Public Health Commons^™

Creating A Common Trajectory: Shared Decision Making And Distributed Cognition In Medical Consultations, Katherine D. Lippa, Valerie L. Shalin

Patient Experience Journal

The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patients and assess how distributed clinical cognition functions during interactions between medical professionals and patients with Multiple Sclerosis (MS). A combination of cognitive task analysis and discourse analysis reveals the distribution of clinical reasoning between 24 patients and 3 medical professionals engaged in MS management. Findings suggest that cognition was distributed between patients and physicians in all major tasks except …

Improving The Patient Experience Through A Commit To Sit Service Excellence Initiative, Cari D. Lidgett

Patient Experience Journal

Effective communication between nurses and patients positively impacts patient care, outcomes, and the patient experience.While in the hospital, patients receive information from multiple caregivers and are often overwhelmed and confused. Nurses make up the majority of interactions with patients and are in an ideal position to improve the patient experience from the front lines. The purpose of implementing the Commit to Sit service excellence initiative was to positively impact the patient’s perception of nurse communication by nurses sitting with their patients during each shift. Outcomes were measured by the overall nurse communication composite on the Press Ganey survey, as well …

Beyond Patient-Centered Care: Enhancing The Patient Experience In Mental Health Services Through Patient-Perspective Care, Timothy A. Carey Prof

Patient Experience Journal

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To …

Patient Organizations And Primary Care Development: Reflections By Patients With Chronic Diseases, Britta E. Berglund, Irene Westerlund

Patient Experience Journal

To explore how patients with chronic diseases, as well as members of patient organizations, perceive primary care and how they think about how to participate in primary care development. Focus group interviews with 28 patients in three regions in Sweden were conducted. We identified four themes: Availability of care, How to be met by professionals, Information needs and Continuity and prevention in care. Important was to meet the same doctor at every visit and to be met with empathy and knowledge about your disease. Suggestions about better use of technical information services, introduction of a coordinator in the waiting room …

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …

Why Human Resources Policies And Practices Are Critical To Improving The Patient Experience, Shari Berman

Patient Experience Journal

While providing patient-centered care seems to be a goal for many organizations, delivering on this goal requires practices which are embedded in the organization, which incent patient-centered behavior. The author argues Human Resources (HR) policies, procedures and programs are key to supporting an organizations’ vision and culture. This means an HR executive partnering with the CEO who sets the vision and HR builds programs to support the vision. As the organization understands what is important to patients and how to best serve them, HR can build patient care improvement into every aspect of the organization. The author describes how competency …

‘First, Do No Harm’: Shifting The Paradigm Towards A Culture Of Health, Karen Luxford

Patient Experience Journal

Over the past 17 years since the release of the Institute of Medicine report ‘To Err is Human’,¹ health services and agencies around the world have increasingly focused on improving the safety and quality of health care. Historically, the commitment by health care professionals to ‘first do no harm’ has produced a focus on the absence of interventions that may cause adverse outcomes. This clinical approach links to the Hippocratic Oath which includes the promise "to abstain from doing harm". The Oath reminds clinicians to first consider the possible harm that any intervention might do. This approach to interactions …

The Experience Era Is Upon Us, Jason A. Wolf Phd

Patient Experience Journal

In this moment in healthcare, the challenges for those in the system are dynamically shifting and the perspectives, desires and needs of the healthcare consumer are putting positive and lasting pressures on how healthcare works that will shift healthcare from where it has been to where it must go. At the heart of this transition are the ideas framing an experience era, where collaborative, consumer-focused and purposeful actions can and will lead to a healthcare system returning to its fundamental calling, that of human beings caring for human beings. In doing so we can change the nature of healthcare and …

Rhabdomyosarcoma Incidence And Survival In Whites, Blacks, And Hispanics From 1973-2013: Analysis From The Surveillance, Epidemiology, And End Results Program, Heather Tinsley

USF Tampa Graduate Theses and Dissertations

Purpose

Our objectives were to 1) determine the difference in Rhabdomyosarcoma (RMS) incidence and survival between different race/ethnicity groups, and 2) evaluate the difference in survival of RMS between children and adults of these race/ethnicity groups, using the Surveillance, Epidemiology, and End Results Program (SEER) database between 1973-2013.

Patients and Methods

We analyzed racial characteristic and incidence data from 4,280 patients diagnosed with RMS, between 1973-2013, that were reported to the SEER database. Survival and hazard analyses were conducted on 4,268 patients with known follow-up data, with end point being death from any cause.

Results

Over the 40-year study period …

Access To Health Services And Health Seeking Behavior Among Former Child Soldiers In Manizales, Colombia, Adriana Marcella Dail

USF Tampa Graduate Theses and Dissertations

Through the Colombian Institute for Family Welfare (ICBF), the Colombian government aims to provide comprehensive reintegration for children demobilized from the country’s various armed groups. The reestablishment of rights, including the right to health (guaranteed by the Colombian constitution), is a key factor in successful reintegration. This thesis explores the topic of access to health care and health seeking behavior among former child soldiers in Manizales, Colombia who are over the age of 18 and were previously in the Hogar Tutor program (foster care-based youth reintegration) in Manizales. This thesis utilizes semi-structured interviews (n=9) and body mapping (n=9) with former …

Late Newborn Hearing Screening, Late Follow-Up, And Multiple Follow-Ups Increase The Risk Of Incomplete Audiologic Diagnosis Evaluation, Tri Tran, Ian Ng, Thiravat Choojitarom, Jeanette Webb, Wendy Jumonville, Mary Jo Smith, Terri Ibieta, Melinda Peat, Susan Berry

Journal of Early Hearing Detection and Intervention

This study aimed to determine whether the following factors were associated with an incomplete audiologic diagnosis evaluation (IAD): age at newborn screening, length of time between newborn screening and first follow-up, and total number of follow-ups. 2011-2013 linked Louisiana Early Hearing Detection and Intervention data and birth records were analyzed. Logistic regression models were used to evaluate different effects of the predictors on IAD among birth weight groups. In very low birth weight newborns, there were no statistical associations of IAD with age at NHS or length of time between NHS and first follow-up, but there was with the number …

Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud.

Journal of Early Hearing Detection and Intervention

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive and social functioning. Although technology such as hearing aids and cochlear implants are an option for providing access to sound, they fail to teach the child how to listen or attend, how to process language (whether visual or spoken), or how to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet …

Time Trend And Factors Associated With Late Enrollment In Early Intervention Among Children With Permanent Hearing Loss In Louisiana 2008-2013, Tri Tran, Yao Wang, Mary Jo Smith, Brenda Sharp, Terri Ibieta, Jeanette Webb, Wendy Jumonville, Melinda Peat, Susan Berry

Journal of Early Hearing Detection and Intervention

This study aimed to identify the time trend of and factors associated with late enrollment in early intervention (EI) services among children with permanent hearing loss (HL) born between 2008 and 2013 in Louisiana. 2008-2013 linked Louisiana Early Hearing Detection and Intervention, birth records, EarlySteps (IDEA, Part C), Parent-Pupil Education Program, and Medicaid data were analyzed. Logistic regression models were used to evaluate the trend and associations of mother and child’s demographic and hearing loss characteristics with late EI enrollment. Results of data analyses did not show any trend of late enrollment in EI services from 2008 to 2013. Delayed …

Prevalence And Trends Of Childhood Hearing Loss Based On Federally-Funded National Surveys: 1994–2013, Tyson S. Barrett, Karl R. White

Journal of Early Hearing Detection and Intervention

A recent highly cited publication, using data from the National Health and Nutrition Examination Survey (NHANES), concluded that the prevalence of childhood hearing loss in the United States is increasing (Shargorodsky, Curan, Curhan, & Eavey, 2010). This article examines the accuracy of that conclusion based on additional data from three nationally-representative surveys of childhood health. Using data from NHANES, the National Survey of Children’s Health (NSCH), and the National Health Interview Survey (NHIS), logistic regression was used to assess trends from audiometry-measured and parent-reported childhood hearing loss.

In contrast to prior research, the results were highly conflicting. NHANES suggested both …

Progress In Standardization Of Reporting And Analysis Of Data From Early Hearing Detection And Intervention (Ehdi) Programs, Suhana Alam, Ashley Satterfield, Xidong Deng, Craig A. Mason

Journal of Early Hearing Detection and Intervention

Congenital hearing loss affects one to three of every 1,000 live born infants. If left undetected, it may negatively impact children through delayed speech and language development. To help avoid developmental delays and ensure that deaf or hard of hearing (DHH) infants are identified and receiving services as early as possible, complete and accurate data are crucial. Despite substantial progress made over the years, some children are still delayed in identification and/or lost to the early hearing detection and intervention (EHDI) surveillance and tracking systems. Lack of standardization in data reporting contributes to this issue. This article discusses reasons for …

Predictive Mapping Of Mycobacterium Tuberculosis At The County Level In The State Of Florida, Ali Moradi

USF Tampa Graduate Theses and Dissertations

Introduction: One of the major barriers to developing an accurate tuberculosis (TB) surveillance program for Florida is the design and implementation of a sampling system that will adequately monitor and predict varying sizes and characteristics of county-level vulnerable endemic sub-populations and their explanatory covariates (e.g., living or working in a residential care facility). The aim of this research study is to envision an endemic, tuberculosis-related web-based interface for use by public health officials in the State of Florida which includes generating essential information such as a real-time syndrome-based reporting to regulate automated and immediate 'Alerts' to public health officials, doctors, …

Hiv/Stis And Intimate Partner Violence: Results From The Togo 2013-2014 Demographic And Health Surveys, Anthony H. Nguyen

USF Tampa Graduate Theses and Dissertations

Background: Among clinic based studies, intimate partner violence (IPV) has been shown to contribute to HIV/AIDS among young girls and women. Results from studies among the general population have been less consistent. This study evaluated the associations between HIV infection, any sexually transmitted infections, and IPV in a population based sample of Togolese women.

Methods: Data from the Togo 2013-2014 Demographic and Health Surveys were utilized for these analyses. Women aged 15-49 who were currently married, had HIV test results and answered the Domestic Violence Module were analyzed (n = 2386). Generalized linear mixed-models adjusting for sociodemographic variables, risk behaviors, …

Association Between Folate Levels And Preterm Birth In Tampa, Florida, Carolyn Heeraman

USF Tampa Graduate Theses and Dissertations

Background: Preterm birth is one of the leading causes of perinatal mortality and morbidity and poses extensive economic liability. The rate of preterm births globally is approximately 11.1%, and in the US, the preterm birth rate has been estimated to be 12-13%. Folate and B₁₂ requirements increase during pregnancy as a result of increased cell division to accommodate maternal and fetal growth; inadequate levels can result in placental abnormalities and thus present implications for preterm birth.

Objective: To investigate the association between red blood cell (RBC) folate and B₁₂ concentrations with the risk of preterm birth.

Methods: Study …

The Abortion Question: A Nonsectarian Approach, Robert M. Byrn

The Catholic Lawyer

No abstract provided.

Eating Well (When You Can): Food Security Among Stateside Puerto Ricans, Melissa Fuster, Center For Puerto Rican Studies

CUNY Centro, The Center for Puerto Rican Studies

Food security among Puerto Rican households is low. Food security is defined as having “access by all people at all times to enough food for an active, healthy life” (1). Conversely, food insecurity implies limited or uncertain access to healthy foods (1). This economic and social condition has been associated with poor health outcomes, including chronic-diet related conditions, as well as decreases in mental health — conditions that also affect the stateside Puerto Rican community in a disproportionate manner. This brief presents trends and a research overview of the food security situation among stateside Puerto Ricans. The aim of this …

Policy Brief: Expanding Food Benefits For Immigrants: Charting A Policy Agenda For New York City, Anabel Perez-Jimenez, Nicholas Freudenberg

Publications and Research

This policy brief explores the eligibility of various categories of New York City’s immigrant populations, from those who have become citizens to permanent residents (Green Card holders) to those who lack legal immigration status, for SNAP, WIC and School Food, the nation’s main food benefit programs. We also examine factors that facilitate or block immigrants’ enrollment in these programs. Our larger goals are to encourage more systematic study of immigrant access to food benefits and identify opportunities for improving access. We hope to widen a public conversation among immigrants and their organizations, food security groups, food justice advocates and policy …

Grant Application: The Une Flu Crew: An Interdisciplinary Approach To The Assessment Of Knowledge, Beliefs And Perceptions Surrounding Influenza Immunizations And The Promotion Of Preventing Infection, Jeff Wisniowski, Christina Tsui, Samantha Grela, Marissa Laramie, Cameron Bubar

UNE Flu Crew

IPEC Mini-grant application for funding of UNE student project The UNE Flu Crew: An Interdisciplinary Approach to the Assessment of Knowledge, Beliefs and Perceptions surrounding Influenza Immunizations and the Promotion of Preventing Infection. Osteopathic medicine and public health students collaborated to assess the knowledge and perceptions regarding the influenza vaccine among the University of New England’s student and faculty populations. The project also provided a peer-to-peer education model where members of the Flu Crew designed a teaching curriculum and provided community outreach to the UNE Biddeford campus and local community schools.

Results From Ireland North And South's 2016 Report Card On Physical Activity For Children And Youth, Deirdre M. Harrington, Marie Murphy, Angela Carlin, Tara Coppinger, Alan Donnelly, Kieran P. Dowd, Teresa Keating, Niamh Murphy, Elaine Murtagh, Wesley O'Brien, Catherine Woods, Sarahjane Belton

Publications

Background: Physical activity (PA) is a key performance indicator for policy documents in both the Republic of Ireland and Northern Ireland. Building on baseline grades set in 2014, Ireland's second Report Card on Physical Activity for Children and Youth allows for continued surveillance of indicators related to PA in children and youth. Methods: Data and information were extracted and collated for 10 indicators and graded using an international standardized grading system. Results: Overall, 7 grades stayed the same, 2 increased, and 1 decreased. Grades were assigned as follows: Overall PA, D (an increase); Sedentary Behavior (TV), C-; Physical Education, D-; …

Perceptions Of And Preferences For A Mobile Health Clinic For Underserved Populations, Melinda Gillispie, Catherine Mobley, Lynette M. Gibson, Arelis Moore De Peralta

Publications

Background: Research has established that members of particular demographic groups are inordinately burdened by differential healthcare access. Mobile health clinics (MHCs) are emerging across health systems to improve access to care of marginalized populations. This study explored the perceptions and concerns of community residents living in underserved neighborhoods toward MHC services.

Methods: This study used a qualitative descriptive design with 5 focus group meetings. Purposive sampling was used to recruit ethnically diverse, English- and Spanish-speaking men and women ages 20–67 residing in 5 underserved neighborhoods in Greenville County, SC.

Results: Participants (N = 35) felt positive about obtaining personalized health …

Chemokine Levels In The Penile Coronal Sulcus Correlate With Hiv-1 Acquisition And Are Reduced By Male Circumcision In Rakai, Uganda., Jessica L Prodger, Ronald H Gray, Brett Shannon, Kamnoosh Shahabi, Xiangrong Kong, Kate Grabowski, Godfrey Kigozi, Fred Nalugoda, David Serwadda, Maria J Wawer, Steven J Reynolds, Cindy M. Liu, Aaron A R Tobian, Rupert Kaul

Environmental and Occupational Health Faculty Publications

Individual susceptibility to HIV is heterogeneous, but the biological mechanisms explaining differences are incompletely understood. We hypothesized that penile inflammation may increase HIV susceptibility in men by recruiting permissive CD4 T cells, and that male circumcision may decrease HIV susceptibility in part by reducing genital inflammation. We used multi-array technology to measure levels of seven cytokines in coronal sulcus (penile) swabs collected longitudinally from initially uncircumcised men enrolled in a randomized trial of circumcision in Rakai, Uganda. Coronal sulcus cytokine levels were compared between men who acquired HIV and controls who remained seronegative. Cytokines were also compared within men before …

Concluding Commentary: Children In All Cancer Prevention Policy Decisions., Cynthia F Bearer, Lynn Goldman

Environmental and Occupational Health Faculty Publications

This interesting series of articles on Opportunities for Cancer Prevention During Early Life brings many ideas for the primary prevention of cancer in childhood, or in adults due to early life events. The economic burden not only of cancer mortality but also of lifelong morbidity among cancer survivors, as shown by Guy et al,1 raises the importance of this critical public health issue. The topics of these articles were developed during online seminars with the pioneers in this area, some of whom authored the articles. They reflect the determinants of health diagrammed so eloquently in Healthy People 2020.2 …

How We Care: Provider Perspectives On Services For Vietnamese Elderly In Boston’S Dorchester Neighborhood, Loan Thi Dao

Institute for Asian American Studies Publications

The need for culturally competent care for the elderly is of growing concern for Asian American and Pacific Islander (AAPI) communities and health providers. In 2012, a preliminary study was conducted to ascertain the perspectives of service providers about the cultural competency of services for elderly Vietnamese Americans in Boston, Massachusetts. The study includes interviews with key informants representing the five major community health centers (CHC) programs in Boston’s Vietnamese enclave in the Dorchester neighborhood. Secondary data collection from field observations and informal communications with other staff and elderly clients also inform the findings. While the study recognizes the value …

Circumcision Status Is Not Associated With Condom Use And Prevalence Of Sexually Transmitted Infections Among Young Black Msm, Richard A. Crosby, Cynthia A. Graham, Leandro Mena, William L. Yarber, Stephanie A. Sanders, Robin R. Milhausen, Angelica Geter

Health, Behavior & Society Faculty Publications

This study investigated whether intact young Black MSM differed from their circumcised counterparts regarding condom use behaviors and perceptions and HIV/Chlamydia/gonorrhea. Young Black MSM completed a self-interview, including a pictorial item assessing circumcision status and measures of condom use. Twenty-seven percent of 388 participants reported not being circumcised. With one exception, no associations tested approached significance. The mean frequency of unprotected insertive anal sex for circumcised men was about twice as high compared to those intact (P = .04). Intact young Black MSM did not differ from circumcised men relative to prevalence of STIs (including HIV) or condom use behaviors …

Accuracy Of Name And Age Data Provided About Network Members In A Social Network Study Of People Who Use Drugs: Implications For Constructing Sociometric Networks, April M. Young, Abby E. Rudolph, Amanda E. Su, Lee King, Susan Jent, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Purpose—Network analysis has become increasingly popular in epidemiologic research, but the accuracy of data key to constructing risk networks is largely unknown. Using network data from people who use drugs (PWUD), the study examined how accurately PWUD reported their network members’ (i.e., alters’) names and ages.

Methods—Data were collected from 2008 to 2010 from 503 PWUD residing in rural Appalachia. Network ties (n=897) involved recent (past 6 months) sex, drug co-usage, and/or social support. Participants provided alters’ names, ages, and relationship-level characteristics; these data were cross-referenced to that of other participants to identify participant-participant relationships and to determine …