Health Services Administration Commons^™

Growing And Sustaining Community Health Workers In Missouri, Jennifer Trott, Jacqueline Baños, Marsha Regenstein

Health Policy and Management Issue Briefs

With funding from the Missouri Foundation for Health, in August 2022 The George Washington University Milken Institute School of Public Health began a 12-month study to assess the Community Health Worker field in Missouri. The resulting report, Growing and Sustaining Community Health Workers in Missouri, provides a landscape of current CHW workforce activity in the state, reviews recent milestones in the development of the profession, and profiles innovative training and practice models being employed in Missouri. The report draws on perspectives about the profession from interviews with 40 individuals from the field, including CHWs and others who supervise or …

Examining Nationwide Disparities In Managing Critical Limb Threatening Ischemia Among Individuals With Diabetes Mellitus Or End-Stage Kidney Disease By Race And Ethnicity, Daniel Dominguez, Waseem Wahood

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with tables.

Introduction: Critical Limb Threatening Ischemia (CLTI) presents a significant challenge, particularly for individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD). Healthcare disparities related to race and ethnicity are a pressing concern. This study aims to examine a 16-year trend to assess whether the disparities in managing critical limb-threatening ischemia (CLTI) are diminishing among individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD).

Methods: The analysis involved an examination of the National Inpatient Sample data from 2005 to 2020, with a focus on hospitalizations related to CLI. Identification of …

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

Gaps In Behavioral Health Care In Rural Primary Care Clinics And The Promise Of Vbhi: Perspectives From Clinic Staff, Monique Gill

Articles, Abstracts, and Reports

No abstract provided.

Ua61/3 Health & Human Services Dean's Office, Wku Archives

WKU Archives Collection Inventories

Unprocessed records created by and about the Dean of the College of Health and Human Services.

Delivering Health Services During Early Days Of Covid-19 Pandemic: Perspectives Of Frontline Healthcare Workers In Kenya’S Urban Informal Settlements, Vibian Angweny, Sabina Odero, Stephen Mulupi, Derrick Ssewanyana, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

The COVID-19 pandemic has caused widespread disruptions to health, economic and social lives globally. This qualitative study explores frontline healthcare workers’ (HCWs) experiences delivering routine care in Kenya’s informal settlements during the early phases of the pandemic, amidst stringent COVID-19 mitigation measures. Thirteen telephone interviews were conducted with facility and community-based HCWs serving three informal settlements in Nairobi and Mombasa. Data were analyzed using the framework approach. Results indicate there were widespread fears and anxieties surrounding COVID-19 and its management. Secondly, access to facility-based care at the onset of the pandemic was reported to decline, with service availability hampered by …

Effects Of Insurance Coverage On Healthcare Access And Outcomes For Children In Ohio, Haley Hurst, Patrick Ruz

Scholarship in Medicine - All Papers

Objective: Despite health insurance coverage correlating to improved child health outcomes and reduced healthcare costs, it is estimated that 8.7% of children in America lack continuous insurance. Although coverage has expanded multiple times through the Children's Health Insurance Program (CHIP) initiated in 1997, rates for child insurance vary drastically across regions of the country. In this study we investigated child insurance rates over time and by state, as well as explored the effects of having insurance and child health outcomes. To do this, we measured the association of uninsured children to primary care physician access and child mortality in the …

The Future Of Community Health Center Executive Leadership A Mixed-Method Formative Evaluation, Lizbeth Bayardo Cardenas

CGU Theses & Dissertations

This is a formative evaluation study of the California Primary Care Association's (CPCA) Leadership Equity Program, developed in response to the need for greater alignment between the communities accessing care provided by Community Health Centers and the representativeness of their future executive leaders. Community Health Centers (CHC) are a critical network of primary healthcare systems that deliver high-quality, comprehensive healthcare services to patients predominantly from under-resourced and marginalized communities of color. The study used a mixed-method concurrent triangulation design to describe how participants perceived the program achieved its goals and objectives using Kirkpatrick's Model and systems thinking. The study integrated …

Relationship Between Patient Race And Provider Communication, Kristin M. Marino

Honors Undergraduate Theses

Health disparities by race in the United States have been persistent over decades and one possible reason for that could be that physicians are communicating differently with different races. The purpose of this study was to systematically review literature regarding the relationship of patient race/ethnicity with physician-patient communication. The overall project of which this is a part is a mixed methods review, but my part of the study involved only studies using observational data such as audio and video recordings of physician-patient encounters. This study investigated research that compares physician communication with patients across a wide range of ethnic groups, …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Kenyan Healthcare Professionals’ Perceptions Of Global Health Engagements In Relation To The Covid-19 Pandemic, Erick Amick

Graduate Research Theses & Dissertations

Over the past 30 years, there has been a significant increase in opportunities available for individuals living in high-income countries (HICs) to participate in programs that provide health services in low- and middle-income countries (LMICs). These global health engagements (GHEs) have become common in many LMICs around the world, including Kenya. Prior to the advent of the COVID-19 pandemic, much of the research exploring individuals’ perspectives of GHEs were situated from the viewpoint of participants traveling from HICs to participate in global health programs. Few studies have examined perspectives of constituent groups in LMICs, such as healthcare professionals (i.e., healthcare …

Impactos Do Trabalho Em Hospitais Públicos, Lorena Em Fernandes, Carlos Eduardo Siqueira, Gabriella Barreto Soares, Francis Sodré

Gastón Institute Publications

This paper shows the result of a qualitative pilot study carried out with workers from public hospitals managed by private institutions, whose objective was to identify and analyze the main impacts of work on health professionals in these institutions, known as Social Health Organizations. The survey occurred in Espírito Santo, Brazil, in 2019. Workers who have a job in at least one of the participating institutions were individually interviewed. The analysis was based on grounded theory techniques, carried out with careful coding and comparative methodology, resulting in four empirical categories: “Admission”; “People management”; “Management and quality”; and “Health and quality …

Fostering A High-Functioning Team In Cancer Care Using The 4r Oncology Model: Assessment In A Large Health System And A Blueprint For Other Institutions, Raymond Liu, Christine B Weldon, Elizabeth Linehan, Nancy Gordon, Thea Abbe, Marti Hennings, Henie James, Jed Katzel, Chun Ng, Megumi Tomita, Jeffrey B Velotta, Stephanie Ossowski, Lori C Sakoda, Sharon Likely Sprague, Anna Dowling, Kimberly Beringer, Arliene Ravelo, Elaine Yu, Julia R Trosman

Faculty, Staff and Student Publications

PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Oncology model for team-based interdependent care delivery and patient self-management affected team functioning in a large community-based health system.

METHODS: 4R was deployed at four locations in breast and lung cancers and assessed along four characteristics of high-functioning teams: recognition as a team internally and externally; commitment to an explicit shared goal; enablement of interdependent work to achieve the goal; and engagement in regular reflection to adapt objectives and processes. …

National Cross-Sectional Study On Cost Consciousness, Cost Accuracy, And National Medical Waste Reduction Initiative Knowledge Among Pediatric Hospitalists In The United States, Benjamin C Lee, Matt Hall, Ladan Agharokh, Andrew G Yu, Kavita Parikh, Samir S Shah

Faculty, Staff and Student Publications

BACKGROUND/OBJECTIVE: Despite initiatives to reduce waste and spending, there is a gap in physician knowledge regarding the cost of commonly ordered items. We examined the relationship between pediatric hospitalists' knowledge of national medical waste reduction initiatives, self-reported level of cost-consciousness (the degree in which cost affects practice), and cost accuracy (how close an estimate is to its hospital cost) at a national level.

METHODS: This cross-sectional study used a national, online survey sent to hospitalists at 49 children's hospitals to assess their knowledge of national medical waste reduction initiatives, self-reported cost consciousness, and cost estimates for commonly ordered laboratory studies, …

Exploring Relationship Among Programmatic Expertise, Work Engagement, And Turnover Intentions Across Different Generation Cohorts In State And Local Governmental Public Health Agencies, Stephanie L. Irvin

College of Graduate Studies: Theses & Dissertations

This study examined the relationship among public health programmatic competencies, work engagement, and turnover intentions among state and local public health workers. It also explored the moderating role of generational cohorts in these relationships. It employed a quantitative secondary data analysis using the 2021 PHWINS survey, a collaboration between the de Beaumont Foundation and The Association of State and Territorial Health Officials. The study's principal findings shed light on critical relationships within the public health workforce: Firstly, an increase in programmatic expertise among public health professionals is linked to increased work engagement, particularly notable within the Millennial cohort. Secondly, a …

Expanding Reach Of Public Health: Lessons From A Pilot Project To Develop Remote Dementia Diagnostic Processes., Chloe Hale, Jennifer Harrison

Georgia Public Health Association Annual Meeting & Conference

Georgia Department of Public Health Injury Prevention Program works to create a healthy Georgia by leveraging resources, addressing systems change, and fortifying a robust person-centered public health response to dementia, including Alzheimer’s disease. The response utilizes Georgia’s established infrastructure, clear priorities, and the dynamic network of partnerships guided by a regularly updated state plan to increase capacity and access to quality care. Systemic change through collaboration and communication can empower people living with dementia, their care partners, professionals, and communities.

The pilot remote dementia diagnostic process and procedure engages long-term plans for increasing annual wellness visits, dementia risk reduction, early …

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Ecologic Analysis Of Antimicrobial Use In South Carolina Hospitals During 2020–2022, Pamela Bailey, Shujie Chen, Majdi N. Al-Hasan, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background:

Factors influencing excessive antimicrobial utilization in hospitalized patients remain poorly understood, particularly with the COVID-19 pandemic.

Methods:

In this retrospective cohort, we compared administrative data regarding antimicrobial prescriptions in hospitalized patients in South Carolina from March 2020 through September 2022. The study examined variables associated with antimicrobial use across demographics, COVID status, and length of stay, among other variables.

Results:

Significant relationships were seen with antimicrobial use in COVID-19 positive patients (OR 2.00, 95% Confidence Interval (CI): 1.9–2.1), young adults (OR 1.08, 95% CI: 0.99–1.12, COVID-19 positive Blacks and Hispanics (OR 1.06, 95% CI: 1.01–1.11, OR 1.05, 95% CI: …

Residential Segregation And County-Level Covid-19 Booster Coverage In The Deep South: Surveillance Report And Ecological Study, Chengbo Zeng, Jiajia Zhang Ph.D., Zhenlong Li, Xiaowen Sun, Huan Ning, Xueying Yang, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: COVID-19 had a greater impact in the Deep South compared with other regions in the United States. While vaccination remains a top priority for all eligible individuals, data regarding the progress of booster coverage in the Deep South and how the coverage varies by county and age are sparse. Despite existing evidence of racial and ethnic disparities in COVID-19 vaccinations at the individual level, there is an urgent need for evidence at the population level. Such information could highlight vulnerable communities and guide future health care policy-making and resource allocation.

Objective: We aimed to evaluate county-level COVID-19 booster coverage …

Using Geospatial Social Media Data For Infectious Disease Studies: A Systematic Review, Fengrui Jing, Zhenlong Li, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Geospatial social media (GSM) data has been increasingly used in public health due to its rich, timely, and accessible spatial information, particularly in infectious disease research. This review synthesized 86 research articles that use GSM data in infectious diseases published between December 2013 and March 2022. These articles cover 12 infectious disease types ranging from respiratory infectious diseases to sexually transmitted diseases with spatial levels varying from the neighborhood, county, state, and country. We categorized these studies into three major infectious disease research domains: surveillance, explanation, and prediction. With the assistance of advanced computing, statistical and spatial methods, GSM data …

An Exploratory Study Of Ergonomics In College Students, Wesley Ryan Tinker

Murray State Theses and Dissertations

Abstract

This study aimed to examine the relationship between poor ergonomic conditions and student physiological discrepancies. This examination provided great insight into students’ daily experiences and concerns for their futures. The methodology used for this study was quantitative as two source data sets were collected and analyzed. The tool REBA was used to measure the specific body angles while students sat working. A survey yielded great results, giving the students an opportunity to subjectively choose options.

This exploratory study allowed the researcher to use quantitative data to answer this study’s research questions. The research questions asked from this study were …