Public Health Commons^™

The Role Of Insurance Coverage In Outpatient Substance Use Disorder Treatment Referral, Utilization, And Outcomes, Huyen Pham

Theses and Dissertations

Opioid-related overdoses increased dramatically in recent years. Medicaid plays a predominant role in paying for opioid use disorder (OUD) treatment. However, there is a critical gap in understanding the role of Medicaid coverage in referrals to treatment, treatment utilization, and treatment retention. The three studies used observational and quasi-experimental (i.e., natural experiment) designs leveraging state and year variation in Medicaid expansion to characterize the role of Medicaid coverage in OUD treatment. We found that individuals with OUD with Medicaid insurance were more likely to use outpatient treatment, whereas those who were uninsured were more likely to use self-help groups only. …

Health Outcomes And Utilization Associated With Renal Diseases In Patients With Cancer In The United States, Mitisha Dedhia

Theses and Dissertations

Background: Adverse events and impairments associated with cancer and its treatments causes worse outcomes. Increased incidence of renal diseases among cancer patients is of particular concern. Objective: To determine the risk factors for renal disease in cancer patients and compare healthcare costs, utilization and health-related quality of life (HRQoL) of cancer patients with a renal disease and cancer patients without renal diseases. Methods: Medical Expenditure Panel Survey files from 2009 – 2018 for cancer patients was used for this study. Multiple logistic regression, generalized linear model, Poisson regression and multiple linear regression for analyses after adjusting for demographic, socioeconomic and …

Another Step In Diagnostics Consultation Model© Actualization: Examining The Impact Of Consultation Workflow Processes On Providers' Clinical Decision Making, Elizabeth K. Leibach

Theses and Dissertations

Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions …

Feeling The Squeeze: The Association Between Multigeneration Caregiving And Informal Caregivers’ Health, Christine L. Patterson

Theses and Dissertations

While U.S. public policy and research has focused on the health needs of the aging population, less attention has been given to the consequences informal caregivers face caring for this generation. With the segment of the population aged 65 years or older growing rapidly, it is important to understand the factors that place informal caregivers at risk for poor health outcomes and health behaviors. Since multigeneration caregivers balance more personal, work, and caregiving demands than single-generation informal caregivers of older adults, they may be at higher risk for poor health outcomes. The aim of this study was to examine the …

The Lived Experiences Of Developmental Disability Caregivers And Service Providers In Ontario, Tetyana Ali

Theses and Dissertations (Comprehensive)

Providing care for children with developmental disabilities (CwDD) is complex and is a life-long journey. Caregivers (CGs) of CwDD experience higher levels of stress, declining mental and physical health, feelings of isolation, diminished financial outcomes, and an overall lower quality of life. Additionally, they often face marginalization and numerous barriers when trying to access funding and supports. This study explored the experiences of CGs of CwDD in the context of Ontario and included the perspectives of CGs and service providers (SPs) to investigate the role the government played in CGs ability to provide adequate care.

Twenty participants were recruited through …

Economic Burden Of Low-Value Healthcare On Patients With Localized Prostate Cancer: Statistical & Machine Learning Approaches, Ryan Fiano

Graduate Theses, Dissertations, and Problem Reports (ETD)

Adults with incident localized prostate cancer represent a large, medically complex population at risk for low-value care. Evidence-based guidelines recommend conservative management (CM) for localized prostate cancer patients with multimorbidity and limited life expectancy, however, 2 in 3 still choose treatment. This dissertation pursued three Aims to address research gaps related to healthcare practices associated with significant morbidity and economic burden on older men with incident localized prostate cancer: 1) examine the leading predictors of low-value healthcare practice of prostate cancer treatment for low-risk prostate cancer; 2) assess the role of patient‐reported experience with care on high-value prostate cancer management; …

Implementation Of The 2017 Aha Guidelines By Primary Care Providers In Managing Elevated Blood Pressure A Modifiable Risk Factor Of Stroke, Chelsi Archie, Chelsea Bullock, Nekesha Johnson, Elizabeth Lishman

MSN Research Projects

Elevated blood pressure is a condition in which systolic blood pressure is 120-129 mmHg and diastolic blood pressure is less than 80 mmHg, according to the CDC (2020), which points out that elevated blood pressure often leads to hypertension. In 2017, The American Heart Association (AHA) released guidelines to aid providers in the early detection and management of hypertension. These guidelines integrate nonpharmacological and pharmacological therapies. The nonpharmacological therapies include following a heart-healthy diet, weight loss, sodium restriction, limitation of alcohol and tobacco consumption, and increased physical activity (AHA, 2018). Hypertension, “the silent killer” is one of the major causes …

Qualitative Study Of Factors Contributing To Fertility Service Use Among Cancer Survivors Of Reproductive Age In The Us, Angela Rodgers Moore

College of Graduate Studies: Theses & Dissertations

Cancer remains the second leading cause of death in the United States; however, there has been a decline in incidence and mortality due to advances in screening and treatment. Currently 16.9 million survivors are thriving within the United States, and the population of cancer survivors has been projected to grow to 22.2 million by 2030. Although cancer survivors report an increased surge of vitality and vigor, they often face physical, mental, psychosocial, or financial challenges that threaten their quality of life. A late treatment effect of particular concern for cancer survivors of reproductive age that has both physical and psychosocial …

Syphilis Screening Among Primary Care Providers, Sarah Christian, Nikki Franklin, Seth Stuart, Casey Tramel, Sereka Walker

MSN Research Projects

Syphilis is a sexually transmitted infection (STI) that can cause lesions on various mucosal areas of the body on an infected individual. If the disease is left untreated, syphilis can progress and affect an individual’s cardiovascular, neurological, and immune systems. The STI rates are on the rise across the United States, especially in the state of Mississippi. Because of the increase in syphilis rates in Mississippi, the researchers developed this study. The purpose of this study is to determine if primary care providers (PCPs) are knowledgeable and screening according to the guidelines of the Early and Periodic Screening, Diagnostic, and …

Knowledge Of The 2017 American Heart Association Hypertension Guidelines, Kelsey Creel, Kristan Kelly, Linda Turner

MSN Research Projects

The primary purpose of this project was to determine the knowledge of nurse practitioners in Mississippi regarding the 2017 American Heart Association Hypertension Guidelines. Following approval by the Institutional Review Board (IRB), the researchers utilized a descriptive, quantitative survey design to evaluate the knowledge of Mississippi nurse practitioners of the 2017 American Heart Association Hypertension Guidelines in regards to diagnosis and management of hypertension. Utilizing social media, the researchers targeted specific Facebook sites for nurse practitioners who practice in the state of Mississippi. Data was gathered through SurveyMonkey using a questionnaire. The data gathered from the completed questionnaires were then …

Peer-Taught Virtual Research Workshops For Surgical Residents: Protocol For A Novel And Sustainable Solution To Improving Surgical Research In Pakistan, Russell S. Martins, Ronika Devi Ukrani, Mohummad Hassan Raza Raja, Maria Khan, Haissan Iftikhar, Syeda Sadia Fatima, Saulat Fatimi

Medical College Documents

Objective: To generate a protocol describing the methodology for a study assessing the effectiveness of a comprehensive series of peer-taught online research workshops for surgical residents across Pakistan in terms of improving research-related knowledge and skills, and long-term research involvement and output.
Methods: The quasi-experimental study will consist of a series of six online research workshops conducted over Zoom for surgical residents across Pakistan. An online sign-up form will be circulated on social media to current surgical residents throughout Pakistan. Curricular content covered in the workshops will be developed in collaboration with experienced research faculty at the Departments of Surgery …

Perceptions Of Integrated Mental And Behavioral Health In Pediatric Specialty Care Settings: A Mixed-Methods Study, Desireé Nicole Williford

Graduate Theses, Dissertations, and Problem Reports (ETD)

Pediatric patients are at an increased risk of experiencing mental and behavioral health concerns, which have direct associations with HRQOL, physiological health, and likelihood that youth will engage in health promoting behavior. Researchers and practitioners have increased their awareness of these concerns and identified strategies for improving the mental and behavioral health of these youth, specifically via implementing organizational efforts (i.e., task forces) and guidelines around integrating psychosocial screening and other services into routine practice. Despite this, there are several identified barriers to families receiving mental/behavioral health care in these settings. These barriers exist at all levels, including at the …

Association Of Incident Cancer To Low-Value Care And Healthcare Cost Burden Among Elderly Medicare Beneficiaries, Chibuzo Iloabuchi

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the United States (US), 25% of healthcare spending is considered wasteful because it is spent reimbursing low-value care. Low-value care is the utilization of healthcare services, medical tests, and procedures that have unclear or no clinical benefit to patients but still exposes them to risk. World-wide, low-value care imposes a significant economic burden on patients, payers, governments, and society. Cancer care among older adults > 65 years is one of the biggest drivers of healthcare expenditure in the US and accounts for nearly 40% of all spending, and low-value care among cancer patients is prevalent and contributes to the financial …

An Exploration Of Interventions For Healing Intergeneration Trauma To Develop Successful Healing Programs For Aboriginal Australians: A Literature Review, Alison J. Simpson, William Abur, James A. Charles

Australian Indigenous HealthBulletin

Introduction

Health outcomes and life expectancy of Indigenous people throughout the world are far poorer than non-Indigenous populations. Emerging evidence from research shows that many social issues which impact on Indigenous peoples globally is linked to trauma over generations. This review explores literature about Indigenous people from around the world to seek interventions which have been successful in healing intergenerational trauma.

Method

To identify interventions that have been successful in healing intergenerational trauma amongst Indigenous populations globally, a systematic search strategy was conducted using keywords and synonyms related to the topic. Peer reviewed academic literature was sourced from four …

Reproductive Health Care In The Time Of Covid-19: Perspectives Of Poor Women And Service Providers From Rahim Yar Khan, Punjab, Iram Kamran, Tahira Parveen, Rehan M. Niazi, Irfan Masood

Reproductive Health

This study was conducted by the Population Council in Rahim Yar Khan district of Punjab, with the support of the United Nations Population Fund (UNFPA), to uncover urgently needed evidence about the challenges and needs of poor women and health care providers during the COVID-19 pandemic. Over 200 poor women—beneficiaries of the Benazir Income Support Programme (BISP), one of the largest social protection programs in the world—and 60 public and private sector health care providers participated in this investigation of BISP beneficiaries’ knowledge of COVID-19, the effects of the pandemic on their lives, mental health and wellbeing, and their access …

Covid-19 Viral Testing Disparities In Los Angeles City, Laura Cyphers

Student Scholar Symposium Abstracts and Posters

Hispanic and Black communities have been disproportionately impacted by COVID-19-related morbidity and mortality (California Department of Public Health, 2020). Inequitable access to viral testing resources may have exacerbated these COVID-19-related racial and ethnic health disparities. For example, reports from the Los Angeles Department of Public Health revealed glaring viral testing disparities in April 2020 (early pandemic), with predominantly White communities in Los Angeles County receiving 65% more tests than Hispanic and Black communities. In response, California statewide testing was expanded for communities of color (Vann et al., 2020). To investigate access to viral testing in Los Angeles City, the current …

Improving Clinicians’ Access To Patient Education And Va Resource Information, Ella Bermudez

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: In a western US Veterans Administration (VA) hospital system, patient education materials are provider-specific, not standardized, and not located in a central, readily available location.

Context: How does a patient education tool affect the clinicians' delivery of health education in increasing health literacy compared to written information alone in the US veteran population? An integrated literature review was performed using Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases to address the PICOT question above and determine the impact of patient education tools on health literacy and patient engagement. The literature recommended improving patient education for better …

Imagining A Lean And Agile Digital Health Ecosystem - A Measure Of Pandemic Responsiveness, Zainab Samad, Sana Mahmood, Sameen Siddiqi, Zulfiqar Ahmed Bhutta

Section of Cardiology

No abstract provided.

The Green House Nursing Home Model: The Gh Elements And Their Impact On Quality Of Care In Nursing Homes., Deborah Kaminka Niyongabo

Electronic Theses and Dissertations

Nursing homes (NHs) have been described as hospital-like facilities where residents are more likely to experience isolation or abuse. The Green House (GH) model is a type of culture change which focuses on deinstitutionalizing traditional NHs to provide better quality of care and quality of life to NH residents. The two main objectives of this study are: to describe the GH model and its elements and to identify which GH elements impact the quality of care. This study also seeks to identify organizational theories used in the GH analysis. The next objective is to analyze the impact of the GH …

A Look Into The Relationship Between Socioeconomic Status And Health, Hunter L. Howell

Honors Theses

Disparities in health have always been present, and major steps have been made to narrow this gap in healthcare. With that said, socioeconomic status still plays a significant role in access to healthcare. This study looks into how socioeconomic factors such as age, race, and income affect access to healthcare while also studying avenues as to why these disparities exist.

Bystanders’ Perspectives On The Provision Of Informal, Hospital-Based Care To Bedridden Patients With Cancer In Sri Lanka, B. Sunil S. De Silva

Nursing ETDs

Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. …

Homelessness Prevention Contacts Datasheet, Juan Whitehead

Capstone Projects and Master's Theses

The Coalition of Homeless Providers, located in Seaside, California provides services for over 2,400 homeless people in Monterey County. This organization collaborates with other agencies to provide support for those who are in need of emergency, transitional, or permanent housing. Because of lack of affordable housing in the area, and the lack of available resources, many men and women, as well as families find themselves without a place to stay. Homelessness Prevention Contacts Datasheet establishes a list of rental property management companies and landlords who may be interested in some of the programs provided by the Coalition. These programs provide …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Association Between Social Media Exposure To Food And Beverages With Nutrient Intake Of Female Adolescents, Cholida Adiba, Siti Fatimah Pradigdo, Martha Irene Kartasurya

Kesmas

Communication technology development has influenced adolescent food choices and intakes. This study aimed to investigate the association between social media exposure to food and beverage content and nutrient intake among female adolescents. The study was conducted in a cross-sectional design. The targeted population was 104 female students aged 14–18 years old at 'XY' High School in Semarang, Central Java, Indonesia. Eighty-one subjects were chosen by clustered random sampling. Data were collected by interviews using structured questionnaires and a 3x24-hour recall method. Data analyses were conducted by chi-square, Fisher exact tests, and logistic regression. The median and standard deviations of social-media, …

Ultraviolet Exposure And Photokeratitis Complaints Among Informal Welding Workers In Depok, West Java, Indonesia, Maria K I J Yustheresani, Fajaria Nurcandra, Azizah Musliha Fitri, Annisa Ika Putri, Dyah Utari

Kesmas

One of the photokeratitis risk factors is acute reversible radiation of ultraviolet (UV) rays, which injure the cornea's epithelial tissue. Informal welding workers are susceptible populations to UV rays exposure. This study aimed to confirm the influence of UV radiation exposure on photokeratitis complaints in welding workers in Cimanggis, Depok, West Java. A cross-sectional study was conducted from February to June 2019 and used to select 100 welding workers purposively. A semi-structured questionnaire was used to determine photokeratitis complaints, age, education level, eye protection, safety knowledge, and work period; the UV radiation measured by A UV meter. Data were analyzed …

Assessment Of Knowledge, Attitudes, And Behaviors Of Turkish Women On Breast And Cervical Cancer In Karabük Province, Turkey, Nergiz Sevinc, Belgin Oral, Burcu Korkut

Kesmas

Breast and cervical cancer incidence and mortality among women have been increasing worldwide. This cross-sectional study aimed to evaluate women's knowledge, attitudes, and behaviors regarding breast and cervical cancers. The sample was composed of 507 women aged 18 years and older who were admitted to a primary health care center in Karabük, Turkey, from October to December 2019. The data was obtained using a questionnaire consisting of 34 questions regarding participants’ socio demographic characteristics, knowledge, attitudes, and behaviors toward breast and cervical cancers. The mean age of the participants was 41.3±12.0 years and 68.4% of them were married. Slightly more …

Evaluating The Effect Of Care Around Labor And Delivery Practices On Early Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Archana B. Patel, Elizabeth M. Simmon, Sowmya R. Rao, Janet Moore, Tracy L. Nolen, Robert L. Goldenberg, Shivaprasad S. Goudar, Manjunath S. Somannavar, Sarah Saleem, Farnaz Naqvi

Community Health Sciences

Background: Neonatal deaths in first 28-days of life represent 47% of all deaths under the age of five years globally and are a focus of the United Nation's (UN's) Sustainable Development Goals. Pregnant women are delivering in facilities but that does not indicate quality of care during delivery and the postpartum period. The World Health Organization's Essential Newborn Care (ENC) package reduces neonatal mortality, but lacks a simple and valid composite index that measures its effectiveness.
Methods: Data on 5 intra-partum and 3 post-partum practices (indicators) recommended as part of ENC, routinely collected in NICHD's Global Network's (GN) Maternal Newborn …

Policy Implementation: Teachers’ Role As First Responders In Emergencies And Disasters, Shabir Hyder, Adnan Fazal Manzoor, Muhammad Amjad Iqbal

Kesmas

During the past decade, the schoolchildren faced many disasters and emergencies originating from natural and man-made sources. The safety of schoolchildren rests with school management and teachers. This study aimed to assess teachers' awareness with regard to disaster prevention and health, safety, security, and environment (HSSE) policies at primary schools in Pakistan. In addition, it explores the suitability of teachers to perform as emergency handlers in the absence of school nurses and resource officers (SROs). The study involved a qualitative study, based on open-ended interviews from a sample of 25 school teachers. Methodology triangulation was applied to reduce bias. Results …

When Will The Covid-19 Pandemic In Indonesia End?, Dewi Susanna

Kesmas

On January 30, 2020, the World Health Organization(WHO) declared 2019-nCOV to be a Public Health Emergency of International Concern (PHEIC), due to the significant increase in confirmed new cases in various countries.1 In Indonesia, the first confirmed COVID-19 case was a female who had a closed contact with the 24th confirmed case in Malaysia and the second case was the mother of the first case.2 As time goes by, the number of new cases has increased significantly, reaching 160.165 confirmed cases with 6,944 deaths by August 27, 2020.3 The time when the COVID-19 pandemic in Indonesia will end is not …

Obesity Indicators And C-Reactive Protein In Indonesian Adults (More Than Equal To 40 Years Old): The Indonesian Family Life Survey 5, Yeni Mahwati, Dieta Nurrika

Kesmas

C-reactive protein (CRP) is the best clinical marker for systemic inflammation. Obesity is associated with increased CRP levels. Systemic inflammation is present before morbidity occurs. Research reveals that the identification of obesity indicators and CRP levels is limited among Indonesians. The present study investigated the associations between obesity indicators (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]) and CRP levels among Indonesian adults. This cross-sectional study based on Indonesian Family Life Survey-5 2014–2015 was conducted among 3,386 adults (≥ 40 years) living in 13 provinces in Indonesia during the study period. All data were collected …