Journal of health and human services administration最新文献

Most Americans will acquire a chronic disease during their lifetime. One of the most prevalent chronic diseases that affect Americans is hypertension (HTN). Despite the known comorbidities and increased mortality rate associated with uncontrolled HTN, most community dwelling adults with HTN do not have sufficient blood pressure control Therefore, the aim of this article is to report the preliminary efficacy of a serious game for health to enhance blood pressure control among community dwelling adults with HTN. A nonprobability sample of 116 community dwelling adults with HTN participated in this nonblinded, randomized controlled trial. Participants were randomly assigned to: (1) an intervention arm that consisted of four exposures to a serious game for health known as eSMART-HD; or (2) an attentional control arm that compromised of four exposures to screen-based HTN education. The primary outcome measure for this trial was blood pressure reduction over a four month observational period. In this study, baseline characteristics and blood pressure measurements were similar between participants in each study arm. There was no significant between-group difference in blood pressure reduction over time. However, there were significant within-group reductions in systolic and diastolic blood pressures across time among favoring participants exposed to eSMART-HD. This study establishes the preliminary efficacy of eSMART-HD that can be easily administered to community dwelling adults and facilitate clinically significant reductions in systolic and diastolic blood pressures. Future studies should assess the influential components of this promising serious game for health (eSMART-HD) combined with medication management in larger and more diverse samples of community dwelling adults with HTN.

This study seeks to determine the payer source for single, elderly women in nursing homes by using secondary data from the 2004 National Nursing Home Survey was extracted and analyzed for the aforementioned hypotheses. By determining the payer source for single, elderly women, the next generation of women can prepare for high nursing home costs by saving earlier or investing in long-term care insurance. The analyses indicated self-pay and Medicaid was the primary sources for elderly women in nursing homes. Marital status did not have an impact on the payer source for elderly women. Single women did not have different payer sources than married elderly women. However, the study did not focus on payer sources for single, elderly women in nursing homes, but the demographic population as a whole.

Recently, recommendations have been made that global health initiatives change their focus from disease specific intervention to bolstering health systems and general health care. The aim of this is to ultimately increase access to primary care, clean water, education, hygiene, and prevent malnutrition, among other goals. While many major global health initiatives have followed this trend, so have many smaller scale programs including short-term medical brigades. Despite a trending increase in the number of privately run short-term medical brigades, until recently, little research has been done on the potential positive and negative effects that can arise from such programs. Now, guidelines have been initiated to create well-structured programs. When followed, these smaller scale initiatives can be successful in helping increase access to healthcare, sustainably strengthening communities in terms of general health. While recent legislation in the United States has addressed domestic policy in the Patient Protection Affordable Care Act of 2010 (ACA), the ACA should also consider some of the basic "sustainable" policies being implemented by international health care providers.

The California State University (CSU) Chancellor's Office reached an agreement with all CSU collective bargaining units and Employee Relations on a uniform Catastrophic (CAT) Leave Donation Program in 1992. The CAT Leave Donation Program allows employees to donate sick and/or vacation leave credits to employees who are incapacitated due to a catastrophic illness or injury and have exhausted all of their own leave credits. This also extends to employees with whom family illnesses are deemed catastrophic, thus requiring the employee to care for an immediate family member. Stakeholders include union represented employees who accrue leave credits as well as any employee who receives or donates hours of leave credits in the program. Other stakeholders include the family members and program administrators.

Objectives: We explored barriers to healthcare as perceived by members of medically and socially disenfranchised communities.

Methods: We conducted focus groups with 28 women and 32 men from Northeast Ohio who identified themselves as African-American, Hispanic/Latino, lesbian/gay/bisexual/transgendered, and/or Russian immigrant.

Results: Participants described their experiences of waiting, things they won't tolerate, when they won't participate, and what they want from providers. They described behaviors, actions and relationship characteristics that they want from their providers and characteristics that they prefer in health systems.

Conclusions: The themes of Wait, Won't, and Want have healthcare practice and policy implications. Patient-provider interactions are known to be significant determinants of healthcare outcomes and these exploratory findings suggest that they might also affect patient self-management strategies. Future efforts should focus on developing and testing patient-centered strategies that address the themes identified to increase engagement to increase self-management of health.

Objective: To translate and adapt an effective, validated, benchmarked, and widely used patient satisfaction measurement tool for use with an Arabic-speaking population.

Design: Translation of survey's items, survey administration process development, evaluation of reliability, and international benchmarking

Setting: Three hundred-bed tertiary care hospital in Jeddah, Saudi Arabia.

Participants: 645 patients discharged during 2011 from the hospital's inpatient care units. INTERVENTIONS; The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was translated into Arabic, a randomized weekly sample of patients was selected, and the survey was administered via telephone during 2011 to patients or their relatives.

Main outcome measures: Scores were compiled for each of the HCAHPS questions and then for each of the six HCAHPS clinical composites, two non-clinical items, and two global items.

Results: Clinical composite scores, as well as the two non-clinical and two global items were analyzed for the 645 respondents. Clinical composites were analyzed using Spearman's correlation coefficient and Cronbach's alpha to demonstrate acceptable internal consistency for these items and scales demonstrated acceptable internal consistency for the clinical composites. (Spearman's correlation coefficient = 0.327 - 0.750, P < 0.01; Cronbach's alpha = 0.516 - 0.851) All ten HCAHPS measures were compared quarterly to US national averages with results that closely paralleled the US benchmarks.

Conclusion: . The Arabic translation and adaptation of the HCAHPS is a valid, reliable, and feasible tool for evaluation and benchmarking of inpatient satisfaction in Arabic speaking populations.