Health Services Research Commons^™

La Medicina Alternativa En Oaxaca: Su Coexistencia Con La Medicina Alópata, Katie Deeg

Independent Study Project (ISP) Collection

En este ensayo exploro la coexistencia entre la medicina alternativa y la alópata en Oaxaca y determino que, dada la relevancia cultural de la medicina alternativa y el estatus deficiente de la salud y servicios médicos en el estado, la promoción de la medicina alternativa es importante para ayudar a la gente a alcanzar la mejor calidad posible de salud. Primero presento una definición de la medicina alternativa dentro del contexto de Oaxaca y describo su presencia en Oaxaca. Considerando la naturaleza de la coexistencia entre la medicina alternativa y alópata, presento mis descubrimientos sobre la importancia de usar los …

Access To Mental Health Services And Family Impact Of Rural Children With Mental Health Problems, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, David Lambert Phd, Melanie M. Race Ms, Anush Yousefian Hansen Ms, Ma

Mental Health / Substance Use Disorders

Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care. This working paper and policy brief provide information on prevalence …

Regional Collaborations As A Way Forward For Maternal, Newborn And Child Health:The South Asian Healthcare Professional Workshop, Jennifer H. Requejo, Kadidiatou Toure, Zulfiqar Ahmed Bhutta, Imtiaz Katz, Shahida Zaidi, Andres De Francisco

Woman and Child Health

This article reviews the importance of regional initiatives in the context of global efforts to achieve the Millennium Development Goal 4 and 5 and describes the action-oriented multi-country healthcare professional association (HCPA) workshops organized by the Partnership for Maternal, Newborn and Child Health. The South Asian HCPA workshop served as a catalyst for strengthening the ability of HCPAs in South Asian countries to organize and coordinate their activities effectively, play a larger role in national planning, and collaborate with other key stakeholders in maternal, newborn and child health.

Public Health Insurance Utilization In New York City, 2008, Rachael Varra

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines demographic and socioeconomic factors of racial/ethnic groups in New York City between as of 2008 – particularly the utilization of public health insurance (PHI) benefits.

Methods: Data on Latinos and other racial/ethnic groups were obtained from the U.S. Census Bureau American Community Survey, reorganized for public use by the Minnesota Population Center, University of Minnesota, IPUMSusa. Cases in the dataset were weighted and analyzed to produce population estimates.

Results: Of the 25% of New Yorkers receiving PHI in 2008, the absolute number of whites, blacks and Latinos receiving PHI was similar. However, greater proportions of Latinos …

The Primary Care Safety Net: Strained, Transitioning, Critical, Jessamyn Taylor

National Health Policy Forum

This background paper examines the primary care safety net. It describes key primary care safety net providers, including federally qualified health centers, free clinics, local health departments, and safety net hospital outpatient departments and clinics, among others. The paper also explores the changing role of the primary care safety net in a post–health reform marketplace.

High Hopes: Public Health Approaches To Reducing The Need For Health Care, Michele J. Orza

National Health Policy Forum

Driven in part by a desire to contain health care costs, policymakers are looking beyond medical care for opportunities to reduce the need for expensive services. This paper briefly reviews current public health concepts and strategies for improving health that emphasize nonmedical factors such as behavior, socioeconomic status, and environment. It also provides examples of how these concepts and strategies undergird many of the public health provisions of the Patient Protection and Affordable Care Act, other legislation, and several programs and initiatives. These concepts include prevention, health in all policies, global health, the One Health Initiative, and climate change and …

Using Hospital Discharge Abstract Data To Identify Incident Breast Cancer Cases And Assess Quality Of Care, Elaine J. Yuen, Daniel Z. Louis, Carol Rabinowitz, Vittorio Maio, L. Cisbani, R. Depalma, R. Grilli

College of Population Health Faculty Papers

No abstract provided.

The Importance Of Examining Movements Within The Us Health Caresystem: Sequential Logit Modeling, Chioun Lee, Stephanie L L. Ayers, Jennie Jacobs Kronenfeld, Jemima A. Frimpong, Patrick A. Rivers, Sam S. Kim

Dartmouth Scholarship

Utilization of specialty care may not be a discrete, isolated behavior but rather, a behavior of sequential movements within the health care system. Although patients may often visit their primary care physician and receive a referral before utilizing specialty care, prior studies have underestimated the importance of accounting for these sequential movements. The sample included 6,772 adults aged 18 years and older who participated in the 2001 Survey on Disparities in Quality of Care, sponsored by the Commonwealth Fund. A sequential logit model was used to account for movement in all stages of utilization: use of any health services (i.e., …

Prevalence, Knowledge And Care Patterns For Gastro-Oesophageal Reflux Disease In United States Minority Populations., Elaine Yuen, Martha Romney, Richard W. Toner, Nicole M. Cobb, Philip O. Katz, Maya Spodik, Neil I. Goldfarb

College of Population Health Faculty Papers

BACKGROUND: While there is evidence of ethnic variation in the prevalence of gastro-oesophageal reflux disease (GERD) symptoms, few population-based studies examine GERD symptom prevalence amongst the growing Hispanic minority in the US as well as Asians in the West. AIM: To examine the prevalence, awareness and care patterns for GERD across different ethnic groups.

METHODS: A population-based, cross-sectional survey was fielded in English, Chinese and Spanish that assessed self-reported GERD prevalence, awareness and care patterns in four ethnic groups (Caucasian, African American, Asian, Hispanic).

RESULTS: A total of 1172 subjects were included for analysis: 34.6% experienced GERD symptoms at least …

Time Will Tell: Community Acceptability Of Hiv Vaccine Research Before And After The "Step Study" Vaccine Discontinuation, Paula M. Frew, Mark J. Mulligan, Su-I Hou, Kayshin Chan, Carlos Del Rio

Environmental & Global Health Faculty Research

Objective This study examines whether men-who-have-sex-with-men (MSM) and transgender (TG) persons’ attitudes, beliefs, and risk perceptions toward human immunodeficiency virus (HIV) vaccine research have been altered as a result of the negative findings from a phase 2B HIV vaccine study. Design We conducted a cross-sectional survey among MSM and TG persons (N = 176) recruited from community settings in Atlanta from 2007 to 2008. The first group was recruited during an active phase 2B HIV vaccine trial in which a candidate vaccine was being evaluated (the “Step Study”), and the second group was recruited after product futility was widely reported …

One And Only Campaign Nevada Evaluation Of Educational Materials For Injection Safety Executive Summary, Nevada Institute For Children’S Research And Policy, School Of Community Health Science, University Of Nevada, Las Vegas, Amanda Haboush, Tara Phebus, Kari Wolkwitz, Denise Tanata Ashby, Enrique Lopez, Christopher M. Aquino, Sheila Clark

Nevada Institute for Children's Research and Policy Reports

The goal of the evaluation was to measure the effectiveness of the Campaign’s educational materials in raising awareness among the general public and enhancing the knowledge of healthcare personnel. Through this measurement the evaluation results would then also provide recommendations for improvements to the materials. To achieve these goals the evaluation team at NICRP created a strategic dissemination plan designed to support a formal evaluation of messages within the materials, message delivery and general knowledge and understanding of safe injection practices by both providers and the general public. Methods utilized to conduct this evaluation included:

• Surveys of both patients and …

Governmental Public Health: An Overview Of State And Local Public Health Agencies, Eileen Salinsky

National Health Policy Forum

The Patient Protection and Affordable Care Act significantly expands federal support for community prevention and public health. This paper describes the governmental public health infrastructure at both the state and local level in terms of organizational structure, activities, financing, workforce, partnerships, and performance improvement efforts.

Chhs August Enewsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

2009 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

In an effort to identify risk factors and prevent future child deaths, in 1992 the State of Nevada joined many other states in mandating Child Death Review Teams. Since that time, both the law and the regional teams throughout Nevada have evolved to facilitate the growing need for collaborative efforts to identify interventions necessary to reduce the rate of child deaths in Nevada. While the primary legislative focus of Nevada Child Death Review Teams has been on addressing fatalities related to child maltreatment and/or involvement with the child welfare system, the teams have expanded their focus to address risk factors …

Assessing Mississippians’ Preparedness For Disasters Using The Citizen Corps National Survey 2009, Carl Huston Mangum Ii

Dissertations

Disaster preparedness, a shared responsibility of all citizens and disaster agencies, is the most critical component in minimizing risk and damage from disaster. Mississippi has been affected by some of the most devastating disasters in American history, both in terms of physical destruction and human life. The purpose of this study was to assess Mississippians’ disaster preparedness by replicating The 2009 Citizen Corps National Survey (CCNS). The 65 question 2009 CCNS was slightly modified to survey 678 randomly selected Mississippians about the Citizen Corps Personal Disaster Preparedness Model: Demographics, Volunteering, Drills/Exercises, Community Plan, Household Plan, Disaster Supplies, Prevention, Self-efficacy, Reliance, …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit

National Health Policy Forum

Medicare’s physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians’ incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS’s methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective ”counterweight” to vested interests in establishing and updating the …

Tapping The Potential Of The Health Care Workforce: Scope-Of-Practice And Payment Policies For Advanced Practice Nurses And Physician Assistants, Robert Cunningham

National Health Policy Forum

Expanding coverage and increasing delivery of team-based care are likely to entail a growing role in the
health system for advanced practice nurses (APNs), physician assistants (PAs), and other nonphysician clinicians. These professions have already grown rapidly and have increased access to primary and specialty care, especially in rural and other underserved areas. This background paper provides an overview of the role of APNs and PAs. It reviews the primary features of the training and credentialing of these health professions, including the impact of public policies and market forces on their growth and deployment. It describes variations in state scope-of-practice …

Clinical And Economic Impact Of Infusion Reactions In Patients With Colorectal Cancer Treated With Cetuximab., K A Foley, P F Wang, B L Barber, S R Long, J E Bagalman, V Wagner, X Song, Z Zhao

College of Population Health Faculty Papers

BACKGROUND: Systemic agents in cancer treatment were often associated with possible infusion reactions (IRs). This study estimated the incidence of IRs requiring medical intervention and assessed the clinical and economic impacts of IRs in patients with colorectal cancer (CRC) treated with cetuximab.

PATIENTS AND METHODS: Details on patients with CRC receiving cetuximab in 2004-2006 were extracted from a large USA administrative claims database. IRs were identified based on the occurrence of outpatient treatment, emergency room (ER) visit, and/or hospitalization for hypersensitivity and allergic reactions. Multivariate regressions were used to examine potential risk factors and quantify the economic impact of IRs. …