Health Services Research Commons^™

Facility-Based Uptake Of Colorectal Cancer Screening In 45-49-Year-Olds After U.S. Guideline Changes, Alyssa H. Harris, Hannah Murphy, Madeleine Mcdowell, Margaret E. Wright, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

No abstract provided.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Experiences And Impacts Of A Hospital-Based, Spanish-Language Teaching Kitchen And Garden On Staff And Participants, Sarah E Roth, Benjamin Gronowski, Heidi Davis

Articles, Abstracts, and Reports

No abstract provided.

Oregon Doula Workforce Analysis, Aisha K Gilmore, Apoorva Somayazulu, Lindsay Dickey, Rosemelty Jimenez Medal

Articles, Abstracts, and Reports

No abstract provided.

Researching Dementia Indicators Among Rural Populations, Justin S. Yount

Theses and Dissertations--Community & Leadership Development

The study explored potential dementia indicators and risk factors among older adults residing in rural areas who are actively engaged in farming operations. Data was collected in three components a questionnaire, an audiogram test, and a memory impairment screening. 104 people responded to the questionnaire, 133 participants took the audiogram test, and 94 participated in the memory impairment screening. The findings revealed that 80.9% of participants showed no sign of cognitive impairment while 19.1% showed signs of possible impairment. Participants reported moderate levels of physical and social activity, but common risk factors such as elevated BMI, diabetes, hearing loss, and …

Understanding The Impact Of The Care Connect Washington Program, Hannah Cohen-Cline, Dan Fish, Taylor Doren, Abby Bush

Articles, Abstracts, and Reports

No abstract provided.

At The Crossroads: Initial Findings And Lessons Learned From A Medicaid Housing Benefit Pilot, Cat Livingston, Megan Holtorf, Benjamin Gronowski, Alyssa Cragie

Articles, Abstracts, and Reports

No abstract provided.

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

Non-Profit Hospital Spending On Community Health Improvement: Catalysts, Impediments, And Opportunities In New York State, Isaac H. Michaels

Electronic Theses & Dissertations (2024 - present)

This dissertation assesses the distribution and determinants of spending by non-profit hospitals in New York State on community health improvement services and community benefit operations. Utilizing the Social Ecological Model of Health, this study considers multiple levels of influence on this spending, including organizational and community characteristics. Using quantitative analysis, it examines cross-sectional, spatial, and longitudinal patterns in spending and identifies organizational and community-level factors influencing it. Qualitative analysis investigates operational factors affecting spending, including individual and interpersonal influences. The results of this mixed-methods study can inform hospital administrators, public health officials, policymakers, and communities in optimizing policies and decision-making …

State Of The States: Blueprints For Building Age-Friendly Futures, Megan Stubbs-Richardson, Lauren E. Etheredge, Tockie V. Hemphill, Zaccheus J. Ahonle, Danielle K. Nadorff

Publications

Executive Summary:

Mississippi’s aging population growth mirrors national trends and suggests a need to establish equitable and sustainable age-friendly policies and programs. This report offers an overview of the best practices from age-friendly states, which can be adapted to meet unique challenges and opportunities for Mississippi’s aging population. We highlight five age-friendly policy areas that can improve Mississippi’s livability.

• Aging in Place: Best practices from California, Florida, and Massachusetts can be adapted to promote aging in place through structural changes to homes via universal design and home modifications, or through supportive housing programs and home care.

• Cross-Sector Collaboration: …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Determinant Factors Of Unmet Need In Family Plannung (Fp): A Systematic Review, Titin Ifayanti

Preventia: The Indonesian Journal of Public Health

Unmet Needs in family planning (FP) remain a concern in many countries worldwide and can, therefore, adversely affect women, families, and society. Around 12 percent of women worldwide have an unmet need. Such effects include widespread disease, increased maternal mortality, and psychological disorders among women. This study aimed to elucidate the factors associated with the unmet need for family planning. The research approach used was a systematic review, literature was identified through Google Scholar, PubMed, and (NLM): National Library of Medicine. A systematic review and literature analysis of 9 articles was carried out, which utilized secondary data and cross-sectional study …

Strategy For Improving Smoking Cessation Services In Primary Health Care, Evita Rosdiana Hutapea, Risky Kusuma Hartono

Preventia: The Indonesian Journal of Public Health

Amidst the rising numbers of smokers in Indonesia and the increasing burden of smoking-related diseases on the country, the Smoking Cessation Services (SCS) still fail to operate optimally. The aim of this research is to develop a more effective strategy for the SCS model based on the challenges encountered during its implementation. The research method employed qualitative study with a case study approach. The research location was in Depok City, chosen as a national exemplary of SCS. Research period from February to May 2024. Data collection was conducted through in-depth interviews and observations at Community Health Centers who involved in …

Bio-Preparedness In A Global Context: Multi-Site International Study Investigating Global Health Security Challenges In Egypt, Oman, And The United States, Rima M. Al Balushi

Theses & Dissertations

The COVID-19 pandemic exposed myriad vulnerabilities globally within public health systems, from inadequate bio-risk management in laboratories to overwhelming utilization of hospital resources and disparities in vaccine access and uptake. The Global Health Security Index (GHSI), which critically evaluates health security domains including health systems and risk environments, reports serious weaknesses in global health security. This dissertation aims to investigate critical aspects of global health security domains by examining factors impacting biosafety and biosecurity capacities in laboratories in Egypt, healthcare resource utilization in hospitals in Oman relating to acute respiratory infections (ARI), and COVID-19 vaccine uptake in the United States. …

Reflections From The Pandemic: Is Connectivism The Panacea For Clinicians?, Jennifer Benjamin, Tyson Pillow, Heather Macneill, Ken Masters, Anoop Agrawal, Neil Mehta

Faculty, Staff and Students Publications

The COVID-19 pandemic and the recent increased interest in generative artificial intelligence (GenAI) highlight the need for interprofessional communities' collaboration to find solutions to complex problems. A personal narrative experience of one of the authors compels us to reflect on current approaches to learning and knowledge acquisition and use solutions to the challenges posed by GenAI through social learning contexts using connectivism. We recognize the need for constructivism and experiential learning for knowledge acquisition to establish foundational understanding. We explore how connectivist approaches can enhance traditional constructivist paradigms amid rapidly changing learning environments and online communities. Learning in connectivism includes …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Service Provider Perceptions Of Systems Serving Individuals Experiencing Homelessness: A Needs Assessment And Strategic Plan In Johnson City, Tn, Opal Frye-Clark

Electronic Theses and Dissertations

This Integrated Learning Experience (ILE) investigates service providers' perceptions of Johnson City, Tennessee's homelessness services, aiming to inform a city-wide strategic plan for reduction. Employing a mixed-methods approach, the study gathered qualitative data through in-depth interviews with service providers in 2022 and quantitative data via a 2024 survey. The research focused on those directly involved in serving or significantly influencing the lives of individuals experiencing homelessness (IEH). Three key aims guided the investigation: (1) To analyze provider perspectives to identify community assets, opportunities, barriers, and unmet needs, informing a comprehensive needs assessment; (2) To refine these findings through SWOT analysis …

Quality Of Outpatient Care In Lebanon: A Cross-Sectional Survey, Georges Choueiry, Anna Maria Henaine, Rayan Darwish, Pascale Salameh

Patient Experience Journal

Patient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average …

Evaluation Of A Trauma-Informed Care (Tic) Training Program Across Community Health Centers In Texas: A Qualitative Study, Jihye Choi, Efrat K Gabay, Aimee Rachel, Aniela Brown, Roxana Cruz, Qiheng Yan, Paula M Cuccaro

Faculty, Staff and Student Publications

BACKGROUND: In April 2019, Texas Association of Community Health Centers launched the Trauma-Informed Care (TIC) program in community health centers across Texas. This initiative aimed to transform organizational culture for consistent delivery of TIC by providing training and coaching opportunities for Trainers and Champions in each health center. This study is an interim qualitative evaluation to gain participants' insights into their experiences of and perceptions about TIC training as part of the TIC initiative.

METHODS: We conducted semi-structured key informant interviews via Zoom with Trainers across four cohorts of participating health centers between February 2020 and April 2023. We used …

Experiences And Impacts Associated With A Spanish Language Cooking And Gardening Pilot Program, Sarah E Roth, Benjamin Gronowski, Roma Leiva

Articles, Abstracts, and Reports

No abstract provided.

Housing As A Medicaid Benefit: Initial Lessons Learned From Health Share’S Housing Benefit Pilot Program, Monique Gill, Benjamin Gronowski, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Implementation Of Healthy Heart Ambassador To Improve Blood Pressure Control At Community Health Centers In Texas, Natalia I Heredia, Ella R Garza, Fernanda Velasco-Huerta, Tracy L Swoboda, Pierre Fwelo, Patenne D Mathews, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Hypertension is one of the most prevalent chronic diseases in the United States and can increase a person's risk of stroke and other cardiovascular complications. Yet only 1 in 4 people with high blood pressure in the United States have their blood pressure managed. To improve hypertension control, we supported 9 health centers in Texas with the implementation of the Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA) Program.

METHODS: We provided health center training using the HHA Program Facilitation Training Guide, recorded barriers to implementing the HHA program, and employed strategies to overcome those barriers.

RESULTS: There were 68 …

The Challenges Of Down Syndrome Screening In Primary Healthcare For Pregnant Women In Iran In 2018, Mona Zeinaloo, Mohammad Shariati, Masoud Younesian, Azita Kheiltash

Makara Journal of Health Research

Background: This study aimed to evaluate the various aspects of the implementation phase, including an economic evaluation, of Iran’s Down syndrome (DS) screening program.

Methods: Data were collected via phone interviews involving three random sample groups, with each group consisting of 1000 mothers who completed their pregnancies in 2018. To analyze the DS screening program from an economic aspect, we compared the costs related to the care of a DS individual in the country with that of finding and aborting a DS fetus based on the current screening program. In addition, to examine the financial expenses, we assessed …

Perceptions Of Hiv-Related Comorbidities And Usability Of A Virtual Environment For Cardiovascular Disease Prevention Education In Sexual Minority Men With Hiv: Formative Phases Of A Pilot Randomized Controlled Trial, S Raquel Ramos, Harmony Reynolds, Constance Johnson, Gail Melkus, Trace Kershaw, Julian F Thayer, Allison Vorderstrasse

Faculty, Staff and Student Publications

Background: Sexual minority men with HIV are at an increased risk of cardiovascular disease (CVD) and have been underrepresented in behavioral research and clinical trials.

Objective: This study aims to explore perceptions of HIV-related comorbidities and assess the interest in and usability of a virtual environment for CVD prevention education in Black and Latinx sexual minority men with HIV.

Methods: This is a 3-phase pilot behavioral randomized controlled trial. We report on formative phases 1 and 2 that informed virtual environment content and features using qualitative interviews, usability testing, and beta testing with a total of 25 individuals. In phase …

Rural Oral Health Access Disparities In New York State, Renae Williams Atkinson Dmd, Ms, Stacy Mcilduff Cfre, Hayward Derek Horton Phd

The New York State Dental Journal

Disparities in access to dental care for those whose primary/only dental insurance is Medicaid is a known issue. The infamous case of 12-year-old Deamonte Driver from Maryland brought this great need for access to private dental care through Medicaid to the fore. Yet, to this date, there has been no resource to address this great need.

Dentists accepting Medicaid fall into two categories: those who practice in federally qualified health centers (FQHC), and those who practice privately. FQHCs are known anecdotally to have long waitlists, delaying access to needed care (as in the case of Driver). This is compounded by …

Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow

University Honors Theses

Harm reduction (HR) is a movement focused on reducing the harms of the opioid overdose crisis through education, advocacy, and community engagement. A key component of HR is naloxone, a medication which reverses opioid overdoses when administered. Due to increased fentanyl contamination, opioid overdose deaths have been on the rise among adolescents in the U.S and HR practices are crucially important at this point in time. In recent years, alternative curricula of HR education have included a neuroscience-based approach to the topic of substance use. While both traditional and alternative programs have had success increasing substance use literacy among adolescents, …

Double Burden Of Persons With Disabilities: Are Those More Likely To Suffer From Chronic Disease?, Salsabila Kusumawardani, Hardiyani Puspitasari, Muhammad Ciro Danuza, Yusuf Faisal Martak

Masyarakat: Jurnal Sosiologi

This study examines the likelihood of persons with disabilities experiencing chronic diseases compared to those without disabilities, emphasizing the role of demographic characteristics. Prior research shows that individuals with disabilities have a higher risk of chronic diseases due to pre-existing health conditions, secondary complications, healthcare access barriers, and limited health education. Beyond these factors, we argue that demographic characteristics—such as age, gender, insurance status, and living environment—also shape daily habits and lifestyles that influence long-term health outcomes. Using probit regression analysis, this study quantifies the probability of chronic disease among persons with disabilities. Our findings indicate that individuals with disabilities …

Transitions Of Care And The Prevention Of Readmissions, Beatriz Granado

Student Scholarly Projects

Unplanned hospital readmissions often result from poor discharge planning and challenges during the transition from hospital to home, including medication errors and weak communication with primary care providers. A well-organized and personalized discharge plan can significantly reduce hospital stays, lower readmission rates, minimize medication errors, and improve patient outcomes, all while decreasing healthcare costs. In post-discharge Medicare-eligible patients (P), how does transitional care coordination through organized, personalized, and patient-focused discharge planning (I), compared with standard or no transitional care coordination provided (C), affect readmissions (O) within the 30-day post-discharge phase monitored over a 10–12-week period (T)? A search was conducted …

Community Participation Of The “Kampung Kb” Program: Study In Malang City Year 2020, Rany Ekawati, Ema Novita Deniati, Anindya Hapsari, Lu'luim Mutakifah, Annisaa Annisaa, Lilik Ariyanti

Preventia: The Indonesian Journal of Public Health

Indonesia has a significant population problem. The national population grows by a staggering 4.5 million people annually, and Malang is one example of a city experiencing this rapid growth. The government is implementing a program called "Kampung KB" to address this issue. The purpose of this research is to provide an overview of the participation of the people of “Kampung KB” Malang City. This study uses qualitative research with in-depth interviews, then analyzed using data triangulation. This research was conducted from September to December 2020. The research location was six “Kampung KB” in Malang City. The result of this research …

Barriers To The Assessment And Recommendation Of Hpv Vaccination Among Healthcare Providers In Texas, Onyema G Chido-Amajuoyi, Ikponmwosa Osaghae, Henry K Onyeaka, Sanjay Shete

Faculty, Staff and Student Publications

BACKGROUND: Healthcare providers (HCPs) recommendations for HPV vaccination plays a critical role in increasing vaccination uptake. This study assesses the prevalence of reported barriers to HPV vaccination assessment and recommendation among HCPs in Texas.

METHODS: Study data were obtained from a population-based survey of HCPs currently practicing in Texas. Participants were asked about their HPV vaccination assessment and recommendation practices and the reasons for not assessing or recommending the vaccine. Barriers were stratified by HCP characteristics including age, sex, race/ethnicity, location of practice, provider type, and type of facility.

RESULTS: Among the 826 HCPs included in this study, 47.3 % …