scholarly journals 3201 Patient Perceptions of Healthcare Provider Interactions among Higher-Weight Women with Eating Disorders: Opportunities for Earlier Screening, Improved Referral, and Increased Clinician Rapport

2019 ◽  
Vol 3 (s1) ◽  
pp. 151-151
Author(s):  
Erin Nicole Harrop
Keyword(s):  
Healthcare Provider ◽  
Qualitative Interviews ◽  
Treatment Delay ◽  
Diagnostic Interview ◽  
Provider Education ◽  
Significant Treatment ◽  
Community Provider ◽  
Patient Interview ◽  
Family Advocacy ◽  
The Right

OBJECTIVES/SPECIFIC AIMS: Objective: Identify barriers and facilitators of positive patient-provider interactions for AAN patients. METHODS/STUDY POPULATION: Methods: Using a mixed-methods, longitudinal, patient-interview design, N = 29 (to date) women with a history of AAN have been enrolled. Each patient completed a diagnostic interview and standardized surveys to establish ED diagnosis, severity, and associated psychopathology. Transcribed, semi-structured qualitative interviews are assessed for common themes using content analysis methods. RESULTS/ANTICIPATED RESULTS: Anticipated Results: Patients aged 18 to 74 (M = 36.3, SD = 12.0), with mean BMI = 39.8 (22.7-61.1; SD = 11.3), and mean weight suppression (lbs) during their illness = 119.41 (SD = 69.3). Women reported a mean=12.75 years (0-37 years, SD = 10.5) treatment delay. Qualitative analysis revealed the following barriers in healthcare provider interactions: 1) experiences of provider weight-bias, 2) low specificity in ED screening questions, 3) lack of indicated screening procedures/diagnostic tests (orthostatic screening, EKG, food log, labs), and 4) provider praise of ED behaviors. Facilitators: 1) lower BMI at presentation, 2) provider education in EDs, 3) community-provider collaboration, and 4) patient self- and family- advocacy. DISCUSSION/SIGNIFICANCE OF IMPACT: Discussion: Unfortunately, while early intervention best predicts positive outcomes, higher-weight patients in this study experienced significant treatment delay. Translationally, it is taking too long for AAN patients to receive the right treatment at the right time. However, findings indicate that interventions at the provider level (increasing ED education, building community partnerships, increased adherence to screening protocols) could improve screening, diagnostic, and referral practices—and ultimately long-term outcomes for this unique patient population.

scholarly journals Implementation Research to Understand and Target Complex Needs: A Case Study of US-based Food Assistance Programming (P10-147-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Andrea Warren ◽  
Edward Frongillo ◽  
Shana Alford ◽  
Erin McDonald ◽  
Jessica Escobar-Alegria
Keyword(s):  
Implementation Research ◽  
Qualitative Interviews ◽  
Food Assistance ◽  
Functional Abilities ◽  
Social Environments ◽  
Physical Strength ◽  
Complex Needs ◽  
Assistance Programs ◽  
The Right ◽  
Insight Into

Abstract Objectives The objective of this study was to understand needs among seniors for food and food assistance and to develop a comprehensive taxonomy for these needs. Methods A total of 147 seniors were purposively sampled from 12 food-assistance programs in 9 states. Of the 12 programs, 10 provided unprepared foods and 2 provided pre-cooked meals. Data were semi-structured qualitative interviews. Coding and analysis of transcripts followed an inductive qualitative analysis approach. A series of thematic summaries were prepared to reflect the content of the interviews for discussion and refinement of the analytic approach. Results An emergent taxonomy comprised 3 categories consisting of abilities and ranges or variants of those abilities. The category of physical ability consists of physical strength, the ability to prepare food, the ability to walk or stand, and health status. These relate to an individual's functional abilities to live and act independently and may be considered pre-conditions for program uptake and benefit distinct from dietary and food security-related needs and limitations. The category of consuming food consists of preferences, accessibility, affordability, and dietary needs. This category highlights the relationship between economic constraints and dietary needs that often necessitates meaningful tradeoffs in consuming the right foods for their health. The category of access and use of transportation consists of own means, friends or family, and public or private services. This category highlights challenges in accessing programs and provides insight into seniors’ experiences of poverty, declining functional abilities, social networks and connectedness, geography, and public services. Conclusions The process used to develop the taxonomy and the taxonomy itself provide an exemplar for implementation research when the nature of need is complex and programs integrated across sectors are required to address the need. The taxonomy provides structure to facilitate the identification of key factors in program engagement—and insight into the economic and social environments in which they occur—that translate into needs relevant to the design, targeting, and uptake of food assistance in a diverse population of seniors. Funding Sources Enterprise Rent-a-Car Foundation.

scholarly journals Putting them on a strong spiritual path: Indigenous doulas responding to the needs of Indigenous mothers and communities

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jaime Cidro ◽  
Caroline Doenmez ◽  
Stephanie Sinclair ◽  
Alexandra Nychuk ◽  
Larissa Wodtke ◽  
...  
Keyword(s):  
Social Services ◽  
Post Partum ◽  
Qualitative Interviews ◽  
Critical Role ◽  
Community Needs ◽  
Cultural Aspects ◽  
Trauma Informed Care ◽  
Wide Range ◽  
Post Partum Period ◽  
The Right

Abstract Objective In the past few years, increasing numbers of Indigenous doula collectives have been forming across Canada. Indigenous doulas provide continuous, culturally appropriate support to Indigenous women during pregnancy, birth, and the post-partum period. This support is critical to counter systemic medical racism and socioeconomic barriers that Indigenous families disproportionately face. This paper analyzes interviews with members of five Indigenous doula collectives to demonstrate their shared challenges, strategies, and missions. Methods Qualitative interviews were conducted with members of five Indigenous doula collectives across Canada in 2020. Interviews were transcribed and returned to participants for their approval. Approved transcripts were then coded by all members of the research team to ascertain the dominant themes emerging across the interviews. Results Two prominent themes emerged in the interviews. The first theme is “Indigenous doulas responding to community needs.” Participants indicated that responding to community needs involves harm reduction and trauma-informed care, supporting cultural aspects of birthing and family, and helping clients navigate socioeconomic barriers. The second theme is “Indigenous doulas building connections with mothers.” Participants’ comments on providing care to mothers emphasize the importance of advocacy in healthcare systems, boosting their clients’ confidence and skills, and being the “right” doula for their clients. These two inter-related themes stem from Indigenous doulas’ efforts to counter dynamics in healthcare and social services that can be harmful to Indigenous families, while also integrating cultural teachings and practices. Conclusion This paper illustrates that Indigenous doula care responds to a wide range of issues that affect Indigenous women’s experiences of pregnancy, birth, and the post-partum period. Through building strong, trusting, and non-judgemental connections with mothers and responding to community needs, Indigenous doulas play a critical role in countering medical racism in hospital settings and advancing the resurgence of Indigenous birthing sovereignty.

scholarly journals Redrawing the border through the ‘Right to Rent’: Exclusion, discrimination and hostility in the English housing market

2020 ◽  
pp. 026101831989704 ◽  
Author(s):  
Kim Mckee ◽  
Sharon Leahy ◽  
Trudi Tokarczyk ◽  
Joe Crawford
Keyword(s):  
Racial Profiling ◽  
Qualitative Interviews ◽  
Criminal Prosecution ◽  
Undocumented Migrants ◽  
Hostile Environment ◽  
Home Office ◽  
Illegal Migrants ◽  
Guidance Documents ◽  
The Uk ◽  
The Right

The UK Immigration Act 2016 is central to the Conservative Government’s drive to create a more hostile environment for potential migrants and current ‘illegal’ migrants residing in the UK. The Right to Rent provisions of the Act, which require private landlords in England to conduct mandatory immigration document checks on prospective tenants, or face sizeable fines and criminal prosecution, have been highlighted as a key facet of the legislation. Drawing on qualitative interviews with key experts and analysis of Home Office guidance documents, we argue the Right to Rent has turned the private rental market into a border-check, with landlords responsibilised to perform ‘everyday bordering’ on behalf of the State. This creates a potentially discriminatory environment for all migrants, as well as for British citizens who lack documentation and/or may be subject to racial profiling. It may also be forcing vulnerable, undocumented migrants into even more precarious housing situations.

scholarly journals A stoic and altruistic orientation towards their work: a qualitative study of healthcare professionals’ experiences of awaiting a COVID-19 test result

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Malene Missel ◽  
Camilla Bernild ◽  
Ilkay Dagyaran ◽  
Signe Westh Christensen ◽  
Selina Kikkenborg Berg
Keyword(s):  
Professional Identity ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Analytical Framework ◽  
Hard Time ◽  
Knowing That ◽  
Current Outbreak ◽  
The Right ◽  
Decisive Parameter ◽  
Test Result

Abstract Background Extensive measures to reduce person-to-person transmission of COVID-19 are required to control the current outbreak. Special attention is directed at healthcare professionals as reducing the risk of infection in healthcare is essential. The purpose of this study was to explore healthcare professionals’ experiences of awaiting a test result for a potential COVID-19 infection. Methods Qualitative interviews with 15 healthcare professionals were performed, underpinned by a phenomenological hermeneutical analytical framework. Results The participating healthcare professionals’ experiences of awaiting a COVID-19 test result were found to be associated with a stoic and altruistic orientation towards their work. These healthcare professionals presented a strong professional identity overriding most concerns about their own health. The result of the coronavirus test was a decisive parameter for whether healthcare professionals could return to work. The healthcare professionals were aware that their family and friends were having a hard time knowing that the COVID-19 infection risk was part of their jobs. This concern did not, however, cause the healthcare professionals to falter in their belief that they were doing the right thing by focusing on their core area. The threat to own health ran through the minds of the healthcare professionals occasionally, which makes access to testing particularly important. Conclusion The participating healthcare professionals had a strong professional identity. However, a discrepancy between an altruistic role as a healthcare professional and the expectations that come from the community was illuminated. A mental health coronavirus hotline for healthcare professionals is suggested.

The Asylum Procedure in Germany: Desperation and Uncertainty as Risk Factors for Violence Among Young Adult Asylum Seekers in Collective Accommodations

2020 ◽  
pp. 088626052095797
Author(s):  
Ahmad Al Ajlan
Keyword(s):  
Young Adult ◽  
Social Workers ◽  
Asylum Seekers ◽  
Qualitative Interviews ◽  
Total Institution ◽  
African Countries ◽  
Human Needs ◽  
Right To Work ◽  
The Right ◽  
Asylum Procedure

This study explores how violence occurs among young adult asylum seekers in collective accommodations in the state of North Rhine-Westphalia in Germany. It provides an insider perspective to understand a phenomenon related to non-European people who were forced to leave their countries to seek asylum. Based on 16 qualitative interviews with young adult male asylum seekers from Syria and some African countries, seven interviews with social workers, and one interview with a German psychological therapist, the author finds that the asylum procedure in Germany as a total institution catalyzes violence among young adult asylum seekers in collective accommodations. The present study shows that collective accommodations are unhomely places, where “inmates” lack privacy and autonomy. In addition, the asylum procedure deprives them of essential human needs, such as the right to work and to have full access to the health care system. These circumstances make them uncertain and desperate, which leads to violence among them. The author calls for more attention towards the human needs of asylum seekers, rather than making them related to the granting of asylum, which can ultimately take years.

scholarly journals Can we normalise developmentally appropriate health care for young people in UK hospital settings? An ethnographic study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029107 ◽  
Author(s):  
Tim Rapley ◽  
Albert Farre ◽  
Jeremy R Parr ◽  
Victoria J Wood ◽  
Debbie Reape ◽  
...  
Keyword(s):  
Young People ◽  
Qualitative Interviews ◽  
Developmentally Appropriate ◽  
Young Person ◽  
Ethnographic Study ◽  
Adolescent And Young Adult ◽  
Normalisation Process Theory ◽  
Care Hospital ◽  
Informal Networks ◽  
The Right

ObjectiveThe WHO has argued that adolescent-responsive health systems are required. Developmentally appropriate healthcare (DAH) for young people is one approach that could underpin this move. The aim of this study was to explore the potential for DAH to become normalised, to become a routine, taken-for-granted, element of clinical practice.DesignQualitative ethnographic study. Analyses were based on procedures from first-generation grounded theory and theoretically informed by normalisation process theory.SettingTwo tertiary and one secondary care hospital in England.Participants192 participants, health professionals (n=121) and managers (n=71) were recruited between June 2013 and January 2015. Approximately 1600 hours of non-participant observations in clinics, wards and meeting rooms were conducted, alongside 65 formal qualitative interviews.ResultsWe observed diverse values and commitments towards the care of young people and provision of DAH, including a distributed network of young person-orientated practitioners. Informal networks of trust existed, where specific people, teams or wards were understood to have the right skill-mix, or mindset, or access to resources, to work effectively with young people. As young people move through an organisation, the preference is to direct them to other young person-orientated practitioners, so inequities in skills and experience can be self-sustaining. At two sites, initiatives around adolescent and young adult training remained mostly within these informal networks of trust. At another, through support by wider management, we observed a programme that sought to make the young people’s healthcare visible across the organisation, and to get people to reappraise values and commitment.ConclusionTo move towards normalisation of DAH within an organisation, we cannot solely rely on informal networks and cultures of young person-orientated training, practice and mutual referral and support. Organisation-wide strategies and training are needed, to enable better integration and consistency of health services for all young people.

scholarly journals Why do general practitioners not refer patients to behaviour-change programmes after preventive health checks? A mixed-method study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Nina Kamstrup-Larsen ◽  
Marie Broholm-Jørgensen ◽  
Susanne O. Dalton ◽  
Lars B. Larsen ◽  
Janus L. Thomsen ◽  
...  
Keyword(s):  
General Practitioners ◽  
Behaviour Change ◽  
Mixed Method ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Behavioural Change ◽  
Preventive Health ◽  
Health Checks ◽  
Randomised Controlled ◽  
The Right

Abstract Background This study was embedded in the Check-In randomised controlled trial that investigated the effectiveness of general practice-based preventive health checks on adverse health behaviour and early detection of non-communicable diseases offered to individuals with low socioeconomic positions. Despite successful recruitment of patients, the intervention had no effect. One reason for the lack of effectiveness could be low rates of referral to behaviour-change programmes in the municipality, resulting in a low dose of the intervention delivered. The aim of this study is to examine the referral pattern of the general practitioners and potential barriers to referring eligible patients to these behaviour-change programmes. Methods A mixed-method design was used, including patients’ questionnaires, recording sheet from the health checks and semi-structured qualitative interviews with general practitioners. All data used in the study were collected during the time of the intervention. Logistic regressions were used to estimate odds ratios for being eligible and for receiving referrals. The qualitative empirical material was analysed thematically. Emerging themes were grouped, discussed and the material was re-read. The themes were reviewed alongside the analysis of the quantitative material to refine and discuss the themes. Results Of the 364 patients, who attended the health check, 165 (45%) were marked as eligible for a referral to behaviour-change programme by their general practitioner and of these, 90 (55%) received referrals. Daily smoking (OR = 3.22; 95% CI:2.01–5.17), high-risk alcohol consumption (OR = 2.66; 95% CI:1.38–5.12), obesity (OR = 2.89; 95% CI:1.61–5.16) and poor lung function (OR = 2.05; 95% CI:1.14–3.70) were all significantly associated with being eligible, but not with receiving referral. Four themes emerged as the main barriers to referring patients to behaviour-change programmes: 1) general practitioners’ responsibility and ownership for their patients, 2) balancing information and accepting a rejection, 3) assessment of the right time for behavioural change and 4) general practitioners’ attitudes towards behaviour-change programmes in the municipality. Conclusion We identified important barriers among the general practitioners which influenced whether the patients received referrals to behaviour-change programmes in the municipality and thereby influenced the dose of intervention delivered in Check-In. The findings suggest that an effort is needed to assist the collaboration between general practices and the municipalities’ primary preventive services. Trial registration Clinical Trials NCT01979107; October 25, 2013.

The effect of healthcare provider education on diabetes management of hospitalised patients

2010 ◽  
Vol 64 (7) ◽  
pp. 917-924 ◽  
Author(s):  
J. M. Chehade ◽  
M. Sheikh-Ali ◽  
I. Alexandraki ◽  
J. House ◽  
A. D. Mooradian
Keyword(s):  
Healthcare Provider ◽  
Diabetes Management ◽  
Provider Education ◽  
Hospitalised Patients

Breastfeeding Knowledge and Intent to Breastfeed

2016 ◽  
Vol 7 (2) ◽  
pp. 62-68 ◽  
Author(s):  
Emily Lee ◽  
Joanie Jackson
Keyword(s):  
Healthcare Provider ◽  
Healthcare Providers ◽  
The United States ◽  
Evidence Based ◽  
Provider Education ◽  
Breastfeeding Knowledge ◽  
Self Confidence ◽  
Breastfeeding Education ◽  
Provider Knowledge ◽  
Common Barriers

Objectives: Identify, synthesize, and critically review research on common barriers to successful breastfeeding and ways healthcare providers can assist patients in overcoming the barriers.Methods: A search of databases and citations for evidence-based research published from 2001 to 2015 was conducted. Forty-nine articles were reviewed with 22 articles being discussed.Results: Three major themes were identified: (a) characteristics of breastfeeding education in the prenatal setting, (b) primary care interventions to promote breastfeeding, and (c) healthcare provider education on breastfeeding.Conclusions: Findings of this review collectively suggest the need to increase breastfeeding rates among women in the United States. To achieve this, there is great significance placed on healthcare providers implementing interventions to promote breastfeeding, which subsequently requires improving healthcare provider knowledge and self-confidence on breastfeeding.

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