Health Services Research Commons^™

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

College of Graduate Studies: Theses & Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …

Country Readiness And Prerequisites For Successful Design And Transition To Implementation Of Essential Packages Of Health Services: Experience From Six Countries, Ala Alwan, Reza Majdzadeh, Gavin Yamey, Karl Blanchet, Alemayehu Hailu, Mohamed Jama, Kjell Arne Johansson, Mohammed Yusuf Ahmed Musa, Omar Mwalim, Sameen Siddiqi

Community Health Sciences

This paper reviews the experience of six low-income and lower middle-income countries in setting their own essential packages of health services (EPHS), with the purpose of identifying the key requirements for the successful design and transition to implementation of the packages in the context of accelerating progress towards universal health coverage (UHC). The analysis is based on input from three meetings of a knowledge network established by the Disease Control Priorities 3 Country Translation Project and working groups, supplemented by a survey of participating countries. All countries endorsed the Sustainable Development Goals target 3.8 on UHC for achievement by 2030. …

Human Papillomavirus Dose Reminder Preferences Among Parents From A Diverse Clinical Sample: A Qualitative Study, Jacqueline M Hirth, Kayla A Eboreime, Leslie E Cofie, Richard E Rupp, Abbey B Berenson

Faculty, Staff and Students Publications

Reminders are an important method for encouraging patients to return for follow-up visits, such as for successive doses of the human papillomavirus (HPV) vaccine. However, patients may have preferences for different types of reminders. This study examined which reminder methods parents of pediatric patients found most useful and their thoughts on how the reminders helped them to complete their children's HPV vaccine series. This qualitative study was conducted on a purposively sampled group of parents who participated in a multi-level intervention intended to improve uptake and completion of the HPV vaccine series. Parents who agreed to participate were interviewed by …

Advances In Nlp Algorithms On Unstructured Medical Notes Data And Approaches To Handling Class Imbalance Issues, Hanna Lu

Computational and Data Sciences (PhD) Dissertations

This dissertation is composed of three research projects, each addressing one aspect of the text classification tasks on unstructured medical notes.

The first study investigated the model performance of sequence deep learning models that are widely used in NLP tasks such as RNN, GRU, LSTM, Bi-LSTM, as well as CNN and the novel and more advanced attention-based algorithms such as the Transformer Encoder and BERT-Base. The model performances of these algorithms were evaluated with and without pre-trained word embeddings. The Transformer Encoder model stood out as the best model for all tasks and the CNN model produced comparable performance when …

Swach Network Map Summary Report: Healthconnect Hub & Broader Ecosystem: Network Maps, Natalie Royal Kenton, Benjamin Gronowski, Sarah Roth, Hannah Cohen-Cline, Abby Bush

Articles, Abstracts, and Reports

No abstract provided.

The Clinical Healthcare Provided To Homeless Communities Across The United States: A Literature Review, Saylor Sisemore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Homelessness has become a global public health concern as it results in poorer physical and mental health than age-matched people living in permanent housing (Ortiz & Roser, 2017). The area that comprises Northwest Arkansas (NWA), like other areas of the United States experiencing rapid growth, has seen a marked increase in the number of people experiencing homelessness in recent years. The homeless population is one of the most vulnerable and underserved groups of individuals in NWA and beyond. Public health nursing as a discipline is dedicated to providing compassionate care and exceptional service for all members of communities, with special …

Healthconnect Hub Report Long Term Impact Of Pathways, Hannah Cohen-Cline, Taylor Doren, Kyle G Jones, Jb Rinaldi, Sarah E Roth

Articles, Abstracts, and Reports

No abstract provided.

Healthconnect Long-Term Impact Of The Healthconnect Hub By County, Hannah Cohen-Cline, Taylor Doren, Kyle G Jones, Katherine Marsi, Jb Rinaldi, Sarah E Roth

Articles, Abstracts, and Reports

No abstract provided.

Hpv-Associated Anal Cancer Knowledge, Attitudes, And Health Communication Behaviors Among Non-Clinical Providers At Hiv/Aids Service Organizations In Southern United States Region, Olufunto A Olusanya, Aditi Tomar, Jonathan Thomas, Praisy Johnson, Lisa T Wigfall

Faculty, Staff and Student Publications

Co-infection with HIV/HPV and bio-behavioral risk factors (e.g., immunodeficiency, un-protected sex) increase likelihood for developing anal and other HPV-associated cancers among people living with HIV/AIDS (PLWHA). We explored knowledge, attitudes, and health communication regarding HPV-associated anal cancers among HIV/AIDS service organization (ASO) employees/volunteers delivering non-clinical services to PLWHA. Participants (n=59) were recruited from six ASOs located in the South United States Census region and completed a 118-item self-administered survey. For current analyses, outcome measures were knowledge, attitudes, and health communication regarding anal cancer. Descriptive statistics assessed outcome measures which were subsequently dichotomized into binary variables (i.e., high/favorable or low/unfavorable). Fisher's …

Lessons Learned: Covid-19 In Post-Corrections Secured Behavioral Rehabilitation, Jennifer G. Jones, Maria Devalpine, Erica J. Lewis

Virginia Journal of Public Health

Background: The COVID-19 case rate on June 5, 2020, for prisoners in the United States (US) was 5.5 times higher than the US population case rate (Saloner et al., 2020). Secure facilities were challenged to mitigate the spread of COVID-19. One secure behavioral rehabilitation facility made many changes to facility and program protocols to meet this challenge.

Methods: The purpose of this program evaluation was to assess newly implemented infection control measures at a secure behavioral rehabilitation facility and to inform policy and procedure recommendations for the mitigation of COVID-19 transmission in congregate living facilities in the future. Case rates, …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Determinants Of Ambulatory Patients’ Satisfaction With Encounter At Core Service Stations In A Tertiary Hospital Of A Developing Country, Ndubuisi Emuka Opurum, Ogaji Samuel Daprim, Felix Emeka Anyiam

Patient Experience Journal

Patients may have different and complex convictions of what their idea of satisfaction is, which may not be addressed regarding what they perceive as satisfaction. Therefore, using the patients’ demographic and clinical characteristics could tailor the individual needs of these patients, hence, providing feedback and recommendations on improvement in services provided. This study examined the determinants of patients’ satisfaction with general outpatient department (GOPD) services of a tertiary hospital in Rivers State, Nigeria. A descriptive cross-sectional study was carried out among new and repeat patients attending the GOPD of the University of Port-Harcourt Teaching Hospital, Rivers State, Nigeria. A structured …

The Experiences And Challenges Of Community Health Volunteers As Agents For Behaviour Change Programming In Africa: A Scoping Review, Mary Ndu, Ellena Andoniou, Sorcha Mcnally, Francisco Olea Popelka, Marisa Tippet, Elysee Nouvet

Health Studies Publications

ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a …

Full Issue, Winthrop Mcnair Research Bulletin

The Winthrop McNair Research Bulletin

Winthrop McNair Research Bulletin Volume 5, Full Issue

Brazil's Family Health Strategy: An Examination Of The Experience Of Community Health Workers And Their Impact On The Commonwealth, Ximena Perez-Velazco

The Winthrop McNair Research Bulletin

This study explores the experience of community health workers―front line public health workers― who provide low-level health intervention as they are integrated into multidisciplinary teams of health professionals, under the constitution of Brazil’s Family Health strategy, a policy established in order to provide universal primary care in Brazil. Furthermore, this research looks into how the community health workers’ role in bridging the gap between the public health efforts and the commonwealth initiates health literacy and health practices within the community and the CHWs themselves. There is little to no research on the subject of community health workers’ physical or mental …

Vitamin C Supplementation For The Treatment Of Covid-19: A Systematic Review And Meta-Analysis, Monika Olczak-Pruc, Damian Swieczkowski, Jerzy R Ladny, Michal Pruc, Raul Juarez-Vela, Zubaid Rafique, Frank W Peacock, Lukasz Szarpak

Faculty, Staff and Students Publications

Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), millions of people have died, and the medical system has faced significant difficulties. Our purpose was to perform a meta-analysis to estimate the effect of vitamin C on in-hospital mortality and the ICU or hospital length of stay for patients diagnosed with COVID-19. We conducted a systematic review with meta-analysis in the following databases: PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials. We included studies that evaluated the effect of vitamin C supplementation, compared with standard treatment …

From World War Ii To Covid-19: A Historical Perspective On The American Medical Supply Chain, Hunter D Bechtold, Andrea T Cruz, Brent D Kaziny

Faculty, Staff and Students Publications

COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.

Observational Study Of The Clinical Performance Of A Public-Private Partnership National Referral Hospital Network In Lesotho: Do Improvements Last Over Time?, Nancy A. Scott, Jeanette L. Kaiser, Brian W. Jack, Elizabeth L. Nkholongo, Allison Juntunen, Tshema Nash, Mayowa Alade, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Public-private partnerships (PPP) may increase healthcare quality but lack longitudinal evidence for success. The Queen ‘Mamohato Memorial Hospital (QMMH) in Lesotho is one of Africa’s first healthcare PPPs. We compare data from 2012 and 2018 on capacity, utilization, quality, and outcomes to understand if early documented successes have been sustained using the same measures over time. In this observational study using administrative and clinical data, we assessed beds, admissions, average length of stay (ALOS), outpatient visits, and patient outcomes. We measured triage time and crash cart stock through direct observation in 2013 and 2020. Operational hospital beds increased from 390 …

Patterns And Determinants Of Hiv Postexposure Prophylaxis In A Tertiary Health Facility In Nigeria, Onyinye H. Chime, Edmund O Ndibuagu, Wilfred O. Okenwa

International Journal of Health and Allied Sciences

Background: One of the targets of HIV prevention strategy is to ensure that 95% of the population access prevention services by 2030 with the aspiration of ending the AIDS epidemic by 2030. Methods: This is a record-based cross-sectional review. Data was extracted from the PEP registers and treatment folders from January 2017 to December 2021. Results: Non-occupational exposure (82.5%) was reported more than occupational (17.5%). Majority of cases (442) resulted from rape. Only 9.1% of the clients returned for follow-up and all were negative. Conclusion: Behavioral interventions designed to promote HIV risk reduction and protective behaviors should be promoted.

Cross-Sectional Study On Overweight And Obesity Associated With Fast-Food Consumption In Bangladesh, Farhana Sultana, Shafayet Ahmed Siddiqui, Md. Ashraful Islam, Mohammad Hamid Al Muktadir, Md. Shalahuddin Millat, Muhammed Mohibul Islam, Abu Montakim Tareq, Nahida Afroz, Mahabuba Rahman, Mohammad Nurul Amin, Talha Bin Emran

Makara Journal of Health Research

Background: This study aimed to investigate the risk factors and status of fast-food consumption among students in Bangladesh.

Methods: This cross-sectional study was conducted from March to November 2020. A total of 654 samples were collected from several schools, colleges, and universities during this study period.

Results: About 60.1% and 39.9% of the students were male and female, respectively. Of the students, 53.1% considered fast food as unhealthy (p < 0.001), but only 47.7% were leading a sedentary lifestyle. A significant outcome of overweight and pre-obesity was observed for student institutions, consumption frequency, daily fast-food consumption, and sedentary lifestyle (p < 0.001). In addition, positive association was observed for fast-food consumption more than three times and less than three times per week (OR and 95% CI: 11.13 [7.52–16.47], p < 0.001), higher social class and lower class (OR and 95% CI: 2.18 [1.31–3.62], p = 0.003), fast food preference and other foods (OR and 95% CI: 1.55 [1.11–2.15], p = 0.009), and sedentary and heavily active lifestyle (OR …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

Visual Factors Associated With Physical Activity In Schoolchildren, Síofra Harrington, John Kearney Prof, Veronica O'Dwyer Dr

Articles

Clinical relevance Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland.

Background This study explored the association between visual function in children and their engagement with physical activities outside school.

Methods Participants were 1,626 schoolchildren (728 aged 6–7 years, 898 old 12–13 years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (/week engaged in sports), or regular activity ( …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

Improving Knowledge, Attitude, And Compliance Of Hand Hygiene Of Iranian Healthcare Workers: A Pilot Study Using Reminder Card, Zahra Chegini, Ifeoluwapo Kolawole, Prashant Singh, Farzaneh Alikhah, Yalda Rasti, Zahra Motazedi

Journal of Health Research

Background: Compliance rate of hand hygiene practice by healthcare workers has been observed to be universally low despite its importance, simplicity and cost-effectiveness in preventing the spread of infectious diseases in the healthcare settings. This study aimed to improve healthcare workers’ knowledge, attitudes, and compliance with hand hygiene by using reminder cards displayed by patients.

Method: This before-after interventional study was carried out in 2019 among healthcare workers of a hospital in Tabriz, Iran. The intervention was a ‘Reminder Card’ showed by patients to remind healthcare workers to clean their hands. Participants' knowledge and attitude about hand hygiene and …

On Epidemiology As Racial-Capitalist (Re)Colonization And Epistemic Violence, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never …

Covid-19 Pandemic Impact On Essential Public Health Services And Online Health Communication—Appalachian Kentucky, March–December 2020, Margaret A. Riggs, Kenny Ortiz-Jurado, Keith Klein

Journal of Appalachian Health

Introduction: The COVID-19 pandemic posed many challenges for local health departments (LHDs). This study examines how stay-at-home orders impacted the provision of essential public health services and subsequent increased use of online health communication by LHDs for rural populations in Appalachian Kentucky during the first year of the COVID-19 pandemic.

Methods: A survey to gather information about provision of essential public health services was administered to five LHDs representing 13 counties between June 2020 and December 2020. Additionally, demographic and health-outcome data from LHD, state health department, and CDC websites were reviewed, alongside health communications posted on LHD social media …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …