Public Health Commons^™

Access To Care And Melanoma Incidence And Mortality In Nebraska, Natalia Trinidad

Capstone Experience: Master of Public Health

The purpose of this study is to determine incidence and mortality of melanoma across all counties in Nebraska in the context of access to primary care providers and dermatologists. Crude and age-adjusted incidence rates of melanoma from 2001-2016 by county were calculated for the following year intervals: 2001-2005, 2006-2010, 2011-2016. Variables for melanoma cases were obtained from the Nebraska Cancer Registry and included the case’s zip code at diagnosis, race, ethnicity, sex, age at diagnosis, year, cancer site, vital status, stage of disease, and the ICD-O code for the cancer type. Crude and age-adjusted mortality rates were calculated for the …

Explore Barriers Associated With Not Testing For Hiv Among Men Who Have Sex With Men In Dodoma, City, Tanzania, Maria M. Mushi

Capstone Experience: Master of Public Health

Goal

The goal of the project is to explore barriers associated with not testing for HIV among men who have sex with men (MSM) in Dodoma City, Tanzania.

Objectives

In order to achieve the goal of exploring barriers associated with not testing for HIV among MSM, I will plan and conduct the study, analyze the data, and prepare the final research report.

Methods

A qualitative descriptive study will be conducted in Dodoma City, Tanzania. A total of 10 MSM 19 years of age and above will be purposefully selected by 3 peer educators to be part of the study. I …

Improving Internal Reliability Of A Trauma-Informed Care Program Evaluation Instrument, Ashley A. Raposo-Hadley

Capstone Experience: Master of Public Health

The project has analyzed the recent changes to the trauma-informed care (TIC) curriculum evaluation instrument by assessing the changes in Cronbach’s Alpha scores and effect significance. Data was collected from pre-training and post-training surveys completed at the time of delivery of the TIC curriculum training. Participants included hospital staff and medical or nursing students at Nebraska Medicine, University of Nebraska Medicine Center, and Health Creighton University Medical Center. The three research questions are (1) Did the item edits change item subgroupings? (2) Did the item edits increase instrument reliability? (3) Did the item edits impact statistical significance? 3 subscales, working …

Preoccupation With Failure And Adherence To Shared Baselines: Measuring High-Reliability Organizational Culture, Jason M Etchegaray, Eric J Thomas, Jochen Profit

Faculty, Staff and Student Publications

OBJECTIVE: To create, administer, and psychometrically examine a survey to measure two new organizational culture factors - preoccupation with failure and adherence to shared baselines - in healthcare settings.

METHOD: Direct care providers (n = 4484) from a large healthcare system in the Southern United States completed a survey as part of their annual safety culture assessment.

RESULTS: We provide evidence about the internal consistency (Cronbach's alpha ranged from .80 to .89) factor structure, concurrent validity (correlation with overall patient safety grade ranged from .60 to .67, p

CONCLUSIONS: We established evidence for internal consistency and validity of two new …

Factors Associated With Eosinophilic Esophagitis In Nevada, Julia Lorraine Anderson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eosinophilic esophagitis (EoE) is a rare immune-mediated illness with symptoms that range from difficulty swallowing to food impaction of the esophagus. Most published studies have been documented among patients residing in cool regions with significant annual rainfall. No published studies to our knowledge have been performed examining the healthcare utilization trends of EoE in Nevada. Utilizing two unique databases, the factors associated with EoE healthcare utilization patterns in Nevada were examined. All analyses were performed in R version 3.5.1. This study included a demographic and regional analysis identifying risk factors associated with having an EoE healthcare visit in Nevada. Several …

Healthcare Access And Utilization By Transgender Populations: A United States Transgender Survey Study, Axenya Kachen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender communities in the United States are highly marginalized and have been systematically and infrastructurally ignored due to the widespread fundamental belief that gender exists as a binary classification. The dichotomous theoretical framework of sex and gender prevented public recognition of this community as a population of interest for public health research and targeted intervention. Sexual and gender minority (SGM) populations have fought for basic human rights, including access to affordable healthcare. The National Center for Transgender Equality (NCTE) was founded in 2003 to advocate for the advancement of equality for transgender people. In 2015, the NCTE conducted the United …

How Acceptable Is The Hiv/Aids Self-Testing Among Women Attending Immunization Clinics In Effurun, Southern Nigeria, Wasiu Olalekan Adebimpe, Doraebikeme Ebikeme, Olubukunola Omobuwa, Edward Oladejo

Marshall Journal of Medicine

HIV testing remains the gateway to HIV/AIDS prevention, treatment, care and support interventions. In Nigeria, a significant proportion of the populations do not know their HIV status. HIV self-testing done without the help of a healthcare provider could remove identified barriers to HIV testing, and close gaps in HIV treatment and prevention cascades. This study set out to assess the knowledge and acceptability of hiv self-testing (HIVST) among women of child bearing age attending immunization clinics in Effurun, Nigeria. A descriptive, cross-sectional study was conducted among 357 women of child-bearing age selected using multistage sampling technique. Research instrument used was …

Availability Of Long Acting Reversible Contraceptives For Adolescents In Urban Vs Rural West Virginia Counties, Brooke Andrews, Cameron Ross, Jennie L. Yoost

Marshall Journal of Medicine

The study objective was to evaluate long acting reversible contraceptive (LARC) method availability and access for adolescents in rural and urban counties in West Virginia (WV). A cross-sectional survey of Title X family planning providers throughout WV was conducted from January 2016-July 2017. This survey was sent to 226 family planning providers in WV to assess patterns of LARC availability. The survey assessed provider training level, LARC services provided and frequency, clinical practice, referral patterns, and comfort level providing adolescent LARC services. Survey results were analyzed by providers’ rural vs urban status, based on US census county codes. Survey responses …

Designing The Arriving Refugee Informatics Surveillance And Epidemiology (Arive) System: A Web-Based Electronic Database For Epidemiological Surveillance, William A. Mattingly, Ruth M. Carrico, Timothy L. Wiemken, Robert R. Kelley, Rebecca A. Ford, Rahel Bosson, Kimberley A. Buckner, Julio A. Ramirez

Journal of Refugee & Global Health

Objectives: We design and implement the Arriving Refugee Informatics surVeillance and Epidemiology (ARIVE) system to improve the health of refugees undergoing resettlement and enhance existing health surveillance networks.

Materials and Methods: Using the REDCap electronic data capture software as a basis we create a refugee health database incorporating data from the Center for Disease Control and Prevention’s Electronic Disease Notification (EDN) system and domestic screening data from refugee health care providers.

Results: Domestic screening and EDN refugee health data have been integrated for 13,824 refugees resettled from 35 different countries into the state of Kentucky from the years 2013-2016.

Discussion: …

Body Mass Index Z-Score Modifies The Association Between Added Sugar Intake And Arterial Stiffness In Youth With Type 1 Diabetes: The Search Nutrition Ancillary Study, Natalie S. The, Sarah C. Couch, Elaine M. Urbina, Jamie L. Crandell, Angela D. Liese, Dana Dabelea, Grace J. Kim, Janet A. Tooze, Jean M. Lawrence, Elizabeth J. Mayer-Davis

Faculty Publications

The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D(n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. …

The Implementation Analysis Of The Inclusion Of Health Warnings And Health Information Policy On Cigarette Packaging, Diah Ekawati, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Pictorial health warnings already implemented for more than two years since June 24, 2014, however, there are no changes made following the Minister of Health Regulation No. 28 of 2013 until now. According to the results of the National Survey of Assessment of the Implementation of Pictorial Health Warning (PHW) in Indonesia in 2015 towards the compliance of the tobacco industry, it is known that the cigarette industry has not yet adhered to pictorial health warnings. The Government hopesthat the existence of the Minister of Health Regulation No. 28 can reduce the prevalence of smokers, but data from 2016 SIRKERNAS …

Hear Me Out: An Evaluation Of The Services Provided To Parents Prior To A Diagnosis Of Hearing Loss, Amber Wagster

McNair Scholars Research

This study seeks to identify and evaluate the services provided to parents of children who did not pass their newborn hearing screening. This study will determine what educational services were offered and if they effectively-prepared parents for navigating the process of their child's potential hearing loss diagnosis. A questionnaire was distributed to parents through the offices of audiologists and through Hands & Voices, a parental advocacy organization.

The Determinant Of Outpatient Health Services Utilization For Elderly Patient In Indonesia (Susenas 2017 Data Analysis), Rizki Asriani Putri, Yaslis Ilyas

Journal of Indonesian Health Policy and Administration

Indonesia has entered an aging population as showed by the number of elderly population which has reached more than 7% of the population. Basically, the increase in the elderly population will also increase the number of illnesses, because the more a person ages, the physical condition will decrease and be more susceptible to disease. This research is a quantitative study that aims to determine the determinants of outpatient health service use for Indonesian elderly in 2017. This research used secondary data from the 2017 National Socio-Economic Survey (Susenas) results with the unit of analysis is people aged ≥ 60 years …

Puskesmas Readiness In Accreditation Implementation As Efforts To Improve The Health Service Quality In Sumbawa District, Nurul Saptorini Rahmadhani, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

. In achieving Universal Health Coverage in 2019, it is necessary to increase access and quality of health services to the community. Puskesmas accreditation is a method of improving the quality of service and patient safety as well as a condition to do collaboration with BPJS. According to Donabedian, quality of services needs to be supported by standardized structures, processes and outcomes which are oriented to internal and external customers. This study aims to analyze the readiness of Puskesmas in accreditation implementation as an effort to improve the quality of health services in Sumbawa Regency. This effort is an implementation …

Implementation Of Control Policy Of Diphtheria Outbreak And Outbreak Response Immunization (Ori) In Kota Depok, 2017, Dian Novita Sari, Anhari Achadi

Journal of Indonesian Health Policy and Administration

Diphtheria is a contributor to an outbreak (KLB) for some regions in Indonesia, included West Java Province. Diphtheria cases had increased through 2015 - 2016, the cases increased from 59 cases to 153 cases. Depok City became one of the contributors of diphtheria cases that have fluctuating incidents. Disease trends have decreased in 2013-2015 but then increased in 2016 to 8 cases. This study discusses policy implementation, viewed from policy sources, resource arrangements, the characteristics of implementing agencies, bureaucratic structures, communications, the influence of dispositions and socio-economic and political circumstances in control of Diphtheria Outbreak and Outbreak Response Immunization (ORI) …

Analysis Of Trends In The Availability Of Indicator Drugs And Vaccines In Public Health Center For 2016-2017, Aji Wicaksono, Kemal Nazarudin Siregar

Journal of Indonesian Health Policy and Administration

The health development strategies for 2015-2019 is about improving the availability, affordability, equity and quality of pharmaceuticals and medical devices. Since the enactment of national health insurance (JKN) on January 1, 2014, the availability of drug at the public health center become a very important aspect in primary health care services. Drug logistics management is an important aspect that influences accessibility to health services including the availability of essential drugs and vaccines. The aim of this study is to explore the trend of availability indicator drugs and vaccines in public health center for the period of 2016-2017 and drug logistics …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Celebrating A Quarter-Century Of Public Domain Research: 25th Annual Conference Of The Health Care Systems Research Network, Sarah M. Greene, Carolyn A. Taylor, Suma Vupputuri

Journal of Patient-Centered Research and Reviews

The 25th annual conference of the Health Care Systems Research Network (HCSRN) was held April 10–12 in Portland, Oregon, attracting 420 attendees. The HCSRN, a consortium of 18 community-based research organizations embedded in or affiliated with large health care delivery systems, has hosted annual research conferences since 1994. The primary objective of the conference is to convene researchers, project staff, funders, and other stakeholders to share latest scientific findings and cultivate new partnerships among research teams, patients, and clinicians. Collaboration is the cornerstone of the HCSRN’s success; the conference serves as a catalyst for a variety of collaborative ventures as …

House Calls Are Reaching The Tipping Point — Now We Need The Workforce, Thomas Cornwell

Journal of Patient-Centered Research and Reviews

Home-based primary care (HBPC) improves the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of HBPC, and improved payments for HBPC. There are 2 million to 4 million patients who could benefit from HBPC, but only 12% are receiving it. The number of these patients is expected to double over the next two decades. This requires a larger and better …

Measuring Patients’ Perceptions Of Health Care Encounters: Examining The Factor Structure Of The Revised Patient Perception Of Patient-Centeredness (Pppc-R) Questionnaire, Bridget L. Ryan, Judith Belle Brown, Paul F. Tremblay, Moira Stewart

Journal of Patient-Centered Research and Reviews

Purpose: Given the ongoing desire to make health care more patient-centered and growing evidence supporting the provision of patient-centered care, it is important to have valid tools for measuring patient-centered care. The patient-centered clinical method (PCCM) is a conceptual framework for providing patient-centered care. A revision to the PCCM framework led to a corresponding need to enhance the Patient Perception of Patient-Centeredness (PPPC) questionnaire. The original PPPC was aligned with the components of the PCCM conceptual framework and developed to measure patient-centeredness from the patient’s perspective. The purpose of this study was to examine the factor structure of a revised …

A Letter To My Departed Niece, * Anonymous *

Journal of Patient-Centered Research and Reviews

The following piece was written in the weeks following the death of the author’s niece. It is an attempt to explore how we as a society handle health crises differently for medical versus mental health diagnoses.

Across Continents And Demographics, Unpredictable Maternal Signals Are Associated With Children's Cognitive Function, Elyssia Poggi Davis, Riikka Korja, Linnea Karlsson, Laura Glynn, Curt A. Sandman, Brian Vegetabile, Eeva-Leena Kataja, Saara Nolvi, Eija Sinervä, Juho Pelto, Hasse Karlsson, Hal S. Stern, Tallie Z. Baram

Psychology Faculty Articles and Research

Background

Early life experiences have persisting influence on brain function throughout life. Maternal signals constitute a primary source of early life experiences, and their quantity and quality during sensitive developmental periods exert enduring effects on cognitive function and emotional and social behaviors. Here we examined if, in addition to established qualitative dimensions of maternal behavior during her interactions with her infant and child, patterns of maternal signals may contribute to the maturation of children's executive functions. We focused primarily on effortful control, a potent predictor of mental health outcomes later in life.

Methods

In two independent prospective cohorts in Turku, …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern: Impact of Employee Relationships in Financially Distressed and Highly Financially Distressed Hospitals

Do Employees From Less-Healthy Communities Use More Care And Cost More? Seeking To Establish A Business Case For Investment In Community Health., Russell K. Mcintire, Martha C. Romney, Greg Alonzo, Jill Hutt, Lauren Bartolome, Greg Wood, Gary Klein, Neil I. Goldfarb

College of Population Health Faculty Papers

INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities.

METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel …

Call For Submissions Special Issue - July 2020: Patient & Family Experience In Behavioral Health, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2020 special issue on the topic of patient & family experience in behavioral health. With a continued focus on the critical role of behavioral health in society today and a growing recognition of the importance of experience for those in behavioral health settings, a conversation on the practices in place and the identification of evidence of efforts leading to positive outcomes will be essential expanding the experience conversation in this setting. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices …

“Anyone Can Co-Design?”: A Case Study Synthesis Of Six Experience-Based Co-Design (Ebcd) Projects For Healthcare Systems Improvement In New South Wales, Australia, Tara L. Dimopoulos-Bick, Claire O'Connor, Jane Montgomery, Tracey Szanto, Marion Fisher, Violeta Sutherland, Helen Baines, Phillip Orcher, John Stubbs, Lynne Maher, Raj Verma, Victoria J. Palmer

Patient Experience Journal

Experience-based co-design (EBCD) is a quality improvement approach that is being used internationally to bring service users and health professionals together to improve healthcare experiences, systems and processes. Early evaluations and case studies of EBCD have shown promise in terms of improvements to experience and organisational processes, however challenges remain in participation around shared power and decision making, mobilisation for implementation, sustainment of improvements and measurement of outcomes. The objective of this case study was to explore the emergent issues in EBCD participation and implementation in six quality improvement projects conducted in mental health, rehabilitation, blood and bone marrow transplant, …

Engagement Of Patients With Scleroderma To Revise An Internet Self-Management Program, Janet L. Poole, Sharon L. Newbill, Jennifer Serrano, Dana Rosson, Josephine Battyany, Laura Dyas, Luke Evnin, Dennis W. Raisch, Cynthia Maxwell, Mary Alore, Saville Kellner, Pedro Cuencas, Richard M. Silver, Dinesh Khanna

Patient Experience Journal

Systemic sclerosis (SSc) or scleroderma is a rare connective tissue disease. Many people do not have access to education programs. A self-management program was developed several years ago based on the literature and input from people with SSc. However, new therapies and treatment options have been developed since the program was developed. The purpose of this qualitative study was to identify and remedy gaps in an internet SSc self-management program to improve the quality of critical information relevant to effective management of the disease. Six focus groups with 30 participants with SSc were conducted: 2 telephone groups and 4 face-to-face …

Involving Patients And Families In A Social Robot Study, Lillian Hung, Annette Berndt, Christine Wallsworth, Neil Horne, Mario Gregorio, Jim Mann, Cindy Liu, Evan Woldum, Andy Au-Yeung, Habib Chaudhury

Patient Experience Journal

Innovative research in care practice for older people can benefit from the active involvement of patient and family partners. Involvement may begin with identifying priorities, then move to formulate research questions and to plan the research methods, to data collection, and finally to analysis and knowledge dissemination. However, in the field of dementia care, actively engaging patients and families in co-research is a novel practice that needs exploration. This paper describes the experiences and perspectives of two patient researchers and three family researchers, along with four clinicians (two physicians, a nurse, and an occupational therapist) within a social robot project …

A Next-Day, Brief E-Survey Overcomes The Excessive Variability Seen In Cahps-Style Emergency Department Surveys So That Individual Physician Performance Can Be Assessed On A Regular Basis, Tom Scaletta, Eva Hare, Christopher Sung Lee

Patient Experience Journal

Traditional CAHPS-style emergency department (ED) surveys result in excessive variability when assessing individual physician performance. The objective of this study is to measure the variability of a brief, electronic survey (e-survey). The study team also measured the association of individual physicians to demographic data, physician and patient factors, and a physician burnout assessment tool. Data from SmartContact (SmartER, La Grange, IL) is a next-day, e-survey that takes about 30-seconds to complete. This tool was used by a hospital-employed emergency department (ED) group during calendar year 2017 across 2 EDs and 37 physicians.^1,2 Variability was estimated regarding raw patient experience …

Beneath The Surface Of Talking About Physicians: A Statistical Model Of Language For Patient Experience Comments, Taylor Turpen, Lea Matthews Md, Senem Guney Phd, Cpxp

Patient Experience Journal

This study applies natural language processing (NLP) techniques to patient experience comments. Our goal was to examine the language describing care experiences with two groups of physicians: those with scores in the top 100 and those with scores in the bottom 100 among all physicians (n=498) who received scores from patient satisfaction surveys. Our analysis showed a statistically significant difference in the language used to describe care experiences with these two distinct groups of physicians. This analysis illustrates how to apply NLP techniques in categorizing and building a statistical model for language use in order to identify meaningful language and …