Clinician Experience with Telemedicine at a Safety-net Hospital Network during COVID-19: A Cross-sectional Survey

AbstractObjective:The purpose of this evaluation study was to identify strengths and opportunities for improvement in programme functioning and common aspects of patients’ experiences at a hospital-based food pantry.Design:Semi-structured, in-depth interviews with patients and a cross-sectional survey for providers were used. Interview transcripts were coded using both inductive and deductive approaches and assessed for inter-rater reliability. Descriptive statistics were produced from quantitative data.Setting:An academic urban safety-net hospital in the Northeastern US offering inpatient and outpatient services.Participants:Thirty patients and 89 providers.Results:Patients expressed feeling comfortable, trusting the food, high satisfaction with food quality, convenience, and lack of stigma at the hospital-based pantry. Patients mentioned the pantry helped them eat more fruits and vegetables, but expressed concerns about the healthfulness of other foods distributed. Providers believed they should discuss food insecurity (FI) with patients (99 %) and that the pantry improves the health of patients (97 %), but faced barriers to consistently screening for FI and referring patients to the pantry, such as insufficient training on FI (53 %) and time constraints (35 %).Conclusions:Findings suggest hospital-based food pantries may have several advantages. Hospitals with onsite food pantries must work to eliminate barriers to FI screening and pantry referral. To optimize their impact, such pantries should develop nutritional guidelines for food donations and connect patients with nutrition education resources. Future research should examine health outcomes for patients using hospital-based food pantries.

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Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey

BMC Health Services Research ◽

10.1186/s12913-016-1443-1 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 5

Author(s):

Naomi Yu Ko ◽

Tracy A. Battaglia ◽

Rebecca Gupta-Lawrence ◽

Jessica Schiller ◽

Christine Gunn ◽

...

Keyword(s):

Cancer Care ◽

Safety Net ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Services ◽

Vulnerable Patients ◽

Safety Net Hospital ◽

Urban Safety

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Universal screening for SARS-CoV-2 infection among pregnant women at Elmhurst Hospital Center, Queens, New York

PLoS ONE ◽

10.1371/journal.pone.0238409 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0238409

Author(s):

Sheela Maru ◽

Uday Patil ◽

Rachel Carroll-Bennett ◽

Aaron Baum ◽

Tracy Bohn-Hemmerdinger ◽

...

Keyword(s):

New York ◽

Pregnant Women ◽

Universal Screening ◽

Screening Program ◽

Safety Net ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Percentage Points ◽

Safety Net Hospital

Background Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. Methods and findings We conducted a retrospective cross-sectional study. All pregnant women admitted to the L&D Unit of Elmhurst Hospital from March 29, 2020 to April 22, 2020 were included for analysis. The primary outcomes of the study were: (1) SARS-CoV-2 positivity among universally screened pregnant women, stratified by demographic characteristics, maternal comorbidities, and delivery outcomes; and (2) Symptomatic or asymptomatic presentation at the time of testing among SARS-CoV-2 positive women. A total of 126 obstetric patients were screened for SARS-CoV-2 between March 29 and April 22. Of these, 37% were positive. Of the women who tested positive, 72% were asymptomatic at the time of testing. Patients who tested positive for SARS-CoV-2 were more likely to be of Hispanic ethnicity (unadjusted difference 24.4 percentage points, CI 7.9, 41.0) and report their primary language as Spanish (unadjusted difference 32.9 percentage points, CI 15.8, 49.9) than patients who tested negative. Conclusions In this retrospective cross-sectional study of data from a universal SARS-Cov-2 screening program implemented in the L&D unit of a safety-net hospital in Queens, New York, we found over one-third of pregnant women testing positive, the majority of those asymptomatic. The rationale for universal screening at the L&D Unit at Elmhurst Hospital was to ensure safety of patients and staff during an acute surge in SARS-Cov-2 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their SARS-CoV-2 status given increasing space limitations. In addition, postpartum counseling was tailored to infection status. We quickly established discharge counseling and follow-up protocols tailored to their specific social needs. The experience at Elmhurst Hospital is instructive for other L&D units serving vulnerable populations and for pandemic preparedness.

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Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: Results from a cross-sectional survey

10.1101/2021.09.14.21263588 ◽

2021 ◽

Author(s):

Nicole M. Gatto ◽

Jerusha E Lee ◽

Donatella Massai ◽

Susanna Zamarripa ◽

Bijan Sasaninia ◽

...

Keyword(s):

Health System ◽

Healthcare Workers ◽

Model Building ◽

Safety Net ◽

Childhood Vaccination ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Job Classification

Information on vaccine acceptance among healthcare workers is needed as health professionals provide front line care to COVID-19 patients. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbachs alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. Appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates in healthcare workers.

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Long-term benefit of hepatitis C therapy in a safety net hospital system: a cross-sectional study with median 5-year follow-up

BMJ Open ◽

10.1136/bmjopen-2013-003231 ◽

2013 ◽

Vol 3 (9) ◽

pp. e003231 ◽

Cited By ~ 7

Author(s):

Amit G Singal ◽

Tushar D Dharia ◽

Peter F Malet ◽

Saleh Alqahtani ◽

Song Zhang ◽

...

Keyword(s):

Safety Net ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Hospital System ◽

System A ◽

Safety Net Hospital ◽

Term Benefit

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Animal Source Food Consumption in Young Children from Four Regions of Ethiopia: Association with Religion, Livelihood, and Participation in the Productive Safety Net Program

Nutrients ◽

10.3390/nu11020354 ◽

2019 ◽

Vol 11 (2) ◽

pp. 354 ◽

Cited By ~ 1

Author(s):

Kaitlin S. Potts ◽

Afework Mulugeta ◽

Alessandra N. Bazzano

Keyword(s):

Young Children ◽

Dietary Diversity ◽

Safety Net ◽

Local Context ◽

Cross Sectional Survey ◽

Critical Determinant ◽

Cross Sectional ◽

Community Factors ◽

Animal Source Foods ◽

Animal Source

Introduction: Child undernutrition remains a challenge globally and in the geographically diverse country of Ethiopia. Improving dietary diversity and consumption of animal source foods are important for improving child nutrition and corresponding health outcomes. Objective: The objective of the study was to identify household and community factors associated with consumption of animal source foods among 6 to 36-month-old children from four regions of Ethiopia. Methods: A cross-sectional survey using multistage probability sampling in eight geographic zones and four regions of Ethiopia took place in 2015 with parents/caretakers of 6 to 36-month-old children. Data was collected on demographic information, proxy indicators of socioeconomic status, and food consumed by the child the day before the survey. Results: Increased child age, pastoral livelihood, Muslim religion, and participation in the Productive Safety Net Program were associated with increased consumption of animal source foods. Odds of animal source foods consumption increased by 8% with each 3-month age increase. Children from pastoralist households were the most likely to have consumed animal source foods in the preceding 24 hours as compared with those in agro-pastoralist households (0.21 times as likely) or those in agriculturalist/farming households (0.15 times as likely). The odds of consumption of animal source foods for families with food aid or safety net support was 1.7 times greater among those receiving traditional support from the Productive Safety Net Program and 4.5 times greater for those in the direct support arm of the program. Conclusions: The findings illustrate the importance of accounting for local context and community characteristics, such as livelihood and religion, when undertaking programming designed to improve diversity of children’s diets through increasing animal source foods. In addition, the Productive Safety Net Program may be a critical determinant of dietary diversity for young children in these regions.

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A pilot study to implement and sustain the US PHS clinical practice guidelines for treating tobacco use and dependence in free clinics, a safety net care setting for the uninsured

The Journal of Smoking Cessation ◽

10.1017/jsc.2019.21 ◽

2019 ◽

Vol 15 (1) ◽

pp. 14-22

Author(s):

Kristie L. Foley ◽

Eunyoung Y Song ◽

Jessica Pockey ◽

Cindy Jones ◽

John G. Spangler ◽

...

Keyword(s):

Tobacco Use ◽

Care Setting ◽

Safety Net ◽

Free Clinics ◽

Community Partner ◽

Cross Sectional Survey ◽

Uninsured Patients ◽

Cross Sectional ◽

Community Partners ◽

The Us

AbstractIntroductionUninsured patients are more likely than the general population to use tobacco and less likely to quit.AimsTo determine if the mode of delivering the PHS Guidelines influenced the effectiveness of smoking cessation among patients in a safety net setting.MethodsSix free clinics were randomly assigned to a training program delivered by an academic physician or community partner plus video support. A repeated cross-sectional survey of patients was conducted at three waves to assess effectiveness to promote quitting.ResultsTobacco use was triple the rate of the US population: 57.7% (Wave 1), 44.7% (Wave 2), and 48.9% (Wave 3). Patients were more likely to report receipt of at least one evidence-based strategy to promote quitting at Wave 2 (AOR = 2.33, 95% CI (1.18–4.58)). Patients treated in clinics trained by the community partner were significantly more likely to report receiving cessation assistance at Wave 2 (AOR 2.54, 95%CI 1.29–5.00) and the trend was similar, but not significant at Wave 3. Patients in the community partner-led arm were significantly less likely to report tobacco use at Wave 3 (AOR 0.59, 95% CI 0.35–0.99).ConclusionsImplementation of the PHS Guidelines in free clinics demonstrates preliminary efficacy, with delivery by community partners offering greater scalability.

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Livelihoods Strategies and Household Resilience to Food Insecurity: A Case Study from Rural Tunisia

Sustainability ◽

10.3390/su11030907 ◽

2019 ◽

Vol 11 (3) ◽

pp. 907 ◽

Cited By ~ 1

Author(s):

Mohamed Dhraief ◽

Boubaker Dhehibi ◽

Hamed Daly Hassen ◽

Meriem Zlaoui ◽

Chaima Khatoui ◽

...

Keyword(s):

Climate Change ◽

Food Insecurity ◽

Safety Net ◽

Food Prices ◽

Negative Effects ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Resilience Index ◽

Household Incomes ◽

Different Levels

Due to the decrease of household incomes, the increase of food prices, and the negative effects of climate change on agricultural production, Tunisia faces a food insecurity challenge, especially in rural and arid areas. The purpose of our research is to understand and explore household resilience to food insecurity in two villages, Selta and Zoghmar, in central Tunisia. A cross-sectional survey of 250 sample households was conducted in the villages. Factor analysis and regression models were employed to analyze the data using SPSS version 21. The results indicate that only around 36% of the households were resilient at different levels. In Selta, 62.8% and in Zoghmar 66.7% of the households were vulnerable. As indicated by the factor loadings and beta coefficients, income and food access, adaptive capacity, and the social safety net were important dimensions of household resilience to food insecurity, being positively correlated with the resilience index. However, asset possession, and climate change negatively affect household resilience. Therefore, interventions must target strategies that address the different levels of resilience reflected by the resilience estimators. These estimators were generated by focusing mainly on building farmers’ knowledge of how to face the different difficulties and challenges.

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