Health Services Research Commons^™

Economic Burden Of Renal Cell Carcinoma (Rcc) And Treatment Patterns, Overall Survival And Healthcare Costs Among Older Metastatic Rcc Patients, Hrishikesh P. Kale

Theses and Dissertations

Background

Renal cell carcinoma (RCC) is the most common type of kidney cancer. Patients diagnosed with metastatic RCC (mRCC) have shorter overall survival compared to those diagnosed at earlier stages. Several targeted therapies, which cost from $7,000 - $16,000 per month have been approved since 2005 to treat mRCC. In addition, there is a growing interest in the use of cytoreductive nephrectomy (CN) with targeted therapies among mRCC patients. However, little is known regarding the economic burden of RCC and role of CN and prescribing patterns of targeted therapies among older mRCC patients.

Objectives

1) To assess the economic burden …

Family Planning And Hiv Interventions Among Women In Low-Income Settings, Steven P. Masiano

Theses and Dissertations

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.

This …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

The Impact Of The Medicaid Coverage Expansion And The Removal Of Cost-Sharing Under The Affordable Care Act On Mammography And Pap Tests, Abeer Alharbi

Theses and Dissertations

Background: The Affordable Care Act (ACA) aimed at making health care affordable and accessible including the use of preventive care services. To achieve these aims, the ACA expanded Medicaid coverage to population with income below 138% of FPL and removed cost-sharing when using preventive care services recommended by the USPSTF. This study tried to assess the impact of these provisions on the rate of mammography and Pap tests among women. Methods: Data was obtained from the Medical Expenditure Panel Survey - Household Component MEPS-HC. A difference-indifference design was used to determine the effect of Medicaid eligibility expansion on the outcomes …

Patient Characteristics, Discharge Disposition, And Hospital Factors Associated With All Cause 30-Day Hospital Readmission For Total Joint Arthroplasty In 2014, Hamad Yahya Alzamanan

Theses and Dissertations

Objective: Recent improvements in hospital care have come from a growing knowledge of factors that contribute to readmission. The objective of this work is to identify and describe the national readmission rate after Total Joint Arthroplasty, and to evaluate selected hospitals’ and patients’ factors for their association with the all-cause 30-day readmission rate after TJA in the United States in 2014. Method: Retrospective analysis of 938,504 TJA acute care hospital discharge records was performed, using a nationally representative database that is dedicated to the study of hospital readmissions, and accounts for 51% of total US hospitalizations. Logistic regression models were …

Evaluation Of A Peer Group Model Of Supervision For The Allied Health Workforce In Queensland: A Descriptive Overview, Susan C. Pager, Pim Kuipers, Karen Bell, Fiona Hall

Internet Journal of Allied Health Sciences and Practice

Purpose: An evaluation of a large scale implementation of a peer group model of professional supervision was conducted to inform service planning and guide policy and practice. A descriptive overview of the findings is presented. Method: Allied health staff trained in peer group supervision were surveyed about their experience of the model, its challenges and benefits. Interviews were also conducted with senior managers. Results: Analysis of 248 responses indicated that 72% of trained staff had participated in peer group supervision, and that these peer groups had continued for an average of 17.2 months. The majority of groups adhered …

Scaling Out Evidence-Based Interventions Outside The U.S. Mainland: Social Justice Or Trojan Horse?, Melanie M. Domenech-Rodriguez, Ana A. L. Baumann, Alejandro L. Vázquez, Nancy G. Amador-Buenabad, Natalie Franceschi Rivera, Nydia Ortiz-Pons, J. Rubén Parra-Cardona

Psychology Faculty Publications

Global health disparities continue to widen as professional standards for effectiveness of mental health services provision become more precise and difficult to achieve across varied economic and social contexts. Within the U.S., health disparities are evident in Latinx populations. Globally, the health disparities are also evident in Latin America as compared to the U.S. and other economically affluent nations. The diversification of psychology in content and persons has led to a unique opportunity to build bridges that can help reduce disparities in- and outside of the U.S. mainland. Collaborations can be of great use in addressing health disparities internationally but …

Sociocultural Interactions Of Cuban Doctors Participating In The More Doctors Program In Brazil, Joaquin Molina, Carlos Eduardo Siqueira, Leonardo Cavalcanti

Gastón Institute Publications

This book focuses on a different and underexplored attribute of the More Doctors Program by surveying doctors in the feld with the purpose of identifying important answers regarding the sociocultural interactions of Cuban doctors recruited by the program and of producing knowledge, while also making improvements in the participation, still limited, of foreign doctors in the primary care services offered by SUS. It proposes to induce perceptions, memories, and possible explanations to anyone who is somehow associated with the Program’s development, especially those committed to universal health care and primary assistance as the only paths to an effective health system. …

Water Insecurity And Gendered Risk For Depression In Rural Uganda: A Hotspot Analysis, Christine E. Cooper-Vince, Hawk Arachy, Bernard Kakuhikire, Dagmar Vořechovská, Rumbidzai Mushavi, C. Baguma, Amy Q. Mcdonough, David R. Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:

Water insecurity is linked to depression in low- and middle-income countries (LMICs), though it remains unclear how geospatial clustering of water insecurity in rural regions is associated with risk for depression.

Methods: We conducted a population-based survey of a rural parish in southwestern Uganda (N = 1603) to evaluate the joint geospatial clustering of water insecurity and risk for depression among men and women living in rural Uganda.

Results:

Geospatial clustering of self-reported water insecurity and depressive symptoms was found to be present among both men and women. Depression hotspots were more often observed near water insecurity hotspots among …

Mchd Student Health Centers Needs Analysis - Claims Analysis, Hannah Cohen-Cline, Kristen Dulacki, Claire Devine, Megan Holtorf, Bill J. Wright

Articles, Abstracts, and Reports

No abstract provided.

Understanding Behavioral Health And Treatment Engagement With Former Users Of Prenatal Substances: A Strengths-Focused Mixed Methods Inquiry, Jennifer G. Benson, Peggy Maclean, Andrew Hsi, Sarah J. Erickson

Psychology ETDs

Accessible services for users of prenatal substances are lacking, and treatment engagement is poor with services that are available. Furthermore, legal consequences are often punitive, which ultimately damages the well-being of mother and child. Milagro and FOCUS are two New Mexico programs that provide comprehensive, coordinated care, including medication-assisted treatment, to former users of prenatal substances during pregnancy (in the Milagro Program) and for three years post-birth (in the FOCUS Program). This mixed methods study explored the lived experiences of women from this complex, high-risk population, using a high-engagement sample of women who utilized services at both Milagro and FOCUS. …

Social Marketing For A Farmer's Market In An Underserved Community: A Needs Assessment, Meg Skizim, Melinda Sothern, Ondrej Blaha, Tung-Sung Tseng, Lauren Griffiths, Jonathan Joseph, Henry Nuss

School of Public Health Faculty Publications

The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants …

Changes In The Utilization Of Osteoporosis Drugs After The 2010 Fda Bisphosphonate Drug Safety Communication, Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Introduction

In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs.

Methods

Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and …

Sharing The Burden, Robert Livingston

Capstone Projects and Master's Theses

Family caregivers of hospice patients experience an increased burden due to providing ongoing care. Research on the issue produces no consensus on evidence-based programs to alleviate the burden. Respite or relief services continue to be the primary solution applied to the problem. Central Coast Visiting Nurse Association and Hospice supported a project to address caregiver burden. Hospice provides volunteers to families to reduce the caregiver burden. The project consists of outreach and recruitment to obtain new volunteers that continue to deliver respite within the community. Project duration lasted for approximately three months and was implemented by completing six tabling activities …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience: Master of Public Health

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Effect Of Health Education On Community Participation To Eradicate Aedes Aegypti-Breeding Sites In Buahbatu And Cinambo Districts, Bandung, Zahratul Elsa, Uun Sumardi, Lia Faridah

Kesmas

Dengue hemorrhagic fever (DHF) is still a major public health problem in many regions in Indonesia including Bandung City. Community participation in implementing Eradication of Mosquito-Breeding Sites is still needed as it is considered the most effective method in controlling the dengue fever. This study aimed to determine the influence of health education towards community participation to eradicate mosquito-breeding sites, which was measured by knowledge level and larva index conducted in Bandung, specifically in two different locations with the highest and the lowest incidence rates of DHF. This study used quasi-experimental method. Samples were 100 people living in Cijawura and …

Maternal Energy Intake At The Sixth Month As Dominant Factor Of Exclusive Breastfeeding Success, Devi Suryanti Sihite, Sandra Fikawati, Ahmad Syafiq

Kesmas

Breastfeeding mothers needed adequate energy intake to provide 6-month exclusive breastfeeding that is necessary for infant growth and development. This study aimed to investigate real intake at the first and sixth month of breastfeeding and determine the dominant factor affecting 6-month exclusive breastfeeding provision. The design of this study was cross-sectional conducted in March-April 2015 among 109 mothers with 6-12- month-old infant living and registered at integrated health care in Kalangan Primary Health Care area. Data were collected through interview using questionnaires. Breastfeeding mothers’ intake was asked using Semi-Quantitative Food Frequency Questionnaire. The study found that 6-month exclusive breastfeeding proportion …

Equity Level Of Health Insurance Ownership In Indonesia, Risky Kusuma Hartono

Kesmas

Social health insurance from government program are expected to be able to reduce inequalities access to health services in the middle of rising of health care cost, while private health insurance is still limited for up and middle class population. This study aimed to analyze the equity level of health insurance ownership including social and private health insurance in Indonesia. This study examined the condition of Indonesia in the middle of entering National Health Insurance (NHI) era. This study used data of Indonesian Socio-Economic Survey 2012. Data were analyzed by using econometric approach through multinomial logit analysis. The results showed …

Increasing Use Of Research Findings In Improving Evidence-Based Health Policy At The National Level, Meiwita Budiharsana

Kesmas

In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program …