Health Services Research Commons^™

The Relationship Of Attitude, Self-Efficacy, Physician, And Significant Other Influence To Type 2 Diabetes Outcomes, Heidi A. Larson

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to investigate the Theory of Planned Behavior (TPB) and its' relationship to Type 2 diabetes outcomes. One hundred and sixty-two adults ages 45 to 75 with Type 2 diabetes were recruited from two physicians' offices in the Midwest. Participants completed instruments that assessed (a) diabetes-specific attitude, (b) diabetes-specific self-efficacy, ( c) physician influence, ( d) significant other influence, and ( e) diabetes-specific quality of life. A measurement of metabolic control was also obtained. Multiple regressions were performed using (a) quality of life and (b) metabolic control as criterion variables. Attitude, self-efficacy, and physician influence …

Scope Of Services Offered By Critical Access Hospitals: Results Of The 2004 National Cah Survey, David Hartley Phd, Mha, Stephenie L. Loux Ms

Rural Hospitals (Flex Program)

No abstract provided.

Mainecare And Its Role In Maine’S Healthcare System, Paul Saucier

Disability & Aging

No abstract provided.

Technical Assistance And Training For Procosi Operations Research Program, Bolivia, Fernando Gonzales Salguero, Ricardo Vernon

Reproductive Health

In September 1999, PROCOSI, a Bolivian network of 24 nongovernmental organizations that provide health services, invited the Population Council Frontiers in Reproductive Health (FRONTIERS) program to provide technical assistance for designing and conducting operations research aimed at increasing the quality and impact of their reproductive health programs. In collaboration with PROCOSI, FRONTIERS conducted four training workshops on design of operations research projects, qualitative research methods, utilization and dissemination of research results, and preparing research reports. Technical assistance on other topics, such as developing research instruments, creating databases, and using EpiInfo for transcribing and analyzing data was provided on-site to each …

Transferring Ghana's System Of Evidence-Based Health Program Development: Program For An Initial Exchange With Sierra Leone And Burkina Faso, Frontiers In Reproductive Health

Reproductive Health

Ghana’s Community-based Health Planning and Services (CHPS) experiment demonstrated that mobilizing community volunteerism, in combination with retraining and redeploying nurses to village-based locations reduced childhood mortality rates in that country. Thus, CHPS has become the government’s primary strategy for realizing universal access to health care. This report provides a description of an initial exchange organized by the Ghana Health Service, the Navrongo Health Research Centre, and the Population Council to explore ways of transferring and adapting these evidence-based strategies to other countries in the region. The exchange included representatives from the Sierra Leone Ministry of Health and Sanitation and the …

Cross-Cultural Adaptation Of Reproductive Health Services In Bolivia, Fernando Gonzales Salguero, Antonieta Martin, Rosario Perez Mendoza, Ricardo Vernon

Reproductive Health

The Bolivian Ministry of Health and Sports and the Integral Health Project, with the technical assistance of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS), tested several strategies to make health services in Bolivia more culturally appropriate for the country’s indigenous peoples. The goal of the project was to increase women’s access to, use of, and satisfaction with health services in general, and reproductive health services in particular, through: a) enhanced understanding and acceptance of the “other” culture; b) improving communication skills; c) facilitating and promoting use of the Quechua language in clinics; d) systematically screening clients’ health service …

Operations Research To Improve Postabortion (Pac) Services In Three Public Hospitals, Bolivia, Fernando Gonzales Salguero, Mariel Loayza

Reproductive Health

In the last five years, Pathfinder Bolivia has provided technical assistance, training and equipment to the Ministry of Health (MOH) to implement postabortion care (PAC) services in eight hospitals. They invited Frontiers in Reproductive Health (FRONTIERS) to provide the technical assistance and training for conducting operations research (OR) activities. This report describes the second stage of this collaborative effort as presented in a three-day workshop attended by providers and staff members of the participant hospitals. During the workshop, participants received OR training and developed draft OR proposals seeking to improve PAC service delivery problems identified during the first study. The …

Use Of Systematic Screening To Increase The Provision Of Reproductive Health Services In Bolivia, James R. Foreit, Ricardo Vernon, Patricia Riveros Hamel

Reproductive Health

The objective of this study was to determine if the use of a checklist to screen for unmet service needs could increase the number of services per visit provided to clients using rural Bolivian health facilities. Measurement included changes in services per visit before and after the introduction of the intervention, and a comparison of services received at screened and non-screened visits. Findings show that, to the degree that provider compliance can be secured, systematic screening of clients appears to be an effective method for reducing unmet health service needs. The findings of this study replicate those of other studies …

Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr

Reproductive Health

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the …

A Descriptive Study Of Ethical Procedures That Maintain Cultural Security When Conducting Health Research With Aboriginal And Torres Strait Islander School Children In Western Australia, Dionne Paki

Theses : Honours

Cultural security is the maintenance of values and beliefs and the celebration of diversity unique to different cultures. This honours thesis developed a proposed framework to guide collaborative ethics procedures that demonstrate the Aboriginal values relevant to health research for use in Western Australia (WA). These values of reciprocity, respect, equality, responsibility, survival and protection, and spirit and integrity have been identified in the National Health and Medical Research Council's Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Ethical procedures for maintaining cultural security when conducting health research among Aboriginal people throughout Australia …

Mainecare Behavioral Health Care Expenditures State Fiscal Years 1996 – 2002, Susan Payne Phd, Stuart Bratesman Mpp, David Lambert Phd

Disability & Aging

No abstract provided.

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Gerontology Institute Publications

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

Mainecare Managed Care Performance Report 2003, Catherine Ormond, Stuart Bratesman

Disability & Aging

No abstract provided.

Research In Home-Care Telemedicine: Challenges In Patient Recruitment, Usha Subramanian, Faith Hopp, Julie Lowery, Peter Woodbridge, David Smith

Social Work Faculty Publications

This study reports challenges in recruiting patients for a randomized controHed trial of home-care telemedicinae. Descriptive statistics on patient eligibility for home-care telemedidne services and patient refusals for participation are provided. Frequency counts of reasons for study exclusion and participant refusal and Chi-square tests to compare race and age-related differences are given. Of 302 home-care patients reviewed, 197 (65.2%) did not meet inclusion criteria. The most common reasons for study exclusion were patients either needing <2 visits per month (n = 59, 30%) or >3 skilled nurse visits per week (n = 46, 23.4%). Of the eligible patients (n = 105), 79 …

Racial Discrepancies In The Association Between Paternal Vs. Maternal Educational Level And Risk Of Low Birthweight In Washington State, Christina Nicolaidis, Cynthia W. Ko, Somnath Saha, Thomas D. Koepsell

School of Social Work Faculty Publications and Presentations

Background: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups.

Methods: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for …

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Gerontology Institute Publications

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …

Democratic Ideas To Address The Problem Of Americans Without Health Insurance, Jeanne Lambrew

Health Policy and Management Congressional Testimonies

No abstract provided.

Effects And Cost Of Implementing A Gender-Sensitive Reproductive Health Program In Bolivia, Erica Palenque, Lizzy Montano, Ricardo Vernon, Fernando Gonzales Salguero, Patricia Riveros, John H. Bratt

Reproductive Health

The Integral Health Coordination Program (Programa de Coordinación en Salud Integral or PROCOSI), a network of 24 Bolivian NGOs, and the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program evaluated the effects of interventions on clinic clients and their partners, and estimated the costs of incorporating a gender perspective into service delivery. Results show that sexual and reproductive health service organizations can implement action plans to change organizational policies and service delivery practices and to improve their infrastructure and equipment to make them more convenient for clients. The results further show that the intervention made modest but important changes in …

Introduction Of Emergency Contraception In Bangladesh: Using Operations Research For Policy Decisions, M.E. Khan, Sharif M.I. Hossain, Md. Moshiur Rahman

Reproductive Health

The Directorate of Family Planning, Bangladesh, the Population Council, Pathfinder International, and John Snow Incorporated collaborated to conduct this operations research study to assess the acceptability and feasibility of providing emergency contraception pills (ECP) as a backup support to existing family planning methods. The study demonstrated that all categories of health providers, including NGO outreach workers, could be effectively trained to provide ECP services. The study also demonstrated high acceptability of ECP and revealed that if used correctly, the success rate in avoiding unwanted pregnancy was extremely high. The positive findings of the study have helped the Ministry of Health …

Improving Adolescent Reproductive Health In Bangladesh, Ismat Bhuiya, Ubaidur Rob, Asiful Haider Chowdhury, Laila Rahman, Nazmul Haque, Susan E. Adamchak, Rick Homan, M.E. Khan

Reproductive Health

An operations research project was launched in northwestern Bangladesh with the objective of preventing adverse outcomes and promoting healthy lifestyles among adolescents by providing reproductive health education and services. The Population Council, in collaboration with the Urban Family Health Partnership and its three nongovernmental service delivery partners, worked in three urban areas of the country. On the basis of its findings, the study first recommends implementation of a combination of reproductive health interventions at the school, community, and health-facility levels, accompanied by community sensitization, to effectively respond to adolescent reproductive health needs. Second, information providers such as teachers and facilitators …

Evaluation Of Community Education Interventions In Sexual And Reproductive Health Services In Urban-Marginal Areas Of La Paz, Bolivia, Maria Dolores Castro Mantilla, Mariel Loayza Antezana

Reproductive Health

The purpose of this study was to strengthen community strategies to improve quality-of-care services first implemented as part of a Bolivian Ministry of Health and Prevention and World Health Organization (WHO) project in 1997–98. To reach groups that do not regularly attend health facilities and improve community demand for services, the Centro de Información y Desarrollo de la Mujer (Center for Information and Development of Women) implemented a community education intervention focusing on sexual and reproductive health and rights targeting adolescents, men, and women with older or no children. Results showed that the interventions improved access to and utilization of …

Impact Of Improved Client-Provider Interaction On Women's Achievement Of Fertility Goals In Egypt, Laila Nawar, Ibrahim Kharboush, Magdi A. Ibrahim, Hesham Makhlouf, Susan E. Adamchak

Reproductive Health

A two-phase operations research study was launched in Egypt in early 2000 with the goal of demonstrating how improving the quality of client–provider interaction (CPI) could be achieved in large healthcare systems, specifically in relation to family planning. The study was designed to explore how CPI improvements could enhance family planning knowledge, method continuation rates, client satisfaction, and achievement of fertility goals. Client outcome variables were expected to improve as a result of improving client–provider interaction. The study recommends continued development and testing of innovative, attractive, and well-designed IEC messages that influence woman's fertility preferences; continuous training of health providers; …

Mental Health Of Incarcerated Juveniles In Nevada: Final Report, Nevada Institute For Children's Rerearch And Policy, University Of Nevada, Las Vegas, Jennifer Petsonius, Denise Tanata, Michelle Chino Dr

Nevada Institute for Children's Research and Policy Reports

The prevalence of mental health problems in the juvenile offender population is substantially higher than that of the general population (Cocozza & Skowyra, 2000). Studies estimate that one in five juvenile offenders has serious mental health problems, which is nearly twice the rate of occurrence of mental illness in children and adults in the general population (NMHA Fact Sheet #l). However, there have been several methodological problems encountered in previous research. These include the use of inconsistent definitions and measurements of mental illness; the use of biased, nonrandom samples, a reliance on retrospective case report data, and the use of …

Maine Employer Experience And Perceptions Related To Providing Health Insurance: 2003 Summary Report, Gino Nalli, Elizabeth Kilbreth

Disability & Aging

No abstract provided.

Predictors That Affect The Caregiver's Health Status And The Role Of Social Support On The Caregiver's Health Status, Hong Wang

All-Inclusive List of Electronic Theses and Dissertations

This study examines whether the caregiver's self-rated health status is affected by the caregiver's demographic characteristics (age, education level, and income), caregiver's stressor (the number of ADL and IADL), mediating variables of the caregiver's appraisal (willingness to help non-family members, level satisfaction with life, and financial burden), of and mediating variable of social support (information and/or advice from other family members or friends). Data were drawn from Chronic Illness and Caregiving, a national telephone survey conducted by Harris Interactive Inc. on behalf of The Robert Wood Johnson Foundation, Johns Hopkins University, and Partnership for Solutions. The sample size of caregivers …

The Relationship Of Attitude, Social Influence, And Self-Efficacy To Diabetes Type Ii Outcomes, Autumn L. Keefer-Ward

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to investigate the Attitude-Social Influence-Self Efficacy model and its relationship to Type II diabetes outcomes. One hundred-twelve adults ages 55-75 with Type II diabetes were recruited from a physician's office in West Central Indiana. Participants completed instruments that assessed (a) attitude, (b) social influence of the physician, (c) diabetes-specific self-efficacy, and (d) diabetes-specific quality oflife. A measurement of metabolic control was also obtained. Multiple regressions were performed using ( a) quality of life, and (b) metabolic control as criterion variables. Only one subscale of the self-efficacy variable scale, Managing the Psychosocial Aspects of Diabetes, …

Next-Of-Kin Perceptions Of Physician Responsiveness To Symptoms Of Hospitalized Patients Near Death, Joel C. Cantor, Jan Blustein, Matthew J. Carlson, David A. Gould

Sociology Faculty Publications and Presentations

Many different medical providers visit critically ill patients during a hospitalization, and patients and family members may not feel any physician is truly in charge of care. This study explores whether perceiving that a physician was clearly in charge is associated with reports by surviving next of kin about the responsiveness of physicians to symptoms in hospitalized patients near the end of life. We conducted telephone interviews with surviving next of kin of adult patients (n = 1107) who died in one of five New York City teaching hospitals between April 1998 and June 1999 after a minimum 3-day inpatient …

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Gerontology Institute Publications

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand

Reproductive Health

The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …

The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig

Reproductive Health

This project provides convincing empirical evidence on the impact of quality of care on contraceptive use and fertility behavior through analysis of a unique longitudinal data set from rural Bangladesh. The findings from this project add important new and methodologically rigorous evidence to the emerging literature on the implications of service quality on contraceptive behavior. The results reaffirm the importance of female fieldworker outreach—both in terms of quality and the number of visits—on contraceptive use dynamics in rural Bangladesh. In addition to these substantive findings, the study makes important methodological contributions in assessing the impact of programmatic variables—especially quality of …