Health Services Administration Commons^™

An Exercise Program To Prevent Frailty In Community-Dwelling Older Adults: A Proposed Pilot Study, Kendra Harrington, Mikhail Beg, Laura Kelly, Jinto Mathew, Neil Ryan

Annual SHSP Student Research and Scholarship Day

No abstract provided.

Development Of A Diabetes Self-Management + Mhealth Program: Tailoring The Intervention For A Pilot Study In A Low-Income Setting In Mexico, Robin Whittemore, Mireya Vilar-Compte, Soraya Burrola-Méndez, Annel Lozano-Marrufo, Roberta Delvy, Mariana Pardo-Carrillo, Selene De La Cerda, Ninfa Pena-Purcell, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: Type 2 diabetes (T2D) is a public health pandemic disproportionately affecting low- and middle-income countries. The purpose of this formative research was to adapt evidence-based diabetes self-management education programs to the context of Seguro Popular clinics in Mexico. A theory-based mHealth (pictorial text messaging) component was developed.

Method: Our formative research and development of the program protocol consisted of six phases: (1) interviews and focus groups with stakeholders on the challenges to T2D management, curriculum content needs, and the use of mHealth as a supplement to a DSME program; (2) review of the theoretical underpinning, curriculum, and interactive strategies …

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

Department of Public Health Scholarship and Creative Works

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

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

Body Mass Index (Bmi) And Healthcare Utilization Among Us Adults With Asthma In 2016, Saleh Khateeb

Annual SHSP Student Research and Scholarship Day

No abstract provided.

Implementing A Health Coach Into Your Healthcare Continuum, Dalton Jarvis

Masters Theses/Capstone Projects

Presentation on Implementing a Health-coach into your Healthcare Continuum.

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …

Clinic Exploration Of Care Processes To Promote Colorectal Cancer Screening In Rural Accountable Care Organization Clinics: A Qualitative Case Study, Sarbinaz Bekmuratova, Jungyoon Kim, Hongmei Wang, Lufei Young, Daniel J. Schober, Li-Wu Chen

The Qualitative Report

It is essential to have an effective care process to promote colorectal cancer (CRC) screening particularly in rural areas. Primary care health care providers may have a significant impact on improving CRC screening rates among rural residents through systematic screening processes in their clinics. In this qualitative study, we aimed to explore the whole clinic processes of recommending and referring CRC screening in the rural accountable care organization (ACO) primary care clinics. We collected qualitative data through 21 semi-structured in-depth interviews with healthcare providers in rural primary care ACO clinics in Nebraska. We audio recorded and transcribed the interviews and …

Suicidal Thoughts, Plans, And Attempts By Non-Metropolitan And Metropolitan Residence, Kathi Harp, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

• Mean prevalence rates for suicidal thoughts, plans, and attempts were significantly higher (P < .05) among residents of non-metropolitan than large metropolitan counties.
• The adjusted odds of suicidal thoughts, plans, and attempts did not improve significantly from 2010 to 2016 among residents of any county type.
• The study findings suggest that suicide prevention interventions should be further targeted toward non-metropolitan counties. However, new interventions may need to be specifically developed to meet the unique needs of residents in non-metropolitan counties.

Redesigning Gambling Treatment Programs For Success: A Model Based Approach Toward Program Development, Jeffrey J. Marotta, Greta Coe

International Conference on Gambling & Risk Taking

Abstract

This presentation will describe a program improvement initiative launched by Oregon Problem Gambling Services to assist with the development of its 47 publicly-funded gambling treatment programs. The development approach incorporated best practices as identified by SAMHSA, the gambling disorders literature, and expert review. The resulting Technical Assistance Visit Toolkit & Gambling Treatment Program Capability Index (GTPCI) offer a streamline program improvement protocol for use specifically with gambling treatment programs. The presenters will share their experience in implementing this program development approach, merits of the model, and program results.

Implications

This presentation will introduce participants to a model and evaluation …

Addressing Lapses In Medical Education In Relation To Lgbtqia+ Healthcare Disparities, Daniel Pinto, Aubrey Olson

Rowan-Virtua Research Day

As the LGBT community gains more visibility and acceptance, the individuals identifying as LGBTQIA+ have been increasing. Unfortunately for this community, healthcare disparities for LGBT individuals continue. In fact in a national online survey done with LGBTQIA+ physicians, 65% had heard discriminatory comments made towards LGBTQIA+ patients, and 34% witnessed discriminatory care given to LGBTQIA+ patients. (Bonvinci) Rose Chapman, a senior lecturer at Curtin University Nursing School, contributed this discomfort that medical professionals seem to have with LGBTQIA+ families with socioeconomic background such as religious beliefs or familiarity with the topic. (Chapman) Nevertheless, another study published by the Medical Journal …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Elevating Communities Into Self-Sufficiency Through Federally-Funded Health Partnerships, Nalleli Martinez

Master's Projects and Capstones

Purpose: This qualitative study is to identify programing that encourages increased self-sufficiency in SNAP recipients. The goal was to identify themes related to successful self-sufficiency programming at federally-funded health centers/health programs (HCHPs). The study also investigated the role of social determinants of health in relation to achieving self-sufficiency.

Method: A series of 45-minute to 1-hour-long interviews were conducted to explore the perspectives of seven total staff at seven federally-funded HCHPs across the U.S. western region. Using Nvivo, a qualitative data analysis software, responses were categorized into six themes: patient-centered care, one-stop-shop/integrated care model, community partnerships, organizational and staff support, leadership …

Health On The Move: Health-Seeking Behavior Of Changpa Nomads In Ladakh, India, Maya Lubeck-Schricker

Independent Study Project (ISP) Collection

The goal of this study is to understand the health-seeking behavior of Changpa nomads in the Changthang region of Ladakh, India including what health issues these communities face, what they do when they fall sick, any preventative health behavior they implement, as well as the health infrastructure available to them. Very little literature exists on the health seeking-behavior of people in South Asia in general, much less among nondominant lifestyles such as that of nomadic or semi-nomadic people. As such, this research hopes to move towards closing that knowledge gap by conducting and analyzing 26 in depth semi-structured interviews and …

An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández

Department of Public Health Scholarship and Creative Works

The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …

Ua66/13/2 Ogden College Of Science & Engineering Public Health Centers, Wku Archives

WKU Archives Collection Inventories

Records related to Public Health Centers.

Ua66/13/3 Ogden College Of Science & Engineering Public Health Publications, Wku Archives

WKU Archives Collection Inventories

Publications by and about the Department of Public Health, previously known as Health & Safety.

Ua66/13/4 Ogden College Of Science & Engineering Public Health Allied Organizations, Wku Archives

WKU Archives Collection Inventories

Records related to Public Health allied organizations.

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

Philosophia Soteria: How Occupational Safety And Health Professionals Influence Decision Makers, Daniel Jay Snyder

Graduate Theses and Dissertations

The purpose of this study was to identify ideas about how occupational safety and health (OSH) professionals influence decision-makers on matters impacting occupational health and safety management systems. A modified nominal group technique was used that involved 67 participants in ten nominal groups and identified the most important ideas about how OSH professionals can influence workplace safety and health decision making. The research produced themes of communication, scientific, professionalism, leadership, adaptability, and business acumen that resulted in six domains of occupational safety and health professional influence.

Update: Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, 2012-2015, Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Between 2014 and 2015, the number of pneumococcal vaccine services delivered to fee-for-service (FFS) Medicare beneficiaries increased by 380% as a result of uptake of PCV13 vaccine.
• Continued disparities in delivery of pneumococcal vaccine services to FFS Medicare beneficiaries in rural and urban communities are noted, with a 63% higher vaccination rate observed in urban areas.
• The majority of pneumococcal vaccine services delivered to FFS Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (24.2%) of these services.
• Pharmacy providers in rural communities play an increasing role in pneumococcal vaccine …

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those around them. …

School‐Level Body Mass Index Shapes Children's Weight Trajectories, Ashley W. Kranjac

Sociology Faculty Articles and Research

BACKGROUND

Embedded within children's weight trajectories are complex environmental contexts that influence obesity risk. As such, the normative environment of body mass index (BMI) within schools may influence children's weight trajectories as they age from kindergarten to fifth grade.

METHODS

I use 5 waves of the ECLS‐K—Kindergarten Class 1998‐1999 data and a series of multilevel growth models to examine whether attending schools with higher overall BMI influences children's weight status over time.

RESULTS

Results show that, net of child, family, and school sociodemographic characteristics, children who attend schools with higher rates of obesity have increased weight compared to children who …

A Characterization Of The Medical-Legal Partnership (Mlp) Of Nebraska Medicine, Jordan Pieper

Capstone Experience: Master of Public Health

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project through the partnership it has formed working with Nebraska Medicine and Iowa Legal Aid. Traditionally, health and disease have always been viewed exclusively as "healthcare" issues. But with healthcare consistently growing towards holistic approaches to help patients, we now know there are deeper, structural conditions of society that can act as strong driving forces of a person's poor daily living conditions that can negatively impact health. The importance of a Medical-Legal Partnership is that it considers a patient's social determinants of health (SDHs). The goal …

Exploring Direct And Indirect Effects Of English Proficiency On Access, Utilization, And Health Status Among Californian Adults With Limited English Proficiency (Lep), Renee E. Pierre-Louis

Seton Hall University Dissertations and Theses (ETDs)

Background and Study Purpose: Findings from previous studies suggest that, in a health care delivery context, individuals with limited English proficiency (LEP) are adversely impacted by lack of patient-provider language concordance. Yet, the concept of LEP has been mostly studied in the context of cultural competence and language has been generally considered a demographic or cultural characteristic. There is a growing body of research concerning LEP and health status; however, it is limited. This study sought to evaluate the effects of LEP on access, utilization, and self-rated health status (SRHS) among LEP respondents to a large health interview survey …

Examining The Benefits And Client Satisfaction Of The Open Arms Of Minnesota Meal Service Program, Carlie Rhinehart

Capstone Experience: Master of Public Health

Chronic disease can leave individuals incapable of caring for themselves, leading to a low quality of life. Public health researchers have proven how crucial medically tailored meals are to those fighting such chronic diseases. Open Arms is a local nonprofit that started in 1986. They make and deliver meals, free of charge, to people with life-threatening illnesses.

The goal of this study is to examine the benefits of the meal services provided by Open Arms of Minnesota to clients who are chronically ill. To learn about the benefits, analysis was conducted on the client satisfaction survey data collected. The anonymous …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience: Master of Public Health

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …