Health Services Research Commons^™

Assessment Of Stakeholder Engagement In A Down Syndrome Research Study, Jeanhee Chung, Ashwini Sarathy, Yichuan Grace Hsieh, Greg Estey, Amy Torres, Vasiliki Patsiogiannis, Karen Donelan, Brian G. Skotko

Journal of Patient-Centered Research and Reviews

There is growing recognition of the importance of engaging patients early in the design of research studies. For studies involving patients with intellectual and cognitive disabilities, researchers may consider engaging with family caregivers, health professionals, community advocates, and/or subject matter experts to provide a more multifaceted, surrogate perspective. Evaluating the engagement of these stakeholder groups in research is nascent, and tools are limited. Research studies involving these individuals provide the opportunity to test new methods of measurement of stakeholder engagement in research. We conducted a 3-year research study implementing and evaluating Down Syndrome Clinic to You, an online platform for …

Facilitators And Barriers To Patient-Centered Outcomes Research Partnership Sustainability In The United States, Tristen L. Hall, Charlene Barrientos-Ortiz, Griselda Peña-Jackson, Courtney Fultineer, Kevin Werner, Justine Sunshine

Journal of Patient-Centered Research and Reviews

Purpose: Engaging patients in research can enhance relevance and accelerate implementation of findings. Despite investment in patient-centered outcomes research (PCOR), short-term funding cannot maintain such efforts beyond the program timeframe. Sustained interaction between researchers, practitioners, patients, and other stakeholders is needed to sustain use of evidence-based practices and achieve maximum benefit. While previous literature describes components of public health program sustainability, such factors do not necessarily apply to the partnerships that implement those programs, and facilitators are likely to differ across disciplines. We sought to determine facilitators and barriers to PCOR partnership sustainability from participant experiences with sustainable and unsustainable …

Comprehensive Echocardiographic Findings In Critically Ill Covid-19 Patients With Or Without Prior Cardiac Disease, Renuka Jain, Pedro D. Salinas, Stacie Kroboth, Abigail Kaminski, Sarah Roemer, Ana Cristina Perez Moreno, Bijoy K Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: Coronavirus disease 2019 (COVID-19) presents with a spectrum of disease severity, the most serious cases requiring intensive care. Echocardiography is a front-line tool in evaluating cardiovascular complications of COVID-19 in the intensive care unit (ICU); we analyzed transthoracic echocardiograms obtained from this patient population with state-of-the-art ultrasound technology.

Methods: All patients with COVID-19 requiring ICU admission on whom a transthoracic echocardiogram was obtained were included in the study. Focused transthoracic protocols were performed by experienced sonographers. Echocardiographic variables, including speckle-tracking echocardiography, were collected and analyzed. Clinical information was obtained from the electronic medical record. Patients were followed until discharge. …

Using Mobile Phones To Improve Young People Sexual And Reproductive Health In Low And Middle-Income Countries: A Systematic Review To Identify Barriers, Facilitators, And Range Of Mhealth Solutions, Anam Shahil Feroz, Naureen Akber Ali, Adeel Khoja, Armish Asad, Sarah Saleem

Community Health Sciences

Background: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions that can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people.
Methods: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane Central, and grey literature were searched …

Frontiers In Human Factors: Embedding Specialists In Multi-Disciplinary Efforts To Improve Healthcare., Ken Catchpole, Paul Bowie, Sarah Fouquet, Joy Rivera, Sue Hignett

Manuscripts, Articles, Book Chapters and Other Papers

Despite the application of a huge range of human factors (HF) principles in a growing range of care contexts, there is much more that could be done to realize this expertise for patient benefit, staff well-being and organizational performance. Healthcare has struggled to embrace system safety approaches, misapplied or misinterpreted others, and has stuck to a range of outdated and potentially counter-productive myths even has safety science has developed. One consequence of these persistent misunderstandings is that few opportunities exist in clinical settings for qualified HF professionals. Instead, HF has been applied by clinicians and others, to highly variable degrees-sometimes …

Improving Evidence-Based Grouping Of Transitional Care Strategies In Hospital Implementation Using Statistical Tools And Expert Review, Jing Li, Gaixin Du, Jessica Miller Clouser, Arnold J. Stromberg, Glen Mays, Joann Sorra, Jane Brock, Terry Davis, Suzanne Mitchell, Huong Q. Nguyen, Mark V. Williams

Center for Health Services Research Faculty Publications

BACKGROUND: As health systems transition to value-based care, improving transitional care (TC) remains a priority. Hospitals implementing evidence-based TC models often adapt them to local contexts. However, limited research has evaluated which groups of TC strategies, or transitional care activities, commonly implemented by hospitals correspond with improved patient outcomes. In order to identify TC strategy groups for evaluation, we applied a data-driven approach informed by literature review and expert opinion.

METHODS: Based on a review of evidence-based TC models and the literature, focus groups with patients and family caregivers identifying what matters most to them during care transitions, and expert …

Trends In Diagnoses Of Neonatal Abstinence Syndrome At Newborn Hospitalization In Maine, 2009-2018, Emily C. Bauer Mph, Katherine Ahrens Phd, Jenny L. Carwile Mph, Scd

Journal of Maine Medical Center

Introduction: Incidence rates of neonatal abstinence syndrome (NAS) have increased in Maine, but whether this increase can be explained by use of different diagnosis codes over time is unknown. Our objective was to estimate trends in diagnoses of NAS at newborn hospitalization in Maine using different NAS case definitions.

Methods: We used International Classification of Diseases (ICD) diagnosis codes to identify newborns diagnosed with NAS in Maine between 2009 and 2018 using state-level hospital discharge data (n = 123 519). First, we considered only ICD-9 and ICD-10 codes used for confirmed NAS. Then we used an expanded ICD-10 NAS case …

Impact Of Benzodiazepines And Polysubstance Status On Repeat Non-Fatal Drug Overdoses, Sarah Mayberry, Sarah Nechuta, Shanthi Krishnaswami

Peer Reviewed Articles

Research has shown that benzodiazepines and mental health disorders can increase the likelihood of repeat overdose, but researcher have not explored this association in Tennessee (TN). We examined benzodiazepines, polysubstance overdose status with/without benzodiazepines, and mental health comorbidities with repeat overdose using statewide data in TN. This study analyzed TN hospital discharge data on nonfatal overdoses for patients ages 18–64 from 2012 to 2016 for 21,066 patients with an initial inpatient visit and 36,244 patients with an initial outpatient visit. The study assessed each patient at one year after initial overdose to determine likelihood of repeat overdose. We used a …

What Are The Life Experiences Of Health Care Professionals Working During The Covid Pandemic?, Laniece Mcgee

Public Health Education, MPH

Since the end of December 2019, a virus named Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. First originated in Wuhan China, COVID-19 was declared an international public health emergency by the World Health Organization on January 30, 2020. On March 11, 2020, the COVID-19 outbreak was declared a pandemic. Approximately, there were 792,000 deaths attributed to COVID 19 as of August 21, 2020. Photovoice is a highly recommended participatory research method first introduced by Wang and Burris in the early 90s. The main purpose of photovoice was to give people a way to reflect, talk, learn, share, and make …

Knowledge Of The 2017 American Heart Association Hypertension Guidelines, Kelsey Creel, Kristan Kelly, Linda Turner

MSN Research Projects

The primary purpose of this project was to determine the knowledge of nurse practitioners in Mississippi regarding the 2017 American Heart Association Hypertension Guidelines. Following approval by the Institutional Review Board (IRB), the researchers utilized a descriptive, quantitative survey design to evaluate the knowledge of Mississippi nurse practitioners of the 2017 American Heart Association Hypertension Guidelines in regards to diagnosis and management of hypertension. Utilizing social media, the researchers targeted specific Facebook sites for nurse practitioners who practice in the state of Mississippi. Data was gathered through SurveyMonkey using a questionnaire. The data gathered from the completed questionnaires were then …

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Healthier Oregon Qualitative Study, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Closing The Health Disparity Gap In U.S. Immigrant Communities In The Era Of Covid-19: A Narrative Review, Dina Refki, Rukhsana Ahmed, Jeanette Altarriba

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

The COVID-19 pandemic continues to have significant impacts on social determinants of health. Immigrant communities often bear a disproportionate burden of the crisis because of the immigration experience, which serves as an additional social determinant of health. Evidence suggests that these communities are hard hit by economic instability, food insecurities, isolation, lack of safe housing and safe neighborhoods, environmental dynamics that cut them off from systems of support, lack of sufficient access to educational tools that have become critical in remote and digital learning, limited access to health and healthcare resources, low health literacy, and restricted access to culturally and …

Syphilis Screening Among Primary Care Providers, Sarah Christian, Nikki Franklin, Seth Stuart, Casey Tramel, Sereka Walker

MSN Research Projects

Syphilis is a sexually transmitted infection (STI) that can cause lesions on various mucosal areas of the body on an infected individual. If the disease is left untreated, syphilis can progress and affect an individual’s cardiovascular, neurological, and immune systems. The STI rates are on the rise across the United States, especially in the state of Mississippi. Because of the increase in syphilis rates in Mississippi, the researchers developed this study. The purpose of this study is to determine if primary care providers (PCPs) are knowledgeable and screening according to the guidelines of the Early and Periodic Screening, Diagnostic, and …

Implementation Of The 2017 Aha Guidelines By Primary Care Providers In Managing Elevated Blood Pressure A Modifiable Risk Factor Of Stroke, Chelsi Archie, Chelsea Bullock, Nekesha Johnson, Elizabeth Lishman

MSN Research Projects

Elevated blood pressure is a condition in which systolic blood pressure is 120-129 mmHg and diastolic blood pressure is less than 80 mmHg, according to the CDC (2020), which points out that elevated blood pressure often leads to hypertension. In 2017, The American Heart Association (AHA) released guidelines to aid providers in the early detection and management of hypertension. These guidelines integrate nonpharmacological and pharmacological therapies. The nonpharmacological therapies include following a heart-healthy diet, weight loss, sodium restriction, limitation of alcohol and tobacco consumption, and increased physical activity (AHA, 2018). Hypertension, “the silent killer” is one of the major causes …

Nursing: Global Impact Increases Healthcare Effectiveness, Madison Slacktish

Student Research Poster Presentations 2021

The discipline of nursing has a major impact on the world globally. Research has found when nurses collaborate across boarders, then patient outcomes tend to increase. Disease does not stop because there is a boarder from one country to the next. Therefore, worldly collaboration has positive influences on how nurse's practice and ways to change protocols to increase better patient outcomes.

Impact Of Covid-19 On The Italian And American Healthcare Systems : A Comparative Assessment, Bita Pejam, Jennifer Lam

All Reports

This report aims to examine and assess the impact of the COVID-19 global pandemic on the healthcare systems of the United States of America and Italy; two of the most heavily affected nations. Using data from December 2019 to January 2021, several consultations, and policy reviews, we identify risks and notable areas of issue in each nations’ approach to combating the virus. We focus our report particularly on the health policies and the governmental structures in place that contributed to each nations’ initial method of alleviating the impact of COVID-19. Our report compares the two healthcare systems and proposes a …

Covid-19 Related Physical And Mental Health Stressors In Families Using A Social Determinants Lens., Elizabeth Vasquez, Erin Bell, Melissa Tracy

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

Racial and ethnic minorities, those of lower socioeconomic status (SES), and older adults have experienced higher rates of infection, severity of illness, and mortality from COVID-19 than other groups. These populations are also disproportionately affected by financial and social disruptions caused by the pandemic, including job loss, reduction in community services, and disconnection from supportive networks critically important for the health and well-being of families. Further, these same populations often live in multi- generational households and rely on a family-dependent caregiver model. The aim of this project is to beta test an online questionnaire to identify individual and household risk …

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …

Unboxing The Japanese Sojourning Mom’S Pediatric-Going Experience: A Phenomenological Study Of Culturally And Linguistically Appropriate Health Services, Carolyn Oldham

Theses and Dissertations--Education Sciences

This study explores how twelve former Lexington-area Japanese sojourning mothers define culturally and linguistically appropriate services and how culture, gender and language shaped their health care beliefs, behaviors and experiences in pediatric settings. It is a naturalistic, pragmatic line of inquiry born in collaboration with Japanese sojourning moms across cups of matcha 末茶 and mugicha 麦茶. Framed by constructivist and intersectionality research lenses, this phenomenological study seeks to understand how study participants perceived the cultural and linguistic appropriateness of their interactions with Lexington-area pediatric offices and to begin to ascertain the meanings they created based on their subjective experiences. Its …

Housing Is Healthcare Measuring The Cross-Sector Impact Of A Major Housing Initiative In Portland, Oregon, Keri B Vartanian, Aisha K Gilmore, Kyle Jones

View All

No abstract provided.

A Mixed Methods Approach To Examine Racial Disparities In Adherence To Surveillance Mammography Among Breast Cancer Survivors, Megan C. Edmonds

Theses and Dissertations

PURPOSE: Annual surveillance mammography is a critical part of routine cancer care for breast cancer (BC) survivors; reducing mortality by 39%. However, disparities exist with regard to adherence to surveillance mammograms among BC survivors; Black women are 44% less likely to adhere than their White counterparts. Despite the existence of this racial disparity for over a decade, little is known about factors that explain reasons for Black BC survivors’ non-adherence. This is because most studies have not evaluated the role of healthcare delivery or psychosocial factors. Guided by the Behavioral Model for Vulnerable Populations, the purpose of this mixed methods …

The Role Of Insurance Coverage In Outpatient Substance Use Disorder Treatment Referral, Utilization, And Outcomes, Huyen Pham

Theses and Dissertations

Opioid-related overdoses increased dramatically in recent years. Medicaid plays a predominant role in paying for opioid use disorder (OUD) treatment. However, there is a critical gap in understanding the role of Medicaid coverage in referrals to treatment, treatment utilization, and treatment retention. The three studies used observational and quasi-experimental (i.e., natural experiment) designs leveraging state and year variation in Medicaid expansion to characterize the role of Medicaid coverage in OUD treatment. We found that individuals with OUD with Medicaid insurance were more likely to use outpatient treatment, whereas those who were uninsured were more likely to use self-help groups only. …

Feeling The Squeeze: The Association Between Multigeneration Caregiving And Informal Caregivers’ Health, Christine L. Patterson

Theses and Dissertations

While U.S. public policy and research has focused on the health needs of the aging population, less attention has been given to the consequences informal caregivers face caring for this generation. With the segment of the population aged 65 years or older growing rapidly, it is important to understand the factors that place informal caregivers at risk for poor health outcomes and health behaviors. Since multigeneration caregivers balance more personal, work, and caregiving demands than single-generation informal caregivers of older adults, they may be at higher risk for poor health outcomes. The aim of this study was to examine the …

Another Step In Diagnostics Consultation Model© Actualization: Examining The Impact Of Consultation Workflow Processes On Providers' Clinical Decision Making, Elizabeth K. Leibach

Theses and Dissertations

Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions …

Health Outcomes And Utilization Associated With Renal Diseases In Patients With Cancer In The United States, Mitisha Dedhia

Theses and Dissertations

Background: Adverse events and impairments associated with cancer and its treatments causes worse outcomes. Increased incidence of renal diseases among cancer patients is of particular concern. Objective: To determine the risk factors for renal disease in cancer patients and compare healthcare costs, utilization and health-related quality of life (HRQoL) of cancer patients with a renal disease and cancer patients without renal diseases. Methods: Medical Expenditure Panel Survey files from 2009 – 2018 for cancer patients was used for this study. Multiple logistic regression, generalized linear model, Poisson regression and multiple linear regression for analyses after adjusting for demographic, socioeconomic and …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews, Colette Henderson, Abby Kra-Friedman, Li-Anne Audet, Isabelle Savard, Lori A. Spies, Heather Mcgrath, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Mra Jabbour, Renée Atallah, Melanie Rogers, Kelley Kilpatrick

Ellmer School of Nursing Faculty Publications

No abstract provided.

Primary Care Physician-Nurse Practitioner Collaboration And Physicians Career Satisfaction, Tania Alidina

Electronic Theses and Dissertations, 2020-2023

Dissatisfaction amongst US physicians has been steadily increasing over the past few decades as health care reform changes the practice of medicine (Hoff, Young, Xiang, & Raver, 2015; Rosenstein, & Mudge-Riley, 2010). In 2008, physician dissatisfaction rates had increased to 19% (Mazaurenko & Menachemi, 2012). By 2012, 42% of physicians voiced dissatisfaction, with family medicine reporting most likely to be dissatisfied (Sorrell & Jennings, 2014). One factor that could affect physician career dissatisfaction/satisfaction that has not been studied is collaborative relationships with other healthcare providers, such as nurse practitioners. This study used secondary quantitative data from the National Survey of …

Perceptions And Health Effects Of Electronic Cigarettes Among College Students, Safia Centner

Honors Undergraduate Theses

Electronic cigarettes, or e-cigarettes, are devices that allow users to inhale an aerosol, which contains chemical additives. E-cigarettes are becoming common for nicotine delivery in addition to traditional cigarettes. The goal of this study was to determine how college students perceive e-cigarettes, how often college students use e-cigarettes, and how they view e-cigarettes compared to tobacco cigarettes. This was accomplished through sending a survey built on Qualtrics to UCF students via Knights Email. This survey included questions about demographics, perceptions, and usage of e-cigarettes. The collected data was downloaded into SPSS and analyzed to compare data among different groups. The …

A Mixed Methods Study On Food Insecurity Screening And Patient-Centered Care: Perspectives Of Patients And Healthcare Providers On Practices And Barriers To Effective Screening In Outpatient Medical Settings, Christina Bernhardt

Electronic Theses and Dissertations, 2020-2023

The purpose of this study was to better understand the relationship between elements of patient-centered care and patient/provider comfort with conversing about food insecurity and related social determinants of health. A mixed methods study was conducted. Patients and healthcare providers were surveyed on their experiences with patient-centered care and comfort discussing food insecurity and related social concerns. Telephone interviews were conducted to gain a richer understanding of the concepts under investigation. In the survey and telephone interviews, both samples were also asked about changes in communication during COVID-19 times. Quantitative findings show that patient involvement in care and cultural sensitivity …