Health Services Research Commons^™

Comparing Patency Of Pulmonary Stent Implantation And Balloon Angioplasty In Pulmonary Vein Stenosis: A Systematic Review And Meta-Analysis, Izza Batool, Muhammad K. Khan, Muhammad Zohaib, Ibrahim A. Khan, Syed A. A. Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce D. Klugherz

Abington Jefferson Health Papers

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta‐analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross‐sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5‐year freedom from restenosis, …

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

How To Approach Medical Education Research, Stefanie Attardi, Jeff Cross, Sarah Lerchenfeldt

Books and Book Chapters

Medical education research blends two of the core functions of academic medicine: teaching and scholarship. Its value is increasingly recognized in promotion and tenure decisions, and in the number of funding sources available. Similar to other types of research, it starts with a well-crafted question and a thorough review of the literature. For a successful project, it is critical to select the research design that can best answer the research question, keeping in mind its advantages and limitations. Because the research design must also adhere to ethical principles, working closely with the local Institutional Review Board prior to starting the …

Facility-Based Uptake Of Colorectal Cancer Screening In 45-49-Year-Olds After U.S. Guideline Changes, Alyssa H. Harris, Hannah Murphy, Madeleine Mcdowell, Margaret E. Wright, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

No abstract provided.

Perceptions Of The Health Care System As Mediators In The Association Between Experiences Of Discrimination, Communication From Providers, And Gaps In Mammography, Hannah Cohen-Cline

Articles, Abstracts, and Reports

No abstract provided.

Understanding The Impact Of The Care Connect Washington Program, Hannah Cohen-Cline, Dan Fish, Taylor Doren, Abby Bush

Articles, Abstracts, and Reports

No abstract provided.

At The Crossroads: Initial Findings And Lessons Learned From A Medicaid Housing Benefit Pilot, Cat Livingston, Megan Holtorf, Benjamin Gronowski, Alyssa Cragie

Articles, Abstracts, and Reports

No abstract provided.

A Scoping Review Of The Social Determinants Of Pediatric And Adolescent Obesity, Deepali K Ernest, Elizabeth A Onugha, Bipin Singh, Shreela V Sharma, Jayna M Dave

Faculty, Staff and Student Publications

Context: Social determinants of health (SDOH) play a large role in pediatric and adolescent metabolic health worldwide.

Objective: The study is aimed at exploring key SDOH related to childhood obesity, worldwide.

Methods: Primary research articles from PubMed, Embase, and Medline databases published between 2013 and 2023, had a study population of 0-19-year-olds, and examined the association between WHO-defined SDOH and childhood obesity were included. Non-English papers and those outside WHO-defined SDOHs were excluded. Two reviewers independently performed a blinded screening of titles and abstracts, followed by a full-text assessment of selected articles.

Results: Of the 703 initial articles, 22 duplicates …

How Do Young Adults With Drug Use Disorder (Dud) Utilize Treatment? Exploring And Examining Lived Experiences Towards Treatment Completion In Indonesia, Dewi Kartikawatiningsih

Electronic Theses & Dissertations (2024 - present)

In Indonesia which has the highest rate of drug addiction in Southeast Asia, there is currently little knowledge about how young adults perceive the barriers faced when completing treatment or how treatment providers' perspectives influence their treatment completion. Understanding and identifying barriers to treatment completion is essential to making drug treatment more effective. The purpose of this study is to explore the perspectives and live experiences of young adults with DUD and their addiction counselors to develop a deeper understanding of treatment needs. This study interviewed 33 clients and 15 counselors from the rehabilitation center of the Badan Nasional Narkotika …

Impact Of The New York State Gender Recognition Act On Mental Health Outcomes Among Non-Binary Adults Served By The New York Public Mental Health System, Sahil Chaudhry

Electronic Theses & Dissertations (2024 - present)

This dissertation explores the impact of the 2021 New York State Gender Recognition Act (GRA) on mental health outcomes and service utilization among non-binary adults in the public mental health system. The GRA introduced pivotal legal reforms—including the option for an “X” gender marker and self-attestation for gender identity changes on state-issued documents—designed to affirm gender diversity and reduce structural barriers for transgender and non-binary populations. Guided by gender affirmation theory and minority stress frameworks, this study investigates how these legal shifts relate to changes in mental health service engagement and psychological well-being among non-binary individuals.

Using a difference-in-differences (DD) …

Place, Culture, And Care: A Socioecological Examination Of Type 2 Diabetes Among Hispanics In The U.S., Danielle Montoya

Theses and Dissertations

Introduction: Type 2 diabetes (T2D) disproportionately affects U.S. Hispanic populations. This dissertation examined whether structural determinants fundamentally drive T2D disparities among Hispanics, with attention to within-group racial heterogeneity.

Methods: Three studies utilized nationally representative data. Study 1 examined neighborhood segregation and ethnic enclave residence associations with T2D using restricted NHANES data (2011-2018, n=5,056). Study 2 investigated acculturation and T2D associations using restricted NHANES data (2011-2018, n=4,540). Study 3 analyzed patient-provider racial/ethnic concordance and adequate diabetes care using MEPS data (2008-2021, n=17,138).

Results: Structural factors demonstrated primacy across all studies. Neighborhood segregation (aOR=1.17, p>0.05) and ethnic enclave residence showed no …

Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

Understanding Women's Access To And Utilization Of Syringe Service Programs, Annelisa E. Swiersz

Honors Undergraduate Theses

As of 2020, 138 million Americans ages 12 and over reported illicit drug use in their lifetime, with over 3 million of those people injecting drugs. There are risks for all people who use drugs, but people who inject drugs (PWID) pose specific risks such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV), with women who inject drugs (WWID) facing even more risks. WWID involved in sex work have a higher risk of HIV transmission and lack access to sterile injection devices and sexual and reproductive health services. To address these risks, syringe service programs (SSPs) were developed …

Non-Profit Hospital Spending On Community Health Improvement: Catalysts, Impediments, And Opportunities In New York State, Isaac H. Michaels

Electronic Theses & Dissertations (2024 - present)

This dissertation assesses the distribution and determinants of spending by non-profit hospitals in New York State on community health improvement services and community benefit operations. Utilizing the Social Ecological Model of Health, this study considers multiple levels of influence on this spending, including organizational and community characteristics. Using quantitative analysis, it examines cross-sectional, spatial, and longitudinal patterns in spending and identifies organizational and community-level factors influencing it. Qualitative analysis investigates operational factors affecting spending, including individual and interpersonal influences. The results of this mixed-methods study can inform hospital administrators, public health officials, policymakers, and communities in optimizing policies and decision-making …

Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark

Antioch University Dissertations & Theses

This hermeneutic phenomenological study explores the leadership experiences of Black birth workers (BBWs), revealing critical insights into leadership dynamics within maternal healthcare. Through a theoretical framework integrating African feminism, Black feminism, and anti-racist feminism, the research examines how BBWs conceptualize and enact leadership through embodied, relational, and liberatory approaches. This study addresses a significant gap in leadership literature, particularly regarding generational knowledge and practices of BBWs, which remain understudied despite their vital role in Black maternal healthcare. This study reveals distinct leadership perspectives and methodologies through in-depth interviews with eight BBWs and a detailed interpretive analysis. The findings contribute to …

Applying The Ecological Model Of Medical Encounters To Understand Patient-Centered Communication For Older Korean Migrants In The U.S., Seulgi Park

Electronic Theses & Dissertations (2024 - present)

Patient-Centered Communication (PCC) is defined as an approach that places patients at the center of communication with healthcare providers. PCC has been recognized as a strategy to address disparities experienced by minority populations. However, despite its associations with positive health outcomes and ethical significance, there has been a paucity of research on PCC in minority populations such as older Korean migrants in the U.S. Understanding PCC within this group may contribute to improving healthcare communication tailored to their needs. This dissertation aimed to (1) explore the expectations of PCC in primary care settings among older Korean migrants in the U.S., …

Understanding Oncology Physician Movement And Its Implications On Cancer Care Teams And Patients, Sarah L. Cornelius

Dartmouth College Ph.D Dissertations

Nearly 20% of oncology physicians planned to move to new practices or leave practice altogether in 2023, with common stressors related to limited staffing and increased clinical burden. This combination of movement and departures is collectively referred to as turnover. High-quality cancer care relies on access to well-staffed and coordinated clinical teams, and thus, turnover within these teams can compromise care access, delivery, and quality. Prior research within primary care has demonstrated that turnover can result in delayed or worsened care and higher health care spending. However, there are limited studies of turnover within the oncology workforce. Understanding how oncology …

All-Terrain Vehicle Injuries Among Youth: A Multidimensional Analysis Of Injury Patterns In West Virginia And Safety Laws Across High-Fatality States, Sabrina Chyann Beal

Graduate Theses, Dissertations, and Problem Reports (ETD)

All-terrain vehicles (ATVs) pose significant injury risks, particularly among youth. These powerful machines are widely used across recreational and rural settings. West Virginia consistently ranks among the top five states for ATV-related deaths and injuries. Safety equipment and requirements are often not followed nor enforced, causing children and adolescents to be the most vulnerable group because they tend to not wear safety equipment such as helmets, ride on roadways, carry passengers, and operate oversized ATVS. This study examined ATV injury patterns from the WVU Medicine Trauma Registry and ATV laws across the five states with the highest reported fatalities. This …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Exploring The Reassessment Of Palliative Home Care Clients: A Mixed Methods Study, Maya Canham

Theses and Dissertations (Comprehensive)

Introduction: The timely reassessment of clients receiving palliative home care (HC) is critical for supporting clinicians with care planning and service delivery. However, there is little information on the frequency of reassessments and factors driving reassessment in palliative HC clients.

Objectives: The objectives of this study were to: (i) determine the proportion of palliative HC clients reassessed with the interRAI Palliative Care (interRAI PC) instrument, (ii) calculate the average interRAI PC reassessment interval, (iii) identify the key factors driving interRAI PC reassessment at various intervals, and (iv) explore the factors that influence palliative HC clinicians to reassess their clients in …