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.

scholarly journals Addressing opioid use disorder among rural pregnant and postpartum women: a study protocol

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
M. Aryana Bryan ◽  
Marcela C. Smid ◽  
Melissa Cheng ◽  
Katherine T. Fortenberry ◽  
Amy Kenney ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Study Protocol ◽  
Repeated Measures ◽  
Perinatal Care ◽  
The United States ◽  
Opioid Use Disorder ◽  
Rural Setting ◽  
Evidence Based ◽  
Provider Education ◽  
Opioid Use

Abstract Background Opioid use disorder (OUD) among women delivering at a hospital has increased 400% from 1999–2014 in the United States. From the years 2007 to 2016, opioid-related mortality during pregnancy increased over 200%, and drug-overdose deaths made up nearly 10% of all pregnancy-associated mortality in 2016 in the US. Disproportionately higher rates of neonatal opioid withdrawal syndrome (NOWS) have been reported in rural areas of the country, suggesting that perinatal OUD is a pressing issue among these communities. There is an urgent need for comprehensive, evidence-based treatment services for pregnant women experiencing OUD. The purpose of this article is to describe a study protocol aimed at developing and evaluating a perinatal OUD curriculum, enhancing evidence-based perinatal OUD treatment in a rural setting, and evaluating the implementation of such collaborative care for perinatal OUD. Methods This two-year study employed a one group, repeated measures, hybrid type-1 effectiveness-implementation design. This study delivered interventions at 2 levels, both targeting improvement of care for pregnant women with OUD. The first area of focus was at the community healthcare provider-level, which aimed to evaluate the acceptability and feasibility of perinatal OUD education across time and to improve provider education by increasing knowledge specific to: MOUD provision; screening, brief intervention, and referral to treatment (SBIRT) utilization; and NOWS treatment. The second area of intervention focus was at the patient-level, which assessed the preliminary effect of perinatal OUD provider education in promoting illicit opioid abstinence and treatment engagement among pregnant women with OUD. We adopted constructs from the Consolidated Framework for Implementation Research (CFIR) to assess contextual factors that may influence implementation, and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model to comprehensively evaluate implementation outcomes. Discussion This article presents the protocol of an implementation study that is employing the CFIR and RE-AIM frameworks to implement and evaluate a perinatal OUD education and service coordination program in two rural counties. This protocol could serve as a model for clinicians and researchers seeking to implement improvements in perinatal care for women with OUD in other rural communities. Trial registration NCT04448015 clinicaltrials.gov.

Uncovering inefficiencies in the workers’ compensation industry using Lean methodology

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Omar Taha ◽  
Thomas A. Mazzuchi ◽  
Shahram Sarkani ◽  
Jiju Antony ◽  
Sandra Furterer
Keyword(s):  
Physical Therapy ◽  
Case Studies ◽  
Healthcare Provider ◽  
Healthcare Providers ◽  
Value Added ◽  
The United States ◽  
Injured Workers ◽  
Insurance Companies ◽  
Workers Compensation ◽  
Content Type

PurposeThe purpose of this paper is to apply Lean in the workers’ compensation industry. It focuses on identifying patterns of repetitive non-value-added transnational activities for physical-therapy patients and healthcare providers. It addresses the research gap in this field.Design/methodology/approachIn this study, we designed and deployed multiple case studies to better understand the journey of an injured worker within the worker compensation system in the United States of America. We partnered with Concentra Inc., a leading national healthcare provider in the field of workers’ compensation having 520 medical centers in 44 states. Both case studies included conducting direct observations, Gemba walk, in five clinics in two states: Florida and Pennsylvania. We analyzed the data of 263 injured workers with 8 or more physical therapy visits who got admitted to Concentra clinics in both states over the period of 31 days.FindingsThe results revealed that the time intervals at which activities associated with physical therapy treatment pre-authorization accounted for 91.59% of the total non-value-added activities and are thus the key administrative factor leading to process inefficiency in the state of Florida. The Process Cycle Efficiency of Pennsylvania was 75.36% compared to 53.16% of Florida. The injured workers in Florida needed 39.58 days on average to complete eight physical therapy visits compared to 27.92 days in Pennsylvania (a median of 34.09 vs 22.15 days).Research limitations/implicationsThis study is limited as it only focuses on processes on the healthcare provider side. An expanded value stream map that includes the treatment pre-authorization process on the insurance side would be beneficial for generating more potential solutions to streamline the process.Practical implicationsThis study shows that Lean could play a critical role in identifying and quantifying continuous improvement opportunities that could accelerate patient’s treatment, reduce administrative burden on healthcare providers and improve the overall claim cost of insurance companies. It provides data-driven argument for insurance companies to consider eliminating physical therapy pre-authorization.Originality/valueThis is the first study to apply Lean methodology in the workers’ compensation field.

scholarly journals Family-healthcare Provider Communication and Reported Health among Children and Adolescents in the United States

2017 ◽  
Vol 15 (1) ◽  
pp. 46-55
Author(s):  
Gergana D. Kodjebacheva ◽  
Leobardo F. Estrada ◽  
Shan Parker
Keyword(s):  
Healthcare Provider ◽  
Healthcare Providers ◽  
The United States ◽  
Children's Health ◽  
Children’S Health ◽  
Activity Limitations ◽  
Provider Communication ◽  
Health Coverage ◽  
Reported Health ◽  
Healthcare Communication

Background and Purpose: Most research regarding healthcare communication focuses on adults. The study investigated how family-healthcare provider communication influences reported health and activity limitations among U.S. children ages 0 to 17. Methods: In the 2011-2012 National Survey of Children’s Health, parents reported information on 87,133 children aged 0 to 17 years. The influences of different aspects of perceived healthcare communication on reported health and activity limitations were assessed using weighted logistic regression. Results: Children who were Hispanic or non-Hispanic Black, spoke a language other than English, had unemployed parents, and received public health coverage tended to have healthcare providers who did not communicate effectively. Hispanics reported worse communication experiences than non-Hispanic Blacks. Children whose provider never/sometimes spent enough time with them were more likely to have poor/fair health and to have activity limitations compared to those whose provider usually/always spent enough time. Having a healthcare provider who reportedly never/sometimes listened carefully to the caregiver was associated with poor/fair health and activity limitations (among children. Conclusion: Ineffective communication between healthcare providers and families was associated with poor reported health. Ineffective communication was more commonly reported by non-Hispanic Black and Hispanic families compared to non-Hispanic White families. Interventions to improve communication may promote children’s health.

scholarly journals Discovering healthcare provider behavior patterns through the lens of Medicare excess charge

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sagnika Sen ◽  
Amit V. Deokar
Keyword(s):  
Healthcare Provider ◽  
Private Insurance ◽  
Healthcare Providers ◽  
The United States ◽  
Behavior Patterns ◽  
Public Healthcare ◽  
Medical Procedure ◽  
Excess Charge ◽  
Cost Shifting ◽  
Specific Patient

Abstract Background The phenomenon of excess charge, where a healthcare service provider bills Medicare beyond the limit allowed for a medical procedure, is quite common in the United States public healthcare system. For example, in 2014, healthcare providers charged an average of 3.27 times (and up to 528 times) the allowable limit for cataract surgery. Previous research contends that such excess charges may be indicative of the actual amount that providers bill to non-Medicare patients and subsequent cost-shifting behavior, where a healthcare provider tries to recoup underpayment by Medicare from privately insured, self-pay, out-of-network, and uninsured patients. Objectives The objective of this study is to examine the drivers of a provider’s excess charge patterns, especially the extent to which the degree of excess charges may be associated with physician characteristics, Medicare reimbursement policy, or socioeconomic status and demographics of a provider’s patient base. Methods Using data from the 2014 Medicare Provider Utilization files, we identify three procedures with the highest variation in Medicare reimbursements to study the excess charge phenomenon. We then employ a two-step cluster analysis within each procedure to identify distinct provider groups. Results Each procedure code yielded distinct healthcare provider segments with specific patient demographics and related behavior patterns. Cluster silhouette coefficients indicate that these segments are unique. Three random subsamples from each procedure establish the stability of the clusters. Conclusions For each of the three procedures investigated in this study, a sizeable number of healthcare providers serving poorer, riskier patients are often paid significantly lower than their peers, and subsequently have the highest excess charges. For some providers, excess charges reveal possible cost-shifting to private insurance. Patterns of excess charges also indicate an imbalance of market power, especially in areas with lower provider competition and access to health care, thus leading to urban-rural healthcare disparities. Our results reinforce the call for price transparency and an upper limit to overbilling.

scholarly journals Latino Fathers Report Low Awareness and Knowledge of the Human Papillomavirus Vaccine, but High Willingness to Vaccinate Their Children if Recommended by Primary Healthcare Provider: a Qualitative Study

2020 ◽  
Author(s):  
Ana Cristina Lindsay ◽  
Denisse Delgado ◽  
Madelyne J. Valdez ◽  
Phillip Granberry
Keyword(s):  
United States ◽  
Qualitative Study ◽  
Healthcare Provider ◽  
Primary Healthcare ◽  
Hpv Vaccine ◽  
Critical Role ◽  
Healthcare Providers ◽  
The United States ◽  
Future Research ◽  
Primary Healthcare Provider

Objective: Despite increasing interest in understanding factors influencing awareness, knowledge, and acceptability of the human papilloma virus (HPV) vaccine among Latino parents to date, limited information is available specific to Latino fathers living in the United States. Methods: This descriptive qualitative study explored Latino fathers’ awareness, knowledge, and acceptability of the HPV vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analyzed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Results: Nineteen, majority foreign-born Latino fathers (63.2%; n = 12) fathers of male and female adolescents participated in the study. Four main themes and two subthemes emerged from the analyses. Results found fathers’ low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers’ positive attitude toward vaccines in general. Moreover, results revealed fathers’ trust in healthcare providers. This trust translated into an increased willingness to vaccinate their children against HPV if recommended by their child’s primary healthcare provider. Conclusion: Findings indicate the need for increased efforts to raise awareness and knowledge among Latino fathers of HPV and the HPV vaccine. In addition, findings underscore the critical role of healthcare providers’ recommendation of the HPV vaccine. Given the limited research focused on Latino fathers, this study’s findings are valuable in building a knowledge foundation needed for developing future studies and interventions to promote the HPV vaccine by targeting Latino fathers living in the United States. Future research should quantify Latino fathers' awareness, knowledge, and acceptability of the HPV vaccine for their children, and preferences for educational interventions to promote HPV vaccination.

The Speech-Language Assessment of English Language Learning Students: A Non-Standardized Approach

2013 ◽  
Vol 14 (4) ◽  
pp. 95-101 ◽  
Author(s):  
Robert Kraemer ◽  
Allison Coltisor ◽  
Meesha Kalra ◽  
Megan Martinez ◽  
Bailey Savage ◽  
...  
Keyword(s):  
Language Learning ◽  
Language Impairment ◽  
Specific Language Impairment ◽  
English Language ◽  
Language Assessment ◽  
The United States ◽  
English Language Learning ◽  
Assessment Practices ◽  
Evidence Based ◽  
English Speaking

English language learning (ELL) children suspected of having specific-language impairment (SLI) should be assessed using the same methods as monolingual English-speaking children born and raised in the United States. In an effort to reduce over- and under-identification of ELL children as SLI, speech-language pathologists (SLP) must employ nonbiased assessment practices. This article presents several evidence-based, nonstandarized assessment practices SLPs can implement in place of standardized tools. As the number of ELL children SLPs come in contact with increases, the need for well-trained and knowledgeable SLPs grows. The goal of the authors is to present several well-establish, evidence-based assessment methods for assessing ELL children suspected of SLI.

440: Barriers to the Practice of Evidence Based Urology in the United States

2007 ◽  
Vol 177 (4S) ◽  
pp. 147-148
Author(s):  
Philipp Dahm ◽  
Hubert R. Kuebler ◽  
Susan F. Fesperman ◽  
Roger L. Sur ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Evidence Based

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

Capturing the surge of public interest towards Hydroxychloroquine, Azithromycin and BCG vaccine during COVID-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Shabbir Syed-Abdul ◽  
Shwetambara Malwade ◽  
Sim-Mei Choo
Keyword(s):  
Social Media ◽  
Preventive Measures ◽  
Healthcare Providers ◽  
Specific Treatment ◽  
Drug Effects ◽  
The United States ◽  
Bcg Vaccine ◽  
Public Interests ◽  
Treatment Regimes ◽  
Appropriate Treatment

UNSTRUCTURED The outbreak of COVID-19 that started in December 2019, was declared a pandemic in March 2020. Currently, there is no specific treatment recommended and healthcare providers are struggling to find appropriate treatment regimes. Medication misinformation spread through social media has caused panic situations and self-prescription leading to harmful drug effects. The situation worsened following false propaganda via social media, leading to shortage of some medications. Our study shows the frequency of search for the medications Hydroxychloroquine (HCQ), Azithromycin and Bacillus Calmette-Guérin (BCG) vaccine in Google Trends, across 6 countries. Public interests from the United States, Italy and Spain leaned towards HCQ, whereas those from Taiwan, Japan and South Korea were keen towards learning about the BCG vaccine. Our article aimed to inform the general public of the adverse drug reactions to avoid self-prescription or yield to the assumptions of leaders and unanimous social media posts. Proactive participation and preventive measures such as social distancing, use of face masks and hand sanitizers are recommended to help curb COVID-19 and other infections.

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