Health Services Research Commons^™

Patient Self-Management: Tools And Barriers, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In his issue introduction, the editor-in-chief of the Journal of Patient-Centered Research and Reviews comments on the theme of patient self-management of chronic diseases and the related articles published therein. Illnesses such as cardiovascular disease, diabetes, epilepsy, arthritis, asthma, and obesity often require patients to administer their own medication daily or adhere to strict dietary restrictions. Progress is being made on the process of implementation and evaluation of patient self-management tools in primary care practices. Barriers to self-management tool implementations in clinics, as well as their use by individual patients, must be understood and addressed.

Implementing Community-Created Self-Management Support Tools In Primary Care Practices: Multimethod Analysis From The Insttepp Study, Douglas H. Fernald, Matthew J. Simpson, Donald E. Nease Jr., David L. Hahn, Amanda E. Hoffmann, Leann C. Michaels, Lyle J. Fagnan, Jeanette M. Daly, Barcey T. Levy

Journal of Patient-Centered Research and Reviews

Purpose: With one-half of Americans projected to be living with at least one chronic condition before 2020, enhancing patient self-management support (SMS) may improve health-related behaviors and clinical outcomes. Routine SMS implementation in primary care settings is difficult. Little is known about the practice conditions required for successful implementation of SMS tools.

Methods: Four primary care practice-based research networks (PBRNs) recruited 16 practices to participate in a boot camp translation process to adapt patient-centered SMS tools. Boot camp translation sessions were held over a 2-month period with 2 patients, a clinician, and a care manager from each practice. Qualitative case …

How To Translate Self-Management Support Tools Into Clinical Practice, Matthew J. Simpson, Jeanette M. Daly, Douglas H. Fernald, John M. Westfall, Leann C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Purpose: Patient self-management is an inevitable part of the work of being a patient, and self-management support (SMS) has become increasingly important in chronic disease management. However, the majority of SMS resources available in the Agency for Healthcare Research and Quality SMS Resource Library were developed without explicit collaboration between clinicians and patients.

Methods: Translation of SMS tools derived from the library into primary care practices occurred utilizing boot camp translation in four different practice-based research networks (PBRNs). The typical model of boot camp translation was adapted for the purpose of the Implementing Networks’ Self-management Tools Through Engaging Patients and …

Adapting Boot Camp Translation Methods To Engage Clinician/Patient Research Teams Within Practice-Based Research Networks, Lyle J. Fagnan, Matthew J. Simpson, Jeanette M. Daly, Leann C. Michaels, David L. Hahn, Barcey T. Levy, Douglas H. Fernald, John M. Westfall, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Purpose: Boot camp translation is a proven process to engage community members and health professionals in translating and disseminating evidence-based “best practices” models for health prevention and chronic illness care. Primary care practice improvement studies, particularly involving patient-driven change, as seen with self-management support (SMS), require engaged practice teams that include patients. Models of engagement such as boot camp translation may be effective.

Methods: Four geographically dispersed practice-based research networks (PBRNs) from the Meta-LARC consortium engaged 16 practices to form SMS implementation teams involving a clinician, care manager, and 2 patients in each team. Our study adapted the boot camp …

Practice-Based Research Networks Ceding To A Single Institutional Review Board, Jeanette M. Daly, Tabria Weiner Harrod, Kate Judge, Leann C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Historically, a single research project involving numerous practice-based research networks (PBRNs) required multiple institutional review boards (IRBs) to be involved in approval of the project. However, to avoid redundancies, federal IRB regulations now allow cooperative research projects that involve more than one institution to use reasonable methods of cooperative IRB review and to cede authority for review and oversight of the project to a single lead IRB. Through ceding, a lead IRB has the authority for review and oversight of the project delegated by all participating sites’ IRBs and becomes the IRB of record for the ceded sites. In the …

Occupational Exposures And Associated Risk Factors Among U.S. Casino Workers: A Narrative Review, Jessica Miller Clouser, John C. Flunker, Jennifer E. Swanberg, Gail Betz, Surjeet Baidwan, J. Kathleen Tracy

Center for Health Services Research Faculty Publications

We conducted a narrative literature review of U.S. casino occupational health and safety research based on the following inclusion criteria: 1) focused on workers, 2) provided information pertaining to exposures present in the occupational environment (e.g., hazards, stressors, etc.), and 3) pertained to casino, gaming, or gambling workers. Following a multi-step process, a total of 11 articles were identified that related to the occupational health and safety of U.S. casino workers. These articles primarily focused on environmental tobacco smoke (ETS) exposures (n = 7 articles), with the remaining articles related to casino worker risk behaviors (i.e., problem gambling and drinking) …

Identifying Key Factors Associated With High Risk Asthma Patients To Reduce The Cost Of Health Resources Utilization, Amani Ahmad

LSU Master's Theses

Asthma is associated with frequent use of primary health services and places a burden on the United States economy. Identifying key factors associated with increased cost of asthma is an essential step to improve practices of asthma management.

The aim of this study was to identify factors associated with over utilization of primary health services and increased cost via claims data and to explore the effectiveness of case management program in reducing overall asthma related cost.

Claims data analysis for Medicaid insured asthma patients in Louisiana was conducted. Asthma patients were identified using their ICD-9 and ICD-10 codes, forward variable …

Perceptions Of Needs, Assets, And Priorities Among Black Men Who Have Sex With Men With Hiv: Community-Driven Actions And Impacts Of A Participatory Photovoice Process, Christina J. Sun, Jennifer L. Nall, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice. Photovoice, a participatory, collaborative research methodology that combines documentary photography with group discussion, was conducted with six Black MSM with HIV. From the photographs and discussions, primary themes of discrimination and rejection, lack of mental health services, coping strategies to reduce …

Trust, Access, And Adaptation To Needs: The Role Of Community-Based Promoters In Health Insurance Delivery In Gujarat, India, Lauryn Stafford

Independent Study Project (ISP) Collection

The research question this study addresses is: How do community-based promoters contribute to the delivery and utilization of health insurance among marginalized populations in India? To address this question, the successes and difficulties experienced by VimoSEWA community-based insurance promoters, called aagewans, were investigated through field visits and personal interviews in Ahmedabad and nearby rural districts in Gujarat. VimoSEWA’s insurance delivery model is an appropriate topic of investigation for this study because its beneficiaries are self-employed women with limited prior access to financial protection. Both aagewans and insurance members were interviewed during this study to develop a comprehensive understanding of the …

Effects Of The Affordable Care Act On Health Care Access And Self-Assessed Health After 3 Years, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata

Economics Faculty Publications

Using data from the Behavioral Risk Factor Surveillance System, we examine the causal impact of the Affordable Care Act on health-related outcomes after 3 years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from 2 sources: (1) local area prereform uninsured rates from 2013 and (2) state participation in the Medicaid expansion. Including the third postreform year leads to 2 important insights. First, gains in health insurance coverage and access to care from the policy continued to increase in the third year. Second, an improvement in the probability of reporting excellent health emerged in the third year, with …

Burden Of Lipohypertrophy Among Insulin Dependent Diabetes Mellitus Patients In China: An Analysis Of Outcomes And Impact Of Pen Needle Reimbursement Policy, Arthi Chandran

Dissertations and Theses

Background

Diabetes is a global epidemic and with an aging population accompanied by rapid urbanization China ranks highest in disease prevalence and associated burden. Independent of diabetes type, insulin is an eventual and costly requirement for disease management. The consequences of insulin administration however are poorly understood. Lipohypertrophy (LH) is one such consequence. It is hypothesized that method of insulin delivery and poor delivery technique are significant risk factors for this condition which is believed to alter insulin pharmacodynamics. Subsequently, insulin pen needles are a critical component of care however access to pen needles varies across China.

Objective

The objective …

Development And Implementation Of A Mobile Device-Based Pediatric Electronic Decision Support Tool As Part Of A National Practice Standardization Project, Russell J. Mcculloh, Sarah Fouquet, Joshua Herigon, Eric A. Biondi, Brandan Kennedy, Ellen Kerns, Adrienne G. Deporre, Jessica L. Markham, Y Raymond Chan, Krista Nelson, Jason G. Newland

Manuscripts, Articles, Book Chapters and Other Papers

© The Author(s) 2018.

Objective: Implementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project.

Materials and Methods: We developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled "Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE)." The mobile application (app), PedsGuide, was developed using evidence-based …

Web-Based Application To Support Physical Fitness Information Of Elderly People, Yudhy Dharmawan, Suroto Suroto, Priguna Septia Putra

Kesmas

Penduduk lanjut usia (lansia) semakin banyak seiring meningkatnya usia harapan hidup. Banyak upaya yang harus dilakukan untuk mencegah kesakitan di lansia, salah satunya dari aspek preventif dengan menjaga kebugaran para lansia. Untuk memonitor status kebugaran lansia, maka diperlukan aplikasi pemantauan kebugaran jasmani berbasis teknologi web karena tidak ada sistem yang merekam data kebugaran para lansia. Aplikasi ini ditujukan untuk merekam data kebugaran jasmani para lansia untuk merekomendasikan gym yang sesuai berdasarkan kondisi kesehatan yang dapat diakses di mana saja. Aplikasi ini dibuat dengan bahasa pemrograman PHP dan MYSQL sebagai pengolahan basis data yang dilengkapi dengan grafik untuk memantau kebugaran jasmaninya. …

The Implementation Of Documentation By Midwives In Pekanbaru, Wan Anita

Kesmas

Dokumentasi kebidanan adalah suatu bukti pencatatan dan pelaporan yang dimiliki oleh bidan dalam melakukan catatan perawatan yang berguna untuk kepentingan pasien, bidan, dan tim kesehatan. Pendokumentasian dapat diterapkan dengan metode Subjektif, Objektif, Analisa dan Perencanaan (SOAP). Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan pelaksanaan dokumentasi SOAP oleh bidan di Kota Pekanbaru tahun 2016. Penelitian bersifat kuantitatif analitik observasional dengan desain penelitian potong lintang analitik. Sampel penelitian adalah seluruh populasi bidan yang praktik mandiri atau di rumah bersalin di Kota Pekanbaru dengan jumlah sampel sebanyak 191 bidan yang diambil dengan prosedur systematic random sampling. Data dikumpulkan melalui wawancara langsung dengan …

Adolescent’S Knowledge And Skill To Refuse Drugs, Lucky Herawati, Johan Arief Budiman, Haryono Haryono

Kesmas

Berbagai upaya telah dilakukan untuk mencegah remaja dari penggunaan narkoba, kendatipun evaluasi pengetahuan dan keterampilan remaja menolak narkoba belum pernah dilakukan. Penelitian ini dilakukan pada 300 remaja, siswa kelas 7 atau setara usia 12-15 tahun di dua kota di Provinsi Daerah Istimewa Yogyakarta. Penelitian analitik bertujuan mengetahui gambaran pengetahuan, keterampilan remaja menolak narkoba, dan hubungan keduanya dengan karakteristik remaja. Variabel yang diteliti adalah pengetahuan remaja tentang narkoba, keterampilan menolak narkoba, dan karakteristik remaja, yang dikumpulkan dengan menggunakan kuesioner (self-reported questionnaire). Data dianalisis dengan uji korelasi Pearson dan Spearman rho, dengan tingkat signifikansi 95 persen. Hasil penelitian menunjukkan bahwa rata-rata nilai …

Factors Influencing Immunisation Schedule Adherence And Completion At The Regional Level In The Philippines, Paolo Miguel Manalang Vicerra

Kesmas

Penyebab utama kematian bayi sebagian besar dapat dicegah dan terdapat alasan baik dari sisi suplai maupun permintaan layanan kesehatan hal itu dapat terus berlangsung. Penelitian ini bertujuan memastikan faktor-faktor yang memengaruhi perilaku layanan kesehatan preventif imunisasi bayi di Filipina yang tepat waktu karena tingkat kelengkapan, atau kepatuhan, telah stabil dalam beberapa dekade terakhir. Metode yang digunakan adalah pembuatan model statistik di tingkat subnasional. Sampel berisi bayi yang lahir sebelum Survei Demografi dan Kesehatan Nasional Filipina tahun 2013 untuk menentukan kepatuhan yang tepat terhadap jadwal imunisasi yang dimandatkan oleh pemerintah. Hal ini melibatkan penggabungan 17 wilayah administratif negara ke tiga wilayah …

Husband’S Support For Their Wives In Antenatal Care Visit, Awalia Hanifah, Hadi Pratomo, Giang Hoang

Kesmas

Di wilayah Puskesmas Cimanggis, Kota Depok, cakupan kunjungan antenatal pertama (K1) dan kunjungan ke-4 (K4) sebesar 99,4% (2013) dan 91% (2014). Dukungan suami ibu hamil merupakan salah satu faktor yang berperan penting dalam kunjungan antenatal pada ibu hamil. Penelitian ini bertujuan menilai faktor predisposisi, pemungkin dan penguat dari dukungan suami terhadap ANC istrinya dengan menggunakan pendekatan kualitatif dengan desain Rapid Assessment Procedure. Lima suami dan istrinya yang sedang hamil dipilih sebagai informan serta dua bidan puskesmas sebagai informan kunci. Analisis data menggunakan matriks data kualitatif dan teknik analisis tematik. Hasil penelitian menunjukkan bahwa faktor predisposisi, pemungkin dan penguat dari suami …

Influential Host Factors To The Incidence Of Hiv/Aids In Key Populations In Pati District, Dwi Murtono, Puguh Riyanto, Zahroh Shaluhiyah

Kesmas

Human Immunodeficiency Virus (HIV) dan Acquired Immune Deficiency Syndrome (AIDS) merupakan penyakit berbahaya di dunia yang salah satu metode penularannya adalah melalui hubungan seksual. Penelitian ini bertujuan menjelaskan faktor-faktor yang berpengaruh terhadap kejadian HIV/AIDS pada populasi kunci. Penelitian dilakukan dari bulan Maret sampai September 2016. Penelitian analitik observasional dengan rancangan kasus kontrol pada populasi kunci di Kabupaten Pati. Kasus sebanyak 53 pasien positif HIV/AIDS, sedangkan kontrol sebanyak 53 pasien negative HIV/AIDS.Pengambilan sampel menggunakan teknik consecutive sampling. Data diperoleh dari riwayat medis dan wawancara kuesioner. Penelitian ini menggunakan uji kai kuadrat pada analisis bivariat dan regresi logistik ganda pada analisis multivariat. …

Unsafe Behavior Of Workers In Rotary Lathe Section In One Of The Plywood Industries In East Kalimantan, Iwan Muhamad Ramdan, Dyyka Indah Wijayanti

Kesmas

Kecelakaan kerja dan penyakit akibat kerja masih menjadi masalah kesehatan dunia, dua faktor utama penyebabnya adalah perilaku dan kondisi lingkungan kerja yang tidak aman. Penelitian sebelumnya membuktikan penyebab utamanya adalah faktor perilaku yang tidak aman. Penelitian ini bertujuan menganalisis faktor-faktor yang berhubungan dengan perilaku tidak aman dalam bekerja pada tenaga kerja di PT IAW dan menganalisis faktor yang paling berpengaruh. Penelitian potong lintang dilakukan pada bulan Juli sampai Agustus 2016 terhadap 104 sampel penelitian. Variabel bebas terdiri dari persepsi, komunikasi, pengawasan, ketersediaan alat pelindung diri (APD), pelatihan dan suhu lingkungan kerja. Variabel terikat adalah perilaku tidak aman. Analisis data menggunakan …

Direct Experience With Cervical Cancer Patient, Husband Support, And Self-Perception As Determinant Factors Of Women’S Desire To Take Via Screening Test, Nur Anisah Rahmawati, Linda Dewanti

Kesmas

Kanker serviks menyebabkan 10.3% kematian pada perempuan di Indonesia. Inspeksi visual asam asetat (IVA) telah digunakan untuk program skrining sejak tahun 2014 tetapi hanya 2,45 % perempuan yang melakukan pemeriksaan pada tahun 2015. Di tempat penelitian, cakupan skrining metode IVA kurang dari 1%. Penelitian sebelumnya menyebutkan faktor psikososial sebagai satu faktor penting, tetapi sedikit penelitian yang menganalisis peran dukungan suami dan pengalaman langsung dengan penderita kanker serviks. Penelitian ini bertujuan mempelajari hubungan antara pengalaman langsung dengan penderita kanker serviks, dukungan suami, persepsi diri dan keinginan perempuan melakukan skrining IVA. Penelitian potong lintang dilakukan secara acak pada perempuan berusia 25-55 tahun …