Health Services Research Commons^™

Patient And Provider Experience With Artificial Intelligence Screening Technology For Diabetic Retinopathy In A Rural Primary Care Setting, Brian M. Nolan, Emma R. Daybranch, Kerri Barton, Neil Korsen

Journal of Maine Medical Center

Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.

Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.

Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified …

Cost Effectiveness Of Buprenorphine When Used Long Term Versus Short Term Use, Ty Hudgens

MUSC Theses and Dissertations

Since 1999, nearly 841,000 people have died from a drug overdose (CDC, 2022), and substance use disorder (SUD) continues to be a crisis that faces communities across the country. As the crisis continues across communities, the need for medication-assisted opioid use disorder (MOUD) therapy continues to surge.

This was a retrospective analysis of archival data from large national data sources. We constructed well-matched cohorts of patients with short and long-term use of MOUD using propensity score matching of 3 months of baseline data. To measure the cost effectiveness of short-term buprenorphine use verse long-term buprenorphine use.

Evaluating Pulp Therapy Provided By Medicaid-Participating Pediatric And General Dentists In Georgia From 2010-2019, Michelle Zin, Beau Meyer, Michael Milano

Journal of the Georgia Public Health Association

Abstract

Background: The purpose of this study was to evaluate reimbursable pulp therapy trends in primary teeth performed by general and pediatric dentists.

Methods: Aggregate Medicaid claims data from 2010-2019 were obtained from the state of Georgia’s Department of Community Health. Two different primary dentition pulp therapy rates were compared between general and pediatric dentists: procedures per provider and children treated per provider. Descriptive statistics, poisson regression, and correlational analysis were performed.

Results: Pulp therapy utilization for procedures per provider and children treated per provider decreased (Incidence rate ratio (IRR)=0.97, 95% confidence interval (CI): 0.95 to 0.99; …

Combating Long-Term Care Isolation Through Healing Touch, Veronica J. Butts

ONU Student Research Colloquium

Loneliness is defined as feelings of disconnectedness, lack of belonging, and perceived isolation that can manifest as a physical or psychological state. In long-term care facilities, this sentiment can develop into social isolation in which residents are disconnected from family, removed from familiar environments, and suffer from various cognitive conditions that cause them to socially withdraw. Various clinical studies seek to identify the connection between isolation, loneliness, and lack of human touch with worsening health conditions and outcomes, determining that there is a correlation between this feeling of discontent. To combat this, healing touch has been a rising topic of …

Patients And Families As Partners In Patient-Oriented Research: How Should They Be Compensated?, Monika Novak-Pavlic, Jan Willem Gorter, Michelle P. Phoenix, Samantha K. Micsinszki, Kinga Pozniak, Lin Li, Linda Nguyen, Alice K. Soper, Elaine Yuen Ling Kwok, Jael N. Bootsma, Francine Buchanan, Hanae Davis, Sandra Abdel Malek, Karen M. Van Meeteren, Peter L. Rosenbaum

Journal of Patient-Centered Research and Reviews

Patient and family engagement has become a widely accepted approach in health care research. We recognize that research conducted in partnership with people with relevant lived experience can substantially improve the quality of that research and lead to meaningful outcomes. Despite the benefits of patient-researcher collaboration, research teams sometimes face challenges in answering the questions of how patient and family research partners should be compensated, due to the limited guidance and lack of infrastructure for acknowledging partner contributions. In this paper, we present some of the resources that might help teams to navigate conversations about compensation with their patient and …

Increasing Covid-19 Vaccination Coverage For Newcomer Communities: The Importance Of Disaggregation By Language, Abigail Steiner, Kristine Knuti Rodrigues, Nadège Mudenge, Janine Young, Rasulo Rasulo, Colleen Payton, Malini Desilva, Jeremy Michel, Mary Fabio, Katherine Yun

College of Population Health Faculty Papers

The COVID-19 pandemic has disproportionately affected refugee, immigrant, and migrant populations. Vaccines are essential for decreasing transmission and severity of COVID-19 infection. Understanding differences in vaccination coverage based on preferred language is crucial for focusing efforts to decrease COVID-19-related disparities. Four sites in the Minnesota Center of Excellence in Newcomer Health collaboratively evaluated completion of primary COVID-19 vaccination series on or before December 31, 2021, for patients who were 12 years or older on June 30, 2021, by preferred language. The non-English/non-Spanish speaking population included 46,714 patients who spoke 174 languages; COVID-19 vaccination coverage by language ranged from 26.2% to …

Overview: Bias In-Bias Out In Data Science, Allison C. Augustus-Wallace

School of Medicine Faculty Publications

DiscoverBMB, March 25 - 28, 2023, Seattle, WA

Precision Medicine, Ancestry, Genetics And Race, Lucio Miele

School of Medicine Faculty Publications

DiscoverBMB, March 25 - 28, 2023, Seattle, WA

Prevalence And Beliefs Associated With Vaccine Hesitancy Among Muslim-Americans, Marina Ali

Health and Kinesiology Theses

Background. Vaccine hesitancy hinders the eradication of preventable illnesses. Furthermore, there are gaps in public health research on vaccine hesitancy among Muslims in heterogenous societies.

Objective. This study aimed to determine whether socioeconomic demographics, political beliefs and trust in public institutions were associated with vaccine hesitancy beliefs. Additionally, two models were applied to determine which factors had the strongest influence in rejecting vaccines.

Method. Participants were recruited through Facebook group posts. Seventy-three responses were received. Sixty-three responses met the inclusion criteria and were included in the final analysis. Participants rated their opinions on political beliefs, religious practices, trust in institutions …

Oral Health In Relation To The Covid-19 Pandemic, Anika L. Gram

Honors Thesis

Oral health has seen significant changes through the Covid-19 pandemic. Many people experienced the lifestyle alteration of wearing a mask for a major portion of their day-to-day life, and some went to the dentist significantly less than they did pre-pandemic. The literature review explores dental practices during the Covid-19 pandemic. It also examines mask-wearing behaviors both before and during the pandemic and the research that has been conducted previously regarding the potential effects of mask-wearing. Despite the decrease in use of masks post-pandemic, many healthcare professionals continue to wear masks daily. Additionally, in the event of future disease outbreak, it …

Accuracy Of Therapeutic Drug Monitoring In Vancomycin And The Pharmacist Role: A Retrospective Case-Series, Kateryna Parkhomenko

Senior Theses

Vancomycin is a mainstay of therapy for treating virulent and resistant infections, especially methicillin-resistant Staphylococcus aureus (MRSA). However, vancomycin requires therapeutic drug monitoring (TDM) for optimal dosing and treatment. This requires pharmacists to calculate a dosing regimen that correlates to appropriate goal vancomycin concentrations in the blood. Dosing vancomycin can be difficult, as it varies on a patient’s weight, renal function, age, etc. Doses may have to be adjusted in response to out-of-range concentrations, which requires further pharmacy calculations. Inaccurate dosing poses a risk to patient safety and places a resource and time burden on pharmacists. If vancomycin dosing methods …

Fear Of Recurrence, Emotional Well-Being And Quality Of Life Among Long-Term Advanced Ovarian Cancer Survivors, Kathryn Osann, Lari Wenzel, Chelsea Mckinney, Lynne Wagner, David Cella, Giulia Fulci, Mary J Scroggins, Heather A Lankes, Victoria Wang, Kenneth P Nephew, George L Maxwell, Samuel C Mok, Thomas P Conrads, Austin Miller, Michael Birrer

Faculty, Staff and Student Publications

OBJECTIVE: Although advanced stage epithelial ovarian cancer is widely considered life-threatening, 17% of women with advanced disease will survive long-term. Little is known about the health-related quality of life (QOL) of long-term ovarian cancer survivors, or how fear of recurrence might affect QOL.

METHODS: 58 long-term survivors with advanced disease participated in the study. Participants completed standardized questionnaires to capture cancer history, QOL, and fear of recurrent disease (FOR). Statistical analyses included multivariable linear models.

RESULTS: Participants averaged 52.8 years at diagnosis and had survived >8 years (mean:13.5); 64% had recurrent disease. Mean FACT-G, FACT-O, and FACT-O-TOI (TOI) scores were …

Cancer Patient And Provider Responses To Companion Scales Assessing Experiences With Lgbtqi-Affirming Healthcare, Mandi L. Pratt-Chapman, Yan Wang, Gwendolyn P. Quinn, Sylvia Shirima, Sarah Adler, Ruta Brazinskaite, Asa Radix, Barbara Warren, Kristen Eckstrand, Ana Maria Lopez

Department of Medical Oncology Faculty Papers

Background: Sexual and gender minority (SGM) persons are at a higher risk for some cancers and may have poorer health outcomes as a result of ongoing minority stress, social stigma, and cisnormative, heteronormative healthcare environments. This study compared patient and provider experiences of affirming environmental and behavioral cues and also examined provider-reported knowledge, attitudes, behaviors, and clinical preparedness in caring for SGM patients among a convenience sample.

Methods: National convenience samples of oncology providers (n = 107) and patients (n = 88) were recruited separately via snowball sampling. No incentives were provided. After reverse coding of appropriate items for unidirectional …

Exploring Communication In Healthcare Through Decision-Making Interventions And A Novel Measure Of Clinician Spoken Plain Language, Renata W. Yen

Dartmouth College Ph.D Dissertations

Statement of the Problem

Good communication in clinical encounters is a key component of quality healthcare. Improving clinician communication would benefit all populations, however patients with lower health literacy or who are socially disadvantaged stand to benefit the most due to the complex content in clinical encounters. Shared decision-making can improve outcomes, but shared decision-making cannot occur without good clinician communication. In this dissertation, I reviewed interventions for facilitating shared decision-making for socially disadvantaged patients. Then, I examined the use of spoken plain language, or clinician use of familiar, clear verbal language when communicating with patients, and developed a prototype …

Effects Of The Needle Exchange Program And Its Current Status In West Virginia, Thomas Norton, Amber Graves, Anthony Uriarte, Katherine Duty, Alberto Coustasse

Management Faculty Research

Excerpt:

One of the main problems that have impacted the state of healthcare in West Virginia has been the rising costs of treatments for bloodborne infections (Bates et al., 2019). Bloodborne pathogens and their resulting diseases have commonly spread by exchanging contaminated needles (Denault & Gardner, 2021). In West Virginia, Needle Exchange Programs (NEPs) have been implemented to reduce the transmission of certain infections, such as HIV, hepatitis B, and hepatitis C, which have been more common among drug users (Beck & Kersey, 2018). In 2015, West Virginia had the second-highest rate of cases of hepatitis C Virus (HCV) in …

Rural Working-Age Adults Report More Cost Barriers To Health Care, Erika C. Ziller Phd, Carly Milkowski Mph, Amanda Burgess Mppm, Mph

Access / Insurance

Using the 2019-2020 National Health Insurance Survey, researchers at the Maine Rural Health Research Center examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults. Rural adults (18-64) were more likely than their urban counterparts to report problems paying, or being unable to pay, their medical bills. They were also more likely to delay or go without needed care because of the cost. Compared with urban adults, those in rural areas were more likely to engage in prescription drug cost-saving measures such as skipping doses, delaying refills, or taking less medication than prescribed. For all affordability measures, …

Sexual Behaviors, Contraception Use And Barriers Among Adolescents And Young Adults In Rural Haiti., Abbey R. Masonbrink, Emily A. Hurley, Nikolaus Schuetz, Jonathan Rodean, Emily Rupe, Kemi Lewis, Marie Daphnée Boncoeur, Melissa K. Miller

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Adolescents and young adults (AYAs) in Haiti experience a high unintended pregnancy rate, in part due to unmet contraception needs. Little is known about AYA opinions of and experiences with contraception that may explain remaining gaps in coverage. We aimed to describe barriers and facilitators to contraception use among AYAs in Haiti.

METHODS: We conducted a cross-sectional survey and semi-structured qualitative interviews with a convenience sample of AYA females aged 14-24 in two rural communities in Haiti. The survey and semi-structured interviews assessed demographics, sexual health and pregnancy prevention behaviors and explored contraception opinions and experiences according to Theory …

Exploration Of Data Science Toolbox And Predictive Models To Detect And Prevent Medicare Fraud, Waste, And Abuse, Benjamin P. Goodwin, Adam Canton, Babatunde Olanipekun

SMU Data Science Review

The Federal Department of Health and Human Services spends approximately $830 Billion annually on Medicare of which an estimated $30 to $110 billion is some form of fraud, waste, or abuse (FWA). Despite the Federal Government’s ongoing auditing efforts, fraud, waste, and abuse is rampant and requires modern machine learning approaches to generalize and detect such patterns. New and novel machine learning algorithms offer hope to help detect fraud, waste, and abuse. The existence of publicly accessible datasets complied by The Centers for Medicare & Medicaid Services (CMS) contain vast quantities of structured data. This data, coupled with industry standardized …

Impact Of A Health Fair On Student Organizations Providing Care To The Detroit Hispanic/Latinx Community And Barriers Affecting Patients Of A Student-Run Clinic Primarily Serving This Population, Amanda Rodriguez Bs, Lucas Edgren Bs, Sanjana Rao Bsph, Diane L. Levine Md, Jennifer Mendez Phd, Joel Appel Do

Medical Student Research Symposium

Current literature shows Hispanic/Latinx populations in the U.S. face health inequities. Amigos Medicos (AM) Clinic, located in Southwest Detroit, is a student-run free clinic that addresses these issues through preventive health screenings. We hosted a health fair in 2022 and invited other student organizations in efforts to connect the community to resources. Our aim is to identify specific barriers faced by our population in receiving health care and to identify the impact of participation in the fair on those organizations. One survey was administered to patients attending clinic that identified health barriers they face. The other survey was administered to …

The Role Of Vigorous And High Intensity Interval Training Physical Activity Counseling In Prenatal Care, Emily Lau, Brendan T. Lynch, Sonia Hassan

Medical Student Research Symposium

Background: Physical activity is becoming a more common component of preventative medicine and patient counseling; however, the prevalence of physical activity counseling and specific social determinants of health have prevented women, namely prenatal patients, from receiving this counseling from their providers¹. Physical activity, including high intensity interval training (HIIT), has been shown to be feasible for implementation in patient counseling³ and shown to be safe for pregnant women, even into the third trimester². We hypothesize that the current percentage of patients, including prenatal patients, being counseled on physical activity is lacking. In addition, we hypothesize …