Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Quality Of Outpatient Care In Lebanon: A Cross-Sectional Survey, Georges Choueiry, Anna Maria Henaine, Rayan Darwish, Pascale Salameh

Patient Experience Journal

Patient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average …

Churning The Tides Of Care: When Nurse Turnover Makes Waves In Patient Access To Primary Care, Kelley Arredondo, Ashley M Hughes, Houston F Lester, Trang N D Pham, Laura A Petersen, Lechauncy Woodard, Richard Sorelle, Cheng Rebecca Jiang, Frederick L Oswald, Daniel R Murphy, Hilary N Touchett, Joshua Hamer, Sylvia J Hysong

Faculty, Staff and Students Publications

BACKGROUND: Team-based primary care (PC) enhances the quality of and access to health care. The Veterans Health Administration (VHA) implements team-based care through Patient Aligned Care Teams (PACTs), consisting of four core members: a primary care provider, registered nurse (RN) care manager, licensed vocational nurse, and scheduling clerk. RNs play a central role: they coordinate patient care, manage operational needs, and serve as a patient point of contact. Currently, it is not known how varying levels of RN staffing on primary care teams impact patient outcomes.

OBJECTIVE: This study aims to empirically assess how the stability of RN staffing within …

Personalized Nutrition: Tailoring Dietary Recommendations Through Genetic Insights, Saiful Singar, Ravinder Nagpal, Bahram H. Arjmandi, Neda S. Akhavan

Kinesiology and Nutrition Sciences Faculty Research

Personalized nutrition (PN) represents a transformative approach in dietary science, where individual genetic profiles guide tailored dietary recommendations, thereby optimizing health outcomes and managing chronic diseases more effectively. This review synthesizes key aspects of PN, emphasizing the genetic basis of dietary responses, contemporary research, and practical applications. We explore how individual genetic differences influence dietary metabolisms, thus underscoring the importance of nutrigenomics in developing personalized dietary guidelines. Current research in PN highlights significant gene–diet interactions that affect various conditions, including obesity and diabetes, suggesting that dietary interventions could be more precise and beneficial if they are customized to genetic profiles. …

Transitions Of Care And The Prevention Of Readmissions, Beatriz Granado

Student Scholarly Projects

Unplanned hospital readmissions often result from poor discharge planning and challenges during the transition from hospital to home, including medication errors and weak communication with primary care providers. A well-organized and personalized discharge plan can significantly reduce hospital stays, lower readmission rates, minimize medication errors, and improve patient outcomes, all while decreasing healthcare costs. In post-discharge Medicare-eligible patients (P), how does transitional care coordination through organized, personalized, and patient-focused discharge planning (I), compared with standard or no transitional care coordination provided (C), affect readmissions (O) within the 30-day post-discharge phase monitored over a 10–12-week period (T)? A search was conducted …

Analysis Of Accessibility Of People With Sensory Disabilities In Rsud Pasar Minggu, Daffaldo Suryoputra, Masyitoh Basabih, Fify Mulyani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

People with a disability is someone who has conditions, whether physically and mentally that make a person experience difficulty in certain conditions and interact with their environment. Pasar Minggu Regional Hospital (RSUD Pasar Minggu) has achieved a general patient satisfaction indicator with satisfaction rate of 90% in 2022. This satisfaction indicator mainly comes from infrastructure and facility factors, along with the competence of service providers and costs. As a regional referral hospital, this hospital certainly has patients with physical limitations due to disabilities or illnesses. To ensure patient satisfaction can also be felt by patients with physical limitations, this study …

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience: Master of Public Health

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Risk Evaluation In Occupational Safety And Health Research: Results From A Benchmarking Exercise Of Federal And Academic Irbs, Sarah A Felknor, Jessica M K Streit, Angela M Morley, John D Piacentino

Faculty, Staff and Student Publications

OBJECTIVE: Research involving working populations can pose unique ethical and risk evaluation challenges. The purpose of this benchmarking project was to assess how federal agencies and academic institutions approach the interpretation and application of key risk evaluation concepts in research involving workers in their places of employment.

METHODS: Key informant interviews were conducted to ascertain current practices related to assessing soundness of research design, determining risk reasonableness and research relatedness of risks, and evaluating the risk of noninvasive clinical tests in occupational settings.

RESULTS: There were noteworthy commonalities among the approaches described to review and address critical aspects of risk …

Perception Of Lean Adoption Among Emergency Department Personnel In Public Hospitals In Selangor, Malaysia, Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan Puteh, Kiran Ganesh Balakrishnan

Makara Journal of Health Research

Background: This research aims to assess the perceptions of the staff working in emergency departments in Selangor, Malaysia, regarding the adoption of lean management and identify the factors that affect their perceptions.

Methods: A cross-sectional study using the Lean in Healthcare Questionnaire was conducted with 251 respondents, which consisted of doctors, nurses and medical assistants employed in three selected hospitals.

Results: One-way analysis of variance (ANOVA) showed a significant difference in every domain score in accordance with the occupation category. For the domain process, a significant negative correlation was found between age and domain score (r = …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Impact Of Ehr On Security Check And Patient Outcomes, Arun Kumar Marumudi

Harrisburg University Dissertations and Theses

This study aims to explore patient perspectives on how electronic health record (EHR) security protocols influence care quality and outcomes. In the context of methodology, an online survey was conducted in March 2024 with 10 participants from the USA who provided informed consent. Questions assessed experience with EHRs, security concerns, perceptions of authentication impacts, satisfaction with balancing priorities, and open-ended feedback. Descriptive analysis was used to identify key themes.

Most respondents had direct EHR exposure, which validated their viewpoints. Universal concerns co-existed with preferring digital records due to facilitated sharing when regulated appropriately. One-third reported occasional access issues correlating with …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Implementation Of Mindfulness & Stress Reduction Training For Medical Students, Jill Berenato

SACAD: Scholarly Activities

Abstract

This proposal advocates for implementing mandatory mindfulness and stress reduction training sessions for surgical students at Philadelphia College of Osteopathic Medicine (PCOM). It is well-documented that medical students, particularly those in surgical disciplines, experience high levels of stress, which can negatively impact their mental health, academic performance and overall well-being. Mindfulness-based interventions have shown promise in reducing stress and enhancing resilience among medical students. By integrating mindfulness training into the surgical curriculum, PCOM aims to equip students with essential coping skills to effectively manage stress, thereby promoting their mental health and academic success. This handout serves to accompany the …

A Case Study To Investigate Factors Influencing The Santa Clara County Getting To Zero Initiative’S Collective Impact Model, Harit Agroia, Rebecca Reno, Jenette Spezeski, Leyla Mousli, Richard Sarabia, Erin Starzyk

Journal of Social, Behavioral, and Health Sciences

Our objective was to explore how factors, such as backbone organization changes and COVID-19, affected a collective impact (CI) initiative’s progression through the five CI phases and its components of success. We conducted a case study using semistructured interviews with 17 representatives from the action committee, community-based organization, and health department between January and February 2023 in Santa Clara County, California. Participants were asked how internal and external factors affected their engagement and experiences with the CI initiative. We analyzed the data using structural and holistic coding. Results showed that the initiative’s progression was impacted by intersecting factors; overall findings …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Evaluation Of A Community Based Teaching Hospital’S Geriatric Emergency Medicine Initiative, Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose

Journal of Geriatric Emergency Medicine

INTRODUCTION: To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.

METHODS: This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of …

A Helping Hand Out Of The River: Refugee Perspectives For Provider Engagement, Brian L. Isakson, Elizabeth R. Stein, Alexandra Olson, Destiny Waggoner, Jill Holtz, Sara Ali, Suha Amer, Martin Ndayisenga

Journal of Patient-Centered Research and Reviews

Purpose: A growing number of refugee groups are seeking care within the U.S. health care system for medical, psychological, and social needs. Research is limited in understanding refugee-specific conceptualizations of helping relationships and provider characteristics that improve interactions in health systems. This study aimed to identify provider characteristics that facilitate engagement and helpfulness in a refugee-specific population from refugee participant voices to inform future practices of health care clinics.

Methods: Semi-structured interviews with refugee participants were conducted to assess 1) experiences moving on from difficult experiences, 2) engagement with the health system, and 3) provider characteristics that facilitated engagement and …

A Clear, Succinct Research Question Portends The Rest Of The Story, Jessica J. F. Kram, Lisa Sullivan Vedder, Brenda Fay, Deborah Simpson

Journal of Patient-Centered Research and Reviews

The goal of any research manuscript is to convey the story of a systematic answer to an important question in the field. A clear, succinct research or study question is what provides the storyline that connects all the sections of a manuscript. One of the most common strategies to developing a meaningful research question is the FINER approach, which encompasses five standards to determine the quality of a question: feasible, interesting, novel, ethical, and relevant. Using the FINER approach can provide the guidepost for all design and reporting decisions. This editorial recommends creating a study protocol aimed at answering your …

Pulmonary Specialist-Supported Health Coaching Delivered By Lay Personnel Improves Receipt Of Quality Care For Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial, Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise Devore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, Doranne Donesky, Stephanie Tsao, David H. Thom, George Su

Journal of Patient-Centered Research and Reviews

Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting.

Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care …

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.

Patient And Provider Experience With Artificial Intelligence Screening Technology For Diabetic Retinopathy In A Rural Primary Care Setting, Brian M. Nolan, Emma R. Daybranch, Kerri Barton, Neil Korsen

Journal of Maine Medical Center

Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.

Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.

Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified …

Post-Partum Depression (Ppd) Screening Tools Effectiveness In Refugee Populations, Joshua Jensen

Annual Research Symposium

Purpose:

Immigrant mothers check all the boxes that are significant risk factors for developing or exacerbating Postpartum Depression (PPD). These risk factors include, suffering in solitude, cultural conceptualizations, barriers to help seeking, and a lack of facilitators to help seeking. Despite this very little research has been done to find effective screening methods for this population.

The purpose of this research project is to compile the works of those before me to determine whether the Edinburgh Postnatal Depression or the PHQ 9 screening tool is the most effective for immigrant mothers.

Methods:

Research determining the effectivity of the two tests …

Time Is Brain: How A Descriptive Analysis Of Telestroke Metrics Can Improve Program Performance, Christopher Cordero

MUSC Theses and Dissertations

In the event of an acute ischemic stroke, 1.9 million neurons are lost in the brain per minute. Since the inception of thrombolytic therapy and mechanical thrombectomy as effective tools in the treatment of acute ischemic stroke, the focal point of quality improvement in this field has become the time to treatment delivery. As rural and more interspersed environments exhibit high disability and mortality rates associated with these acute neurological conditions, inequities in timely care delivered to these patient populations persist. Limitations in access are now abated by the extension of neurologist expertise into these areas via Telestroke. This study …

Nudging Health Care Providers' Adoption Of Clinical Decision Support: Protocol For The User-Centered Development Of A Behavioral Economics-Inspired Electronic Health Record Tool, Safiya Richardson, Katherine Dauber-Decker, Jeffrey Solomon, Sundas Khan, Douglas Barnaby, John Chelico, Michael Qiu, Yan Liu, Devin Mann, Renee Pekmezaris, Thomas Mcginn, Michael Diefenbach

Faculty, Staff and Students Publications

BACKGROUND: The improvements in care resulting from clinical decision support (CDS) have been significantly limited by consistently low health care provider adoption. Health care provider attitudes toward CDS, specifically psychological and behavioral barriers, are not typically addressed during any stage of CDS development, although they represent an important barrier to adoption. Emerging evidence has shown the surprising power of using insights from the field of behavioral economics to address psychological and behavioral barriers. Nudges are formal applications of behavioral economics, defined as positive reinforcement and indirect suggestions that have a nonforced effect on decision-making.

OBJECTIVE: Our goal is to employ …

Understanding Quality Of Life In Patients With Acute Leukemia, A Global Survey, Zack Pemberton-Whiteley, Samantha Nier, Jan Geissler, Sophie Wintrich, Bregje Verhoeven, Rita O. Christensen, Sam Salek, Esther Natalie Oliva, Tatyana Ionova, Jennie Bradley

Journal of Patient-Centered Research and Reviews

Purpose: The Acute Leukemia Advocates Network (ALAN) sought to determine which factors are most associated with poor quality of life (QoL) in patients with acute leukemia and to determine key issues and unmet needs through administration of an online survey distributed worldwide via partner patient organizations.

Methods: ALAN developed a questionnaire informed by literature review and based extensively on the hematological malignancy-specific patient-reported outcomes (HM-PRO) measure to assess the impact of acute leukemia on QoL and its relationships with patients’ demographics, disease state, disease impact, and support from health care professionals. Univariate and multivariable statistical analysis was used to investigate …