Health Services Research Commons^™

Population Council's Support For Nigeria's Third National Human Resources For Health Conference And Efforts To Institutionalize Hrh Conferences In Nigeria, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

This project brief describes the Population Council's partnership efforts with public health stakeholders in Nigeria to plan and host a third national conference for provision of necessary and relevant information on critical health issues to health staff and stakeholders throughout Nigeria.

The Children's Oncology Group: Organizational Structure, Membership, And Institutional Characteristics., Janice S. Withycombe, Todd A. Alonzo, Michele A. Wilkins-Sanchez, Maxine Hetherington, Peter C. Adamson, Wendy Landier

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Children's Oncology Group (COG) is the only organization within the National Cancer Institute's National Clinical Trials Network dedicated exclusively to pediatric cancer research. The purpose of this article is to provide an overview of COG's organizational structure, to characterize its institutional and individual membership, and to summarize enrollments onto COG clinical trials.

METHOD: Data from 2013 to 2015 were compiled from sources internal (Network Operations, Statistics and Data Center, Chair's Office) and external (American Hospital Association, American Nurses Credentialing Center) to COG, to present a comprehensive overview of COG's structure, individual and institutional membership, and group operations.

RESULTS: …

Evaluation Of A Palliative Care Initiative On The African Continent: Responsibly Improving Access To Pain Treatment, J. Spencer Hirschi

MPA/MPP/MPFM Capstone Projects

The African continent today faces a crisis of inadequate palliative care, in spite of the growing level of suffering of its citizens who are faced with debilitating diseases and injuries. Much of this problem stems from deeply ingrained attitudes towards opioids: while the American continent grapples with the effects of opioid overprescribing, physicians trained in Africa are taught that opioids are inappropriate for virtually all scenarios, and therefore they come to fear and avoid their use or simply remain untrained on them altogether. Patients fail to advocate for themselves out of submission to the doctor’s authority, governments remain apathetic to …

Family Caregiver Satisfaction With Inpatient Rehabilitation Care, Kristine T. Hanson, Kathleen F. Carlson, Greta Friedemann-Sanchez, Laura A. Meis, Courtney H. Van Houtven, Agnes C. Jensen, Sean M. Phelan, Joan M. Griffin

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction:

Informal family caregivers play an increasingly important role in healthcare. Despite their role in ongoing management and coordination of care, caregiver satisfaction with the healthcare services care recipients receive has been understudied. We sought to assess what influences caregiver satisfaction with inpatient care provided to their care recipient among caregivers of veterans with traumatic brain injury (TBI) and polytrauma.

Methods:

Data from the Family and Caregiver Experience Survey, a national survey of caregivers of veterans with TBI and polytrauma, was used to explore factors associated with caregiver satisfaction with the care his/her care recipient received while an inpatient at …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Emergency Room Services Used By Pediatric Patients Who Have An Established Primary Care, Rebecca J. Cooksey

DNP Projects

Background: The use of emergency room services for primary care issues is an ongoing problem. The incidence is higher in the Medicaid population and is associated with emergency room overcrowding and excessive medical costs.

Purpose: The purpose of this study was to explore the extent of and the details surrounding non-acute emergency room visits in a pediatric population within an urban primary care clinic.

Methods: This was a two-part descriptive study with both quantitative and qualitative components. A retrospective chart review of this facility’s ER data constituted the quantitative descriptive part of the study. The qualitative arm of the study …

Adoption And Impact Of Telemental Health On Healthcare Outcomes In The United States, Xiaohui Zhao

Graduate Theses, Dissertations, and Problem Reports (ETD)

Mental health conditions (MHCs) are the most expensive conditions in the United States (US). The high MHC prevalence coupled with continued undertreatment of MHC has contributed significantly to this high economic burden. Despite policy changes to increase mental health parity and integrate mental and physical healthcare, the shortage of mental health providers remains a significant barrier to mental health (MH) treatment. Telemental health (TMH) has emerged as an alternative care delivery approach to meet the growing demand of MH care and shortages of MH providers. Understanding the adoption of TMH among mental health facilities is critical for informing the broad …

Characteristics And Patterns Of Opioid-Related Overdoses Among Veterans, Sara Catherine Warfield

Graduate Theses, Dissertations, and Problem Reports (ETD)

BACKGROUND AND OBJECTIVES: The United States is in the midst of an opioid overdose crisis and is now considered a public health emergency. Given the alarming rise in opioid overdose deaths, there is an urgent need to understand the characteristics and risks associated with opioid overdoses. The objectives of this study were 1) to compare factors associated with different type of opioid overdose, 2) to determine the conditional probability of repeat overdose among veterans with a prior overdose event and corresponding probability of mortality for each overdose event and, 3) to identify cause-specific mortality rate of those who experienced a …

Community Perceptions On Access To And Communication Gaps Regarding Dementia-Specific Health Resources And Services, Randi G. Bastian

College of Graduate Studies: Theses & Dissertations

The people of Appalachia have less access to healthcare resources subsequently leading to deficits in healthcare, health education, and health research. There is a need to address the communication of healthcare resources among populations with low economic status such as the Appalachian communities in Northeast Tennessee. Alzheimer’s disease and related dementias (ADRD) uniquely challenges the healthcare industry while further dividing communities already experiencing hardship in healthcare resources. The Baby Boomer generation is advancing into the age range frequently affected by ADRD, 65 and over. In preparation, healthcare continuum must acknowledge and set out to address dementia-specific care challenges. “Keep …

Advanced Practice Nursing In Nigerian Healthcare: Prospects And Challenges, Raymond O. Chimezie, Sally N. Ibe

Journal of Sustainable Social Impact

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from …

Depression Among Epileptic Patients And Its Association With Drug Therapy In Sub-Saharan Africa: A Systematic Review And Meta-Analysis., Getenet Dessie, Henok Mulugeta, Cheru Tesema Leshargie, Fasil Wagnew, Sahai Burrowes

BACKGROUND: Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. The objective of this systematic review and meta-analysis is to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa.

METHODS: A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) conducted from December 2, 2017 …

Is Optometry Ready For Myopia Control? Education And Other Barriers To The Treatment Of Myopia, Saoirse Mccrann, Daniel Ian Flitcroft, James Loughman

Other Resources

Background

With the increasing prevalence of myopia there is growing interest in active myopia control. However, the majority of progressive myopes are still prescribed single vision spectacles. This prospective study aims to elucidate the knowledge and attitudes of optometrists toward myopia control, and thereby identify perceived barriers to the implementation of a risk focussed model of myopia management.

Methods

A series of four focus group discussions were conducted involving optometrists in different settings and career stages.

Results

The key finding to emerge is a clear disconnect between academic optometrists, optometry students and clinicians in practice. Academic faculty considered themselves competent …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Public Health Workforce Perceived Impact Of Emerging Issues In Public Health, Kristie C. Waterfield

College of Graduate Studies: Theses & Dissertations

Background: In an era where public health has been viewed as a global, multi-disciplinary field, the public health workforce has remained united to unfailingly holding fast to the mission of protecting, promoting, and improving the health of the public. However, the practice of public health is consistently evolving, and the workforce is continually facing a mirage of challenges. In order to overcome these challenges, practitioners need to be up-to-date on the necessary knowledge and skills to effectively deliver the core public health services.

Purpose: The purpose of this research was to explore the perceived impact of emerging trends in public …

Are Chronic Inflammatory Diseases Associated With Trauma Exposure And Gender? An Empirical Analysis Of Self-Reported Trauma And Health Histories Of Men And Women, Meghan Lacienski

College of Graduate Studies: Theses & Dissertations

A growing body of research indicates an association between trauma, inflammation, and chronic inflammatory disease; however, the mechanisms of this relationship are not fully understood, and the salience of potential risk factors, such as cumulative effects of trauma, trauma type, and gender, remain unclear. Trauma is associated with poor mental and physical health, such as PTSD, depression, and chronic inflammatory conditions, and this association may be stronger when certain risk factors are considered (Brody, Pratt, & Hughes, 2018; Groer, Kane, Williams, & Duffy, 2014; Husky, Mazure, & Kovess-Masfety, 2018; Kilpatrick et al., 2013). For example, sexual trauma and multiple traumatic …

Open Science Precision Medicine In Canada: Points To Consider, Palmira Granados Moreno, Sarah E. Ali-Khan, Benjamin Capps, Timothy Caulfield, Damien Chalaud, Aled Edwards, E. Richard Gold, Vasiliki Rahimzadeh, Adrian Thorogood, Daniel Auld, Gabrielle Bertier, Felix Breden, Roxanne Caron, Priscilla M.D.G. César, Robert Cook-Deegan, Megan Doerr, Ros Duncan, Amalia M. Issa, Jerome Reichman, Jacques Simard, Derek So, Sandeep Vanamala, Yann Joly

Faculty Scholarship

Open science can significantly influence the development and translational process of precision medicine in Canada. Precision medicine presents a unique opportunity to improve disease prevention and healthcare, as well as to reduce health-related expenditures. However, the development of precision medicine also brings about economic challenges, such as costly development, high failure rates, and reduced market size in comparison with the traditional blockbuster drug development model. Open science, characterized by principles of open data sharing, fast dissemination of knowledge, cumulative research, and cooperation, presents a unique opportunity to address these economic challenges while also promoting the public good.

The Centre of …

Trends In Opioid Use In Pediatric Patients In Us Emergency Departments From 2006 To 2015, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Erik J. Linstead

Pharmacy Faculty Articles and Research

Importance The use of opioids to treat pain in pediatric patients has been viewed as necessary; however, this practice has raised concerns regarding opioid abuse and the effects of opioid use. To effectively adjust policy regarding opioids in the pediatric population, prescribing patterns must be better understood.

Objective To evaluate opioid prescribing patterns in US pediatric patients and factors associated with opioid prescribing.

Design, Setting, and Participants This cross-sectional study used publicly available data from the National Hospital Ambulatory Medical Care Survey from January 1, 2006, to December 31, 2015. Analysis included the use of bivariate and multivariate models to …

Child Obesity And The Interaction Of Family And Neighborhood Socioeconomic Context, Ashley W. Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

One-Sentence, One-Word: An Innovative Data Collection Method To Enhance Exploration Of The Lived Experiences, Shannon L. Sibbald, Dylan Brennan, Aleksandra Zecevic

The Qualitative Report

Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and subsequently propose solutions to potential problems in the partnership. By applying an experience-based methods lens, we sought to augment traditional qualitative interviewing methodologies by using a novel method we named “one-sentence, one-word” (1S1W). To apply our 1S1W method, we used a phenomenological study that examined the relationship between the risk of falling and the desire of master athletes to engage in competitive sports. Participants reflected and recorded their subjective …