Health Services Research Commons^™

Primary Care Practices In Western North Carolina: Adaptation To The Covid-19 Pandemic And Ongoing Challenges, Hannah R. Friedman, Joseph Konstanzer, Erica Richman, Brian Cass, Bryan Hodge, Sheri Denslow, Jacqueline Halladay

HCA Healthcare Journal of Medicine

Introduction

The COVID-19 pandemic has created unique challenges for primary care practices while also highlighting their importance in the pandemic response. To understand primary care practice needs, a survey was conducted of practices in Western North Carolina.

Methods

Phase 2 of a primary care needs assessment was administered to 63 practices in Western North Carolina over the course of six weeks, from July 23 to August 31, 2021.

Results

Most practices were operating with normal hours, though some still operated with reduced hours. Many practices reported insufficient personal protective equipment (PPE) supplies. While most practices provided at least some care …

Reported Barriers To Hepatitis C Treatment Among Pregnant And Early-Parenting Mothers Undergoing Substance Use Disorder Treatment In One U.S. State, Ayooluwatomiwa Deborah Adekunle, Kathi L. Harp, Zaynab G. Al-Abdali, Agatha S. Critchfield, Sheila Barnhart, Kathleen T. Winter

Health Management and Policy Faculty Publications

Nationwide, the prevalence of the hepatitis C virus (HCV) has risen in recent years. At least 90% of infected persons must be treated to achieve global elimination targets. The current study aimed to explore barriers to, and facilitators of, direct-acting antiviral (DAA) HCV treatment uptake amongst pregnant and early-parenting women undergoing comprehensive substance use treatment. Twenty participants with documented HCV antibody positivity were recruited from two substance use treatment centers in central Kentucky. Semi-structured interviews were conducted to explore knowledge about HCV, previous experiences, and intentions to seek care. Themes were extracted using an inductive analytical approach. Most participants were …

Demographic Analysis Of African Americans Enrolled In A Community-Based Diabetes Prevention Program, Kennedy Palmer, Lovoria B. Williams, Hannah Bowman

Posters-at-the-Capitol

Type 2 diabetes (T2D) is preventable. While all racial and ethnic groups are susceptible to the condition, African Americans (AAs) are among the groups with the highest T2D prevalence (13.3%:9.4 %) among their white counterparts. Lifestyle interventions, such as the Diabetes Prevention Program (DPP) effectively decrease incident diabetes by 58%. Moreover, evidence indicates that culturally adapted health interventions enhance subject participation and increase adherence to lifestyle programs. The purpose of this project is to examine the baseline demographics of AA participants of Fit & Faithful, a culturally adapted DPP. Fit & Faithful concentrates on the prominent religious aspect of AA …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer

Health Management and Policy Faculty Publications

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …

Feasibility Of Delivering Fall Prevention Intervention For People With Intellectual Disability In Group-Homes, Poram Choi

Theses and Dissertations

Adults with intellectual disability (ID) have a higher rate of falls than the general population, and changing health behaviors through exercise program could enhance health and reduce falls in this population. However, the feasibility study of fall prevention based on the theoretical framework for adults with ID has not been explored to date. This study examined the feasibility of a home-based exercise intervention for people with ID living in a residential setting. We provided an 8 week intervention consisting of a training workshop for support workers and sessions for adults with ID devoted to behavior reward, education about fall prevention …

New Orleans During A Pandemic: Engaging African American Community Stakeholders On Covid-19 Information, Prevention, Testing And Vaccination, Anthony Thompson

XULAneXUS

This case study examines how the Louisiana Community Engagement Alliance Against COVID-19 Disparities (LA-CEAL) worked to engage African American residents in New Orleans during the COVID-19 pandemic. Drawing on research interviews with Black physicians, pharmacists, and community health providers, along with field notes collected during 12 months of project assistance, the study addresses four research questions concerning African American hesitancy toward COVID-19 treatment and vaccination, strategies for community engagement, clinical trial recruitment, and inclusive research practices during a pandemic. Findings indicate that vaccine hesitancy and research mistrust among Black New Orleanians are rooted in a long history of scientific racism …

Examining The Need For Parental Satisfaction With The Msu Extension Equine Assisted Therapy Program, Ashlyn Ann Kiker

Theses and Dissertations

Animal assisted interventions are becoming more prevalent in our society. Animal interventions have become a popular therapy technique that exist to aid a variety of disabilities. Equine therapeutic riding has become one of the most popular forms of animal assisted therapy for both children and adults. While research shows the importance and benefits of animal assisted therapy for children, there is a lack of research concerning parental satisfaction within therapeutic riding programs.

This study tested a newly developed instrument for measuring parental satisfaction for therapeutic riding programs. The Parent/Caregiver Evaluation Tool (Kerr, 2021) was administered to parents/caregivers whose children participated …

The Relationship Between Collective Nursing Knowledge And Nurse Turnover: An Application Of Nursing Intellectual Capital Theory, Pamela Russman-Chambers

Doctorate of Nursing Science Dissertations

The value of a healthcare organization is vested in the expertise, intellect, and wisdom of employees. Nursing knowledge resides both within the individual nurse and the collective knowledge embedded in organizational structures and practice environments. Healthcare organizations rely on their ability to utilize this knowledge to deliver high-quality care to patients. Hospitals wanting to gain a competitive advantage and achieve financial stability must be adept at acquiring, cultivating, and using the nursing knowledge stocks of the organization. When this knowledge can be utilized to mitigate healthcare issues and improve patients' health, this collective knowledge or intellectual capital is often the …

Validation Of A Brazilian Portuguese Measure Of Family Resources In A Sample Of Parents To Children With Congenital Zika Virus Syndrome, Sarah Barker Ladd

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the aftermath of the 2015 Zika virus outbreak in Brazil, thousands of children and their families continue to face challenges associated with Congenital Zika Syndrome, a developmental condition associated with microcephaly and other serious birth defects affecting the central nervous system. Family-centered rehabilitative care is critical to optimize the trajectories of children who have significant developmental disabilities like CZS. These services involve assessing for the presence of family resources that may help to promote positive outcomes for children. Little is known regarding family resources in the context of caring for a child with CZS in Brazil due to the …

The Yearly Financing Need Of Providing Paid Maternity Leave In The Informal Sector In Indonesia, Adiatma Y. M. Siregar, Pipit Pitriyan, Donny Hardiawan, Paul Zambrano, Mireya Vilar-Compte, Graciela Ma Teruel Belismelis, Meztli Moncada, David Tamayo, Grace Carroll, Rafael Perez-Escamilla, Roger Mathisen

Department of Public Health Scholarship and Creative Works

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

The Impact Of Statin Use On Outcomes Of Diabetic Adult Patients Hospitalized For Community Acquired Pneumonia., Joel Lanceta

Electronic Theses and Dissertations

BACKGROUND: Statins, a class of drugs that treat hyperlipidemia, may have an immunosuppressive effect for patients with community acquired pneumonia (CAP). Retrospective and in vitro studies have suggested an immunomodulatory, antioxidative and anticoagulant effects from statin use in patients with Type 2 Diabetes Mellitus (T2DM) hospitalized for CAP. Prospective studies that have tested any effect of statin therapy on patients with T2DM and CAP have not been found literature. To date, prospective studies showing of the effects statin therapy may have on T2DM patients hospitalized for CAP are not available. METHODS: This dissertation is a secondary analysis using deidentified data …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

Hospital-Based Professional Spiritual Care: Evaluating The Utilization, Availability, And Impact Of Chaplains., Kelsey B. White

Electronic Theses and Dissertations

BACKGROUND: The Affordable Care Act, enacted in 2010, transformed healthcare policy and forced hospitals to reevaluate traditional methods for care delivery. Researcher advocated for patient-centered models of care to reduce costs, address inequitable access to services, and improve service quality. These models prioritize patient values, preferences, and beliefs inclusive of patients’ religious and spiritual needs. Professional chaplains provide religious and spiritual care within many hospital settings. This dissertation explored the characteristics of hospitalized persons using chaplains, the factors associated with a hospital reporting a chaplaincy department, and how those services impacted patient satisfaction. METHODS: The first analysis used a two-part …

Improving Maternal And Child Health In Pakistan: A Programme Evaluation Using A Difference In Difference Analysis, Muhammad Ashar Malik, Lara Riedige Rohm, Pieter Van Baal, Eddy Van Doorslaer Van Doorslaer

Community Health Sciences

Introduction: Pakistan is a country with high maternal and infant mortality. Several large foreign funded projects were targeted at improving maternal, neonatal and child health. The Norway-Pakistan Partnership Initiative (NPPI) was one of these projects. This study aims to evaluate whether NPPI was successful in improving access and use of skilled maternal healthcare.
Methods: We used data from three rounds (2009-2010, 2011-2012 and 2013-2014) of the Pakistan Social and Living Standards Measurement Survey (PSLM). A difference-in-difference regression framework was used to estimate the effectiveness of NPPI and its different programme components with respect to maternal healthcare seeking behaviour of pregnant …

The Indonesian Strategy To Achieve Universal Health Coverage Through National Health Insurance System: Challenges In Human Resources, Atikah Adyas

Kesmas

Many countries are currently trying to achieve universal health insurance coverage in order to provide health protection for their population. Indonesia has received a strong political commitment to implement national health insurance including government support to finance the poor. The implementation of comprehensive national health insurance requires human resources, each of which has a role in fighting for noble goals for the welfare of all people. This paper is taken from the experience of Indonesia and several other countries as well as guidelines that can be used in exploring the role of human resources for the success of the implementation …

Breastfeeding Knowledge And Behavior In Lactational Amenorrhea Method (Lam) As A Natural Contraceptive, Mufdlilah Mufdlilah, Reza Bintangdari Johan, Sri Ratna Ningsih

Kesmas

The lactational amenorrhea method (LAM) is a natural contraceptive that is highly effective after the three essential criteria are fulfilled. However, there is a significantly low adoption resulting from poor knowledge and correct practices. This study aimed to determine the correlation between knowledge and behavior of breastfeeding mothers on breastfeeding as a natural contraceptive. This was an analytic observational study with a cross-sectional design involving 89 breastfeeding mothers and was performed from January to March 2018. Furthermore, data were collected using a questionnaire, and the results showed knowledge of breastfeeding mothers to be good (59.6%) and not good (51.7%). However, …

Predictors Of The Covid-19 Social Distancing Practice Among Undergraduate Health Students In Samarinda City, Indonesia: A Cross-Sectional Study, Siti Hadijah Aspan, Pramon Viwattanakulvanid

Kesmas

Social distancing is a health protocol recommended by the World Health Organization (WHO) for reducing the spread of COVID-19. Undergraduate health students play an important role in the dissemination of accurate information. This study identified predictors that influenced the COVID-19 social distancing practice and examined the sources of social distancing information among undergraduate health students in Samarinda City, Indonesia. This cross-sectionalonline survey study (March-April 2021) involved 422 undergraduate students from medicine, public health, and pharmacy faculties at Mulawarman University. Binary logistic regression was conducted to identify factors associated with the COVID-19 social distancing practice. The results showed that age (AOR …

The Covid-19 Pandemic: Role Of Coping Humor And Internal Health Locus Of Control On Social Dysfunction And Anxiety & Depression, Muhammad Arief Sumantri, Zahrani Zahrani, Hilda Rosa Ainiyah, Azmul Fuady Idham

Kesmas

The concerns about the impact of social distancing on mental health have been widely discussed. This study aimed to know the predictive effect of coping humor and Internal Health Locus of Control (Internal HLoC) on social dysfunction and anxiety & depression during the implementation of the COVID-19 social distancing agenda. This study was also intended to assess the effect of humor content on coping humor. A quantitative approach was used as the method ofthe study with 243 online-recruited participants, and a PLS-SEM analysis was applied to find out the predictive effect in this study. The results and conclusions showed that …

Are We Passing On Violence To The Next Generation?: Gender Norms And Gender-Based Violence Attitudes Among Early Adolescents In Indonesia, I Gusti A A. Mahendra, Anggriyani Wahyu Pinandari, Ifta Choiriyah, Siswanto Agus Wilopo

Kesmas

Intensification of gender norms during puberty affects adolescents’ perceptions and behavior related to violence. This study examined the association between gender norms and gender-based violence (GBV) among early adolescents considering socio-ecological variables using cross-sectional data from 3,618 Indonesian Global Early Adolescent Study pupils. Chi square tests with simple and multiple logistic regression analyses examined how different factors' levels predict GBV. Among boys, GBV attitudes were found high (53%). Furthermore, they also had high heteronormative expectations, threatened feelings, experiences of violence, porn access, and 5+ adverse childhood experiences (ACEs). Logistic regression results revealed that adolescent boys having one or two scores …

The Seroprevalence Of Toxoplasma Gondii In Cats At The House Of Maternal Women With Toxoplasmosis In Badung, Indonesia, Made Subrata, Nyoman Mantik Astawa, Nyoman Tigeh Suryadi, Sang Gede Purnama, Kadek Karang Agustina, Ngakan Putu Anom Harjana, Made Damriyasa

Kesmas

Toxoplasmosis is a zoonotic disease caused by infection with the parasite called Toxoplasma gondii (T. gondii). The health and social impacts of the infectionare enormous, including miscarriage, hydrocephalus, blindness, and mental retardation. The occurrence of toxoplasmosis in maternal women cannot be se parated from cats around their houses. This study aimed to determine the seroprevalence of the parasite in cats found in the human carriers residences and identify the risk factors of toxoplasmosis in maternal women in Badung District, Bali Province, Indonesia. A total of 80 cat serum samples were obtained from two residential groups, 40 from the housing where …

Mental Fatigue And Its Associated Factors Among Coal Mining Workers After One Year Of The Covid-19 Pandemic In Indonesia, Hendra Djamalus, Budi Utomo, I Made Djaja, Sjahrul M. Nasri

Kesmas

Mental fatigue among coal mining operators was related to driving activities that require high concentration. This study aimed to determine factors that contributed to mental fatigue among coal mine operators in Indonesia, specifically in Kalimantan and Sumatra, after a one-year COVID-19 pandemic. This cross-sectional study was conducted among 480 operators from two companies and seven sites. A self-administrated questionnaire in the Google Form was used to measure mental fatigue, the non-work-related factors (age, education, marital status, residence, and stress level), and work-related factors (working periods, shift pattern, type of shift, and work area in mining). The data analyzed using Chi-square …

Integrated Model Of A Family Approach And Local Support In Tuberculosis Case Finding Efforts In People With Hiv/Aids, Erni Astutik, Chatarina Umbul Wahyuni, Imelda F E Manurung, Geofrey Ssekalembe

Kesmas

The human immunodeficiency virus (HIV) remains a major global public health problem. People with HIV/acquired immune deficiency syndrome (AIDS) are more susceptible to opportunistic infections such as tuberculosis (TB). Therefore, families and community leaders need to help monitor people living with HIV/AIDS (PLWHA). This study aimed to analyze an integrated family approach and local support model to detect TB cases in PLWHA. This study used a case-control study in Kupang City, East Nusa Tenggara Province, in July 2020. The sample comprised 100 people (50 PLWHA with TB case and 50 controls) using total sampling and random sampling, respectively. The variables …

Knowledge, Attitudes, And Practices Of Health Personnel In Responding To The Covid-19 Pandemic In Indonesia, Dyah Suryani, Suyitno Suyitno, Maretalinia Maretalinia, Elvi Juliansyah, Vernonia Yora Saki, Kraichat Tantrakarnapa

Kesmas

The COVID-19 pandemic, originated in China, has spread to worldwide, including Indonesia. Until July 2021, the growth rate has been gradually increasing, and cases have been found in all 34 provinces of Indonesia. This cross-sectional study aimed to investigate the knowledge, attitude, and practices (KAP) of health personnel in the primary health care towards the COVID-19 pandemic in Indonesia using online self-report questionnaire. A total of 440 respondents contributed to this online survey. The average level of KAP were 7.7 out of 10.0, 14.3 out of 15.0, and 31.9 out of 36.0, respectively. There was no significant association between respondents’ …

The Effectiveness And Safety Of Favipiravir In Covid-19 Hospitalized Patients At Tertiary Referral Hospital, Bali, Indonesia, Herni Damayanti, I Gede K Sajinadiyasa, Hindun Wilda Risni, Rani Sauriasari

Kesmas

COVID-19 is a major public health problem, with still questionable specific cure. Favipiravir is a COVID-19 antiviral that is potentially a therapy for COVID-19. This study aimed to analyze its effectivity and safety in moderate to critical hospitalized patients. This study was a retrospective cohort in a tertiary referral hospital in Denpasar City, Bali Province, Indonesia, from August 2020 to January 2021. There was a total of 192 patients; 96 in the favipiravir group and 96in the non-favipiravir group (remdesivir/oseltamivir). Effectivity was measured by assessing the clinical condition at the end of the isolation period of 14 days. The favipiravir …

How Risky People Of Getting Covid-19 Based On Their Daily Activities?, Fajar Ariyanti, Mustakim Mustakim, Moch T A Al Ayubi, Desty Pratiwi Marlisman

Kesmas

In Indonesia at the end of 2020, COVID-19 cases were increasing and predicted to continue, as it had not yet passed the peak of the pandemic curve. The government had implemented mobility restrictions to reduce exposure to COVID-19. This study aimed to identify the risk of people getting COVID-19 based on their daily activities. Using a cross-sectional design, this study took 315 respondents under non-probability sampling from September to October 2020. Thedata were analyzed using the Chi-square test with α 0.05. This study showed that the risk percentage of people infected with COVID-19 based on their daily activities was 15.56% …

Analisis Manajemen Pengelolaan Data Sistem Informasi Puskesmas Di Tingkat Dinas Kesehatan Di Kabupaten Bondowoso, Nanthyan Khampa Usada, Artha Prabawa

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Ketepatan proses pengelolaan data Sistem Informasi Puskesmas di tingkat Dinas Kesehatan sangat menentukan dalam menghasilkan informasi berkualitas yang digunakan untuk pengambilan keputusan di pusat atau jenjang yang lebih tinggi. Penelitian bertujuan mengetahui gambaran manajemen pengelolaan data Sistem Informasi Puskesmas di tingkat Dinas Kesehatan Kabupaten Bondowoso. Merupakan penelitian kualitatif dengan metode case study. Pengumpulan data melalui observasi dan wawancara mendalam yang berpedoman pada system approach. Subyek penelitian adalah kepala Subbagian PIEP, petugas pengelola program dan laporan serta petugas pengelola sistem informasi. Penelitian menunjukkan manajemen pengelolaan data sudah baik meski belum optimal, ditemukan kendala diantaranya adalah keterlambatan, inkonsistensi data, alur pelaporan …

Kinerja Pelaksana Manajemen Informasi Kesehatan Di Lingkungan Dinas Kesehatan Kabupaten Bondowoso, Nanthyan Khampa Usada, Artha Prabawa

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Sistem manajemen dan informasi kesehatan merupakan komponen yang berfokus pada terwujudnya sistem kesehatan yang berdaya guna dan berhasil guna secara efektif dan efisien. Pentingnya tujuan tersebut menjadi dasar aturan bahwa setiap fasilitas pelayanan kesehatan berkewajiban dalam menyelenggarakan Sistem Informasi Kesehatan (SIK) demi membantu tercapainya sasaran pembangunan kesehatan. Penelitian ini bertujuan menganalisis determinan kinerja pelaksana manajemen sistem informasi kesehatan di lingkungan Dinas Kesehatan Kabupaten Bondowoso. Merupakan penelitian kuantitatif dengan pendekatan sistem menggunakan metode cross sectional. Kuesioner online dengan google form disebarkan melalui whatsapp group terhadap sampel penelitian yaitu seluruh (111 responden) pelaksana manajemen sistem informasi kesehatan di 25 puskesmas. Hasil …

Analisis Spasial Gizi Kurang Balita Di Kota Tangerang Tahun 2019, Nanthyan Khampa Usada, Kartika Sari Wanodya, Nadia Trisna

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Kekurangan gizi pada balita dapat menyebabkan kematian hal ini dikarenakan balita lebih rentan terinfeksi penyakit. Adapun penyebab tidak langsung gizi kurang yaitu ketahanan pangan di keluarga, pola pengasuhan anak, pelayanan kesehatan dan kesehatan lingkungan. Pada tahun 2018 prevalensi gizi kurang balita di Provinsi Banten sebesar 12,6%. Di kota tangerang sendiri terdapat 5.555 kasus atau 5,99% kejadian kasus gizi kurang pada balita pada tahun 2019. Penelitian ini bertujuan untuk mengetahui gambaran distribusi faktor risiko kejadian gizi kurang pada balita di Kota Tangerang tahun 2019 dengan menggunakan analisis spasial. Penelitian ini merupakan rancangan deskriptif kuantitatif dan desain studi ekologi menggunakan data sekunder …