Health Services Research Commons^™

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Closing The Health Disparity Gap In U.S. Immigrant Communities In The Era Of Covid-19: A Narrative Review, Dina Refki, Rukhsana Ahmed, Jeanette Altarriba

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

The COVID-19 pandemic continues to have significant impacts on social determinants of health. Immigrant communities often bear a disproportionate burden of the crisis because of the immigration experience, which serves as an additional social determinant of health. Evidence suggests that these communities are hard hit by economic instability, food insecurities, isolation, lack of safe housing and safe neighborhoods, environmental dynamics that cut them off from systems of support, lack of sufficient access to educational tools that have become critical in remote and digital learning, limited access to health and healthcare resources, low health literacy, and restricted access to culturally and …

Nursing: Global Impact Increases Healthcare Effectiveness, Madison Slacktish

Student Research Poster Presentations 2021

The discipline of nursing has a major impact on the world globally. Research has found when nurses collaborate across boarders, then patient outcomes tend to increase. Disease does not stop because there is a boarder from one country to the next. Therefore, worldly collaboration has positive influences on how nurse's practice and ways to change protocols to increase better patient outcomes.

Impact Of Covid-19 On The Italian And American Healthcare Systems : A Comparative Assessment, Bita Pejam, Jennifer Lam

All Reports

This report aims to examine and assess the impact of the COVID-19 global pandemic on the healthcare systems of the United States of America and Italy; two of the most heavily affected nations. Using data from December 2019 to January 2021, several consultations, and policy reviews, we identify risks and notable areas of issue in each nations’ approach to combating the virus. We focus our report particularly on the health policies and the governmental structures in place that contributed to each nations’ initial method of alleviating the impact of COVID-19. Our report compares the two healthcare systems and proposes a …

Covid-19 Related Physical And Mental Health Stressors In Families Using A Social Determinants Lens., Elizabeth Vasquez, Erin Bell, Melissa Tracy

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

Racial and ethnic minorities, those of lower socioeconomic status (SES), and older adults have experienced higher rates of infection, severity of illness, and mortality from COVID-19 than other groups. These populations are also disproportionately affected by financial and social disruptions caused by the pandemic, including job loss, reduction in community services, and disconnection from supportive networks critically important for the health and well-being of families. Further, these same populations often live in multi- generational households and rely on a family-dependent caregiver model. The aim of this project is to beta test an online questionnaire to identify individual and household risk …

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …

Unboxing The Japanese Sojourning Mom’S Pediatric-Going Experience: A Phenomenological Study Of Culturally And Linguistically Appropriate Health Services, Carolyn Oldham

Theses and Dissertations--Education Sciences

This study explores how twelve former Lexington-area Japanese sojourning mothers define culturally and linguistically appropriate services and how culture, gender and language shaped their health care beliefs, behaviors and experiences in pediatric settings. It is a naturalistic, pragmatic line of inquiry born in collaboration with Japanese sojourning moms across cups of matcha 末茶 and mugicha 麦茶. Framed by constructivist and intersectionality research lenses, this phenomenological study seeks to understand how study participants perceived the cultural and linguistic appropriateness of their interactions with Lexington-area pediatric offices and to begin to ascertain the meanings they created based on their subjective experiences. Its …

Housing Is Healthcare Measuring The Cross-Sector Impact Of A Major Housing Initiative In Portland, Oregon, Keri B Vartanian, Aisha K Gilmore, Kyle Jones

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No abstract provided.

Respecting Autonomy And Enabling Diversity: The Effect Of Eligibility And Enrollment On Research Data Demographics, Kayte Spector-Bagdady, Shengpu Tang, Sarah Jabbour, Nicholson Price, Ana Bracic, Melissa S. Creary, Sachin Kheterpal, Chad M. Brummett, Jenna Wiens

Articles

Many promising advances in precision health and other Big Data research rely on large data sets to analyze correlations among genetic variants, behavior, environment, and outcomes to improve population health. But these data sets are generally populated with demographically homogeneous cohorts. We conducted a retrospective cohort study of patients at a major academic medical center during 2012–19 to explore how recruitment and enrollment approaches affected the demographic diversity of participants in its research biospecimen and data bank. We found that compared with the overall clinical population, patients who consented to enroll in the research data bank were significantly less diverse …

Primary Care Physician-Nurse Practitioner Collaboration And Physicians Career Satisfaction, Tania Alidina

Electronic Theses and Dissertations, 2020-2023

Dissatisfaction amongst US physicians has been steadily increasing over the past few decades as health care reform changes the practice of medicine (Hoff, Young, Xiang, & Raver, 2015; Rosenstein, & Mudge-Riley, 2010). In 2008, physician dissatisfaction rates had increased to 19% (Mazaurenko & Menachemi, 2012). By 2012, 42% of physicians voiced dissatisfaction, with family medicine reporting most likely to be dissatisfied (Sorrell & Jennings, 2014). One factor that could affect physician career dissatisfaction/satisfaction that has not been studied is collaborative relationships with other healthcare providers, such as nurse practitioners. This study used secondary quantitative data from the National Survey of …

Impact Of Benzodiazepines And Polysubstance Status On Repeat Non-Fatal Drug Overdoses, Sarah Mayberry, Sarah Nechuta, Shanthi Krishnaswami

Peer Reviewed Articles

Research has shown that benzodiazepines and mental health disorders can increase the likelihood of repeat overdose, but researcher have not explored this association in Tennessee (TN). We examined benzodiazepines, polysubstance overdose status with/without benzodiazepines, and mental health comorbidities with repeat overdose using statewide data in TN. This study analyzed TN hospital discharge data on nonfatal overdoses for patients ages 18–64 from 2012 to 2016 for 21,066 patients with an initial inpatient visit and 36,244 patients with an initial outpatient visit. The study assessed each patient at one year after initial overdose to determine likelihood of repeat overdose. We used a …

Prevalence And Correlates Of Secondary Syringe Exchange (Sse) Among People Who Inject Drugs (Pwid) In Rural Kentucky, Jordan R. Wilson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To describe the prevalence of secondary syringe exchange (SSE) in a sample of syringe service program (SSP) clients in rural Appalachian Kentucky and to identify the correlates of SSE.

Methods: Participants (n=338) completed interviewer-administered questionnaires. Only those who reported having ever exchanged syringes at a SSP (n=140) were included in analysis. SSE was measured through self-report of obtaining syringes for someone else at a SSP in the past 6 months. Prevalence and correlates of SSE were examined using bivariate analysis and multiple logistic regression.

Results: Overall, 30% of participants reported SSE. Participants in the second [aOR= 3.83; 95% CI: …

Perceptions And Health Effects Of Electronic Cigarettes Among College Students, Safia Centner

Honors Undergraduate Theses

Electronic cigarettes, or e-cigarettes, are devices that allow users to inhale an aerosol, which contains chemical additives. E-cigarettes are becoming common for nicotine delivery in addition to traditional cigarettes. The goal of this study was to determine how college students perceive e-cigarettes, how often college students use e-cigarettes, and how they view e-cigarettes compared to tobacco cigarettes. This was accomplished through sending a survey built on Qualtrics to UCF students via Knights Email. This survey included questions about demographics, perceptions, and usage of e-cigarettes. The collected data was downloaded into SPSS and analyzed to compare data among different groups. The …

A Mixed Methods Study On Food Insecurity Screening And Patient-Centered Care: Perspectives Of Patients And Healthcare Providers On Practices And Barriers To Effective Screening In Outpatient Medical Settings, Christina Bernhardt

Electronic Theses and Dissertations, 2020-2023

The purpose of this study was to better understand the relationship between elements of patient-centered care and patient/provider comfort with conversing about food insecurity and related social determinants of health. A mixed methods study was conducted. Patients and healthcare providers were surveyed on their experiences with patient-centered care and comfort discussing food insecurity and related social concerns. Telephone interviews were conducted to gain a richer understanding of the concepts under investigation. In the survey and telephone interviews, both samples were also asked about changes in communication during COVID-19 times. Quantitative findings show that patient involvement in care and cultural sensitivity …

Health Literacy, Knowledge, Attitudes, And Opioid Use Behavior Among College Students, Khristen Holmes

Electronic Theses and Dissertations, 2020-2023

Opioid-related deaths have increased rapidly over the last couple of decades due to the overprescribing of prescription opioids and the availability of illicit drugs from family members, friends, or street dealers. To address this crisis, this research will attempt to identify how health literacy levels affect knowledge, attitudes, and behaviors. Hence, this study is informed by the Knowledge-Attitude-Behavior (KAB) Model. The KAB model is used to determine the influence of knowledge and attitudes on behaviors, which includes prescription drugs, illicit drugs, and fentanyl. This dissertation aims to explore the relationships between health literacy, knowledge, attitude, and behavior for opioids (prescription …

Medical Knowledge As A Recalcitrant Epistemological System: An Application Of Standpoint Epistemology In The Analysis Of Marginalization Within U.S Healthcare, Abby Deshazo

CMC Senior Theses

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to …

A Comparison Of Health Habits Between Nursing And Non Nursing Majors, Reilly K. Gilmour

Honors Theses and Capstones

No abstract provided.

The Impact Of The Hospital Value-Based Purchasing Program On Healthy Days, Health Inequity, And Hospital Community Benefit Spending, Samhita Kadiyala

Scripps Senior Theses

The Hospital Value-Based Purchasing Program (HVBP) is a Centers for Medicare and Medicaid Services (CMS) program implemented in 2012 to reward acute-care hospitals with incentive payments for the quality of care provided to Medicare patients in inpatient settings. Under this policy, payment adjustments are made based on a variety of factors including clinical quality, patient experience, and cost reductions. This paper uses state-level variation in the implementation of HVBP to ascertain whether the policy led to improvements in Healthy Days (a CDC-designed composite measure of individuals’ self-reported number of physically and mentally “healthy” days per month), health disparities, and community …

The Development Of A Survey Instrument To Assess Racial And Cultural Inclusiveness: A Case Study Of Staff, Jolene Rios

All Master's Theses

Background:

The hierarchy of the medical system and its lack of racial and cultural inclusiveness has created systematically inequitable healthcare with direct outcomes to health disparities. Inequitable non-inclusive healthcare perpetuated and negatively impacted health disparities among minorities and has been a major preventable public health problem. Research studies have established a correlation between racism and various adverse health outcomes, including higher mortality, lower rates of cancer screening, elevated blood pressure, higher C-reactive protein levels, substance use, and mental health conditions (Shavers et al, 2012). Measuring exposure to racism has been essential to establishing racism’s influence on equitable, inclusive healthcare and …

Quantification Of Bacterial Shedding From The Respiratory Tract Of Health Care Workers Wearing Paprs And Other Types Of Air-Purifying Respirators On Sterile Conditions In A Simulated Operating Rooms (Ors), Segun Olanrewaju Ajewole

Graduate Theses, Dissertations, and Problem Reports (ETD)

The role of powered air- purifying respirators (PAPRs) in healthcare settings during infectious diseases outbreaks and highly contagious pathogens (e.g., SARS, HINI, Ebola, COVID etc.) has attracted much interest based on the level of respiratory protection they provide and their many positive user features. A common practice among healthcare workers to minimize airborne contaminant exposure has been to use surgical masks or N95 filtering facepiece respirators (FFRs). Surgical masks have been shown to offer minimal respiratory protection and while N95 FFRs offer better respiratory protection, they are not comfortable to use for a prolonged period. With current PAPR designs, exhaled …