Health Policy Commons^™

Advocacy In Action: A Framework For Implementation Of The American Counselors Association Advocacy Competencies On A Local Level, Jeffrey M. Lown

Educational Specialist, 2009-2019

Despite calls from within the professional field and external forces, counselors have faced ongoing challenges in their efforts to be effective advocates for their clients and themselves. A review of the literature reveals that throughout the history of the profession, prominent figures have called on counselors to assume advocacy roles, and that some initiatives have been successful in fostering lasting change. However, as counselors and their clients’ needs continue to evolve, so too must strategies to address these needs be reevaluated and new initiatives put into place.

In this paper, I have outlined a committee structure and agenda that seeks …

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan

Senior Honors Projects, 2010-2019

Primary care physicians operate on the front lines of health care. Although primary care physicians play a critical role in improving health outcomes, workforce trends in the United States show a growing shortage of primary care physicians as demand for primary care rises. In conveying the importance of primary care physicians, the worsening physician shortage, the inequitable distribution of providers, and the lackluster institutional response thus far, this paper calls into question the effectiveness of current indicators used to identify underserved areas and provide appropriate government assistance. Through the use of data from the 2010 census and American Medical Association …

Capstone Revival, Mary Mesele, Ruochen Lu, Quilin Jiang

School of Professional Studies

The capstone project is a culminating experience whereby students choose to research a topic that is relevant in their field of study and have been highly regarded as important learning activities. The capstone allows students to use research, analytical, problem solving and evaluation skills they have learned in the course of the graduate program. McGill indicates the benefit of the completion of a capstone project not only in gaining knowledge in capstone but also in learning how to apply the knowledge gained in other courses in the major (McGill, 2012). Currently, COPACE (College of Professional and Continuing Education) has three …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Expanding Access To Naloxone In Maine: Opportunities And Barriers, Kate E. Richardson

Muskie School Capstones and Dissertations

The Centers for Disease Control and Prevention have declared prescription drug abuse a national epidemic (Office of National Drug Control Policy, 2014). In addition to strategies designed to prevent opioid abuse and misuse, many public health officials, policy makers, healthcare providers and harm reduction task forces seek to increase access to naloxone, a prescription drug known to reverse the effects of an opioid overdose. This report provides an overview of the barriers and opportunities for the state of Maine to expand access to the opioid antagonist, naloxone, in an effort to reduce fatal opioid drug overdose rates.

Examining Implementation Of The Massachusetts Act Relative To Safety Regulations For School Athletic Programs (Sessions Laws: Chapter 166 Of The Acts Of 2010): A Multiple-Case Study, Mitchell L. Doucette

Masters Theses

Background/Purpose: Reducing the incidence and negative consequences of concussion among youth athletes is a public health priority. Fifty states have adopted legislation addressing the problem of sports-related concussions among youth-athletes. In 2010, Massachusetts adopted legislation based on Washington State’s Lystedt Law, enacting state-wide requirements for high school athletic programs. This study explored how the legislation has been implemented within Massachusetts schools and school-districts and identified factors influential to local implementation.

Methods: A qualitative multiple-case study approach was utilized. US Census data concerning the household median income and population size of the school-district’s representative town(s) were used to purposively recruit cases. …

Prostate Cancer Education In The African American Community: Implcations For Community-Based Health Communication Strategies, Barry Charles Hill

Open Access Theses

This paper examines the social milieu of African American barbershops by exploring health discussions and information transfer between barbers and barbershop clients. This paper examines associations between peer helper and health promotion intervention variables, and peer helper intervention effectiveness in increasing knowledge and health discussion frequency. Study findings suggest barbers with higher education are significantly more effective as peer helpers in discussing health topics more frequently (OR 4.64; CI 1.00 - 21.49) and in increasing client knowledge (β 0.94; CI 0.26 - 1.63). Additionally, barbershop health educational materials were significantly associated with increased barber health discussion (OR 4.13; CI 1.32 …

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

National Quality Awards In Healthcare And Actual Quality In U.S. Hospitals, Beth M. Beaudin-Seiler

Dissertations

This study examined performance outcome data from the Medicare Compare Hospital database for differences in performance between national award-winning hospitals and non-national award-winning hospitals. Specific variables examined were related to clinical care and were identified in literature as well as professional medical associations and societies as being quality indicators. National award-winning hospitals were defined as those having received the Malcolm Baldrige Quality Award in Healthcare or the Healthgrades Distinguished Hospital for Clinical Excellence. The characteristics of highly reliable organizations were also used to align the indicators of excellence for Malcolm Baldrige and Healthgrades recipients. Finally, a closer examination of data …

Advocacy: A Vital Step In Attaining Full Practice Authority For The Advanced Practice Registered Nurse, Mandi Cafasso

Doctor of Nursing Practice Scholarly Projects

Problem Statement

Recent passage of the Affordable Care Act has made the imminent concern of poor patient/provider ratios a reality. Unfortunately, despite increasing numbers of advanced practice registered nurses graduating annually, the access to healthcare issue continues. Advanced practice registered nurses (APRNs) are limited in the care they can provide as a result of Ohio law.

The Ohio Nurse Practice Act requires APRNs to work in a collaborative relationship with a physician and also requires that prescribing practices be guided by an inclusionary formulary (Nurse Practice Act, 2014). Thus, APRNs in Ohio cannot practice to their fullest scope of education …

Foodborne Illness Risk Factor Study, Kathi-Anne M. Fortin

Muskie School Capstones and Dissertations

The initial purpose of this capstone was to establish a baseline for the occurrence of the top five foodbome illness risk factors, to write a report on the baseline findings and to develop a plan to repeat this study at least once every 60 months for the Portland Environmental Health & Safety Program. It soon became clear, however, that the scope was too broad. An extensive effort was required to integrate national methodology and comparability principles with the State and local restaurant inspection structure. Subsequently, the focus of the capstone shifted to the development of a comprehensive data collection manual. …

Localizing The International: Examining How Fieldworkers Combat Adolescent Pregnancy In Northern Ghana, Alexandra C. Sloss

Honors Capstone Projects - All

International aid is often ineffective because it is delivered without an understanding of local ideologies and contexts. My Capstone examined whether or not international aid in northern Ghana could be effective when addressing adolescent pregnancy. The Ghanaian programs I address in my Capstone are six non-governmental organizations, a government sub-district clinic and government junior high schools. The majority of my data was collected through interviews with individuals at all levels of the organizations, including directors, staff members, volunteers and individuals seeking the organization’s services. Alongside interviews I also spent time in the field, participating in youth group discussions, visiting regional …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …

The Social Costs Of Industrial Growth In The Sub-Arctic Regions Of "Canada", Caylee T. Cody

Electronic Thesis and Dissertation Repository

Colonialism in the land that is now called “Canada” is rooted in the ongoing dispossession of Indigenous people’s way of existing and interacting with the world. The present study identifies that the social costs of industrial growth are part of an ongoing process of colonialism which continues to annex Indigenous lands to feed the capitalist economy and reify the power of the state. Through a comparative analysis of literature written about the Attawapiskat First Nation and the Innu Nation, the study reveals that the financial rewards of industrial growth are few, while the cultural, human, and environmental costs are many. …

Impact Of A State Evidence-Based Practice Legislative Mandate On County Practice Implementation Patterns And Inpatient Behavioral Health Discharge, Carl William Foreman

Dissertations and Theses

Evidence-based practices and comparative effectiveness research are salient topics in public policy. Empirical validation of agency operating processes provides agencies and policy-makers the opportunity to address uncertainty surrounding effectiveness. While this is an increasingly accepted rational approach to public policy, the exact mechanism for how this operates is less known. In order to evaluate several theoretical assumptions and normative rational expectations inherent in this approach, the implementation of a state legislative mandate stating policy expectations for behavioral health evidence-based practices is assessed. This study sought to assess whether implementation patterns and associated outcomes reflect "rational mechanism" policy expectations. While the …

Barriers And Motivations In Mental Health Legislative Advocacy In Oregon, Bethany Webb

Doctor of Psychology (PsyD)

Compared to other allied health fields, psychology continuously lags behind in representation on the state, national, and local level. The percentage of advocacy involvement by psychologists is very low compared with other professions. There is a great need for all psychologists to become advocates. Unfortunately, there has been limited research into the reasons why few psychologists actually engage in this process. The purpose of this study was to explore the differences in state psychological membership and primary place of practice among Oregon psychologists and students with regard to participation in mental health legislation and to identify barriers and motivations to …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri

DNP Scholarly Projects

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.

Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …

Evaluating State Policy Interventions For Opioid Abuse And Diversion: The Impact On Consumers, Healthcare Providers, And The U.S. Market For Prescription Opioids, Amie Goodin

Theses and Dissertations--Public Policy and Administration

Prescription opioid pain reliever utilization has been increasing since the 1990s, due in part to changes in recommendations for the treatment of chronic pain, but also to abuse and diversion. One innovative policy solution to the abuse and diversion of prescription opioids is state prescription drug monitoring programs (PDMPs), which provide prescribers and other selected parties with patient controlled substance dispensation history; thereby, correcting an information asymmetry problem between prescribers and patients.

The widespread implementation of state PDMPs, which vary in program design and requirements, has resulted in a variety of intended and unintended consequences. Previous PDMP evaluations have suggested …

Analyzing Charges And Payments Received For Discharged Patients At Teaching Hospitals In Relation To Patient Satisfaction And Overall Medicare Charges, Rob Sutter

MPA/MPP/MPFM Capstone Projects

The affordability of healthcare is a major, recurring topic in the media. One of President Obama’s cornerstone policies has been the attempt to make health care affordable. Part of the concern lies in cost differences for similar procedures. The cost for a standardized procedure such as abnormal cardiac dysrhythmia without complication varies greatly between hospitals. The cost difference of a patient getting treated for such an event can be an average of $30,000 depending on which hospital you go to. There is no immediately apparent reason for such a large difference. Another noticeable item is that all the hospitals receive …

What's In A Name? Effects Of The "Mentally Ill" Label On Autonomy, Miriam E. Cruz

CMC Senior Theses

Over the past years, mental health has attracted increased attention throughout the world, in the form of initiatives, programs, support groups, etc. all with goals to increase awareness and support of mental health. The stark discrepancy between the vision driving this mental health movement and our reality comes from a basic misunderstanding. While there are both legislative and cultural efforts in place to reform our mental health system, the two must work hand in hand in order to affect substantial change. Rather than producing a collaborative effort, our legislators and society tend to ignore each other, resulting in isolated attempts …

Diagnosing An International Health Crisis: A Structural Exploration Of Ebola 2014, Maddison Zayn Jansen

Honors Program Theses

The Ebola crisis of 2014, though concentrated most heavily in three small countries in western Africa, awoke the international community to its lack of effective health crisis infrastructure. As the disease rocked the globe, multinational groups scrambled to help those directly affected and protect the overwhelming majority of people not directly affected. Most preventative measures failed, and pre-existing initiatives to stem the flow of the disease only served to open the floodgates more. After careful examination of the literature surrounding medical, cultural, financial, national, and global circumstances enabling Ebola to flourish, as well as applying individual analysis and examination, it …

Gender Difference When Processing Death By Suicide: Attitudes Amongst Third Level Students Aged 18-25 Attending Cork Institute Of Technology And College Support Professionals, Sandra Conroy

Masters

Rationale behind research: Survivors of suicide/ suicide bereaved face unique challenges in their grief, resulting in a greater risk of conditions such as complicated grief, PTSD and suicidal ideation developing (Young, Iglewicz, Glorioso, Lanouette, Seay, llapakurti & Zisook, 2012). In dealing with or 'processing' the loss of a loved one by suicide, Wertheimer details that, "suicidal thoughts are not uncommon during the early months of bereavement" (1991: 178). The incidence of young men dying by suicide is notably higher than that of women in this country; a stubborn gender difference persists in Ireland with males representing on average 80% of …

“Don’T Talk About It”: Investigating The Effects Of Pei’S Cultural Silence On Abortion Access And Advocacy From The Perspective Of Advocates And Support People, Emily A. Rutledge

Theses and Dissertations (Comprehensive)

As an arm of a greater study that investigates the impacts of PEI's abortion restriction over the past two decades, "Don't talk about it" explores the situation from the perspective of support people and advocates to abortion access including; their emotional experiences of support and advocacy, the associated risks and repercussions, as well as their understandings of the barriers, facilitators and impacts of compromised access to off-Island services for PEI women and girls. Key findings show an overarching culture of silence and blame surrounding abortion on PEI, reinforced by stigma and repercussions for those speaking out. This silence serves to …