Community Health and Preventive Medicine Commons^™

Health Care Shortage Designations: Hpsa, Mua, And Tbd, Eileen Salinsky

National Health Policy Forum

A wide variety of federal programs designed to improve access to health care services rely on specific criteria to designate areas and populations eligible for funding and other types of aid. Two related yet distinct designations, the Health Professional Shortage Area (HPSA) and the Medically Underserved Area (MUA), are most commonly used to identify underserved people or places. This background paper reviews the methodologies currently utilized in these designations, identifies the federal programs that use these designations to allocate resources, describes proposals that have been advanced to consolidate and improve these designations, and discusses key issues and challenges for future …

Heath Care Spending: Why Is Miami An Outlier?, Laura A. Dummit, Mary Ellen Stahlman

National Health Policy Forum

The National Health Policy Forum’s site visit to Miami focused on the complex factors that drive health care spending and is the latest in a series on the dynamics of health care markets. Miami has long been recognized as having among the highest Medicare per capita spending in the country, along with high rates of uninsured, strong managed care presence, and a history of health care fraud. This colorful health care market brings into stark relief many of the reasons for high and growing health care spending across the country. It also highlights several issues involved in building and maintaining …

Prevalence Of Obesity, Type Ii Diabetes Mellitus, Hyperlipidemia, And Hypertension In The United States: Findings From The Ge Centricity Electronic Medical Record Database., Albert G Crawford, Christine Cote, Joseph Couto, Mehmet Daskiran, Candace Gunnarsson, Kara Haas, Sara Haas, Somesh C Nigam, Rob Schuette

College of Population Health Faculty Papers

This study analyzed GE Centricity Electronic Medical Record (EMR) data to examine the effects of body mass index (BMI) and obesity, key risk factor components of metabolic syndrome, on the prevalence of 3 chronic diseases: type II diabetes mellitus, hyperlipidemia, and hypertension. These chronic diseases occur with high prevalence and impose high disease burdens. The rationale for using Centricity EMR data is 2-fold. First, EMRs may be a good source of BMI/obesity data, which are often underreported in surveys and administrative databases. Second, EMRs provide an ideal means to track variables over time and, thus, allow longitudinal analyses of relationships …

Comparison Of Ge Centricity Electronic Medical Record Database And National Ambulatory Medical Care Survey Findings On The Prevalence Of Major Conditions In The United States., Albert G. Crawford, Christine Cote, Joseph Couto, Mehmet Daskiran, Candace Gunnarsson, Kara Haas, Sara Haas, Somesh C Nigam, Rob Schuette, Joseph Yaskin

College of Population Health Faculty Papers

The study objective was to facilitate investigations by assessing the external validity and generalizability of the Centricity Electronic Medical Record (EMR) database and analytical results to the US population using the National Ambulatory Medical Care Survey (NAMCS) data and results as an appropriate validation resource. Demographic and diagnostic data from the NAMCS were compared to similar data from the Centricity EMR database, and the impact of the different methods of data collection was analyzed. Compared to NAMCS survey data on visits, Centricity EMR data shows higher proportions of visits by younger patients and by females. Other comparisons suggest more acute …

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Dartmouth Scholarship

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk …

Physician Assessment: Measuring Competence And Performance, Lisa Sprague

National Health Policy Forum

No abstract provided.

Medical-Legal Partnerships: Addressing The Unmet Legal Needs Of Health Center Patients, Peter Shin, Fraser Rothenberg Byrne, Emily Jones, Joel B. Teitelbaum, Lee Repasch, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Medical-legal partnerships (MLPs), now available at over 180 hospitals and health centers across 38 states, are an important option for addressing the legal needs affecting low-income and vulnerable patients, and thereby improving their overall health. We estimate that each year, anywhere between 50 and 85 percent of health centers users - or between ten and 17 million people - experience unmet legal needs, many of which negatively impact their health. In a medical-legal partnership, health care staff at hospitals, clinics, and other sites are trained to screen for health-related legal issues, refer the patient to an affiliated lawyer or legal …

Female Condom Knowledge, Attributes And Behavior: Barriers To Use And Potential For Acceptance Among Sexually Active Undergraduate Students, Paige Nuzzolillo 6368479

Honors Scholar Theses

Minimal research has been conducted on the acceptability of the female condom among college populations despite its existence in the world market since 1992. The FC2, an improved version of FC1, has recently been released in the United States, thus prompting the need for further acceptability studies. Due to increasingly high rates of STDs among those aged 15-24, every method of protection against STDs/HIV and pregnancy must be utilized. This study involved a campus-wide survey which examined University of Connecticut (Uconn) main campus (Storrs) undergraduate students’ knowledge of the female condom, perceptions of and attitudes towards the female condom as …

Everything's Better In Moderation: Young Women's Gender Role Attitudes And Risky Sexual Behavior, Tamara Leech

Department of Public Health Scholarship and Creative Works

Purpose This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Methods Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18–19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Results Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of …

Implementation Of The Wiegand Sun Safety Program Into Physicians’ Offices In Southern Nevada, Breanne Eddington

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study Nevada Cancer Institute’s Wiegand Sun Safety Program was implemented in 14 clinics in Southern Nevada as a pilot run to increase awareness in children and their guardians through educational materials in pediatricians’ and family physicians’ offices. It was hypothesized that the increased display of information regarding sun safety and skin cancer in physicians’ offices would increase patient and guardian awareness of the subject and increase the likelihood of patients and/or guardians asking their physician questions about skin cancer and sun safety, resulting in an increase in preventive actions by guardians to protect their children from damaging rays …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

Belize As A Classroom, Jordan Norris, Molly Calico

Impact Belize

During the week of January 7-14, 2010, Molly Calico and Jordan Norris participated in the Impact Belize program through the College of Health and Human Services. This program took place in Gales Point, a rural, underserved community in Belize. Impact students provided medical, dental and public health services to the community in an interdisciplinary service-learning format. As Master of Public Health students, Molly and Jordan directed health education initiatives and served on the Leadership Team for the program. Having participated in January of 2009 as well, Molly and Jordan were well prepared to conduct public health research and to assume …

Impact Belize 2010 Executive Report, Ritchie D. Taylor, Jordan Norris, Molly Calico, Bernie Strenecky, Daniel Carter, Dawn Garrett Wright, Eve Main, Bonny Petty, Molly Kerby, Jill Norris

Impact Belize

No abstract provided.

Information And Incentives: Improving The Health Of New York City's Low-Income Population, Kathryn Linehan, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to New York City (NYC) in April 2010 to explore health care delivery for Medicaid beneficiaries and the uninsured in New York City’s hospital-dominated market. New York offers real-time examples of government policy and provider initiatives in health information technology (IT) and quality improvement being played out on a large, complex, and dynamic stage with multiple stakeholders. Site visit participants heard from providers and others who discussed efforts to improve the quality of care for low-income New Yorkers through a variety of methods, such as the adoption and use of electronic …

A Colorectal Cancer Screening Project In An Old Order Mennonite Community: Capstone Project Technical Report, Maria Eve Main

Nursing Faculty Publications

The purpose of this project was to determine if colorectal cancer (CRC) screening education and community access to fecal occult blood tests (FOBT) is associated with an increase in the uptake of FOBT in an old order Mennonite community. Utilizing a modified cultural model, an educational offering on CRC screening and access to FOBT in the community was delivered to a self-selected sample of age-eligible participants. Thirty-three age eligible residents completed the CRC screening questionnaires and received education on CRC screening. Twenty-nine of the age-eligible participants were found to be at average risk and twenty-three elected to receive FOBT testing …

Effects Of Perceived Fitness Level Of Exercise Partner On Intensity Of Exertion, Thomas G. Plante, Meghan Madden, Sonia Mann, Grace Lee

Psychology

Problem statement: Social comparison theory was used to examine if exercising with a research confederate posing as either high fit or low fit would increase the exertion in exercising. Approach: 91 college students were randomly assigned to one of three conditions: Biking alone, biking with a high fit confederate, or biking with a low fit confederate. All participants were instructed to complete 20 min of exercise at 60-70% of their maximum target heart rate. Results: Results indicated that participants in the high fit condition exercised harder than those in the low fit condition. However, no mood differences emerged between conditions. …

The State Health Insurance Assistance Program (Ship), Carol O'Shaughnessy

National Health Policy Forum

The State Health Insurance Assistance Program (SHIP), created by section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 and administered by the Centers for Medicare & Medicaid Services (CMS), supports grants to states and jurisdictions to provide information, counseling, and assistance to Medicare beneficiaries and their families on Medicare and other health insurance questions. This publication describes the program and presents its funding history.

Oral Health Checkup: Progress In Tough Fiscal Times?, Cynthia Shirk

National Health Policy Forum

Almost ten years after the surgeon general’s report designating dental disease as the “silent epidemic,” the nation continues to struggle with adequate access to and utilization of dental services. This is particularly true for low-income individuals, who experience more than twice the amount of untreated dental disease as their higher-income peers. This issue brief reviews sources of dental coverage for low-income children and adults and the challenges these programs face. It highlights some examples of state Medicaid initiatives to improve access and utilization for children and the progress of these initiatives. Finally, it examines the potential effects of the economy …

Latino Family Variables And Sexual Activity In Latino Adolescents, Brittany Nicole Barber

Counselor Education and Counseling Psychology Research Exchange Conference

Researchers’ focused examination of Latino adolescents’ cultural values and sexual activity has yielded questions regarding the cultural- and gender-specific attitudes and practices of these youth (Deardorff, Tschann, & Flores, 2008). Cultural values include family-related variables such as different aspects of familism, parent-adolescent communication, and parental monitoring, which have been found to decrease adolescents’ engagement in other negative activities such as aggressive behavior, (Dishion & McMahon, 1998), substance use (Estrada, Rabow, & Watts, 1982), and delinquency (Clark & Shields, 1997). Research investigating these risk behaviors has often implicated Latino adolescents’ level of assimilation to White, mainstream society as a potential risk …

The Ryan White Hiv/Aids Program, Jessamyn Taylor

National Health Policy Forum

This publication describes the basics of the Ryan White HIV/AIDS Program, the largest federal program solely focused on treating people living with HIV/AIDS in the United States. The program funds cities, states, and community-based organizations to provide primary care, prescription drugs, and support services to low-income, uninsured, and underinsured people living with HIV/AIDS.