Public Health Commons^™

Navigating Recovery: A Qualtitive Study Of Harm Reduction And Sobriety Among African American In Redlined Chicago Neighborhoods, Erica N. Tate

Dissertations

This qualitative study examines the lived experiences of African American individuals residing in historically redlined communities in Chicago who are maintaining sobriety using harm reduction strategies. Grounded in the context of structural inequities, the study explores how social determinants of health, including limited healthcare access, transportation barriers, and community disinvestment, shape recovery pathways. Semi-structured interviews were conducted with individuals in sustained recovery and providers, and the data were analyzed using inductive and deductive thematic approaches. Findings indicate that recovery is an ongoing process influenced by environmental exposure, trauma, and access to support systems.

Participants identified harm reduction strategies, such as …

Factors Affecting Pedestrian-Vehicle Conflicts: An Empirical Analysis, Christo D. Jamo

Honors Scholar Theses

The number of pedestrian deaths increased by 78% between 2009 and 2023, while other motor vehicle crash deaths increased by 13% in the same period [1]. To identify potential pedestrian safety measures, this study analyzed the effects of location-based demographics, pedestrian phasing type, and other physical infrastructure and behavior variables on the probability of pedestrian-vehicle conflicts at signalized intersections, which is a surrogate measure of crash risk. Data were collected from 55 intersections in Connecticut, and the pedestrian-vehicle interactions were classified by severity based on the Swedish Traffic Conflict Technique: undisturbed passage, potential conflict, minor conflict, or serious conflict. Because …

Caregiver Self-Reflection: Does It Matter? A Study Of The Relationship Between Caregiver Self-Reflection And Participation In Home Programs In Outpatient Pediatric Physical Therapy Settings, Andrea Myane

Graduate Theses and Dissertations

Despite evidence that caregiver coaching can improve patient outcomes and caregiver participation, little information exists on the effects of its individual components. Additionally, previous research has highlighted the importance of home programs in improving pediatric physical therapy outcomes. The aim of this study is to explore the role that caregiver self-reflection, a component of caregiver coaching, plays in facilitating outcomes in the pediatric physical therapy outpatient setting. Caregivers will be asked to complete a series of self-reflection questions based on Gibbs’ Reflective Cycle, while also recording the number of minutes they spend facilitating a prescribed home program. All study participants …

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Miserly Thinking: Understanding The Factors Shaping Public Support Towards Project Wolbachia In Singapore, Shirley S. Ho, Agnes S. F. Chuah, Fiona J. W. Goh, Nova Mengxia Huang, Mengxue Qu, Hye Kyung Kim, Sonny Rosenthal

Research Collection College of Integrative Studies

Project Wolbachia is a vector control method that releases male Wolbachia-infected Aedes mosquitoes to curb dengue transmission in Singapore. While research has primarily focused on its efficacy, few studies have examined public opinion. This study draws upon the cognitive miser model and scientific literacy model to examine the factors shaping public support for Project Wolbachia. A nationally representative door-to-door survey was conducted in Singapore (N = 1,000) using multi-stage stratified random sampling. Our findings revealed that while knowledge about Project Wolbachia explains public support, laypeople may often rely on cognitive shortcuts, such as value predispositions, media attention, and pre-existing perceptions, …

Occupational Stressors And Health Impacts Among First Responders, Mason N. Roach

Honors College Theses

The United States 911 emergency response system is an interconnected web of public services that seeks to provide its community with care, resources, and safety in times of need. However, the impact of this support on the employees providing the service often goes unnoticed. This review identifies and analyzes the unique strains on first responders' physical and mental health using the Job Demand-Control Model and the Allostatic Load Model. A review of available research literature supports the conclusion that occupational-related stress, including trauma exposure, shift work, poor leadership, and inadequate communication, can have long-lasting negative impacts on provider health.

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

A Hybrid Coaching Model In A Multi-Center Networked Care Experience Learning Collaborative, Elizabeth Rizzo, Victoria Adams, James Perry, Nicole Szalay, Samuel Verkhovsky, Megan Morse Holthoff, Alice Mae Kennedy, Brant Oliver

Patient Experience Journal

Coaching teams and leaders conducting quality improvement (QI) has shown to be an effective method for project success. Our coaches were well versed in Lean Six Sigma and IHI Model for Improvement methods. Certified Lean Six Sigma Blackbelts coaches were assigned to project teams. Routine participation in project team meetings and one-on-one coaching sessions reenforced tools necessary to complete improvement work. Additionally, coaches met with one another to discuss their methods, work through challenges, and celebrate successes. Fourteen improvement teams led work in Care Experience related projects. Eleven project leaders certified in Lean Six Sigma methodology through the Value Institute …

Documentation And Dashboard Driven Quality And Safety Improvement In Interpreter Services For Limited English Proficient Patients, Richard T. Dillehay, Samuel Verkhovsky, Andrew Bohm, Harley Friedman, Dawn Welshman, Ann Morong, Vidya Karthikeyan, Jessica Dampier, Amanda Racine, Brant Oliver

Patient Experience Journal

Limited English Proficiency is known as an independent driver of disparities in patient's access to healthcare and their healthcare outcomes. The Joint Commission standards require that health systems document language services delivery to patients with limited English proficiency in a systematic way. Our health system had not historically utilized a methodical system for documenting language services utilization prior to the launch of this initiative. By utilizing a Lean Six Sigma approach, a project team comprised of leaders from interpreter services, operations, data analytics, and data informatics codesigned an Epic SmartForm data collection instrument and series of Tableau dashboards to monitor …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Patient Engagement In Developing Radiology Patient Education Materials, T Arleo, Harrisd Harrisd, J Hislop, J Moon, H Li, N Kadom

Patient Experience Journal

Purpose: This initiative aimed to engage patients in the process of developing patient education materials (PEM) on the major imaging modalities at our institution. Materials and Methods: PEM were created for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), fluoroscopy, and radiography. Content was sourced from various sources, consolidated into a draft, and iteratively updated: They were simplified using a ChatGPT-4.0 prompt designed to achieve a 7th grade reading level; they were reviewed for accuracy by subject matter experts (SME); they were assessed for readability and understandability using the Flesch-Kincaid Grade Level (FKGL) and the Patient Education Materials Assessment …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Multilevel Factors Shaping The Patient Experience With Health Services In Torbat Heydarieh, Iran, Fatemeh Pourhaji, Mohammad Hossein Delshad

Patient Experience Journal

Background: One of the main aims of public health is to ensure that health services are used and available. However, access alone does not guarantee a positive patient experience, which is critical to achieving optimal health outcomes and ensuring health equity. Aims: The objective of this study is to analyse in a comprehensive way the multiple factors influencing the patient experience and subsequent use of healthcare services by households in Torbat Heydarieh, Iran, by examining the independent and interactive contributions of individual, household and environmental (community) determinants using THUMS data. Methods: This analytical study, which covered a 1-year period, looked …

Factors Influencing Patient Satisfaction In Health Services: A Cross-Sectional Study In The Holy City Of Najaf, Ahmed Abdul Hasan Mohsin, Lamees A. Abdul-Lateef, Noor Ismeal Nasser

Patient Experience Journal

The healthcare system in the city of Najaf works to improve the quality of services provided to patients. Since patient satisfaction serves as a key measure of service quality, this study was designed to identify the potential factors that influence satisfaction within these facilities. cross-sectional study was conducted for 300 patients using public healthcare services in Najaf. the selection of patients based on the stratified random sampling across hospitals and primary health centers. Data were collected using a 24-item structured questionnaire that measured four domains: accessibility, staff attitude, service quality, and physical environment, rated on a four-point Likert scale. The …

Nursing Staff Attitude Towards Nurse-Physician Collaboration In The Neonatal Intensive Care Unit In Al Ahsa City, Saudi Arabia, Makarim Taqi Al Helal, Yaqoub Yousef Al Mousa

Patient Experience Journal

Objective: Effective nurse-physician collaboration is fundamental to ensuring quality healthcare delivery, particularly in Neonatal Intensive Care Units (NICUs), where patient outcomes rely heavily on coordinated teamwork. This study aimed to assess nursing staff attitudes toward nurse-physician collaboration in NICUs, examine the influence of demographic and professional characteristics, and provide evidence-based recommendations to strengthen interprofessional collaboration. Methods: A quantitative, non-experimental, cross-sectional survey was conducted from April to June 2024 in the NICU of Maternity and Children's Hospital, Al Ahsa, Saudi Arabia. A total of 180 nurses with at least one year of NICU experience participated. Data were collected using the …

Do Allied Health Professionals' Workplace Experiences Affect Their Decisions To Stay? A Quantitative Investigation Into The Relationship Between Wellness And Employee Retention In United States Hospitals, Dina Jarjees, Lihua Dishman

Patient Experience Journal

Allied Health Professionals (AHPs) are university-trained practitioners with specialized skills essential for preventing, diagnosing, and treating health conditions. AHPs play a vital role in comprehensive healthcare, including hospitals, where they comprise a significant portion of the workforce and recurrent health expenditures. However, AHPs experience considerable burnout and emotional distress, negatively impacting retention. This issue worsens workforce shortages and limits access to care, which jeopardizes patient safety. This national, cross-sectional, quantitative study examined the relationship between AHPs' wellness dimensions (physical, emotional, mental, social, and spiritual) and AHPs' retention in United States hospitals. A self-developed survey instrument included 10 demographic and 25 …

Investigating The Effectiveness Of Different Modalities In Interprofessional Training, Rose Ann Mathai, Sean Lopez, Maureen Emlund, Jim Scherrer, Elisa Buzinski, Julia Sonnichsen, Myra Carew

Patient Experience Journal

Background: Interprofessional education (IPE) highlights the importance of values and ethics, teamwork, communication, and roles and responsibilities for healthcare professionals. Different modalities have been used to teach these skills. The most effective teaching modality must be determined to enhance the collaborative learning experience. Purpose: This study evaluated the changes in student perceptions on each interprofessional competency with respect to the teaching modality. Two groups were evaluated for this study. One was taught using a hybrid curriculum and the other in-person. Methods: This study utilized the Students' Perceptions of Interprofessional Clinical Education (SPICE-R2) survey to determine the changes in student …

Exploring Patient Satisfaction: Descriptive And Predictive Insights From Hcahps Surveys In U.S. Hospitals, Naveen Gudigantala, Tanush Sistla, Ramu Gudigantala, Naga Vemprala

Patient Experience Journal

This study analyzes patient experience data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys across three time periods: 2020–21, 2021–22, and 2022–23. Utilizing both descriptive and predictive analytics, we examined ten key variables related to patient communication, hospital environment, discharge information, and overall hospital ratings. Descriptive analytics using longitudinal data analysis revealed that while patient experience metrics were strong in 2020–21, a significant downturn was observed in 2021–22, followed by a marked recovery in 2022–23. These results suggest that while COVID-19 pandemic negatively impacted patient satisfaction metrics in 2021–22, the emerging evidence suggests U.S. healthcare system …

Patient Satisfaction And Perceived Quality Of Care: A Population-Based Cross-Sectional Study Of United States Adults, Samuel Ofei-Dodoo, Carter Altenbernt, Yessin Wael, Hayrettin Okut, Alex Watkins, Nola Tran, Alishka Rojas-Addari

Patient Experience Journal

Patient satisfaction and perceived quality of care are key indicators of health care performance, yet the relative influence of demographic versus communication-related factors remains underexplored. Using data from 7,278 non-institutionalized United States adults in the nationally representative Health Information National Trends Survey, descriptive statistics summarized respondent characteristics and experiences with health care professionals, and survey-weighted multinomial logistic regression identified predictors of perceived health care quality. Respondents generally reported positive experiences, with communication-related factors emerging as the strongest predictors of excellent ratings. Patients who were always included in decisions (OR = 3.44; 95% CI, 1.11-10.69), received clear explanations (OR = 11.24; …

System-Level Barriers To Patient Engagement With Electronic Medical Records, Corey Adams, Reema Harrison, Guncag Ozavci, Kathleen Gray, Nilmini Wickramasinghe, Vicky Yuan, Tracey Bucknall, Elizabeth Manias

Patient Experience Journal

Objective: Electronic medical records (EMRs) can support patient-centered care, but system-level barriers often limit how patients engage with EMR systems. This study explored the system-level barriers and enablers to patient engagement with EMRs from the perspectives of healthcare leaders. Methods: Semi-structured interviews were conducted with 20 participants in senior EMR-related roles across healthcare organizations in two Australian states. Data were analyzed using reflexive thematic analysis to identify key system-level influences on patient engagement. Results: Seven themes were identified: 1) EMRs for digital storage, not connection, 2) Privacy rules create challenges to accessing information, 3) Communication barriers when using EMRs, 4) …

Virtual Caregiving And The Evolving Role Of Carers And Patients: Virtual Hospital Interview Analysis, Kanesha Ward, Tim Jackson, Jenna Bartyn, Shannon Saad, Sue Amanatidis, Owen Hutchings, Annie Y.S. Lau

Patient Experience Journal

Virtual hospitals are transforming healthcare by enabling remote monitoring and management of patients, improving accessibility and care continuity. As part of the transformation, there are changes to the roles and responsibilities of patients and their carers as they engage in virtual hospital care. The impact on family caregiving remains underexplored. Guided by Family Systems Theory, this qualitative study investigated how family caregiving roles adapt within a virtual hospital and identified opportunities to further support families. Semi-structured interviews were conducted with patients, carers, and healthcare workers from one model of care, at a metropolitan virtual hospital in New South Wales, Australia. …

Leveraging Digital Patient And Family Advisory Councils To Drive Patient Engagement, Priya Radhakrishnan, Shambhavi Mishra, Melissa Price, Cammy Sanders, Fiker Bekele, Kathi Zarubi, Craig Kartchner, Amrit Singh Johal, Carol Mayer, Craig Norquist

Patient Experience Journal

Patient and Family Advisory Councils (PFACs) have been integral in enhancing patient care, but their limited reach often excludes underrepresented populations. Digital PFACs present an opportunity to overcome these barriers and engage a broader spectrum of patients and families, fostering more inclusive healthcare decision-making. We implemented a Digital Patient and Family Advisory Council (DPFAC) at HonorHealth, as part of the Patient Centered Outcomes Research Institute (PCORI) capacity building grant. We used the RE-AIM and PRISM frameworks to engage participants through a digital platform. The process began with a needs assessment and was followed by the development of the platform, during …

Supporting Families Of Children With Craniosynostosis: A Qualitative Exploration Of Parental Usage Of Online Forums, Elisha L. Rea, Rachel M. Roberts, Amanda J. Osborn

Patient Experience Journal

Objective: Craniosynostosis is characterised by the early fusion of cranial sutures, resulting in an abnormal head shape. This study examines the psychosocial impact of a child's craniosynostosis diagnosis on families, by analysing online forum discussions. While surgery is often needed to address appearance-related and neuropsychological concerns, parents face challenges navigating their child's diagnosis. Many seek support through online forums, yet research on their experiences remains limited. This study aims to understand parental needs and experiences by analysing forum discussions. Method: Online forums were analysed using reflexive thematic analysis. Significant features of the data were systematically coded and themes reflecting …

Validation Of A Copd Patient-Reported Experience Measure (Prem-C9) In Ontario, Canada, Elaine Zibrowski, Floriana Islami, Alyson Kellar, Christopher Licskai, Madonna Ferrone, Shannon L. Sibbald

Patient Experience Journal

Objective: Patient-reported experience measures (PREM) are important tools for evaluating healthcare quality, yet their implementation in chronic obstructive pulmonary disease (COPD) care within Canada remains limited. Our objective was to examine the construct validity of the PREM-C9 instrument in a Canadian context and explore its potential clinical applications beyond measuring patient experience. Methods: A two-phase, prospective, cross-sectional, mixed-methods study was conducted across 41 Best Care COPD sites in Ontario, Canada. In the quantitative phase, confirmatory factor analysis assessed the construct validity of the PREM-C9. In the qualitative phase, focus group interviews with COPD case managers explored implementation experiences and perceived …

A Study To Assess Prom And Prem Of Cld Patients In A Tertiary Care Hospital, Anagha Nandakumar, Rubasree M, Priya Nair, Dr. Dinesh Nair, Krishnapriya S

Patient Experience Journal

Chronic liver disease (CLD) leads to progressive liver dysfunction, significantly affecting patients quality of life (QOL). Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are critical in evaluating the health status and care experiences of CLD patients. This study aimed to assess the impact of PROMs and PREMs in CLD patients undergoing endoscopic procedures. A prospective study was conducted in the Gastroenterology and Hepatology Department over three months, involving 245 CLD patients (160 inpatients and 85 outpatients). PROMs were assessed using the Liver-specific PROM (LC PROM), which focused on daily living, symptom management, psychological well-being, and treatment effectiveness. PREMs …

Patient-Centered Care To Improve Recruitment And Retention In Clinical Trials: Insights From A Real-Time Interview-Based Satisfaction Study, Christina Zhuang, Aishwarya Prasad, Anshu Arora, Arun Arora, Jeena Vaid, Wisam Aljumaili, Arif Khan

Patient Experience Journal

Patient-centered care is increasingly recognized as essential for understanding participant expectations and generating more accurate and reliable clinical trial results. This study aimed to evaluate an interview-based feedback tool designed to provide a comprehensive assessment of patient experience at a free standing high-enrolling clinical site in the Pacific Northwest. The primary objectives were to identify strengths and weaknesses in current procedures, enhance recruitment and retention, and develop a model adaptable to other sites. A structured interview tool was independently developed based on literature supporting the integration of qualitative and quantitative feedback to capture a multidimensional view of patient experience. The …

Cartoon-Printed Uniforms: A Strategy To Ease Pediatric Hospital Anxiety, Karnellya R. Ohol, Janaki P. Shinde

Patient Experience Journal

This quasi-experimental study evaluated the effectiveness of cartoon-printed nurse uniforms in reducing anxiety among hospitalized children aged 3–12 years. Conducted at a tertiary care hospital in Maharashtra, India, the study included 100 participants (50 intervention, 50 control) who received care from nurses wearing either cartoon-printed uniforms or traditional clinical attire. Anxiety was assessed at baseline and on hospital days 2, 3, and 4 using validated age-appropriate scales: the modified Faces Anxiety Scale (ages 3–6) and the STAI-C short form (ages 7–12). Mixed-effects repeated-measures ANOVA demonstrated a significant group × time interaction (F(3,294) = 42.67, p < .001, partial η² = .304). Children cared for by nurses in cartoon uniforms showed a 48.8% reduction in anxiety compared to 14.7% in controls. Between-group effect sizes increased progressively across days (d = 0.87 to 2.13), indicating cumulative benefit rather than transient novelty. Clinically meaningful improvement (≥30% reduction) was achieved by 76% of intervention participants versus 24% of controls (NNT = 1.92). Staff acceptability was high (95%). Findings indicate that cartoon-printed uniforms are a simple, low-cost, high-impact environmental intervention that significantly enhances pediatric patient experience. Their strong clinical utility, ease of implementation, and alignment with child-centered care principles support adoption across pediatric healthcare settings.