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Full-Text Articles in Public Health

Hiv Treatment Utilization: An Exploration Of One Ryan White Clinic, Joseph Powe May 2023

Hiv Treatment Utilization: An Exploration Of One Ryan White Clinic, Joseph Powe

MUSC Theses and Dissertations

According to the findings of recent research, the HIV epidemic is still an active problem all over the world. Some racial and ethnic groups have a significantly higher likelihood of contracting HIV, even though many efforts have been made at all levels of government, from the municipal to the federal, to raise public awareness of the recognized risk. There are two focal points for the HIV epidemic. While prevention is essential, infected patients must also be encouraged to continue treatment to accomplish viral suppression and delay the onset of AIDS. When we look more deeply at a local Ryan White …


Dance/Movement Therapy Used As An Intervention To Heal Racial Trauma Within The Black Community: A Literature Review, Jennifer Noboise May 2023

Dance/Movement Therapy Used As An Intervention To Heal Racial Trauma Within The Black Community: A Literature Review, Jennifer Noboise

Expressive Therapies Capstone Theses

The history of dance within the black community has served an important role while living through a racist and discriminatory society. Dance has been used to express anger, grief, and joy during hardships and moments of rejoicing from the black experience. African American people have endured years of trauma and abuse from oppressive systems. Research has been conducted to demonstrate that dance/movement therapy has been effective in treating those who have experienced a form of trauma since the trauma is stored in the body. Examining trauma symptoms such as anxiety, depression, and substance use, the research found these symptoms diminished …


Epidemiology Of Island And Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, And Metabolic Diseases?, Jake Thomas D. Palisoc May 2023

Epidemiology Of Island And Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, And Metabolic Diseases?, Jake Thomas D. Palisoc

Honors Projects

Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage …


Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe May 2023

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …


Social Creatures: The Impact Of Solitary Confinement On Psychophysiological Health And How Inmates Percieve Their Humanity And Social Well-Being, Julia Austin May 2023

Social Creatures: The Impact Of Solitary Confinement On Psychophysiological Health And How Inmates Percieve Their Humanity And Social Well-Being, Julia Austin

Honors Projects

This paper will define and examine the use of solitary confinement within the United States prison system and review its mental, physical, and social impacts. As social creatures, human mental and physical well-being depends on meaningful social interactions absent in segregation units. As it currently stands, vulnerable populations, including racial minorities, LGBTQIA+ individuals, and those with developmental disabilities or psychological disorders, are at risk of irrevocable harm and abuse within these facilities from staff as well as other inmates. With a rotating 80,000 inmates held in solitary confinement every day, the current structure of the prison system deemphasizes rehabilitation and …


Facilitators And Barriers To Effective Scale-Up Of Evidence-Based Nonprofit-Level Hiv Prevention And Treatment Interventions Among Black Men Who Have Sex With Men (Msm), Ugochukwu C. Uzoeghelu May 2023

Facilitators And Barriers To Effective Scale-Up Of Evidence-Based Nonprofit-Level Hiv Prevention And Treatment Interventions Among Black Men Who Have Sex With Men (Msm), Ugochukwu C. Uzoeghelu

Master's Projects and Capstones

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple in nonprofit settings, it is crucial to examine processes that occur in the translation of the EBIs into practice that affect successful implementation through the lens of nonprofit principles and practices. This paper examines the facilitators and barriers to effective scale-up of evidence-based HIV prevention and treatment services for nonprofit health organizations that serve Black men who have sex with men (MSM). I interviewed nonprofit health organizations (n = 4) engaged in the global response to end the HIV epidemic, specifically those who provide HIV prevention and …


Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb May 2023

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …


Trends And Determinants Of Modern Contraceptive Utilisation Among Adolescent Girls Aged 15-19 Years In Sierra Leone: An Analysis Of Demographic And Health Surveys, 2008-2019, Emmanuel Olal, Fassou Mathias Grovogui, Ritah Nantale, Quraish Sserwanja, Chola Nakazwe, Lilian Nuwabaine, David Mukunya, Eric Nzirakaindi Ikoona, Lenka Benova May 2023

Trends And Determinants Of Modern Contraceptive Utilisation Among Adolescent Girls Aged 15-19 Years In Sierra Leone: An Analysis Of Demographic And Health Surveys, 2008-2019, Emmanuel Olal, Fassou Mathias Grovogui, Ritah Nantale, Quraish Sserwanja, Chola Nakazwe, Lilian Nuwabaine, David Mukunya, Eric Nzirakaindi Ikoona, Lenka Benova

School of Nursing & Midwifery, East Africa

Background

Modern contraceptives are effective interventions for preventing unwanted pregnancies, but their use remain low among adolescent girls in sub-Saharan Africa. First, we aimed to assess the trends of modern contraceptive use among adolescent girls aged 15-19 years in Sierra Leone in the period 2008-2019. Second, we explored how individual and contextual determinants of their use changed during this period.

Methods

We used a combined sample of 8,774 adolescent girls aged 15-19 years from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS), respectively, to estimate the modern contraceptive prevalence rate (MCPR) and unmet need for family …


Explaining Adult Obesity, Severe Obesity, And Bmi: Five Decades Of Change, Ashley W. Kranjac, Dinko Kranjac May 2023

Explaining Adult Obesity, Severe Obesity, And Bmi: Five Decades Of Change, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971–2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall …


Joint Effect Of Human Papillomavirus Exposure, Smoking And Alcohol On Risk Of Oral Squamous Cell Carcinoma, Zheng Yang, Peng Sun, Kristina R Dahlstrom, Neil Gross, Guojun Li May 2023

Joint Effect Of Human Papillomavirus Exposure, Smoking And Alcohol On Risk Of Oral Squamous Cell Carcinoma, Zheng Yang, Peng Sun, Kristina R Dahlstrom, Neil Gross, Guojun Li

Faculty, Staff and Students Publications

BACKGROUND: Smoking, alcohol consumption, and human papillomavirus (HPV) infection are known risk factors for oral squamous cell carcinoma (OSCC) including SCC of oropharynx (SCCOP) and SCC of oral cavity (SCCOC). Researchers have examined each of these risk factors independently, but few have observed the potential risk of their interaction. This study investigated the interactions among these risk factors and risk of OSCC.

METHODS: Totally 377 patients with newly diagnosed SCCOP and SCCOC and 433 frequency-matched cancer-free controls by age and sex were included. Multivariable logistic regression was performed to calculate ORs and 95% CIs.

RESULTS: We found that overall OSCC …


Analytical Approach For Monitoring The Behavior Of Patients With Pancreatic Adenocarcinoma At Different Stages As A Function Of Time, Aditya Chakaborty Dr, Chris P. Tsokos Dr May 2023

Analytical Approach For Monitoring The Behavior Of Patients With Pancreatic Adenocarcinoma At Different Stages As A Function Of Time, Aditya Chakaborty Dr, Chris P. Tsokos Dr

Biology and Medicine Through Mathematics Conference

No abstract provided.


Living Separate Lives: How To Nurture A Work-Life Balance, Amanda Bullington May 2023

Living Separate Lives: How To Nurture A Work-Life Balance, Amanda Bullington

OVGTSL 2023: Ongoing Challenges, Creative Solutions

Librarians faced many challenges during the COVID-19 pandemic. Many of us quite literally brought our work home with us as we learned to interact with our colleagues virtually and adapted to performing our job duties from home. During this time, I was handed an additional personal challenge. I was diagnosed with a chronic health condition requiring multiple surgeries. I was now not only struggling to work from home as a cataloger but struggling to work from home as a cataloger while managing my daily pain. As someone who does not enjoy working from home, this seemed like an impossible challenge. …


Improving Health Outcomes For Lgbtq+ Youth Through Provider Education, Marissa Simko May 2023

Improving Health Outcomes For Lgbtq+ Youth Through Provider Education, Marissa Simko

Doctor of Nursing Practice (DNP) Projects

Background and Problem: LGBTQ+ adolescents and young adults (ages 12-25 years) are known to have higher rates of physical and mental health concerns compared to heterosexual and cisgender youth. Within the LGBTQ+ youth community, rates of suicidality, substance misuse, homelessness, and STIs are higher than in the general population. LGBTQ+ youth have greater challenges accessing healthcare and higher rates of healthcare discrimination. This paper presents a quality improvement project focused on improving evidence-based practices in LGBTQ+ healthcare through the development and implementation of a LGBTQ+ youth centered educational workshop for healthcare providers.

Methods: This project was organized in …


Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna May 2023

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure (HF) patients have a high risk of rehospitalization after discharge from acute care. Post-discharge management of HF patients requires coordinating services outside the hospital, such as skilled nursing and home health care to address patients’ complex needs.

Local Problem. High HF readmission rates negatively impact a hospital’s efficiency and pose a risk of financial penalties. In the project setting, the HF patients discharged to skilled nursing facilities and home health agencies had a higher rate of 30-day readmission than patients discharged to home.

Methods: Fourteen post-acute care (PAC) facilities were selected for the interventions. The …


Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval May 2023

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …


Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne May 2023

Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne

Seton Hall University Dissertations and Theses (ETDs)

Burnout is a problem among workers in Nigeria, especially among nurses (Ozumba, & Alabere, 2019). This study examined whether there was a significant relationship between the employee perception of the servant leadership behaviors of the nurse supervisor and the employee’s self-rating of burnout: exhaustion and disengagement, and servant leadership behaviors of the nurse supervisor, and engagement: vigor, dedication, and absorption. Exhaustion refers to an intensive physical, affective, and cognitive strain while disengagement refers to the distancing of oneself from one’s work, and experiencing negative attitudes toward the work object, work content, or one’s work in general (Demerouti et al., 2001). …


Building Sustainable Environmental Activism Programs For Youth, Aminah Habib May 2023

Building Sustainable Environmental Activism Programs For Youth, Aminah Habib

Master's Projects and Capstones

As the negative impacts of climate change become more and more common across the United States, many youth are experiencing eco-anxiety or other negative mental health impacts due to the state of the environment. Engaging with activism has been named as a potential mitigator of the negative impacts of climate change among youth, but the relationship between activism and youth well-being is an emerging area of research. To explore this relationship, this scoping review explored and synthesized available literature to inform the next steps. In addition to the community-level and society-level contributions that come from youth activism, there are also …


The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne May 2023

The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne

Master's Projects and Capstones

Problem: Numerous recent studies have emerged detailing the benefits of horticultural therapy on mental health and wellness. Despite this, substance use disorder treatment facilities rarely include an outdoor component in their programming. The project seeks to examine the advantages of incorporating therapeutic gardening as a complementary part of addiction treatment.

Context: The microsystem where the study was conducted was at a 32-bed residential substance abuse treatment facility for adult men who have previously been involved in the criminal justice system. The treatment approach employed at the facility aligns with the Integrated Dual Disorder Treatment (IDDT) curriculum, which emphasizes mental health-informed …


Health Services Use Among Formerly Incarcerated Louisiana Medicaid Members Within One Year Of Release, Ashley Wennerstrom, Olivia K. Sugarma, Bruce Reilly, Andrea Armstrong, Angel Whittington, Marcus A. Bachhuber May 2023

Health Services Use Among Formerly Incarcerated Louisiana Medicaid Members Within One Year Of Release, Ashley Wennerstrom, Olivia K. Sugarma, Bruce Reilly, Andrea Armstrong, Angel Whittington, Marcus A. Bachhuber

School of Public Health Faculty Publications

OBJECTIVES: To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody. METHODS: We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release. Outcome measures included receipt of general health services (primary care visits, …


Generalized Differential Equation Models For Disease Interventions: A Novel Approach For Predicting Sexually Transmitted Disease Outbreaks, Scott Greenhalgh May 2023

Generalized Differential Equation Models For Disease Interventions: A Novel Approach For Predicting Sexually Transmitted Disease Outbreaks, Scott Greenhalgh

Biology and Medicine Through Mathematics Conference

No abstract provided.


Relative Efficacy Of Resource Constrained Forward And Backward Contact Tracing In An Open Population, Nicholas Roberts May 2023

Relative Efficacy Of Resource Constrained Forward And Backward Contact Tracing In An Open Population, Nicholas Roberts

Biology and Medicine Through Mathematics Conference

No abstract provided.


Modeling The Dynamics Of Alcohol-Marijuana Co-Abuse In Virginia, Ana L. Vivas-Barber, James Tipton, Sujan Pant, Anne Fernando May 2023

Modeling The Dynamics Of Alcohol-Marijuana Co-Abuse In Virginia, Ana L. Vivas-Barber, James Tipton, Sujan Pant, Anne Fernando

Biology and Medicine Through Mathematics Conference

No abstract provided.


Dailymichigancovid19collection, Michigan Department Of Health & Human Services May 2023

Dailymichigancovid19collection, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

This is a zipped file of all the pngs uploaded to this collection, spanning from 2020-03-04 through 2023-04-25.


Post-Resettlement Food Insecurity: Afghan Refugees And Challenges Of The New Environment, Zahra Goliaei, Mariaelena Gonzalez, Karina Diaz Rios, Mamata Pokhrel, Nancy J Burke May 2023

Post-Resettlement Food Insecurity: Afghan Refugees And Challenges Of The New Environment, Zahra Goliaei, Mariaelena Gonzalez, Karina Diaz Rios, Mamata Pokhrel, Nancy J Burke

Faculty Publications & Research of the TUC Public Health Program

BACKGROUND: Lack of access to adequate, safe, and nutritious food is a major concern for the Afghan population due to ongoing war and humanitarian crises. Recently resettled Afghan refugees in the US continue to face challenges securing adequate, nutritious food resources in new environments. This study examined Afghan refugees' food access and insecurity in the San Joaquin Valley, California.

METHODS: Semi-structured, in-depth interviews were conducted to collect the perspectives and experiences of key informants and newly arrived Afghan refugees.

RESULTS: This study highlights environmental and structural factors (availability and accessibility of grocery stores; availability of religious-appropriate items in the stores; …


Analysis Of Nurse And Patient Preferences For Pre-Filled Pen Devices For Self-Injection Of Highly Purified Human Menopausal Gonadotropin (Hp-Hmg, Menopur®), Guy De Mesmaeker, Brigitte Calles, Judith A Smith May 2023

Analysis Of Nurse And Patient Preferences For Pre-Filled Pen Devices For Self-Injection Of Highly Purified Human Menopausal Gonadotropin (Hp-Hmg, Menopur®), Guy De Mesmaeker, Brigitte Calles, Judith A Smith

Faculty, Staff and Student Publications

PURPOSE: This study aimed to identify the most important attributes for a gonadotropin pen as perceived by assisted reproductive technology (ART) patients and fertility nurses, and to examine how well a prototype HP-hMG (MENOPUR

PATIENTS AND METHODS: This market research study incorporated a two-part survey with respondents (N=221) from Poland, Spain and the UK. Respondents included patients (n=141) who consulted a fertility specialist in the previous 2 years, and fertility nurses (n=80) who assisted in at least 75 ART cycles/year. Patients were divided into two subgroups depending on their experience with ART (experienced and naïve). Key attributes for an injection …


The Child Healthcare At Mater Pediatric Study (Champs): A 2-Arm Cluster Randomized Control Trial Of Group Well Child Care For Mothers In Treatment For Opioid Use Disorder And Their Children, Vanessa L. Short, Diane J. Abatemarco, Erica Sood, Dennis J. Hand, Meghan Gannon, Jobayer Hossain, Neera K. Goyal May 2023

The Child Healthcare At Mater Pediatric Study (Champs): A 2-Arm Cluster Randomized Control Trial Of Group Well Child Care For Mothers In Treatment For Opioid Use Disorder And Their Children, Vanessa L. Short, Diane J. Abatemarco, Erica Sood, Dennis J. Hand, Meghan Gannon, Jobayer Hossain, Neera K. Goyal

Department of Pediatrics Faculty Papers

BACKGROUND: Studies suggest that group-based well child care-a shared medical appointment where families come together as a group to receive pediatric primary care-increases patient-reported satisfaction and adherence to recommended care. Evidence supporting the use of group well child care for mothers with opioid use disorder, however, is lacking. The overall objective of the Child Healthcare at MATER Pediatric Study (CHAMPS) trial is to evaluate a group model of well child care for mothers with opioid use disorder and their children.

METHODS: CHAMPS is a single-site 2-arm cluster randomized controlled trial. A total of 108 mother-child dyads will be enrolled into …


Review Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Aime Powell, Ami Morseu-Diop, Maya Morton Ninomiya, Uday Narayan Yadav, Emily Phillips, Devendra Raj Singh, Tamara Butler, Emma Allanson, Lisa J. Whop May 2023

Review Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Aime Powell, Ami Morseu-Diop, Maya Morton Ninomiya, Uday Narayan Yadav, Emily Phillips, Devendra Raj Singh, Tamara Butler, Emma Allanson, Lisa J. Whop

Journal of the Australian Indigenous HealthInfoNet

Gynaecological cancers bear a significant burden on the health of Australians. Whilst Australia has made great strides in reducing the overall gynaecological cancer burden nationally, Aboriginal and/or Torres Strait Islander women continue to experience disproportionately high rates of gynaecological cancers.

This review focuses on the social, cultural, and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women. An in-depth discussion on cervical cancer, ovarian cancer, and uterine cancer are described; including the incidence, mortality, survival, and management of these diseases for Aboriginal and/or Torres Strait Islander women.

It highlights both the persistent barriers …


Longitudinal Trends (2011–2020) Of Premature Mortality And Years Of Potential Life Loss (Ypll) And Associated Covariates Of The 62 New York State Counties, Maria-Isabel Roldos, John Orazem, Talita Fortunato-Tavares May 2023

Longitudinal Trends (2011–2020) Of Premature Mortality And Years Of Potential Life Loss (Ypll) And Associated Covariates Of The 62 New York State Counties, Maria-Isabel Roldos, John Orazem, Talita Fortunato-Tavares

Publications and Research

Background

New York State (NYS) is the 27th largest state and the 4th most populous state in the U.S., with close to 20 million people in 62 counties. Territories with diverse populations present the best opportunity to study health outcomes and associated covariates, and how these differ across different populations and groups. The County Health Ranking and Roadmaps (CHR&R) ranks counties by linking the population’s characteristics and health outcomes and contextual factors in a synchronic approach.

Methods

The goal of this study is to analyze the longitudinal trends in NYS counties of age‑adjusted premature mortality rate and years of potential …


How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman May 2023

How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman

Faculty, Staff and Student Publications

BACKGROUND: Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts.

OBJECTIVE: Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy.

METHODS: Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial …


How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman May 2023

How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman

Faculty, Staff and Student Publications

BACKGROUND: Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts.

OBJECTIVE: Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy.

METHODS: Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial …