Health Services Research Commons^™

The Power Of Patient Ownership: The Path From Engagement To Equity, Zal Press, Dawn Richards

Patient Experience Journal

Understanding patient engagement from the lens of a person who is suffering, who is in pain and anguish, who is wracked with fear of the impact of this pain on their body, their family, their career, and their mortality, is a complex undertaking. The authors provide an important patient perspective in acknowledging and highlighting efforts to shift the conversation on experience from one about patients and families to one with patients and families. They challenge us to consider the power that can be found in creating ownership for patients and suggest it may be the one true path to moving …

Reframing The Work On Patient Experience Improvement, Jocelyn Cornwell

Patient Experience Journal

In reframing the work on patient experience improvement Dr. Jocelyn Cornwell, chief executive of The Point of Care Foundation, challenges us to broaden our view on what is necessary to impact patient experience efforts. From a defined need to reduce avoidable suffering associated with health care delivery dysfunction, she suggests we extend the discussion in two ways: First, to include a concern for staff engagement, experience and well-being, and second, to position patient experience improvement as one type of quality improvement (QI) in healthcare, and urge practitioners to pay more attention to the lessons from QI in other domains. High …

Patient Experience Established: One Year Later, Geoffrey A. Silvera, Jason A. Wolf Phd

Patient Experience Journal

Scholars and administrators have long dedicated themselves to centering healthcare conversations and debates on the experiences of patients and their families. Patient experience advocates view these experiences as critical to evaluations of healthcare quality. There have been a great multitude of important contributions, yet, for decades, these calls for patient-centric care experiences and healthcare systems have been confined to the fringes of disparate health policy and reform debates. This bygone reality created a diaspora of scholars and administrators dedicated to understanding, evaluating, and improving the patient experience. This article begins to explore a coalescing around patient experience research efforts citing …

The Patient Experience Movement Moves On, Jason A. Wolf Phd

Patient Experience Journal

As we present Volume 2 of Patient Experience Journal (PXJ) we both recognize the contributions that helped launch this publication and acknowledge the work that helped build the foundation of the broader research exploration in the emerging field of patient experience. On this base of knowledge we have worked to establish a new home for expanding the exploration of new ideas and practices through this publication. The importance of building, supporting and sustaining an outlet for research in patient experience is grounded in the belief that positive patient experience is good for healthcare, it is good for the people who …

Ulaanbaatar’S Ger District Issues: Changes And Attitudes, David Engel

Independent Study Project (ISP) Collection

Several of Ulaanbaatar’s current issues are directly related to Ulaanbaatar’s sprawling Ger District. The Ger District is home to approximately 736,000 residents, 61% of Ulaanbaatar’s population (Galimbyek, 2015). The significant growth in Ulaanbaatar is shown by its 52.8% of residents who were born outside of the city, the majority of migrants moving into the Ger District due to a lack of housing. (Chilkhaasuren & Baasankhuu, 2012). The development of Ulaanbaatar has not kept up with the rapid growth leading to inadequate infrastructure in much of the Ger District. In turn, inadequate infrastructure has lead to high pollution levels, negatively affecting …

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Health Management and Policy Presentations

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.

Deconstructing Unmade Examining The Capacity Of Ayurveda To Address India’S Mental Health Crisis, Cassie Sutten Coats

Independent Study Project (ISP) Collection

Though India does not have a credible, widespread system in place to recognize and focus on issues of mental health, especially in allopathic treatments, it is imperative to evaluate the existing practices and approaches in regards to mental health alongside the impact that these approaches may have on Indian society. In contrast to Westernized systems of medicine, the traditional Indian system of Ayurveda inherently addresses issues in mental health due to the holistic approach through mind-body medicine. This study evaluates the enormous potential that exists within Ayurvedic philosophy to provide adequate, culturally congruent, treatments and care in mental health, and …

Investigating Barriers To Early Cancer Detection For Rural Indian Women: A Qualitative Analysis Of Cancer Outreach In Dehradun, Uttarakhand, Blair Burnett

Independent Study Project (ISP) Collection

This study examines barriers to early detection for women’s specific cancers in rural India in and around Dehradun, Uttarakhand, within the framework of existing health outreach programs from tertiary hospitals in the state. The burden of cancer mortality within India is disproportionately affecting women living in rural populations considering the current health education and health care infrastructure in place. Barriers of knowledge, access to knowledge, economic condition, geography, and cultural norms are all examined within this study in the context of early cancer detection. National Indian health policy is currently framed to address the burden of cancer within India; however, …

Effect Of Females In Leadership Roles On Menstrual Sanitation In Rural Jamkhed, India, Kirsten Hughes

Independent Study Project (ISP) Collection

Introduction: Menstruation is integral to puberty and maturation of adolescent girls. Education about menstruation and menstrual hygiene effects a woman’s physical and psychosocial health through the majority of her life.

Purpose: This study seeks to answer the following questions: Who is providing information to girls before or after their first menstruation? Is this information timely, appropriate and accurate? Is the information effective enough to see changes in menstrual practices through a family and community? In answering these questions, the study attempts to determine the pathways of communications regarding menstruation and menstrual health in the Jamkhed area of the Ahmednagar district …

Babies First: Ensuring Proper Infant Nutrition During Emergencies, Abigail M. Alonso

Independent Study Project (ISP) Collection

Background: Breastfeeding is the best source of nutrition for an infant, living in all regions and cultures. Recommendations apply across the board, from developed nations to refugee camps, from women with HIV to those with time constraints regarding feeding. There also exists a complex relationship between corporations that provide BMS and the NGOs working to promote breastfeeding in emergency situations amongst vulnerable populations.

Objective: The objective of this paper is to expose breastfeeding promotion, using the Dadaab camps in Northeastern Kenya as a case study of IYCF programs and support of breastfeeding among low-literacy populations with an emphasis on women …

El Rol Del Parto Mapuche En El Mundo De La Medicina Moderna / The Role Of Mapuche Birth In A World Of Modern Medicine, Nita Chai

Independent Study Project (ISP) Collection

Research Question: Is there existing demand for Mapuche birth practices and what are the barriers to incorporating them in the Chilean healthcare system? Objective: Analyze the current role of Mapuche birth practicesby determining what is the demand from the Mapuche for their use, describing the quality of communication between Mapuche women andmodern professionals, and identifying the perspectives of modern professionals on Mapuche birth practices. Background: Childbirth is an integral process for the human race. For many indigenous communities, the arrival of a new life holds cultural significance that is recognized through ceremonies during or after childbirth. Chile has implemented health …

The Impact Of The Veterans Health Administration's Home Based Primary Care On Health Services Use, Expenditures, And Mortality, Melissa Castora-Binkley

USF Tampa Graduate Theses and Dissertations

Background: Among patients with multiple chronic conditions, care coordination and integration remains one of the major challenges facing the U.S. health care system. A home-based, patient-centered primary care program has been offered through the Veterans Health Administration (VHA) since the 1970s for frail veterans who have difficulty accessing VHA clinics. The VHA Home Based Primary Care (VHA HBPC) aims to integrate primary care, rehabilitation, disease management, palliative care, and coordination of care for frail individuals with complex, chronic diseases within their homes. Early research suggested that VHA HBPC was associated with positive outcomes (e.g., reduced resource use and patient satisfaction). …

Answering The Call To Integrate: Simple Strategies From Public Health And Healthcare Executives In One Urban County, Erik L. Carlton, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Background: As the Affordable Care Act transforms the practice of both public health and health care, it also provides opportunity for both to become more closely linked through improved integration and collaboration. Yet, while public health agencies are increasingly called to work with healthcare partners to address population health needs, both public health leaders and their healthcare counterparts may not be well equipped to answer that call. Although recent studies have begun exploring the collaborative strategies and capacity of public health system partners, there is still much to learn. The purpose of this study was to identify, through the perspective …

Accreditation Intent, Community Health Assessments, And Local Health Department–Hospital Collaboration, Erik L. Carlton, Simone Singh

Frontiers in Public Health Services and Systems Research

Background: Community health assessments (CHAs) are among the most core of activities conducted by local health departments (LHDs), and many LHDs have been conducting CHAs on a regular basis for years. More recently, completing a CHA has also become a prerequisite for LHDs seeking accreditation by the Public Health Accreditation Board (PHAB). Similarly, under the Affordable Care Act, tax-exempt hospitals are required to conduct periodic community health needs assessments. Opportunities thus exist for LHDs and tax-exempt hospitals to engage in collaborations related to CHAs. Yet, it remains unclear whether interest in PHAB accreditation provides incentive to LHDs to engage in …

Alternate Payment Models For Ryan White Hiv/Aids Program Funded Services: Strategies Used By Nine Grantees, Naomi Seiler, Scott Dafflitto, Rosalind Fennell, Julia Hidalgo, Katie Horton, Mary-Beth Malcarney

Health Policy and Management Faculty Publications

The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) offers Ryan White HIV/AIDS Program (RWHAP) Part A and Part B grantees some flexibility in determining the method used for paying subgrantees for core medical and support services. Many Part A and Part B grantees use a traditional “cost-based reimbursement” approach, in which subgrantees submit budgets that include personnel costs, other direct costs related to the provision of funded services, and capped indirect costs (IDCs). Some grantees, however, have developed alternative reimbursement models for core medical and/or support services. This report summarizes the reimbursement approaches taken by nine RWHAP grantees. …

Teaching Health Centers: A Promising Approach For Building Primary Care Work Force For The 21 St Century, Leighton Ku, Fitzhugh Mullan, Christine Cerrano, Zoe Barber, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Refining And Improving The Methodology For The National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

This first meeting of two newly reconstituted Working Groups for the National Health Security Preparedness Index Program examined opportunities for improving and refining the Index's measurement, scaling, weighting, and aggregation methodologies. Methodological improvements will enhance the Index's utility for education, planning, policy development, and quality improvement efforts focused on improving national preparedness and resiliency for large-scale health threats.

The Gas Cylinder, The Motorcycle And The Village Health Team Member: A Proof-Of-Concept Study For The Use Of The Microsystems Quality Improvement Approach To Strengthen The Routine Immunization System In Uganda, Dorothy A. Bazos, Lea R. Ayers Lafave, Gautham Suresh, Kevin C. Shannon, Fred Nuwaha, Mark E. Splaine

Dartmouth Scholarship

Although global efforts to support routine immunization (RI) system strengthening have resulted in higher immunization rates, the World Health Organization (WHO) estimates that the proportion of children receiving recommended DPT3 vaccines has stagnated at 80% for the past 3 years (WHO Fact sheet-Immunization coverage 2014, WHO, 2014). Meeting the WHO goal of 90% national DPT3 coverage may require locally based strategies to support conventional approaches. The Africa Routine Immunization Systems Essentials-System Innovation (ARISE-SI) initiative is a proof-of-concept study to assess the application of the Microsystems Quality Improvement Approach for generating local solutions to strengthen RI systems and reach those unreached …

Community Health Centers: A 2013 Profile And Prospects As Aca Implementation Proceeds, Peter Shin, Jessica Sharac, Zoe Barber, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2013, more than 1,200 federally funded community health centers provided access to care for low-income populations living in medically underserved communities throughout the country. The Affordable Care Act made expansion of health centers a key part of its strategy for ensuring that these communities would realize the benefits of increased health insurance coverage for their residents. As health insurance coverage expands under the Affordable Care Act (ACA) and the demand for primary care increases, the role of health centers is likely to increase. A key question going forward is whether health centers’ expanded capacity, developed over the past five …

Determinan Perilaku Tes Hiv Pada Ibu Hamil, Nanik Setiyawati, Niken Meilani

Kesmas

Human immunodeficiency virus (HIV) dan Acquired immune deficiency syndrome (AIDS) merupakan salah satu sorotan dalam pencapaian target Millenium Development Goals (MDGs). Ibu hamil dengan HIV akan berisiko menularkan kepada bayinya. Tes HIV merupakan gerbang pembuka status HIV yang sangat penting dilakukan pada ibu hamil. Penelitian ini bertujuan untuk menentukan determinan perilaku tes HIV pada ibu hamil yaitu tingkat pendidikan, tingkat pengetahuan, persepsi kerentanan diri tertular HIV, sikap, Provider-Initiated Testing and Counselling (PITC) dan ketersediaan sumber informasi (keluarga dan kader kesehatan). Jenis penelitian adalah potong lintang dengan metode survei. Penelitian ini dilakukan di Puskesmas Mantrijeron dan Puskesmas Sleman yang telah memiliki …

Efektivitas Air Perasan Kulit Jeruk Manis Sebagai Larvasida Nyamuk Aedes Aegypti, Dita Nurhaifah, Tri Wahyuni Sukesi

Kesmas

Demam berdarah dengue ditularkan nyamuk Aedes aegypti yang dapat dicegah dengan temefos. Penggunaan yang berkelanjutan berdampak pada resistensi nyamuk dan kerusakan lingkungan. Untuk itu perlu larvasida alami dengan menggunakan air perasan kulit jeruk manis. Tujuan penelitian untuk membuktikan efektivitas air perasan kulit jeruk manis dalam membunuh larva uji dilihat dari nilai LC50 dan LT50 serta perbedaan efektivitasnya dengan temefos. Sampel 25 larva Aedes aegypti setiap gelas media dengan kriteria inklusi instar III yang aktif dan kriteria eksklusi larva instar I, II dan yang telah menjadi pupa/mati. Larva uji diamati selama 24 jam dengan tiga kali pengulangan. Desain penelitian adalah eksperimental …

Pengaruh Faktor Personal Berpengaruh Terhadap Perilaku Seksual Pranikah Pada Remaja Di Kota Kendari Provinsi Sulawesi Tenggara, Rosdarni Rosdarni, Djaswadi Dasuki, Sumarni Djoko Waluyo

Kesmas

Perilaku seksual pranikah yang tinggi pada remaja disebabkan oleh faktor personal seperti pengetahuan kesehatan seksual, Infeksi Menular Seksual (IMS) dan HIV / AIDS, sikap terhadap seksualitas, harga diri dan efikasi diri. Penelitian ini bertujuan untuk mengetahui pengaruh faktor personal seperti pengetahuan tentang kesehatan seksual, IMS dan HIV / AIDS, sikap, harga diri dan efikasi diri terhadap perilaku seksual pranikah pada remaja di Kota Kendari yang diukur melalui kuesioner dan wawancara mendalam. Desain penelitian adalah studi potong lintang dengan jumlah sampel 200 remaja yang berasal dari empat sekolah negeri di Kota Kendari mulai dari Agustus sampai dengan Oktober 2014. Analisis regresi …

Determinan Stres Pada Pegawai Kementerian Kesehatan Republik Indonesia, Besral Besral, Winne Widiantini

Kesmas

Kejadian stres pada pelbagai kelompok di Indonesia cukup tinggi dan belum banyak diketahui determinannya. Penelitian ini bertujuan untuk mengetahui determinan stres pada pegawai Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Penelitian potong lintang ini dilakukan pada tahun 2013 terhadap 230 pegawai sekretariat jenderal yang dipilih secara acak. Analisis statistik menggunakan regresi logistik ganda. Responden dikatakan stres jika memiliki skor 28 atau lebih dengan menggunakan 17 pertanyaan terkait personal stress inventory. Hasil penelitian menunjukkan prevalensi stres sebesar 79% dan determinan stres adalah obesitas, usia, jabatan, suku, pendidikan, dan aktivitas fisik. Risiko stres lebih tinggi pada pegawai yang obesitas (ORadj = 1,9), pegawai …

Bioindikator Cemaran Timbal Pada Rambut Masyarakat Sekitar Kilang Minyak, Sukar Sukar, Suharjo Suharjo

Kesmas

Timbal atau Plumbum (Pb) bersifat toksik, karsinogenik, bioakumulator dan biomagnifikasi. Bioakumulasi Timbal dari media lingkungan dapat terjadi pada kuku, hati, dan rambut. Tujuan penelitian untuk mengetahui faktor risiko kejadian bioindikator timbal rambut masyarakat di kawasan industri minyak. Penelitian dilakukan pada tahun 2012 di Kota Dumai, Provinsi Riau. Rancangan penelitian khusus pencemaran lingkungan 2012 adalah type- 1 health study, yang disarankan US Agency for Toxic Substances and Drugs Registry (ATSDR). Analisis statistik bivariat dengan uji kai kuadrat. Populasi penelitian adalah penduduk Kota Dumai yang tinggal di desa Jayamukti, Tanjung Palas, Mekarsari, dan Bukit Timah. Sejumlah 110 ibu rumah tangga diambil dengan …

Mekanisme Hubungan Sosial Ekonomi, Pemanfaatan Pelayanan Kesehatan Dan Kehamilan Risiko Tinggi Terhadap Prevalensi Panjang Badan Lahir Pendek, Demsa Simbolon, Wahyu Dwi Astuti, Lusi Andriani

Kesmas

Prevalensi panjang badan lahir pendek di Indonesia masih tinggi dan menjadi masalah kesehatan masyarakat yang disebabkan oleh pelbagai faktor secara langsung dan tidak langsung serta berdampak luas dan berkelanjutan dalam siklus kehidupan. Penelitian menggunakan data Riset Kesehatan Dasar (Riskesdas) 2013 dengan pendekatan potong lintang bertujuan mengetahui mekanisme hubungan berbagai variabel laten terhadap prevalensi panjang badan lahir pendek. Sampel adalah 497 kabupaten yang diagregat dari data individu, yaitu anak lahir dari ibu berusia 15 hingga 49 tahun dengan kriteria anak kandung dan lahir tunggal. Pemodelan menggunakan Structural Equation Modelling. Kehamilan berisiko tinggi berhubungan positif langsung dengan prevalensi panjang badan lahir pendek …

Risiko Ergonomi Ketidaksesuaian Desain Dan Ukuran Tempat Duduk Sepeda Motor Terhadap Antropometri Pada Mahasiswa, Zulkifli Djunaidi, Rahmadani Arnur

Kesmas

Transportasi merupakan hal yang sangat dibutuhkan dalam menunjang pembangunan nasional. Belum baiknya sistem transportasi massal di Indonesia, membuat masyarakat lebih memilih menggunakan kendaraan pribadi, seperti sepeda motor yang praktis dan ekonomis untuk digunakan. Namun, dalam menggunakan sepeda motor, aspek ergonomi dan kenyamanan bagi pengendara perlu untuk diperhatikan. Desain dan ukuran tempat duduk sepeda motor yang tidak sesuai dengan antropometri duduk statis pengendara dapat menimbulkan kelelahan pada pengendara dan mengakibatkan terjadinya kecelakaan. Tujuan dari penelitian ini adalah untuk mengetahui risiko ergonomi dari ketidaksesuaian antara desain dan ukuran tempat duduk sepeda motor dengan antropometri duduk statis. Untuk menganalisis risiko ergonomi, dilakukan penelitian …

Model Pengendalian Faktor Risiko Stunting Pada Anak Bawah Tiga Tahun, Erna Kusumawati, Setiyowati Rahardjo, Hesti Permata Sari

Kesmas

Stunting merupakan masalah gizi, terbukti data pemantauan status gizi Kabupaten Banyumas 2012 prevalensi stunting sebesar 28,37% dan prevalensi tertinggi (41,6%) di Puskesmas Kedungbanteng. Tujuan penelitian untuk menganalisis faktor risiko terkait faktor anak, ibu, lingkungan terhadap stunting bawah tiga tahun (batita) agar dapat dikembangkan model pengendaliannya. Penelitian menggunakan desain kasus kontrol, populasi adalah seluruh anak usia 6 sampai 36 bulan di Puskesmas Kedungbanteng Kabupaten Banyumas selama enam bulan tahun 2013. Sampel kasus adalah 50 batita stunting, sampel kontrol adalah 50 batita status normal. Teknik pengambilan sampel kasus diambil dari tujuh desa yang terbanyak stuntingnya, sedangkan kontrol adalah batita normal tetangga terdekat …

Lama Merokok Dan Jumlah Konsumsi Rokok Terhadap Trombosit Pada Laki-Laki Perokok Aktif, Rini Sundari, Dinyar Supiadi Widjaya, Aditya Nugraha

Kesmas

Jumlah perokok dan jumlah rokok yang dikonsumsi mengalami peningkatan dari waktu ke waktu. Rokok dapat memengaruhi trombosit yang dapat menyebabkan gangguan kardiovaskular. Penelitian ini merupakan penelitian potong lintang yang bertujuan untuk menganalisis lama merokok dan jumlah rokok yang dikonsumsi terhadap jumlah trombosit, mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), dan platelet large cell ratio (PLCR). Penelitian dilakukan di Pabrik Garmen Cimahi pada tahun 2014 yang diikuti oleh 31 laki-laki perokok aktif berusia 19 - 50 (32,97 + 10,28) tahun, 70,9% di antaranya sebagai perokok sedang. Analisis data dilakukan secara deskriptif, uji normalitas Shapiro-Wilk, dan uji korelasi …

Kejadian Anemia Pada Siswa Sekolah Dasar, Saifuddin Sirajuddin, Masni Masni

Kesmas

Anemia gizi besi masih merupakan masalah kesehatan masyarakat dengan prevalensi pada anak 5 - 12 tahun sebesar 29% di Indonesia dan di Kota Makassar sebesar 37,6%. Penelitian ini bertujuan untuk mengetahui faktor determinan (status kecacingan, status seng, kebiasaan sarapan pagi, pola konsumsi makanan sumber heme dan nonheme, pola konsumsi sumber makanan pelancar dan penghambat zat besi) terhadap kejadian anemia. Desain penelitian yang digunakan adalah potong lintang yang dilaksanakan pada bulan April – Juni 2014. Penelitian ini menggunakan desain potong lintang yang dilaksanakan pada siswa kelas 3 - 5 SD Negeri Cambaya Kecamatan Ujung Tanah Kota Makassar. Sampel sebanyak 120 siswa …

Pencegahan Resurgensi Malaria Dengan Deteksi Dini Dan Pengobatan Segera Di Daerah Reseptif, Teni Supriyani, Umar Fahmi Achmadi, Dewi Susanna

Kesmas

Jawa Barat merupakan salah satu wilayah reseptif malaria di Indonesia, khususnya Kabupaten Tasikmalaya bagian selatan. Tahun 2009, 2011, dan 2012 telah terjadi kejadian luar biasa (KLB) terutama di Kecamatan Cineam. Namun, pada tahun 2013 tidak terjadi KLB serupa. Ekosistem Cineam berupa pegunungan dan perkebunan kondusif untuk penularan malaria. Selain itu, banyak penduduk Cineam yang merupakan pekerja migran. Tujuan penelitian ini untuk mengidentifikasi faktor-faktor yang berkontribusi terhadap tidak terjadinya peningkatan kasus (resurgensi) malaria di daerah reseptif. Penelitian ini merupakan penelitian deskriptif kuantitatif yang dilakukan pada bulan Juni - Desember 2014, dengan menggunakan sampel seluruh penderita malaria positif di Kecamatan Cineam tahun …