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1
Carrigan, Amanda Jane. "Determining the Cost-Effectiveness of Preventive Health Services." Thesis, The University of Arizona, 2010. http://hdl.handle.net/10150/146241.
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The purpose of the thesis was to explore the issues surrounding the cost and implementation of prevention. Specifically, methods for determining cost-effectiveness and measuring the health benefits conferred from prevention were explored and services that have been determined to be cost-effective were discussed. Through interviews with health care professionals, administrators, and public health professors, perceptions of the benefits and costs of prevention were explored. Barriers to the implementation of prevention were discussed. The thesis concludes with suggestions on steps that health care providers and policy-makers can take to improve the health of the U.S. population through prevention.
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Berry, Elizabeth. "PREVENTIVE DENTAL SERVICES FOR INFANTS AND SUBSEQUENT UTILIZATION OF DENTAL SERVICES." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1708.
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The purpose of this study was to examine the use of dental services for young children following a preventive oral health intervention in a pediatric medical clinic. Over a 3 year period (2005-2008), children 0-36 months of age, enrolled in Medicaid, were provided preventive oral health services in a medical setting. Descriptive statistics and multivariate logistic regression were used to determine the effect receiving the preventive oral health services in a medical setting with the outcomes of dental utilization. 15% were determined to have dental caries at the intervention and 42% found to have a dental visit post-intervention. Children determined to have decay at the intervention were significantly more likely to have one or more restorative or adjunctive service post-intervention. After receiving preventive oral health care in a medical clinic, the resulting utilization of dental services was higher than what is commonly reported for dental utilization in infant populations of low-income children.
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Marine, Marjorie Butler. "Marketing health care services for a preventive health care agency : a categorical study." Virtual Press, 1987. http://liblink.bsu.edu/uhtbin/catkey/530368.
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The purpose of the study was to determine the needs of one marketing segment of clients seen in a contraceptive clinic in the Midwest. The marketing segment targeted for study was women with positive Pap smears. A comparison group of women with negative Pap smears was sampled from the same clinic during the time frame July 1, 1982, to July 1, 1984.Nine research questions were investigated. Responses have been reported relative to the following questions:1. Does the incidence of positive Pap smears depend on the presence of cervical infection a woman may have?2. Does the incidence of positive Pap smears depend on whether or not a woman smokes?3. Does the incidence of positive Pap smears depend on the type of contraceptive (pill or barrier) used by a woman?4. Does the incidence of positive Pap smears depend number of abortions experienced by a woman?5. Does the incidence of positive Pap smears depend on the number of pregnancies experienced by a woman?6. Does the incidence of positive Pap smears depend on whether the woman is white or black?7. Does the incidence of positive Pap age of the woman?8. Does the incidence of positive Pap smears depend on the smears depend on whether the woman is married or not?9. Does the incidence of positive Pap smears depend on the educational status of the woman?Five conclusions were drawn from findings of the study and were confined to the population for the study, clients of the selected clinic:1. Women with positive Pap smears are more likely to have infections than women with negative Pap smears.2. Women who have had abortions are more likely to have positive Pap smears.3. The incidence of positive Pap smears is associated with pregnancies; that is women with one or more pregnancies are more likely to have positive Pap smears.4. A higher proportion of black women have positive Pap smears than white women.5. Women with less education have more positive Pap smears than women with higher levels of education.<br>Department of Educational Administration and Supervision
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Guo, Jong-long. "Comparisons of clinical preventive services utilization among elderly, middle-aged and young adults in five Texas sites /." Digital version accessible at:, 2000. http://wwwlib.umi.com/cr/utexas/main.
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Lapierre, Sophie. "The logistics of preventive health services using fixed and mobile facilities." Diss., Georgia Institute of Technology, 1995. http://hdl.handle.net/1853/24353.
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Li, Jun. "The use of child health computing systems in primary preventive care : an evaluation." Thesis, University College London (University of London), 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274686.
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Balogh-Reynolds, Joanna. "Self-Rated Health Status' Influence on Utilization of Clinical Preventive Services." Thesis, Carlow University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10605473.
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<p> Early identification through preventive care screenings has proven to lessen the cost and impact of illness, while reducing premature mortality. Current literature has identified disparities related to access and utilization of preventive care services. The current assumption is that females have a higher likelihood to comply with recommended preventive care screenings than men. A variance identified in gender studies indicated women have a higher usage of preventive care screenings, and a higher use of overall medical services. The objective of this study is to understand if there is a predictive value of self-reported health status that can impact the utilization of preventive care services in women accessing a mammogram voucher program.</p><p> A convenience sample of 40 participants from the Mammogram Voucher Program administered by Adagio Health was surveyed. Using the RAND 36-Item Health Survey, participants’ self-rated health status was assessed. Demographic data and survey responses were compared with utilization of the mammogram voucher to ascertain if a correlation occurs. The survey results did not indicate, in this sample, that a relationship exists. However, demographic data indicated there is a relative impact on voucher utilization compared to self-perception. Specifically, the education level of the respondents yielded a statistically significant result. Participants with a reported education level of at least 12 years were found to be more likely to utilize a voucher while those with greater than 12 years of education did not. The lack of demonstrated statistical correlations for the self-rated health status questions do not necessarily prove a lack of relationship with utilization of preventative health care, rather suggests that demographics may influence preventive health care utilization more strongly. A larger sample size comparing additional factors will need to be studied.</p><p>
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Ruston, Annmarie. "Implementation of preventive health policies in the field of sexual health : an examination of the influence of health professionals in the implementation of the Health of the NationStrategy-HIV/AIDS and Sexual Health Key Area." Thesis, University of Kent, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310165.
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Dalla, Palu Alice J. "An examination of the process of program evaluation in a community prevention project." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1996. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University, 1996.<br>Source: Masters Abstracts International, Volume: 45-06, page: 2937. Abstract precedes thesis as [3] preliminary leaves. Typescript. Includes bibliographical references (leaves [3]).
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Condon, Louise Jane. "Understanding preventive community health services for pre-school children : origins, policy and current practice." Thesis, University of Bristol, 2009. http://hdl.handle.net/1983/cf5dd7c3-8fef-492d-b8a4-192e4c6b98e2.
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Community health services for pre-school children have been the major universal health provision for well-children for over a hundred years. Traditionally these services have been largely delivered by health visitors, who are now community nurses with a specialist post-graduate qualification. Preventive health services for children in the UK have been increasingly criticised as insufficiently evidence-based. Criticism has led to reform of national policy and subsequent major changes to existing services, particularly in targeting services to those with the highest health and social needs. The effect of these policy changes upon the service provided for pre-school children by health visitors is not known. This thesis explores the origins and development of children's preventive health services and examines the effect of post-1989 policy changes in practice, in particular the move to a predominately targeted child health promotion programme. The empirical study used a mixed methods approach to investigate changes to local policy and practice. A national survey was made of health visitors' child health promotion practice (n=1043) which was followed by an in-depth interview study (n=25) of health visitors' views on service changes. Study findings illuminate the effect of post-1989 reforms on child health services, showing a diversity of practice across the country, and resistance to key aspects of policy and practice among health visitors. Despite a revised national child health promotion programme being published in April 2008, which addresses some of the areas of concern highlighted by this study, flaws remain which have implications for the successful implementation of this programme. These flaws reflect wider contentious issues in NHS policy-making, related to the distribution of power and resources between different professional groups within the NHS and service users. Failing to explore these issues in policy and practice reduces the ability of preventive health services to maintain and improve pre-school children's health.
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Zhang, Jianzhen (Jenny). "Socioeconomic position and utilisation of preventive health services among adults in the general population." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16532/1/Jianzhen_Zhang_Thesis.pdf.
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Background: International research has shown that socioeconomically disadvantaged groups experience significantly higher mortality and morbidity rates than other groups. Both cardiovascular disease (CVD) and diabetes are major contributors to Australia's burden of disease, and individuals from lower socioeconomic groups are more likely to be affected by both, and to have worse prognoses and outcomes. There is substantial research evidence that a range of preventive activities can reduce the morbidity and mortality associated with these conditions. Research in countries with good access to primary health care services has demonstrated that socioeconomically disadvantaged groups tend to have higher levels of medical consultations, but make less use of preventive care and screening services. This fact contributes to their poorer health outcomes, as diagnosis will typically occur later than for more advantaged individuals, thus leading to a poorer prognosis. However, to date, there has been little research on the differential utilisation of preventive health services for CVD and diabetes by different socioeconomic groups in Australia. To understand socioeconomic influences on the use of preventive health services, a comprehensive review of the literature of determinants of health service utilisation was conducted and a number of explanations for this relationship considered. It was proposed that the following factors are likely to be important in this relationship: differences in the perception of the availability of, and accessibility to health care, attitudes and beliefs toward preventive health care, having a regular source of care, perception of interpersonal care from general practitioners, and social support. A number of theoretical models were also reviewed; in particular, the Andersen Behavioural Model of Health Service Research Utilisation.
Aims: This doctoral research program has described the relationship between socioeconomic position (SEP) and utilisation of preventive health services in relation to CVD and diabetes. It aims to improve the understanding of the determinants of uptake and utilisation of preventive health services in general practice by different socioeconomic groups in Australia.
Methods: The study was conducted in Brisbane Australia, in 2004, using a cross-sectional design and a self-administered mailed survey for data collection. A sample of adults aged 25-64 years was selected randomly from the Brisbane Electoral Roll. A conceptual model incorporating a range of relevant socio-demographic, risk-factor and behavioural variables in the relationship between SEP and GP-based use of preventive health services was used to develop a self-administered questionnaire. The questionnaire was pilot-tested and then reviewed by a panel of international experts. A new self-administered questionnaire, the Health Service Utilisation Questionnaire (HSUQ), was developed. It included 79 items: 12 socio-demographic items; 10 items assessing health status, disease conditions and smoking status; 20 items assessing use of health services; and 37 items assessing the factors that might affect use of health services utilisation. The HSUQ was then mailed to 800 randomly selected survey participants. The survey response rate was 65.6 per cent. After exclusion of those patients with cardiovascular diseases and diabetes, the final sample size was 381, consisting of 155 males and 226 females. Socioeconomic indicators were individual education level and family income. Blood pressure, blood cholesterol and blood glucose check-ups by general practitioners (GPs) were used as the major outcome variables. Nine scales and two dichotomous variables that measure those potential factors were derived following Principal Component Analysis and reliability testing. The data were analysed separately by gender, and adjusted for age and each of the socioeconomic indicators. Statistical description, bivariate analysis and multivariable modelling in SPSS were applied for the data analysis.
Results: The survey results were suggestive of socioeconomically disadvantaged people being less likely than more advantaged people to utilise preventive health services for CVD and diabetes. For males, the low socioeconomic groups recorded the least use of preventive health services among the three education and income groups, including blood cholesterol and blood glucose check-ups, while the high socioeconomic group recorded the greatest use of preventive health services. There was no apparent relationship between education level and blood pressure check-up, while individuals from low-income families were less likely to go for a blood pressure check-up. For females, most of the results suggested that the low socioeconomic groups were less likely than the high socioeconomic groups to have blood cholesterol and blood glucose check-ups. However, this was not the case for blood pressure check-ups. The results showed that the low and middle socioeconomic groups were more likely than the high socioeconomic groups to have BP check-ups. However, the low socioeconomic groups were still less likely than the middle socioeconomic groups to have a blood pressure check-up. Overall, there was a similar pattern between education and income and the use of GP-based preventive health services among both males and females.
The findings from the examination of the mediating factors between SEP and the GP-based use of preventive health services suggested that socioeconomically disadvantaged adults (both low level of education and low income) are more concerned about transport and travel time to health care, and accessibility to health care in terms of finding a GP who bulk bills, the cost of seeing a GP and having a choice of GP. They are also less likely to have a regular place of care and social support. These potential factors are likely to result in a lesser use of preventive health services than their high-SEP counterparts. In addition, the findings also suggested that respondents with a low level of education have less-positive attitudes towards health care, and that those from low-income families do not have a regular care provider and are less likely to visit their GP for a preventive check-up in relation to CVD and diabetes in Australia.
Conclusions: Strategies for reducing socioeconomic health inequalities are partly associated with changing social and economic policies, empowering individuals, strengthening social and family networks, and improving the equity of the health care system. Strategies have been recommended for implementation in general practice that are directed at targeting the needs of disadvantaged groups; for example, providing longer consultation time and actively offering information on preventive care. Implementation of health promotion programs is needed in disadvantaged areas to keep the community informed about the availability of health services and to make health services more accessible. The health care system needs to be geographically accessible through improvements to the transport system. In addition, improving access to a regular source of primary health care is likely to be an important step in encouraging low-SEP individuals to use preventive health services.
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Zhang, Jianzhen (Jenny). "Socioeconomic position and utilisation of preventive health services among adults in the general population." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16532/.
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Background: International research has shown that socioeconomically disadvantaged groups experience significantly higher mortality and morbidity rates than other groups. Both cardiovascular disease (CVD) and diabetes are major contributors to Australia's burden of disease, and individuals from lower socioeconomic groups are more likely to be affected by both, and to have worse prognoses and outcomes. There is substantial research evidence that a range of preventive activities can reduce the morbidity and mortality associated with these conditions. Research in countries with good access to primary health care services has demonstrated that socioeconomically disadvantaged groups tend to have higher levels of medical consultations, but make less use of preventive care and screening services. This fact contributes to their poorer health outcomes, as diagnosis will typically occur later than for more advantaged individuals, thus leading to a poorer prognosis. However, to date, there has been little research on the differential utilisation of preventive health services for CVD and diabetes by different socioeconomic groups in Australia. To understand socioeconomic influences on the use of preventive health services, a comprehensive review of the literature of determinants of health service utilisation was conducted and a number of explanations for this relationship considered. It was proposed that the following factors are likely to be important in this relationship: differences in the perception of the availability of, and accessibility to health care, attitudes and beliefs toward preventive health care, having a regular source of care, perception of interpersonal care from general practitioners, and social support. A number of theoretical models were also reviewed; in particular, the Andersen Behavioural Model of Health Service Research Utilisation. Aims: This doctoral research program has described the relationship between socioeconomic position (SEP) and utilisation of preventive health services in relation to CVD and diabetes. It aims to improve the understanding of the determinants of uptake and utilisation of preventive health services in general practice by different socioeconomic groups in Australia. Methods: The study was conducted in Brisbane Australia, in 2004, using a cross-sectional design and a self-administered mailed survey for data collection. A sample of adults aged 25-64 years was selected randomly from the Brisbane Electoral Roll. A conceptual model incorporating a range of relevant socio-demographic, risk-factor and behavioural variables in the relationship between SEP and GP-based use of preventive health services was used to develop a self-administered questionnaire. The questionnaire was pilot-tested and then reviewed by a panel of international experts. A new self-administered questionnaire, the Health Service Utilisation Questionnaire (HSUQ), was developed. It included 79 items: 12 socio-demographic items; 10 items assessing health status, disease conditions and smoking status; 20 items assessing use of health services; and 37 items assessing the factors that might affect use of health services utilisation. The HSUQ was then mailed to 800 randomly selected survey participants. The survey response rate was 65.6 per cent. After exclusion of those patients with cardiovascular diseases and diabetes, the final sample size was 381, consisting of 155 males and 226 females. Socioeconomic indicators were individual education level and family income. Blood pressure, blood cholesterol and blood glucose check-ups by general practitioners (GPs) were used as the major outcome variables. Nine scales and two dichotomous variables that measure those potential factors were derived following Principal Component Analysis and reliability testing. The data were analysed separately by gender, and adjusted for age and each of the socioeconomic indicators. Statistical description, bivariate analysis and multivariable modelling in SPSS were applied for the data analysis. Results: The survey results were suggestive of socioeconomically disadvantaged people being less likely than more advantaged people to utilise preventive health services for CVD and diabetes. For males, the low socioeconomic groups recorded the least use of preventive health services among the three education and income groups, including blood cholesterol and blood glucose check-ups, while the high socioeconomic group recorded the greatest use of preventive health services. There was no apparent relationship between education level and blood pressure check-up, while individuals from low-income families were less likely to go for a blood pressure check-up. For females, most of the results suggested that the low socioeconomic groups were less likely than the high socioeconomic groups to have blood cholesterol and blood glucose check-ups. However, this was not the case for blood pressure check-ups. The results showed that the low and middle socioeconomic groups were more likely than the high socioeconomic groups to have BP check-ups. However, the low socioeconomic groups were still less likely than the middle socioeconomic groups to have a blood pressure check-up. Overall, there was a similar pattern between education and income and the use of GP-based preventive health services among both males and females. The findings from the examination of the mediating factors between SEP and the GP-based use of preventive health services suggested that socioeconomically disadvantaged adults (both low level of education and low income) are more concerned about transport and travel time to health care, and accessibility to health care in terms of finding a GP who bulk bills, the cost of seeing a GP and having a choice of GP. They are also less likely to have a regular place of care and social support. These potential factors are likely to result in a lesser use of preventive health services than their high-SEP counterparts. In addition, the findings also suggested that respondents with a low level of education have less-positive attitudes towards health care, and that those from low-income families do not have a regular care provider and are less likely to visit their GP for a preventive check-up in relation to CVD and diabetes in Australia. Conclusions: Strategies for reducing socioeconomic health inequalities are partly associated with changing social and economic policies, empowering individuals, strengthening social and family networks, and improving the equity of the health care system. Strategies have been recommended for implementation in general practice that are directed at targeting the needs of disadvantaged groups; for example, providing longer consultation time and actively offering information on preventive care. Implementation of health promotion programs is needed in disadvantaged areas to keep the community informed about the availability of health services and to make health services more accessible. The health care system needs to be geographically accessible through improvements to the transport system. In addition, improving access to a regular source of primary health care is likely to be an important step in encouraging low-SEP individuals to use preventive health services.
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James, Janet. "Preventing childhood obesity : a school-based intervention trial - CHOPPS - the Christchurch Obesity Prevention Programme in Schools." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/385141/.
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Hu, Weiming. "Effects of parents' health attitudes and beliefs on children's preventive care utilization." PDXScholar, 1992. https://pdxscholar.library.pdx.edu/open_access_etds/4315.
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This thesis was designed to test the relationship between parents' health attitudes and beliefs and utilization of preventive health services of their children. Four measures of health attitudes and beliefs (HAB) were examined in this study, they were: 1) Interest in and concern with health; 2) Skepticism about physicians; 3) Tendency to consult physicians; and 4) Efficacy. Preventive care utilization included well-child care and immunization.
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Mansman, Robert William II. "Oral Health Services in a Medical Setting." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/753.
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Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's teeth, and socio-demographic characteristics of the family. Six-months after the medical visit, dental claims were examined to see if children had made a dental visit. Results: One hundred and ninety-five children received preventive oral health services in this clinic. Of these, 103 caregivers agreed to complete the oral health knowledge and socio-demographic questionnaire. Twenty-percent of children screening had visible signs of tooth decay, according to risk-assessment 72% were categorized as high-risk for tooth decay, and 83% received a fluoride varnish treatment. At 6-months, 9% of children were found to have had a dental visit. According to the caregiver questionnaire the likelihood of having a dental visit was correlated with the caregiver's knowledge of when a child should have their first dental visit and having been told by a medical professional when their child should be going to the dentist. Conclusion: Children are more likely to have a dental visit when caregivers are aware of the age 1 dental visit, or when advised to seek care by a medical professional. With increased education of medical providers, starting in medical residency training, more children can be seen for preventive oral health care resulting in an earlier establishment of a dental home.
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Chon, Vichea Veena Sirisook. "HIV preventive behaviors among high school male students in Phnom Penh city, Cambodia : an application of health belief model /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737940.pdf.
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Richter, Sundberg Linda. "Mind the Gap : exploring evidence-based policymaking for improved preventive and mental health services in the Swedish health system." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-118179.
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Background: The challenges in the utilization of scientific findings in the fields of prevention and mental health are well documented. Scholars have found significant gaps between the knowledge available and the knowledge applied in healthcare. Studies have suggested that about half of the patients receive the recommended care for their medical condition. In order to address this gap, health systems at global, national, regional and local levels have made diverse efforts to facilitate the uptake of research for example through evidence-based health policy processes. In Sweden, government agencies and health policy actors such as the National Board of Health and Welfare support and control the health care system through evidence-based policies amongst other steering tools. The overall aim of this thesis is to explore evidence-based policy processes, and to further understand barriers to implementation of policies in the fields of preventive and mental health services. Methods: A multiple case study approach was used, and data were collected from several sources. Qualitative content analysis methodology was used. Case 1 comprises the development and early implementation of national guidelines for methods of preventing disease managed by the National Board of Health and Welfare during 2007–2014. Case 2 covers the effort to improve health care for the older population that was undertaken through an agreement between the Swedish government and the Swedish Association of Local Authorities and Regions during 2009–2014. Case 3 involves an effort to implement an adapted version of a systematic review from the Swedish agency for health technology assessment and assessment of social services on treatment of depression in primary health care. Data was collected between 2007 and 2010. In Paper 1, the policies from Case 1 and 2 were studied using a longitudinal, comparative case study approach. Data were collected through interviews, documents and observations. A conceptual model was developed based on prior frameworks. The model was used to organize and analyse the data. In Paper 2, the guideline development process (Case 1) was studied through interviews and the collection of documents. A prior framework on guideline quality was used in order to organize the data. Paper 3 investigated decision-making processes during guideline development using a longitudinal approach. Qualitative data were collected from questionnaires, documents and observations and analysed using conventional and summative content analysis. In Paper 4, the barriers to implementation were investigated through interviews and the collection of documents. Data were analysed using qualitative content analysis with a conceptual model to structure the analysis. Results: The sources and procedures for policy formulation differed in Case 1 and 2, as did the approaches to promote the implementation of the policies. The policy processes were cyclical, and phases overlapped to a large degree. The policy actors intended to promote implementation, both during and after the policy formulation process. The thesis shows variation in how the key policy actors defined and used research evidence in the policy processes. In addition, other types of knowledge (e.g. politics, context, experience) served as alternative or multiple sources to inform the health policies. The composition of sources that informed the policies changed over time in Cases 1 and B. During the policy formulation and implementation process, efforts to integrate research evidence with clinical experiences and values were associated with tension and recurrent dilemmas. On the local level (i.e. primary health care centres), barriers to implementation were found related to the innovation and among health professionals, patients, in social networks as well as in the organizational, economic and political contexts. Conclusion: The concept of evidence holds a key position in terms of goals and means for knowledge based policymaking in the Swedish health system. Broad definitions of evidence – including research and non-research evidence - were requested and to various extents utilized by the policy actors in the studied cases. An explicit terminology and systematic, transparent methodology to define, identify, and assess also non-research evidence in policy processes would potentially strengthen the clarity and validity of these processes and also enhance policy implementation. Particular determinants to implementation, such as the interventions characteristic, are to a considerable degree established early in the policy process, during agenda setting and policy formulation. This early phase offers unique opportunities to assess and build capacity, initiate and facilitate implementation. Early analysis and considerations of target populations and contexts and other implementation determinants related to the specific policy scope (e.g. disease preventive guidelines) could enhance the forth-coming implementation of the policy.
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Kartakoullis, Nicos Louca. "Fitness levels and exercise behaviour of Cypriots aged 25-34 as preventive measures for one of the risk factors associated with heart disease : implications for health promotion." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301047.
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Brandon, Amy Ford Schuessler Jenny H. "The effects of an advanced practice nurse-led telephone-based intervention upon hospital readmissions, quality of life, and self-care behaviors of heart failure patients." Auburn, Ala, 2008. http://repo.lib.auburn.edu/EtdRoot/2008/SUMMER/Nursing/Thesis/Brandon_Amy_11.pdf.
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Talbot, Molly A. "Nutrition and health promotion activities and nutrition." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/774735.
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The study was designed to identify current levels of corporate health promotion and nutrition activities and to highlight the need for continued health promotion activities, in particular nutrition education, throughout corporate America.Five hundred surveys were mailed to the Fortune 500 companies throughout the United States. One hundred and twenty-one were completed, yielding a 24% sample for analysis.The wellness/health promotion activities reported to be a part of corporate wellness programs included exercise, nutrition education, CPR training, stress management and intramural sports. It appeared that size of the corporation influenced the nutrition promotion provided at the worksite. There appeared to be no difference between CEO support or lack of support to the wellness/health promotion program and the variety of health promotion activities. It was apparent that having a nutrition consultant resulted in greater and more varied nutrition health promotion activities at the worksite, and that in the future, America's Fortune 500 companies will need to hire a nutrition professional to disseminate nutrition and health promotion information at the worksite.<br>Institute for Wellness
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Shelton, Melissa E. "Identifying Communication Barriers and Trust Issues of Black Women Seeking Preventive Health Services in Houston, Texas." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3411.
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Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. Data were collected using open-ended interview questions from Black women in public health and health care professions in southeast Texas (N=10). Results were coded and evaluated by thematic analysis. NVivo 10 software was used to store and manage data. Study findings showed 4 participants voiced their beliefs that their healthcare provider was somewhat apathetic when it came to addressing their health care needs, and 3 of the participants who visited a doctor's office within the last 12 months reportedly expressed having poor communication and trust issues with their health care provider. Emerged themes included lack of attentiveness from health care providers and lack of a comfortable atmosphere or bedside manner when receiving preventive health care services from their healthcare provider. This research has implications for social change if the health inequalities of Black women are identified and addressed, then Black women may have a reduction in health disparities when receiving preventive health services and an increase healthier outcomes.
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Stephenson, Winsome Beverly. "The Experiences of Obese African American Women and Their Utilization of Preventive Healthcare Services." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/nursing_diss/17.
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Obesity is associated with higher death rates from breast and gynecological cancers. African American women(AAW) are more likely to be diagnosed with these cancers at later stages and have lower survival rates than Caucasian women. African American women are also disproportionately affected by obesity. Studies suggest that the healthcare experiences of obese women (primarily stigmatization), may contribute to their decisions to utilize healthcare services. However, these studies have largely comprised Caucasian women; there remains a paucity of studies addressing this issue in AAW. The purpose of this study was to explore the healthcare experiences of obese AAW and their utilization of preventive healthcare services.
Interpretive phenomenology, based on the work of Maxx van Manen, was used to describe and interpret the healthcare experiences of 15 obese AAW living in communities in Georgia. The women ranged in age from 23 to 62, with body mass index ranging from 35-55. The majority of the sample (83%) had adequate health insurance. This was a well educated sample with 87% having college degrees or some college education. Individual, audio-taped interviews were used to collect data.
Data were analyzed using interpretive phenomenological methods, with analysis and collection occurring concurrently. Data were analyzed as a whole then line by line to identify themes across transcripts. Two patterns and five themes were identified. Patterns were: They're not listening and Good or bad, it's my decision. Themes were: Attributing all problems to weight; They say lose weight but give us no tools; Stigmatization; Cancel my appointment please: I won't be back, and Empowerment.
The women recalled a pleothra of negative encounters with providers that they termed "demeaning" and "nastiness for no reason." Many women reacted by delaying or avoiding healthcare, some not returning for preventive health screens for many years. The significant association between obesity and mortality from cervical and breast cancers necessitates timely preventive screens by obese women. The results of this study can help to inform practice, education, and research. Recommendations for all three areas were deleneated in the study.
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Kirkpatrick, Tara. "Just what the doctor ordered: reformation of the U.S. healthcare system through a dose of preventative and primary care." [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/TKirkpatrick2008.pdf.
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Carney, Patricia Anne. "Using unannounced standardized patients to assess HIV prevention in primary care : a study of clinical performance /." Thesis, Connect to this title online; UW restricted, 1994. http://hdl.handle.net/1773/7258.
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Chisolm, Deena Brown. "The Role of Perceived Discrimination and Perceived Cultural Competence in Predicting Use of Preventive Health Care Services." The Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1052409673.
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Kunz, Laura Marie. "A comparison of the use of preventive health services for diabetics Canada and the United States /." Connect to Electronic Thesis (CONTENTdm), 2010. http://worldcat.org/oclc/647184839/viewonline.
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Aoyama, Atsuko, Asmaa Ghareds Mohamed, Michiyo Higuchi, Shokria Adly Labeeb, and Chifa Chiang. "BARRIERS TO THE USE OF BASIC HEALTH SERVICES AMONG WOMEN IN RURAL SOUTHERN EGYPT (UPPER EGYPT)." Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/18471.
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Larkin, Shaun Maurice. "Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/26735/1/Shaun_Larkin_Thesis.pdf.
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Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services.
Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.
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Larkin, Shaun Maurice. "Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia." Queensland University of Technology, 2008. http://eprints.qut.edu.au/26735/.
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Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services.
Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.
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HAMAJIMA, NOBUYUKI, YOKO MITSUDA, SAYO KAWAI, YOSHIKAZU KAMIYA, YASUYUKI GOTO, TAKAAKI KONDO, MIO KURATA, and TAKASHI TAMURA. "PREVENTIVE MEDICAL SERVICES NOT COVERED BY PUBLIC HEALTH INSURANCE AT DAIKO MEDICAL CENTER IN JAPAN, 2004–2011." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16028.
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Hak, Sithan Nonglak Pancharuniti. "Dental health preventive behavior among mothers with preschool children in Nakhon Pathom province, Thailand /." Abstract, 2003. http://mulinet3.li.mahidol.ac.th/thesis/2546/4537452.pdf.
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Awat, Joselito G. Pantyp Ramasoota. "Preventive behavior of malaria among people living along the Thai-Cambodia border, Khilonghad district, Srakaeo province /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4837996.pdf.
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Isaacs, Anna. "Keeping healthy and accessing primary and preventive health services in Glasgow : the experiences of refugees and asylum seekers from Sub Saharan Africa." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/8971/.
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Background and aims: Recent decades have seen material shifts in global migration flows. Migrants now come to the UK for an increasing number of reasons and from an increasing number of countries. This presents a challenge for health services that must provide care to individuals with a broad range of needs. In particular, there is concern that asylum seekers and refugees (ASRs) are at heightened risk of poor wellbeing and of receiving suboptimal healthcare. Concurrent with these shifts in migration, increasing attention is being paid to noncommunicable diseases (NCDs), which are now the most significant drivers of morbidity and mortality in most regions of the world. In the UK, the burden of NCDs is not evenly distributed, with inequalities related to ethnicity and socioeconomic status shaping an individual’s risk of ill health. Little is known, however, about how diverse migrant groups, including ASRs, conceptualise health and respond to health prevention messaging. Against this backdrop, this thesis aims to understand the health-related experiences of one such group – asylum seekers and refugees (ASRs) from Sub Saharan Africa living in Glasgow Scotland. Specifically, it explores: a) perceptions of health, wellbeing, and illness causation, b) experiences of accessing primary and preventive healthcare, and c) the factors influencing these perceptions and experiences. It also seeks to elucidate professional perspectives on ASR health. Methods: To gain an in depth understanding of ASR health perceptions and experiences, as well as professional perspectives, a focused ethnography was undertaken. This approach utilised four qualitative methods: community engagement, participatory focus groups, semistructured interviews, and go- along interviews. In total 12 primary care and public health professionals were interviewed, and 27 ASRs took part in either a focus group, an interview, or both. The thesis took a theoretically informed approach, seeking to determine whether and how two theories – ‘candidacy’ (Dixon-Woods et al 2005) and ‘structural vulnerability’ (Quesada et al 2011) – might deepen our understanding of ASR health. Results: Candidacy enhanced understanding of how ASRs identified and responded to messages about ‘healthy lifestyles’. ASR participants considered keeping healthy to be an individual responsibility, with diet and exercise highlighted as especially important. At the same time, however, perceptions and experiences of health and wellbeing were shaped by a number of structural influences, which limited the capacity of ASRs to engage in health practices. Therefore, while ASRs considered health to be an individual choice in theory, they did not necessarily feel they had the ability to be healthy in practice. The theory of structural vulnerability proved useful in identifying the wider structural determinants that impacted on an individual’s capacity to respond. There were several important structural influences, including poverty, racism, discrimination, and language barriers. The greatest negative influence, however, and one that compounded all the others, was the asylum process. This diminished individuals’ capacity to identify as candidates for prevention messages, engage in preventive health practices, and/ or access care in an optimal fashion. Conclusions: Efforts to engage ASRs in preventive health programmes and practices must take into account the ways in which the immigration and asylum system acts as a determinant of health, affecting both what it means to be healthy and what capacity individuals have to engage. The NHS, together with non statutory bodies, has a role to play in mitigating some of the vulnerabilities to which ASRs are subject.
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Rossouw, Willem Wouter. "Efficacy of a HIV intervention in the workplace, as measured by KAP (knowledge, attitudes, and practices) questionnaires a before and after study /." Connect to this title online, 2003. http://upetd.up.ac.za/thesis/available/etd-05092005-102002/.
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Campbell, Desiree. "An evaluation of patient engagement with diabetes out-patient services in an ethically diverse urban area in the UK." Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/21477/.
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Diabetes has been described as an epidemic with a significant global burden of illness. This burden is associated with poorer engagement with services and the cost of managing avoidable complications. One outcome measure of engagement in the national health service (NHS) in the United Kingdom (UK) is attendance at appointments. The cost implications (direct and indirect) of non-attendance are significant, with empirical evidence consistently demonstrating higher than average non-attendance rates for out-patient appointments and education sessions by minority ethnic and socio-economically deprived individuals. A gap was identified whereby a comprehensive understanding of non-attendance which moves beyond clinical and technical aspects such as capacity and demand is still required. This thesis provides a fresh approach and granular understanding of patient engagement which can influence clinical care, service delivery and policy. The main research questions in this thesis were: 1. What are the predictors of out-patient attendance? 2. What are the barriers and enablers to attendance? To answer these questions, a retrospective geo-demographic trend analysis, critical narrative literature review of Community Health Worker (CHW) and peer support interventions and a research study were conducted. The case study is based on a dataset which comprised of 35,597 appointments. Its findings highlighted that factors such as age, gender, ethnicity, local geography and deprivation were significant predictors of out-patient attendance. A critical review of CHW and peer support interventions demonstrated that despite the heterogeneity of programme designs, duration of interventions, follow up and healthcare systems in which they were used, they were assessed to be both clinically and cost effective. There was limited evidence on the sustainability of these interventions due to a lack of longitudinal studies. The research element was conducted in two stages and utilised multi methods (focus groups, semi-structured interviews and questionnaires) to evaluate the barriers and facilitators to attendance. Key findings included the need for effective and on-going education, better alignment of health and social care due to the impact of the wider determinants of health but more interestingly, the influence of family on the concept of ownership for one's health by some individuals whose self-determination is limited by language and health literacy. The relationship between patient activation (knowledge, skills and confidence) and attendance was also evaluated. This evaluation demonstrated that the more activated individuals are, they are significantly more likely to attend appointments. However, to maximise care planning and operational effectiveness, activation should not be assessed in isolation. The findings of this thesis highlighted the influence of individual, organisational and structural factors on patients' engagement with out-patient services and the need for a synergistic approach involving service users, clinicians, organisations and policy makers to minimise patient dis-engagement with healthcare services.
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Rukundo, Emmanuel Nshakira [Verfasser]. "Effects of community-based health insurance on child health outcomes and utilisation of preventive health services : Evidence from rural south-western Uganda / Emmanuel Nshakira Rukundo." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1173898611/34.
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Tang, Sze-kit, and 鄧施潔. "Parents' knowledge concerning their new immigrant child's preventive health care and access to care in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B27050464.
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Aveling, Emma-Louise. "Partnership in whose interests? : the impact of partnership-working in a Cambodian HIV prevention program." Thesis, University of Cambridge, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609077.
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Sawyer, Ashlee. "ARE YOU COVERED? EXAMINING HOW KNOWLEDGE OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT INFLUENCES USE OF PREVENTIVE REPRODUCTIVE HEALTH SERVICES." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4265.
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The Patient Protection and Affordable Care Act (PPACA) expanded access to insurance coverage and health care services for many citizens, and has increased access for women in particular by including preventive reproductive health services as essential health benefits. The current national rates of sexually transmitted infections (STIs), reproductive cancer diagnoses, and unintended pregnancy serve as major areas of concern for women’s health and public health. The present study examined how knowledge of the PPACA influences receipt of preventive reproductive health services among women. Results indicate that higher levels of knowledge of the PPACA are associated with a greater likelihood of receiving cancer and STI screenings, as well as contraceptive counseling, and that increasing contraceptive knowledge, rates of contraceptive counseling, and pap screenings are related to greater use of highly effective contraception. The present study offers support for increased outreach and education efforts, along with additional policy and provider involvement.
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Dusabe, John. "Development and evaluation of an mHealth intervention to improve the uptake of sexual and reproductive health services in Mwanza Tanzania." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2014371/.
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This thesis documents the development and evaluation of an mHealth intervention for sexual and reproductive health (SRH) referral from drugstores to health facilities in Mwanza Tanzania. SRH is an important factor for human development. Over the last 2 decades, provision and accessibility to SRH services has benefited from international and national health promotion interventions. In developing countries, use of close to community providers (CTC providers), such as village health workers, has been a key component of health promotion. This has been especially true in Tanzania where up to 70% of formal primary health care facilities lack health staff. CTC providers have been promoted through international initiatives such as the World Health Organization’s (WHO) task-shifting initiative. WHO’s recognition of CTC providers ranges from cadres at the grassroots level such as village health workers and drugstores to formal auxiliary providers based in health facilities, such as medical aides and nurses. In Tanzania, drugstores provide a range of SRH services ranging from simple advice on how to use a condom to complex prescriptions of antibiotics for STI treatment. Evidence has shown that drugstores – though more likely to have health-related training than any other informal CTC providers – lack skills necessary for provision of SRH services. This may contribute to poor SRH outcomes, such as increase in prevalence of sexually transmitted infections (STIs)/human immunodeficiency virus (HIV) and antibiotic resistance. Accessing SRH services at the formal health facility level is key to improving these outcomes. To create SRH service linkages and integration between drugstores and health facilities in Mwanza, Tanzania, an intervention that pioneered an mHealth SRH referral from drugstores to health facilities was designed and implemented for 18 months from September 2012 to February 2014. Referral between these two SRH providers using mHealth tools had not been attempted before. The intervention provided an electronic platform accessible to 52 drugstores and 18 health facilities in two districts of Mwanza region. Through a toll-free number and password, drugstores referred patients with SRH conditions to health facilities using the text-messaging feature on their mobile phones. From the platform’s in-built data collection tool, SRH uptake data demonstrated that 38% of patients referred from drugstores accessed HIV, STIs, family planning and maternal health services at the health facility level. A follow-up randomised household survey found that 72% of the participants would accept such type of referral in future, and among those who had ever visited drugstores for SRH services, 15% had heard about the intervention. At the end of the intervention, drugstores and health facilities confirmed that it was beneficial to their SRH service provision and that they would like to continue implementing it. In conclusion, this text messaging intervention pioneered community referral from drugstores to health facilities for SRH treatment by using mobile phones which appeared to be acceptable and effective in Mwanza Tanzania. With the growing use of mobile phones in Africa and the need to provide SRH services beyond the Millennium Development Goals (MDGs) era, mobile phone-based community referral through CTC providers, such as drugstores, could make an important contribution to achieving Universal Health Coverage targets.
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Schira, Norma. "A Survey of Health Promotion Activities of Health Systems Agencies." TopSCHOLAR®, 1986. http://digitalcommons.wku.edu/theses/1980.
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The National Health Planning and Resources Development Act. Public Law 93-641, the last major step in the regulation of the health care system, created a network of health system agencies and state level health planning agencies. Subsequent legislation, the Health Planning and Resources Development Amendment 1929, Public Law 96-79, amended 1974 Law and changed the role and function of health systems agencies to include more regulatory activities. By 1981, the activities of Health System Agencies were being curtained by the action of the Reagan administration.
The Health promotion/wellness movement which seeks to improve health has been developing as a compliment to medical medicine for several years. Previous research has determined that health systems agencies were active in health promotion and identified several planning and implementation activities related to this involvement. This is a survey of health systems agencies to determine their efforts in healthy promotions. Resources allocated to these activities, and opinions of the director relevant to agency involvement in health promotion.
All active healthy system agencies listed in the 1980. Directory of Health System Agencies (DHSH) were surveyed by a mailed questionnaire. Reponses were receive from 112 agencies (57%) and the respondents were found to be representative of the population.
The results revealed health systems agencies to be involved in health promotion. More than 90 percent of the responders listed some type of health promotion activity in their Healthy System Plans for the 1979-1980 planning year. Approximately half of the responders reported some community activity in health promotion. The majority of executive directors saw health systems agencies as being only moderately effective in controlling health care costs: considered healthy promotion as a viable means of controlling health care cost: and believed that modifications of individual life-styles had the greatest potential for improving health status.
The survey revealed that Healthy System Agencies did not restrict the wellness/health promotion activities to traditional health facilities, but were defining health broadly and working with a variety of agencies to develop services.
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Lindblom, Johanna, and Maria Lundberg. "HIV prevention work in Moshi, Tanzania : Nurses’ and physicians’ views on Kilimanjaro Aids Control Association." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-112505.
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<p>ABSTRACTAim: Since 2003 Kilimanjaro Aids Control Association (KACA) has collaborated with the Mawenzi Hospital in Moshi, in order to prevent the transmission of HIV/AIDS. The aim of this study was to investigate Mawenzi Hospital’s staff’s views about KACA and its work. Method: Eight semi structured interviews were performed with nurses and physicians. The interviews were recorded, transcribed and analyzed by a qualitative manifest content analysis according to Graneheim and Lundman (2004). Results: All the informants mentioned that KACA is an important stakeholder needed in the collaboration with the government to prevent HIV transmission. They also mentioned that the main problems KACA struggles with is lack of recourses, insufficient HIV tests and lack of information to their clients. KACA was described as an accessible non governmental organization (NGO) working as a bridge from society, channeling HIV positive clients to Mawenzi Hospital. Conclusion: This study confirms that KACA is considered doing a good job and is appreciated by the nurses and physicians at the Mawenzi Hospital. For KACA this may be important information to maintain their prevention work. The problems presented by the informants should be taken under consideration when planning the future work.</p>
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Weller, David P. "The pursuit of better health: what is the role of the general practitioner /." Title page, contents and synopsis only, 1990. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmw448.pdf.
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Thesis (M.P.H.)--University of Adelaide, Dept. of Community Medicine, 1991.<br>Result of a research project undertaken within the Department of Primary Health Care, Flinders Medical Centre ... part of a larger study which has been funded by the Research Into Drug and Alcohol Advisory Committee of the Commonwealth Department of Health. Typescript (Photocopy). Includes bibliographical references.
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Millard, Sharon Rae. "Factors related to health-promoting behaviors in Seventh-Day Adventist older adults /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.
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Sokhanya, In Santhat Sermsri. "TB preventive behavior of patients consulting at the general Outpatient department at Paholpolpayuhasana Hospital, Kanchanaburi province, Thailand /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd414/5037984.pdf.
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Malachi, Judia Yael. "Physician Assistants' Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/890.
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Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in preventive medicine activities about half the time, believed it was very important to counsel patients on prevention topics, felt they were somewhat effective in changing patient behaviors, and reported that barriers were somewhat important in hindering preventive care delivery. Significant and predictive relationships between physician assistants' health habits, attitudes, perceived barriers, and practices were found. These findings may guide researchers, providers, policymakers, and the public in making informed and comprehensive health care decisions. This study contributes to social change by serving as a baseline for the creation of effective strategies for physician assistant practice and self-assessment. Additionally, data from this study can be used to advocate changes in the education, training, and certification of physician assistants, as well as foster medicine and public health collaborations.
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Mutoro, Antonina Namaemba. "Feeding, care-giving and behaviour characteristics of undernourished children aged between 6 and 24 months in low income areas in Nairobi, Kenya." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/8892/.
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Childhood undernutrition remains a public health problem in slums in Nairobi, yet little is known about current childcare practices, particularly child eating and maternal feeding behavior and their impact on child growth. Treatment options for malnutrition in this setting involve the use of sweet, high energy ready to use foods (RUF), which have the potential to displace home foods, but few studies have assessed this. This thesis therefore aimed to quantify high-risk caring practices in children aged 6-24 months and how these vary with nutrition status. The effects of RUF on meal frequency and eating and feeding behavior were also assessed. The programme of research was underpinned by the following research questions: • What are the commonest modifiable risk factors for undernutrition found in children and how does this pattern vary with nutrition status? • Do ready to use foods displace complementary foods in moderately undernourished children? • Do ready to use foods affect eating and feeding behaviour? Preliminary studies were carried out to test the feasibility of using observations to assess childcare practices. Caregivers of children aged between 6 and 24 months were recruited in Wagha town, a semi urban area in Lahore, Pakistan and in selected slums in Nairobi, Kenya. A structured observation guide was used to collect information on caregiver child interactions during mid-morning meals in Pakistan and lunch time meals in Kenya. A description of childcare practices in the household, specifically dietary practices, feeding behaviour and hygiene practices were assessed by asking the following questions: Who feeds the child? How is the child fed? What is the child fed and how often? What are the hygiene practices of caregivers? Thirty meal observations, 11 in Pakistan and 19 in Kenya, were carried out in homes, while 11 meals were observed in day-care centres in Nairobi. Eating and feeding behaviours varied between cultures. Compared to caregivers in Kenya, caregivers in Pakistan offered more encouragement during meals. In Kenya, encouragement was mainly in response to food refusal and undernourished children were more likely to show aversive eating behaviour. Caregivers would respond to this behaviour by either restraining the child or simply leaving them alone. In day-care centres, laissez faire feeding was common as children were left to feed themselves with little or no assistance. Poor hygiene practices were also common, especially in Kenya where caregivers did not wash their hands before feeding their children. Meal observations were not representative as only one meal could be observed and they were also not practical because of insecurity in the slums. Based on these findings, a cross sectional study carried out in seven health facilities was designed. Caregivers of children aged 6-24 months were recruited from health facilities in two stages. In the first stage, undernourished children (weight for age or weight for length below - 2 Z scores or length for age below -3 Z scores) were quota sampled either from outpatient therapeutic or supplementary feeding programs based on severity and supplementation status between February and August 2015. Undernourished children were recruited from well-baby clinics during growth monitoring. Between July and August 2016 healthy children (weight for age above-2 Z scores) were also recruited from well-baby clinics at the same health facilities. For both groups, child anthropometric measurements were taken and information on sociodemographic, hygiene breastfeeding frequency, meal frequency, dietary diversity, child eating and caregiver feeding behaviour collected using a structured interview guide. Among children receiving ready to use foods, information on child interest in food, food refusal and caregiver force-feeding was also collected for both family meals and ready to use food meals. We recruited 415 children (54.5% female), over half (58.6%) of whom were undernourished. Caregivers and their children came from disadvantaged backgrounds characterized by low parental education. They also lacked access to basic hygiene and sanitation facilities. There was no association between nutrition status and hygiene as nearly all children came from households that lacked piped water (83.6%) and shared toilets (82.9%). Compared to healthy children, undernourished children were more likely not to be breastfeeding (undernourished 11.5%; healthy 5.2% P=0.002) and to receive plated meals at a low frequency (undernourished 12.2%; healthy 26.2% P=0.002). Diets offered were mainly carbohydrate based and there was no association between dietary diversity and nutrition status. Close to one third of children showed low interest in food 25.8% (107) and high food refusal 22.5% (93). Force-feeding was also relatively common 38.5% (155). Compared to healthy children, undernourished children were more likely to show low interest in food (undernourished 34.2%; healthy 14.0% P < 0.001) and high food refusal (undernourished 30.9%; healthy 10.5% P < 0.001); and their mothers were more likely to be anxious about feeding them (undernourished 20.6%; healthy 6.4% P < 0.001). Within the undernourished group, 49.4% had either low interest in food or high food refusal or both. Force-feeding was common in both groups, with a non-significant trend towards more force-feeding in the undernourished infants (undernourished 41.4%; healthy 34.5% P=0.087). Children were more likely to be force-fed if they had low interest in food (odds ratio[95% CI] 3.72 [1.93 to 7.15] P < 0.001) or high food refusal (4.83[2.38 to 9.78] P < 0.001), after controlling for maternal anxiety and child nutrition status. Children appeared to prefer RUF to home foods which is good for treatment compliance, but it may have a negative impact on intake of home foods. Although a single sachet of RUF appeared not to displace family meals in moderately undernourished children, actual energy intake was not measured in this study and these findings are therefore inconclusive. Children in slum areas in Nairobi are exposed to many risk factors which puts them at risk of infection and undernutrition and provision of ready to use foods as a treatment option does not address the underlying problem. There is therefore a need for poverty alleviation strategies which will lead to improved access to hygiene facilities and better environmental conditions. Measures to improve access and utilization of safe nutritious foods as well as mother-child interactions during meals are also required. A better understanding of child care practices and underlying factors that influence them is also required for the design of effective and sustainable interventions in this setting.
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Sims, Donna. "Impact on Material and Child Health Knowledge as a Result of Participation in a Family Resource\Youth Services Center New and Expectant Parenting Series." TopSCHOLAR®, 1998. http://digitalcommons.wku.edu/theses/320.
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The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the pre-test and posttest questionnaires. The questionnaire was a 20 item multiple choice instrument (Learning About Parenting Survey or LAPS) which measured maternal and child health knowledge in such areas as family planning; informed parenting; maternal health; basic baby care; breast-feeding; bottle-feeding; first aid; child's health including immunizations, child safety; nutrition; child development and discipline. Analysis of covariance was performed using the LAPS raw scores from the posttests as the dependent variable, the pretest scores as the covariate and the treatment as the independent variable. The results showed no significant difference in parenting knowledge between the individuals enrolled in the Family Resource\Youth Services Center's New and Expectant Parenting Series and the comparison group who did not take the course.
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Tucker, Helen Jean. "Integrated care : the presence, nature and development of integrated care in community health services in England and Ireland." Thesis, University of Warwick, 2012. http://wrap.warwick.ac.uk/56879/.
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Background: Integrated care is a policy imperative in health and social care services globally, and yet there are reported difficulties in defining, developing and sustaining this way of working. Research Question: This research explores staff views and experiences of the presence, nature and development of integrated care in two programmes of community services. Method: A case study approach was adopted using secondary analysis of qualitative data from staff questionnaires using themed content analysis and pattern matching, with findings triangulated with documentary sources. The study considers the presence and nature of integrated care using the conceptual framework “to what extent integrated care is for everyone (inclusive) and not just for some (exclusive)” as interpreted from the literature. The development of integrated care was explored using systems theory for the management of change in a complex environment. Findings: A meta-analysis of the two case studies demonstrated that integration was present in all 66 services within the two programmes. The nature of integrated care varied and was demonstrated as multiple types (in community hospitals) and processes (in community services). The most frequently reported type was multidisciplinary working. The processes most teams chose to develop were information sharing systems. The development of integration within the case studies was affected by a number of factors, such as commitment and staffing. Conclusion: This study provides new evidence of the presence, nature and development of integration within a wide range of established services spanning all ages. From this and other measures, the extent to which integrated care is presented as “exclusive” can be questioned. These findings have informed the development of a framework of five principles, reflecting whether integrated care is: for everyone, extensive, enduring, can be enabled and essential. The implications and application of this research for policy, service development and training are discussed, and proposals for further research include testing the applicability of this framework and widening this study.
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Denver, Sara Jane. "Experiences of developing cancer and palliative care services in one community in North West England 1976-2000 : an oral history and documentary reconstruction." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5526/.
Full textAbstract:
The purpose of this study was to explore how cancer and palliative care services developed in one place and changed in the course of time. Research on how local cancer and palliative care services have developed is limited. A small number of researchers have provided accounts of hospice developments nationally, but they did not explore individual experiences and the micro context in detail. Other studies have examined accounts of developing local cancer support services, but not hospice developments. This research addresses the question - how were cancer and palliative care services developed in Lancaster 1976 ? 2000? Oral history and documentary sources were used to generate data, which was analysed using thematic analysis/constant comparison. Social constructionism offered a fruitful theoretical basis that increased understandings of oral history accounts. A snowball sample recruited a broad group of participants that had been involved with the local cancer and palliative care services in the relevant period. Thirty five interviews were conducted. The study revealed that services developed in the absence of national planning; participants worked to make them respectable, but there was tension at times. Progress was shaped by a combination of individual and social factors. Services evolved outside the National Health Service, yet alongside oncology and were therefore tripartite in character. Elsewhere developments were often fragmented. Many participants were involved in all the local services; they created networks and collaborated to form comprehensive facilities, which were available from diagnosis to the terminal stage of illness. The approaches complemented each other to reveal that at the macro level services were initially flexible. In time they became more structured, as social, historical, economic, professional and political mechanisms in the broader context impacted to shape them; this created some challenges. The study also uncovered aspects of the meaning of compassion. It revealed that compassionate practices challenged the rationality of conventional approaches and shared relativist perspectives because participants found different ways of providing care. All of these findings contributed to new knowledge about the development of local cancer and palliative care services. The study was limited by the historical period, perhaps by the place and because the reconstruction was one interpretation. It is possible there are others.