern

Walden Dissertations and Doctoral Studies

No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …

Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh

Walden Dissertations and Doctoral Studies

Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …

Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell

Walden Dissertations and Doctoral Studies

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …