Health Services Administration Commons^™

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 …

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 …

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 …

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 …

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 …

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 …

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, …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Family Impact Seminar 2018: The Kids Are Not All Right: Policy Options To Address Youth Trauma In Massachusetts, Denise Hines, Laurie Ross Ph.D, Marianne Sarkis Ph.D

Mosakowski Institute for Public Enterprise

Family Impact Seminars are a series of annual seminars, briefing reports, and discussion sessions that provide up-to-date, solution-oriented research on current issues for state legislators and their aides. The seminars provide objective, nonpartisan research on current issues and do not lobby for particular policies. Seminar participants discuss policy options and identify common ground where it exists.

The Kids are NOT All Right: Policy Options to Address Youth Trauma in Massachusetts is the ninth Massachusetts Family Impact Seminar. Today’s seminar is designed to emphasize a family perspective in policymaking on issues related to early intervention in childhood trauma, sex trafficking and …

Addressing Hydrocephaly In Viet Nam: A Plausible Prevention And Intervention Medical Support Program Proposal, Chelle Mcintyre-Brewer

UNO Student Research and Creative Activity Fair

Families affected by hydrocephalus in Viet Nam have few options for sustainable treatment for a myriad of reasons, primarily centering on barriers to care prevalent to minority, underserved, and economically disadvantaged populations. High morbidity and abandonment rates often result from these circumstances. An interdisciplinary examination of the factors contributing to causal concerns reveals unique cultural considerations, language and literacy barriers, ethnic and geographic differences, as well as economic and governmental issues greatly impacting patient outcome for this condition. The author contends that a program that addresses sociological concerns, along with the medical treatment of the patient, proffers the opportunity for …

Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger

Public Health Faculty Publications

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety as important. …

Wellness And Multiple Sclerosis: The National Ms Society Establishes A Wellness Research Working Group And Research Priorities, Robert W. Motl, Ellen M. Mowry, Dawn M. Ehde, Nicholas G. Larocca, Kathy E. Smith, Kathleen Costello, Lynne Shinto, Alexander V. Ng, Amy B. Sullivan, Barbara Giesser, Kevin K. Mccully, Bo Fernhall, Malachy Bishop, Matthew Plow, Patrizia Casaccia, Nancy D. Chiaravalloti

Early Childhood, Special Education, and Counselor Education Faculty Publications

Background: People with multiple sclerosis (MS) have identified “wellness” and associated behaviors as a high priority based on “social media listening” undertaken by the National MS Society (i.e. the Society).

Objective: The Society recently convened a group that consisted of researchers with experience in MS and wellness-related research, Society staff members, and an individual with MS for developing recommendations regarding a wellness research agenda.

Method: The members of the group engaged in focal reviews and discussions involving the state of science within three approaches for promoting wellness in MS, namely diet, exercise, and emotional wellness.

Results: That process informed a …

Wdph 2017 Summer Internship Report, Lauren Meininger

Mosakowski Institute for Public Enterprise

In the spring of 2014, the Worcester Division of Public Health, UMass Memorial Health Care, and Clark University’s Mosakowski Institute for Public Enterprise joined forces to begin developing a partnership that would combine academic resources, student input, and public health needs in the City of Worcester. Founders of this program were motivated to seek and implement innovative interventions for public health issues while simultaneously inspiring a new generation of public health professionals.

Each year, the Academic Health Collaborative of Worcester (AHCW) brings in student interns to work on the pressing public health issues of the moment. Interns work alongside epidemiologists, …

Leadership In Community Public-Private Partnership Health And Social Care Initiatives, Hawa Yatera Mshana, Magdeline Aagard, Cheryl Cullen, Patrick A. Tschida

Journal of Sustainable Social Impact

Although the public–private partnerships in health have been adopted as the best pathway to improving health outcomes in many developing nations, implementation lacks collaborative leadership. The purpose of this empirical qualitative case study was to determine key factors that promote leadership synergy (LS) between partners that enhance ownership and accountability of community health and social initiatives in Tanzania. The diffusion of innovation theory and public–private integrated partnership module were the theoretical framework guided this study. Diffusion of innovation theory is based on the importance of effective communication to spread new ideas and foster change in behavior in a social group …