Health Services Research Commons^™

Child Health Promotion Research Centre - Research For The Future, Margaret Hall

ECU Research Week

Research for the Future: Overview of Research within the Child Health Promotion Research Centre.

Health Status Of Children Entering Kindergarten: Results Of The 2009-2010 (Year Two) Nevada Kindergarten Health Survey, Nevada Institute For Children’S Research And Policy, Clark County School District, Nevada School District Superintendents, Nevada Head Start State Collaboration, Early Childhood Comprehensive Services Office, Nevada State Health Division, Denise Tanata Ashby, Kari Wolkwitz, Tara Phebus, Amanda Haboush,, Enrique Lopez, Norman Torres

Nevada Institute for Children's Research and Policy Reports

Academic achievement for children is vital to their success in life. Those that do well in school have greater opportunities for post-secondary education, and later have better prospects for employment. One of the major factors that can affect a child’s academic achievement is his or her health status. Academic outcomes and health conditions are consistently linked in the literature (Taras & Potts-Datema, 2005). Children with poor health status, and especially those with common chronic health conditions, have increased numbers of school absences and more academic deficiencies (Taras & Potts-Datema, 2005). In a study concerning excused versus unexcused absences, children with …

Psychological Care For Persons Of Diverse Religions: A Collaborative Continuum, Glen Milstein, Anne Marie Yali

Publications and Research

The purpose of this paper is to describe to psychologists and other clinicians a continuum of mental health care for persons of diverse religions. The continuum delineates boundaries between clinical care provided by mental health professionals and religious care provided by clergy, as well as describes pathways of collaboration across these boundaries. A prevention science based model of Clergy Outreach and Professional Engagement (COPE) is offered to guide this collaboration. The model describes a continuum that moves from the care already present in religious communities, through professional clinical care provided in response to dysfunction and returns persons to their own …

Using The Andersen Behavioral Model Of Health Services Use To Examine Adult Uninsured Patient Health Services Use At A Community Health Center, Jewel Shonette Goodman

Health Services Research Dissertations

Prescription medications are essential to the treatment and management of chronic conditions (Smith et al., 2005). Lack of access can result in pain, worsening of the condition and increased risk of additional health problems. Health care expenditures in the United States were reportedly 1.7 trillion in 2003 (Smithetal.,2005) and exceeded" role="presentation" style="box-sizing: border-box; display: inline-table; line-height: 0; font-size: 16.66px; overflow-wrap: normal; word-spacing: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; margin: 0px; padding: 1px 0px; position: relative;">1.7trillionin2003(Smithetal.,2005)andexceeded1.7trillionin2003(Smithetal.,2005)andexceeded2.3 trillion in 2008 (Centers for Medicare and Medicaid Services, 2010). Prescription medication costs …

Women’S Health Guides [Review Article], Meg Miner

Scholarly Publications

The fight for equal rights for women may be over a hundred years old, but in medical research, women have only been treated equally since the 1990s. That is also the time that evidence-based women’s health handbooks started to appear. Up to that point, most studies only included recommendations for women that had been deduced from analyses of men’s responses to clinical trials.This article reviews four new publications on women’s health: two that were written for health professionals and two for consumers.

Inadequate Health Numeracy Affects Cancer Screening Practices In Vulnerable Populations, Sherrine Eid Mph, Dorothy Faulkner Phd

Administration & Leadership

No abstract provided.

No Free Lunch? Current Challenges Facing The National School Lunch And School Breakfast Programs, Eileen Salinsky

National Health Policy Forum

This background paper describes important characteristics of the National School Lunch Program and the School Breakfast Program, reviews U.S. Department of Agriculture rules regarding the nutritional content of school meals, and examines compliance with current nutrition standards. It also considers the dietary status and obesity risk of meal program participants, discusses proposed improvements to nutritional standards and meal requirements, and highlights key legislative issues.

Got Junk? The Federal Role In Regulating “Competitive” Foods, Eileen Salinsky

National Health Policy Forum

A wide variety of food and beverage items are available in schools in addition to the school meals provided through the National School Lunch Program and School Breakfast Program. A long-standing source of controversy, the need for stronger federal restrictions on foods that compete with school meals is again under debate. This issue brief examines the availability and consumption of competitive foods, explores the regulation of these foods at the federal level, considers trends in state and local restrictions, and summarizes perceived barriers to improving the nutritional quality of competitive food options.

The Role Of Ombudsmen In Assuring Quality For Residents Of Long-Term Care Facilities: Straining To Make Ends Meet, Carol O'Shaughnessy

National Health Policy Forum

Assuring quality of care for residents in long-term care facilities has been a serious and continuing concern of policymakers for decades. The Older Americans Act’s long-term care ombudsman program is a consumer advocacy model intended to improve quality of care by helping the 2.5 million residents of almost 67,000 nursing and other residential care facilities resolve complaints about their care and protect their rights. Despite broad recognition of its value in assisting residents and its efforts to complement federal and state oversight of long-term care facilities, some observers are concerned about the program’s ability to meet its legislative mandates. Limited …

Impact Of Parent’S Hiv Status On Their Uninfected Child—A Comparative Analysis Of The Child’S Healthcare Utilization, Access And Health Outcomes, Arijit Ganguli

Theses and Dissertations (ETD)

With the advent of effective antiretroviral medication and increased expectancy of life span among HIV-infected individuals has lead to an increase in the at-risk population of uninfected children living with their HIV-infected parent(s). The purpose of this study was to investigate the impact of parent’s HIV status on their child’s access to healthcare resources, healthcare utilization and health outcomes.

This was a cross-sectional study in which the information on the children of HIV seropositive parent(s) was collected through a face-to-face interview of the HIV-infected parents having children currently residing with them. The comparative group comprising of children of HIV seronegative …

Analogical Reasoning: A Process For Fostering Learning Transfer From The Classroom To Clinical Practice, Timothy E. Speicher, Marijke Kehrhahn

All PTHMS Faculty Publications

In 2001, the Institute of Medicine (IOM), a committee of physicians and health policy experts charged to improve the health of the United States by the National Academy of Science, identified a gap in the area of education of health care practitioners as one of the reasons for medical error. However, one of the most common instructional methods in medical education to promote transfer and problem solving is examination of a single patient case (Shine, 2002), a pedagogical practice shown to be ineffective (Gentner, Loewenstein & Thompson, 2003; Norman et al., 2007). Therefore, adult learners in health care may be …

Direct Healthcare Costs Of Hip, Vertebral, And Non-Hip, Non-Vertebral Fractures., Nianwen Shi, Kathleen Foley, Gregory Lenhart, Enkhe Badamgarav

College of Population Health Faculty Papers

Limited data exist regarding the cost of non-hip, non-vertebral (NHNV) fractures. Although NHNV fractures may be less expensive than hip and vertebral fractures, they have a higher incidence rate. The objective of this study was to quantify first-year healthcare costs of hip, vertebral, and NHNV fractures. This was a claims-based retrospective analysis using a case-control design among patients with commercial insurance and Medicare employer-based supplemental coverage. Patients were > or =50 years old with a closed hip, vertebral, or NHNV fracture between 7/1/2001 and 12/31/2004, and continuous enrollment 6 months prior to and 12 months after the index fracture. Adjusted mean …

A Comparison Of Frequentist And Bayesian Approaches To The Estimation Of Long-Stay Per-Diems, Jeff Hatcher, Jason M. Sutherland

Dartmouth Scholarship

Within many diagnosis related group (DRG) systems, there is recognition that a single cost weight per DRG is not suitable, and that cost weights should take into account extremely lengthy hospital stays. Long lengths of stay are considered to be due to factors largely beyond the control of the hospital, and a single weight per DRG would potentially place hospitals under financial risk.

Within Canada's acute-care, inpatient grouping methodology - Case Mix Groups (CMG+) - long-stay episodes represent approximately 4.5% of all discharges. Within a CMG (analogous to DRG), the cost weight assigned to long-stay cases consists of the typical …

Lot Quality Assurance Sampling (Lqas) And The Mozambique Malaria Indicator Surveys, Caitlin Biedron, Marcello Pagano, Bethany L. Hedt, Albert Kilian, Amy Ratcliffe, Samuel Mabunda, Joseph J. Valadez

Harvard University Biostatistics Working Paper Series

No abstract provided.

Selected Comparison Of Global Health Organizations, Steven C. Mccullar

Scholarship in Medicine - All Papers

Due to a potential, worldwide adverse impact on health, transnational dependencies, and the need for effective response, global cooperation is imperative (Buchanan & Decamp, 2006). There are more than 100 global health agencies, including the World Health Organization. As the number of organizations increases, each with their own agendas, so does the concern for lack of coherence and collaboration among organizations in the effort of disease eradication and development of health systems (Beaglehole & Bonita, 2008). The focus of this study is on comparing the effectiveness of selected global health organizations in efforts to detect a need to either establish …

Health Insurance Patterns Among Latinos In Comparative Perspective, 2004 — 2007, Rachael Varra

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report examines the rates at which the four major racial/ethnic groups in the United States — Latinos, non-Hispanic Whites, non-Hispanic Blacks and Asians — lacked health insurance from 2004- 2006 in the U.S. overall and in the ten states with the largest Latino populations: California, Texas, Florida, New York, Illinois, Arizona, New Jersey, Colorado, New Mexico and Georgia.

Methods: The “lack of insurance data” in this report were derived from Health Statistics Data obtained by the Center for Disease Control from 2004 to 2006. In September 2008 these data became available by race, age and ethnicity/race on a …

Early Childhood Summit On Comprehensive Services For Homeless Children And Their Families, Nevada Institute For Children’S Research And Policy, Nevada Head Start State Collaboration Office, Head Start State Training And Technical Assistance Office For Nevada, Nevada Public Health Foundation

Nevada Institute for Children's Research and Policy Reports

On October 23, 2009 the Nevada Head Start State Collaboration Office in partnership with the Nevada Institute for Children’s Research and Policy, Head Start State Training and Technical Assistance Office for Nevada and the Nevada Public Health Foundation sponsored the Early Childhood Summit on Comprehensive Services for Homeless Children and Their Families. The Summit brought together 142 professionals working with homeless children and families in Nevada from a variety of different organizations and backgrounds. The goal of the summit was to discuss the problem of families experiencing homelessness and offer solutions to professionals in how to better serve these populations.

A Community Benefit Reporting Toolkit For Critical Access Hospitals, John A. Gale Ms, Melanie Race Ms

Rural Hospitals (Flex Program)

No abstract provided.

It's Your Life: Building Connections Through Work - Project Summary Report, Sherrie Winton Med

Disability & Aging

This report gives a detailed description of It's Your Life: Building Connections Through Work project from design, to implementation and evaluation of the workshop sessions. It is our hope that you enjoy learning about this project and that professionals working in the rehabilitation field continue to seek out opportunities to provide co-training models, partnering with adults with disabilities to train their peers.

Profiling Maine’S Long Term Support System [Project Brief], Eileen Griffin Jd

Disability & Aging

A recent report by the Muskie School and the Maine Department of Health and Human Services provides a new way of looking at the state’s long term support system. With an emphasis on developing a common approach for description and analysis across programs, the profile reveals that users of long term services and supports in Maine span all age groups and types of service users. In fact, 28% are ages 17 or younger and 29% are between the age of 35 and 64. Long term service users include people with physical impairments, cognitive and intellectual disabilities, and people who need …

Family Education For Psychosis, Amresh Srivastava

Data and Test Instruments

No abstract provided.

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Stimulus Bill Implementation: Expanding Meaningful Use Of Health It, Rob Cunningham

National Health Policy Forum

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish health IT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government’s leadership role in promoting health IT. But successful adoption and utilization across the health system will …

Solar Water Disinfection In Household Settings:Hype Or Hope?, Zulfiqar Ahmed Bhutta

Woman and Child Health

No abstract provided.

The Medicare Drug Benefit: Update On The Low-Income Subsidy, Mary Ellen Stahlman

National Health Policy Forum

The Medicare drug benefit (Medicare "Part D"), provides federal subsidies to pay premiums and cost sharing for low-income beneficiaries—almost 10 million in 2009. Yet there are several policy issues concerning these low-income beneficiaries under Part D. First, over 2 million individuals who may qualify for the subsidies have not enrolled. Second, in some states, low-income beneficiaries have little choice of plans (while non-low-income beneficiaries have dozens of choices), unless they pay out-of-pocket for premium amounts above what the subsidy covers. And third, millions of those who have enrolled in the benefit face the prospect each year of switching drug plans …

Knowledge, Attitudes And Practices Around Health Research: The Perspective Of Physicians-In-Training In Pakistan, Hassan Khan, Sadaf Khan, Arshad Iqbal

Department of Surgery Docs

Background:Health research training is an essential component of medical education and a vital exercise to help develop physician research skills. This study was carried out to assess the level of knowledge, attitudes and practices towards research amongst a group of Post Graduate Medical Trainees (PGMTs') at Aga Khan University (AKU), Pakistan.

Methods:

A cross sectional health research survey was carried out on all PGMTs' at AKU Pakistan. AKU is a tertiary care health facility which offers residency in 28 specialties and fellowship in 16 programs. Knowledge, attitudes and practices related to health research were assessed using a pretested, structured …

A Functional Difficulty And Functional Pain Instrument For Hip And Knee Osteoarthritis, Alan M. Jette, Christine M. Mcdonough, Pengsheng Ni, Stephen M. Haley

Dartmouth Scholarship

The objectives of this study were to develop a functional outcome instrument for hip and knee osteoarthritis research (OA-FUNCTION-CAT) using item response theory (IRT) and computer adaptive test (CAT) methods and to assess its psychometric performance compared to the current standard in the field.

Maine Barriers To Integration Study: The View From Maine On The Barriers To Integrated Care And Recommendations For Moving Forward, John A. Gale Ms, David Lambert Phd

Mental Health / Substance Use Disorders

Following up on the Environmental Scan report (http://muskie.usm.maine.edu/Publications/rural/Barriers-to-Integration-Environmental-Scan.pdf), the authors interviewed representatives from Maine’s business community, payers, purchasers, professional associations, state legislators, advocacy organizations, state government, and provider organizations. The interviews provided a context to understand the barriers to integration in Maine and develop recommendations to overcome them. Our Final Report presents key findings from the study, recommendations for addressing barriers, and next steps for moving forward. This study recognizes the need for integration of behavioral and physical health services in all settings. Although most discussions of integration focus on the development of behavioral health services in primary care settings, …

Health Insurance Profile Indicates Need To Expand Coverage In Rural Areas, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, Andrew F. Coburn Phd, Nathaniel J. Anderson Ms, Mph

Access / Insurance

Key Findings: A greater percentage of rural residents than urban residents are uninsured, especially those living in remote areas Among adults over age 50, uninsured rates are highest in the most remote rural places Compared to urban adults, rural adults are less likely to be in employment situations where private coverage is offered.

Impact Of Allhat Publication On Antihypertensive Prescribing Patterns In Regione Emilia-Romagna, Italy, Vittorio Maio, Pharmd, Ms, Msph, Joshua J. Gagne, Pharmd, Ms

College of Population Health Faculty Papers

Background and objective: Studies from the US and Canada observed changes in antihypertensive prescribing patterns in accordance with Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) study findings immediately after the study's publication, but little is known about the impact of ALLHAT in Italy. The objective of this study was to examine antihypertensive prescribing patterns in Regione Emilia-Romagna (RER), Italy, following the publication of the ALLHAT main results.

Methods: We conducted a time series analysis using automated pharmacy data of approximately 4 million RER residents between 1 January 2000 and 31 December 2003. We computed monthly relative percentages …