Health Services Research Commons^™

Health Expectations, Risk Tolerance, And Walking In Peripheral Artery Disease-Related Claudication, Sherene Sharath, Panos Kougias, Neal Barshes

Journal of Social, Behavioral, and Health Sciences

We examined the association between health expectations, baseline physical activity, and self-reported symptom severity among patients with claudication: calf pain that occurs during walking and is relieved at rest. Beliefs and attitudes toward exercise influence the behavior. When walking is prescribed as an alternative to surgical intervention with the intention of decreasing symptom severity, as is the case with claudication, it is important to assess patient perceptions, beliefs, and expectations. Through a phone survey, participants described the severity of their symptoms via the Walking Impairment Questionnaire. Data were collected on (1) health expectations and attitudes, assessments of value placed on …

Violence Against Healthcare Workers: An Epidemic Within A Pandemic, Michaela Ramandanes

College of Health Sciences Posters

Violence and harassment towards healthcare workers has been an underlying problem throughout history. However, with the rapid and evolving onset of the COVID-19 pandemic, the risks that healthcare workers face has been a focal topic of discussion among administration, staff and the public. What was once considered an occupational hazard is now being raised as a public health issue- an epidemic within a pandemic. This literature review seeks to identify the prevalence and causes of violence and harassment towards healthcare workers. Was healthcare violence as prevalent before COVID-19? Has violence increased because patient volume increased? Additionally, this review will determine …

Understanding The Mental And Emotional Impacts Of Being A Caregiver Of Socially Isolated Residents During The Covid-19 Pandemic, Chloe Kerrick

Mahurin Honors College Capstone Experience/Thesis Projects

The mental health and emotional wellbeing of individuals has declined in many ways over the course of the COVID-19 pandemic. Some groups have seen more drastic changes in their mental health and emotional wellbeing, especially those working in healthcare. While nearly all healthcare facility workers have experienced an increased burden brought about by the pandemic, long-term care facility workers have been tasked with caring for clients that, for periods of time, experienced complete social isolation. This project will attempt to answer the question of how caring for a group of socially isolated residents over an extended period has affected the …

Prevalence And Determinants Of Home Delivery In Urban And Rural Philippines: Evidence From The 2017 National Demographic And Health Survey, Arianna Maever L. Amit, Veincent Christian F. Pepito, Sarah J. De Los Reyes, Clinton S. Tang, Neil Andrew K. Aliazas, Lourdes S. Tanchanco

Ateneo School of Medicine and Public Health Publications

Background: Women’s choice of place of delivery has implications on maternal and child mortality. This study aims to provide an updated and detailed comparison of prevalence and determinants of home delivery in the Philippines, and in urban and rural communities.

Methods: Based on data from the 2017 Philippine National Demographic and Health Survey (NDHS), we estimated the prevalence of home delivery and determined factors influencing women’s decision to deliver at home. Analyses were restricted to data from 7229 women who were cohabiting or married, and their last-born child using logistic regression methods for survey data.

Results: There remain a considerable …

Instrumental And Emotional Social Support Intention And Utilization Among Pregnant And Postpartum Women During The Covid-19 Pandemic, Gracie Minks

All Master's Theses

Postpartum depression impacts 1 in 7 women across the U.S. As a whole population, between 10-16% of women are impacted by maternal depression during pregnancy or the first year postpartum. Those who experience postpartum depression are at risk for repeated depressive episodes and a lower quality of life over time. The postnatal period may reflect the most vulnerable time for mental health concerns such as anxiety and depression. Fear, judgment, and perceived criticism are commonly named as barriers that delay the mobilization of support.

There is a prevailing perception that postpartum depression is a normal part of motherhood which may …

The Impact Of Covid-19 On Collaboration And Turnover Among State Health Leadership, Kaylee Gouge

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background/Objectives: State Health Officials (SHOs), the physician-leaders of state public health departments in the US, have long been indicated as potential peacemakers between the fields of medicine and public health. However, the average term length of SHOs has declined in recent years. Meanwhile, the COVID-19 pandemic has increased public visibility of state public health departments and their leadership. Some have hypothesized that the political strain of the pandemic has further accelerated SHO turnover, compromising their leadership efficacy. Contrarily, others have suggested that the pandemic would force public health and organized medicine into closer collaborative alignment through a common enemy. …

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

The 2019 Philippine Uhc Act, Pandemic Management And Implementation Implications In A Post-Covid-19 World: A Content Analysis, Maria Cristina G. Bautista, Paulyn Jean Acacio-Claro, Nori Benjamin Mendoza, Christian Pulmano, Ma. Regina Justina Estuar, Manuel Dayrit, Vincent Festin, Madeleine Valera, Quirino Sugon Jr, Dennis Andrew Villamor

Graduate School of Business Publications

The 2019 Philippine Universal Health Care Act (Republic Act 11223) was set for implementation in January 2020 when disruptions brought on by the pandemic occurred. Will the provisions of the new UHC Act for an improved health system enable agile responses to forthcoming shocks, such as this COVID-19 pandemic? A content analysis of the 2019 Philippine UHC Act can identify neglected and leverage areas for systems’ improvement in a post-pandemic world. While content or document analysis is commonly undertaken as part of scoping or systematic reviews of a qualitative nature, quantitative analyses using a two-way mixed effects, consistency, multiple raters …

Who's Included? A Systematic Review Of Socio-Demographics And Participant Recruitment Within The Investigation Of Periodontal Disease And Its Treatment Effect On Hemoglobin A1c, Jaclyn L. Johnson

All Master's Theses

Diabetes mellitus and periodontal disease are major global public health concerns. Within the United States (U.S.) over 34 million adults have diagnosed diabetes (Centers for Disease Control and Prevention [CDC], 2020a), and 64 million U.S. adults have periodontitis (American Academy of Periodontology [AAP], 2021a). Research has shown that persons with diabetes have a coinfection with periodontal disease at a rate between 2.6 and 2.9 times higher than persons without diabetes (Wang et al., 2014). Diabetes and periodontal disease collectively and disproportionately affect persons of low socioeconomic status (SES), age, and particular racial/ethnic identities (AAP, n.d.b; CDC, 2021; Connolly et al., …

Education And Awareness Of Workplace Hazards: An Educational Intervention For First Responder Trainees, Emily Portune

All Master's Theses

First responder paramedics, emergency medical technicians (EMTs), and firefighters provide emergency services to communities everywhere, often in life-threatening circumstances. At the same time, these first responders face high-stress life and death situations and may also endure unique workplace hazards like racism, sexual harassment and discrimination, verbal and physical patient assault, and extreme sleep deprivation. These hazards make prehospital providers vulnerable to mental illness, a fact proven by preexisting research that found more than 85% of first responders reported negative mental health symptoms and outcomes directly related to their career. Not only are prehospital providers at high risk of mental illness; …

Implementing Trauma-Informed Care Through A Multi-Agency Learning Collaborative: A Theory-Driven Analysis Of Outcomes And Sustainability, Mira D H Snider M.S.

Graduate Theses, Dissertations, and Problem Reports (ETD)

Learning collaboratives (LCs) are often used in large-scale implementation initiatives to promote evidence-based practice across provider networks. Although the outcomes and stakeholder perspectives of many LCs have been documented, support for the effectiveness of LCs is equivocal, and the means by which LCs achieve long-term improvements in clinical care are not understood. The current study investigated outcomes and sustainability of a multi-agency LC for implementing trauma-informed care in 23 rural Pennsylvania counties. Changes in outcomes (i.e., trauma symptom screening, trauma-informed care training attendance, clinician confidence with using trauma informed-care, utilization of trauma-related diagnostic codes, retention in service, service unit density) …

Screen Media Use Among Children And Adolescents – Applications Of Supervised And Unsupervised Machine Learning And Sentiment Analysis, Yifan Zhang

Graduate Theses, Dissertations, and Problem Reports (ETD)

Screen media has become increasingly pervasive in our everyday lives and has profoundly changed the way people communicate and interact with each other. However, we are still unclear about the long-term influence of screen media use on our physical health, mental health, and social wellbeing. Children and adolescents are in an important stage of brain development and are susceptible to the environmental influence that screen media possess. This dissertation pursued three aims to address research gaps related to screen media use among children and adolescents: 1) identify topics and knowledge gaps in screen media use research among children and adolescents …

Incidence Of Cancer, Depression, And Economic Burden Of Prescription Nsaids Among Older Adults With Osteoarthritis: Statistical And Machine Learning Approaches, Nazneen Fatima Mohammed Umer Shaikh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding the role of chronic inflammation among older adults is critical because of its implications on chronic inflammatory conditions as well as its interaction with anti-inflammatory medications. Osteoarthritis (OA) is a heterogeneous multi-faceted joint disease with multi-tissue involvement of varying severity, and increasing evidence demonstrates a key role of chronic inflammation in its pathogenesis. Approximately 30 million adults in the United States have OA, and it is reported that a large proportion (43%) of them are older than 65 years. OA is typically treated using non-steroidal anti-inflammatory drugs (NSAIDs) for minimizing pain and reducing inflammation. NSAIDs have consistently shown clinically …

Using Difference-In-Difference To Assess The Impact Of Medicaid Policy On The Addiction Treatment Provider Workforce And Prescribing Behavior In Virginia, Erin Britton

Theses and Dissertations

This dissertation is unified by both policy opportunity and estimation method, examining the impact of Medicaid behavioral health policy in Virginia using a difference-in-differences framework. Medicaid-covered substance use disorder (SUD) treatment benefits in Virginia were significantly enhanced through a Section 1115 SUD waiver, which are required to be budget neutral. Therefore, it is critical to understand whether the objectives of the waiver are met using reliable, unbiased estimation methods. This dissertation includes two empirical research projects evaluating the impact of Medicaid policy on removing barriers in access to care and one methodological project comparing the performance of alternate approaches to …

Pharmacists' Role In Opioid Use Disorder And Overdose Prevention And Treatment And Their Attitudes And Perceptions Towards Distributing Naloxone Under A Standing Order, Stephen C. Ijioma

Theses and Dissertations

Background: Opioids are a class of drugs that bind to opioid receptors (mu, delta, and kappa), located in the central and peripheral nervous systems, to exert responses such as analgesia, respiratory depression, euphoria, and miosis. The opioid epidemic is characterized in large part by an increase in opioid overdose deaths. Community pharmacists are one of the most accessible healthcare professionals who frequently interact with patients and can implement OUD and opioid overdose prevention strategies. Treatment for opioid overdose and OUD include naloxone for overdose deaths as well as medication-assisted treatment for OUD.

Objective: The specific aims of this thesis include …

Using Implementation Mapping To Develop Implementation Strategies For The Delivery Of A Cancer Prevention And Control Phone Navigation Program: A Collaboration With 2-1-1, Lynn N Ibekwe, Timothy J Walker, Ebun Ebunlomo, Katharine Ball Ricks, Sapna Prasad, Lara S Savas, Maria E Fernandez

Faculty, Staff and Student Publications

Cancer prevention and control (CPC) behaviors, such as cancer screening, human papillomavirus vaccination, and smoking cessation, are critical public health issues. Evidence-based interventions have been identified to improve the uptake of CPC behaviors; however, they are often inconsistently implemented, affecting their reach and effectiveness. Patient navigation is an evidence-based approach to increasing CPC behaviors. Nevertheless, there are few navigation programs that use systematically developed implementation strategies to facilitate adoption, implementation, and maintenance, which affects uptake and outcomes. This article describes the development of a multifaceted implementation strategy designed to facilitate delivery of a CPC phone navigation program to increase breast, …

An Analysis Of The Special Focus Facility Program And Nursing Home Quality, Annie S. Rhodes

Theses and Dissertations

The Special Focus Facility Program is an intensive program meant to rapidly support 88 of the lowest quality nursing homes in the United States, as determined by the Five-Star Quality Ranking system. There are also 435 facility candidates which are similarly low performing but not enrolled in the program. Academic literature has largely ignored this program, and the existing grey literature is more than a decade old and does not include COVID-19 data. Applying a political economy of aging framework and using a case matching methodology, Special Focus Facilities (SFF), Special Focus Facility Candidate (SFFc) nursing homes, and 5-star nursing …

Becoming A Public Health Professional: Millennials’ Perspective On Organizational Assimilation And Professional Identity, Tony K. Winters

College of Graduate Studies: Theses & Dissertations

ABSTRACT

Public health must confront the ongoing challenge of workforce transitions and the impending exodus of existing employees. The millennial generation rises as an option to fill this workforce gap. Using the Socialization Resource Theory as a framework and qualitative data from in-depth interviews with 27 millennial professionals from federal, state, local, and non-governmental public health agencies, this study describes (a) the organizational assimilation (OA) process for millennial public health professionals, (b) explores the impact of OA on professional identity, and (c) describes how the OA process may impact the retention of public health professionals.

The results from this study …

Communicating Clinic Visit Information To Family Caregivers, Reed Wr Bratches

Dartmouth College Ph.D Dissertations

Statement of the Problem: Information from clinic visits is critical to family caregivers, who are the family members or friends who provide at-home care for their loved ones. However, patient’s clinic visits are infrequently attended by caregivers. While methods exist to communicate information from visits to patients, little is known about the methods used to communicate with caregivers, or their effects on caregiver outcomes. I address this gap in this dissertation through three studies.

Methods: A systematic review was used synthesize the methods used to communicate information to family caregivers and their impact on caregivers. A national survey of family …