Health Services Research Commons^™

Implementing Text-Messaging To Support And Enhance Delivery Of Health Behavior Change Interventions In Low- To Middle-Income Countries: Case Study Of The Lifestyle Africa Intervention., Frank T. Materia, Joshua M. Smyth, Thandi Puoane, Lungiswa Tsolekile, Kathy Goggin, Stephen R. Kodish, Andrew T. Fox, Ken Resnicow, Scott Werntz, Delwyn Catley

Manuscripts, Articles, Book Chapters and Other Papers

The prevalence of non-communicable diseases, such as diabetes and cardiovascular disease, is rising in low- and middle-income countries (LMICs). Health behavior change (HBC) interventions such as the widely used Diabetes Prevention Program (DPP) are effective at reducing chronic disease risk, but have not been adapted for LMICs. Leveraging mobile health (mHealth) technology such as text messaging (SMS) to enhance reach and participant engagement with these interventions has great promise, yet we lack evidence-informed approaches to guide the integration of SMS specifically to support HBC interventions in LMIC contexts. To address this gap, we integrated guidance from the mHealth literature with …

Author Correction: Membrane Translocation Process Revealed By In Situ Structures Of Type Ii Secretion System Secretins, Zhili Yu, Yaoming Wu, Muyuan Chen, Tong Huo, Wei Zheng, Steven J Ludtke, Xiaodong Shi, Zhao Wang

Faculty, Staff and Students Publications

No abstract provided.

Exploring The Post-Surgical Needs Of Guatemalan Children And Their Families From Low Socioeconomic Status (Ses) Communities Using An Occupational Therapy Perspective, Diana Del Carmen Tojin Romero, Karen Aranha, Angela Labrie Blackwell

Summer 2023 Virtual OTD Capstone Symposium

Background: Despite a decline in infant mortality rates in the Global South (GS), there has been a rise in congenital and developmental disabilities. International short-term medical (ISTM) missions in Guatemala seek to address the surgical needs of children from low SES communities, but the understanding of the impacts of such assistance and the post-surgical needs of these communities remains limited. Embracing the Human Rights-Based Approach (HRBA) to healthcare as a foundation for this study recognizes health as a fundamental human right. The main tenets of this approach will guide this investigation to understand the post-surgical needs of children and their …

Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini

MUSC Theses and Dissertations

Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …

Psychometric Properties Of The Impact Index In Patients With Chronic Conditions, Kd Valentine, Suzanne Brodney, Carol Cosenza, J. Lee Hargraves, Karen Sepucha, Susan Edgman-Levitan, Michael Barry

Patient Experience Journal

The purpose of this paper was to extend the generalizability of the patient-reported Impact Index by assessing convergent validity in patients with common chronic conditions. We conducted a cross-sectional survey of 1,000 English-speaking patients aged 21 and older who visited their provider in the past 6 months and were included in one or more of a hospital’s chronic condition registries. Patients completed a survey that included the Impact Index (4-item measure of how impacted a patient is by their health condition: range 0-12, higher score indicating greater negative impact on quality of life), overall health, and self-report of diagnosis of …

‘Making It Meaningful’: Co-Designing An Intervention To Improve Medication Safety For People From Culturally And Linguistically Diverse Backgrounds Accessing Cancer Services., Ashfaq Chauhan, Bronwyn Newman, Elsa Roberto, Ramesh Lahiru Walpola, Holly Seale, Melvin Chin, Reema Harrison

Patient Experience Journal

This study reports on the process of using an adapted Experienced-Based Co-Design (EBCD) conducted with culturally and linguistically diverse (CALD) consumers and cancer service staff to co-design the novel ‘Making it Meaningful’(MiM) instrument at a cancer service in Australia. Multi-source experiential and contextual information was gathered in phase 1 of the co-design and this evidence, coupled with knowledge gathered via a feedback event was used to inform three co-design workshops in phase 2. A series of meetings were conducted prior to and in between the workshops. Theory was progressively integrated into the workshop content. Two Mandarin speaking CALD consumers and …

Patient-Centered Care Frameworks, Models And Approaches: An Environmental Scan, Aghna Wasim, Maria Sajan, Umair Majid

Patient Experience Journal

Although the definition of patient-centered care (PCC) remains unclear, researchers and healthcare professionals describe the concept as treating the patient as a unique human being with consideration for their physical and psychosocial needs and emphasize the importance of shared-decision making between patients and healthcare professionals. However, discussion around the connection and overlap between PCC and patient and family engagement (PE) has been limited. Some authors describe PE as an operationalization of PCC, while others consider PE a type of PCC. An enhanced understanding of PCC might allow for improvements in implementing PE across healthcare systems. Insight into the operationalization of …

A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, Yvonne Jonk Phd, Gary Wingrove Facpe, Cp-C, Nikiah Nudell Ms, Mphil, Nrp, Facpe, Kevin Mcginnis Mps

Emergency Medical Services (EMS)

This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Key Highlights: An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions. A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a …

The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam

Dissertations

Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …

Clinical And Environmental Factors Affecting The Survival Outcomes Among Stage 1a Tn0m0 First Primary Non-Small Cell Lung Carcinoma Patients In The United States., Naiya Patel

Electronic Theses and Dissertations

Background: Lung cancer is the second leading cause of death in the United States (U.S.). The most prevalent histological type of lung cancer is Non-Small Cell Lung Cancer (NSCLC), which has an overall five years survival of 5% if left untreated. Therefore, early treatment of NSCLC is vital to improve overall survival (OS) outcomes. Several factors affect survival outcomes, which can be categorized as modifiable or non-modifiable. The difference in timely receipt of guideline-concordant treatment affects the survival outcomes of patients with stage 1A NSCLC. This dissertation explored factors that affect treatment and survival outcomes among stage 1A NSCLC patients …

A Review Of A Strategic Roadmapping Exercise To Advance Clinical Translation Of Photoacoustic Imaging: From Current Barriers To Future Adoption, Hisham Assi, Rui Cao, Madhura Castelino, Ben Cox, Fiona J Gilbert, Janek Gröhl, Kurinchi Gurusamy, Lina Hacker, Aoife M Ivory, James Joseph, Ferdinand Knieling, Martin J Leahy, Ledia Lilaj, Srirang Manohar, Igor Meglinski, Carmel Moran, Andrea Murray, Alexander A Oraevsky, Mark D Pagel, Manojit Pramanik, Jason Raymond, Mithun Kuniyil Ajith Singh, William C Vogt, Lihong Wang, Shufan Yang, Members Of Ipasc, Sarah E Bohndiek

Faculty, Staff and Student Publications

Photoacoustic imaging (PAI), also referred to as optoacoustic imaging, has shown promise in early-stage clinical trials in a range of applications from inflammatory diseases to cancer. While the first PAI systems have recently received regulatory approvals, successful adoption of PAI technology into healthcare systems for clinical decision making must still overcome a range of barriers, from education and training to data acquisition and interpretation. The International Photoacoustic Standardisation Consortium (IPASC) undertook an community exercise in 2022 to identify and understand these barriers, then develop a roadmap of strategic plans to address them. Here, we outline the nature and scope of …

Disparities In Antifibrotic Medication Utilization Among Veterans With Idiopathic Pulmonary Fibrosis, Bhavika Kaul, Joyce S Lee, Laura A Petersen, Charles Mcculloch, Ivan O Rosas, Venkata D Bandi, Ning Zhang, Alison M Dedent, Harold R Collard, Mary A Whooley

Faculty, Staff and Students Publications

Background: Two antifibrotic medications, pirfenidone and nintedanib, are approved for the treatment of idiopathic pulmonary fibrosis (IPF). Little is known about their real-world adoption.

Research question: What are the real-world antifibrotic utilization rates and factors associated with uptake among a national cohort of veterans with IPF?

Study design and methods: This study identified veterans with IPF who received care either provided by the Veterans Affairs (VA) Healthcare System or non-VA care paid for by the VA. Patients who had filled at least one antifibrotic prescription through the VA pharmacy or Medicare Part D between October 15, 2014, and December 31, …

Hunger Extends Lifespan By Modulating Histone Proteins, Hailan Liu, Hongjie Li, Yong Xu

Faculty, Staff and Students Publications

No abstract provided.

Feasibility Of Delivering A Virtual 1-Day Acceptance And Commitment Therapy Workshop To Rural Veterans Through Community Partnerships, Lilian Dindo, Angelic Chaison, Merlyn Rodrigues, Ken Woods, Alicia Mark, Derrecka Boykin

Faculty, Staff and Students Publications

Background: This single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans.

Methods: We collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short …

The Benefits Of Making Peace With Pain: Chronic Pain Acceptance Moderates The Indirect Effect Of Perceived Burdensomeness Between Pain Severity And Suicidal Cognitions, Willie Hale, Sarah Vacek, Meghan Crabtree, Kaitlin Grelle, Craig J Bryan, Donald D Mcgeary, Kathryn E Kanzler

Faculty, Staff and Students Publications

Objective: The purpose of this study was (1) to examine the degree to which perceived burdensomeness mediates the relationship between pain severity and suicidal cognitions and (2) to determine whether this mediated relationship was moderated by pain acceptance. We predicted that high levels of pain acceptance would buffer relationships on both paths of the indirect effect.

Methods: Two-hundred seven patients with chronic pain completed an anonymous self-report battery of measures, including the Chronic Pain Acceptance Questionnaire, the Interpersonal Needs Questionnaire, the Suicidal Cognitions Scale, and the pain severity subscale of the West Haven-Yale Multidimensional Pain Inventory. Conditional process models were …

Transplanting Hepatitis B Surface Antigen-Positive Livers In The United States: Outcomes And Opportunities, Anshul Bhatnagar, Sameer Prakash, Peter Lymberopoulos, Cameron Goff, Anjiya Shaikh, Donghee Kim, Aijaz Ahmed, Carl Berg, Susanna Naggie, Fasiha Kanwal, George Cholankeril, Tzu-Hao Lee

Faculty, Staff and Students Publications

Livers from donors with positive hepatitis B surface antigens (HBsAg+) have been used to expand the donor pool; however, outcome data are limited. We aim to evaluate survival following liver transplant (LT) from HBsAg+ donors. Using the United Network for Organ Sharing registry, we identified HBsAg+ donors used for LT from 2009 to 2020. We used Kaplan-Meier survival and Cox proportional hazards regression to compare post-LT survival in hepatitis B virus-negative recipients who utilized HBsAg+ donors to propensity-matched cohorts who utilized other types of donors. From 2009-2020, 70 patients received HBsAg+ livers, and 58 of them did not carry a …

High Risk Lung Nodule: A Multidisciplinary Approach To Diagnosis And Management, Babith J Mankidy, Ghasemirad Mohammad, Kelly Trinh, Anoop P Ayyappan, Quillan Huang, Steven Bujarski, Mohammad S Jafferji, Ravi Ghanta, Alexander N Hanania, Donald R Lazarus

Faculty, Staff and Students Publications

Pulmonary nodules are often discovered incidentally during CT scans performed for other reasons. While the vast majority of nodules are benign, a small percentage may represent early-stage lung cancer with the potential for curative treatments. With the growing use of CT for both clinical purposes and lung cancer screening, the number of pulmonary nodules detected is expected to increase substantially. Despite well-established guidelines, many nodules do not receive proper evaluation due to a variety of factors, including inadequate coordination of care and financial and social barriers. To address this quality gap, novel approaches such as multidisciplinary nodule clinics and multidisciplinary …

Blunted Adaptive Immune Responses And Acute Exacerbations Of Copd: Breaking The Code, Ken R Bracke, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Leveraging Omics To Predict Chronic Obstructive Pulmonary Disease Exacerbations: The "Immunome", Francesca Polverino, Ravi Kalhan

Faculty, Staff and Students Publications

No abstract provided.

Improving The Diagnostic Process For Patients With Possible Bladder And Kidney Cancer: A Mixed-Methods Study To Identify Potential Missed Diagnostic Opportunities, Yin Zhou, Hardeep Singh, Willie Hamilton, Stephanie Archer, Sapphire Tan, James Brimicombe, Georgios Lyratzopoulos, Fiona M Walter

Faculty, Staff and Students Publications

Background: Patients with bladder and kidney cancer may experience diagnostic delays.

Aim: To identify patterns of suboptimal care and contributors of potential missed diagnostic opportunities (MDOs).

Design and setting: Prospective, mixed-methods study recruiting participants from nine general practices in Eastern England between June 2018 and October 2019.

Method: Patients with possible bladder and kidney cancer were identified using eligibility criteria based on National Institute for Health and Care Excellence (NICE) guidelines for suspected cancer. Primary care records were reviewed at recruitment and at 1 year for data on symptoms, tests, referrals, and diagnosis. Referral predictors were examined using logistic regression. …

Editorial, Al Asyary

Kesmas

No abstract provided.

Reshaping Healthcare: A Bibliometric Analysis Of Lessons Learned In Post-Covid-19 Health Policy, Azliyana Azizan, Khairul Hafezad Abdullah, Sri Ratna Rahayu, Nadia Safirah Rusli, Nornajehah Tarmidzi

Kesmas

The COVID-19 pandemic has profoundly impacted health policy globally, leading to heightened concern and urgency. However, previous studies have been hampered by limited resources and insufficient discussions on the long-term implications for health policies following multiple COVID-19 waves. Thus, this study examined the evolution of international studies on post-COVID-19 health policy. A comprehensive analysis used well-known literature databases Scopus and Web of Science to explore parameters including publication growth, participating countries, areas of interest, and keyword analysis of topics such as"COVID-19" and "Health Policy." The United States emerged as an active participant, focusing on "Computer science." Key themes included "COVID-19 …

Rendahnya Skor Methods Information Index (Mii) Dan Faktor-Faktor Terkait: Analisis Survei Demografi Dan Kesehatan Indonesia (Sdki) 2012 Dan 2017, Wiji Wahyuningsih, Meiwita P. Budiharsana

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Informed choice memastikan bahwa pilihan kontrasepsi modern diputuskan perempuan setelah menerima informasi lengkap tentang metode kontrasepsi yang tersedia. Indeks informasi yang disebut Methods Information Index (MII) mengukur tiga elemen, yaitu efek samping masing-masing metode, kemana harus berobat jika efek samping muncul, dan perlu berganti ke kontrasepsi mana. Pemberian informasi lengkap tentang ketiga elemen MII merupakan pemenuhan etika dan hak-hak reproduksi perempuan. Penelitian ini menyajikan temuan rendahnya skoring MII di Indonesia, cermin dari tinggginya persentase perempuan pengguna kontrasepsi yang tidak menerima informasi lengkap dan faktor-faktor terkait. Sebanyak 45.607 dan 49.627 perempuan usia 15-49 tahun yang tercakup dalam Survei Demografi dan Kesehatan …

The Extent Of Knowledge, Preparedness And Perception Of Telemedicine Among Family Medicine Residents In Cebu City During Covid-19, Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Telemedicine is providing healthcare services using electronic means at a distance including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation, and education of healthcare providers. Its role in the time of the pandemic is vital, especially to the practice of medicine. This study is a descriptive, cross-sectional, survey research study conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire about the extent of knowledge, preparedness and perceptions of telemedicine. Out of the 41 respondents, 56.10% were young adults (26-30 …

Pengaruh Komorbid Terhadap Tingkat Survival Pasien Dengan Diabetes Tipe Ii: Analisis Data Sampel Bpjs 2015-2021, Anggi Tria Abimayu, Martya Rahmaniati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Tahun 2021 Indonesia menempati peringkat ke-6 di dunia dengan kasus kematian akibat diabetes terbanyak. Tingginya angka kematian diabetes disebabkan oleh banyak hal, salah satunya adalah komorbiditas. Tujuan penelitian ini adalah untuk melihat pengaruh komorbid terhadap tingkat survival penderita diabetes tipe II di Indonesia. Penelitian ini menggunakan data sampel kontekstual diabetes melitus BPJS tahun 2015-2021 dengan desain kohort retrospektif dan didapatkan jumlah sampel 96.379 terbobot. Dilakukan analisis statistik univariat, bivariat dengan kurva Kaplan-Meier dan Uji Log-Rank, dan multivariat dengan uji cox proportional hazard. Hasil penelitian menunjukan bahwa penderita diabetes tipe II yang memiliki komorbid mempunyai cumulative survival probability (CSP) yang …

Determinan Kematian Balita Di Provinsi Bangka Belitung, Gorontalo, Dan Papua Barat: Analisis Data Sdki 2017, Jilan Salshabilla Mutaqin, Martya Rahmaniati, Sutanto Priyo Hastono, Tiopan Sipahutar

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Bangka Belitung, Gorontalo, dan Papua Barat memiliki angka kematian balita tertinggi berdasarkan wilayah Indonesia bagian Barat, Tengah, dan Timur. Tingginya kematian balita terkait langsung dengan keberlanjutan hidup anak dan merefleksikan kondisi sosio-ekonomi, lingkungan tempat tinggal, serta pemeliharaan kesehatan anak. Penelitian ini dilakukan untuk menyelidiki determinan kematian balita menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) 2017. Analisis dilakukan pada 1056 sampel dengan uji potong lintang dan regresi logistik untuk melihat faktor kematian balita yang signifikan serta besar risiko masing-masing faktor pada determinan sosio-ekonomi dan proksi. Jumlah kelahirkan, jenis kelamin anak, ibu yang tidak memberikan ASI, pendidikan ibu, dan umur ibu …

Faktor-Faktor Yang Berhubungan Dengan Perilaku Aktivitas Fisik Pada Remaja Di Kota Banjarbaru Tahun 2021, Annisa Sujarwati, Emelia Agustina, Muhammad Azmiyannoor, Dian Rosadi, Rudi Fakhriyadi, Noor Ahda Fadillah, Hadrianti H.D. Lasari, Mufatihatul Aziza Nisa

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Data Riskesdas 2013-2018 menunjukkan peningkatan aktivitas fisik yang kurang pada penduduk usia ≥10 tahun di Indonesia. Kurangnya aktivitas fisik dapat disebabkan dari berbagai hal. Oleh karena itu, dilakukan penelitian ini dengan tujuan untuk mengetahui faktor-faktor yang berhubungan dengan kurangnya aktfitas fisik pada remaja 10-24 tahun di Kota Banjarbaru melalui pendekatan teori perilaku Lawrence Green. Penelitian ini menggunakan rancangan kuantitatif dengan pendekatan cross-sectional. Populasinya adalah seluruh remaja usia 10-24 tahun di Kota Banjarbaru. Teknik sampling yang digunakan adalah accidental sampling dengan jumlah sampel 80 responden. Instrumen yang digunakan adalah kuesioner yang telah diuji validitas dan dinyatakan valid. Variabel bebas yang diteliti …

Communication Of Patients’ And Family Members’ Ethical Concerns To Their Healthcare Providers, Mariam Noorulhuda, Christine Grady, Paul Wakim, Talia Bernhard, Hae Lin Cho, Marion Danis

Student Papers, Posters & Projects

BACKGROUND: Little is known about communication between patients, families, and healthcare providers regarding ethical concerns that patients and families experience in the course of illness and medical care. To address this gap in the literature, we surveyed patients and family members to learn about their ethical concerns and the extent to which they discussed them with their healthcare providers.

METHODS: We surveyed adult, English-speaking patients and family members receiving inpatient care in five hospitals in the Washington DC-Baltimore metropolitan area from July 2017 to March 2020. Descriptive statistics were used to determine the frequency, comfortableness, and helpfulness of discussions regarding …

Revitalizing The Healthcare Market: An Analysis Of Hospital Pricing Transparency Compliance, Ellie Bruggeman

Business and Economics Summer Fellows

The healthcare industry is one of the most praised industries in the US due to its lifesaving capabilities and immersive care. Consumers regularly report that are satisfied with the care they receive from their physicians. Conversely, they also report frustrations and confusions associated with the costs of such care. In extreme cases, this frustration can turn to financial ruin as medical debt is the leading cause of bankruptcy in the US. The healthcare industry does not operate in congruence with other markets, largely due to the presence of insurance and other third-party payers. The undisclosed interactions between third party payers …

Covid-19 Proactive Disease Management Using Covid Virtual Hospital In A Rural Community, Gandhari Loomis, Regina Rhodes, Ed Bujold, Golnosh Sharafsaleh, Ellen Collett, Mark Irwin, Elizabeth W. Staton, John M. Westfall

Journal of Patient-Centered Research and Reviews

Purpose: A community teaching hospital serving a rural population established an intensive “hospital at home” program for patients with COVID-19 utilizing disease risk stratification and pulse oximeter readings to dictate nurse and clinician contact. Herein, we report patient outcomes and provider experiences resulting from this “virtual” approach to triaging pandemic care.

Methods: COVID-19-positive patients appropriate for outpatient management were enrolled in our COVID Virtual Hospital (CVH). Patients received pulse oximeters and instructions for home monitoring of vital signs. CVH nurses contacted the patient within 12–48 hours. The primary care provider was alerted of the patient’s diagnosis and held a virtual …