Health Services Research Commons^™

Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy

National Health Policy Forum

This document offers a basic description of the Older Americans Act of 1965. The Act is considered the major vehicle for promoting the delivery of social services to the aging population. The Act's seven titles and multiple programs are described, along with a chart showing fiscal year 2012 federal appropriations.

A Monitoring And Evaluation Plan For The Core Competencies Of Skilled Birth Attendants In Nepal, Roberta Goldstein

Capstone Collection

The purpose of this capstone is to present a Monitoring and Evaluation (M&E) plan of the core competencies, for Skilled Birth Attendants (SBA) of Nepal. The World Health Organization has laid out 10 specific skills that assess a SBAs competency. Nepal presently lacks any formal process for monitoring quality assurance of its SBAs and therefore has no measurement of their effectiveness. This Capstone proposes a simple M&E plan to begin the process of quality measurement, using a recent follow-up study done by the Nepali government, other articles and the experiences of the author. The tools included in this Capstone are …

Public Health Spending, Preventable Outcomes, And Medical Cost Offsets: Questions For Health Reform, Glen P. Mays

Health Management and Policy Presentations

Uncertainty continues to surround the health and economic effects that can be expected from increased federal spending on public health and prevention strategies. Recent research provides some insight into the question of whether spending on public health strategies can offset the need for future spending on medical care.

Health Status, Service Use And Cost Among Mainecare Children In Foster Care, Erika C. Ziller Phd, Tina Gressani, Catherine Mcguire Bs, Kimberley S. Fox Mpa, Kyra Chamberlain Ms, Rn

Population Health & Health Policy

The purpose of this study was to inform IHOC program planning with baseline data on the health care use and expenditures of MaineCare children in the foster care program in general and to compare use and costs for foster care children that receive comprehensive health assessments through the Edmund N. Ervin Pediatric Center’s Pediatric Rapid Evaluation Program (PREP), and those that do not. In 2011, other organizations including Key Clinic at Penobscot Pediatrics in Bangor and the Portland-based Spurwink Services program also began conducting comprehensive health assessments for children in foster care. However, because of the timing of this study, …

Insights From "Creating The Healthcare Workforce For The 21(St) Century" Conference., Amanda R Solis

College of Population Health Faculty Papers

No abstract provided.

Improved Cardiac Management With A Disease Management Program Incorporating Comprehensive Lipid Profiling., John F Mcana, Neil I Goldfarb, Joseph Couto, Michelle A Henry, Gary Piefer, George M Rapier

College of Population Health Faculty Papers

Abstract The objective of this study was to evaluate the improved effectiveness of a disease management treatment protocol incorporating comprehensive lipid profiling and targeted lipid care based on lipid profile findings in patients with ischemic heart disease (IHD) or congestive heart failure (CHF) enrolled in a managed care plan. This retrospective cohort study, conducted over a 2-year period, compared outcomes between patients with a standard lipid profile to those evaluated with a comprehensive lipid profile. All adult members of the WellMed Medical Management, Inc. managed care health plan diagnosed with IHD or CHF, and continuously enrolled between July 1, 2006 …

Improved Cardiac Management With A Disease Management Program Incorporating Comprehensive Lipid Profiling., John F Mcana, Neil I Goldfarb, Joseph Couto, Michelle A Henry, Gary Piefer, George M Rapier

College of Population Health Faculty Papers

The objective of this study was to evaluate the improved effectiveness of a disease management treatment protocol incorporating comprehensive lipid profiling and targeted lipid care based on lipid profile findings in patients with ischemic heart disease (IHD) or congestive heart failure (CHF) enrolled in a managed care plan. This retrospective cohort study, conducted over a 2-year period, compared outcomes between patients with a standard lipid profile to those evaluated with a comprehensive lipid profile. All adult members of the WellMed Medical Management, Inc. managed care health plan diagnosed with IHD or CHF, and continuously enrolled between July 1, 2006 and …

National Longitudinal Survey Of Public Health Systems: 2011-2012 Wave, Public Health Practice-Based Research Networks

Health Management and Policy Reports

Since 1998, researchers have followed a nationally representative cohort of U.S. communities to examine the types of public health activities performed within the community, the range of organizations contributing to each activity, and the perceived effectiveness of each activity in addressing community needs. This information, obtained through a validated survey of local public health officials, provides an in-depth view of the structure and function of local public health delivery systems and how these systems evolve over time. Originally conducted with support from the U.S. Centers for Disease Control and Prevention, the National Longitudinal Survey of Public Health Systems (NLSPHS) was …

The Social Production Of Substance Abuse And Hiv/Hcv Risk: An Exploratory Study Of Opioid-Using Immigrants From The Former Soviet Union Living In New York City, Honoria Guarino, Sarah K. Moore, Lisa A. Marsch, Sal Florio

Dartmouth Scholarship

Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection. In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment …

Quality Of Life Of Families With Children Who Have Severe Developmental Disabilities: A Comparison Based On Child Residence, Joni Taylor Mcfelea, Sharon Raver

Communication Disorders & Special Education Faculty Publications

This study measured the quality of life of two groups of families with children who had severe developmental disabilities-families whose child lived at home and families whose child lived in a residential facility. Participants were 54 primary caregivers of children who had severe intellectual disabilities and who lacked the ability to both ambulate without assistance and communicate conversationally. Participants completed the "Family Quality of Life Scale" (Hoffman, Marquis, Poston, Summers, & Turnbull, 2006). Analyses revealed that both groups rated their family quality of life (FQOL) as exemplary. FQOL was higher in the family home group than in the residential facility …

Pursuing High Performance In Rural Health Care, A. Clinton Mackinney Md, Ms, Keith J. Mueller Phd, Andrew F. Coburn Phd, Jennifer P. Lundblad Phd, Mba, Timothy D. Mcbride Phd, Sidney D. Watson Jd

Health System Reform

Rural Futures Lab Foundation Papers are intended to present current thinking on the economic drivers and opportunities that will shape the future of rural America. They provide the foundation upon which it will be possible to answer the question that drives the Lab’s work—What has to happen today in order to achieve positive rural outcomes tomorrow?

Community Psychology In Australia, Ken Robinson Dr, Lynne Cohen, Julie Dean, Heather Gridley, Rebecca Hogea, Emma Sampson, Anne Sibbel, Colleen Turner

ECU Research Week

No abstract provided.

Teen Pregnancy Prevention Program Year Two Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Dawn Davidson, Tara Phebus, Alyson Baker

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services and the Clark County Department of Family Services to offer this curriculum to the youth in juvenile detention, probation, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and is collecting data to help measure the …

The Role Of Medications In Predicting Activity Restriction Due To A Fear Of Falling, Dawn M. Guthrie, Paula C. Fletcher, Evelyn Williams, Nicole Boumans, John P. Hirdes

Kinesiology and Physical Education Faculty Publications

Objectives: To examine the role of medication use and other factors in predicting activity restriction due to a fear of falling (AR/FF). Methods: Older adults were assessed twice with the interRAI Community Health Assessment and the Berg Balance Scale (BBS). The main outcome was limiting going outdoors due to an AR/FF. Medications were recorded by trained assessors. Results: Participants (n=441) had a mean age of 80.3 (sd=7.1) years, most were aged 65+ (96.8%) and 29.3% reported activity restriction. Taking nervous system active or cardiovascular medications was associated with AR/FF. In a multivariate model, the main predictors were having 3+ comorbid …

Nonclinical Development Needs And Regulatory Requirements For Multipurpose Prevention Technologies: A Primer, Joseph W. Romano, Martha Brady, Judy Manning

HIV and AIDS

This summary outlines key development elements that will be necessary for various configurations of multipurpose prevention products for the simultaneous prevention of HIV, sexually transmitted infections, and/or pregnancy.

Assessing And Improving Self-Reporting Of Male Circumcision In Zambia And Swaziland, Paul C. Hewett, Nicole Haberland, Barbara Mensch, Louis Apicella

HIV and AIDS

The Male Circumcision (MC) Partnership was established with the support of the Gates Foundation and PEPFAR to scale up MC services in Zambia, in collaboration with the Zambian government. The MC Partnership is a five-year project led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International (MSI), and the Population Council. The ultimate objective of this study is to provide researchers and program managers with evidence-based recommendations for the collection of self-reported data on MC status through an assessment of different methods to describe and explain MC. Specifically, the study assessed tools for …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Shaping The Operations Research Agenda For Antiretroviral-Based Prevention Products For Women: Gels And Rings, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

This report summarizes discussions from a two-day international experts consultation meeting in 2012 on preparing for the successful introduction of women-centered antiretroviral-based HIV prevention methods. It examines the limits and expectations of operations research in antiretroviral health technologies.

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

Governance In Large Nonprofit Health Systems: Current Profile And Emerging Patterns, Lawrence Prybil, Samuel Levey, Rex Killian, David Fardo, Richard Chait, David R. Bardach, William Roach

Health Management and Policy Faculty Book Gallery

From the foreword:

Nonprofit healthcare organizations are not exempt from good governance. In fact, more today than ever, the hospitals and health care systems of this country must have the discipline and commitment to organize their governance structures and practices to provide forward-thinking leadership and stand up to scrutiny from any type of evaluation and review. As we move from “sick care” organizations to “health care” organizations with accountability for the health of the population of our communities from birth to end-of-life, the role of governance becomes even more critical.

Fourteen of the largest and most notable health care systems …

Designing The First Ever Health Insurance For The Poor In Pakistan - A Pilot Project, Rashid Jooma, Sabeena Jalal

Section of Neurosurgery

Several developing countries lack a medical insurance system with universal coverage, so access to medical services is not easy, principally for people living in poverty. One of the biggest issues for designing healthcare systems in developing countries is how to include those not formally employed. Therefore, it is important to implement targeted interventions so that the most in need are not left out. The World Health Report 2000 distinguishes four functions for the health system to fulfill: (i) the provision of health services; (ii) the creation of the necessary investment and training resources for health; (iii) health financing; and (iv) …

Prevalence And Correlates Of Hiv Infection In A Cohort Of Male Injection Drug Users In Delhi, Waimar Tun, Vartika Sharma, Mary Philip Sebastian, Ira Madan, Amita Yadav, Meredith Sheehy, Dean Lewis, Ibou Thior, Avina Sarna

HIV and AIDS

Baseline assessment of HIV infection among male injection drug users to understand the correlates of HIV infection and high risk injection practices and sexual behavior in Delhi, India.

Understanding Underinsurance In Ohio, Meaghan Ebetino

Master of Public Health Program Student Publications

Objectives: To determine the prevalence, predictors, and consequences of underinsurance in the state of Ohio.

Study Design: The investigators created the dependent variables Underinsured, Financial Stress, and Harder to get Health Care using the 2008 Ohio Family Health Survey (OFHS). The sample used for this study included 29,778 respondents, who were adults less than 65 years old and who were continuously insured for the past 12 months.

Results: The study categorized twenty-two percent of the sample respondents as underinsured because they were not able to obtain or delayed needed medical care because of an inability to pay in …

Effect Of A Physician Uncertainty Reduction Intervention On Blood Pressure In Uncontrolled Hypertensives-A Cluster Randomized Trial, David J. Hyman, Valory N. Pavik, Anthony J. Greisinger, Wenyaw Chan, Jose Bayona, Carol Mansyur, Victor Simjms, James Pool

Community & Environmental Health Faculty Publications

BACKGROUND: Clinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient’s usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.

OBJECTIVE: To test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.

DESIGN: Cluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).

SETTING: Six public and 4 private primary care clinics.

PARTICIPANTS: …

Healthcare Access And Mammography Screening In Michigan: A Multilevel Cross-Sectional Study, Tomi F. Akinyemiju, Amr S. Soliman, May Yassine, Mousumi Banerjee, Kendra Schwartz, Sofia Merajver

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Breast cancer screening rates have increased over time in the United States. However actual screening rates appear to be lower among black women compared with white women.

Purpose

To assess determinants of breast cancer screening among women in Michigan USA, focusing on individual and neighborhood socio-economic status and healthcare access.

Methods

Data from 1163 women ages 50-74 years who participated in the 2008 Michigan Special Cancer Behavioral Risk Factor Survey were analyzed. County-level SES and healthcare access were obtained from the Area Resource File. Multilevel logistic regression models were fit using SAS Proc Glimmix to account for clustering …

Rehabilitation Utilization And The Marginal Cost Of Ischemic Stroke In South Carolina, Ann-Catherin Simpson

MUSC Theses and Dissertations

This study uses Medicare claims from 1997 and 2004 to examine two important health policy issues using patients with ischemic stroke as an example. We explore the differences in rehabilitation services utilization and expenditures for stroke prior to and after outpatient rehabilitation caps were enacted. We then examine the effect of using a total cost approach versus a marginal cost method to estimate the first year cost of stroke and stroke rehabilitation. We found the cap did constrain outpatient rehabilitation utilization and cost of rehabilitation services if examined only using Medicare Part B provider costs, but not when facility costs …

Summary Of Findings From The 2012 Child Death Review Annual Report, Nevada Institute For Children's Research And Policy Reports

Nevada Institute for Children's Research and Policy Reports

The 2012 Annual Report of Child Deaths in Clark County, Nevada provides data regarding all infant, child, and fetal (over 20 weeks gestation) deaths occurring in Clark County in 2012. Since 2008, the Child Death Review Team in Clark County has reviewed 100% of the child deaths referred to the team by the Clark County Office of the Coroner/Medical Examiner. This includes all natural deaths, as well as all accidents, homicides, suicides, and undetermined cases.

The Association Of Natural Elements And Trail Use By Adults, Anna E. Greer, Julian A. Reed, Steve P. Hooker

All PTHMS Faculty Publications

We used the System for Observing Play and Recreation in Communities to examine the association between variations in natural elements (ie, season, weather, and temperature) and adults’ use of a rail-trail in South Carolina (2006-2009). Most (62%) of the 4,468 trail users observed were walkers; 38% were observed participating in vigorous physical activity. Adults were most often observed using the trail during the summer (32%), sunny weather (78%), and moderate temperatures (54%). When promoting trail use among adults, natural elements should be considered.

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Healthway Research Program, Laura Drummy

ECU Research Week

No abstract provided.