Health Services Research Commons^™

Service Provider Perceptions Of Systems Serving Individuals Experiencing Homelessness: A Needs Assessment And Strategic Plan In Johnson City, Tn, Opal Frye-Clark

Electronic Theses and Dissertations

This Integrated Learning Experience (ILE) investigates service providers' perceptions of Johnson City, Tennessee's homelessness services, aiming to inform a city-wide strategic plan for reduction. Employing a mixed-methods approach, the study gathered qualitative data through in-depth interviews with service providers in 2022 and quantitative data via a 2024 survey. The research focused on those directly involved in serving or significantly influencing the lives of individuals experiencing homelessness (IEH). Three key aims guided the investigation: (1) To analyze provider perspectives to identify community assets, opportunities, barriers, and unmet needs, informing a comprehensive needs assessment; (2) To refine these findings through SWOT analysis …

Patient, Provider, And Health System Characteristics Leading To The Delivery Of Low Value Health Care Services And Outcomes Of An Intervention For Mitigating Low Value Care., Philip Ray Rohrer

Electronic Theses and Dissertations

The United States spends more on health care than any other country, and Medicare accounted for nearly one-quarter of total personal health care spending in 2019. Waste within the health care system in the United States is estimated to represent approximately 25% of total U.S. health care expenditures. Low value care includes health care services that provide little or no benefit to patients, have potential to cause harm, incur unnecessary costs to patients, or waste limited healthcare resources. Low value care is estimated to represent roughly 10% of total health care waste, or between $75.7 billion and $101.2 billion dollars …

Understanding Carceral Pathways And Outcomes Of Marginalized Adults Who Use Drugs., Carmen Renee Mitchell

Electronic Theses and Dissertations

This dissertation is an examination of outcomes among substance users at various stages of the incarceration process divided among five chapters. Chapter One provides an overview of substance use disorder (SUD), incarceration, and wider justice system-involvement, and explores how the political economy of health theoretical framework can be applied to examine how the criminal justice system creates and perpetuates inequality among marginalized people who use substances. Chapter Two examines post-release health outcomes among the population of incarcerated people who use substances using a scoping review and finds that people in reentry with SUD have poorer overall outcomes that without transitional …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Trends In Family Planning Uptake In Tanzania: An Analysis Of National Survey Data 2021-2022, Harun Yussuf Ayoub, Sabarinah Prasetyo

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

The purpose of this study is to uncover the socioeconomic and demographic factors that influence the usage of contraceptives by analysing trends and patterns in Tanzania's family planning uptake using data from national surveys. The results show that while Tanzania has made progress in increasing contraceptive prevalence from 27% in 2010 to 39% in 2021-22, disparities persist across socioeconomic and demographic lines. Women in urban areas, from higher wealth quintiles, and with higher educational attainment have significantly higher contraceptive prevalence rates compared to their counterparts. The study also reveals that the majority of women are aware of family planning methods, …

Gambaran Perilaku Merokok Siswa Smp Negeri, R Nasrullah Nur Nugroho

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Remaja mudah terjerumus pada perilaku berisiko, seperti merokok, karena mereka tidak tahu banyak, mudah dipengaruhi, dan ingin mencoba hal-hal baru. Pada tahun 2018, proporsi merokok pada remaja berusia 10–14 tahun adalah 2,1%, dan mereka rata-rata menghisap 6–7 batang setiap hari. Dengan menggunakan konsep penelitian cross-sectional dari 406 siswa laki-laki SMP negeri di kelurahan Kebayoran Lama Utara, penelitian ini memberikan gambaran tentang perilaku merokok siswa SMP negeri. Besar sampel yang digunakan adalah 117 orang yang menjawab. Dalam penelitian ini, teknik quota sampling digunakan untuk pengambilan sampel. Data penelitian ini dikumpulkan melalui kuesioner yang diisi langsung oleh responden. Hasil analisis menunjukkan bahwa …

Faktor Kontributor Prevalensi Stunting: Studi Kasus Jawa Timur Tahun 2022, Sofiyulloh Sofiyulloh, Martya Rahmaniati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Malnutrisi, termasuk stunting, masih menjadi masalah kesehatan yang mempengaruhi kemajuan pembangunan berkelanjutan. Stunting, akibat kekurangan gizi berkepanjangan dan infeksi berulang, menghambat pertumbuhan anak. Di Indonesia, prevalensi stunting pada tahun 2022 adalah 21,6% dan masih belum mencapai target. Dan Jawa timur, angka stunting di 2022 adalah 19,2%, mendekati angka nasional pun masih belum mencapai target. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berkontribusi terhadap stunting di Jawa Timur, dengan fokus pada faktor soial ekonomi dan kesehatan. Data sekunder dari Kementerian Kesehatan, dan Dinas Kesehatan Jawa Timur dianalisis menggunakan uji korelasi. Hasil menunjukkan bahwa Indeks Pembangunan Manusia (IPM) dan rata-rata lama sekolah memiliki …

Keunggulan Dan Tantangan Dalam Penggunaan Computer Vision Untuk Diagnosis Pneumonia Pediatri: A Systematic Review, Hafshah Farah Fadhilah, Rico Kurniawan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Pneumonia pediatrik merupakan penyebab utama kematian anak-anak di bawah usia lima tahun. Teknologi computer vision menawarkan potensi besar untuk meningkatkan diagnosis pneumonia pediatrik dengan menganalisis gambar radiografi dada secara otomatis. Penelitian ini menggunakan metode systematic literature review dengan pendekatan PRISMA, meninjau artikel dari database IEEE Xplore, Science Direct, dan Scopus yang diterbitkan antara tahun 2020 hingga 2024. Studi ini menemukan bahwa algoritma deep learning seperti Convolutional Neural Networks (CNN) menunjukkan akurasi tinggi dalam diagnosis pneumonia pediatrik. Namun, tantangan seperti kebutuhan akan data berkualitas tinggi, interpretasi hasil AI, dan integrasi teknologi ini dengan sistem kesehatan yang ada masih perlu diatasi. Penggunaan …

Telemedicine Adoption In Developing Economies: A Systematic Review On The Enablers And Barriers, Zaidbren Macabato, Lemuel Clark Velasco, Art Brian Escabarte, Mae-Lanie Ong Poblete, Armando Isla Jr., Rentor Cafino, Sarah Lizette Aquino-Cafino, Frevy Teofilo-Orencia

Kesmas

Telemedicine’s adoption has been effective in certain contexts despite being controversial in certain settings because of its tendency to cause misdiagnosis and concerns about data privacy. This study aimed to synthesize the research findings on the factors leading to the adoption of telemedicine among developing economies. The study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology to analyze 27 related literature and the Unified Theory of Acceptance and Use of Technology to map out the factors considered enablers and barriers in adopting telemedicine. Results showed that performance expectancy, effort expectancy, social influence, and facilitating conditions were significant predictors. …

Gut Microbiota Profiling In Injection Drug Users With And Without Hiv-1 Infection In Puerto Rico, Nirosh Aluthge, Seidu Adams, Carmen A. Davila, Nova R. Gocchi Carrasco, Kathy S. Chiou, Roberto Abadie, Sydney J. Bennett, Kirk Dombrowski, Angel M. Major, Aníbal Valentín-Acevedo, John T. West, Charles Wood, Samodha C. Fernando

School of Medicine Faculty Publications

INTRODUCTION: The full extent of interactions between human immunodeficiency virus (HIV) infection, injection drug use, and the human microbiome is unclear. In this study, we examined the microbiomes of HIV-positive and HIV-negative individuals, both drug-injecting and non-injecting, to identify bacterial community changes in response to HIV and drug use. We utilized a well-established cohort of people who inject drugs in Puerto Rico, a region with historically high levels of injection drug use and an HIV incidence rate disproportionately associated with drug use. METHODS: Using amplicon-based 16S rDNA sequencing, we identified amplicon sequence variants (ASVs) that demonstrated significant variations in the …

Nature Healing Mental Stress: What U.S. Healthcare Can Learn From Other Nations, Shannon Frank-Richter, Lindsay Gietzen

Pacific Journal of Health

The United States healthcare system lags many developed nations in healthcare access and practices, especially surrounding ecotherapy [1]. Ecotherapy is the practice of mindfulness in tandem with intentional immersion among natural spaces or with natural elements. Research from Asia, Europe and Canada indicate immense benefits from ecotherapy, or mindful nature immersion, as an effective treatment for burnout and stress. By adopting regular nature engagement, the U.S. could significantly improve mental health and reduce occupational stress. This literature review examines how nature immersion, especially with mindfulness, positively affects the brain and nervous system. Key components in nature are identified, such as …

Who Cares For The Caregiver? Exploring Extension’S Role In Informal Caregiving Support, Mckenzie R. Tuttle, Erin L. Martinez, Aimee Fox

Journal of Extension

Family caregivers provide invaluable service by taking on the responsibility of caring for older adults in the United States. With a growing aging population, the need for family caregivers and demands on their time and resources will continue to increase. Although a variety of caregiving resources and support services exist, family caregivers often lack the awareness, time, transportation, or financial resources to connect to services. There is a critical need to address the barriers that prevent caregivers from accessing services. In this commentary, we highlight barriers and make recommendations for improving conversations, research, and practice to meet this growing problem.

A Case Study On The Impact Of An Adapted Community Jury In Shaping The Nutrition Standards For Hospital Menus In New South Wales Australia, Tara L. Dimopoulos-Bick, Melanie Schier, Kim Crawley, Kim Sutherland

Patient Experience Journal

Community juries are a form of deliberative democracy and can engage community groups in decision-making about healthcare and service delivery issues and priorities. They can provide insights and value-based perspectives from community groups and are particularly important in resolving perennial and complex system challenges. One such challenge is nutrition in hospitals–where there is a need to balance nutrition support, variety, taste and cost. The New South Wales (NSW) public health system in Australia operates more than 200 public hospitals. When revising the Nutrition Standards in 2021, stakeholders debated the upper limits of sodium (salt) and saturated fat in food products …

Factors Influencing Patient Satisfaction With Zambia's National Health Insurance Scheme: A Systematic Literature Review Using Empirical Evidence From Nigeria And Ghana, Wesley Kapaya Mwambazi, Abubaker Qutieshat

Patient Experience Journal

Universal Health Coverage (UHC) has become important for African nations as they strive to provide equitable healthcare access to all citizens. Implementing a successful National Health Insurance Scheme (NHIS) is crucial to achieving this goal. In pursuit of achieving UHC, Zambia launched the NHIS in 2019 with the ambitious goal of reaching 100% coverage by 2021. Some of those enrolled had reported varying levels of satisfaction with the NHIS services. Understanding patient satisfaction with NHIS-provided services is therefore essential for improving its implementation and enhancing NHIS patient satisfaction. Following PRISMA guidelines, a systematic review of empirical studies from Nigeria and …

Quality Of Outpatient Care In Lebanon: A Cross-Sectional Survey, Georges Choueiry, Anna Maria Henaine, Rayan Darwish, Pascale Salameh

Patient Experience Journal

Patient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average …

An Exploratory Qualitative Study Of Perinatal Experiences In An Acute Setting During Early Phases Of The Covid-19 Pandemic, Sharon Hoosein, Pamela Winchester, Stephanie Babinski, Naomi Smith, Payalben Bhavsar, Susan Law

Patient Experience Journal

The COVID-19 pandemic was highly disruptive for people delivering babies in-hospital and for obstetrical healthcare professionals. The purpose of this study was to explore the experiences of people with or without COVID-19 giving birth in a community-based hospital to provide patient insight to obstetrical care providers regarding the services/policies used during the pandemic. Nine interviews were conducted with participants within six months of giving birth in-hospital – four who tested positive for COVID-19 and five who tested negative. Seven themes were identified in the analysis: conflicting emotions; experiences of COVID-related protocols; altered experiences of pregnancy and birth; other aspects of …

Co-Developing A Paediatric Patient Reported Experience Measure: The Perspectives Of Children And Young People, Karlen R. Barr, Jessica Nikolovski, Les White, Sarah Elliott, Lynn Mccartney, Claire Treadgold, Barb Vernon, James R. John, Valsamma Eapen

Patient Experience Journal

NOTE: A minor correction was made to this article. It was revised on August 6, 2025.

Paediatric Patient Reported Experience Measures (PREMs) are tools that capture what children and young people (CYP) value in their healthcare and promote their involvement in clinical decision-making. A standardised paediatric PREM could improve quality of care for CYP across hospital settings, but CYP are rarely included in the development of PREMs. This study aimed to explore CYP's perspectives regarding their experiences of hospitals as the initial stage of developing the first self-reported paediatric PREM for use in Australia, including the perspectives of vulnerable populations. …

A Qualitative Evaluation Of Huntington’S Disease Perspectives On Social Media, Paige Conrad, Heather Sterchele, Ryan Wong, Sahar Sarrami Amini

HCA-NSU MD Research Day

A Qualitative Evaluation of Huntington’s Disease Perspectives on Social Media Paige Conrad OMS-III Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Heather Sterchele OMS-III Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Ryan Wong OMS-III Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Sahar S Amini D.O. Objective: The objective of this study is to qualitatively examine the content of the most watched videos related to HD on the social media application Tik Tok and explore how social media is being utilized to discuss the disease. Background: Huntington’s Disease (HD) is a neurodegenerative disorder …

Short-Term Effects Of Opioids During Therapeutic Hypothermia For Neonatal Encephalopathy, Tina Jumani, Priya Mishra, Tonya Robinson, Jeffrey Shenberger, Jonathan Davis, Benjamin Sweigart, Rodica Turcu

Department of Pediatrics Faculty Papers

OBJECTIVE: To examine the effects of opioids during therapeutic hypothermia (TH) on short-term outcomes in neonates with neonatal encephalopathy (NE).

METHODS: Multicenter retrospective study of neonates with moderate/severe NE from Jan. 2013-Feb 2021. Opioid exposure was classified as positive (>0.1 mg/kg) or negative (no exposure or ≤0.1 mg/kg) based on cumulative morphine milligram equivalents (MME). Negative binomial regression models were used to evaluate clinical outcomes.

RESULTS: One hundred and twenty neonates were included. Adjusted analyses indicated that opioid exposure was associated with an increase in (1) length of hospitalization, (2) hypotension/use of vasopressors, and (3) need for and longer …

A Contemporary Review Of Robotic Resection For Hepatocellular Carcinoma, William A. Preston, Nina R. Spitofsky, Adam S. Bodzin

Department of Surgery Faculty Papers

Background: Robotic hepatectomy represents an appealing treatment modality for resectable hepatocellular carcinoma (HCC). A contemporary review of robotic hepatectomy compared to laparo- scopic/open hepatectomy is necessary. Methods: We performed a literature review to identify studies between 2018–2024 comparing robotic to laparoscopic/open hepatectomy for HCC with measurable outcomes. Results: A total of 10 studies were identified, including 943 patients undergoing robotic hepatectomy compared to 1678 patients undergoing laparoscopic/open hepatectomy. Generally, while similar short/long-term survival was noted across all resection modalities, robotic hepatectomy was associated with longer operative time, shorter length of stay, and less post-operative compli- cations. An additional 4 studies …