Health Policy Commons^™

The Affordable Care Act And The For-Profit Congregate Care Industry: How Good Policy Intent Turned A Fringe Industry Into A Taxpayer-Funded Multi Billion Dollar Industry, Erin Viehmann

College of Graduate Studies: Theses & Dissertations

The Affordable Care Act significantly transformed the for-profit congregate care (FPCC) industry, which provides residential treatment for adolescents with behavioral and mental health issues. This study analyzes financial records from Universal Health Services (UHS), the largest provider in the industry, to examine how healthcare policy changes and economic conditions affected the industry's growth and funding structure. Through analysis of SEC Form 10-K filings from 2006-2016, the research documents how the ACA's mental health coverage mandates created new revenue streams that enabled dramatic industry expansion. Findings show that following ACA passage in 2010, UHS more than doubled its behavioral health capacity …

The Texas Electorate's Views Of Health Care As A Human Right, Community Health Centers, And Certain Matters Of The Health Care Safety Net, Scott Elphingstone

Graduate Liberal Studies Theses and Dissertations

In a country in which the government does not recognize a right to health care,social safety nets are the last hope for persons without insurance or other means to pay for needed care. In United States, community health centers, hospital emergency rooms, and private charities comprise that safety net. Community health centers offer a practicable alternative for politicians and citizens who want to help improve the lives of persons who struggle to access health care. This dissertation reviews the political history of community health centers from their founding as part of the War on Poverty in the 1960s through Democratic …

Reduction Of Seclusion And Restraint Among Children And Adolescents In An Inpatient Psychiatric Hospital: A Health Policy Analysis, Huma Moez

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Seclusion and restraint (SR) or restrictive intervention in inpatient/ acute psychiatric hospitals, emergency departments, crisis stabilization units, residentials, or group homes is a pressing and an immediate concern in mental health settings, particularly for children and adolescents, for whom SR rates are higher. The Joint Commission and other national organizations have made significant strides in prioritizing the reduction and elimination of SR among children and adolescents due to its negative physical and psychological consequences.

Objective: This DNP project will aim to provide the results of a policy analysis to present evidence-based techniques and a resulting re-envisioned policy recommendation to …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

Planetary Health Learning Objectives: Foundational Knowledge For Global Health Education In An Era Of Climate Change, Kathryn H. Jacobsen, Caryl E. Waggett, Pamela Berenbaum, Brett R. Bayles, Gail L. Carlson, René English, Carlos A Faerron Guzmán, Meredith L. Gartin, Liz Grant, Thomas L. Henshaw, Lora L. Iannotti, Philip J. Landrigan, Nina Lansbury, Hao Li, Maureen Y. Lichtveld, Ketrell Mcwhorter, Jessica E. Rettig, Cecilia J. Sorensen, Eric J. Wetzel, Dawn Michele Whitehead, Peter J. Winch, Keith Martin

Earth and Environmental Sciences Faculty Publications

Planetary health is an emerging field that emphasises that humans depend on a healthy Earth for survival and, conversely, that the sustainability of Earth systems is dependent on human behaviours. In response to member demands for resources to support teaching and learning related to planetary health, the Consortium of Universities for Global Health (CUGH) convened a working group to develop a set of planetary health learning objectives (PHLOs) that would complement the existing ten CUGH global health learning objectives. The eight PHLOs feature Earth system changes, planetary boundaries, and climate change science; ecological systems and One Health; human health outcomes; …

Archetypal Energies And Global Mental Health, Carroy U. Ferguson

Psychology Faculty Publication Series

As a keynote speaker at the Global Mental Health Conference 2024, held at Sophia University, Costa Mesa, CA, in-person and virtually, August 16-18, 2024, my topic was "Archetypal Energies As A Framework for Self-Empowerment and Well Being". The theme of this 2024 global conference was: Enlightened Minds, Compassionate Hearts, and Embodied Wisdom. To supplement my keynote address, I wrote this blog article titled "Archetypal Energies and Global Mental Health".

Promoting Cultural Humility, Belonging, And Inclusion To Improve Well-Being Among Direct Care Staff In Oregon Assisted Living, Residential Care, And Memory Care Communities, 2024, Jacklyn Kohon, Dani Himes, Laura Rodriguez, Sarah Dys, Paula Carder, Diana Jacoby, Madeline Fox

Institute on Aging Publications

The voices and experiences of those working and living in assisted living, residential care, and memory care (AL/RC) settings in Oregon are highlighted in this study to understand cultural humility, belonging, inclusion, and intersectional experiences related to sustaining the workforce and promoting quality care. This qualitative study collected data through individual and focus group interviews with a total of 68 people, including 25 direct care staff, voice memos or interviews with 9 former direct care staff, interviews with 9 administrators, interviews with 7 management representatives (owner/operators, human resources specialists, directors of operations, among other titles), and interviews with 18 current …

Climate And Extreme Weather Event Impacts On Administrators, Direct Care Staff, And Residents In Oregon Assisted Living, Residential Care, And Memory Care Communities, 2024, Dani Himes, Jacklyn Kohon, Madeline Fox, Laura Rodriguez, Sarah Dys, Diana Jacoby, Paula Carder

Institute on Aging Publications

This brief report on AL/RC staff and resident experiences with climate events highlights the voices of AL/RC direct care staff, former direct care staff, residents, administrators, and management representatives to promote well-being in these care settings. This study can inform Oregon’s efforts to support long-term care workforce readiness for future climate emergencies and inform future quantitative data collection on AL/RC and other long-term care workers, including those employed in home health agencies, nursing facilities, and adult foster homes.

Double Burden Of Persons With Disabilities: Are Those More Likely To Suffer From Chronic Disease?, Salsabila Kusumawardani, Hardiyani Puspitasari, Muhammad Ciro Danuza, Yusuf Faisal Martak

Masyarakat: Jurnal Sosiologi

This study examines the likelihood of persons with disabilities experiencing chronic diseases compared to those without disabilities, emphasizing the role of demographic characteristics. Prior research shows that individuals with disabilities have a higher risk of chronic diseases due to pre-existing health conditions, secondary complications, healthcare access barriers, and limited health education. Beyond these factors, we argue that demographic characteristics—such as age, gender, insurance status, and living environment—also shape daily habits and lifestyles that influence long-term health outcomes. Using probit regression analysis, this study quantifies the probability of chronic disease among persons with disabilities. Our findings indicate that individuals with disabilities …

Examining Dietary Disparities And Associated Factors Among Young Children Across Diverse Racial, Ethnic And Immigrant Households In Nebraska, Naveta Bhatti

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Early childhood is a crucial stage for developing eating behaviors which in turn plays a major role in determining health outcomes. Assessing children’s diet plays a crucial role in tackling the obesity epidemic. One of the ways to assess children’s dietary intake is by evaluating their dietary quality. Dietary quality refers to the overall healthfulness and nutritional value of an individual's diet, considering the combination of foods consumed over time. Research has consistently demonstrated that a high-quality diet is associated with a reduced risk of several health issues, such as all-cause mortality, cardiovascular disease incidence or mortality, cancer incidence or …

Mental Health In Price: A Report On Community Perspectives, Kristen Koci, Jessica Ulrich-Schad

Publications

This report is from a research project conducted at the end 2022 that focuses on mental health in Price. Dr. Kristen Koci conducted interviews in Price to understand community members’ perspectives on and factors affecting mental health in the area. Community leaders from government and local organizations were interviewed along with general community residents, for a total of 27 interviews. The report that follows summarizes themes and perspectives gathered during these interviews.

[2024 Honorable Mention] Hasta Que El Cuerpo Aguante, Brisa Rosiles

Ethnic Studies Research Paper Award

The focus of this project revolves around a critical examination of the alarming occurrences of heat stroke-related deaths among field workers in California, with a specific emphasis on cases documented in the Salinas Valley. The core of my artistic expression lies in a digital painting that captures the reality of a laborer enduring the devastating effects of heat stroke in the agricultural fields.

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Exploring Hypertension Prevalence Among Ill-Housed Individuals In Urban Environments, Lia Summer Goldberg, Sameer Shah, Nikhila Archakam, Murod Khikmatov, Kesha Choksi, Anddee White

Rowan-Virtua Research Day

This study explores the interrelations of hypertension, homelessness, and access to healthcare in urban ill-housed populations. It was found that conditions such as heart disease and diabetes significantly exacerbate hypertension, which remains highly prevalent due to the population's limited access to consistent medical care. Homelessness further complicates the management of hypertension due to unstable living conditions, making adherence to treatment and follow-up with healthcare providers challenging. Additionally, factors like higher rates of substance abuse and malnutrition among homeless populations contribute to worsening hypertension, which, if untreated, can lead to severe health crises including heart attacks and strokes.

The research underscores …

Pros, Cons, And The Barriers To Implementing A Universal Healthcare System In The United States, Arpun Shah

Rowan-Virtua Research Day

Background: The United States has the most expensive healthcare system in the world. Despite that, it also has worse health outcomes than that of several other countries. The United States is also the only wealthy/developed country without universal healthcare. Universal healthcare, also known as a single-payer healthcare system, refers to the concept that the government finances and governs healthcare for most, if not all residents of the country. The United States currently has a multi-payer system, which means that healthcare is financed through various sources such as the public and private sectors. Purpose: The purpose of this is …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

How Do Differences In Sex Education Alter Perception Of Consent?, Hannah G. Stone

ATU Scholars Symposium

The following research was conducted to answer the question: how do differences in sex education alter perception of consent? As of 2021, only 7 states and the District of Columbia mandate comprehensive sex education policies that include consent education, and in contrast, 17 states do not mandate comprehensive or non-comprehensive sex education (“Sex and HIV Education” 2021). Because sex education in schools is where a large proportion of young adults receive all of their instruction on sexual topics, it can be inferred that the lack of sex education would constitute a lack of consent education as well (Deluna 2019; “Section …

Competency To Stand Trial Evaluations: Using Vignettes With Patients Who Lack Insight, Katelyn Fuller

James Madison Undergraduate Research Journal (JMURJ)

In the United States, an attorney may request a competency to stand trial evaluation if they are concerned that their client is not mentally fit to adequately participate in their case and defense. Patients found incompetent must undergo treatment for restoration of competency, regardless of their willingness. Clinicians and psychiatrists may use vignettes, or hypothetical scenarios, to help restore competency if the patient lacks insight into their mental illness. While vignettes have been well documented in studying attitudes and awareness, decision making, and identifying mental illness, there is little to no research into their use in psychiatric hospitals due to …

U.S. Government Agency Podcasts, Bert Chapman

Libraries Faculty and Staff Presentations

Presents podcasts from U.S. Government agencies which can be discovered through the U.S. Government Publishing Office's Catalog of Government Publications. Agencies whose podcasts are presented include the National Institutes of Health, U.S. Peace Corps, U.S. Department of Agriculture, Government Accountability Office (GAO), National Park Service, Department of Justice, Federal Reserve System, and U.S. Naval War College.

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

The Increase Of Allergies In Developed Countries: A Comparison Of The Quality Of Life And Psychosocial Burden Of Individuals With Food Allergies In Switzerland And The United States Of America, Adrienne Ell

Independent Study Project (ISP) Collection

The Hygiene Hypothesis suggests that as societies become increasingly sterile and there is less exposure to microorganisms early in life; consequently, there is an increase in inflammatory autoimmune disorders and allergies due to a maladapted immune system to the new sterile environment. This hypothesis can offer a possible explanation for the observed increase in allergies, specifically food allergies, in developed countries. To explore the psychosocial burden of allergies and evaluate the quality of life this paper will explore the food allergen labeling policies for prepackaged foods, the regulation of allergen information for non-prepackaged foods, and the psychosocial burden food allergies …

Establishing Consent: The Role Of Women Representatives In Passing Informed Consent Laws, Sophia Stockham

Department of Political Science: Dissertations, Theses, and Student Research

What predicts the adoption of informed consent laws for pelvic exams within the United States? As of January 2023, 22 states have adopted informed consent laws for pelvic examinations on women, with eleven being under Democratic control, six being Republican control, and five with divided control between the legislature and gubernatorial level at the time of adoption. Little attention, however, has been given to women’s health mandates outside the issue of abortion and to variation among state partisan adoption regarding informed consent for pelvic exams. This paper examines the impact of partisanship, the percentage of women in the legislature, and …

From Collaboration To Continuity: Exploring Stakeholder Engagement For Sustainable Global Health Partnerships, Annabelle Falconer

Independent Study Project (ISP) Collection

Global health partnerships have been identified as crucial to achieving the Sustainable Development Goals and targets related to health and wellbeing. Specifically, the Global Fund, UNAIDS Joint Programme, and the World Food Programme are examples of some of the relevant partners currently engaged in this work, filling roles in global health financing, governance, and delivery. Current literature has identified that the effective engagement of stakeholders in partnerships can be crucial in effective project implementation and that global health partnerships during the era of the Millennium Development Goals did impact health outcomes. This research aims to investigate the current strategies for …

Complementariedad En La Comuna De Putre: Reflexiones Sobre El Sistema De Salud Y Los Conocimientos Comunitarios Aymaras, Grace Benish

Independent Study Project (ISP) Collection

In the comuna of Putre, which lies in the XV region of Chile, exists a community and culture unique from the rest of the country. Half of the population identifies as part of the Aymara indigenous group, which according to Chilean law, means that a system of intercultural health must exist in the commune. Our objective included establishing the format in which the intercultural system of health functions nowadays and assessing how well the system serves the community, keeping in mind the history of the commune, barriers to access, community needs, and Aymaran culture. Furthermore, the domination of the Aymaran …

Pornography: Social, Emotional And Mental Implications Among Adolescents, William K. Canady

National Youth Advocacy & Resilience Conference

This presentation will explain the historical development of pornography. It will highlight three segments: 1- Porn’s impact on brain development of reward pathways, ultimately increasing the appetite for more porn. 2- Porn can be a false substitute for real intimacy, resulting in decreased sexual satisfaction with a real person and increased verbal and physical aggression. 3- Porn promotes sex trafficking, promotes multiple sex partners and reduced STD prevention.

Human Zoo Healthcare At The 1904 World’S Fair, Angel Blake

Undergraduate Research Symposium

Human Zoo Healthcare at the 1904 World’s Fair

Were precautions taken or put into place for the Human Zoo performers at the 1904 World’s Fair? This topic has been overlooked and understudied by historians, there are few articles written and we do not know the true death toll which shows the racism towards these indigenous peoples. The research for this project was conducted at the State Historical Society of Missouri, the St. Louis Mercantile Library, Newspapers.com, Archives.com, St. Louis Public Library, and the Missouri Historical Society, including research on primary sources such as official World’s Fair committee meeting minutes, hospital …

Personalized Trial Ethics And Institutional Review Board Submissions

Faculty, Staff and Student Publications

The ethical and regulatory oversight of any clinical activity related to human subjects is commonly determined based on its categorization as either clinical practice or research. Prominent bioethicists have criticized the traditional distinctions used to delineate these categories, calling them counterproductive and outmoded, and arguing that learning and clinical practice should be deliberately and appropriately integrated. Personalized trials represent a clinical activity with characteristics that overlap both categories, making ethical and regulatory oversight requirements less straightforward. When the primary intent of the personalized trial is to assist in the conduct of individualized patient care with an emphasis on protecting the …