Health Services Research Commons^™

Adoption Of Health Information Technology In Nursing Homes, Robert Smiley

Applied Research Projects

Background: Comprehensive knowledge about the level of Health Information Technology (HIT) adoption in Nursing Homes remains subpar to 21st century healthcare standards.

Objective: This study is to determine the factors that will aid in the adoption of HIT in Nursing Homes in the New York metropolitan area.

Methods: A pilot survey was issued to employees at three Nursing Homes to collect data that would aid in the adoption of HIT in Nursing Homes in the New York metropolitan area.

Study Design: A 16 question survey was administered to twenty-one employees at three separate Nursing Homes in the New York metropolitan …

Meaningful Use: Electronic Clinical Quality Measure Reporting, Rhonda K. Denzel

Applied Research Projects

The adoption of health information technology and the meaningful use of electronic health records is a byproduct of the 2009 American Recovery and Reinvestment Act (ARRA). One measure of ARRA is the Health Information and Technology for Economic and Clinical Health (HITECH) Act which authorizes the Centers for Medicare and Medicaid Services (CMS) to provide monetary incentives to hospitals and providers who demonstrate meaningful use of certified electronic health records (EHRs).

The electronic reporting of clinical quality measures is but one requirement for demonstrating meaningful use. Reporting of clinical quality measures has been around for 25 plus years as a …

Meaningful Use – Is It Worth It?, Karen Perry Callahan

Applied Research Projects

The world of medicine has long been an ever changing environment. The advancements and progress in both knowledge and techniques has made patient care and treatment an increasingly successful endeavor. Physicians are often eager to embrace any new technology in the medical field that allows them to better care for their patients. The problem with new medical technology is that unless this technology can be shared or related to others, it is somewhat useless.

The medical profession has been somewhat reluctant to come to terms with the use of computer technology and its many benefits. Generally embedded in the use …

An Analysis Of Waiting Time Reduction In A Private Hospital In The Middle East, Husam Asfoor

Applied Research Projects

The study of patient’s waiting time reduction have been receiving attention since the implementation of recent changes in the healthcare quality indicators. However, there is still many areas of improvement the healthcare industry could implement to improve waiting time and positively affect patient satisfaction. This is especially crucial for private healthcare organizations since it has a direct effect on their bottom-line.

In this study, we examine the patient waiting time between the registration stage and the vital sign stage at a private hospital in the Middle East country of United Arab Emirates.

By retrieving the data logs from the EHR …

Integrated System Post-Implementation Evaluation And Use Assessment, Anne L. Pedigo

Applied Research Projects

Part of a well-designed health informatics implementation process includes the mechanisms put in place to help the day-to-day operators of the systems. Continual appraisal of these methods necessitates up-to-date investigations. Understanding critical elements which support a positive transition of health information technology (HIT) within healthcare facilities is the objective of the following research. To help develop these findings, a prospective post-implementation and use assessment survey was conducted on two hospitals in Central Texas. The population studied included RN case managers, social workers and supportive staff in the Continuum of Care departments at two Scott & White Healthcare acute care facilities. …

Comparison Of Body Composition Measures In Older Adult Males, Cody Smith

Honors Projects

Body Mass Index (BMI) is a measure created to assess population wide staistics of obesity and stratify health risk. However, there are large differences in health risk when comparing BMI with measures of body composition. BMI is not a measure of body composition. Body composition measures are used to distinguish between fat mass, fat-free mass. This percent body fat is more significantly correlated with health risk.

This study analyzed various body composition methodologies including waist circumference at the umbilicus and at the narrowest point of the abdomen, sagittal abdominal diameter, bioelectrical impedance analysis, and air displacement plethysmography. The study’s purpose …

Measuring Sense Of Presence And User Characteristics To Predict Effective Training In An Online Simulated Virtual Environment, Gianluca De Leo, Leigh A. Diggs, Elena Radici, Thomas W. Mastaglio

VMASC Publications

Introduction: Virtual-reality solutions have successfully been used to train distributed teams. This study aimed to investigate the correlation between user characteristics and sense of presence in an online virtual-reality environment where distributed teams are trained. A greater sense of presence has the potential to make training in the virtual environment more effective, leading to the formation of teams that perform better in a real environment. Being able to identify, before starting online training, those user characteristics that are predictors of a greater sense of presence can lead to the selection of trainees who would benefit most from the online simulated …

Evaluation Of The Jewish Community Housing For The Elderly Memory Support Initiative, Joan Hyde

Gerontology Institute Publications

Jewish Community Housing for the Elderly (JCHE) is a large, multi-campus organization that houses and serves 1,500 residents (80 market rate and 1,420 low income). The average age is 80 years old, with one-third of residents 85 and older. Three quarters of the residents are not native English speakers. Through HUD and other funding, JCHE offers a range of supports to these residents, including translators, interpreters and staff with language and cultural competence, meals, transportation and, through their Service Coordinators, facilitation of resident access to government benefits, home care and other services.

According to the Alzheimer’s Association’s 2012 special report …

Assessing Transgender Attitudes Toward Health Care: Can These Attitudes Help Predict Health Outcomes?, Sara M. Shane

PCOM Psychology Dissertations

Research has identified the fact that race/ethnicity, sexual orientation, gender identity, socioeconomic status, education level, geographic location, help seeking behaviors, and experiences of discrimination are associated with health outcomes. In addition, attitudes towards providers can also help determine health outcomes. The transgender community experiences barriers to health care services and therefore their overall health is affected. There is not a sufficient amount of literature that assesses, using standardized measure, the attitudes of the transgender community and their health. The present study will assess the attitudes of the transgender community toward health care (mental and medical health) and, using standardized measures, …

Study On Private Health Insurance Coverage For Adults Under 65: 34 States From 2003 To 2010, Weisheng Gu

MPA/MPP/MPFM Capstone Projects

Objectives: The analysis in this paper is designed to find out what factors contributed to the change of uninsured rate of people aged between 18 and 65 from 2003 to 2010.

Method: A fixed-effect analysis with panel data is conducted. The analysis unit is state. The main independent variable is the private health insurance cost per enrollee per year. The private insurance cost data covered 34 states sampled in Medical Expenditure Panel Survey from 2003 to 2010.

Key finding: The private insurance cost per enrolled adult below 65, private insurance cost per enrolled adult below 65 as a proportion of …

Role Of Nicotine Dependence On The Relationship Between Variants In The Nicotinic Receptor Genes And Risk Of Lung Adenocarcinoma, Tung-Sung Tseng, Jong Y. Park, Jovanny Zabaleta, Sarah Moody-Thomas, Melinda S. Sothern, Ted Chen, David E. Evans, Hui-Yi Lin

School of Public Health Faculty Publications

Several variations in the nicotinic receptor genes have been identified to be associated with both lung cancer risk and smoking in the genome-wide association (GWA) studies. However, the relationships among these three factors (genetic variants, nicotine dependence, and lung cancer) remain unclear. In an attempt to elucidate these relationships, we applied mediation analysis to quantify the impact of nicotine dependence on the association between the nicotinic receptor genetic variants and lung adenocarcinoma risk. We evaluated 23 single nucleotide polymorphisms (SNPs) in the five nicotinic receptor related genes (CHRNB3, CHRNA6, and CHRNA5/A3/B4) previously reported to be associated with lung cancer risk …

Social Networks, Drug Use, And Drug Abuse Help-Seeking: A Test Of The Network Episode Model Among African American Women, Erin L. Pullen

Theses and Dissertations--Sociology

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in …

Does The Sequence Of Instruction Matter During Simulation?, Jill E. Stefaniak, Carman L. Turkelson

STEMPS Faculty Publications

Introduction: Instructional strategies must be balanced when subjecting students to full-immersion simulation so as not to discourage learning and increase cognitive overload. The purpose of this study was to determine if participating in a simulation exercise before lecture yielded better performance outcomes among novice learners.

Methods: Twenty-nine participants were divided into 2 groups as follows: group 1 participated in simulation exercises followed by a didactic lecture and group 2 participated in the same learning activities presented in the opposite order. Participants were administered a multiple-choice cognitive assessment upon completion of a workshop.

Results: Learners who participated in the simulated exercises …

Navigating The Health Care Labyrinth: Portraits Of The Socioeconomically Disadvantaged, Thomas C. Crawford Phd

Antioch University Dissertations & Theses

In 2010, an estimated population of the 311,212,863 Americans generated approximately 1,014,688,290 physician office encounters (Moore, 2010). The frequency and number of professional interactions between caregivers and patients/family members in medical office settings equated to a staggering 1,931 visits per minute. Based on the massive volume of interactions that occurred between patients of different races, ethnicities, genders, sexual orientations, and socioeconomic standings that generated an average household income of $49,445 in 2010 (United States Census Bureau, 2010a) with a physician workforce that the Association of American Medical Colleges (2010) captured as being 75% White that earned (primary care specialties) in …

Exploring Perceptions And Experiences With Research Ethics In Bolivia, Sarah Sullivan, Armando Basagoitia, Annette Aalborg, Oscar Lanza, Jacqueline Cortez

Background: In Bolivia, there is increasing interest in the necessity of incorporating research ethics into study designs and procedures, but there is minimal data on the perceptions and experiences of Bolivian health science faculty, researchers, and national health administrators on research ethics. The Touro University California (TUC) Public Health Program is partnering with Bolivian universities to develop a comprehensive Research Education Ethics Program. In 2013, The Universidad Mayor de San Andrés received a National Institute of Health/Fogarty International Center Planning Grant award to develop the program. The two central aims of this program needs assessment are to describe the …

Evaluating Quality Improvement To Improve Hiv Reporting, Nandi A. Marshall, William C. Livingood, Angela Peden, Gulzar H. Shah, Russ Toal, Dayna Alexander, Alesha Wright, Sandra Jump, Shelby Freeman, Kay Davis, Lynn Woodhouse, Kellie Penix

Frontiers in Public Health Services and Systems Research

The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts.

Online Social Networks To The Rescue: Fulfilling The Ten Essential Public Health Services, Melanie D. Mason, Maureen P. Bezold

Frontiers in Public Health Services and Systems Research

Budget cuts and shortages in the public health workforce have contributed to the reduction of public health services in 91% of state health departments (SHDs). To adjust for these changes, health departments must discover novel ways to deliver essential public health services to their constituents. Researchers conducted a retrospective analysis of the content published on SHDs’ Twitter pages to determine if online social networks were used to fulfill the ten essential public health services. While 42 SHDs had a Twitter page, the volume and content of tweets varied. Although tweets were posted that related to all ten of the essential …

Commentary: Moving Beyond The Numbers, Effectively Using Research To Influence Policy, F. Douglas Scutchfield, Marylou Wallace

Frontiers in Public Health Services and Systems Research

This seventh issue of Frontiers reflects the variety of PHSSR. One emerging theme, however, is the notion of public health and its role in policy and policy development. PHSSR focuses on several potential users, researchers, practitioners and policy makers. As it concerns policy makers, PHSSR delivers research that allows them to make decisions about policy change that not only influences public health status, but creates healthy conditions. In this way, PHSSR essentially influences decisions about support for public health services.

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

Exploring The Effects Of Multi-Level Protective And Risk Factors On Child And Parenting Outcomes In Families Participating In Healthy Start/Healthy Families Oregon (Hs/Hfo), Peggy Nygren

Dissertations and Theses

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy …

A Profile Of Community Health Center Patients: Implications For Policy, Peter Shin, Carmen Alvarez, Jessica Sharac, Sara J. Rosenbaum, Amanda Van Vleet, Julia Paradise, Rachel Garfield

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers are a key source of comprehensive primary care in medically underserved communities across the country, and their role is expected to grow as health coverage expands under the Affordable Care Act (ACA). To sharpen understanding of the health center patient population, this brief compares it to the overall low-income population, using data from the Health Center Patient Survey and the National Health Interview Survey,respectively. The pre-ACA profile of health center patients that emerges sets the stage for measuring change following implementation of the reform law and can inform health center policy, planning, and assessment moving forward.

Chhs December 2013 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Factors Influencing The Decision And Ability To Seek Health Services Among Hiv/Aids Patients In Tanzania, Savitri Grover

Masters Theses & Specialist Projects

Understanding the barriers to treatment for individuals with HIV/AIDS in developing countries could have a major impact on their ability to seek healthcare services. The purpose of this study is to quantitatively analyze the effect of daily activities and structural factors, which act as barriers to seeking health services for individuals living with HIV/AIDS in Tanzania.

The study is based on the hypothesis that (1) Individuals living with HIV/AIDS who face both personal and structural barriers have poor health compared to those not facing the barriers. (2) Individuals living with HIV/AIDS demonstrate different decisions and abilities to seek health services …

2013 Survey Of Children Served By Mainecare, Jean A. Talbot Phd, Deborah Thayer Mba, Zachariah T. Croll Mph, Kimberley Fox Mpa

Medicaid

These survey results help identify areas for improvement for future initiatives both for the MaineCare program and for providers serving this population. Key Findings: MaineCare higher than the national average on most patient experience measures. Significant improvements in MaineCare provider/family communication and care coordination. MaineCare lower than national average on customer service, availability of treatment choices, and care coordination among providers. Patient experience generally similar for Medicaid and CHIP enrollees. Many MaineCare children have special health care needs. 35% of children enrolled in MaineCare have special health care needs, according to the 2013 survey. Experience of children with special health …

Telemental Health In Today's Rural Health System, David Lambert Phd, John A. Gale Ms, Anush Yousefian Hansen Ms, Ma, Zachariah T. Croll Ba, David Hartley Phd, Mha

Mental Health / Substance Use Disorders

Telemental health has long been promoted in rural areas to address chronic access barriers to mental health care. While support and enthusiasm for telemental health in rural areas remains quite high, we lack a clear picture of the reality of telemental health in rural areas, compared to its promise. This Research & Policy Brief reports on the first part of our study—the online survey of 53 telemental health programs—and describes the organizational setting, services provided, and the staff mix of these programs. We draw from our telephone interviews with 23 of these programs to help describe the organizational context of …

Public Health Research Implementation And Translation: Evidence From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg, Doris M. Castellanos-Cruz, Anna G. Hoover, Lizeth C. Fowler

Health and Clinical Sciences Faculty Publications

BACKGROUND: Research on how best to deliver efficacious public health strategies in heterogeneous community and organizational contexts remains limited. Such studies require the active engagement of public health practice settings in the design, implementation, and translation of research. Practice-based research networks (PBRNs) provide mechanisms for research engagement, but until now they have not been tested in public health settings.

PURPOSE: This study uses data from participants in 14 public health PBRNs and a national comparison group of public health agencies to study processes influencing the engagement of public health settings in research implementation and translation activities.

METHODS: A cross-sectional network …

Diagnosis And Acute Management Of Patients With Concussion At Children's Hospitals., Jeffrey D. Colvin, Cary Thurm, Brian M. Pate, Jason G. Newland, Matt Hall, William P. Meehan Iii

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: To describe the number of hospital admissions for concussion at paediatric hospitals in the USA. To describe the use of imaging and medications for acute concussion paediatric patients.

Design: Cross-sectional study.

Setting: Children's hospitals participating in the Pediatric Health Information System in the USA during a 10-year period.

Patients: All emergency department (ED) visits and inpatient admissions with the primary diagnosis of concussion, defined as International Classification of Diseases, Ninth Revision, Clinical Modification codes for: (1) concussion, (2) postconcussion syndrome or (3) skull fracture without mention of intracranial injury with concussion.

Main outcome measures: The proportion of concussion patients …

“Many Miles To Go …”: A Systematic Review Of The Implementation Of Patient Decision Support Interventions Into Routine Clinical Practice, Glyn Elwyn, Isabelle Scholl, Caroline Tietbohl, Mala Mann, Adrian G. K. Edwards, Catharine Clay

Dartmouth Scholarship

Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings.

Estimating The Costs Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

From (Un)Willingness To Involvement: Development Of A Successful Study Brand For Recruitment Of Diverse Msm To A Longitudinal Hiv Research, Paula M. Frew, Victoria A. Williams, Eve T. Shapiro, Travis Sanchez, Eli S. Rosenberg, Vincent L. Fenimore, Patrick S. Sullivan

Environmental & Global Health Faculty Research

Background. HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results. Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (, ). Qualitative and quantitative results indicate …