Public Health Commons^™

Housing With Services Evaluation Report, Hannah Cohen-Cline, Jannate Ahmed, Kyle Jones, Jb Rinaldi

Articles, Abstracts, and Reports

No abstract provided.

A Population-Based Investigation Of Health-Care Needs And Preferences In American Adults With Multiple Sclerosis, Chungyi Chiu, Malachy Bishop, Bradley Mcdaniels, Byung-Jin Kim, Lebogang Tiro

Early Childhood, Special Education, and Counselor Education Faculty Publications

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and …

Health Care Use And Access Among Rural And Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller Phd, Amanda Burgess Mppm, Deborah Thayer Mba

Access / Insurance

Little is known about the characteristics and health care use of rural residents with disabilities. Using the Medicare Current Beneficiary Survey (2009-2013), we compared access to and use of health services among rural and urban nonelderly Medicare beneficiaries with a disability, and examined their health and functional status along with sociodemographic characteristics. We found that the characteristics of nonelderly Medicare beneficiaries with a disability reflected the differences observed between rural and urban populations overall: rural recipients were more likely than their urban peers to be older, non-Hispanic white, and have a lower level of educational attainment. Although self-reported access to …

The Implementation Of Indonesian Navy Victim Identification Policy In Ladokgi R.E. Martadinata, Sugeng Winarno, Suhardjo Sitam, Bambang Hidayat Hidayat, Yuli Subiyakto

Journal of Indonesian Health Policy and Administration

Soldier is a death-risk profession; thus, identification to have their exact identity is a fundamental right. The Presidential Regulation Number 107 of 2013 mandates Ladokgi RE. Martadinata as the investigator of victim identification activities for Indonesian Navy Soldiers. This study analyzes the implementation of the policy with a qualitative descriptive approach using the Edward III model analysis. Retrieval of primary informant data through in depth interviews and secondary data, including observation and review of the literature, documents, and related laws and regulations. Data validation is done by triangulating data sources, theories, and methodologies. The results of the study indicate that …

The Impact Of National Health Insurance Policy On Outpatient Visit In Maluku And Papua: Logit Model, Rira Wahdani Martaliza, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The National Health Insurance (JKN) is one manifestation of the National Social Security System program which aims to provide benefits for health care and protection. This study uses secondary data from the 2017 National Socio-Economic Survey (Susenas) which aims to prove that JKN ownership has an influence on outpatient visits. The research respondents were all people who were registered as JKN participants in the Maluku and Papua Islands regions as many as 77.307 people. This study uses the econometric approach with the Logit regression model. The results showed that JKN was positively associated with outpatient visits, with coefficients of PBI …

Policy Implementation In Achieving Basic Complete Immunization And Universal Child Immunization Indicators In Kapuas District In 2018, Lia Rosi Vela, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

Completing the basic immunization and implementing Universal Child Immunization (UCI) are the objectives for the Immunization Program according to the Ministry of Health of Republic Indonesia Strategic Planning. In 2017, Kapuas district achieved 66,6% of the Completed Basic Immunization target and 32,2% of the Universal Child Immunization (UCI) target. There is still a 26,4% gap and a 62,8% gap, respectively, from the 95% target of Strategic Plan Ministry of Health 2015-2019. This study aims to discuss the performance of policy implementation of Completed Basic Immunization (CBI) and Universal Child Immunization (UCI) in 2018 at Kapuas Regency, using qualitative research with …

The Implementation Of Enhancing Male Participation On Family Planning Policy In Bandung Barat Regency, Dadang Suhenda, Evalina Franciska Hutasoit

Journal of Indonesian Health Policy and Administration

This study aims to analyze the conduct implementation of the increasing male contraception policy in Bandung Barat Regency. The study is using qualitative methods with case studies approachment. Qualitative data were gained from 16 informants which consist of implementor group as program managers, and partnership and community group as the targeted group. This study was conducted at three locations: district of Cililin, Batu Jajar, and Parongpong. The study shows that the decision process to decide PPM as the standard and goals of the family planning program has been understood by all of its administrators and resources available for this program …

Policy Of Patient Safety Governance For Hospitalized Patient At The Koja Public Hospital In 2019, Tiara Fani Yolanda, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

Clinical governance is a structured organizational framework to improve the quality and safety of patients in the hospital which made by the NHS into seven pillars and adjusted to RI Law No. 44 of 2009. The evaluation results from the quality and patient safety team of Koja Public Regional Hospital in 2018, showed that there is Fall Patient incidents (6 events), KTD and KNC (13 events) which is not following the 0 % of the target from Patient Safety Goals by the Ministry of Health. The study was conducted to analyze patient safety governance for hospitalized patients at the Koja …

Listening To The Patient: A Typology Of Contextual Red Flags In Disease Management Encounters, Amy E. Binns-Calvey, Gunjan Sharma, Naomi Ashley, Brendan Kelly, Frances M. Weaver, Saul J. Weiner

Journal of Patient-Centered Research and Reviews

Purpose: Patients send clues, often unwittingly, when they are grappling with a life challenge that complicates their care. For instance, a patient may lose control of a previously well-managed chronic condition or start missing appointments. When explored, these clues help clinicians uncover the life circumstance impacting the individual’s ability to manage their health and health care. Such clues are termed “contextual red flags.” Effective care requires recognizing them, asking about them, and customizing the care plan where feasible. We sought to develop a typology of contextual red flags by analyzing audio recordings along with the medical records of encounters between …

Surgeons’ Views On Shared Decision-Making, Suraj Kannan, Jayhyun Seo, Kevin R. Riggs, Gail Geller, Emily F. Boss, Zackary D. Berger

Journal of Patient-Centered Research and Reviews

Purpose: Shared decision-making (SDM) has a significant role in surgical encounters, where decisions are influenced by both clinician and patient preferences. Herein, we sought to explore surgeons’ practices and beliefs about SDM.

Methods: We performed a qualitative study consisting of semi-structured individual interviews with 18 surgeons from private practice and academic surgery practices in Baltimore, Maryland. We purposively sampled participants to maximize diversity of practice type (academic vs private), surgical specialty, gender, and experience level. Interview topics included benefits and challenges to patient involvement in decision-making, communicating uncertainty to patients, and use of decision aids. Interviews were audio-recorded and transcribed. …

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

Substance Abuse Treatment In Correctional Versus Non-Correctional Settings: Analysis Of Racial/Ethnic And Gender Differences, George Pro, Ricky Camplain, Samantha Sabo, Julie Baldwin, Paul A. Gilbert

Journal of Health Disparities Research and Practice

Background

Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants …

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

Utilization Of Dental Services Among Medicaid Enrolled Pregnant Women In Virginia, Shillpa Naavaal, Tegwyn Brickhouse, Jonathan W. Yu, Joann Wells

Philips Institute for Oral Health Research Publications

The study evaluated the impact of the Virginia Medicaid dental benefit on dental services utilization among pregnant women enrolled in Medicaid. Data from a total of 10,395 women who had at least one dental claim during the 2015-2017 period were included in the study. The number of dental visits and dental services utilized per person grew from an average of 2.2 visits and 7 services in 2015 to 3.1 visits and 10.5 services in 2017, respectively. In 2017, of all dental services used, 6% were for preventive services and 59% were for treatment services. Continued efforts and targeted interventions are …

Universal Healthcare: Good Or Bad?, Danielle Tait

Student Research Poster Presentations 2020

The topic of universal healthcare seems to come up quite a bit in political platforms, but what does it really mean for Americans? By allowing universal healthcare, instead of private insurance companies, we as a nation will see an increase in healthy citizens, the economy will save money, and patients will be more satisfied with their healthcare. Although we do not have concrete evidence, studies project that universal healthcare will bring immense benefits to America’s healthcare.

Assessing Access To Healthcare For Limited English Proficient Patients, Hannah Bergamini

Mahurin Honors College Capstone Experience/Thesis Projects

Patients with limited English skills often face additional struggles when accessing medical care. These patients, referred to as limited English proficient (LEP) patients, are unable to communicate directly with their physician. This lack of direct communication typically results in unique challenges for the patient and provider. Due to these challenges, LEP patients often have poorer health statuses and experience poorer health outcomes. However, when provided with access to qualified medical interpreters, many of these challenges facing LEP patients can be ameliorated. Therefore, using qualified interpreters is an important component in improving the access to healthcare for LEP patients. To determine …

Diversification Of Research Methodological Approach During Model Enhancements In Health Information System Research, Uche Ikenyei

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

Lincoln County Community Paramedicine Data Collection Initiative, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

No abstract provided.

Challenging Aggressive Behaviors Experienced By Personal Support Workers In Comparison To Home Care Workers: Relationships Between Caregiver Experiences And Psychological Health, Kelsey N. Womack, Teala W. Alvord, Caitlyn F. Trullinger-Dwyer, Sean P.M. Rice, Ryan Olson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Personal support workers (PSW) are caregivers for children and adults with intellectual and developmental disabilities (IDDs) or adults experiencing mental illness or other behavioral health conditions. The work can be very meaningful, but many PSWs must prepare for, monitor, and manage challenging behaviors, including aggression. This study was designed to estimate the prevalence of aggression experienced by PSWs in Oregon, and compare it to a previous sample of Oregon home care workers (HCWs). This comparison included an analysis of relationships between exposures to aggression and psychological health factors. PSWs in Oregon (N = 240) were surveyed electronically at a single …

Unintended Consequences Of Population Health In Medical Home Contracts With Mcos To Improve Quality Of Care, Mildred Scott

MUSC Theses and Dissertations

Public policy efforts to improve population health are important. However, any public policy may have unintended consequences, and the risk of these side-effects may be substantial if they include payment incentives to providers or economic incentives for patients. A recent policy initiative The Population Health Medical Home Contracts with MCOs to Improve Quality of Care is the focus of this study. The Center for Medicare and Medicaid Services (CMS) implemented a quality initiative to improve the quality of healthcare and services for patients with Medicare and Medicaid benefits to improve Healthcare Effectiveness Data and Information Set (HEDIS) Measures. As a …

Mitigating The Risk Of Financial Distress And Closure In Rural Hospitals: A Multiple Case Study, Christopher Brian Wiggs

MUSC Theses and Dissertations

Few studies have explored strategies rural hospitals have implemented to lower the risk of financial distress and closure. The objective of this doctoral project is to explore factors rural hospital stakeholders consider when determining the most appropriate business model for their organization. A multiple case study design was utilized to explore key factors considered in the decision-making processes at three rural hospitals in the southeastern Unites States with varying business models and characteristics. Nine rural hospital stakeholders including administrators, clinician, and community leaders participated in semi-structured interviews. Interviews were recorded, transcribed, and analyzed using an inductive coding process. Seven themes …

A Rural Mother's Guide To Breastfeeding, Haley Tillett

Undergraduate Honors Theses

Breastfeeding is considered as the gold standard of infant health (CDC, n.d.). The benefits provided to both the baby and mother by breastfeeding are unmatched when compared to formula feeding. Recent studies have shown a disparity in rates of breastfeeding, primarily in rural areas. This may be due, in part, to the fact that mothers in rural areas may not have equal access to resources and support they need to successfully breastfeed due to geographic isolation. This guide will provide an overview of breastfeeding resources in rural communities with a focus on Kittitas Valley, Washington. Resources include but are not …

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Eye Screening In U.S. Adults With Diabetes: Examination Of Trends, Racial And Ethnic Differences, And Contribution Of Medicaid Expansion, Meps 2010-2017, Karon Lewis

College of Graduate Studies: Theses & Dissertations

Diabetic retinopathy (DR) is a prevalent cause of vision impairment and blindness among adults in the United States. Early diagnosis of DR through dilated eye examinations can reduce the risk of vision impairment or loss. Differences in eye examination rates by race and ethnicity have been suggested by prior studies emphasizing importance of increasing insurance coverage and access to care among minority populations. The Affordable Care Act aimed to expand health insurance coverage and improve access to care. This study examined trends overall and by race and ethnicity in eye examination rates and the contribution of Medicaid expansion on changes …

Assessing The Efficiency Of Sub-National Units In Making Progress Towards Universal Health Coverage: Evidence From Pakistan, Faraz Khalid, Maria Petro Brunal, Abdul Sattar, Samia Laokri, Matthew Jowett, Wajeeha Raza, David R. Hotchkiss

Community Health Sciences

The World Health Report 2010 encourages countries to reduce wastage and increase efficiency to achieve Universal Health Coverage (UHC). This research examines the efficiency of divisions (sub-provincial geographic units) in Pakistan in moving towards UHC using Data Envelop Analysis. We have used data from the Pakistan National Accounts 2011-12 and the Pakistan Social Living and Measurement Survey 2012-13 to measure per capita pooled public health spending in the divisions as inputs, and a set of UHC indicators (health service coverage and financial protection) as outputs. Sensitivity analysis for factors outside the health sector influencing health outcomes was conducted to refine …

Physician Empathy In Public And Private Internal Medicine Residency Training Programs In Pasig City, Rafael Carlos C. Aniceto, Dave Ryan A. Dela Cruz, Mary Stephanie M. Dofitas, Kenneth Brian M. Fernando, Melody Hope L. Lee Yu, Joseph Anthony Lachica

Ateneo School of Medicine and Public Health Publications

Research Question:
What are the levels of patient-perceived and self-assessed physician empathy among internal medicine (IM) residents in two tertiary hospitals in Pasig City? Is there a significant difference in patient-perceived and self-assessed physician empathy levels between public and private tertiary hospitals?

Background:
Empathy is important because it has been speculated to have a positive effect on patient outcomes; it is a skill that can be learned and developed.

Objectives:
This study obtained quantitative measurements of patient-perceived and self-assessed physician empathy. Empathy levels between public and private tertiary hospitals were compared.

General Study Design:
This study utilized a quantitative cross-sectional …

Quality Of Medical Care For Adults With Intellectual/Developmental Disabilities, Priya Chandan

Theses and Dissertations

QUALITY OF MEDICAL CARE FOR ADULTS WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES

By Priya Chandan, M.D., M.P.H.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of

Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020.

Director: Director: Gloria J. Bazzoli, Ph.D.

Bon Secours Professor, Department of Health Administration

People with intellectual/developmental disabilities (IDD) are difficult to identify in administrative data, limiting the ability to study the quality of health care provided to this population. This study utilized clinical diagnoses to define a sample of hospitalized patients with IDD in the largest publicly available all-payer inpatient care database—the …

The Association Between The Medicare Bundled Payments Initiative And Cardiac Rehabilitation Enrollment, Jing Li

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cardiac rehabilitation (CR) represents a proven-effective intervention in secondary prevention that can stabilize, slow or reverse cardiovascular disease (CVD) progression, facilitate the ability of the patient to preserve or resume an active and functional contribution to the community, and reduce the risk of future cardiovascular events. Despite multiple guideline recommendations for CR and coverage by Medicare and most health plans, participation in CR remains low. Bundled payments are one of the suggested reforms designed to move health care providers toward to value-based care and is very applicable to the CR utilization in patients diagnosed with acute myocardial infarction (AMI) or …

Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In November 2013, Scotland piloted a program in Grampian for the treatment of Urinary Tract Infections (UTIs) in community pharmacies, increasing health access for patients and reducing general practitioner workload. This program became known as ‘Pharmacy First’ and was later implemented nationwide in November 2017. This paper seeks to understand utilization of the Pharmacy First program across Scotland by patients and potential barriers to access.

Methods: Using data from the Prescribing Information System collected by the National Health Service of Scotland from July 2013 to April 2019, orders for uncomplicated UTIs were gathered by examining all nitrofurantoin and trimethoprim …