Health Services Research Commons^™

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

Challenging Aggressive Behaviors Experienced By Personal Support Workers In Comparison To Home Care Workers: Relationships Between Caregiver Experiences And Psychological Health, Kelsey N. Womack, Teala W. Alvord, Caitlyn F. Trullinger-Dwyer, Sean P.M. Rice, Ryan Olson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Personal support workers (PSW) are caregivers for children and adults with intellectual and developmental disabilities (IDDs) or adults experiencing mental illness or other behavioral health conditions. The work can be very meaningful, but many PSWs must prepare for, monitor, and manage challenging behaviors, including aggression. This study was designed to estimate the prevalence of aggression experienced by PSWs in Oregon, and compare it to a previous sample of Oregon home care workers (HCWs). This comparison included an analysis of relationships between exposures to aggression and psychological health factors. PSWs in Oregon (N = 240) were surveyed electronically at a single …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud

Senior Honors Projects, 2010-2019

Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Partial Psychiatric Hospitalization Program Availability In Non-Metropolitan And Metropolitan Hospitals Nationally, Timothy Williams, Tyrone F. Borders, Lindsey Jasinski

Rural & Underserved Health Research Center Publications

Overview of Key Findings

Partial psychiatric hospitalization programs (PPHPs) are intended to reduce or avoid inpatient stays by allowing patients to reside at home while receiving intensive psychiatric services in outpatient settings.

A significantly smaller proportion of non-metropolitan than metropolitan hospitals offer PPHPs.

• 11.4% of non-metropolitan compared to 38.7% of metropolitan hospitals offer PPHPs.
• Regardless of location, hospitals that offer PPHPs have higher patient volumes and more beds than hospitals that offer PPHPs through affiliated providers or do not offer PPHPs at all.

Extracting Patterns In Medical Claims Data For Predicting Opioid Overdose, Ryan Sanders

Graduate Theses and Dissertations

The goal of this project is to develop an efficient methodology for extracting features from time-dependent variables in transaction data. Transaction data is collected at varying time intervals making feature extraction more difficult. Unsupervised representational learning techniques are investigated, and the results compared with those from other feature engineering techniques. A successful methodology provides features that improve the accuracy of any machine learning technique. This methodology is then applied to insurance claims data in order to find features to predict whether a patient is at risk of overdosing on opioids. This data covers prescription, inpatient, and outpatient transactions. Features created …

Heterogeneity Introduced By Ehr System Implementation In A De-Identified Data Resource From 100 Non-Affiliated Organizations., Earl F. Glynn, Mark A. Hoffman

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Electronic health record (EHR) data aggregated from multiple, non-affiliated, sources provide an important resource for biomedical research, including digital phenotyping. Unlike work with EHR data from a single organization, aggregate EHR data introduces a number of analysis challenges.

Materials and Methods: We used the Cerner Health Facts data, a de-identified aggregate EHR data resource populated by data from 100 independent health systems, to investigate the impact of EHR implementation factors on the aggregate data. These included use of ancillary modules, data continuity, International Classification of Disease (ICD) version and prompts for clinical documentation.

Results and Discussion: Health Facts includes …

Blueprint For Shared Safety Strategic Plan, Reann Ramos

Capstone Projects and Master's Theses

The Blueprint for Shared Safety strategic plan will be adopted by Santa Cruz County Community Corrections Partnership as a framework of principles and practices that community leaders can use to lead shared safety strategies. By shifting the focus from the traditional criminal justice system to investments that can truly make our communities safer, the Blueprint aims to re-envision public safety together. The Community Corrections Partnership Community Education and Engagement Workgroup (CCP CEEW) has conducted data analysis to identify the key assets and gaps in Santa Cruz County. After identifying the key assets and gaps there were recommendation review sessions that …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Collection Of Analyzed Data From Health And Human Services Professionals: Stressors And Self-Care Practices, Yesenia Alcala

Capstone Projects and Master's Theses

Alliance on Aging is a nonprofit agency in Salinas, California. It was established in 1970, and they help serve the needs of the senior citizen community by offering multiple services. Working professionals experience high levels of stress in the workplace. Although there are many contributing factors for high stress in the workplace, the main factors at play are the lack of self-care and lack of support Zastrow (pg. 332, 2015). Because working professionally in the human services field experience high stress the consequences they may face are burnout, high turnover rates, and poor overall health. The capstone project will assess …

Diabetes And Effectiveness Of Gym Usage, Roberto Moore

Capstone Projects and Master's Theses

The Central Coast YMCA’s Diabetes Prevention Program (DPP) exists to support community members who are diagnosed as pre-diabetic. DPP participants are provided a free membership to the YMCA’s gym, but are under utilizing this resource. Some reasons that participants may not be utilizing the gym are lack of time, work schedules, the language barrier in utilizing the equipment and childcare concerns. If participants are not utilizing the gym they may not complete the program and may be at risk of contracting diabetes and possibly losing a limb. In order to understand the specific barriers for this group in utilizing this …

Organizational Culture Change In The United States Government And Its Application In State And Local Public Health Agencies: A Literature Review, Katherine Barrow

Capstone Experience: Master of Public Health

State and local health agencies play a critical role in the assessment and assurance of public health in the United States. Their authority to shape the structure and delivery of health services makes organizational culture change imperative for the improvement of government services and ultimately, the health of the public. A systematic literature review using SCOPUS, PsycINFO, Business Source, and Academic Search Premier was conducted to 1) analyze organizational culture change efforts in United States federal, state, and local government settings and 2) make recommendations on how to implement organizational culture change initiatives in state and local health agencies. Of …

Effect Of Self-Regulated Learning For Improving Dietary Management And Quality Of Life In Patients With Type-2 Diabetes Mellitus At Dr. Ramelan Naval Hospital, Surabaya, Indonesia, Yayuk Estuningsih, Thinni Nurul Rochmah, Merryana Andriani, Trias Mahmudiono

Kesmas

Self-regulated learning is a process of learning how to manage and regulate oneself to obtain skills and knowledge without depending on others. It is expected that diabetes patients can manage their diabetes by themselves. This study aimed to analyze the effect of self-regulated learning-based educational intervention on quality of life for patients with type-2 diabetes mellitus (DM) at Dr. Ramelan Naval Hospital, Surabaya. This was a quasi-experimental study in the form of pretest and posttest with a control group design. A total of 20 patients with DM were randomly divided into intervention and control groups to undergo a 4-week intervention. …

Maternal Knowledge, Attitude, And Practices About Traditional Food Feeding With Stunting And Wasting Of Toddlers In Farmer Families, Betty Yosephin Simanjuntak, Miratul Haya, Desri Suryani, Ali Khomsan, Che An Ahmad

Kesmas

Traditional foods are foods consumed by a certain ethnic group in a specific region. The habit of consuming traditional foods is usually inherited by the family members, including toddlers, of a respective generation. The study aimed to determine relationship of maternal knowledge, attitude, and practices in traditional food feeding with stunting and wasting of toddlers in the farmer families of the Central Bengkulu District. This study employed a cross-sectional design with a sample of mothers with children aged 12–59 months. The sample included a total of 115 farmer families. Data on nutritional knowledge, attitude, practices about traditional food, sex of …

Overweight And Obesity Status With Dental Caries Among Children Aged 7–12 Years Old In Badung District, Bali 2018, Hariani Rafitha, Putri Bungsu Machmud, Ratna Djuwita, Dwi Gayatri, Fakhrana Ariani Ayub

Kesmas

Dental caries is an infectious disease that Dental is characterized by the dental damage resulting from microorganism products in carbohydrate fermentation. Dental caries and obesity in children are multifactorial diseases associated with eating habits and certain lifestyle factors. This study aimed to assess the association between overweightness, obesity, and dental caries among children aged 7–12 years in Badung district, Bali province in 2018. The total sample of 426 children and their mothers were recruited from all first to fifth elementary grade students in three schools selected by simple random sampling. The logistic regression analysis has demonstrated a significant association between …

Personal Exposure Of Traffic Policeman To Particulate Matter In Jakarta: Distribution Of Size, Chemical Composition, And Work Time, Doni Hikmat Ramdhan, Eka Fitriani Ahmad, Fitri Kurniasari, Zuly Prima Rizky, Hardy Atmajaya, Muhayatun Santoso

Kesmas

Particulate matter (PM) is an air pollutant that has an impact on public health, especially in an urban area. The objective of this study was to analyze the personal concentration of PM2.5 and its composition among police working in the roadside area in Jakarta. PM measurement has done to the policeman that controlled traffic on four near highway locations in Jakarta. Sioutas impactor, Leland Legacy personal pump, and quartz fiber filter were chosen to measure the fine particles. Each PM was measured for 8-hour period. PM concentration was analyzed by the gravimetric method while tracing element and black carbon in …

Users’ Perception Of The Hospital Information System In A Maternity Hospital In Lampung, Indonesia, Al Asyary, Arief Kurniawan Nur Prasetyo, Tris Eryando, Solvay Gerke

Kesmas

Hospital information systems (HIS) have been applied on a massive scale; however, user evaluation of their effectiveness, efficiency, and service quality improvements remain rare. This study aimed to describe the utility of information systems from the users’ point of view by using the Technology Acceptance Model (TAM) in a maternity hospital in Lampung, Indonesia. The study provided an overview of the features of the information system and the workflow of the user through this information system. Screenshots were taken by using Camtasia Studio 2.0 Trial Version application software for one day (two shifts) in the outpatient service. The HIS generally …

Knowledge, Attitude, Practices, And Health Beliefs Of Pregnant Women About Urinary Tract Infection And Its Associated Risk Factors: A Local Filipino Community Experience, Annalyn Navarro, Raphael Enrique Tiongco, Reynaldo Bundalian Jr.

Kesmas

Urinary tract infection (UTI) during pregnancy is assumed to be associated with increased maternal and fetal morbidity and mortality; hence, a proper assessment of knowledge and practices is crucial to formulate preventive strategies to ensure the health of both the mother and the baby. The study determined the knowledge, attitude, practices (KAP), and the beliefs of pregnant women about UTI based on the Health Belief Model. A survey questionnaire was used to gather data from pregnant women with and without UTI. The association of the pregnant women’s sociodemographic characteristics with their KAP and health beliefs was determined using Pearson’s chi-square …

Midwife’S Role In The Mother-To-Child Transmission Prevention Program In Primary Health Care In Yogyakarta, Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa

Kesmas

Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. …