Health Services Administration Commons^™

Behere Nevada: Partnership And Policy, Sara Hunt

Community Engagement Expo Research Posters

Partnership: Nevada ranks 51st in the nation for mental illness prevalence and access to care (Mental Health America). Significant shortages in mental health professions, especially in rural areas. Other states using policy and funding to implement a “grow our own” model for behavioral health workforce development. Proposed a behavioral health workforce development center for Nevada.

The Relationship Between Gender And Experienes Of Weight Stigma From Healthcare Providers, Isabella J. Aceituno, Shannon Sagert

Undergraduate Research Symposium Posters

Healthcare providers are a common source of weight stigma, which is associated with lower physician trust, poorer patient outcomes, and the avoidance of healthcare services. Currently, there is a lack of consensus in research on whether women and men are equally likely to experience weight stigma from healthcare providers. The present study examined whether gender differences exist in weight stigma received from healthcare providers in childhood or adulthood, comfort seeking medical care, and healthcare avoidance. Adult participants (N = 196) reported the frequency at which they experienced stigmatizing experiences in healthcare environments in the past 12 months and during childhood …

The Southern Nevada Care Economy: Challenges And Opportunities, Tripp Umbach

Policy Briefs and Reports

National policymakers increasingly recognize the care economy as an essential economic driver, contributing $648 billion annually to the U.S. economy and supporting 3.6 million jobs. The care economy is also critical in driving economic development and prosperity in Southern Nevada. Yet, as this Tripp Umbach analysis finds, Southern Nevada’s care economy dramatically underperforms compared to national benchmarks and peer regions. High caregiving costs and limited access to care for children, seniors, and individuals with disabilities in Southern Nevada strain families, businesses, and public resources. This burden reduces workforce participation, productivity, and economic growth. Low pay and high turnover among care …

Inpatient Physical Activity Across A Large University City Hospital: A Behavioral Mapping Study, Karin Valkenet, Prue Mcrae, Elja Reijneveld, Marielle Jans, Petra Bor, Lotte Van Delft, Daniel L. Young, Cindy Veenhof

Physical Therapy Faculty Research

Background: Physical inactivity is common during hospitalization. Physical activity has been described in different inpatient populations but never across a hospital. Purpose: To describe inpatient movement behavior and associated factors throughout a single university hospital. Methods: A prospective observational study was performed. Patients admitted to clinical wards were included. Behavioral mapping was undertaken for each participant between 9AM and 4PM. The location, physical activity, daily activity, and company of participants were described. Barriers to physical activity were examined using linear regression analyses. Results: In total, 345 participants from 19 different wards were included. The mean (SD) age was 61 (16) …

Palliative Care And Life-Sustaining/Local Procedures In Colorectal Cancer In The United States Hospitals: A Ten-Year Perspective, Zahra Mojtahedi, Ja Seol Koo, Ji Yoo, Pearl Kim, Hee-Taik Kang, Jinwook Hwang, Moon Kyung Joo, Jay J. Shen

School of Medicine Faculty Research

Background: In recent years, palliative care utilization has been increasing while life-sustaining/local procedures have been declining at the end of life. Palliative care utilization widely varies based on tumor type. Limited information is available on inpatient palliative care in colorectal cancer. Aims: This study investigated inpatient palliative care utilization and its association with patient demographics, hospital charges, and procedures among colorectal cancer patients admitted to US hospitals between 2008 and 2017. Receipt of life-sustaining and local procedures and surgeries were also investigated during the ten years. Methods: Data were extracted from the National inpatient sample (NIS) database containing de-identified information …

Inpatient Palliative Care Is Less Utilized In Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective, Zahra Mojtahedi, Ji Won Yoo, Karen Callahan, Neeraj Bhandari, Donghui Lou, Katayoon Ghodsi, Jay J. Shen

School of Medicine Faculty Research

Background—Extrahepatic cholangiocarcinoma (ECC) is a rare, morbid, fatal cancer with distressing symptoms. Maintaining a high quality of life while reducing hospital charges and length of stay (LOS) for the end-of-life period remains a major challenge for the healthcare system. Palliative care utilization has been shown to address these challenges; moreover, its use has increased in recent years among cancer patients. However, the utilization of palliative care in rare cancers, such as ECC, has not yet been explored. Objectives—To investigate palliative care utilization among ECC patients admitted to US hospitals between 2007 and 2016 and its association with patient demographics, clinical …

Concordance And Patient-Centered Care In Medicaid Enrollees’ Care Experience With Providers, Iwimbong Kum Ghabowen, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, …

Testing The Multi-Theory Model (Mtm) To Predict The Use Of New Technology For Social Connectedness In The Covid-19 Pandemic, Manoj Sharma, Kavita Batra, Jason Flatt

Environmental & Global Health Faculty Research

Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with social isolation. However, till today, no theory-based studies were performed to examine the determinants of technology use. Therefore, the current study aims to test theory-based determinants in explaining the adoption of new technology in a nationally representative sample during the COVID-19 pandemic (n = 382). A psychometrically reliable and valid instrument based on the multi-theory model (MTM) …

American Association For The Surgery Of Trauma Prevention Committee Review: Family Justice Centers-A Not-So-Novel, But Unknown Gem, Thomas K. Duncan, Ronald Stewart, Kimberly Joseph, Deborah A. Kuhls, Tracey Dechert, Sharven Taghavi, Stephanie Bonne, Kazuhide Matsushima

School of Medicine Faculty Research

The American College of Surgeons Committee on Trauma requires that trauma centers demonstrate adequate financial support for an injury prevention program as part of the verification process. With the ongoing challenges that arise with important social determinants of health, trauma centers have the important task of navigating a patient through the complex process of obtaining services and tools for success. This summary from the American Association for the Surgery of Trauma Prevention Committee focuses on a model that has been present for several years, but has not been brought to full awareness in the trauma world. It highlights the importance …

Disparities In Access To After-Hours Care In The U.S.: A National Study, Kavita Mosalpuria, Fernando A. Wilson, Mohammad Siahpush

Journal of Health Disparities Research and Practice

After-hours care provides timely access to continuity of care for chronic illnesses and episodic care for acute illness. Lack of timely access to primary care services is one of the main drivers of emergency department overuse. Our aim was to examine disparities in access to after-hours care based on race, income, geographic location, type of insurance, and health care setting. We used data from the 2010 Health Tracking Household Survey. Multivariable logistic regression was used to assess disparities in access to after-hours care. We found disparities by type of insurance, geographic location, and type of health care setting. People with …

Improving Healthcare Quality In The United States Healthcare System: A Scientific Management Approach, Soumya Upadhyay, William Opoku-Agyeman

School of Public Health Faculty Research

The US healthcare system has been facing pressures from stakeholders to reduce costs and improve quality. The purpose of this paper is to develop a conceptual model to illustrate the approaches used in healthcare quality management (Continuous Quality Improvement/Total Quality Management, Lean, and Six Sigma) weaved into the underlying framework of scientific management theory. This paper employs scientific management theory to explain the healthcare quality tenets that influence the quality of care in our healthcare organizations. The father of scientific management, Frederick Taylor, and other key contributors collectively created scientific management principles, which are widely used for quality improvement purposes …

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 …

A State Of Uncertainty: An Analysis Of Recent State Legislative Proposals To Regulate Preventive Services In The United States, Maxim Gakh, Cody Cris, Prescott Cheong, Courtney Coughenour

School of Public Health Faculty Research

This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. …

Medicaid Managed Care And The Health Care Utilization Of Foster Children, Makayla Palmer, James Marton, Aaron Yelowitz, Jeffery Talbert

Molasky Family Department of Economics and Real Estate Faculty Research

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large …

Levels Of Adoption Of Electronic Health Records And Patient Safety: Effectiveness And Efficiency, Scott Neishi, Yili Gan, Christopher R. Cochran, Jay J. Shen

Interdisciplinary Research Scholarship Day

• Patient safety, including hospital acquired infections has become one of the major concerns in healthcare delivery in recent years
• Electronic health records are becoming an integral aspect of the health care delivery
• Health policies have been looking to improve quality / patient safety and efficiency of healthcare through the adoption of electronic health record (EHR) systems
• Can EHR adoption improve patient safety?
• Can EHR adoption reduce cost?
• H1: Patients treated at hospitals with a higher level of EHR adoption are less likely to incur poorer patient safety indicators
• H2: Patients treated at hospitals with a higher level of EHR adoption …

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

A Geospatial Analysis Of Cdc-Funded Hiv Prevention Programs For African Americans In The United States, G. A. Gilliam, Carol L. Hanchette, Kieran J. Fogarty, Deborah A. Gibbs

Journal of Health Disparities Research and Practice

Given the increase in HIV/AIDS infection rates among racial and ethnic minorities, particularly African Americans, this study was undertaken as part of a larger research effort to examine the distribution of HIV prevention services focusing on African American populations within the United States. Data were gathered via a national survey of community-based organizations (CBOs) funded by the Centers for Disease Control and Prevention (CDC). A geocoded national database was constructed to identify, locate, and map these HIV prevention programs. A total of 1,020 CBOs responded to the survey, yielding a response rate of 70.3%. These CBOs administered a total of …

Multistate Assessment Of Public Health Surveillance Relevant To American Indians And Alaska Natives, 2007, Jeanne Bertolli, Ed Chao, Michael Landen, Eden Wells, John M. Hayes, Zeenat Mahal, Ralph T. Bryan

Journal of Health Disparities Research and Practice

Improving the health of American Indian and Alaska Native (AI/AN) populations involves multiple agencies, levels of government, and jurisdictions. We assessed collaboration between state health departments and AI/AN Tribes and agencies through an online survey of State Epidemiologists. Frequencies and percentages of responses were examined by univariate and bivariate analyses. Among 39 states with federally recognized or state-recognized Tribes or federally funded urban Indian health centers, 25 (64%) participated. Nineteen had discussed public health surveillance with an AI/ AN government or nongovernment entity in the past 2 years (10 (53%) of these had ongoing, regular discussions about public health surveillance; …

Spiritual Care Within Oncology Care: Development Of A Spiritual Care Program At An Indian Health Service Hospital, Catherine Witte, Tamana D. Begay, Kathryn Coe

Journal of Health Disparities Research and Practice

Spiritual care is essential in providing quality health care for patients and their families and is supported in the mission of the Indian Health Service (IHS). Their mission is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. This paper will describe the spiritual care programs at the Phoenix Indian Medical Center, an IHS hospital located in Phoenix, Arizona. Two hospital committees, the Volunteer Chaplains’ Association and the Traditional Cultural Advocacy Committee, provide spiritual care for the medical center and work to sustain a presence of spiritual and cultural awareness …

Responding To American Indian Communities: Southwest American Indian Collaborative Network (Saicn) Cancer Educational Activities, Naomi A. Lane, Kathleen Evans, Agnes Attakai, Catherine Witte, Maylynn Riding In-Warne, Kathryn Coe

Journal of Health Disparities Research and Practice

Developing educational materials and providing trainings in American Indian communities is a highly rewarding activity. However, to do so successfully a number of complex issues must be faced and cultural-tailored strategies to promote awareness must be developed based on the unique traditions of each tribe. In this paper we describe the educational activities conducted over a four year period by the Southwest American Indian Collaborative Network, a project funded by the National Cancer Institute’s Center to Reduce Cancer Health Disparities. Activities fell into two broad areas: dissemination of cancer information through trainings and workshops and development of culturally-tailored educational materials.

Concurrent Panel Session 2: Health Challenges Facing Las Vegas, Carlos Brandenburg, Shawn Gerstenberger, Zaven Khachaturian, John Mcdonald, Dennis Pirages, Thom Reilly, Kathy Silver, Bonnie Sorenson, Carolyn B. Yucha, Maurizio Trevisan

Shaping the Future of Southern Nevada: Economic, Environmental, and Social Sustainability

Moderator: Marcia Turner, NSHE Health Science System Scribe: Candace Griffith, UNLV Department of Sociology Conference white paper & Full summary of panel session, 8 pages