Health Services Research Commons^™

The Influence Of Cultural Factors On Health-Seeking Behaviors Regarding Prostate Cancer Among African Immigrant Men In The United States., Kaitlin Van Voorhis, Ernest Kaninjing, Rae Walker, M E. Ogunsanya, G Asiedu, A Kokayi, M E. Young, F T. Odedina

Graduate Research Showcase

Background: African immigrants represent a rapidly growing segment of the United States immigrant population reshaping the rich diversity of US Blacks. Despite this growth, there is a dearth of research examining the impact of immigration on this subpopulation, particularly regarding chronic diseases like cancer. Little is published about whether SSAIs adapt to health behaviors more common in their new setting or remain immersed in the values, beliefs, and practices reflective of their culture of origin. To better understand drivers of health disparities in prostate cancer outcomes among Blacks, this study explored cultural factors among SSAIs to illuminate the health …

Research Action Brief: Healthcare Experiences And Perceptions As Drivers Of Gaps In Mammography, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

Knowledge And Perception Of Hand Hygiene And Associated Factors Among Final Year Medical And Nursing Students In Dar Es Salaam Tanzania, Anthony Baltazary Ngowi

Master of Obstetrics and Gynecology

Hand hygiene, when practiced correctly and consistently is a simple and effective

method to prevent healthcare associated infections. These infections are acquired during a patients’ hospital stay and pose a major worldwide public health problem. The knowledge and practices related to hand hygiene among health workers need to be instilled early on during their training to develop a culture of correct and consistent practice. Existing literature has explored hand hygiene among health workers but very few studies have looked at it amongst medical and nursing students, who are the healthcare workers of tomorrow. This study aimed to assess hand hygiene …

Challenges In Post Graduate General Surgery Training In Tanzania: A Trainee’S Perspective, Shabbir Adamjee

Master of Surgery

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General Surgery residency training is a complex vigorous program which includes long working hours and complex surgical cases, in order to develop and attain the knowledge and the skills the trainee needs by the end of the program. Worldwide, general surgery programs have high attrition rates and residents have identified challenges which may be work related, related to social wellbeing and/or the residency program structure. Tanzania has public and private institutions providing general surgery residency training and although most have a quality assessment program the data is not readily available. Each institution has its personalized curriculum with its unique …

Microbial Profile And Antimicrobial Resistance Patterns Of Surgical Intra-Abdominal Infections At A Tertiary Hospital In Tanzania A Retrospective Cross-Sectional Study, Abduel Julius Kitua

Master of Surgery

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Among infections of surgical importance, intra-abdominal infections prevail among the most common in surgical patients with considerable morbidity and mortality. The ever-rising microbial resistance to commonly available antibiotics and geographical variations in microbial profile and resistance patterns poses a challenge to the management of these surgical infections of abdominal origin. The aim of this study was to evaluate microbiological characteristics and antibiotic susceptibility of isolates from intra-abdominal infections at a tertiary hospital in Tanzania and how these influence early treatment outcomes.

Factors Associated With Antiretroviral Drug Resistance Mutations Among Plhiv Failing To Achieve Virological Suppression On Second Line Treatment In Tanzania., Mabula M. Mabelele

Master of Internal Medicine

v> Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major public health problem affecting an estimated 38.4 million people globally, with the (54%) of them being from the Eastern and Southern African regions. Despite progress in the availability of multiple classes of antiretroviral drugs and early initiation of treatment with cART, many patients still fail therapy in the first and second-line regimens due to drug resistance driven by continuous acquisition of drug resistance mutation (DRMs). DRMs are high among adults failing treatment regimens, ranging between 50-97%.

Acceptability And Feasibility Of Screening With A Pediatric Care Provider-Led Social Determinants Of Health Identification Tool, Alison Eyre, Janice Cohen, Sarah Funnell, Lynsey James, Sheena Guglani, Hounaida Abi Haidar, Lindy Samson, Michelle Ward, Radha Jetty, Megan Harrison, John Lyons Dr., Leigh Fraser-Roberts, Susan Bennet, Douglas Archibald, Soha Khorsand, Tobey Audcent

Health Management and Policy Faculty Publications

Background Complex social determinants of health may not be easily recognized by health care providers and pose a unique challenge in the vulnerable pediatric population where patients may not be able to advocate for themselves. The goal of this study was to examine the acceptability and feasibility of health care providers using an integrated brief pediatric screening tool in primary care and hospital settings.

Methods The framework of the Child and Adolescent Needs and Strengths (CANS) and Pediatric Intermed tools was used to inform the selection of items for the 9-item Child and Adolescent Needs and Strengths-Pediatric Complexity Indicator (CANS-PCI). …

Leveraging Local Knowledge To Contextualize The Opioid Epidemic Within Healing Communities Study Communities: A Photovoice Protocol, Peter Balvanz, Ramona G. Olvera, Margaret Louise Mcgladrey, Marisa Booty, Dacia Beard, Sylvia Ellison, Craig Mcclay, Monica Nouvong, Carrie B. Oser, Owusua Yamoah, Linda Sprague Martinez

Health Management and Policy Faculty Publications

Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 …

Hawk's Eye Housing Project Clatsop County Context And Early-Stage Reflections, Sarah E Roth, Ritu Ghosal

Articles, Abstracts, and Reports

No abstract provided.

A Sampling Strategy For Longitudinal And Cross-Sectional Analyses Using A Large National Claims Database, Timothy L. Mcmurry, Jennifer M. Lobo, Soyoun Kim, Hyojung Kang, Min-Woong Sohn

Health Management and Policy Faculty Publications

Importance: The United States (US) Medicare claims files are valuable sources of national healthcare utilization data with over 45 million beneficiaries each year. Due to their massive sizes and costs involved in obtaining the data, a method of randomly drawing a representative sample for retrospective cohort studies with multi-year follow-up is not well-documented.

Objective: To present a method to construct longitudinal patient samples from Medicare claims files that are representative of Medicare populations each year.

Design: Retrospective cohort and cross-sectional designs.

Participants: US Medicare beneficiaries with diabetes over a 10-year period.

Methods: Medicare Master Beneficiary Summary Files were used to …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Implementing Social Determinants Of Health Data Collection In A Large Urban Pediatric Hospital Setting, Stormee Williams, Kristina Hill, Barry Owen, Forest Melton

Research

No abstract provided.

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Intersectionality, Racial Discrimination And Oral Healthcare Utilization Among Black Adults In Baltimore City, Maryland, Briona M. Phillips

Theses and Dissertations

INTRODUCTION: Oral health is essential for overall well-being, yet disparities persist, particularly among marginalized populations including Black adults. Limited access to and underutilization of oral healthcare services exacerbate these disparities. Discrimination, both individual and systemic, acts as a significant barrier to accessing care, contributing to disparities in oral health outcomes. Individuals facing discrimination experience mistrust and fear within oral healthcare settings, leading to delayed or avoided care. Therefore, investigating and addressing discrimination among Black adults is essential for promoting equitable access to oral healthcare, improving overall oral health outcomes, and lessening existing disparities.

PURPOSE: The purpose of this dissertation was …

Understanding Intention And Behavior Of Practicing Yoga Through The Lens Of Theory Of Planned Behavior Specifically In Rural Communities; A Qualitative Study, Shelley Meyer

Theses and Dissertations--Kinesiology and Health Promotion

While there are known health benefits for participating in yoga, little has been studied on the intention and behavior for why individuals practice yoga especially through a theoretical lens and intense qualitative thematic analysis. Targeting the rural community considers other extenuating circumstances experienced by rural residents that can impact yoga participation in rural areas. Interviews were used to gain insight into a holistic viewpoint with the rich data bringing clarity to an individual’s thought process (of intention) to incorporate yoga (behavior) in their daily life. Utilizing the Theory of Planned Behavior as the theoretical framework for developing interview questions allowed …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

Genetic Knowledge And Causal Beliefs: Implications For Health Behavior In Clinical And Non-Clinical Samples, Jamey T. Brumbaugh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: As the genomic era in healthcare continues to surge, it is vital to examine genetically-related psychological concepts, such as genetic knowledge and genetic causal beliefs, in genetically relevant clinical groups. Parents /caregivers of children born with cleft lip and/or palate represent a population whose knowledge and beliefs about genetics may be influenced by their frequent utilization of genetically-related healthcare services (e.g., genetic testing and genetic counseling). To date, little is known about how such beliefs vary across disease types. Even less is known regarding how disease-specific genetic causal beliefs relate to perceived behavioral control for disease development. Method: A …

The Impact Of Multidisciplinary Just-In-Time Training On Confidence In The Delivery Of Care In The Humanitarian And Disaster Response Environment, Jennifer Verstreken

DNP Scholarly Projects

Background: Team Rubicon International deploys emergency medical teams with little targeted training on the health and illness patterns common to the geographic region and the type of disasters to which they respond, such as cholera, malaria, and malnutrition. These high-risk, low-incidence illnesses are infrequently seen in Western medical practices. Medical, nursing, and paramedical training programs address these illness patterns in the curriculum. Still, a lack of consistent exposure to the care and treatment of patients with these illnesses can lead to a lack of knowledge and confidence in delivering appropriate care.

Purpose: This quality improvement project aimed to determine if …

Mapping Accessibility To Emergency Care Using Public Transportation, Bach Tran

Honors Undergraduate Theses

Intro: Public transit offers various advantages for both communities and individuals in terms of mobility and has the potential to serve as a practical alternative to private motorized transportation. Timely and convenient public transit becomes a lifeline for people who cannot access other types of transportation, especially when it comes to emergency care. Method: We built a private network analysis within ArcGIS Pro using coordinate data from hospitals and stand-alone emergency rooms as designated by the North American Industrial Classification System (NAICS) and public transit data from Orlando, FL. Establishing the accessible time as 30 minutes, we computed and visualized …

Improving Patient Self-Advocacy And Communication With Providers Through Diabetes Self-Management Education: Analyses From A Randomized Controlled Trial, Brenna Owens Kirk

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle …

Body-Map Storytelling: A Qualitative Exploration Of The Lived Experiences Of Hospital Care Amongst Street Involved Youth, Chelsey Fedchenko

Theses and Dissertations (Comprehensive)

This social work study explores the experiences of hospital care amongst street-involved (SI) youth. Given that SI youth are at a higher risk for health-related harms and experience significant barriers to health care services, they are at an increased likelihood of hospitalization. Yet, inadequate health care support for SI youth remains a critical problem in Canada. While hospital care amongst adult homeless populations has been well studied interdisciplinary, there is a scarcity of research investigating the hospital care experiences amongst SI youth. The aim of this qualitative, arts-based study was to explore how street-life contributes to hospitalization, how SI youth …

Preparing The Future Public Health Workforce: Fostering Global Citizenship Through The Relational Employability Framework - Insights From Two Case Studies, Elizabeth Cook, Sally-Anne Doherty, Ruth M. Wallace

Research outputs 2022 to 2026

A well-prepared public health workforce is essential for reducing disease burdens and improving population health, necessitating an education that addresses global and complex challenges. This paper explores the integration of the Relational Employability Framework in public health education as a tool to foster critical reflection and cultivate global citizenship among students and graduates. Global citizenship encompasses the social, political, environmental and economic actions of globally conscious individuals and communities, recognising that individuals operate within diverse local and global networks. Relational employability expands traditional notions of graduate employability, incorporating not only foundational career development and human interactions but also connections with …

Human Equilibrative Nucleoside Transporter 1: Novel Biomarker And Prognostic Indicator For Patients With Gemcitabine-Treated Pancreatic Cancer, Jianchun Xiao, Fangyu Zhao, Wenhao Luo, Gang Yang, Yicheng Wang, Jiangdong Qiu, Yueze Liu, Lei You, Lianfang Zheng, Taiping Zhang

Faculty, Staff and Student Publications

AIM: This article aimed to find appropriate pancreatic cancer (PC) patients to treat with Gemcitabine with better survival outcomes by detecting hENT1 levels.

METHODS: We collected surgical pathological tissues from PC patients who received radical surgery in our hospital from September 2004 to December 2014. A total of 375 PC tissues and paired adjacent nontumor tissues were employed for the construction of 4 tissue microarrays (TMAs). The quality of the 4 TMAs was examined by HE staining. We performed immunohistochemistry analysis to evaluate hENT1 expression in the TMAs. Moreover, we detected hENT1 expression level and proved the role of hENT1 …

Optimizing The Community Health Worker (Chw) Program In Belize And Understanding Its Unique Intermediary Position Within The Health System: Perspective From The World Health Organization (Who) Health Systems Approach, Andrei R. Chell

Electronic Theses & Dissertations (2024 - present)

Human resources for health (HRH) are the backbone of a well-functioning and resilient health system. Issues related to HRH recruitment, retention, planning, leadership and governance have been amplified by the coronavirus disease 2019 (COVID-19) pandemic and have posed additional and unprecedented challenges in many countries. Community health workers (CHWs) in particular, are uniquely positioned to be frontline health care workers (HCWs) that are considered a vital link between communities and the formal health system. Globally, the benefits of CHW programs have been well documented, and there is substantial evidence of the efficacy and effectiveness of these programs. However, countries are …

Qualitative Study Of Hiv-Related Stigma In The Dental Care Setting, Sania A. Pullen, Dr. Dina T. Garcia

Undergraduate Research Posters

Objectives: People living with HIV (PLWH) are susceptible to developing a variety of oral conditions that if left untreated can lead to sore gums, painful chewing, and tooth loss as well as compromise HIV management and viral suppression. Despite the increased risk of developing oral conditions, it is estimated that up to 58% of PLH do not receive regular dental care. This study aimed to examine HIV-related stigma and discrimination in the dental care setting.

Methods: Adults living with HIV who receive care through the Ryan White HIV/AIDS Program at the VCU Infectious Disease (ID) clinic were recruited to participate. …

Profile Of Caregiving Activities And Association With Physical Health Among Dementia Spousal Caregivers, Jinmyoung Cho, Laura P Sands, Alan B Stevens, Heather G Allore, Molly J Horstman

Faculty, Staff and Students Publications

Background and objectives: This study aims to identify patterns of caregiving intensity and assess associations between caregiving intensity and multidimensional physical health indicators and health behaviors among spousal caregivers of persons with Alzheimer's disease and related dementia.

Research design and methods: Using data from 152 spousal caregivers aged 65 and older, the intensity of their caregiving experience was measured as the number and frequency of health- and medical-related helping activities for their care recipient. Multidimensional health indicators included self-reported fatigue, sleep disturbance, physical functioning, pain interference, general health, and the number of chronic conditions from the electronic health records. Self-reported …

Variability In Chest Radiology Interpretation Between Thoracic And Non-Thoracic Radiologists: Implications For Pulmonary Fibrosis Care, Daniel M Guidot, Danielle Seaman, Roy A Pleasants, Armando Bedoya, Robert M Tighe, Bhavika Kaul

Faculty, Staff and Students Publications

No abstract provided.

Characteristics And Contributing Factors Of Diagnostic Error In Surgery: Analysis Of Closed Medico-Legal Cases And Complaints In Canada, Janice L Kwan, Lisa A Calder, Cara L Bowman, Anna Macintyre, Richard Mimeault, Liisa Honey, Cynthia Dunn, Gary Garber, Hardeep Singh

Faculty, Staff and Students Publications

Background: Diagnostic errors lead to patient harm; however, most research has been conducted in nonsurgical disciplines. We sought to characterize diagnostic error in the pre-, intra-, and postoperative surgical phases, describe their contributing factors, and quantify their impact related to patient harm.

Methods: We performed a retrospective analysis of closed medico-legal cases and complaints using a database representing more than 95% of all Canadian physicians. We included cases if they involved a legal action or complaint that closed between 2014 and 2018 and involved a diagnostic error assigned by peer expert review to a surgeon.

Results: We identified 387 surgical …