Community Health Commons^™

A Path For Evidenced-Based Evaluation: The Case For Restorative Justice, Raúl D. Gierbolini-Rivera, Atc,Cscs

Thinking Matters Symposium

No abstract provided.

Impact Of Group Prenatal Care On Health Outcomes For Women Of Color In The United States: A Systematic Literature Review, Morgan Brockington, Emily Bauer, Julie Kameisha

Thinking Matters Symposium

Women of color in the United States experience disproportionately higher rates of adverse pregnancy-related outcomes, both in the prenatal and postpartum period. Group prenatal care (GPC) has been gaining popularity in recent years and has demonstrated improved health outcomes. The aim of this systematic literature review was to examine and summarize the impact of group prenatal care on health outcomes for women of color in the United States. Using a systematic approach and PRISMA guidelines, two electronic databases—CINAHL and PubMed—were used to search the literature. Quantitative research studies that were published in peer-reviewed journals between 2010 and 2020, written in …

Provision Of Mental Health Services By Critical Access Hospital-Based Rural Health Clinics, John A. Gale Ms, Zachariah T. Croll Mph, Nathan First Lcsw, Msw, Ma, Sara Kahn-Troster Mph

Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural …

New Outpatient Experience Survey Design: A Quality Improvement Case Study, Nathan Paluso

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate the implementation process for a new survey methodology introduced by Maine Medical Partners (MMP), by following the Plan-Do-Study-Act (PDSA) quality improvement cycle framework. This new survey has been implemented to collect data on patients’ experiences in the MMP outpatient facilities, and is offered to the patients via iPad at check-out after their appointment. Through observation at MMP practices and MMP staff interviews, strengths and weaknesses of the implementation process have been identified. Evidence-based solutions pertaining to the identified weaknesses have been selected through a literature review and are incorporated in recommendations …

Assessment Of The Use Of Overdose Education And Naloxone Distribution By Maine Buprenorphine/Naloxone Prescribers, Stephen Kirsch

Muskie School Capstones and Dissertations

Background: Overdose deaths, specifically related to opioids, have been identified as a public health problem both nationally and in the state of Maine. Overdose Education and Naloxone Distribution (OEND) is an innovative model of patient education that has been shown to be effective in increasing knowledge of overdose risk and has the potential to help reduce opiate related overdose deaths.

Methods: A 28-item web-based survey examining clinician attitudes, OEND practices and characteristics was distributed to 196 Maine based physicians with a Drug Enforcement Agency waiver to prescribe burprenorphine/naloxone. Facilitators and barriers to the provision of OEND were also assessed. Surveys …

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Expanding Access To Naloxone In Maine: Opportunities And Barriers, Kate E. Richardson

Muskie School Capstones and Dissertations

The Centers for Disease Control and Prevention have declared prescription drug abuse a national epidemic (Office of National Drug Control Policy, 2014). In addition to strategies designed to prevent opioid abuse and misuse, many public health officials, policy makers, healthcare providers and harm reduction task forces seek to increase access to naloxone, a prescription drug known to reverse the effects of an opioid overdose. This report provides an overview of the barriers and opportunities for the state of Maine to expand access to the opioid antagonist, naloxone, in an effort to reduce fatal opioid drug overdose rates.

Implications Of Rurality And Psychiatric Status For Diabetic Care Use Among Adults With Diabetes, Jean A. Talbot Phd, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, David Hartley Phd

Access / Insurance

This research examined patterns of diabetic preventive care use among adults with diabetes, to determine whether these patterns varied according to respondents’ rural/urban residence or psychiatric status (i.e., the presence/absence of a mental health diagnosis). Specifically, we considered whether rural people with diabetes are less likely than urban peers to use diabetic preventive services; whether having a mental health diagnosis affects preventive service use among diabetics; and, whether rural/ urban differences in service use vary depending on the presence or absence of a mental health diagnosis.

Mainecare Stage A Health Homes Year 1 Report: Implementation Findings And Baseline Analysis, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana, Deborah A. Thayer Mba

Population Health & Health Policy

In January 2013, Maine established Health Homes under federal authority pursuant to Section 2703 of the Affordable Care Act to improve care coordination for MaineCare members with chronic conditions. Stage A of the Health Homes initiative focuses on members with complex medical chronic conditions. Stage B, planned for early 2014, will focus on persons with severe and persistent mental health conditions and children with serious emotional disturbances. The Stage A demonstration builds off the State’s existing Maine multi-payer Patient Centered Medical Home (PCMH) Pilot project and Maine’s Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary …

Mental Health Services In Rural Long-Term Care: Challenges And Opportunities For Improvement, Jean A. Talbot Phd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

To facilitate reform efforts, more research is needed on the current status of mental health services in rural long-term care. Also needed are new tools promoting the targeted use of provisions in the Affordable Care Act (ACA) to address the mental health needs of rural long-term care recipients. In this brief, we explore novel practices that hold promise for enhancing mental health services in rural long-term care, focusing primarily on the needs of rural elders who reside either in nursing facilities or in their own homes in the community. Key Findings: Despite high levels of need, individuals in long-term care …

Challenges And Opportunities For Improving Mental Health Services In Rural Long-Term Care, Jean A. Talbot Phd, Andrew F. Coburn Phd

Long Term Services and Supports

Despite high levels of need, individuals in long-term care often fail to receive appropriate mental health services, especially in rural areas. In this report (and accompanying Research & Policy Brief), we consider challenges and opportunities for improving mental health treatment delivered to long-term care recipients in rural settings. As background, we note the prevalence of mental health problems in long-term care populations, describe deficiencies in the mental health care afforded to long-term care recipients, and identify barriers that hinder the remediation of these deficiencies in rural settings. We also outline a rationale for enhancing mental health services in long-term …

Final Report: The Practice And Impact Of Shared Decision-Making, Shared Decision-Making Study Group For The Dirigo Health Agency’S Maine Quality Forum

Population Health & Health Policy

Several recent developments are likely to address those factors seen as contributing to shared decision-making’s mixed results: the lack of a nationally recognized certification process; insufficient funds to adequately invest in the training and infrastructure to support shared decision-making; and adequate methods for monitoring its effectiveness.

Are Rural Health Clinics Part Of The Rural Safety Net?, David Hartley Phd, Mha, John A. Gale Ms, Al Leighton Ba, Stuart Bratesman Mpp

Rural Health Clinics

Key Findings: 86% of independent RHCs offer free care, sliding fee scales, or both; 97% were currently accepting new Medicaid/SCHIP patients; RHCs' patient mix has a higher proportion of Medicaid/SCHIP patients in counties not served by a federally funded Community Health Center (CHC). Lacking the grant funds and federal technical assistance provided to CHCs to build service capacity, few RHCs have had the resources to expand their scope of services. The Affordable Care Act has made it clear that partnering with CHCs is an option for RHCs that find themselves serving safety net populations. More study is needed laying out …

Safety Net Activities Of Independent Rural Health Clinics, David Hartley Phd, Mha, John A. Gale Ms, Al Leighton Ba, Stuart Bratesman Mpp

Rural Health Clinics

Rural Health Clinics (RHCs) are an important part of the rural health care infrastructure as they provide a wide range of primary care services to the rural residents of 45 states. Since RHCs are located in underserved rural areas and serve vulnerable populations, many consider them safety net providers. In this paper we explore whether and to what extent independent RHCs are serving a safety net role, or have the capacity to serve that role. We address this question through a telephone survey of 392 randomly selected independent RHCs. Response rate for the survey was 93%. We investigated whether and …

Encouraging Rural Health Clinics To Provide Mental Health Services: What Are The Options?, John A. Gale Ms, Stephanie L. Loux Ms, Barbara Shaw Jd, David Hartley Phd, Mha

Rural Health Clinics

Key Findings: Approximately 6% of independent and 2% of provider-based RHCs offer mental health services. 38% of study RHCs reported their mental health services were not profitable but continued to provide them in response to community and patient needs. An important factor in the development of RHC mental health services is the presence of a local "champion" who spearheads the development effort.

Analysis Of Emergency Department Use In Maine: A Study Conducted On Behalf Of The Emergency Department Use Work Group Of The Maine Advisory Council On Health System Development, Elizabeth Kilbreth Phd, Barbara Shaw, Danny Westcott, Carolyn E. Gray Mph

Population Health & Health Policy

This report presents additional statewide analysis of emergency department (ED) utilization and also the results of a comparative analysis of six health service areas in Maine, three selected for above average rates of emergency department visits, and three selected for below average rates of emergency department visits.

Few And Far Away: Detoxification Services In Rural Areas, Jennifer D. Lenardson Mhs, Melanie M. Race Ms, John A. Gale Ms

Mental Health / Substance Use Disorders

Based on Working Paper #41: Availability, Characteristics, and Role of Detoxification Services in Rural Areas. Findings: Few rural detox providers exist; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve a 100 mile radius. Travel distances are a barrier to outpatient detox models. Referral options to substance abuse treatment are limited, especially in isolated rural areas.

Rural Children Don't Receive The Mental Health Care They Need, David Lambert Phd, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs

Mental Health / Substance Use Disorders

Key Findings: Just over one-third of all children with a mental health problem received a mental health visit in the past year; Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children; Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas.

Mental Health And Substance Abuse In Maine: Building A Community-Based System, David Lambert Phd, John A. Gale Ms

Mental Health / Substance Use Disorders

No abstract provided.

The Bulletin: Dayspring Aids Support Services (Spring /Summer 2000), Sharon Pree, Dayspring Aids Support Services

Bulletin / Dayspring AIDS Support Services (1999, 2000)

No abstract provided.

The Bulletin: Dayspring Aids Support Services, Vol.4, No.2 (Summer 1999), Sharon Pree, Dayspring Aids Support Services

Bulletin / Dayspring AIDS Support Services (1999, 2000)

No abstract provided.

Health Risk Behaviors Among Maine Youth : Results Of The 1997 Youth Risk Behavior Survey, Grades 7-12, Chuck Rhoades

Maine Collection

Health Risk Behaviors Among Maine Youth : Results of the 1997 Youth Risk Behavior Survey, Grades 7-12

Prepared for the Maine Department of Education by Chuck Rhoades of CERES Associates, Inc., Survey Administered by Pan Atlantic Consultants / Strategic Marketing Services (June, 1998).

Contents: Introduction / Methodology / Demographics / Safety, Violence & Suicide / Alcohol, Drug & Tobacco Use / Sexual Behaviors / Health Care, Physical Activity & Nutrition / References

Blue Ribbon Commission On The Regulation Of Health Care Expenditures, State Of Maine, 113th Legislature

Maine Collection

Blue Ribbon Commission on the Regulation of Health Care Expenditures

State of Maine, 113th Legislature (January, 1989)

Office of Policy and Legal Analysis, Room 101, State House--Sta. 13, Augusta, Maine 04333.

Contents: Preface / Executive Summary of Recommendations / Introduction and Background / Detailed Recommendations

Report Of The Commissioner's Task Force On Self-Destructive Behaviors And Teen Suicide, Department Of Mental Health And Mental Retardation

Maine Collection

Report of the Commissioner's Task Force on Self-Destructive Behaviors and Teen Suicide.

Susan B. Parker, Commissioner - Department of Mental Health and Mental Retardation, Augusta, Maine (December 1987).

Contents: Foreward / Task Force Members / Introduction / Characteristics of Self-Destructive Teens / Factors Contributing to Self-Destructive Behaviors / Findings and Recommendations / References

Trends In Health Care Expenditures, Maine 1974-1978, Bruce Armstrong

Maine Collection

Trends in Health Care Expenditures, Maine 1974-1978

by Bruce Armstrong, Research Consultant

Maine Department of Human Services, Bureau of Health Planning and Development, Division of Data and Research, Augusta, Maine (August 1981).

Contents: Preface / Highlights / List of Tables and Figures / Yearly Tables / Trend Illustrations and Tabular Descriptions

Maine Mental Health Annual Review And Progress Report 1977, Department Of Mental Health And Corrections

Maine Collection

Maine Mental Health Annual Review and Progress Report 1977

State of Maine., Department of Mental Health and Corrections, Augusta, Maine, 1977.

George A. Zitnay, Commissioner

Contents: Preface / Administrative Part / Services and Facilities Part

Barriers To Attainment Of Health Care In West Central Maine : A Critique By The Poor, Health Facilities Planning Council

Maine Collection

Barriers to Attainment of Health Care in West Central Maine : A Critique by the Poor

"Conducted by the Health Facilities Planning Council, 11 Parkwood Drive, Augusta, Maine under contract to Maine Department of Health and Welfare, June, 1969."

Contents: Foreword / Table of Contents / Introduction / Map / Franklin County / Housing / Dental Rot / Franklin County Memorial Hospital / Family Planning / RN's / State Public Health Nurses / Unmet Health Needs / The Last Outpost / Home Visit in Farmington Falls / Home Visit in Industry / Home Visit in Rangeley Area / Conversations on …