scholarly journals Responses to losses in high-deductible health insurance: persistence, emotions, and rationality

2019 ◽  
Vol 3 (1) ◽  
pp. 72-86
Author(s):  
MARK V. PAULY ◽  
HOWARD KUNREUTHER
Keyword(s):  
Health Insurance ◽  
Empirical Studies ◽  
Emotional Responses ◽  
Self Report ◽  
Future Health ◽  
Web Based ◽  
Loss Probabilities ◽  
Loss Experience ◽  
Classical Economic ◽  
Over Time

AbstractThere have been few empirical studies on how consumers respond to their loss experience over time when choosing between high- and low-deductible health insurance plans. To address this question, we designed a ten-period web-based experiment to explore how subjects respond to the presence or absence of illness-related costs in a given period when making their future health insurance choices when they are explicitly informed that future premiums or loss probabilities will not change over time. A sizable minority of the respondents who initially chose high-deductible plans switched after a loss, and switching is more likely if they self-report negative emotional responses to experiencing an uninsured loss. Switching from low- to high-deductible plans is less likely and less responsive to loss experience. The study reveals that many individuals make their health insurance choices by considering factors not included in classical economic models of choice.

scholarly journals Contribution of socioeconomic factors and health care access to the awarenesss and treatment of diabetes and hypertension among older Mexican adults

2015 ◽  
Vol 57 ◽  
pp. 6 ◽  
Author(s):  
Hiram Beltrán-Sánchez ◽  
Flávia Cristina Drumond-Andrade ◽  
Fernando Riosmena
Keyword(s):  
Health Insurance ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Self Report ◽  
Care Access ◽  
Education And Health ◽  
Aging Study ◽  
Treatment Of Diabetes ◽  
Over Time

Objective. To estimate changes in self-report and treatment of diabetes and hypertension between 2001 and 2012 among Mexican aged 50-80, assessing the contribution of education and health insurance coverage. Materials and methods. The Mexican Health and Aging Study was used to estimate associations of education and insurance on prevalence and treatment of diabetes and hypertension in 2001 and 2012. Multivariate decomposition was used to assess the contribution of changes in the composition of covariates vs. their “effects” on changes in prevalence and treatment over time. Results. Increases in the revalence/diagnosis and treatment during the period are largely attributable to the expansion of health insurance. Its effects on iagnosis/prevalence and treatment have also increased over time. Conclusions. The expansion of Seguro Popular likely improved screening and treatment. More research is needed to assess if these have translated into better control and a lower burden of disease.

scholarly journals The Association Between Web-Based or Face-to-Face Lifestyle Interventions on the Perceived Benefits and Barriers to Exercise in Midlife Women: Three-Arm Equivalency Study

10.2196/10963 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e10963
Author(s):  
Amanda Mary McGuire ◽  
Charrlotte Seib ◽  
Janine Porter-Steele ◽  
Debra Jane Anderson
Keyword(s):  
Physical Activity ◽  
Registered Nurses ◽  
Health Behavior Change ◽  
Midlife Women ◽  
Self Report ◽  
Web Based ◽  
Face To Face ◽  
Barriers To Exercise ◽  
Physical Activity And Exercise ◽  
Over Time

Background Noncommunicable diseases pose a significant threat to women’s health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise. Objective This study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women’s Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women. Methods Women aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time. Results Participants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time. Conclusions The results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.

scholarly journals The Association Between Web-Based or Face-to-Face Lifestyle Interventions on the Perceived Benefits and Barriers to Exercise in Midlife Women: Three-Arm Equivalency Study (Preprint)

2018 ◽  
Author(s):  
Amanda Mary McGuire ◽  
Charrlotte Seib ◽  
Janine Porter-Steele ◽  
Debra Jane Anderson
Keyword(s):  
Physical Activity ◽  
Registered Nurses ◽  
Health Behavior Change ◽  
Midlife Women ◽  
Self Report ◽  
Web Based ◽  
Face To Face ◽  
Barriers To Exercise ◽  
Physical Activity And Exercise ◽  
Over Time

BACKGROUND Noncommunicable diseases pose a significant threat to women’s health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise. OBJECTIVE This study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women’s Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women. METHODS Women aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time. RESULTS Participants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time. CONCLUSIONS The results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.

The Therapist’s Reaction to a Patient’s Suicide

Crisis ◽  
2011 ◽  
Vol 32 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Friedrich Martin Wurst ◽  
Isabella Kunz ◽  
Gregory Skipper ◽  
Manfred Wolfersdorf ◽  
Karl H. Beine ◽  
...  
Keyword(s):  
Emotional Responses ◽  
Well Being ◽  
Emotional Reaction ◽  
Emotional Reactions ◽  
Analog Scale ◽  
General Hospitals ◽  
Item Questionnaire ◽  
Retrospective Nature ◽  
The Impact ◽  
Over Time

Background: A substantial proportion of therapists experience the loss of a patient to suicide at some point during their professional life. Aims: To assess (1) the impact of a patient’s suicide on therapists distress and well-being over time, (2) which factors contribute to the reaction, and (3) which subgroup might need special interventions in the aftermath of suicide. Methods: A 63-item questionnaire was sent to all 185 Psychiatric Clinics at General Hospitals in Germany. The emotional reaction of therapists to patient’s suicide was measured immediately, after 2 weeks, and after 6 months. Results: Three out of ten therapists suffer from severe distress after a patients’ suicide. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. The emotional responses immediately after the suicide explained 43.5% of the variance of total distress in a regression analysis. Limitations: The retrospective nature of the study is its primary limitation. Conclusions: Our data suggest that identifying the severely distressed subgroup could be done using a visual analog scale for overall distress. As a consequence, more specific and intensified help could be provided to these professionals.

The Effect of Searching Versus Surfing on Cognitive and Emotional Responses to Online News

2009 ◽  
Vol 21 (2) ◽  
pp. 49-59 ◽  
Author(s):  
Kevin Wise ◽  
Hyo Jung Kim ◽  
Jeesum Kim
Keyword(s):  
Heart Rate ◽  
Skin Conductance ◽  
Skin Conductance Level ◽  
Emotional Responses ◽  
Online News ◽  
Self Report ◽  
Mixed Design ◽  
Information Need ◽  
News Stories ◽  
Rate Acceleration

A mixed-design experiment was conducted to explore differences between searching and surfing on cognitive and emotional responses to online news. Ninety-two participants read three unpleasant news stories from a website. Half of the participants acquired their stories by searching, meaning they had a previous information need in mind. The other half of the participants acquired their stories by surfing, with no previous information need in mind. Heart rate, skin conductance, and corrugator activation were collected as measures of resource allocation, motivational activation, and unpleasantness, respectively, while participants read each story. Self-report valence and recognition accuracy were also measured. Stories acquired by searching elicited greater heart rate acceleration, skin conductance level, and corrugator activation during reading. These stories were rated as more unpleasant, and their details were recognized more accurately than similar stories that were acquired by surfing. Implications of these results for understanding how people process online media are discussed.

Quantitative Methods for Measuring Neighborhood Characteristics in Neighborhood Health Research

2018 ◽  
Author(s):  
Dustin T. Duncan ◽  
William C. Goedel ◽  
Rumi Chunara
Keyword(s):  
Quantitative Methods ◽  
Assessment Method ◽  
Self Report ◽  
Neighborhood Characteristics ◽  
Web Based ◽  
Neighborhood Characteristic ◽  
Social Observation ◽  
Gis Methods ◽  
Information Retrieval Methods ◽  
Online Sources

Research connecting neighborhoods and health has characterized neighborhood factors in multiple ways. This chapter discusses standard and emerging methods to measure and study neighborhood characteristics. In particular, this chapter provides an overview of neighborhood characteristic assessment methods, including self-report, systematic social observation, geographic information system (GIS) methods, Web-based geospatial methods, real-time geospatial methods, crowd-sourced geospatial methods, and information retrieval methods from online sources such as Instagram and Twitter. This chapter also discusses the strengths and limitations of each neighborhood characteristic assessment method (e.g., ease of administration, validity), and readers are provided with examples of each neighborhood assessment method applied in the epidemiology and population health literature.

Dualities, Dialectics, and Paradoxes in Organizational Life

2018 ◽  
Keyword(s):  
Dynamic Systems ◽  
Empirical Studies ◽  
Organizational Studies ◽  
Organizational Life ◽  
Organizational Processes ◽  
Organization Studies ◽  
Process Studies ◽  
Convergence And Divergence ◽  
Insight Into ◽  
Over Time

Organizational contradictions and process studies offer interwoven and complementary insights. Studies of dialectics, paradox, and dualities depict organizational contradictions that are oppositional as well as interrelated such that they persistently morph and shift over time. Studies of process often examine how contradictions fuel emergent, dynamic systems and stimulate novelty, adaptation, and transformation. Drawing from rich conversations at the Eighth International Symposium on Process Organization Studies, the contributors to this volume unpack these relationships in more depth. The chapters explore three main, connected themes through both conceptual and empirical studies, including (1) offering insight into how process theorizing advances understandings of organizational contradictions; (2) shedding light on how dialectics, paradoxes, and dualities fuel organizational processes that affect persistence and transformation; and (3) exploring the convergence and divergence of dialectics, paradox, and dualities lenses. Taken together, this book offers key insights in order to inform persistent, contradictory dynamics in organizations and organizational studies.

scholarly journals Increasing Voluntary Public Health Reporting to the NHSN Antimicrobial Use Option

2020 ◽  
Vol 41 (S1) ◽  
pp. s296-s297
Author(s):  
Heather Dubendris ◽  
Amy Webb ◽  
Melinda Neuhauser ◽  
Arjun Srinivasan ◽  
Wendy Wise ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Stewardship ◽  
Self Report ◽  
Antimicrobial Use ◽  
Health Departments ◽  
Public Health Reporting ◽  
Use Stage ◽  
Education And Development ◽  
Health Registry ◽  
Over Time

Background: The CDC NHSN launched the Antimicrobial Use Option in 2011. The Antimicrobial Use Option allows users to implement risk-adjusted antimicrobial use benchmarking within- and between- facilities using the standardized antimicrobial administration ratio (SAAR) and to evaluate use over time. The SAAR can be used for public health surveillance and to guide an organization’s stewardship or quality improvement efforts. Methods: Antimicrobial Use Option enrollment grew through partner engagement, targeted education, and development of data benchmarking. We analyze enrollment over time and discuss key drivers of participation. Results: Initial 2011 Antimicrobial Use Option enrollment efforts awarded grant Funding: to 4 health departments. These health departments partnered with hospitals, which encouraged vendors to build infrastructure for electronic antimicrobial use reporting. CDC supported vendors through outreach and education. In 2012, with CDC support, Veterans’ Affairs (VA) Informatics, Decision-Enhancement, and Analytic Sciences Center and partners began implementation of Antimicrobial Use Option reporting and validation of submitted data. These early efforts led to enrollment of 64 facilities by 2014 (Fig. 1). As awareness of the antimicrobial use option grew, we focused on facility engagement and development of benchmark metrics. A second round of grant Funding: in 2015 supported submission to the Antimicrobial Use Option from additional facilities by Funding: a vendor, a healthcare system, and an antimicrobial stewardship network. In 2015, CMS recognized the Antimicrobial Use Option as a choice for public health registry reporting under Meaningful Use Stage 3, resulting in an increase in participating hospitals. Antimicrobial Use Option enrollment increased in 2015 (n = 120), coinciding with national prioritization of antimicrobial stewardship. In 2016, the SAAR, was released in NHSN. We leveraged the SAAR to encourage participation from additional facilities and began quarterly calls to encourage continued participation from existing users. In 2016, the Department of Defense began submitting data to the Antimicrobial Use Option, resulting in 207 facilities enrolled in 2016, which grew to 616 in 2017. As of November 2019, 12 vendors self-report submission capabilities and 1,470 facilities, of ~6,800 active NHSN participants, are enrolled in the Antimicrobial Use Option. Two states have passed requirements regulating Antimicrobial Use Option reporting with Tennessee’s requirement going into effect in 2021. Conclusions: The Antimicrobial Use Option offers evidence that collaboration with partners, and leveraging of benchmarking metrics available to a national surveillance system can lead to increased voluntary participation in surveillance of high-priority public health data. Moving forward, we will continue expanding analytic capabilities and partner engagement.Funding: NoneDisclosures: None

Factors Distinguishing Reciprocal Versus Nonreciprocal Intimate Partner Violence Across Time and Reporter

2021 ◽  
pp. 088626052110014
Author(s):  
Doris F. Pu ◽  
Christina M. Rodriguez ◽  
Marina D. Dimperio
Keyword(s):  
Risk Factors ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Transition To Parenthood ◽  
Intimate Partner ◽  
Self Report ◽  
Cross Sectional ◽  
Couple Functioning ◽  
Female Perpetrators ◽  
Over Time

Although intimate partner violence (IPV) is often conceptualized as occurring unilaterally, reciprocal or bidirectional violence is actually the most prevalent form of IPV. The current study assessed physical IPV experiences in couples and evaluated risk and protective factors that may be differentially associated with reciprocal and nonreciprocal IPV concurrently and over time. As part of a multi-wave longitudinal study, women and men reported on the frequency of their IPV perpetration and victimization three times across the transition to parenthood. Participants also reported on risk factors related to personal adjustment, psychosocial resources, attitudes toward gender role egalitarianism, and sociodemographic characteristics at each wave. Participants were classified into one of four IPV groups (reciprocal violence, male perpetrators only, female perpetrators only, and no violence) based on their self-report and based on a combined report, which incorporated both partners’ reports of IPV for a maximum estimate of violence. Women and men were analyzed separately, as both can be perpetrators and/or victims of IPV. Cross-sectional analyses using self-reported IPV data indicated that IPV groups were most consistently distinguished by their levels of couple satisfaction, across gender; psychological distress also appeared to differentiate IPV groups, although somewhat less consistently. When combined reports of IPV were used, sociodemographic risk markers (i.e., age, income, and education) in addition to couple functioning were among the most robust factors differentiating IPV groups concurrently, across gender. In longitudinal analyses, sociodemographic vulnerabilities were again among the most consistent factors differentiating subsequent IPV groups over time. Several gender differences were also found, suggesting that different risk factors (e.g., women’s social support and men’s emotion regulation abilities) may need to be targeted in interventions to identify, prevent, and treat IPV among women and men.

scholarly journals Rehabilitation Therapy Utilization in Patients with Parkinson’s Disease in Korea

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Han Gil Seo ◽  
Sang Jun Park ◽  
Jiah Seo ◽  
Seong Jun Byun ◽  
Byung-Mo Oh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Health Insurance ◽  
Clinical Practice ◽  
Patient Characteristics ◽  
National Sample ◽  
Present Evidence ◽  
Rehabilitation Therapy ◽  
Swallowing Therapy ◽  
Over Time

Objective. Although evidence and guidelines recommend appropriate rehabilitation from the beginning of diagnosis in patients with Parkinson’s disease (PD), there is a lack of data addressing the utilization of rehabilitation therapies for these patients in practice. The aim of this study is to investigate the rate of rehabilitation therapy utilization over time in patients with PD using a nationwide cohort in Korea. Methods. Patients were identified using the registration code for PD in the program for rare, intractable disease from the National Health Insurance Service-National Sample Cohort database, which consists of 979,390 Korean residents. Data were divided into four periods: 2004–2006, 2007–2009, 2010–2012, and 2013–2015. We assessed the utilization of rehabilitation therapies and the associated patient characteristics. Results. The numbers of patients with PD were 384 in 2004, 855 in 2007, 1,023 in 2010, and 1,222 in 2013. The numbers of physiatrist visits per person were 0.58, 0.96, 1.97, and 2.91, in the respective periods. Among the patients, 35–40% had claims for physical therapy, 16–19% for occupational therapy, and 4–6% for swallowing therapy. There were no remarkable differences between these rates between the study periods. Sex, age, income, disability, and levodopa-equivalent dose were significantly associated with the utilization of rehabilitation therapy. Conclusion. This study demonstrated that the rate of rehabilitation therapy utilization did not change remarkably in patients with PD from 2004 to 2015 in Korea although the number of physiatrist visits increased dramatically. The present evidence and guidelines may have not been adequately integrated into clinical practice during the period of study. Additional efforts may be warranted to provide adequate rehabilitation therapies in clinical practice for patients with PD.

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